Antidepressant Exit's Paper Gift

White iris in our backyard

This month marks one year.

Last July, I saw the first article online discussing a possible link between long-term antidepressant use and dementia.  No legitimate, scientific proof of a link, mind you, since dementia's causes remain unproven.  However, I learned medically-based concern does now exist, not simply alarmist hype.  

And that was all it took:  I decided that if I could get off of antidepressants, I should. 

I didn't consult my primary care doctor.  I just did it.  I weaned myself off over July and August of last year, taking 50% of my dosage.  And then in September... taking none of my dosage at all.  The only side effect I noticed seemed to be increased dizziness, so I simply drank more water.  Some dizziness has remained, but it had already been a minor issue for several years anyway.

From what I've read, dizziness is both a side effect of antidepressants, and a side effect of going off antidepressants!

Eventually, I did tell my primary care doctor, and he didn't even bat an eye.  He didn't try to change my mind.  He's seen the research as well, he knows my family's history with dementia, and his own father had it.  He simply replied that if I ever wanted to get back on my prescriptions, or explore different ones, to let him know.

He knew something I didn't.  But I know it now, too:  One year later, I can say with certainty that I'm definitely not "cured" of my depression.  

Last spring, I'd grown skeptical regarding the effectiveness of my antidepressants, an assortment of which I'd been prescribed for nearly three decades.  That skepticism had initiated my online consultations with "Dr. Google" about antidepressant efficacy, which eventually resulted in seeing those articles plausibly linking them to dementia.  However, being off of them has shown me that, contrary to my doubts, they had indeed been helping after all. 

I'm not anti-antidepressants.  While I'd probably plateaued into a relatively balanced funk with my meds, I'm now noticeably less functional on some days than others.  So it's not like I'm recommending this process to anybody else.  Chronic clinical depression is a real thing, and prescription medications can be beneficial.  Even when they may not be as beneficial as one might like.

There have been a handful of days when I've almost caved and taken one of my antidepressants (I still have my unfinished doses on hand).  And I'm not saying I've stayed "strong" and resisted the "temptation", because I don't want to sound victorious.  If I ever have to return to them, it won't be a sign of failure.  True clinical depression is a complex problem, and I'm well aware the "chronic" part of my diagnosis means there are no easy or quick fixes, if any at all, with or without medications.

But I haven't taken any antidepressants in any dosage since the end of August, 2023.  Yet, anyway.  And it's been hard.

Indeed, I began this blog entry three months ago, knowing that even writing about it wouldn't be easy.

Nevertheless, the specter of dementia chills me to my core even more than depression does.  The experience my Mom and I had when we cared for my Dad during his journey through dementia was not the worst anybody has ever had, but it was bad enough for us.  Even now, eight years after his death, neither of us think we've fully recovered.

That's why I'm forcing myself to at least try and figure out how to survive my chronic clinical depression without antidepressants.  This is not what I wanted to be doing at this time of my life, but it's where I am anyway.  Not that I'm looking for pity, either, although this situation seems to fit the persistent unconventionality my entire life appears to represent! 

Sure, some folks insist mine is a fake illness, and even among those who acknowledge its reality, there remains a considerable taboo regarding its diagnosis and treatment.  And yes, like a lot of medical activity in our society, depression probably is one of the easiest to mis-diagnose or otherwise exploit.  

What we can't see is often difficult to identify or accept.

Which - ironically, of course - is one of the ways depression can get a grip on people like me!

The longer I've gone without any antidepressants, the changes that have taken place in my physiology and emotions have become ever more pronounced.  I'd previously blogged about my weight loss, for example, which apparently has stopped, as I've begun regaining a few pounds.  A couple of people actually think I look ill, so maybe reapplying some of what I'd lost isn't a bad thing, although I didn't get as skinny as I was in my NYC days, when my depression was first diagnosed.  

And something else has happened:  Going without antidepressants appears to have allowed my relentless anxiety - which never went away, but was only masked - to spawn IBS-C, sometimes called "nervous gut".  While it has required some major dietary changes in my life, and I sure miss all of my fried, fatty pleasures, I have to admit it is also forcing me to make healthier decisions about the food I am eating.  So it's not entirely disheartening.

Thankfully, too, I'm blessed with a long-time friend who has faithfully proven himself to be a remarkably resonant sounding board.  He's been the one encouraging me the strongest to get back into writing.  My pastor, with whom I've been meeting monthly, also says I should write more.  So while I'm not crafting prize-winning prose here, what you're reading is part of my therapy.

And yeah... about this blog.  Turns out, journeying without antidepressants has led to a pivotal realization for me:  When I started blogging 15 years ago, I unwittingly incorporated an unhelpful ethos of sociopolitical drama, which I apparently never processed in healthy ways.  It's gotten so I can't tolerate all of the rage and animosity so many of us try to absorb and/or exhibit in our instant, incessant, emotionally-fraught world.

Earlier this year, I began culling my relatively dormant catalog of essays that no longer represent how I want to interact with others, either online, or in-person.  Neither my close friend nor my pastor told me to do it, or even knew I was doing it until I told them.  While I used to have over 1,300 essays, I've whittled that number down by nearly 1,000, and I'm not done deleting yet.  It's just that deleting all those essays - each representing a considerable amount of work - is itself draining.  Why?  Well, for one thing, I can't believe I used to be so haughty and ungracious in my writing.

I may not have been wrong about facts, although obviously, I sometimes was.  Instead many times, I was wrong about the attitude with which I wrote about those facts.  It's easy for us to let angst govern our responses, but that is emotionalism, and if I'm an expert on anything, it's how dangerous emotionalism can be.

Emotions get tricky when it comes to disciplining ourselves in managing them responsibly for everyday life.  And time was, this would be the point at which I'd get quite religious in prescribing fixes and antidotes to such dilemmas... but now I realize I'm in no position to pontificate or proselytize.  I'm still a person of faith, but an increasingly humbled one.

Do you realize there's a difference between being humble, and being humbled?  I'm definitely not the former, but I am the latter.

One year ago, my objective was to see if I could avoid at least one possible route towards a possible future with dementia.  And yes, I'm aware of how much uncertainty exists in that one sentence!  I had no clue then how anything would unfold over the next twelve months, and I'm not yet able to confirm I made the right call.  Nobody knows for certain that any length of antidepressant use has a significant impact on developing dementia.  And if it does, nobody can assure me that stopping my antidepressants will make any significant difference.

Nevertheless, one year on, my experience with my dear Dad continues to tell me today's journey has merit.  But just like I did as one of his caregivers, I'm having to take today one at a time.

And yes, it is both as shallow and deep as it sounds.

Thank you for reading.

_____

PS - Still wondering about the "paper gift" part of this essay's title?  It comes from the traditional wedding anniversary gifting convention, which dictates paper as the first anniversary present.  Paper is usually made of woven material, symbolizing two people intertwining their individualities to create a new identifiable unit.  Paper also represents a blank opportunity upon which the happy couple has (hopefully) begun writing their new chapters together... with"opportunity" as a key theme.  (Hey, I needed something to lighten the mood!)