Coming of Age on Zoloft (25 page)

Dana decided that her worry about long-term effects, coupled with her sense that antidepressants might never have been absolutely necessary for her, made it worthwhile to experiment with stopping. She didn’t quit under a doctor’s guidance, but she recalls trying to set herself up for success as methodically as possible. In college, she said, she had gone on and off her medication “on whims,” and these discontinuations had often led to new depressive episodes and new prescriptions. This time she deliberately tried to stop at a point when her life felt stable. She was in her late twenties and wrapping up her second year of graduate school. “The year before had been pretty arduous, and kind of anxiety provoking, and tearful, but my second year had been a really great year, a bolstering and confidence-building year,” she said.

And I remember thinking, “Here I am in a pretty good place, feeling good about the path I am on, and feeling confident and stable about various aspects of my life.” It felt like a safe time to experiment and get a clearer read on whether I could handle it.

I was aware. I told my parents in advance. I told my boyfriend. And I also told myself that if this doesn’t work and I have to go back on them, that’s okay. This is not, like, the test of a lifetime. If it doesn’t work for me, and I need these again, I feel okay about that.

Was it hard to get off?

No. It felt, actually—I really had no effects. Over the course of about three weeks or a month, I weaned myself. I don’t recall any negative effects at all.

—Dana, age thirty-one

Other people have motives for quitting that seem more intimate. They simply feel, for reasons they can’t always articulate, that they’d prefer to get by without medication if they can. Meghan, twenty-five, described quitting antidepressants as a way of telling a different story about herself—and at the same time, she said, adopting a different story about herself was a way of moving beyond antidepressants. Her experience shows that just as starting antidepressants can be a process that takes place on two levels, combining the literal activity of taking medication with intangible revisions to one’s sense of self, stopping medication can involve the same in reverse.

Meghan had found the idea of antidepressants off-putting from the start. In high school, she had struggled on and off with depression—“It wasn’t always debilitating,” she said—and during her junior year of college, she sought counseling through her school’s mental health ser-vice. After a few months of sessions, her counselor suggested that Meghan be evaluated for medication. “She said, ‘For someone who’s as seriously depressed as you, it can be a good decision,’ ” Meghan remembered. “I was dumbfounded. I was like, ‘I am seriously depressed?’ The whole idea shocked me. But I’d really developed a rapport with this woman, I trusted her opinion, and nothing else seemed to be working.”

Meghan’s counselor referred her to a university psychiatrist. The appointment, Meghan remembered, lasted about half an hour. “The psychiatrist said ‘You know, there’s depression in your family, this is clearly genetic, you were born with this deficiency, and you’re going to need to take these for the rest of your life,’ ” Meghan recalled.

She didn’t know me. But that was just her view of depression, and how to fix it. She thought that this was the way to go. And so I just had this idea like okay, well, if I want not to be depressed for the rest of my life, I guess I do have this deficiency, and I’m going to have to take a pill in order to fix that. So I was prescribed 20 milligrams of Prozac. Which, I went back after a month [for a follow-up] and I was like, “SOMETIMES, I WANT TO JUST BREAK THINGS OUT OF
LOVE
!” And she was like “Okay, well, maybe this is too high of a dose.”

The psychiatrist reduced the dose, and Meghan stayed on Prozac through the end of college. She said that it made a favorable difference, but she never warmed up to the idea of taking pills for her mood. On the other hand, what the psychiatrist had told Meghan about needing Prozac forever stuck with her. Meghan used the words
story line
several times in our interview. She told me that the story given to her by the school psychiatrist intimidated her. “There were a couple of times that I decided I wanted to go off Prozac” during college, Meghan explained, “but every time I did, I would start freaking out, and that whole story line of what [the psychiatrist] told me would come back, and I would be like, ‘I need this, I actually have to take this, you can’t just go off it or you’re not going to be able to function,’ so then I would get back on.”

