The Perspective Project - Antidepressants

Serotonin

WARNING

I endorse no thing for anyone in this entry

With the same tongue I discourage no thing for anyone in this entry.

This entry is based upon my experiences and my own research solely.

Please, before you make decisions for yourself concerning anything in life search your own heart, do your own research, and seek your own counsel with individuals you trust.

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In the beginning there was a perspective towards antidepressants with drastically gritty low value.

In the beginning there was aversive combative attitudes towards myself due to depression, and any support systems trying to help my depression. This was especially true towards a support system involving antidepressants. In the beginning when I first sought help on my own for what I now know as double depression I had waited until it was almost too late. I was severely, abysmally, so lost inside my depression that I literally could see no light at the end of the tunnel. The beginning of anything is hard. The beginning of realizing you have a mental illness can be impossible, because denial is easier. Fighting yourself, fighting the truth, fighting help is easier than accepting the fact that you don’t know yourself, that you’ve been blind to the truth, and that you do desperately need help.

Cymbalta

In the beginning there was Cymbalta (duloxetine) - a serotonin-norepinephrine reuptake inhibitor (SNRI). I first sought the help of a psychologist, because I knew a psychologist had not the ability to prescribe antidepressants. Though my psychologist at the time quickly determined that therapy could not help me fast enough. Therapy is most assuredly not a quick process. I needed something fast if I was going to survive this episode of major depression. That something fast was an antidepressant. In my very first session with the psychologist she stated that I would greatly benefit from an antidepressant. I resisted this with every fiber within every muscle within my being. This is why I sought a psychologist in the first place, so I wouldn’t have to deal with antidepressants. Here I sat though, face to face, with someone who in their professional opinion, believed I was the perfect example of someone who an antidepressant could help. My depression wasn’t life induced. My depression was to her an obvious chemical imbalance within my body. She referred me to a registered nurse with a PhD who specialized in psycho-pharmacology. She would prescribe the goods. I don’t recall much about the initial appointment. I can recall the burning itching sensation the prescription induced in my hand though, and the panic it ignited in my chest as I stared at my named connected to the word Cymbalta in formal chicken scratch.

I wish I could target where the bad taste in my mouth came concerning antidepressants. I do not know where the perspective that antidepressants were the enemy was born. I imagine it is a layered cake of sorts. Society doesn’t favor antidepressants. Society has a taboo perspective towards mental illness, and attached to that is the taboo perspective for antidepressants (along with other mental illness medications). I’m a part of that society, and therefore had adopted that perspective as well. Prescription medications are over prescribed. That’s pretty obvious to anyone who keeps up with current events. I’m not talking about just antidepressants though, no, I’m talking about all prescription medication in general - notably pain medication. I didn’t want to be a part of that cultural of over medicated Americans. That wasn’t who I was, and I didn’t want to become a part of that. I was also terrified of becoming “normal”. “Normal” was not (still is not) my cup of tea, and I was sure that an antidepressant would make me "like everyone else" (I'm not sure what "like everyone else" is today). I had it set in my mind that if I let that antidepressant course through my veins then it would etiolate my skin, petrify my bones, anesthetize my mind and curdle my heart. My poor perspective concerning antidepressants was a layered cake of misunderstanding and irrational fear. It seems most humans poor perspective on the majority of “things” in life, including antidepressants, is laced in misunderstanding and irrational fear. 

I’m not going to lie… my journey with Cymbalta was a terrible one. In saying that, I will also say that that was partly (more like solely) my fault. I did not keep on schedule with my Cymbalta, and that is critical when it comes to taking antidepressants. While taking Cymbalta I also self medicated occasionally with excessive amounts alcohol and prescription pain medication (go figure). This is also not a wise course of action while taking an antidepressant. I also hated taking them. I’m pretty sure this poor attitude didn’t help my plight with depression every time I had to force myself to swallow another pill. Along with my poor behavior while taking Cymbalta I also resented my doctor due to immaturity on my part, and that caused me to clam up while in appointments. If I had been honest with her about the side effects I was experiencing, if I had been honest with her about how I felt about antidepressants, then she could have better helped me. Unfortunately this wasn’t the case. I had terrible side effects like severe “body shocks”, extreme dry mouth, and it also made me feel numb inside my brain. After my attempt to kill myself, my stint in Peninsula and my psychologist “dumping me”, I decided that Cymbalta was no longer something I could tolerate and stopped cold turkey. That is also something you never ever do with an antidepressant. Let’s just say it wasn’t fun. Cymbalta isn’t a “bad” antidepressant. I was a “bad” antidepressant consumer. If I had had an open mind towards antidepressants, if I had been honest with my doctor, if I had given more effort towards my own plight with depression then maybe Cymbalta would have helped - or maybe another antidepressant would have been prescribed instead. This was the beginning with antidepressants, and it was a rough one.

