Life after antidepressants

Antidepressants saved my life at least once and might have saved my brother’s if he’d sought help instead of taking his life. Saturday, November 22 is International Survivors of Suicide Loss Day. This is the story of why I am grateful I had medication and how and why I hope to avoid it for the rest of my life.

It was early 2001 when my mom begged me to see someone and my then-boyfriend told me he “didn’t want to live like this.” My first year of teaching high school had been beyond rough. I cried every morning in the shower and struggled to get any sleep before I had to wake at 5 a.m. It took a lot of effort to figure  out my medical benefits and make some appointments, but there seemed no other way.

The doctor I found through my health insurance plan listened to me and noted that sometimes patterns we’ve learned in our family are as much a part of the issue as chemistry. I didn’t disagree, but I just knew something had to change. He joked drily after he got back from his supply closet to see which brand he had a starting sample of: “Here’s your vitamin P.”

Once the medication had been in my system for a week or two, the difference was dramatic. It was like I’d put on glasses for the first time. “You mean everyone can see individual leaves and not just a green blur? You mean it’s possible that people are not criticizing me all the time? People actually walk through life feeling like smiling?”

This was good stuff. It was a new way of living, this thinking positive thoughts without trying! I took my time getting to know the new me. My doctor supported my plan to stay on medication through my wedding (now that my relationship had turned around), keep up my talk therapy, and wean off the happy pills in preparation for conception after I stopped taking the birth control pill. We’d had two good years together, me and Paxil, but I had learned new skills and was ready to be done.

I tapered my dose gently, but still, during those last few days of taking only a crumb and then nothing, the brain zaps and vertigo freaked me out and convinced me I wouldn’t touch the stuff again. I didn’t want something like that in my body again.

But then, several months later with a new diagnosis of Graves’ Disease, autoimmune hyperthyroidism, and the frenzy and sleeplessness to prove it, my endocrinologist said, “Well, we know Paxil works for you. Let’s get you some more so you can sleep while we’re waiting for you to have the tests to determine how my anti-thyroid medication you’ll need.” That testing was going to take a few weeks, so I took the script and headed to the pharmacy.

This time, the education I underwent wasn’t just mental. Over the next several months, I learned a lot about diet and lifestyle changes that would support my body. I cut out gluten, dairy and soy and started eating animal protein again after years as a near-vegan. I kept up yoga at home but quit my class in favor of learning tai chi. I read books that helped me calm my mind. I got acupuncture. In addition to working with an endocrinologist, I consulted with bodyworkers and a naturopath who recommended nutritional supplements and detox strategies. And I got better.

The second time I went off medication in December 2004, I had only a mild headache for a few hours; my body was so much healthier from all the lifestyle changes I’d made. I learned through that year that my system had gotten really depleted and that it was more than a little sensitive. Through two subsequent pregnancies, my thyroid disorder has never come back, and I’ve never been tempted to go back on antidepressants.

Okay, I’ve been tempted when something gets in the way of my doing all the things that have now collectively become my substitute for medication: sleep enough, eat super clean, have time alone to write, spend time on my yoga mat and walking in the woods, and get support through bodywork or at least by talking with friends.

But not tempted enough. Because my body has become so sensitive, medication is just not an option anymore. I can’t even go in the pool with my kids or wait while they get lessons in an indoor pool without having a reaction to the chemicals in the air. Put me in an elevator with someone wearing perfume or in a bathroom that’s just been cleaned with mainstream sprays, and my skin will itch and my head will hurt. Take me out to dinner and chances are that if my face doesn’t turn a little bit red or the skin on my elbows later gets inflamed, I will end up with tummy trouble. It’s a delicate balance.

My body works if I am very, very kind to it, but I’m pretty clear that my liver is, at 41, too tuckered out from all chemicals I fed it at 14, after my brother committed suicide and I tried non-prescription methods to dull the pain. My skin issues and my labwork show me that my liver, while not diseased, is working really hard even in the best of conditions. I just can’t expect it to process medication without something else breaking down.