Ultimately, Meghan said, receiving a new “story line” about herself from a different doctor was a critical factor that enabled her to stop. After she graduated from college, Meghan moved to a new city with friends. There, about three years after she began taking Prozac, “I ran out of medication at the turn of the year, and I tracked down a psychiatrist and was like, ‘I really need a prescription.’ He said okay, so I made an appointment.” She went on:

So I go and see him, and give him my history. I tell him what the psychiatrist said to me, and my relationship with medication, and he’s like, “Okay, Meghan. That is something that a lot of medical doctors believe. That you need this. But a lot of studies show that there are other things that can stimulate the same areas of the brain that medication does, and that one of the most effective uses of medication is in short bursts, around seven months, and that there are all these other things you can do, including effective therapy, and you really don’t have to be on them forever.”

And I was like, “Oh! Well, that’s great news! Okay.” And just him
telling
me that made me relate to the medication in a different way. I was like, “Oh,
right.
There are other things that can make you happy. It doesn’t have to come from a pill.” And just having this new story line, after a few months—I saw him for a little while but he was expensive—so I didn’t stay in therapy, but it was enough to make me realize, okay.

With the new doctor’s blessing, Megan went off Prozac. She remembers adopting a one-day-at-a-time approach to her moods, and especially making an effort not to see occasional bad days as confirmations of a story about needing medication forever. “The new story I told myself was ‘Okay, well, today I’m going to feel sad, and that’s okay, you can handle this; tomorrow you probably won’t feel as sad, and that’s great, you can handle that,’ ” she said. “And just that new story line helped me, and I haven’t been on it since.”

A surprising number of people described quitting antidepressants
during
a time of crisis. These decisions usually weren’t premeditated, but happened on the spur of the moment. The people who made them acknowledged that stopping impulsively wasn’t necessarily wise, but they spoke of feeling a need to make a big gesture—to assert control over something at a point when nothing else in life seemed to be going as planned.

Alexa, who had taken antidepressants since the time she was thirteen, remembered quitting abruptly at the end of her junior year in college. She had been having an intensely rough semester. “I got to a point where I was probably the most depressed I’d ever been,” she said, “like just crying to the point where I was bursting blood vessels under my eyes for no reason.”

This was while I was on a cocktail of MAO inhibitors and SSRIs and whatever the other one is, Wellbutrin. So I was on everything. And I was cleaning out my room from my junior year, and I was just like, “I’m going to throw them away and see what happens.” That’s the wrong way to go off them, of course; you’re supposed to wean yourself off. But I was like, if I don’t do this dramatically, it won’t feel like I’m making a decision. And that’s definitely the wrong way to do it. But I didn’t have any bad effects. I basically didn’t feel like anything happened except I stopped crying. I definitely felt a little numb for a few months. But this is from someone who used to have to raise her hand in class in college to [be excused to] go cry.

—Alexa, age twenty-three

A few months after stopping, Alexa said, “I kind of felt the same way that I had felt on the drugs. I mean, still having trouble. Still crying a little bit more than normal people.” But it was nothing she couldn’t handle, she explained. After many years on them, Alexa was fascinated to find that she seemed to be all right without medication. She even associated stopping with a kind of delayed adolescence. “I definitely felt freer,” she said, adding that she began to explore sides of herself that she never had before. “Just really simple stuff, like I started wearing dresses. I dated the first boy I had dated in college my senior year,” she said. “I was definitely more confident. I think most of my friends were like, ‘Who is this new person?’ ”

Alexa described quitting antidepressants as an experiment, one that she would abandon if she ever felt like she needed to. (She told me that she had kept her last prescription in her wallet until long after graduation, just in case she ever wanted to fill it.) By the time we talked, though, it had been five years since she’d stopped using medication, and she said that she still preferred life without it. “I think I mainly went off them because I was just really curious what the hell is it going to feel like,” she said. “And then I think I just liked it—I liked it more.”

