Photo by Christina Victoria Craft on Unsplash
I sat down in the stale psychiatrist’s office. It was my first time ever meeting with one, I was eighteen years old. The building was bland; the halls were too long. I could feel sweat pooling under me in the leather waiting room seat. The appointment began at 10 a.m. My blood pressure, temperature, and weight were taken by a nurse before entering the psychiatrist’s office. I sunk into the large chair across from the woman with many degrees hanging nearby.
“What seems to be going on?” the young psychiatrist asked me.
I settled into my seat. “Um, well, I can’t make myself speak in classes, I’m too anxious, it’s like my tongue gets caught in my throat,” I said.
“Hmm, okay,” the woman responded. She opened a manila folder containing a few pieces of paper—presumably documents from my counselor, who had recently set me up with her. “It says here you have some trouble with suicidal thoughts, too?”
Wow. Straight to the point, I thought, as if a psychiatrist would brush over major depression.
“Yeah, maybe more just like, general sadness? You know?” I said hesitantly. “Kind of like a cloud of bummed-out following me around.”
“Got ya,” she said. “Well, I think the first step is an anti-anxiety medicine, we’ll see if that helps with the other issues.”
“Okay,” I said. I glanced at the clock. 10:05.
“I’m also going to prescribe you a mood stabilizer,” she said after piddling around on her computer for a few moments. “I don’t want to give you an SSRI and have it cause an imbalance.”
“Okay,” I said, not fully understanding. I had no clue what an SSRI was at the time. (In case you are in the same boat: SSRI stands for Selective Serotonin Reuptake Inhibitor.) I myself was not, and am not, a mental health professional. My understanding was that this form of treatment, medication, was the route toward a life I had always dreamed of. A simple, easygoing, happy life. On my way out, I was given a piece of paper, which a pharmacist would later inspect and use to give me my new pills. Lexapro and Lamictal. I walked out of the office at 10:10 a.m.
I took these two medications for a few days before noticing any real side effects.
About a week into my new, medicated life, I was flying a kite at the beach with my friend. As the wind loudly ripped through the kite’s body, I accidentally let go and the kite went flying. My friend laughed, naturally.
I began to sob. I didn’t even really know why.
The following day, I woke up to a new pimple, as I did most days. Again, uncontrollably, I sobbed.
I revisited the psychiatrist.
“I don’t think these are working,” I said. “I keep crying. Like more than usual.”
“Hmm, well, that’s no good,” the psychiatrist said. “What do you want to do?” she asked.
The question stumped me. “What do you mean?” I replied. Isn’t this your job? I thought.
“Do you think you need an antidepressant?” she asked.
I did think I needed an antidepressant. I had thought that for years now. I didn’t think it was in the realm of possibility, though. I also didn’t think I had the power to say whether I needed them. What if I was a twisted, manipulative drug addict, deceiving my doctor into giving me happy pills? I mean, I didn’t think I was, but as a mentally ill person, it’s easy to consider that all of your problems are self-inflicted or entirely falsified. Those meds were designed for people with real problems. I was just an overly emotional person, a tad(very) uptight, and a bit of a pessimist.
“Do you think I need an antidepressant?” I replied.
“Lily,” she sighed, “are you depressed?”
I sighed. “I don’t know,” I said honestly.
***
Thus began my years-long process of trying to effectively medicate myself. Dosage increases, dosage decreases, and medication changes on top of medication changes on top of medication changes.
There are a few things I wish I had been forewarned about before dipping my toes into prescription play. First, I wish I had known that it was a process entirely of trial-and-error. I assumed there were set prescriptions for different types of mental health issues. I thought I would get a serving of the same stuff every mentally ill young girl took. A few trips to the psychiatrist showed me this was far from the case. Each time I returned, having more adverse effects from whatever pill I was getting used to, my doctor would ask me What do you want? At the time, I thought it was sort of cool, maybe even liberating, that I had so much say over what prescriptions I took. Looking back, I find it strange I was given so much power. I mean, I never studied psychology, nor medicine. I didn’t know much about anything in that realm. Of available prescription drugs, I knew Xanax was a big, bad, sleepy drug, and I knew Adderall was a fun, study drug, but of the prescriptions that could apply to my situation, the “good” kind of drugs, I knew nothing.
I now know almost everything about any medication someone with anxiety or depression could possibly be prescribed. This is not due to research; it is due to intense personal fieldwork in the matter. In the last four years, I have been prescribed more medications than I can count. Some of my least favorite include: Zoloft, Lexapro, Prozac, and Buspirone, to name a few supervillains.
The scary thing about the process of medicating yourself is that one day you’re switching medications because something isn’t doing the job correctly, and the next thing you know six months have passed, and you’ve been existing in a zombie-like state, completely unknowingly. When you have this realization, your first thought is I need to stop taking this shit, about whatever drug(s) you’re on. Unfortunately, as your doctors and pharmacists will drill into your head, you can’t just stop medication “cold turkey” (whatever that actually means) without a professional’s help.
Weaning off anxiety and depression prescriptions is a degrading process. Whatever pill is fucking you up will have to keep fucking you up in smaller doses for at least about a month after deciding to stop the medication. It’s a slow, cruel process. Each morning you carefully cut a mood-altering pill in half or fourths to ease your body away from relying on the drug. With each slice into a half or fourth of a pill, the meds seem to mock you. You can barely live without me, they tease.
***
Here are some things prescription medications can take from you and never give back:
1. A sense of independence. You will, for a long time, feel an allegiance to the pills that keep you from killing yourself. You will feel like you are too weak to protect yourself. You will feel less than.
