My Lexapro Shuffle
Antidepressants and I danced together for two and a half years. It was awkward. Think, first school disco awkward.
I turned to antidepressants as reluctantly as I did therapy.
I’m a Gen-X, Latch-Key Kid and I don’t do touchy-feely. Deepak Chopra and Eckhart Tolle were peddlers of woo-woo sciences. They exploit the weak and pathetic. I was doing ok. I was fine.
I’m no stranger to mood altering, mind-bending substances. Pharmaceutical assistance for headache wasn’t a huge leap from a blunt for a rough day. In fact, I was a rather proficient self-medicater. Wellbutrin? Lexapro? Why not? Could be fun.
Access to antidepressants in the US is closely tied to the psychotherapy industry. Docs generally won’t prescribe unless you agree to over-share your intimate, inner shit with a stranger. Crap; that sounded like a lot of uncomfortable work just to lift my mood and ease my anxiety.
I eventually found a therapist I could work with. It took months and I kissed a lot of frogs…
I passed on the beardy, sandals and socks dude. His office smelled of joss sticks. A sorry beta-male.
The power chick with the killer heels and bright red lipstick wasn’t a sustainable proposition. She kept coming to me in sex dreams.
The dikey girl that spent her lunch hour at the gun range; she was good company but hard to relate to.
I settled on an older lady who seemed to exist on a whole other plane of consciousness. When she quoted me Buddha, I was all in.
The conversation with my doctor was probably the hardest. I danced around the “ask” unsure if it was appropriate to just ask for drugs. If he was a rasta in a dingy bar, no problem. But sober, under fluorescent light, with a buttoned down preppy boy in a white lab coat — different proposition.
To further heighten the first-disco experience I had to go into how I had no energy, no libido, no desire, no interests, no friends. Oh, I was failing as a dad and my marriage was crumbling. All my dark, rancid, stinking, shadow stuff had to be put before him.
Once I had thoroughly guy-shamed myself and he had recorded all this stuff in my medical record (holy shit!) he took pity on me and wrote me a prescription for Wellbutrin. He reassured me it wouldn’t cause limp-dick (my words) that bums out many men trying out antidepressants. He didn’t seem to get that I wasn’t getting any anyway and that he might be solving for the wrong problem.
Still I gave them a go.
Wellbutrin was a bust. Two weeks in and I was feeling ripped off.
In the scheduled follow-up he switched me to Lexapro (Escitalopram). He assured me it was safe and large numbers of people were taking it. Then proceeded to warn me about side effects, including erectile dysfunction (again). Horney I am. Hugh Heffner, I’m not.
For the first few days I gently ‘tapered up’. I was a little surprised at the mild ‘surges’ (brief, low-level euphoric high not dissimilar to the early stages of MDMA ecstasy). Cool; I could like this. And legal too.
I was disappointed to find they didn’t persist.
About a month in, I ceased to notice any physical or noticeable effects. Each morning I popped my 20mg tab. They’re bitter and harshly synthetic tasting. I stuck to the regimen, refilling prescriptions monthly.
Months passed and I slowly and very subtly became anesthetized to my general anxiety and low level, chronic depression. I didn’t give a shit about much of anything at all.
It was one thing to claim as manly men do, that I was fine and that I didn’t care. It was another to actually feel that way.
Nothing had materially changed in my life. I was just indifferent to almost everything. Life passed in sepia tones. No highlights or lowlights, no contrast or brightness. Birthdays, anniversaries, celebrations were dull and flat. This had become my new normal. I was high functioning just bland and blah. My world had become white bread.
After about two years I became increasingly aware that my short-term memory was declining. Initially I put it down to ‘senior moments’ and later a consequence of a youth spent dabbling in mind-bending substances.
Eventually I no longer bought these excuses. My memory sucked both at home and at work and it was pissing me off.
Then one morning in the bathroom I had what I can only describe as a seizure or fainting. One moment I was going about my routine, the next I woke on the bathroom floor, disorientated. An unnerving start to my day…
Something was going on in my mushy brain and it wasn’t good. The last time I experienced something like this was 15 years prior when I was a regular and heavy stoner.
I became convinced that my daily Lex was a significant factor in these strange, unnerving experiences. I wanted to return to cold, clear reality.
I started to research what was involved in tapering off Lexapro. There was lots of advice not to cold turkey. Depending on your genes and circumstances, awful things could follow.
I started to read about other people’s experiences of “discontinuation syndrome”. While experientially similar, it’s not “withdrawal” in any medical sense. I soon became angry with Dr. Preppy-Boy for not knowing how bad, hard or dangerous this could be.
On Jan 10th 2016 I halved my daily 20mg dose, taking half a tablet a day. They’re easy enough to split in half. I proceeded to take this 10mg dose for the next 8 days with no noticeable effects.
On Jan 18th I halved the dose again to a quarter tablet (5mg a day).
During this week I want to see Dr. Preppy-Boy to inform him of my intention and the progress of my discontinuation plan. He told me 5mg was a pediatric dose and negligible. He warned me I might feel a ‘little rough’ for a few days but it’s not dangerous and would pass. He seemed unaware of reports of serious discontinuation problems.
I left his office feeling pretty good that I was almost done with these things and on the cusp of returning to reality and the ranks of the sane. My monthly date with the unreasonably attractive pharmacist was coming to an end.
On Jan 31st I stopped taking Lex entirely.
By Feb 2nd I was experiencing discontinuation “roughness” in the form of dizzy spells I’d liken to vertigo. They’d come unexpectedly, suddenly and last 60–90 seconds.
Dizziness was accompanied by fitful sleep and strange and vivid dreams. The dreams surprised me, as I couldn’t recall experiencing dreams for many months leading up to this.
By Feb 3rd (Day 3) the dizzy spells were coming every few hours and I was noticeably irritable and tired due to the restless and fitful nights.
Things seemed to peak on Feb 5th with a heavy night sweat. The experience was like breaking a fever.
By Feb 6th I was no longer experiencing any of the symptoms I had been quietly coping with.
March arrived and I found myself fully awake again. I was functioning well and equipped to understand and manage my behaviors. Thanks largely to Ms. Buddha, my therapist.
I was now thinking clearly enough to reflect on just how much Lex had numbed my world; turning the volume down and cancelling out the background noise. It had been quiet enough to actually hear, listen and comprehend what the therapists were softly explaining to me.
I came to realize that Lex hadn’t cured or materially changed anything. It just gave me enough emotional stillness to rest and reflect.
My pain is still there, as is my anger. Their constant presence has become familiar and reassuring. I feed, water and tend to them. I just don’t let them out of their cage.
I’m not the man I was before this dance started. I’m not better or healed; just different. I credit Lexapro for being the catalyst for that epiphany.
I look back on the experience as uncomfortably as I do my first school disco.
I still can’t dance.