Reflection.

Getting Out of Funkytown: Talking Prozac & Depression

While browsing Brain Pickings this morning I was intrigued by Maria Popova’s most recent piece on a book titled Coming of Age on Zoloft: How Antidepressants Cheered Us Up, Let Us Down, and Changed Who We Are. The title pretty much says it all—the book explores the ever-changing attitudes about antidepressants in this country and contributes to that fairly conflicted conversation. The author, Katherine Sharpe, notes that:

This book won’t settle those debates, but it does speak to them. Twenty-five years after the introduction of Prozac, we are still collectively attempting to figure out what an appropriate use of medication would look like, in our culture and in our individual lives. We are trying to figure out what our sadness and pain mean — if they mean anything at all — and when they attain the status of illness. We’re trying to figure out when to turn to pills, when to go another route, and how we might be able to tell. … Good answers to the big questions about medication are likely to proceed from careful attention to the actual experiences of the people who have faced them.

Prozac JE

Image for TC c/o Jackson Epstein

I’m going to take that last line as an invitation–I’ve wanted to write about my own experience with SSRI’s since I began taking them about a year ago. I probably should have started taking them prior to that, but I was adamant that I was not “depressed enough” to warrant needing them. I never spent whole days in bed, and regardless of what was going on in my life, I tended to face the day with verve and plenty of determination to overcome any hardships. I did have low moments, but I generally enjoyed life too thoroughly to consider something as extreme as ending it.

What I would come to realize is that depression manifests itself in vastly different ways, depending on the person. The cliché idea of a person being bedridden and totally cut off from the world is not necessarily depression’s status quo (though to be sure—that is also prevalent).

Another perceived flaw I continued to pick at re: the meds was the oft-discussed notion of “false happiness,” as if by popping Prozac I was going to turn into a head-spinning Malibu Barbie who ran around with a creepy smile plastered on my face and said things like “My vibes are super positive today, let’s go to yoga! Twice!” My very naïve, younger self went so far as to see taking antidepressants as a signifier of weakness, relegated to people who were lazy or just “didn’t make enough effort” to endure the everyday struggle. Yes, I would slap that version of myself too if she piped up now.

But there’s no doubt that depression coursed through periods of my adolescence.  However, I never acknowledged it head on, and it only became really pronounced during my sophomore year of college. Miserable in my environment at the time, and surrounded by a group of people who have so far been unmatched in their capacity for judgment and loathing, I began to shut myself off from the world in my own way. I retreated into my textbooks, setting a new academic standard for myself that was in line with the ever-elusive goal of perfection. I began working out exhaustively—which would eventually lead me down a slippery slope to anorexia. Social events became few and far between and I only spoke to a handful of my friends, albeit pretty irregularly. It felt like I was doing all the right things, and as a lot of toxic people in my life fell to the wayside, I couldn’t help but feel empowered by the changes I was making. Our society praises academic determination and the application of stringent exercise routines—I told myself that I was just finally living up to those ideals.

I felt more in control of my life, without realizing that I didn’t have much of a life anymore at all. I spent almost all of my time alone because that’s what felt safe and was easiest for me to handle—I didn’t have to worry about anyone else’s misinterpretations about me or my life when it was just me, myself, and I. I no longer had to be vulnerable.

These tendencies increased tenfold as my exercise addiction fully gave way to severe anorexia. I had moved to a much happier place, and even made tons of lovely new friends who I genuinely enjoyed spending time with, but it was essentially too late at that point for me to remember the way I behaved pre-depression’s grasp. Deep down I started to believe that the only reason things were now working out so well on the surface was because of how seemingly in control I had become. This meant slaving away on schoolwork and using what little time I had left to run off all calories [which were essentially made up of lettuce, cereal, and the occasional almond—yes, singular]. Isolation was my M-O, and a rough winter in Chicago made this easy to disguise as normal behavior.