When I first began therapy again in December it was (once again) clear to my therapist (my current one) that I would greatly benefit from an antidepressant. I was still quite hesitant towards antidepressants. I hadn’t had a valuable experience before, and I still had misconceptions and fears. I was in the midst of a major depressive episode though, and I was struggling violently to stay above water. She recognized immediately that my depression was “pathological”, and that an antidepressant was necessary for me. I was then referred to a psychiatrist. This second dance with an antidepressant has been the complete opposite compared to before. I learned a few years ago how to be painfully honest with myself, and I had made the decision to do the same thing with my therapist when I started this go around. When I started seeing my psychiatrist I made the same decision, to be painfully honest when it came to antidepressants. Along with honesty, I’ve kept an open mind, and along with that open mind the connection I have with my therapist helps me to trust her judgement.

So, today, every morning, I take twenty milligrams of Lexapro (escitalopram).

Today, this drug, along with other “life savers” has preserved my life.

My perspective on antidepressants has shifted completely.

I understand antidepressants. I have done copious amounts of research (as a layman not a biochemist mind you), and no longer misunderstand them. I lean towards the scientific theory that depression is a genetic abnormality encoded within one’s DNA for those with “pathological depression”. Also without early onset treatment the depression can become worse due to poor thought structuring, and thus by a person developing learned helplessness, as it has been with my own depression. It is unknown exactly how selective serotonin reuptake inhibitors (SSRIs) like Lexapro work. With new research it is safe to assume that the simple notion that lack of the neurotransmitter serotonin is not the only cause of depression. With a genetic abnormality, a “glitch” in one’s DNA could cause a multitude of biological factors which could cause the mental illness depression. It could be the lack of the neurotransmitters serotonin, dopamine, and norepinephrine. Along with this, it could also be a lack of synaptogenesis (the growth of new synapses, or nerve contacts) and neurogenesis (the generation and migration of new neurons) that could cause depression. Lower serotonin levels would merely result when cells stopped making new connections among neurons or the brain stopped making new neurons. So, directly treating the cause of this diminished neuronal activity could prove to be a more effective therapy for depression than simply relying on drugs to increase serotonin levels (click for more on this.).  It is then possible that SSRI’s actually aid in synaptogenesis and neurogenesis; this is why it takes SSRIs sometimes weeks to begin to take effect.

You see, with understanding can come the ease of one’s fears. With the ease of one’s fears can come an open mind. With an open mind more understanding can come. With more understanding wrapped with compassion and love can come acceptance. With acceptance can come the freedom to make choices for yourself and your life that are healthy, intelligent and based in love. I now accept that antidepressants are merely a tool in my existence with depression. It is not 100% known as to how it is helping me. It could be a multitude of reasons; it could be from increasing my serotonin, to aiding in synaptogenesis and neurogenesis, to the the placebo effect (this is not very plausible). What I do know is, Lexapro works for me. Is Lexapro a “cure all”? Can I just take Lexapro, and now it’s all rainbows, butterflies, and sunshine? Uhhh… no - not even close. Lexapro is just a small part in a huge equation that is existing with depression. My family, my therapist, my psychiatrist, my acceptance of who I am, plus many other factors aid in living with a mental illness. My psychiatrist helped to start the shift of my perspective on antidepressants when she asked this, “You’ll seriously consider suicide as an option, but you want to completely dismiss antidepressants as an option? Does that make logical sense to you?” That indeed did not make logical sense to me, and I started to give antidepressants the benefit of the doubt.

Lexapro

Now, if you’re of the type that thinks antidepressants and other similar medications (like ADHD medications, antipsychotic medications, etcetera) are nothing but “big pharma” making money off weak, “crazy”, “asleep” “sheeple” then you’ve never bore witness to the life of someone who lives with a serious, life threatening, mental illness - and you shouldn’t display your ignorance as some proud badge for all to gawk at. If this is you, do yourself a favor, and seek out some knowledge - preferably first hand; go volunteer at mental hospital, connect with a family member who has a mental illness, or contact me personally. I’m more than willing to help you understand that mental illnesses are just as serious as physical illness, and that medications can and do help in treatment. On that same note, I am also not saying that every time you feel sad, you should run to your doctor and ask for an antidepressant. Antidepressants are not “cure alls”, as I stated before. An antidepressant is a tool to help those with “pathological depression” manage their disease. It is a tool to help someone who is suffering from a deep depression due to a life situation stay afloat until they can learn to swim on their own. Antidepressants are tools, and are to be treated as such. They are not saviors, they are not devils, they are neutral tools - let them be just that, and judge them fairly when the time comes for you to do so. 

So…

Hello, my name is Haley.

I take an antidepressant called Lexapro.

Lexapro isn’t who I am. Lexapro is merely a tool I use to manage an illness I have called double depression.

Namaste,

Haley