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This article reflects the personal experiences of the author (under medical supervision of a physician). The author's comments and experiences do not reflect the opinions, positions or policies of Yahoo Canada. This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional to discuss mental health treatment options and before making any changes to your medication.
The following article contains references to depression and suicidal ideation which may be triggering for some readers.
I gingerly place a pill on my tongue like it’s a communion wafer; it's how I’ve started each morning for the past four years and three months. Before I brush my teeth or get dressed for the day, I take an antidepressant, just like 5.8 per cent of my fellow Canadians do. For me, the experience feels almost religious; the way some people place their faith in Jesus, I have placed mine in pharmaceuticals. I don't regret the decision to do so. In fact, antidepressants may have saved my life — but I’m still going to stop taking them.
I barely slept for the first few weeks after I began taking antidepressants. The romantic part of me attributes this sudden burst of energy to a newfound sense of hope. Slowly but surely, the pills brightened my mood after years of my mental health being in a steady state of decline.
When I was 30, the burnout from a diet of emotional despair led me to a breaking point: I was so weak, I barely had the will to keep my head above water. That isn’t a metaphor. There were times when I actually wondered whether I might accidentally drown in the bath.
My doctor had diplomatically raised antidepressants as an option, but I’d rebuffed her advances for years before I started taking them. I’d heard from friends that such medication could cause weight gain, and decades of internalized fatphobia made me think it was better to contemplate jumping off my balcony a few times each month rather than buy jeans in a larger size. But therapy alone was proving insufficient in my case and after years of feeling miserable, I was ready to give pharmaceutical treatment a try.
The first medication I tried caused vivid and persistent suicidal ideation (so that was a bust) but eventually we found a drug that worked. That glorious white pill was "The One" — the fairytale Prince who woke me from my depressed slumber. Apologies for the patriarchal metaphor, but it honestly felt like I was Sleeping Beauty, and my medication was the blandly handsome royal who rescued Aurora when he made contact with her mouth. Thanks to those pills, my life had potential. I felt giddy with excitement about my life, finally in possession of the energy to commit to weekly therapy appointments, clean my room and even go on dates.
The early days on my antidepressants felt so heady that it was like falling in love. For the first time, I felt lucky to be alive. I began writing a dating and relationships column for a major Canadian newspaper and I also made new friends who liked going out for brunch on weekends. I even cashed in my Air Miles and took a vacation to the south of France - an extremely active trip, where I ate croissants each morning and climbed mountains in the afternoon.
I was the happiest I’d ever been, or to be more accurate, I felt what it was to be happy for the first time. I could finally enjoy being in the moment and simultaneously feel excited for what might come next. Taking antidepressants felt like having a superpower.
I met my husband six months after filling out that life-changing prescription. We had our first date at Terroni, an Italian restaurant in downtown Toronto, located in a former courthouse. As soon as I spotted him waiting for me in the lobby, I thought to myself,"Damn, he’s cute!"
After dinner, he asked if I wanted to make out, and I said yes. We kissed for about an hour in front of my building before he eventually caught the bus home. A mere three-and-a-half years later, we’re married with an adorable toddler who is obsessed with the moles on my arms. She smiles and screams, “Mole! Mole! Mole” whenever I push up my shirt sleeves; She’s perfect.
So why would I stop taking the pills that helped me build the life I always wanted?
“Patients’ most common reasons for wanting to come off medications other than just length of time on them are side effects, period," Dr. Jessi Gold, a psychiatrist and professor at the Washington University School of Medicine, explained in an interview with Yahoo Canada.
Gold said the most problematic side effects for most patients include weight gain, as well as sexual side effects, including loss of libido and inability to achieve orgasms. She also cites fatigue as “one that is less tolerable.”
My medication had no discernible effect on my sexuality or my body weight but it did make me sleepy. While the first few weeks on my medication were euphoric, drowsiness, a common side effect of antidepressants, eventually set in. When I was child-free, the fatigue didn’t impact me. I had the luxury of sleeping for 9.5 hours a day, had enough time in the day to work multiple jobs and hang out with friends on weekends; but parenthood has put an end to my once leisurely lifestyle.
