I saw my psychiatrist the other day. I hadn’t seen him in 10 months. Not because I didn’t want to, but because I hadn’t felt the need to see him all throughout that period. For the first time in a long, long time, I felt that my head was screwed on right, and there wasn’t much to report to him except that my life was just fine. Pretty good, even. In fact, that was exactly why I came to see him the other day — in the hopes of tapering myself off of the anti-depressants he prescribed for me, because I was pretty sure they had done their job.
Getting medicated for mental conditions remains a touchy topic in our touchy tropical nation, but there really shouldn’t be a stigma surrounding it. The human body is a staggeringly complex system, and getting wounds, tumors or other more physical glitches is not the only thing that can go wrong with it. Biochemical imbalances can affect the way a person processes the world around him, sometimes to the point of it being debilitating. It’s an illness like any other.
Nega and Chaka
Prior to medication, each day filled me with worry, dread, anger, and sorrow. There were flashes of okay-ness and even rarer blips of actual joy, but for the most part I was preoccupied with negative emotions. (And no, I did not affix Emily the Strange or Jack Skellington all over my trappings and listen to Dashboard bleary-eyed. That’s not depression; that’s just sad.) On the outside, I looked decidedly normal, even functional, and maybe just a bit too quiet, but little did others know that each move I made — choosing what to wear, walking down a sidewalk, buying a snack, talking to someone — required intense personal deliberation, as if one wrong move could ruin the day. And the moments following each act were flooded with all sorts of self-criticism, second guessing, and bad memories only loosely related to the current situation.
Did I say the right thing? Are my shoes too casual? Will this burn enough calories? Did I spend too much? Was this the right color? Should I have smiled? Could I have done it better? Are they sick of me? Did I forget anything? How hard will it be to commute later? Do I have to go to that employee thing? Do they hate me? Why is my hair like this? Why do I work here? Do I deserve him? Why is my family this way? Why can’t I say how I feel? Remember when your uncle told you you brought grief to the family? Remember when you did this and she said this so he did this and now they hate you? Remember when you were a better person and things were looking up? What happened to you? Why are you like this? Can you see yourself like this for the rest of your life?
I had to slog through each day this way. Suffice it to say that it took a toll on my work and my relationships. I found it hard to be with people, much less befriend them; every new assignment at work felt like a huge bag of sand against my gut; I picked ridiculous fights with my boyfriend which led not only to me screeching and bawling ’til dawn, but me clawing at my face and arms ’til they bled and even running away in hysterics. This was normal for me at the time.
Psyching Myself Up
Fortunately, my boyfriend is both incredibly supportive and fiercely logical, and he eventually convinced me that seeing a psychiatrist would do me some good. He was well aware of my none too rosy family history, my anorexia, my frequent run-ins with thieves and other unsavory types, my instantaneous apprehension towards authority figures, etcetera etcetera etcetera, and how all of these were connected one way or another to my difficult personality. Something was not right me. He wasn’t holding it against me. It was just a blatant fact that needed to be addressed.
So I went to a psychiatrist and told him as much as I could about how I thought and felt. (A psychiatrist, by the by, is different from a counselor or psychotherapist, the proverbial shrink who listens to you talk about your childhood and whatnot. Psychiatrists simply diagnose your condition, prescribe medication, and monitor your treatment.) This was the beginning of a slightly tedious process, stretched over several months, of ascertaining what I should do. It was fairly easy for my psychiatrist to conclude that I had major depressive disorder with a touch of social anxiety; what was harder was finding the right pill and dosage for what I had.
I started off with half a pill of escitalopram daily. Escitalopram is an SSRI, or Selective Serotonin Reuptake Inhibitor, the most common form of anti-depressant prescribed today. Serotonin is a chemical neurotransmitter whose presence is linked to feelings of peace and well-being, and what SSRIs do is keep this serotonin from being reabsorbed, letting it stay in the brain longer to better boost one’s mood. This is obviously the layman’s explanation, but that is basically what SSRIs do, because depressed people can’t seem to get the right balance of serotonin in their brain.
Alive, Alert, Awake, Enthusiastic
At the beginning, half a pill packed a punch. I could sense the difference in me immediately: I felt awake and alert — my eyes literally opened wider (they’d apparently been extra droopy and I never noticed), and my movements felt sharper, more precise. More importantly, my thoughts were no longer flooded by unnecessary negativity. When before my thoughts would immediately link themselves to something bad or worrisome, they now stood on their own, guilt- or problem-free. The medication worked so well that I even tried playing tricks with myself, thinking bad thoughts deliberately, only to feel them slip off of my consciousness like pats of butter. I know you think I sound high or something, but that’s how it felt. I felt fine because things really were fine. If I had a legitimate problem in my midst, such as difficulty getting a ride home in the pouring rain, or my big boss sending my work back with endless edits, I didn’t blow it out of proportion and conclude it was the end of the world and I might as well jump out a window or into speeding traffic. I understood what was wrong and did what I had to do to address it, like a normal person.
