What I wish I had known before taking anti-depressants
This opinion is solely based off of my personal experience. I am not a clinical expert!
CW: brief mention of suicidal thoughts
The first time I saw a psychiatrist was the summer before my 18th birthday. At that point, I had been suffering from depressive symptoms for a few years, and my panic attacks and mood swings had increasingly gotten worse. I was starting to fear that what I was feeling was permanent, and a part of me was terrified at the thought that I would live the rest of my life with this empty and dark feeling.
Being raised in an Asian household, my mother did not believe in the concept of "mental health", and whenever I expressed how I was feeling to her, she would call me dramatic, or would tell me to exercise so that I would feel better. I do not blame her nor do I resent her for reacting in such a way as she was also raised in an environment where speaking about your emotions was a taboo and a sign of weakness. However this definitely played a role in whether I thought it was necessary to see a psychiatrist or not.
The main concern I had was that I felt I was not "sick enough" to see a psychiatrist. In my mind, I thought that seeing a psychiatrist was something that only people who had severe mental illnesses did, and I thought I did not belong in this category. In addition to that, I was confused as to what exactly it was that I was feeling. My depressive symptoms would come and go. Some weeks I felt fine, and then some weeks I would feel completely awful. But soon these weeks turned into days, or even hours. One moment I was fine, and the next I wanted to lock myself in my room and cry. I knew, however, that I needed to do something when I noticed a constant feeling of numbness and emptiness that hovered over my existence. I no longer felt sad or angry, I felt nothing. I no longer cared about anything, and many nights I would lay in bed crying from the pain of feeling empty. It was ironic to me, that I could feel absolutely empty and yet so heavy at the same time.
After talking to my mother, she finally agreed for me to see a psychiatrist and even came with me which I did not expect. I remember sitting in the waiting room thinking "I don't belong here". I felt so ashamed of even being seen walking into the clinic. Given that it was my first appointment, I was asked to fill out a questionnaire and draw things. I remember filling out the questionnaire and feeling even more ashamed as I answered questions about whether I had thoughts of hopelessness or thoughts of dying, because I did. After a few visits to the psychiatrist, I was diagnosed with major depressive disorder as well as PMDD (premenstrual dysphoric disorder). When I was told of my diagnoses, I had a sense of relief. Somehow having a name for what I was feeling made me feel reassured that I was not making these emotions up in my head and that there were ways to treat it. My doctor then explained to me what the different treatment options were, and I agreed to try and start taking medication.
Taking anti-depressants was something I never would have considered. It's not that I was ashamed or afraid, but it was more so that I did not think I needed it. A certain part of me felt that by taking medication, I would finally be admitting to myself that what I was sick, that I had an illness that only medication could fix, and I was not ready to come to terms with that. But at this point I was in so much agony that I was willing to do anything to try and "fix" this. (I later realized however this was not the right mentality.) My mother was completely against this of course, and there was a part of me that was not sure if I was making the right decision, but after having done lots of research and having my doctor thoroughly explain everything to me, I agreed this was the right choice.
I started taking Zoloft, an SSRI (selective serotonin reuptake inhibitor), which is basically just a fancy way of saying a type of anti-depressant. I started with the lowest dose and had bi-weekly appointments to monitor my reaction to the medication. This is where I felt like I wish I had more knowledge about how anti-depressants work, and this is the reason why I am writing this post. You see, in my mind, I had the impression that taking medication would magically cure my depression, and I would know longer suffer from the horrible dark thoughts in my mind. I thought that I would finally be freed from the pain that dragged me down everyday. I thought I would finally be "happy". But this is not how anti-depressants work.
According to my psychiatrist, she explained it like this (see poorly drawn illustrations below). While your brain is still adjusting to the medication, there is a possibility that your depressive symptoms get worse, before it stabilizes.
Over the following two months since I started medication I had more frequent panic attacks, and my depression indeed felt more severe. Naturally, I was left feeling hopeless and confused. I felt like I was doomed, and that I just had to accept this life of feeling empty. Nonetheless my psychiatrist recommended that I continue to increase my dosage and monitor my situation rather than switching to a different medication or stopping completely. I trusted her, and that's why I agreed to continue to increase my dosage. It took about four months or so, but my emotions started to stabilize, and I noticed that I no longer had the empty feeling that followed me everywhere. I did not have a feeling of dread every time I did something, and it helped me concentrate on things that I needed to focus on. My mood swings are what improved the most, and this helped me with my interactions with people. I stayed on 100mg of Zoloft for another 6 months or so and then slowly reduced it as I continued to stabilize and my situation improved. I am still on it to this day, however I currently only take 25mg. My psychiatrist recommended that I should not rush to get off of it right away, and instead continue to observe how I feel for another year or so in order to decide the next step. So that's what I'm currently doing.
Depression comes in waves, and when it hits you, it hits you hard. This is regardless of whether you are taking medication or seeing a therapist or not. When you feel depressed, you will feel it and there is no escaping it. That being said, you learn new coping mechanisms and figure out what works for you when you are in a depressive episode. Depression is not something you can run away from, which is what I wanted to do so badly. Instead you learn to live with it and not let it consume every aspect of your life.
My point of writing this is to shed light on my experience with taking anti-depressants in hopes that it can help others in similar situations. Do I think that everyone needs to take medication? Definitely not. It's a difficult choice to make, and although I am in a much better position now, I know that it wasn't just because of the medication. It's a combination of multiple factors.
I also understand that being able to take medication is a privilege in itself. I am lucky to have lived in a country with a great healthcare system. As I was raised by a single mother, I did not have to pay for my medication and each appointment was approximately $5. Furthermore, I had the luxury of time. Taking medication for your mental health is not an easy process. It involves a lot of trial and error, and waiting to see how your body reacts. It's about being patient with yourself and being gentle with yourself. Some medications can cause severe side effects, and in order to ensure that you are being safe, the most important step is having a psychiatrist that knows what they're doing. But all of this requires time and some people can not afford to try different options and see different psychiatrists. This is why it's so important to promote mental health awareness in order to improve the availability and access to resources, and I hope that this project contributes to that!
Thank you so much for reading!
(If anyone is currently contemplating whether they would like to start taking medication or not, please know that you can always talk to me to hear more about my experience. I can not offer any medical expertise, but I will offer you lots of love and support.)