As I wrote about previously, I was eventually hospitalized for my eating disorder and went through various treatment programs. I met many women throughout that time who sung the praises of antidepressants, claiming they changed the progress of their respective recoveries drastically. I wasn’t sold, and, quite frankly, my anorexic self wasn’t ready to give up the unhealthy thoughts I was so used to maintaining. Logic does not come easy to a malnourished woman whose system has been shocked back into pre-pubescence.

Anorexia was my citadel, it protected me from having to feel anything too deeply—love, heartbreak, anger, insecurity. It literally numbed me to the barrage of the surrounding world (I can only describe the sensation as one of floating, coupled with severe and scary chest pains, an inability to sleep, fogginess, etc.), and convinced me that what I was hiding from were endless carbohydrates rather than uncomfortable emotions.

As I neared a yearlong anniversary of my time in treatment, one that—you guessed it—was not celebrated with cake, my family and recovery team (doctor, therapist, psychiatrist) sat down to take a hard look at my slow progress, and try to figure out what to do next. I had gained weight—very, very slowly—but not enough, and my anorexic mindset was still running the show. Feeling too full still gave me enormous anxiety and would often result in tears. My body was still the first thing on my mind every morning when I woke up, and I continued to avoid any hunger cues that I believed to be “excessive.” My team had been pushing antidepressants for weeks, claiming that—though they were no magical cure—they had a reputation for diminishing an anorexic’s tendency to dwell on disordered feelings and thoughts (essentially, the inner chorus of “you’re fat/pathetic”). I had heard from friends who had taken the drugs [albeit friends without ED’s] that they had experienced similar results, with a decrease in the obsessive thought processes common to those who are depressed (harping on the idea that your life sucks—for example—only makes it seem suckier, and feel closer to the truth). So, finally, the small voice inside me that was sick of caving to my eating disorder’s every insistence gave in and decided to give the pills a try.

The first week was a bit strange as I was suddenly giggly all the time, but that dissipated quickly and I began to notice how much easier getting up every day and facing the many meals of my life had become. My entire family saw how different I was acting, how much more present and alive I had become. “Perhaps we should have Prozac filtered throughout our water?” my stepmom jokingly suggested. Rather than hiding in my bedroom away from all the hubbub, I wanted to be with them, around whom I was—for the first time in ages—thoroughly enjoying myself. It seemed like someone had ripped the covers off of my life and I could finally see the gigantic gem that was sitting right there in front of me—my family…a group of people so funny, quirky, a little damaged, and yet still amazing. They loved me so much, wanted so badly to see the old “Jessie” in me again, and yet I had been treating them like the enemy.

Though anorexia never made me treat my friends negatively, it made me fear social contact in general, so much of my communication with friends during this time was via telephone or computer. Prozac helped push me to be with my friends again, face-to-face. I stopped worrying so much that my newfound thighs would push them away—a ridiculous notion, in retrospect, but one that I wholeheartedly believed at the time. Life, and eating, had become much more pleasant—so much easier. I began to gain the last few pounds that were necessary, still with hesitance of course, but with more determination and less denial that it needed to be done.

I’ve read lots of the literature against antidepressants, and I am by no means arguing that they are for everyone, or that people should stay on them 24/7 if they don’t have to. But I do believe they saved my life and propelled me towards my recovery. This quote from Katherine Sharpe’s book, however, is crucial to my experience:

“Though antidepressants are effective at managing negative emotions, they don’t in themselves provide the sense of meaning and direction that a person equally needs in order to find her way in life.”

I was lucky to have an excellent support group of family and friends in my life throughout this process. On top of that, I began writing again which definitely enriched my days (which were quite long and boring at the time) and gave me a sense of meaning when I really, really needed one (anorexia had become my identity and for a long time I believed I was nothing without it).

To this day, I notice that when I begin to question my place in the world, or feel that certain relationships are on shaky ground, my psyche gets a bit rattled. I don’t melt down in the way I once might have during my recovery, or isolate for weeks on end, but I do continue to have the occasional low moment. I snap out of my funks much more effectively now, but the funks still come around. Antidepressants are not a cure-all, they are merely a tool that can be very helpful when combined with other ‘tools.’

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