Bye Bye Bye to my SSRI
Yooooooo!
Happy Day 20 of tapering off zoloft to ME! You know that if times were different, I would 1000% be planning a proper zoloft taper party. Everyone would come dressed as their favorite anti-depressant, and I’d have a “Take a Chill Pill” sparkly banner as the backdrop to a photo booth made of prescription pads.
In all seriousness, this taper process has largely sucked. Even while working with a trusted psychiatrist, strong support, and plant medicines throughout, I have been feeling really weird and out of it for over 3 weeks.
My taper plan for no one asking consists of decreasing my zoloft dosage (originally 150 mg) incrementally. Two weeks of 100 mg then 50, 25, and eventually, zero mg.
Writing about this experience and sharing it with others has honestly been really helpful. It is absolutely W I L D to me how many people have suffered through the taper process in silence. Surprise surprise, the stigmatization of mental health treatment strikes again!
Now… let’s talk about SSRIs for a minute. SSRI stands for selective serotonin reuptake inhibitor — these include medications like citalopram, fluvoxamine and my girl sertraline. While they’re typically prescribed for depression, the fun doesn’t stop there! They can also be prescribed for: obsessive-compulsive disorder, eating disorders, and anxiety disorders all can be treated with SSRIs.
SSRI medications seem to work really well for select people; for some people with major depression, nothing else has worked. But we don’t have a way to reliably predict who SSRIs will help, or who will get side effects like the ones I’ve experienced.
Considering the unpredictable side effects and mental and physical risks entailed by SSRIs, it’s surprising that they’re so readily prescribed. Not to be pessimistic but… I can say pretty positively that part of this is due to big pharma pushing to make a profit at the expense of those who are suffering.
And look, I’m not in the business of forcing anyone to talk about their feelings (oh wait, yes I am) but putting my day job aside for a minute - I still think it’s time for us to start getting real about how much we’re suffering as a society, and how much antidepressants like zoloft may only be a wet band-aid solution to our psychological wounds.
Going off zoloft is not something I’m taking lightly. This medication has helped me immensely in times of deep despair and anxiety. When I started taking it, I was in the midst of the busiest/most stressful time of graduate school/life I had ever experienced, and I will forever be grateful to my boo Z, for giving me the floaties I needed to stay above water in the deep end. But I would be straight up lying if I didn’t mention just how significant the side effects of these meds were for me. Side effects included:
lowwwww libidooooo. Yeah, that’s right, I’m talking about my s-e-x- d-r-i-v-e. I’ve always had struggles regulating my libido (more to come… on this :)) but after about a month of taking zoloft, sex felt even more stressful, annoying, weird, and unappealing than ever before.
For the 3 years I was on zoloft, I cried maybe once every four months. I’m not a chronic crier, really, but this was a bit… alarming. It wasn’t that I didn’t feel sad, but it was just like a blunted sadness. Like… I knew I should feel sadder than I felt, if that makes sense?
If I ever forgot to take my meds, even just for a day, I would get what is literally referred to as “brain zaps.” They are exactly what they sound like. Brain zaps are electrical shock sensations in the brain that can happen in a person who is decreasing or stopping certain medications. So yeah… brain zaps.
Anyone else exhausted? Nope, just me? In the peak of my zoloft intake, I would average 11 hours of sleep a night and still wake up groggy AF. While for some, sleep problems may be more of the insomnia flavor, your girl was the sleepiest person in the world.
By year two, I started feeling more and more disconnected from myself. It’s hard to put into words, but it felt as though the core parts of myself were buried deeeeeeep inside of me. While at times this worked to my advantage (letting things role off my back, getting work done efficiently, having a rough day and just plowing through) on a fundamental level, this made me feel confused and fragmented. Identity crises and being mistaken for Brazilian are par for the course as a mixt woman, but I really felt as though I was constantly fighting against my zoloft to stay connected with my true self.
I never got used to the fact that I really didn’t know why the medication was working for me. Yes, that’s right. While we know that SSRIS temporarily increase the amount of serotonin (an important neurotransmitter that affects your mood, among other things) in the synapses between neurons of your brain, this doesn’t explain why it takes weeks for them to take effect, why withdrawal from SSRIs is so dangerous, or why some people — but not others — respond to them. Also in 2020, we still don’t know how much of the effects of SSRIs are placebo and how much are real drug effects. As Lauren Edwards, a clinical psychiatrist at the University of Nebraska Medical Center, points out:
In general, these drugs work by increasing the availability of neurotransmitter chemicals like serotonin and norepinephrine in the brain. These chemicals help pass signals between neurons, performing a critical function in cranial communication. Why boosting brain communication can help alleviate symptoms of depression, however, is unclear.
These unknowns, along with the complex nature of the illness, mean doctors often have to try multiple antidepressants before they find one that works for each patient.
I was starting to feel uncomfortable with the idea of being anti my symptoms of depression and anxiety. If you notice, all of these medications are advertised as “getting rid” or “lowering” of these negative feelings. While this may sound really appealing in theory, in practice, I think it sends a dangerous message. As Dr. Will Siu points out:
Even if you look at the categories of the medications that we use right now within psychiatry—we have antidepressants, antianxiety antipsychotics—we’re basically saying to people, if you’re feeling anything, let’s suppress it. Let’s get rid of it. We don’t even want it. We don’t know how to deal with it.
Then, societally, we do the same thing. We have a heroin epidemic. We have a lot of alcoholism. And what do alcohol and heroin do? They suppress painful emotions in the short-term. Obviously they have long-term negative consequences, but people are addicted to them because they work. You don’t feel good and you take alcohol, you will feel better… for a little bit.
This is where the use of psychedelics as medicines comes in. Just hear me out, please. If we think about it, psychedelics basically do the opposite of traditional antidepressants. Psychedelics are essentially nonspecific amplifiers of the unconscious (Stan Grof) and when used responsibly, they bring difficult emotions or difficult memories to the surface, so that we can actually work through them and express them. This can be achieved through other modalities as well. Various types of therapy — talk therapy, movement therapy, art therapy, etc. can help us revisit past traumas or painful experiences that weren’t resolved — bringing them to the surface and confronting them.
In other words… confronting some of the causes of our anxiety and depression is necessary for our long term healing. And, as many researchers would argue, going through the confrontation process and realizing that we persevere in spite of our traumas is a form of healing in itself.
With all of this in mind, I want to reiterate that I am not here to preach going off SSRIs if they are working for you. This is an account of my personal experience as a therapist/human-in-training with zoloft, a medication that was immensely helpful to me during a period of acute distress in my life. What I am advocating for is being an active participant in your mental health treatment. Of knowing all of the options available to you, and not just swallowing a pill because someone tells you it might help, kind of. And for anyone who is currently taking any of these medications who may feel like something isn’t right, my hope is that you’ll feel encouraged to speak up to someone about it.
Too often SSRIs — very strong medications with very real side effects — are advertised as the only viable solution to our mental health struggles. Well honey, I’m here to tell you — there are other options out there. And if you’re on SSRIs and going through any of these side effects I described and want some additional support in handling them, let’s talk. Friends don’t let friends suffer with SSRI side effects solo. We’ll get through this together.
I love you,
Jesse