I have a confession to make: I take antidepressant and anti-anxiety medication every day.
Oh, wait. You already knew that. Huh.
Well, what if I told you that there was a time when I thought only weak people took antidepressants. People who didn’t try hard enough…who were cray-zee. Not people like me. Educated. Sober. Financially stable. Successful. I cringe as I type this, wanting to slap the old me in the face for her ignorance and prejudice, but at the same time knowing that I simply didn’t have the framework or experience to be able to understand.
These days, I know that medication is a tool for treating mental illness. It is not a sign of weakness, but a medical treatment for a medical condition. Not to be taken without cautious consideration and the advice of doctors (note the plural there), but for many of us, essential. I am not a different person on the medication; I am a better version of myself. But it wasn’t always that way.
I was diagnosed with postpartum depression in winter 2008, after suffering in silence for months after my first child was born. I saw both a LICSW and a Psychiatric Nurse Practitioner at the time and at my first psychiatric appointment, was reassured by the nurse’s calm and confident demeanor. ”I just love getting moms like you,” she said, “because I know that we can help you. You will be better. You will feel like yourself again.”
Nurse J went over my health history. She talked over many options. She answered my dozens of questions about how the medications worked, and (most importantly to me at the time) how long I would have to be on them. I thought it was like antibiotics. You take it for x days and then you’re better. Needing it for longer meant I was “one of those people.”
Despite my hesitation, I began a small dose of Citalopram and I waited out the horrid side effects: zombie brain, nausea, headache. Each day I was convinced the meds were doing more harm than good. Until one day, a few weeks later, I cried a little less. The day after that, I found it easier to get dressed. And for a few months, I felt okay.
Then I decided that since I was okay, that I must not need the medication anymore. Besides, though the headaches and lethargy had waned, the lack of libido and *ahem* performance were less than desirable. So with my doctor’s support, I began weaning off the medication. If I’m telling the whole truth, I think I knew it was too early to wean, but I was determined not to need the pills anymore. Determined to “do it by myself.”
I cannot describe the depth of the nothingness that returned but I can tell you it had me running back to my therapist and NP. We decided to add Wellbutrin to the Citalopram. Wellbutrin has a reputation for helping with sexual disfunction, so I reluctantly agreed to try it, though inside, I was terrified. Now I was on TWO pills? One medication was bad enough, but how could I be crazy enough to need two?
When I just happened to get a case of the hives three days into the Wellbutrin (which I think was actually caused by a new detergent), I was actually elated to be able to call my doctors and tell them, “I have to stop the Wellbutrin. I have hives.” And so, I went back on the Citalopram – the lowest dose possible, in an attempt to curtail any sexual disfunction.
The lowest dose? Wasn’t enough. But you couldn’t convince me of that. ”It’s not working,” I declared to the new NP that had taken over when my old one moved on to another practice. She suggested increasing the dose but my mind was made up. This was not the med for me. So she switched me to a mood stabilizer, Lamictal. And when the crushing headaches lasted for 4 weeks, that was changed to Trileptal, a second cousin-once-removed of Lamictal (or something like that).
The Trileptal made me almost narcoleptic for the first three weeks. But when it started to work and the side effects eased, I felt like myself again. Less prone to angry outbursts, and less like an emotional rollercoaster all month long, I found something akin to normal. But you can’t take Trileptal while pregnant (or at least the doctors I spoke with advised taking something better-studied).
I quit cold-turkey when I found out I was 4 weeks pregnant with my second child. A surprise pregnancy. After a trip to Vegas. And three weeks later I was having intrusive thoughts about throwing myself down the stairs.
I found my old NP and went to see her as soon as possible. She advised against the lesser-studied Trileptal and suggested I go back to the Citalopram. ”No, I don’t want to be an ice queen,” I stated. So she suggested I try a more “pure” form of Citalopram: Lexapro. After one dose, I had a violent panic attack. I was literally unable to leave my bed and was crushed by irrational, indescribable fear. And so back to the Citalopram I went. I filled the prescription and then sat on my living room floor and sobbed.
I was terrified. What would this medication do to my baby? How could I even need it again? Would it ruin my marriage? What if I never, ever stopped taking it?
Through Postpartum Progress, I was able to find a psychiatrist who specializes in perinatal mental health. She walked me through the statistics, the studies, and the likely outcomes of my many options. And after hearing her recommendation, I took the Citalopram throughout my pregnancy. I continue to take it while nursing, along with an anti-anxiety medication called BusPar. Because of the normal weight-gain of pregnancy (and increased blood volume), I increased dosage several times while pregnant and am currently at a higher dose than I ever thought I’d be okay with taking. I have been on it for almost 2 years now.
It’s working. It allows me to function and feel like myself. And I’m okay with needing it.
I tell you this very long story because before taking psychiatric medication, I had no idea how hard it is to find the right one. I didn’t understand the nuances of weighing the benefits vs the side effects and calculating the most beneficial dosage. I didn’t know it would be so frustrating or that I would fight what I’ve discovered to be an essential treatment for so long.
I was afraid and blanketed by stigma.
So please. If you or someone you know is in the process of finding the right medication for a mood or anxiety disorder, please don’t lose hope. Don’t settle for less than you deserve. Advocate for yourself and ask your doctors hundreds of questions. Tell them the truth. But most of all, don’t be afraid.
Medication isn’t right for everyone. Only you and your doctor can decide that for sure. But it has helped people, and for some of us (like me), it’s worth the long, hard, drawn-out process.
p.s. Y’all know I’m not a doctor, right? This is just my personal experience. Consult your doctor about all medical decisions and do your own research.