Tuesday, October 10, 2023

No More Depression Meds for Me

 

Lantana in our backyard... just because it's colorful and happy!


Depression denies delight.

Nobody likes talking about it.  It is often misunderstood, and sometimes exploited.  It can be taboo, controversial, and destructive.

Some claim it is a figment of one's imagination.  Others seem to let it crush their soul.  It is impossible to quantify but easy to use as an excuse.  Approximately 12% of Americans take antidepressants, and are therefore considered to suffer from some degree of "clinical" depression.  And while an antidepressant prescription requires a medical doctor's authorization, no benchmarks exist for determining who really has the medical condition termed "depression", who doesn't, and how bad or mild a person's depression may be.

Back in 2014, I outed myself on this blog as a person struggling with chronic clinical depression.  I was taking at least two medicines commonly prescribed for such a diagnosis.  However, my history with antidepressants had begun years earlier when I lived in New York City.  While the prescriptions themselves had changed over time, I was taking them daily, year after year - until this past summer.

I am now clean of those anti-anxiety prescription medications.  

But that's not because I'm cured.  Chronic clinical depression is real for many people, and I remain one of them.  And while my depression is characterized by extraordinary anxiety, that actually explains why I've stopped taking my antidepressants.

I'm not anti-medicine, or anti-big-pharma, or anti-science.  In fact, technically, it is the emerging science related to dementia that convinced me to wean myself off of my antidepressants.  Turns out, evidence has begun to accrue regarding a likely link between antidepressant use and one's chances of developing dementia.  And since profound memory loss runs in my family, it looms large as something for me to fear, looming even larger than depression.

During the past several years, I often wondered how effective my antidepressants had become anyway.  I began Googling my way around the Internet, and discovered that other patients - as well as scientists and doctors - were also beginning to express skepticism regarding antidepressants.

Then I discovered something especially troubling:  As science completes more and more research with dementia, the impact long-term antidepressant use has on future memory loss does not appear to be insignificant.   Please notice, however, my cautious phrasing of that sentence, because I don't want to be alarmist.  You see, from what I've read, the research and its findings are not yet conclusive, and they do not currently appear to be stark enough to bring antidepressant use to a standstill.

Of course, I am not a scientist, nor a doctor.  I am not a clinician, a mental or emotional therapist, or a person with any vested financial interest in any individual, company or entity that is.  I'm aware that science evolves.  There are valid reasons why medicine is called a "practice".  Big pharma has been accused of greedily foisting prescription antidepressants onto gullible patients and their doctors, but I can't deny that for a while, it seemed as though my prescriptions did provide some sort of help. 

And I'll admit, I weaned myself off of my antidepressants without consulting my primary care doctor (I haven't seen a psychiatrist or therapist for years).  But when I did tell him, close to the end of my weaning process, he wasn't alarmed.  He listened to my rationale and agreed that antidepressants can lose their efficacy over time.  He also acknowledged that the growing body of evidence regarding dementia is concerning.  So he didn't try and talk me out of my decision. 

I've been completely off of my antidepressants for three months now.  And just to prove I'm not endorsing any similar actions by anybody else taking what I call "happy pills", I'm not going to detail what medications I was taking.  Or how I weaned myself off of them.  

But I have to admit (or boast!):  I've lost over 20 pounds since starting the process.  I think I look the best I have in years, if vanity counts for anything.  Considering how much weight I'd acquired at the height of my antidepressant use, I enjoy looking into mirrors now and not seeing some obese person staring back at me in dismay.  

I'm still not thin, but I'm not trying to be thin.  I didn't do this to lose weight, although losing weight has been a nice bonus.

And for the record:  I haven't been exercising more, or making any concerted effort to lose weight.  Quite simply, my appetite seems to have changed the longer I've been without "happy pills".  From my research, I've learned that this type of weight loss can happen to folks who come off of antidepressants.  Today, I do not crave food, although salty foods can still seem to beg for more!  I'm not as tempted by sweets as I used to be.  I find it bizarre to approach mealtimes now with a bland acknowledgement that my body basically needs some nourishment.

So, bottom line:  What are the pros and cons of what I've done?

PROS:

  • Possible reduction of future dementia risk - or at least, I'm no longer contributing to that risk.  For me, this alone is major, and worth more than all the pros and cons to follow.  Yes, I still may end up developing dementia, but at least I'm trying to avoid it.
  • Weight loss and a better appreciation for my own physical appearance, which is encouraging.  I know looks aren't everything, and I don't want to be vain, but it certainly seems counter-productive for antidepressants to prevent weight loss, thereby compounding things for people who've been prescribed them in the first place!
  • Relatively improved diet, since I'm not strongly craving junk food like I used to.
  • I have far less vertigo than I did before, especially when standing.  It really had gotten annoying.  Vertigo can be a side effect of antidepressants.

CONS:
  • More fitful sleep.  I've lost about an hour of sleep a night, what sleep I get isn't high-quality, and I never feel refreshed when I get up in the morning.
  • My energy level seems lower than before (and I can't remember when it was ever very high!).  Maybe because my body is adjusting to having less food to process, thanks to my diminished appetite.
  • Conversely, my inertia level is higher, and inertia - or disillusionment, apathy, lethargy, lack of ambition, or whatever it is - has unfortunately been a deepening hallmark of my depression journey. 
  • Often I feel as though I'm about to burst into tears.  This has never been a regular issue before.  I haven't had a crying episode yet, because I fight them, but it is not a sensation that inspires confidence.
  • I'm no less anxious than I was when I was taking "happy pills".  More proof that I'm not cured.
  • My temper is noticeably stronger, while my patience is noticeably weaker.
  • I still get dizzy, especially when standing (yes, in addition to the vertigo).  Dizziness has long been a side effect of my antidepressant use, but my research says it can also be a side effect of going OFF of antidepressants!
  • Occasionally I get painful cramping in my abdomen, which can be a side effect of stopping antidepressants.  Nausea can also be a side effect of leaving antidepressants, but fortunately, I haven't had that.


Maybe you've read this far and are wondering what role psychotherapy - either with a PhD/MD, a psychologist, or a certified psychotherapist - has played in my treatment.

I attended psychotherapy for a number of years, both in New York and here in Texas, with a variety of credentialed providers.  Perhaps they worked for a time, but finally, my last psychotherapist was the one who called it off.

"Why do you keep coming to see me?" he asked bluntly during what turned out to be my last session.  "I ask you all these questions, and you always give great answers.  I don't think psychotherapy is doing you any good anymore."  

So that was that.

Again - not that my journey with chronic clinical depression is typical, or replicable.  I'm just journaling about it here, chronicling what it's been like for me thus far.  Besides, since my overall functionality has not improved, and there is no definitive proof I've genuinely decreased my risk for dementia, maybe all I'm really doing is bragging about losing so much weight!

However, if you are a person who is taking antidepressants, maybe what you've read here rings a bell with you.  And if so, I recommend that you talk with your doctor.

You may have something to lose, too!

_____

Check out my update here.