{"id":18147,"date":"2022-08-24T15:21:45","date_gmt":"2022-08-24T20:21:45","guid":{"rendered":"http:\/\/thepapergown.zocdoc.com\/?p=18147"},"modified":"2023-03-19T12:16:51","modified_gmt":"2023-03-19T17:16:51","slug":"after-two-decades-i-decided-to-go-off-antidepressants","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/patient-stories\/after-two-decades-i-decided-to-go-off-antidepressants\/","title":{"rendered":"After Two Decades, I Decided to Go Off Antidepressants"},"content":{"rendered":"

I had my first panic attack when I was 9 years old. One minute, I was in music class, belting out \u201cCamptown Races.\u201d Then, in less time than it took to sing \u201call the doo-dah day,\u201d nausea and weakness swept over my body. With sweaty palms and trembling legs, I asked my teacher if I could go to the school nurse. Within 30 minutes, my mom showed up and carted me to the local emergency room, where an ER doctor suggested I see a therapist for anxiety. <\/span><\/p>\n

It wasn\u2019t a one-time thing. After a few repeat panic episodes, my mom pursued the best solution she knew: medicine. On a spring afternoon in fourth grade, I walked into a child psychiatrist\u2019s office for a consultation and walked out with a prescription for an antidepressant called Luvox.<\/span><\/p>\n

The little pink pills relieved my anxiety<\/span> almost immediately. I exchanged my fears of lockjaw and fatal car accidents for more normal grade-school worries about sleepovers and school play auditions. From that point on, varying doses of SSRIs \u2014 Zoloft, Paxil, Lexapro, Celexa \u2014 were a part of my life. <\/span><\/p>\n

Then, in 2018, I decided to wean myself off the medication I\u2019d relied on for two decades. By that point, I\u2019d made a lot of progress in managing my anxiety through therapy and had begun to see antidepressants as more of a burden than an asset. Thanks to my Lexapro, my libido was nonexistent and my extra pregnancy weight wouldn\u2019t go away. And I couldn\u2019t shake the feeling that I wasn\u2019t fully experiencing the joy of mothering my two toddler sons. Something about my way of being just seemed flat. Didn\u2019t my kids deserve to know an unconstrained, unmedicated version of their mother? <\/em><\/span><\/p>\n

It\u2019s been a few years since I first asked myself these questions, and a lot has changed, both in the world and in my personal life.\u00a0 I\u2019ve realized being strong sometimes means accepting help\u00a0\u2014 even in the form of a pill I take every day \u2014\u00a0and that more than an idealized version of myself, my family needs me to be stable in order to thrive. <\/span><\/p>\n

\n

As of 2017, <\/span>13 percent of Americans take antidepressants<\/span><\/a>. The term \u201cantidepressant\u201d applies to several different classes of drugs, the most popular being SSRIs. Standing for selective serotonin reuptake inhibitors, SSRIs are typically used to treat mood disorders like anxiety and depression. The drugs work by <\/span>increasing the brain\u2019s supply of serotonin<\/span><\/a>, an emotion-stabilizing neurotransmitter. In <\/span>one study<\/span><\/a>, 60 percent of people who took an antidepressant noticed improvements in depression symptoms within two months; <\/span>research also shows<\/span><\/a> SSRIs to be more effective than placebos in treating panic disorder.<\/span><\/p>\n

As for the fine print, SSRIs also have well-documented <\/span>side effects<\/span><\/a>, including decreased sexual desire, weight gain, insomnia, headaches and nausea. And it\u2019s <\/span>debatable<\/span><\/a> how well SSRIs work for anxiety in particular; <\/span>some experts argue<\/span><\/a> they can do more harm than good.<\/span><\/p>\n

When I announced my decision to part ways with Lexapro, my soft-spoken, ultra-zen psychiatrist supported me. \u201cI think you can do it, but we\u2019ll need to come up with a plan for a slow taper,\u201d he said, after laying out the risks. Given how long I\u2019d been on SSRIs, we agreed the one thing I shouldn\u2019t do was quit cold turkey.<\/span><\/p>\n

Discontinuing SSRIs <\/span>can be an extremely difficult process<\/span><\/a>. <\/span>Studies on long-term use<\/span><\/a> have shown that the longer someone is taking an SSRI, the harder it is to quit. Some people develop discontinuation syndrome, a <\/span>real, diagnosable condition<\/span><\/a> that comes with physical symptoms like restlessness, tremors, nausea and vomiting, along with neurological symptoms like dizziness, trouble concentrating and the sensation of \u201cbrain zaps.\u201d People can also experience increased feelings of anxiety and depression during discontinuation, but Dr. <\/span>Anna Lembke<\/span><\/a>, professor of psychiatry and behavioral sciences at Stanford University, says flare-ups generally don\u2019t last more than a few weeks, especially with a gradual taper.<\/span><\/p>\n

\"\"<\/a><\/p>\n

Tapering is something of a hot topic among psychiatrists, and prevailing opinion in the field is changing. For years, it\u2019s been standard for doctors to recommend 2-4 week tapering regimens. But two psychiatric researchers <\/span>recently published<\/span><\/a> a <\/span>paper<\/span><\/a> recommending an \u201cextended tapering regimen, reducing [a patient\u2019s] dosage by smaller and smaller increments, down to one-fortieth of the original amount.\u201d This method takes months or even years, but researchers say it accounts for how antidepressants change brain chemistry, while the old way does not.<\/span><\/p>\n

My psychiatrist switched me to a liquid form of Lexapro and told me to reduce my daily dose of 10 milligrams by one milligram every two weeks. He also prescribed supplements and dietary changes to support serotonin production in my brain.<\/span><\/p>\n

