I love my pills, yes I do…I love my pills, so why can’t youuuuu?
Anyway. Serious writing time. Let me put on my Serious Writing Hat.
Upon occasion, I’ll share bits of my journey with people I know. I’ll tell them that I live with anxiety, and they’ll get stars in their eyes and tell me how incredible I am, and how they couldn’t possibly do what I’ve done, and how strong I must be to manage this…without medicating myself into a stupor.
I suppose I should start leading with, “So, I take fantastic pills every day that keep me from getting too crazy all up in here. How about you?”
Apparently the fact that I’m not a drooling, spaced-out wreck popping pills every five minutes means that I can’t possibly be one of those people. You know, those people who take dangerous chemicals that mess with their brains until they stop being people and start craving human flesh.
First of all, that’s offensive to Undead Americans everywhere. Also, that’s not how antidepressants work. We have a dangerously inaccurate popular understanding of this kind of medication and of the people who take them, and it has grown tiresome. I’ve got enough in life that causes me anxiety; I don’t feel like dealing with people who think I’m taking “the easy way out.”
According to this article in the Scientific American, more Americans are taking prescription antidepressants than ever before. The estimate is somewhere in the realm of 8-10% of adults. This rise was characterized by an editorial in the New York Times as – wait for it – “a glut of antidepressants.”
If you’re like me, you’re now imagining Jabba the Hutt sitting on his throne on Tattooine, surrounded by piles of pills. “Eee choota, Solo! Conda Wookiee chibiti ootaskoota Proooozac! HO HO HO HOOO!”
If one were to believe the opinions expressed by the popular media, antidepressants are dangerous, mind-numbing chemicals handed out like Halloween candy to criminals and psychopaths by shady, uncaring doctors in Big Pharma’s pocket. It’s the last line before the first-quarter commercial break in an episode of Law and Order: Special Victims Unit. The hardworking but oh-so-broken detectives find an unlikely suspect for a rash of human dismemberments, only to discover, to their horror, that the all-star college valedictorian has an open prescription for Prozac! He must have a lair filled with human toes.
That doesn’t even touch on the world of internet comment boards and opinion pieces. You shouldn’t touch on it, either. It’s a dangerous place, and you’ll need to take a shower and cuddle a puppy right afterwards. Because I care for each and every one of you, my lovely readers, I’ve already taken a long, sewage-y swim in its waters, and collected some of the choicest bits of poo just for you!
“Anti-depressants are pushed as a ‘magic pill’ by Big Pharma to make money off of you.”
“The side-effects are enough to make anyone depressed!”
“Doctors and Big Pharma are over-medicating the population. It’s a conspiracy to keep us in their pockets!”
“It’s just a placebo effect.”
“The real danger is in the side effects – it’s dangerous to just put chemicals in your brain! A natural life is the only way to live!”
According to the internet, antidepressants are either the biggest joke being played on us by Big Pharma, or they’re going to give you radioactive super-powers and sparkly farts.
Where does that leave us? It leaves us squarely in the middle of a culture in which one out of ten people take medicine meant to make them feel better, all the while being vilified for deciding to feel better.
If you’ll allow me to roll up my sleeves, I’m going to lay down some Truth.
1. Psychiatrists don’t just “hand out” drugs as a whole. Yes, there are bad apples in every profession, but most psychiatrists – and doctors – want their patients to feel better. Dr. Evil is the exception, as is Dr. Strangelove. Just use your judgment! If your doctor doesn’t seem to listen to you, find one who does. Feeling better is good, and trained psychiatrists will not simply stuff pills down your throat like you’re a reverse Pez-dispenser. When I first started seeing a psychiatrist for my anxiety at age 24, she required that I make lifestyle changes to alleviate my anxiety and continue seeing the counselor at the Student Center who had referred me to her in the first place. She also prescribed me medication. I needed every aspect of my treatment. I made huge dietary changes and began working out every single day. I haven’t kept up the every-day exercise to the rigor that I initially did, but I remain active. I continued talk therapy. But you know what? The medication made it possible for me to do all of those things.
Let me explain. As soon as I began taking Zoloft, I saw results. Not in my anxiety and intrusive thoughts – those took weeks of retraining to reduce – but in other, purely physical symptoms of anxiety. My insomnia lessened, so I could get sleep and have the energy to leave the apartment in the morning, to go to the gym, to walk across campus to go to counseling. My constant nausea – what I’d always thought of as my ‘fussy tummy’ was gone. I was hungry, for possibly the first time in my life. I gained weight. This may not seem like a positive – we live in a world where thinner is better – but I’d spent years as a 115-pound, 5 ft. 10 beanpole. I used to get sick constantly. I was frail, y’all.
The best part of getting the right medication was that it got rid of symptoms that I didn’t realize weren’t normal. People with anxiety often suffer from something called depersonalization: the feeling that your body doesn’t belong to you. You feel like your face is made out of rubber, and when you do move, it feels like you’re starting out of a dream. It’s irritating. And I thought everyone had to deal with it.
