There I sat, fidgeting in my all-too-familiar chair, hoping my clenching fists and white knuckles were going unnoticed. And there my therapist sat, leaning forward much more comfortably in his own chair, giving me an all-too-familiar speech.

“You really should consider taking an SSRI. So many of my patients have had wonderful results on them. It’s just a temporary crutch to help get you through the hard times and really get the most out of your therapy. It’s not forever, it’s just a few months.”

I could not help but wonder as I sat there, how many other patients had been given a similar speech that week? How many other people were hearing it in offices across the country that very hour? And how many people were getting just as angry and defiant as I was? At least a few, I hoped. Because it certainly was the last thing I wanted to hear and I was not about to give in without many questions and, if necessary, a respectful fight.

I had previously discussed my past experiences with these medications with my doctor at length, many times over. Paxil, Zoloft, Lexapro, Celexa…to me, all synonyms for “zombie”. At age 18, my then-doctor ran the gamut of pretty little happy pills with me and all with the same end result. I would feel exhausted, jittery, experience nightmares, gain weight, pace the house, and enjoy numerous other fun side effects. The most unsettling side effect was what I refer to as the “fuzzy-headed numbness”. For someone trying to overcome anxiety, feeling like you are having an ongoing out-of-body experience that you cannot escape does not exactly have a calming effect. In fact, for an over-thinker such as myself, it does quite the opposite. I began looking up my symptoms online, researching the medications I had begrudgingly agreed to consume, and finding information I was not expecting and certainly did not care for.

“Suicidality and Antidepressant Drugs”. A glaring headline atop every page of the antidepressant Selective Serotonin Reuptake Inhibitors’ (SSRI) websites, this (at first) surprised me. Why would a depressed individual be prescribed a medication proven to occasionally cause suicidal thoughts and, less frequently but more disturbingly, suicide attempts? Aren’t we going through enough with our mental distress? Do we really need a medication to speed up the downward spiral?

This was a lesser-known phenomenon when I was prescribed my first SSRI. Fast forward to eight years later, and it has become impossible to take even a quick glance at the side effects of these medications without seeing the warning: “Studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts.” I suppose that the term “small number” is supposed to be comforting, but sitting here as a twenty-six-year-old who is being asked to consider one of these medications, I am anything but comforted. Sure, I’m one year past the “at risk” mark but somehow this does not put my mind at ease. Does a few extra months on the planet really help my brain understand NOT to send the horrible thoughts? That would certainly be nice, but the human body does not work that way. The potential side effects of an antidepressant should, by its very nature, not be a variety of things that would only increase one’s depression.

Upon doing a little research, it was far too easy to find several disturbing statistics for these drugs. The first thing I discover is that Americans are ingesting 66% of the world’s supply of SSRI medications, followed by ALL of Europe at 23%, and the rest of the world at 11%. (Source) This is more than I expected, but when you consider who has the drugs readily available and the doctors willing to prescribe them, it becomes a no-brainer. It seems we are a group of sad, pill-popping citizens. I discovered a survey claiming that 9.5% of Americans meet the diagnostic criteria for some sort of mood disorder. (Source) So nearly 10% of us are screwed up enough to be medically diagnosed as such? No wonder doctors throw prescriptions for these drugs around like they are candy. But wait, it gets better.

Anyone reading this can likely deduce the reason for the over-zealous prescribing of SSRIs – the almighty dollar. A study shows that “in 1985, sales of antidepressants in the US totaled roughly $240 million, but from September 1, 2003 to August 30, 2004, sales rose to $11.2 billion, according to IMS, a health care tracking firm”. (Source)

This is a money-making industry, that is for certain. The pharmaceutical companies have made a killing off of people like me, and they don’t seem to mind that their product can sometimes lead to actual death at the patient’s own hand. If I had a hand in making a drug that led to such severe side effects, I might find it a bit hard to get a good night’s rest. Wait…that’s a side effect! I kid, but this is very serious business. It seems to me that either the drugs need to be altered to cause fewer depressive effects or patients should have to undergo at least one psycho-analysis before being prescribed one. Out of the four SSRIs that I have taken, only one was prescribed by a psychiatrist, after a thorough evaluation. The others were given to me by a family physician who did little else but ask how my moods were and scribble a few notes. And the side effects I experienced were not only unpleasant but at times could have been classified as severe. Weaning off of Paxil, without very close supervision, can be akin to metaphorically flushing your brain down the toilet and feeling every swirl. Now, I know that the majority of people taking these drugs will not have such severe side effects, let alone attempt suicide. I am very aware that many people do benefit from them and take them without any problems. But the question becomes, am I willing to play Russian roulette with my brain in the hopes of obtaining a little more happiness?

I do not know the answer to that question today. As I sat in my therapist’s office, listening to his diatribe about asking for help and trusting his judgment, the effects of this decision flooded into my head. Could I really deal with the weight gain, decreased libido, insomnia, night terrors and plethora of other symptoms of these drugs? That remains unseen. I understand that I am a stubborn person, to an admitted fault, and I realize that that is the main cause of my indecision. But there is deeper concern lying just under the surface. I have been enjoying what my doctor and I call “moderate success” at overcoming my anxiety disorder. I have made numerous baby steps, some grand strides, even a few leaps…and of course, my fair share of tumbles backward. But I have been doing it with MY brain. I do take a medication for my panic attacks, but it is a quick fix, not a long-term solution. When I finally do stomp this problem into the ground, I want to know that I did it of my own accord, albeit with the help of my (usually) wonderful and understanding doctor. I would hate to look back and think that I only succeeded due to a chemical change in my mind, a false sense of happiness found only in swallowing a little yellow pill. I need to know that I can do it, and I do not think that is too much to ask. My doctor may disagree – in fact, I know he does. He would prefer that I simply trust him and fall backward into his arms…and into the arms of a drug that does not just bother me, but outright scares me. And what if I do find relief, only to wean off the drug and go right back to my old ways? That would be a greater disappointment than any I have endured thus far.

There are many questions to ask and many facts to consider. For one, I rather enjoy my dark, cynical side. I have spent many years perfecting it and have become quite accustomed to it over the past decade or so. It is a part of me and a large part of what helps my creative process. Being a non-thinking zombie does not often lead to success in journalism, or life for that matter. If I did not spend a great deal of time pondering the state of the world and the people who make it up, would I become yet another sheep? Unabashedly, I prefer my way. I think, I rant, I discuss, I grow. These are not things I will give up without an impressive fight. Kicking and screaming could be involved.

How much of myself would I be sacrificing in order to gain a bit more control over the anxiety that sometimes accompanies such cynicism? If I do take a pill and support this industry of making people happy at the expense of “a small number of people”, I don’t know how will that make me feel. The word guilt comes to mind, but in therapy, one must release one’s guilt and give in to treatment. Will I give in to this new treatment? Only time will tell. But one thing is for certain – I WILL overcome this disease, one way or another. I will come out on the other side with a grand sense of accomplishment and a smile on my face. I simply hope that the smile will be genuine – not chemically-induced.

These are my personal views and I am in no way condoning or condemning any course of psychiatric treatment. Anyone dealing with a mental disorder deserves options, facts and respect. I urge anyone in need of such care to do the necessary research and understand the risks and benefits of their treatment.

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