And the best thing about the pill working? It was a signal that something really was wrong with me. I was told that SSRIs only worked if something was wrong to begin with (it’s not the kind of pill you can abuse), so the fact that there was a staggering difference in me the moment I popped just half of one in meant I was doing something right.
But of course, like any other kind of medication, there was the risk of side effects. This was one of the main reasons why getting medicated is a trial-and-error process; every individual reacts to each pill in their own unique way, so you really have to whittle all the options down to the one most suited to your body’s chemistry and to your lifestyle. And unfortunately, I hit a particularly annoying snag with escitalopram: my sex drive sputtered out. I felt literally numb down there, and while my boyfriend was very understanding about it, it still really frustrated me. Sex is a normal thing people do and to be denied it felt frustrating and, in the end, depressing.
Thus, my psychiatrist prescribed citalopram, escitalopram’s older, less sophisticated version (a.k.a. fewer side effects), and upped my dosage to a whole pill a day to make up for this pill’s lack of fine-tuning. And it did solve my little quibble. I had to take a larger dose, and citalopram was slightly more expensive than escitalopram, but the fact that it could fight my depression and save me from sexual drought was worth it. My psychiatrist then advised me to take it for an entire year (six months for the actual treatment of my serotonin levels, and then another six months to really bolster the treatment and make sure the effects stay put), and to check in with him every now and then, especially if something was up.
On the Mend
But I didn’t check in with him for the next 10 months. (I would not recommend forgoing the psychiatrist to anyone; I was just being hardheaded and I am not a good example.) It was just that, as I’ve mentioned, I was lucky enough to have everything good since we nailed down the pill and dosage right for me. Long story short, it got to the point where I couldn’t tell the difference between feeling normal and feeling medicated. In fact, here’s a list of personal improvements I’ve achieved, off the top of my head:
- I can hold a conversation and not loathe myself afterwards.
- I am more capable of telling people what I want instead of being meek and doormatty.
- I don’t throw a fit when my boyfriend isn’t home by 6:30 PM.
- I eat what I want and only when I’m hungry, and don’t spend hours staring at my love handles in an awful mixture of sorrow and horror.
- I can forge and maintain friendships with people I sincerely like.
- I am more active about the things I believe in.
- I am more willing to try new things, no matter how far they are from my comfort zone.
- I care far less about what others think of me, my writing, my anything.
- I don’t beat myself up over the way I write.
- I no longer feel the need to pander to people I don’t like, and ultimately don’t crave for others’ approval anymore.
- When I feel upset, it doesn’t stretch on and escalate over the next 12 hours.
- I don’t care about my past, and neither do I worry too much about the future. I’m just fine where I am and I figure myself out from day to day.
I am still the same person I was before, in the sense that I still believe in the same principles, strive for the same goals, enjoy the same things, and swear like the same old sailor. The only significant change is that I’m actually happy to be this person, that I don’t unwittingly pile a whole lot of metaphysical shit on to bring myself down for no reason. I don’t feel different. I feel better. What moron doesn’t want to feel better?
So there. Thanks to my most recent conversation with my psychiatrist, which could possibly be my last, at least for a long while, I am now on a program to taper off my medication. Next month, I will take half a pill each day for the first two weeks, and then take half a pill every other day for the last two weeks. I will then stop taking medication after that, and will monitor how I feel over the next two months. If I feel just fine, that means I’m in remission. If not, that means I’ll have to go back to medication on a higher dosage for another length of time. But I’m pretty confident I’ll be in remission, because everything’s gone pretty well thus far. Unlike before, I now hope for the best.
I’d like to stress again, of course, that medication affects people in different ways, and that my case just happened to be fairly clean-cut. Others have a more difficult time with their treatment, so I cannot really speak for people on meds in general. What I do want to relay, however, is that getting medicated shouldn’t be frowned upon and, in fact, is a perfectly normal option for people with conditions similar to mine. Depression, bi-polar disorder and their ilk are more common than people think, and their methods of treatment are also more mundane than many would like to believe. Medication can be a difficult process, sure, but that doesn’t make it strange or wrong. In fact, I’m happy to be on medication. Wasn’t that why I signed up in the first place?