An article published by Benedict Carey and Robert Gebeloff discusses an issue many people never really consider when they begin taking antidepressants; the risk of quitting. I would like to offer my thoughts about this article, as I myself am on antidepressant medication.
I began taking Zoloft in February or March of 2018, a step that in my mind was long overdue. I had suffered with severe depression and anxiety my entire life, to the point where I could barely function on a normal level. I was antisocial, withdrawn, always cranky, uninspired, and detached from reality. I went through two antidepressants before settling into Zoloft, which seemed like the perfect fit for my personality. It dulled my anxiety, which to me seemed like a tiny man running around inside my head, constantly telling me that I wasn’t good enough and people were watching me and no one actually liked being my friend, that they were just using me. After starting Zoloft, that voice was silenced. If you’ve ever seen the movie Moana, when the spirit of the Island turns into that horrible volcano demon, that’s what my anxiety was like. It lashed out at everyone, and tried its hardest to isolate me. The Zoloft was like the heart of the Island being returned.
My depression was how I identified myself. It was the reason I used to justify my bad behavior. I hurt so many people through the years because “I was depressed”, or “I was anxious”, and part of that might have been true, but I now realize that being depressed was never an excuse to be a shitty person.
So there’s some backstory. Now, onto the article.
They state that
Antidepressants were originally considered a short-term treatment for episodic mood problems, to be taken for six to nine months: enough to get through a crisis, and no more.
and that makes sense. Antidepressants may have originally been designed to be taken to get through a difficult time in your life, but that is an example of an environment, and non-permanent form of depression. Someone might become depressed after losing a family member or ending a relationship, but that depression is not a long term issue. Things like that are fixed with time and experience. There are professionals there to talk to about these huge life changes, which can be shocking and depressing.
However, this does not take into account those people who suffer from long term, genetic, or clinical depression. The depression and anxiety that has been there since before they could remember. The depression and anxiety that made their childhoods into nightmares.
“Most people are put on these drugs in primary care, after a very brief visit and without clear symptoms of clinical depression,” said Dr. Allen Frances, a professor emeritus of psychiatry at Duke University. “Usually there’s improvement, and often it’s based on the passage of time or placebo effect.
Yes, as was the way I began my prescription. I filled out a questionnaire to get a broad idea of how bad my anxiety and depression were, and then as quick as ever, I was taking my first pill. Now, was my improvement in mood simply because I was leaving a difficult period of my life, or that I was under the placebo effect? It’s possible. But as someone who has suffered from depression for a very long time, I knew one thing; I was feeling better than I had in years. Placebo effect or not, the pills had changed how I thought about my life and the world around me, and it was for the better.
The article goes on to state that this placebo effect might mean that a patient will end up taking a drug that is basically useless for a much longer time than is necessary. And long time use is one of the things that leads to such bad withdrawal symptoms. Ok, fair enough. However, the symptoms they state sounded an awful lot like symptoms of depression and anxiety returning. Of course a person who was depressed, starts taking pills, and then stops is going to once again experience depression, if it’s clinical. If the depression is environmental in nature, then yes, by stopping the use of antidepressants, they can return to a normal life. But if the depression continues after the discontinuation of the medication, is that withdrawal? Or is that simply the mental illness returning?
Antidepressants are not harmless; they commonly cause emotional numbing, sexual problems like a lack of desire or erectile dysfunction and weight gain. Long-term users report in interviews a creeping unease that is hard to measure: Daily pill-popping leaves them doubting their own resilience, they say.
Emotional numbing? For someone like me, who feels everything amplified ten times stronger, that’s a good thing. I spent my entire life feeling so many feelings, and feeling them so strongly, that I could barely function. Some call it being empathic, some call it being sensitive, some call it being a little pussy. Whatever. There are just certain people in the world that are too emotional, and I was one of them. By numbing my emotions, I was able to function on a normal human level. I stopped overthinking everything and started taking action.
“Many were critical of the lack of information given by prescribers with regard to withdrawal,” the authors concluded. “And many also expressed disappointment or frustration with the lack of support available in managing withdrawal.”
