Why I quit taking antidepressants after 12 years — and went back to them
Imagine me floating lazily on a canal boat in Amsterdam with my teenage children on a beautiful summer day, on our way to the Van Gogh Museum. We drove through Vondelpark in the sun and later went to see a Banksy exhibition. A perfect day. Except I was throbbing with fear and trying to hide it from my kids.
worse than fear – real fear, waves of it crashing over me like an electric current. There was no external reason – I am not an anxious person and had no existential fear before. But I had to take a deep breath just to keep myself from actually freaking out. Maybe it was menopause – I’d recently had surgery to remove my ovaries after a cancer scare that turned out to be a false alarm. Wasn’t anxiety a symptom of menopause?
Back home, my GP suggested I go back on the antidepressants I had recently stopped taking at a higher dose. A consulting gynecologist suggested the same thing. Almost immediately, my anxiety dissipated and I felt normal again.
That was five years ago and I stuck with them – SSRIs, selective serotonin reuptake inhibitors, the standard prescription used by millions to treat depression and anxiety, the most famous being Prozac. My menopausal symptoms, initially severe, subsided and plateaued. Was it because I was still on antidepressants, or was it the HRT, yoga, whole foods, and all the other things I did to cope?
Last October, I read an article in The Economist that suggested that most people who take antidepressants don’t need them, and that only 15 percent of users get any significant benefit beyond that of a placebo. Maybe it was time to put her down again, this time for good.
By then I had been on Prozac for 12 years, minus a few months around this trip to Amsterdam. Before I started using them, even though I’d eliminated all obvious external tranquilizers from my life—especially alcohol—there had still been days when I’d struggled to get out of bed, days when the Imagine doing the dishes felt like climbing Everest. I felt very irritable, which was terrible.
My knowledge of depression was minimal – didn’t that mean sitting alone in a darkened room listening to The Cure? I had read Elizabeth Wurtzel’s 1994 memoir Prozac nation and had nothing to do with all the breakdowns and suicide attempts. And because my ex-husband had died of untreated depression in 2006, I had always associated the condition with its worst, most irreversible outcome.
It wasn’t until I heard people talk about depression in 12-step meetings in far less dramatic terms that I realized they were describing how I was feeling. Anger, stress, irritability, indecision, overwhelmed – I had no idea this was part of depression. And like many others, I had self-medicated with alcohol to relieve it.
After a standard GP assessment showed that I was indeed on the depression spectrum, the doctor offered antidepressants. Although I had already spent years doing tons of therapy and had psychologically unpacked just about everything there was to unpack, I had never taken any prescription drugs before. I was 42, sober, and my life was stable and content. Why couldn’t I fix this myself, with exercise and diet and more talk therapy when needed? Wasn’t it a cop to treat myself? But I took them anyway after someone reminded me that if I were diabetic I would take insulin, or if I were asthmatic I would use an inhaler, so why should mental health medication be any different?
Two weeks later, at a busy supermarket checkout with my kids, I felt something change—clouds lifted and sunlight shone through. As if my spirit were exhaling. It was extraordinary, it happened at a precise, tangible moment. I realized that felt so “normal”. It felt like a huge breakthrough.
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Antidepressants make an important contribution to psychological well-being for many people. Photo: Getty Images/iStockphoto
As we all know, depression is a cold of the mind that will affect 12 per cent of the adult Irish population in 2022, according to a study by Maynooth University, Trinity College Dublin and the National College of Ireland in a study of 1,100 participants. Another 7 percent were found to be afraid. (In the UK, the number was 17 percent as of summer 2021, according to the Office of National Statistics, in the US it was about 10 percent of the total population, and worldwide, according to the WHO, it was about 5 percent — the lower figure may reflect a cultural reluctance to identify as depressed identify). The good news is that both depression and anxiety are highly treatable through medication and therapy. But does that mean you have to take antidepressants forever?
“The recommended duration of use used to be 6 to 12 months, which has been extended to two years,” says consultant psychiatrist Ivan Murray, medical director of the Neuromed Clinic in Dublin. “But people stay on them for a lot longer.” This, he adds, is not harmful. You can’t get antidepressant poisoning.
But did I still have to be on them? I decided not to do this and gradually reduced my daily dose over a period of weeks to avoid withdrawal symptoms – if you’ve ever accidentally gone on vacation without your Prozac, you’ll know it can feel a bit uncomfortable : brain zaps, general feeling of emptiness, headache, sleep disturbances. I followed medical guidelines and did it right by reducing it in small increments rather than rushing it.
According to Harvard Health, the drug takes about 25 days to leave your system.
A few weeks after that I started not feeling well. Irritated, stressed, overwhelmed. snappy. Crying during savasana on my yoga mat. I felt like chicken licken like the sky was about to fall. Granted, there were external stressors—crazy mortgage rates, financial uncertainty, and the death of my elderly father—but my reaction seemed disproportionate. I felt like I was drowning. I did it. I was determined not to need antidepressants anymore.
Until one day my daughter said, “Oh my god Mom, what’s the matter with you – why are you doing this to yourself?” I think I yelled at the dog. (I never yell at the dog. I love the dog.)
“Life is hard enough,” says Ivan Murray. “To get well, all parts must be used, whatever works. I would always say yes to going off antidepressants because that’s how you find out if you need them or not.
“Your own experience is unique to you – you use what works for you. They are only medicines, not cures, which is why psychiatry sometimes fails by exaggerating them as cures. There is no brain chemistry in these pills. But SSRIs are effective because they turn off the symptoms of depression. Being healthy is like baking a cake – it takes several ingredients. Drugs, therapy and lifestyle – not just diet and exercise, but also social factors.”
Medications are not entirely foolproof. A friend who also uses standard SSRIs told me how hers suddenly stopped working for her after several years. She experienced a mood swing that she couldn’t explain and wouldn’t go away, which unsettled her and affected her ability to function properly until her doctor referred her to a psychiatrist who changed her medication. She was soon back to normal.
“This is called tachyphylaxis, when antidepressants sometimes stop working for no apparent reason,” says Dr. murray “Its causes are unknown, and it can be distressing — but it can be addressed by changing the dosage or switching to a different antidepressant.”
Meanwhile I continue. I may do another review at a later date, but for now I am pleased that antidepressants exist and that I have access to them. When it comes to mental health, pragmatism is key. Why suffer?
Safe Withdrawal Tips
The psychiatrist Dr. Ivan Murray says: ‘Do you have a rationale for stopping medication. Maybe they don’t work, or you want to switch to a different kind. The most important thing is to do it slowly and under medical supervision. Withdrawal can be serious if it is involuntary. I would suggest a tapering off period of at least six to eight weeks.
“Otherwise, your original symptoms may come back, but plus-plus – so if you’re using antidepressants for anxiety, your anxiety could be even worse if you rush off it.” It can be extremely uncomfortable. If you’re on, say 40 mg of fluoxetine [aka Prozac]go down to 20mg for a few weeks and see how you do. If you’re comfortable with that, go down to 20mg every other day and see how you feel again. This process would absolutely take at least a month, probably longer.
“And if you’re not feeling well, take a step back. Keep the antidepressants in your treatment arsenal. There are no hard and fast rules.”
Consult your GP before making any changes to your medication. See aware.ie for more information on depression
https://www.independent.ie/life/health-wellbeing/health-features/why-i-stopped-using-antidepressants-after-12-years-and-went-back-on-them-again-42326990.html Why I quit taking antidepressants after 12 years — and went back to them