Like most, my journey with psychiatric medication has been fraught with uninformed decisions, unintended consequences, and unsettling uncertainties. It began in the spring of 2017. I had convinced myself that random minor pains were signs that my death was imminent (and that was if I didn’t somehow die in a plane crash). I compulsively visited doctors in search of the fatal source hidden away inside my own body. However, my constellation of symptoms didn’t lead to any certain diagnoses, which meant no relief to my anxiety. My partner, noticing my decline in mental well-being, wisely advised me to seek psychiatric help. My first psychiatrist diagnosed me with OCD along with the recommendation I take a robust amount of antidepressants. I was terrified and in my already panicked state determined that these pills would kill me. After about a week of stewing with my diagnosis and one more visit to a doctor to investigate my mystery pains, I decided I would give psychiatric medicine a chance.
My mom, a pharmaceutical aficionado, recommended I try a medicine that she was on for “blood pressure reasons.” I knew she suffered from her own mental illness, but she is convinced the SSRI she takes is for lowering her blood pressure. I told my psychiatrist I would relent to taking a medicine called Paxil for no other reason than I knew it wasn’t fatal for her. He said that was fine but wanted me to know that it isn’t widely used and therefore not very easy to find. He knew I was teetering and knew this was his opening for a positive intervention. I took this pill without any real idea of how the medicine would relieve my symptoms or any potential negatives that come along with it. From my limited experience, people who didn’t like taking their medicine were just rebellious and wanted to be sick. With my medicine, I gained twenty pounds in two months, my libido disappeared, and orgasms became an elusive whisper only experienced under the greatest efforts and focus. My anxiety decreased but I became depressed about my current state. I became one of those rebels who wanted to quit their medicine.
After eight months of enduring Paxil, I emailed my psychiatrist and informed him that my OCD was gone; therefore, I didn’t need my medicine anymore. He cautioned me that many people relapse when they decide they need to go off medication. He offered to meet with me and discuss it further, but it was too late. I had already decided. I followed his advice and correctly tapered off the dreaded Paxil. Within three months of quitting Paxil, I was so overcome with anxiety, the thought of jumping off a roof could only purchase a few moments of calm and peace at a time. Harkening back to my earlier malaise, this current episode was triggered by food poisoning. My serotonin-starved brain believed death was imminent unless I spoke with every doctor in the city. My disturbed partner, seeing the utter mess of a human I had become, called for emergency psychiatric help. Thankfully, I saw a new psychiatrist who quickly brushed off my earlier OCD diagnosis and treated me for major anxiety and depressive disorder. I told her my past experience with Paxil, and she was shocked I had been allowed to take it. I was prescribed Duloxetine, which she promised would have lighter side effects.
Thankfully, it was true, I have had a better experience with Duloxetine. However, the symptoms that I had previously are still here. I suffer from increased appetite, lower libido, and erectile dysfunction. Admittedly, some of this could be due to the fact that I am getting older; however, some of it is due to the medicine. With the trauma of going off my medicine last time still piping fresh, I dutifully followed my doctor’s orders. After about a year of progress in my mental health, both my counselor and psychiatrist determined it was time to try to go off my medicine. I began tapering but this time I encountered a few problems that I didn’t remember from my last tapering. I had trouble sleeping. My moods swung dramatically low to the point that embarrassment couldn’t prevent me from sobbing in public. I spoke with my psychiatrist and she recommended another tapering method. It was to take the lowest dose possible and to take it every two days. This sucked. It felt like a mini-withdrawal every forty-eight hours.
After my last scheduled pill, I quickly descended into an insomnia-fueled downward spiral. This episode was triggered by a general feeling of malaise from jetlag and a weird bout of vertigo. I quickly began my regimen of Duloxetine again and within ten days I was semistable. My psychiatrist pointed out that my anxiety was probably triggered by hidden family trauma that was unearthed during my brother’s wedding festivities, which had unhelpfully coincided with my tapering. So for the next year, I went back to therapy to root out how my childhood family trauma led me to become a hypochondriac. It is depressing that my relationship with psychiatric medication has turned into a vicious cycle that moves from suicidal despair, to gradual acceptance of my poor mental health, to eventual complacency that is hopelessly optimistic of what life sans medication would be like.
Complicating this journey is the fact that my father is two shakes shy of a full-blown faith healer. Every psychiatric problem is demonic in origin. Depending on medication is admitting spiritual defeat. True Christians can give their pain to God and be healed instantaneously. This influence is just one more barrier I have to overcome to treat my mental illness. It’s hard not to see medicine as accepting spiritual defeat. Some would even say I am denying myself the opportunity to fully trust in God. However, if I thoughtfully reflect, I accept that I am sick and I am taking the steps I need to slowly manage my mental health. I am proud of the progress I have made in therapy. I admit to myself and others more publicly than before that I have a disease and that I need to treat it. I accept that medicine has played an important role in my treatment. I even accept that if I ever go off my medication, it will be difficult and I will have to deal with the life-threatening beast of insomnia again. But, I hope that when that time comes I will be able to handle it. But, I honestly won’t know until I try.
Just recently, my therapist mentioned to me that I should think about going off my medication again. My heart leaps at this chance. The stigma from my faith and family still stings, and I impulsively want to swat it away. My mother is in denial and my father is in opposition to treating mental health seriously. There is a valid point in treating mental illness like any other malady, but I also know that it is more complicated in many ways. Many of our diagnoses are based on self-reported symptoms. There is no blood test or outward sign to confirm my anxiety. The science behind brain chemistry is nowhere complete. Clearly, I need to do more work on battling the stigma around taking psychiatric medication. But, when I do try to go off my medicine, I can’t view success as taking that final pill. Even if I can never go off medicine, I am not a failure. Even if I fail multiple times going off medicine, I have to remember that each experience, however negative, I can learn more about myself so that I can take better care of myself in the future.