I'll never forget the day a good friend of mine found out I was taking antidepressants. "What is a happy, bubbly person like you doing taking antidepressants?" he asked, sounding astounded. "You're one of the most un-depressed people I know."
He was right. I am a very "un-depressed" person. And it was around this time when I started wondering if I even needed my antidepressant at all. Perhaps it was time to take the big step and try to wean myself off of them?
Antidepressant use in the United States is widespread. According to the Centers for Disease Control, over a 20 year period, from 1998-1994 through 2005-2008, antidepressant use increased nearly 400 percent among all ages. Antidepressants are the third most common prescription drug taken by Americans of all ages in 2005-2008 and the most frequently used by persons aged 18-44 years.
Many people take antidepressants to treat depression, anxiety or both. Put me in the "both" category. I never took an antidepressant in my life until I headed to Morgantown in 2008 and began preparing for my stem cell transplant. Probably to nobody's surprise, I began feeling edgy, emotional and anxious. My doctor prescribed me a very low dose - at a level that isn't technically considered therapeutic - of an antidepressant. That was a perfect amount for me, however, and it took the edge off.
I maintained this dosage for almost two years - it even worked through two relapses, radiation and six more cycles of chemo. After I reached remission in the summer of 2009, I started thinking that perhaps the worst was behind me.
I didn't notice it at first, but towards the last few months of 2009, my emotions started backsliding. I felt confused about life and my purpose in it. By the time I realized that I wasn't doing so great, I was in a pretty dark hole. I cried constantly, and half of the time I didn't even know what it was about. I didn't want to spend time with my family or my friends, and I made excuses to get out of social activities. I felt like it would be difficult for me to pretend I felt OK, so I just chose not to go. I had no appetite - I even lost weight because I barely ate. I woke up in the morning, went to work, came home, picked at my dinner, showered and went to bed. All I wanted to do when I got home was go to sleep because I just wanted the day to be over.
My mom urged me to call my doctor, so I made an appointment. I asked my doctor why, six months after treatment was over, I was depressed now. She told me that this was actually a very normal reaction to a very stressful life event. During my treatment, my body put up a defense that forced me to focus only on recovery. Once my body realized that treatment was over and I was well, the walls came down. And, unfortunately, all those feelings of helplessness and confusion that the walls were holding back came flooding out. I had nothing else to focus on except "Where do I go from here?" I didn't know the answer, and it created major anxiety, which also morphed into depression.
Increasing my current medication made absolutely no difference, so after some discussion, she switched me to a different antidepressant - Effexor XR. The Effexor, combined with counseling, was a God-send. Not only did the Effexor take the edge off, but the counseling also helped me sort through all the jumbled thoughts in my head. Over time, I began feeling better - much more like my happy, bubbly self. It was also during this time when I met my husband, Justin. Things were finally looking up.
So for two years, I popped my "happy pills" and just went about my business. They worked well for me because they allowed me to focus and function without making me feel like a zombie. I could easily emote - happy, sad, angry - I could do all those things. I never really gave much thought to trying to come off of it.
This spring, however, I decided perhaps now was the time to try to do without it. While I am by no means a medical expert, I amassed enough knowledge during my time as a cancer patient to know that I couldn't just stop taking Effexor cold turkey. So after consulting with my doctors, we came up with a game plan that enabled me to step down in dosage and then gradually wean off of it. Sounded simple enough. With everything I'd already been through, this should have been a piece of cake.
Three days in, I felt like I'd been kicked in the face repeatedly. Effexor, in particular, is a difficult antidepressant to come off of, as I learned from endless amounts of Internet research. There is even a name for all the side effects - SSRI discontinuation syndrome. My head constantly ached - nothing helped the pain go away completely. I drank ginger tea all the time because I was so nauseous. My ability to focus vanished, and perhaps the most bizarre symptom - a feeling of "electric shocks" going through my head, like a "brain zap." I'd feel like my head was turning before I even started moving it. I felt worse going off Effexor than I felt at any time going through cancer treatment.
Taking a hearty dose of fish oil actually helped quell the symptoms, but as I continued to wean, I noticed the brain zaps just wouldn't go away. I felt like my head was stuck in a fog all the time. I was irritable and even hostile. I couldn't sleep well because my dreams were unpleasant.
By the time I was completely off of the drug, I noticed something even worse than all of the symptoms I had before that. After being completely off the drug for about four days, I noticed those old, awful feelings of depression creeping back in. In a way, they were even worse than before I'd started Effexor or saw a counselor. That scared me.
Most of what I'd read online and for most of the people I'd talked to, it could take anywhere from about a month to maybe six months to feel totally normal again. I was 10 days in to not having any Effexor at all and these numbers were disheartening. I seriously couldn't do it any longer. I wasn't afraid of hurting myself, but I was afraid I was going to hurt someone else, whether it be with my road rage or with my tongue, which I seemed to always be snapping at people. I hated the way I felt. I knew I was out of control of my emotions but there was nothing I could do to reign myself in.
Finally, I consulted my doctor again and decided to go back on the antidepressant. Within 24 hours, I felt 150 percent better. Within three days, I felt even better. About a week later, I finally felt like myself again. The fog was lifted. I dropped the attitude and anger. I could sleep. That month of weaning and stopping Effexor was quite possibly the worst month of my life.
I'm fine with taking medicine - it's something I'm used to at this point - especially if it's going to help me. I began taking Effexor because clinically, I was depressed and anxious. The medicine helped make me feel like me again. I can do everything I want, and my "happy pill" does just that - makes me happy and takes the edge off of all those little things that nearly drove me out of my mind while I was off of it. Some people just need to take antidepressants to help regulate their brain chemistry and allow them to function. On the other hand, there are some people who may benefit more from being off of it.
It's a little frightening to think that not taking one little capsule every day can create a 180-degree shift in your behavior and mood.
I'm not ashamed to say I take an antidepressant. In fact, even though trying to go off of it made me feel horrible, I don't regret the experience. Now I know for certain that I do need it - I'm not just using it as a security blanket. I feel much better. It works for me. I think now I still might be one of the most "un-depressed" people you know - thanks, in part, to my encapsulated friend.
Hershberger can be reached at firstname.lastname@example.org