Anti-depressants are strong and not without side effects. Although I’m super glad more people are confronting mental illness and claiming their right to feel good, I’d like to see the goal be how to get well enough so that people can do what is necessary to make sure they won’t need meds forever. As Karen Brody talked recently at a conference about anti-anxiety medication being a bridge, so too I would like to think that people could use their time on medication, when they are feeling good, to investigate some ways to make systemic changes that can help them maintain the positive outlook when they go off.

Whole books could be written on the subject and have, but here are my top five suggestions for supporting your body at a fundamental level. I’d love to see all prescribing doctors (which I am decidedly not!) work with their patients in these areas. Always work with your healthcare practitioner to figure out what is best for you.

1. Sleep. Early and often. Resist the temptation to be productive when everyone is in bed. Sleep before midnight is crucial to your body repairing itself. That’s the time it releases all the crud you’ve accumulated from food, dirty air, and stress. If you don’t sleep when those processes are supposed to happen, the crud stays with you.

Even if your schedule is erratic — if you’re dealing with a breastfeeding baby or bedwetting child and you can’t get enough sleep at night – take naps. Read Arianna Huffington’s Thrive for more on sleep evangelism.

2. Breathe. There is so much research about breath and mood and breath and stress. Just know that holding your breath actually increases stress hormones, breathing shallowly only into your chest or through your mouth keeps you in fight-or-flight mode, and breathing deeply and into your belly puts in you the calmer, restorative parasympathetic mode. If you can’t sleep, at least breathe!

3. Eat well. Your body wants food it can recognize as food, not stuff made in a factory. Respect bioindividuality and do not assume that what works for one person will work for you. I like a lot of what Julia Ross says in The Mood Cure, and I believe in what Dr. Natasha Campbell-McBride says about the gut-brain connection in the Gut and Psychology Syndrome Diet. But some people need lots of raw foods and other people need a traditional diet with lots of animal protein and fat. Many people feel better when they eliminate gluten or dairy, but others don’t. Give yourself some time to figure out what works for you.

What’s important is to eat the most real food you can from the perimeter of the grocery store and not from a box in the middle. Any step in that direction is a great step.

If at all possible, work with a holistic health coach. If you can’t find one nearby, there are plenty who work over the phone. The best ones will do a thorough intake ahead of time and have you keep a food diary before you even get started. The investment will be well worth it to not suffer the frustration of false starts and wrong-for-you paths. And that leads me to the next point…

4. Get help in any way you can, in your daily life. Shore up a support system, whatever that looks like for you. Be unapologetic in asking for help. This is your life and your health. The best give you can give to your kids is a well you, so even if it means time alone or less spending money for them, the dividends will pay out over the long term.

Getting help could look like hiring a babysitter so you can have a break, even if you don’t have anywhere to go but the sidewalk. It could mean a massage, or Reiki, or talk therapy, or just calling a friend and telling her you need to get coffee. It could involve you asking family to come visit (or to stay away!) And it could just mean asking someone to tell you “Good for you” when you’ve said “No” to something.

5. Do something that makes you smile. Or, hell, just smile! Fake it til you make it! Or dance, write, draw, sing, read, or pleasure yourself there. Mix up the happy hormone cocktail that will put you in the frame of mind to keep thinking happy thoughts. The more you practice “happiness,” the easier it will come. Wear down that happy pathway so it becomes the one much easier to take.

This is why I stayed on meds for a long time: to establish habits of being that would replace the negative ways I’d been thinking for nearly thirty years. Sometimes it takes effort and intent – sometimes a whole lot of effort – but it’s the truly sustainable choice.

What works for you to feel your best self?

For more on the loss of my brother and how it has affected me as an adult and as a parent, see my November 22, 2014 post on Scary Mommy: “Remembering the Uncle My Children Will Never Know”. Many thanks to Jill Smokler for giving me the opportunity to share these reflections with her readers.