I followed his instructions to the letter. Every morning, instead of swallowing a pill, I poured unflavored liquid into a syringe and squeezed it into my mouth. And every night I swallowed a handful of vitamins. Each time I cut my dose, I felt out of sorts for about a week, which Lembke says is typical. \u201cAt first, we expect people to feel worse, but that may be withdrawal-mediated anxiety and depression,\u201d she said. \u201cOnce their brain adapts to the new dose, a person might go back to their original baseline. It\u2019s important to wait until the withdrawal is complete, then reassess.\u201d<\/span><\/p>\n

Some days, when I felt too anxious and uncomfortable to engage fully with my kids, I parked myself on the couch and let Curious George marathons do the parenting for me.<\/p><\/blockquote>\n

I couldn\u2019t tell if my anxiety had resurfaced or if I was just experiencing withdrawal symptoms. Either way, I was struggling. In addition to brain zaps and dizziness, I felt like I had the flu. My appetite waned. I was irritable and restless.<\/span> My whole body felt achy and fatigued. Some days, when I felt too anxious and uncomfortable to engage fully with my kids, I parked myself on the couch and let <\/span>Curious George <\/span><\/i>marathons do the parenting for me. Then I felt guilty. It was all so overwhelming.<\/span><\/p>\n

But I didn\u2019t want to undo my progress, so I forged on, reducing my dosage to 5 milligrams over three months. Once I adjusted to this dose, it felt like a comfortable midpoint between panic-stricken and emotionally clogged. Still, I assumed I should continue tapering until I hit zero. There was just something so intriguing about the prospect of living without medication.<\/span><\/p>\n

But my doctor urged me to stay put for a while. If I wanted, I could resume tapering in a few months, or a few years, or whenever I stopped feeling like myself at my new, reduced dosage. By winter, 5 milligrams no longer felt right \u2014 but not in the way I\u2019d hoped. Pummeled by the flu and the oppressive darkness of Minnesota in January, my anxiety came back in full force.<\/span><\/p>\n

I holed up in my room, terrified I\u2019d never get better. After two months of debilitating anxiety, I did what I swore to myself I wouldn\u2019t: I scheduled an appointment with my psychiatrist and begrudgingly increased my dosage to 10 milligrams. I felt like I was giving up my chance of being an emotionally authentic person, but my doctor wasn\u2019t having it.<\/span><\/p>\n

\u201cDon\u2019t think of it as a failure,\u201d he said. \u201cYou\u2019re doing what you need to take care of yourself.\u201d<\/span><\/p>\n

I couldn\u2019t appreciate his advice until my anxiety calmed down enough for me to put my tapering experience in perspective.<\/span><\/p>\n

Originally, I wanted to quit Lexapro, or at least drastically reduce my dosage, to show myself and my kids that I was strong enough to thrive on my own \u2014 without pills to keep serotonin coursing through my synapses. But after coming full circle, I was able to see that being strong isn’t about taking (or not taking) medication. It’s about taking care of myself, just as my doctor said.<\/p>\n

\u201cDon\u2019t think of it as a failure,\u201d my doctor said. \u201cYou\u2019re doing what you need to take care of yourself.\u201d<\/span><\/p><\/blockquote>\n

I\u2019m still taking Lexapro every day four years later. Early in the pandemic, my anxiety symptoms resurfaced, so I actually <\/span>increased<\/span><\/i> my dose (and started seeing my therapist more frequently). The medication has buoyed me during some hard things, like moving to a new state during a pandemic and facing my dad\u2019s cancer diagnosis and later death. I\u2019ve since tapered back down to my normal dose with my psychiatrist\u2019s support, but I don\u2019t have any plans to make it down to zero \u2014 and right now, accepting that reality feels a whole lot braver than fighting it. <\/span><\/p>\n

If I were on medication for epilepsy, diabetes or any chronic illness with more acute physical symptoms, I doubt many people would call me strong or courageous for choosing to manage my disease naturally. <\/span>The truth is, I\u2019ve summoned plenty of strength and courage since I first went on antidepressants. I\u2019ve spent years learning how to control the anxious thoughts that plagued my 10-year-old self. I\u2019ve worked hard to build and maintain relationships that give me the stability I didn\u2019t have as a kid. I pour myself into writing and parenting, both of which lend an empowering sense of purpose to my daily life.<\/span> I<\/span> advocate for my mental health needs whenever I can, and ask for help from friends, family and professionals when I need to. <\/span><\/p>\n

So many times during my taper, I was motivated by self-discovery. I wondered if a \u201creal version\u201d of me was hiding beneath the medication I\u2019d been taking most of my life. I envisioned the emergence of a resilient, vibrant, does-it-all woman. But I didn’t need to go looking for her. She was there all along.<\/span><\/p>\n

\n

Ready to book a doctor’s appointment? Visit Zocdoc.<\/span><\/a><\/span><\/h1>\n","protected":false},"excerpt":{"rendered":"

The months-long process of tapering off Lexapro didn’t go quite as I expected. <\/p>\n","protected":false},"author":26,"featured_media":18173,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[231],"tags":[12,41,129],"class_list":["post-18147","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-patient-stories","tag-anxiety","tag-mental-health","tag-rx","reviewer-dr-nassim-assefi","specialist_by_city-psychiatrists"],"yoast_head":"\nAfter Two Decades, I Decided to Go Off Antidepressants - Patient Stories<\/title>\n<meta name=\"description\" content=\"Tapering off SSRIs can be a long and difficult process. 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