When my toddler wakes me early in the morning, I feel hazy and slow. It’s a feeling similar to carrying six bags of groceries a block or two more than your body can comfortably manage. Thanks to this persistent exhaustion, I worry I’m not giving my daughter the best of me. I want to wake up ready to play, ready to read books, ready to sing songs and excited to run around the park. At the moment, it takes a couple cups of coffee before I feel capable of building a single tower out of blocks. Although I can’t be sure if the antidepressants are the cause of my fatigue, I want to find out.
The second reason I’m weaning off my medication is my perpetually anxious state. My doctor confirmed that I was experiencing postpartum anxiety; postpartum depression’s less famous but it’s no less horrifying cousin.
“Sarah’s Anxiety 2.0,” as I call it, came complete with panic attacks, daily nightmares, and intrusive thoughts about the lovely and not at all violent barista at my coffee shop kidnapping and torturing my baby. Sometimes, I felt so overwhelmed, I thought about hurting myself. Had the pills stopped working?
I knew anxiety was a well-documented side effect of my medication, but I wondered if my postpartum anxiety would still be as debilitating if I weren’t taking a pill known to make some people feel more on edge. It felt as though it was time to get to know my brain without my medication.
The first thing to do when considering weaning off of antidepressants is to talk to a doctor with experience treating mental health issues. Gold said that when she meets with her patients to address the possibility of weaning, they “discuss risks and benefits at length.”
I met with my physician, and after a lengthy consultation, she was supportive of my decision as long as I slowly tapered off of my antidepressants and kept regular appointments with her during the process. I’m rule-abiding by nature, so agreeing to those terms wasn’t a challenge, but the weaning process has been a slog.
Weaning requires the patient to gradually reduce the dose of one’s medication, carefully following a schedule created by their healthcare provider. The process can last for weeks or months, and can trigger a range of symptoms, some of which feel quite bizarre. For example, I frequently experience an almost electric, tingling “pins and needles” sensation in my body, the same one gets after sitting on the couch for too long and having their legs go numb. I’ve also had vivid nightmares and interrupted sleep- both things that are a normal, but unwelcome, part of the process. But for me, the most challenging part of choosing to wean off of my antidepressants has been the worry about who I’ll be without their daily hit of dopamine.
My husband and child have never known me without my medication. I continued taking my pills throughout pregnancy, something a psychiatrist who specializes in treating pregnant people assured me was safe to do. My antidepressants were not a perfect cure; I still had bad days when I cried for six hours and felt like the most worthless person this side of the 49th parallel. However, my symptoms could at least usually be managed with regular therapy, support groups, and exercise. I believe antidepressants made my illness more manageable, if not negligible.
Today, I’m hoping the skills I’ve learned from therapy and the experience of the last four years will be enough to prevent a major depressive episode. I’m also hoping my anxiety will become more manageable and that I’ll have the energy I need to run after my toddler on the playground. But I worry, too. I worry I’ll revert to the pessimistic, despairing person I was before what I call the “Magic Pills” restored my capacity for joy and a sense of optimism. I fear my husband won’t love the person I turn out to be without medication.
I know my fears are paranoid. In fact, they’re probably manifestations of the anxiety that helped instigate my weaning journey. My husband reassures me he is madly in love with me each night before bed. He has loved me steadfastly through previous changes, like pregnancy mood swings and the six months postpartum when I almost never combed my hair. My rational brain knows my worries that his love will evaporate are misguided. My values, dreams, and taste in restaurants do not change based on the antidepressants I do or don’t take. However, my ability to live those values, realize those dreams and even go out to eat a couple times a month can be compromised by depressive episodes, and that scares me.
My weaning process has been marked by trepidation, but I’ve come to a liberating realization: I am entitled to that fear. I will continue to meet with my doctor regularly, so she can monitor and assess my condition. I acknowledge there’s a possibility that my depression symptoms will become so out of control, I’ll have to go back on pharmaceuticals - and I know I’ll feel like a failure if that happens, even though I obviously shouldn’t.
For now, I’m hoping there’s a new world on the horizon, one in which I’m less anxious, unmedicated, madly in love with my family — and they’re still madly in love with me. A girl can dream, or at least I can now; the ability to hope for a brighter future was a present given to me by antidepressants. It’s a gift I hope I’ll never lose.
If you or someone you know is thinking about suicide, please contact Crisis Services Canada's 24 hour Suicide Prevention Service. For a full list of resources including mental health services in your area, visit the Canadian Mental Health Association.