Yes, therapy is vital. Yes, reworking the mental pathways that allow anxious thoughts to spiral is important. Exercise and diet and forming positive relationships are all integral parts of living with mental illness. Medication can be life-changing as a part of that process.
2. Big Pharma is real, but it’s not a reason to deny yourself or anyone else the care they need. Yeah, the pharmaceutical industry is full of all kinds of nastiness. And yeah, its goal is to make money. These are reasons for reform, not rejection of all medications. The oil industry is one of the dirtiest in the world (in more ways than one). Are we rejecting automobiles? No. No we are not. Automobiles make our lives easier and better. What we are doing is breaking the monopoly through alternate-fuel and electric cars. We have to reform the pharmaceutical industry, but that’s not the point here. They may be the Evil Empire, but you’ve got to occasionally admit that they make really quality stuff.
Most doctors, as a matter of fact, will do whatever they can to keep their patients from being under the thumb of insurance companies and the pharmaceutical industry. This includes using samples to try different kinds of medications and making the referral process as easy as possible.
3. Side effects are nothing to sneeze at. They’re real, and they can be scary. However, every drug is different, and it takes time to find the right one for your brain.
When I first started taking SSRIs, my psychiatrist prescribed Prozac. It was the most commonly-prescribed SSRI, and it had shown success in helping some people with anxiety. She told me that I was to keep in contact with the Health Center and to call the 24-hour emergency line if I had any side effects that alarmed me.
I did end up calling the emergency line, at 2:00 in the morning, when it felt like bugs were crawling all over my skin. I couldn’t sleep. My panic had gone through the roof. If my brain had been the Oval Office, the inside would have looked very much like that scene in Independence Day after Jeff Goldblum showed President Bill Pullman that the aliens were using our satellites against us. My sense of self-preservation was on the first Air Force One ride out of that mother. Somewhere in the midst of DEFCON 3, I was able to dial the emergency line. After the on-call psychiatrist calmed me down, I made an appointment online for the very next morning. I told the psychiatrist about the side effects and said, “I know that there are adjustment periods for medicines – I get that. I just don’t think I can make it through this one.”
She listened to me.
She listened to me and prescribed me a different drug. Prozac just wasn’t a good fit for me, she explained. Everyone’s brain works differently, but the goal is to make me feel like I can function. Zoloft might be a better choice for me, and just to be on the safe side, she put me on Valium temporarily. SSRIs change one’s brain chemistry, so sometimes you have to grease the wheels with a mild sedative. She also gave me the choice: I could try another SSRI, or we could keep working without medication.
I’ll admit it: the side effects of Prozac had been so horrific that I was hesitant to try something else. It was like I’d taken an acid trip with Lord Sauron. I wanted to get better so badly, though, that I went for it. It was the best decision I have ever made.
4. Yes, drugs are chemicals that you’re putting in your bodies. You know what else is a chemical? Absolutely everything.
I hate to break it to you, but you’re made of chemicals. So am I. So is the Pope. So is Beyonce. We are all made of chemicals. Even Moby is made of chemicals, because we are all made of stars…which are all made of chemicals.
Every single thing you put in your body, from water to potato chips to plutonium to the fresh blood of your enemies, is a chemical. Some chemicals are good – like water. Some chemicals are bad – like heroin. The “naturallness” of a substance is no measure of its goodness, by the way. I’m all in favor of making natural food, like vegetables and fruits, available as a healthy alternative to chips for people who are not me. However, let’s not pretend that Nature hasn’t been doing her damndest to kill us over the last few million years. Hemlock is totally organic and it will totally kill you. Yes, I choose to put a chemical in my brain because that chemical makes my life better.
I know that there are people who manage their mood disorders without medication. They use exercise, diet, neurotherapy, and essential oils. For them, I have nothing but love. Respect. But what I don’t have is admiration because I don’t consider them to be any stronger than someone like me, who uses medication as a part of my treatment. If you’re healthy, then that’s fantastic, and it doesn’t matter to me how you got there. What I do object to, however, is the “helpful” advice on how to “kick” my “chemical habit.” These well-meaning people only contribute to the stigma surrounding antidepressants that causes people to quit their regimens without consulting their doctors.
The fact remains that many people who take prescription medication to help them with depression, anxiety, schizophrenia, or any other mental illness feel like they have to hide that fact from others – even the people they love the most. How many people feel like they have to lie about their Lipitor? How many people feel that they have to hide their Prednisone in their sock drawer? Would you ever tell someone that they didn’t “need” their chemo?
I remember having to take a deep breath before telling my boyfriend about my nervous breakdown two years ago and the resulting regimen of diet, exercise, and, yes, Zoloft that keeps me healthy in mind and body. I trusted him – of course I did – but I’ve spent a quarter of a century in this culture. He didn’t bat an eye, of course, because he’s sensible and compassionate, but my own internalization of our cultural norms did surprise me.
So here I am. I take pills. They keep me sane.