It is true that during my doctor’s appointment to get on antidepressants, I was not told there would be such a thing as withdrawal. However, as I have weaned between several different drugs, I know the procedure. And I understand that going from a state of drugged to drug free is obviously going to carry some side effects. However, who would ever want to stop taking antidepressants. If I ever had to go back to the way I was before, where I barely left my house and it took every ounce of strength just to wake up in the morning, and putting on makeup just seemed like entirely too much work…if I had to go back to that life, I would be miserable again. I know that my depression would return. My depression was not caused by an environmental issue. It is something that has been there since as far back as I could remember. There is a chemical imbalance in my brain. That’s not something that just corrects itself.
Is it the same for everyone? Obviously not. These are just my thoughts based on my own experience.
In one of the earliest published withdrawal studies, researchers at Eli Lilly had people taking Zoloft, Paxil or Prozac stop the pills abruptly, for about a week. Half of those on Paxil experienced serious dizziness; 42 percent suffered confusion; and 39 percent, insomnia.
Among patients who stopped taking Zoloft, 38 percent had severe irritability; 29 percent experienced dizziness; and 23 percent, fatigue. The symptoms appeared soon after people were taken off the drugs and resolved once they resumed taking the pills.
Stop the pills abruptly? Well that would make anyone have withdrawal symptoms! If you stop a medication cold turkey, you are going to experience things like nausea, dizziness, and confusion. You need to wean off a drug safely in order to prevent severe withdrawal symptoms. And of course you are still going to have some symptoms, but weaning causes a less severe reaction.
And as another point, most of the symptoms listed about for “withdrawal” sound to me like it’s merely the symptoms of their depression and anxiety coming back. I often experienced insomnia, confusion, and fatigue during my years with depression. So can these really be counted as withdrawal? What if it’s just their mental illness returning? And the symptoms stop when they restart the pills? Well of course.
The drug blunted her PMS symptoms, she said, but also caused her to gain 40 pounds in nine months. Quitting was nearly impossible — at first, her doctor tapered her too quickly, she said.
She succeeded in her last attempt, in 2015, by tapering over months to 10 milligrams, then five, down from 20 milligrams and “finally all the way down to particles of dust,” after which she was bedridden for three weeks with severe dizziness, nausea and crying spells, she said.
Blunted PMS symptoms? Sounds like a regulation of emotions. And gaining 40 pounds? Perhaps the gaining of weight is in response to finally eating a healthy diet, as several people who suffer from depression and anxiety have very unhealthy eating habits, like skipping meals due to lack of appetite or energy. And being bedridden for three weeks with severed dizziness, nausea, and crying spells? Once again, sounds like several of the symptoms I often experienced when in the grips of severe depression. Of course these symptoms may be amplified by the lack of the drug. I’m not saying that withdrawal is entirely bullshit. Of course there is always the possibility that she was indeed experiencing withdrawal from her drugs. However, crying spells were something I often experienced when depressed, although I never experienced extreme dizziness. But that is to be expected when you stop taking a drug.
“Had I been told the risks of trying to come off this drug, I never would have started it,” Ms. Hempel said. “A year and a half after stopping, I’m still having problems. I’m not me right now; I don’t have the creativity, the energy. She — Robin — is gone.”
Again, sounds like clinical depression to me. Just a return of the mental illness.
Overall, this article does draw attention to something that is not often considered when discussing antidepressants, and it was very enlightening to read. While I did have some personal points to make about the article, which I have done above, I do agree that more studies should be done around the discontinuation of antidepressant medications, especially with the increase of users throughout the years. To educate myself further I will be having a discussion with my doctor about the effects or side effects of terminating my medication, which I eventually plan on doing if I feel stable enough to live again with my normal brain functioning.
Do any of you have any thoughts or opinions about this article you’d like to share? I would really be interested in what others think about this.
Also, just a reminder if you are one of those who takes medication, don’t forget to take your pills today.