2. A consistent, healthy libido. It only took a few months of SSRIs for my vagina to forget entirely how to self-lubricate. A lot of these pills have dehydrating effects, such as dry mouth. Sometimes, they give you dry pussy too. If you’re thinking, dry pussy? That’s it? Ever heard of lube? Well, yes. It’s not the end of the world, it’s not even the end of any singular sexual encounter if you have lube or saliva (and a vagina, as our arousal is irrelevant to the success of penetrative vaginal sex.) The bigger issue is your actual sex drive. It will excuse itself, like a neighbor offended by something said at a dinner party. While your body focuses on keeping you happy and stable and without a gun to your temple, it struggles to also remember to want sex. To many, this is common knowledge. Personally, I was unaware until the side effects actually started. No warning. Maybe my psychiatrist assumed I wouldn’t notice. That I was a virgin or a devout Christian.
About two years into being medicated, I tried to go fully prescription-free. I weaned off everything and tried to live my life in my natural, unaltered mental state. After a month or so of this, all sexual desire was slowly vacuumed out of my body. Being unmedicated, I investigated the effects of SSRIs on libido after quitting the drug(s). I laid in my bed for an entire day once finding out that these medications had the power to alter your sex drive—permanently. I read comments from people who said their libido never, ever returned. I wanted to sue my psychiatrist, for, I thought, murdering my horny chemicals. Some online comments said restarting meds fixed things, well, down under. This knowledge, plus the reemerging feeling of perpetual doom, were some of the reasons I decided to go back on medication.
3. Certainty. There is no promise that you will one day stop needing the medication. When I first began the process of medicating my mental health issues, there was no false advertising. There were no hints from anyone that these pills would one day become unnecessary. No discussion of “curing” happens. That would be malpractice. You have an incurable condition. You will spend the rest of your life wondering if you’re “fixed.” You can try life without meds, thinking, maybe I’m better now, but it might be worse than it was in the first place. And if you never try the meds at all, you won’t know if prescriptions could genuinely improve your quality of life. Because for some, they do. It is a slippery, unsure slope. It is a game of chancing your own neurological patterns and imbalances.
It’s like having a lifejacket surgically sewn into your body. You can’t drown. You can stick your face down in the water and resist the urge to come up for air, but standing still, not fighting the lifejacket, you can’t drown. But what if you want to touch the bottom of the neighborhood pool like all the other kids? What if you want to try scuba diving? Do you get the jacket surgically removed? Do you take on the gruesome journey of learning to swim on your own? Do you drown in the process? It’s all a guessing game.
***
Independence, sex drive, and certainty are three things that you can lose, perhaps momentarily, perhaps forever, as a result of prescription drugs. As a woman, a young woman-–a teenager as a matter-of-fact when this all began—it terrifies me thinking back to my unknowing, naive self stepping into the psychiatrist's office the first time. After a mere ten-minute session, my very first session ever, I walked out with two prescriptions. I articulated very few details of my personal condition, or of my body’s reaction to any drugs in the past. There was an immediate Well, try this! mentality. This is not uncommon. The sooner you try each medication the sooner you know whether it will make you stable, crazy, fat, asexual, or numb. You become your own guinea pig.
As the years tick on, I have, proudly, quit taking all anxiety medications. My anxiety is as persistent as ever, though I’d take my shaky hands, sweaty palms, and shy nature over feeling like an empty skull, floating through life–not feeling bad, not feeling good–any day. Some people don’t feel this way when taking anxiety medications; I am just not one of those people. I continue to take 300 milligrams of an antidepressant daily. Pushing through panic attacks is much easier than pushing through suicidal episodes. And much safer. My sense of independence has been slowly reclaimed. I run my life, not the drugs. My sex drive has, somewhat miraculously, reignited. (Unfortunately, this took a very, very, very long time.) Certainty is the one thing prescriptions have continued to keep from me. Every physical discomfort I face can be blamed on either my antidepressant or my lack of an anxiety medication. I can’t always believe my own pain, my own emotions. There’s always the chance that what I’m experiencing is the side effect of a pill (or lack thereof.) Plus, there is also still the uncertainty of whether I can survive without the little, stupid happy pill. It’s a tad demeaning.
The choice to medicate for mental health issues is one everyone must make for themselves. My equally neurodivergent partner, who has been diagnosed with Bipolar disorder, ADHD, and anxiety, has been unmedicated for almost three years. Weirdly, it was under the influence of prescription medications when they reached their lowest. It has been a steady incline of stability and peace since stopping.
For myself, not medicating my depression isn’t an option right now. Maybe one day it will be. Psychologists, therapists, and counselors will (almost) never prescribe medications. Usually, they can’t. Talk therapy has the power, for some people, to heal wounds no medication could ever touch. I urge anyone considering psychiatric help to first attempt therapy. If the need to medicate feels persistent, research all possible side effects of what you are prescribed before ingesting it. It’s much easier to not start medication because you know it will probably cause adverse effects based on your own genetic build than it is to stop taking medication once realizing it is causing adverse effects.
Be thoughtful. Insist on taking your time. Find a psychiatrist who aims for long-term solutions. Aim for long-term solutions yourself. Research prescriptions. Don’t believe everything you read. Not even this. Your brain is a complicated, dynamic machine, specifically designed to fit in your skull. No brains are the same. Yours and mine are, likely, vastly different. Work to understand yours before giving someone else permission to take ahold of your chemical reigns. Pursue neuropsychological testing; don’t just guess what is wrong with you. Don't assume the best. Don’t assume the worst. Hold tight to your independence, your certainty, and, for crying out loud, your functioning genitals.
Lily Crowder is a twenty-two-year-old writer based in North Carolina. She attends the University of North Carolina Wilmington as a candidate in their creative writing MFA program. Crowder's writing focuses on the human experience as an irreverent series of utter inconveniences. She has been published in Atlantis Magazine, encore Magazine, The Scriblerus Journal, and more.