Abby was another person who quit at a time when things were at their absolute worst. Abby was twenty-seven when we met, tall and striking-looking, with dark eyes and glossy hair. She had a confident, assertive manner, and it surprised me when she started talking about her childhood, describing a pattern of abuse and neglect that had made her an outcast at school. “For me, it was always very social,” she said. “I think depression is a disease the way poverty is a disease.” Abby had been on various combinations of medications for most of the time since she was fourteen. However—perhaps unsurprisingly given the way she understood the nature of her problem (“I can pinpoint exactly why and how I feel the way I feel, and it doesn’t have to do with necessarily my serotonin level, you know?”)—she’d never found medication to be remarkably effective. Even so, I was startled and a little bit worried when she told me how she had stopped taking antidepressants, almost a year before we talked:

I’d put myself into a horrible situation with a horrible man, a terrible job that I was not happy in, and I was not doing well. I was completely miserable, the winter was there, and it was a really, really low point. I realized that it was an abusive relationship. So, yeah, I decided that obviously this wasn’t working, because I was putting myself in this position. I was at the bottom. And I swear, I told myself, at this point, I was super depressed, I was smoking weed all the time. And I had it in my head that I had AIDS. And then, yeah, I stopped taking antidepressants. I think it might have been a suicidal type of thing too. But what happened was I stopped taking the antidepressants, and then I purposefully lifted myself out of the situation.

I called movers. I quit work. I broke my lease, I lost my deposit. All my furniture, I put in my parents’ basement. My friend was going overseas. I said, “Can I stay in your apartment, in Manhattan?” And there I was. No job, no boyfriend, nothing. And then I started my life all over again.

I’m not saying that all of a sudden everything was like rosy. Shit, no. But at least I did feel like I was closing the book on something.

—Abby, age twenty-seven

In the months since then, Abby told me, she had moved six times, most recently to an apartment where she could stay for at least a year. She was working on a career realignment, into a related field she thought would suit her better. She told me that life still felt hard. While she was glad that she stopped antidepressants when she did, she said she had been thinking actively about getting back on them. Just the week before, she had gone to a psychiatrist and gotten a prescription for Wellbutrin, which was sitting in a bottle on her desk at home while she considered what she wanted to do.

WHETHER THEY DID
so rashly or deliberately, almost everyone who quit described adopting new behaviors and new attitudes to help them manage life without medication. I had noticed myself doing the same thing. I was getting off Zoloft at the same time as I was settling into life in New York, and I found that I was establishing my routines in my new home with a care and a deliberateness that felt different to me. The noise and speed and off-the-rails liveliness of New York appealed to me as much as they ever had, but I also realized that I was paying new attention to carving out times and places to feel calm. I painted my new bedroom a warm shade of cocoa brown that made me feel cozy, and put up fluttering white curtains. While I was in graduate school, cooking had become a favorite ritual, something I found relaxing and nourishing in a way beyond just the literal, and I tried to keep the practice up in our tiny Brooklyn kitchen. On weekdays I packed vegetable lunches and, weather permitting, ate them over a book in the small park near the office of the magazine where I worked. I enjoyed the feeling of being able to take good care of myself.

As the Zoloft dosage came down and then down further, I did notice myself feeling a little bit different. It wasn’t always marked. Most of the time I felt fine. But often, the anxieties that I already had would rise up a little, become sharper. I felt more emotional in all directions; I caught myself welling up more often on the morning subway train because something in the newspaper I was reading seemed moving, hit me right on the spot. It wasn’t all bad. I liked having an intensity. It felt like a kind of return to something I’d forgotten. Every now and then I’d spot another red-eyed rider on the train, or pass someone walking the other way down the street, talking on a cell phone and crying. New York was amazing. People lived their lives out in the open, but the cumulative effect was so mysterious.

In exchange for these new sensitivities, perhaps, I found myself placing more importance on things like getting enough sleep, going home when I was through feeling social, running in the park. I made a conscious effort not to overburden myself or my schedule with commitments. In my journal, I wrote that I felt like a tightrope walker performing the same old routines, without a net this time. The simplest things felt a little more exciting, and I went around with a new consciousness that it was important to be careful. I had to be nice to myself; no one and nothing else was going to do it for me.