“How long have you been experiencing symptoms of depression?” the doctor asks, and I laugh awkwardly. Not because it’s funny, but because I can’t remember.
“Since high school. Maybe before,” I answer, trying not to think about all the hours I have spent feeling depressed. Fifteen years is a long time. He scribbles in my chart.
About a year ago, I started taking an antidepressant. Until then, I had been terrified of meds, even when my first therapist told me she thought I needed them. At the time, I was twenty-two, unhappily married, and more depressed than I had ever been.
“Depression without medication is like cleaning your house with a ball and chain on your ankle,” she said softly, knowing I was afraid. “When you take medication, you still have to clean the house, but without the ball and chain.”
Even with that analogy, I saw medication as a sign of weakness. Depression wasn’t a chemical imbalance, it was the result of a disorderly life. If I could get my marriage, my career, and my writing in order, I would be happy. It was my fault I felt this way. Medication was a cop-out and proved how weak I was against the symptoms of my depression.
“I want to feel what I’m going through,” I told her, believing I deserved every terrible feeling. She didn’t bring up medication again. I saw her weekly for almost two years. Talk therapy helped, but the intense symptoms of my depression remained. Sometimes the tools I learned through therapy helped, but on my worst days, I didn’t stand a chance.
Fast-forward to last summer. I could feel myself spiraling, but now I couldn’t point my finger to unhappy life circumstances. Since my two years of therapy, I had gone back to school for mental health counseling and had learned many additional therapy skills. I had also left my marriage, graduated, gotten a decent job, and was in a happy, healthy relationship in which we were planning for our future. Even still, I needed additional help. Almost seven years after my first therapy appointment, I agreed to try medication.
I started taking Wellbutrin because a friend of mine had good response with it. “I didn’t have many side effects,” she told me. “I just felt stable.” That sounded great, so I got a prescription and had it filled.
The first week or so on Wellbutrin was a blur. We were in the process of moving from Louisiana to Texas, and I felt a little like I was on speed. Wellbutrin contains a stimulant, so it’s different from other antidepressants in that way. I found I couldn’t drink too much coffee or alcohol, because both brought horrible side effects when combined with the medication. I was clenching my teeth and shaking my leg a lot more, but I also wasn’t coming straight home from work and crawling into bed or spending three hours in the bathtub crying, so I accepted the side effects. Eventually, I got used to it and the effects lessened. It helped for a while.
A couple of months ago, I found myself spiraling again. I was now living in a beautiful apartment, in the city I’d always dreamed about, with a man who loved and supported me. I had finally received my LPC license, which was a huge professional step, and had a great job at a private practice. So why was I feeling out of control? Why was I sobbing uncontrollably and having daily anxiety attacks and passive suicidal thoughts? Why was I feeling like there was a crushing weight on my chest that wouldn’t go away no matter how much self-care I attempted?
I talked to my psychologist about a med change, and he agreed. In the state of Texas, he is unable to prescribe, but is extremely knowledgeable about medication. We spent the better part of two sessions talking about med options, and I did my own research as well. He wrote a letter to my prescribing doctor, who wrote me a prescription for Lexapro.
I’ve been taking Lexapro for two weeks now, and to be quite honest, it’s been terrible. Usually, medication takes about a month to fully take effect, so I’m waiting for that. I haven’t been feeling as anxious, and I certainly haven’t been feeling as depressed — I haven’t been feeling much of anything. This is common with SSRIs, or so I’ve been told. I’m sleeping better, almost too well, but not doing much of anything otherwise. I put all of my energy into my work with my clients, and have very little to spare at home. I have more mental clarity and am able to think externally, but am having a hard time processing how I feel internally.
In my personal life and in my work, I have seen time and again how necessary these medications are, despite their side effects. The stigma of mental health treatment is slowly shrinking, largely in part due to people being more vocal about the treatment they are receiving.
An important thing to remember is that medication is not enough by itself. Regular talk therapy and a personalized self-care regime is as important as finding the right medication. Having a good support system is also invaluable, and I don’t know where I would be without my friends and my supportive partner. Talking about medication — what’s working, what’s not, what you like, and what you don’t — are all critical parts of finding the right medication. I have clients who will go months and even years on the wrong medication because they’re convinced that they’re the problem — or they don’t want to complain, again, and ask for yet another med change. But that’s the thing about meds. What works now might not work later, and it’s important to do regular check-ins with yourself and your symptoms.
My experience with medication has proved to be challenging, but not as terrifying as I originally thought. With the right professionals and support systems, a hefty dose of self empowerment, and finally, the assistance of modern medicine, I am confident I am getting the help I need.