My Love/Hate Relationship with Anti-Depressants
Four years ago, I had a nervous breakdown, driven by intense health anxiety. Basically, I thought I was dying, and couldn’t focus on anything else, receding into my man-made shell and desperately trying to block out the world around me. Eventually, and fortunately, I hit rock bottom. After racking up the frequent flier points at various medical offices, where I was repeatedly told “you’re fine,” “nothing is wrong with you,” and “everything looks good,” I finally came across a thoughtful neurologist that said something that altered the course of my life forever: “You have a problem, but it’s not one I can help you with.” Of course, in my journey since to mental wellness, I have developed a complicated relationship with this form of diagnosis. It seems that the default answer from doctors to patients with symptoms that can’t be explained is to send them to a psychiatrist. But in many ways, coping with those symptoms and learning to live in my new normal was exactly what my troubled mind needed. Here I am, 4 years later, living an incredibly fortunate life and preparing to marry a woman that I don’t deserve (shhh…don’t tell her!). I’ve channeled my anxiety into two books and hundreds of meaningful conversations with like-minded people who have had to overcome obstacles put up by their own brains. For this, I am eternally grateful for the “rock bottom” I reached, because through the support of my family and friends it became a springboard that launched me to new heights.
Still, as anyone with an anxiety disorder or depression or any other mental health issue will attest, one simply cannot “beat down” the forces in the mind. We can only hope to contain them. In our society, containing those forces often involves medication, either through SSRI anti-depressants or true anti-anxiety prescriptions. As mental wellness has risen to the forefront, the prevalence of diagnosis and in turn, prescriptions for these medications has also risen dramatically. A quick search showed that in 2011, 20% of Americans were on some form of prescription medication for mental health, and I can only imagine that number has increased substantially in the five years since.
Yet, there is still a stigma associated with using medication to help alleviate the symptoms of a mental disorder. Weird, right? I certainly held that stigma in 2012 when I initially was prescribed the SSRI Zoloft for my anxiety. In fact, I tore up the first three prescriptions I received before finally relenting and starting on the medication, in addition to the psychiatric therapy I received on a weekly basis. And that is where my love/hate relationship with the drug began. Over the next year and a half, I slowly became less focused on my unusual physical symptoms, and built my life back up. While I attribute some of that recovery to my medication, I also didn’t want to be on it for the rest of my life, because, well, that can’t be good for you, right? So with the guidance of my doctor, I weaned off of it and for the next year was on my own…until my anxiety got the better of me once again.
In 2014, I was traveling A LOT. Like, didn’t see my own bed for over a month. That disruption probably contributed to the anxiety returning, and exacerbating my physical symptoms. Fortunately, because of my therapy I was better equipped to deal with it and recognize it this time around, and got back on Zoloft. Things settled down.
And that brings us to now. A few months ago, I relocated to Los Angeles from New York City to live on the beach. I wanted to try a lower-stress environment to see if it would help my symptoms, and decided once again to wean off the medication. As I write this, I’ve gone from 100mg down to 12.5mg, and will be off the medicine again within a month. My physical symptoms are definitely more pervasive, but the possible side affects of Zoloft include the physical symptom that bothers me (muscle twitching), so to be on the medication for the rest of my life and not know if it’s really helping is a struggle for me.
I know that a big mistake made by mental health patients is that they get “better” and fall into a false sense of comfort, believing they can get off the medication. So I’m not looking for a lesson on that. But for the majority of us that are functional albeit anxiety-ridden people, where does the line fall? The quality of life at least initially certainly improves with medication, but is it the most effective way to treat anxiety? That part I’m not sold on.
Here’s what I do know:
Every one of us has a completely unique set of circumstances, and an equally unique chemical and environmental make-up in our brain. So there is no magic formula, unfortunately. For me, medication has worked tremendously to pull me out of the darkness and equip me with the tools to be myself once again. For that, I am eternally grateful, and will never judge myself or others for being on medication. In fact, I’m guessing within a year I’ll be back on it myself, though I’m hopeful that’s not the case.
The social stigma that surrounds this topic is utter bullshit. As my great professor Greg Hall once told me, “People get sick in the head like they get sick in the body.” There should be no shame in admitting that you have a problem and need help. It doesn’t make you weak. It doesn’t make you a failure. And it doesn’t define who you are. Whether you require medication to help you is a conversation that only you and your doctor should have. And whether or not you want to be open about your struggle with mental health is totally up to you. But know that it’s OK to be open about it. When I talked about my battle initially, five of my closest friends approached me to tell me they, too, were seeing someone to help them. The world is a tough place. It’s OK to fall down once in a while.
And to policy makers and leaders, it’s time to recognize that mental health is a real issue in our society. The amount of red tape I have had to climb through to get coverage for my health anxiety has been insane. You can either cover my therapy, or I will continue to go to highly-priced specialists that will cost far more and give me the same diagnosis…where is the logic there? Research backs up this idea. A recent study led by Dan Chisholm, PhD, of the WHO’s Department of Mental Health and Substance Abuse, in Geneva, Switzerland found that for every dollar spent on mental health treatment, the return in regards to productivity and health could be four dollars or higher! I know that all that money I’ve spent on therapy has paid off big time in the quality and happiness I’ve regained in my life.
DISCLAIMER: I am no doctor, so my perspective is only informed by my own experience. My hope with this piece is to share my struggle in the hopes that others having the same internal conversation know that they are not alone!
I’ve written extensively on my mental health struggle and how it inspired a new path to success in my latest book, The Success Disconnect: Why the Smartest People Choose Meaning Over Money.