I’ve accepted I will never be able to simply stop my psychotropic medications.
I’ve been taking one form of psychotropic medication or another since I was twenty-five years old and I will be sixty-two in a couple of months. Okay, I had to use a calculator, but that’s almost thirty-seven years. That’s a long time. I don’t know how many more years I have left, but I know one thing. That I will be on antidepressants until I die.
Thanks to my dad and that side of the family, depression is hard-wired into my DNA. I can’t change that propensity. I’ve read articles and heard people talk about severe withdrawal symptoms from antidepressants and I believe every word.
In 2013 when my father passed away, I’d been on Cymbalta for many years and it just stopped working. That my then psychiatrist, Dr. Lev (not her real name), and I couldn’t find a new antidepressant that was effective in a timely manner, in addition to the raw rage and resentment that surfaced when my father died all contributed to the severe depression I experienced at that time. Which led to my suicide attempt in March 2014.
Finally, we hit upon a combination that worked for me. I take two different antidepressants and a second-generation antipsychotic, which Dr. Lev told me acts as an adjunct to the antidepressants. Additionally, when my depression is severe, as it was in 2014, I tend to experience psychotic features, particularly delusions, tending to believe someone is out to get me.
I always believed as I’m sure many people did that the newer antidepressants — SSRIs or selective serotonin reuptake inhibitors — raised the level of serotonin in the brain. It was a common belief that people who suffered from depression had low levels of serotonin. A recent article in the NY Times titled “Antidepressants Don’t Work The Way Many People Think,” stated “Starting in the 1990s, researchers began to understand that depression was much more complicated and that serotonin played only a nominal role. For one thing, S.S.R.I.s increase serotonin levels immediately, but it takes several weeks before people start to feel better. Studies also started to emerge showing that another brain system played a role: People with depression consistently have less volume in an area called the hippocampus that’s important for regulating mood.”
I thought this was fascinating. I read about the hippocampus. This article in Medical News Today stated, “the hippocampus is part of the limbic system, which manages the functions of feeling and reacting. The limbic system is situated on the edge of the cortex, and it includes the hypothalamus and the amygdala. These structures help control different bodily functions, such as the endocrine system and what is commonly known as the ‘fight or flight’ response.”
So if antidepressants don’t work by raising the level of serotonin in the brain, how do they work? The NY Times article states, “the current prevailing theory, is that chronic stress can cause the loss of connections — called synapses — between cells in the hippocampus and other parts of the brain, potentially leading to depression. Antidepressants are now thought to work at least in part by helping the brain form new connections between cells. Researchers aren’t exactly sure how increasing serotonin with an S.S.R.I. causes these synapses to regrow. One possibility is that the medications also increase levels of other brain chemicals, called growth factors, that help those connections form and spread.”
This paragraph reminded me of when I had my stroke in 2018, and suffered cognitive deficits. All of the doctors told me the brain is capable of forming new neuropathways to compensate for the brain cells that had died. Following my stroke, I also fell into a severe depression, which I understood to be common. It took a lot of work, such as completing basic worksheets that I could have done in my sleep prior to the stroke but now confounded my damaged brain. There were many days I wanted to throw my pencil across the room and quit. It took a long time and working with a rehabilitation neuropsychologist to make lists of each step needed to complete a task, that before I would take for granted my brain would automatically know.
When I had my stroke, I’d already terminated therapy with Dr. Lev, but I returned to treatment with her to address this new episode of depression and continued for eighteen months. This is when she added the second antidepressant that I’ve stayed on. Why mess with something that is working?
I’m not a researcher or a scientist, but I wonder if this is somehow all connected. Regardless, for me, it proves one thing. I have to remain vigilant and proactive about my mental health, which has been hard-won. One definitive action I can take is to stay on my psychotropic medications. For the rest of my life.
Thanks to my dad and that side of the family, depression is hard-wired into my DNA. I can’t change that propensity. I’ve read articles and heard people talk about severe withdrawal symptoms from antidepressants and I believe every word.
In 2013 when my father passed away, I’d been on Cymbalta for many years and it just stopped working. That my then psychiatrist, Dr. Lev (not her real name), and I couldn’t find a new antidepressant that was effective in a timely manner, in addition to the raw rage and resentment that surfaced when my father died all contributed to the severe depression I experienced at that time. Which led to my suicide attempt in March 2014.
Finally, we hit upon a combination that worked for me. I take two different antidepressants and a second-generation antipsychotic, which Dr. Lev told me acts as an adjunct to the antidepressants. Additionally, when my depression is severe, as it was in 2014, I tend to experience psychotic features, particularly delusions, tending to believe someone is out to get me.
I always believed as I’m sure many people did that the newer antidepressants — SSRIs or selective serotonin reuptake inhibitors — raised the level of serotonin in the brain. It was a common belief that people who suffered from depression had low levels of serotonin. A recent article in the NY Times titled “Antidepressants Don’t Work The Way Many People Think,” stated “Starting in the 1990s, researchers began to understand that depression was much more complicated and that serotonin played only a nominal role. For one thing, S.S.R.I.s increase serotonin levels immediately, but it takes several weeks before people start to feel better. Studies also started to emerge showing that another brain system played a role: People with depression consistently have less volume in an area called the hippocampus that’s important for regulating mood.”
I thought this was fascinating. I read about the hippocampus. This article in Medical News Today stated, “the hippocampus is part of the limbic system, which manages the functions of feeling and reacting. The limbic system is situated on the edge of the cortex, and it includes the hypothalamus and the amygdala. These structures help control different bodily functions, such as the endocrine system and what is commonly known as the ‘fight or flight’ response.”
So if antidepressants don’t work by raising the level of serotonin in the brain, how do they work? The NY Times article states, “the current prevailing theory, is that chronic stress can cause the loss of connections — called synapses — between cells in the hippocampus and other parts of the brain, potentially leading to depression. Antidepressants are now thought to work at least in part by helping the brain form new connections between cells. Researchers aren’t exactly sure how increasing serotonin with an S.S.R.I. causes these synapses to regrow. One possibility is that the medications also increase levels of other brain chemicals, called growth factors, that help those connections form and spread.”
This paragraph reminded me of when I had my stroke in 2018, and suffered cognitive deficits. All of the doctors told me the brain is capable of forming new neuropathways to compensate for the brain cells that had died. Following my stroke, I also fell into a severe depression, which I understood to be common. It took a lot of work, such as completing basic worksheets that I could have done in my sleep prior to the stroke but now confounded my damaged brain. There were many days I wanted to throw my pencil across the room and quit. It took a long time and working with a rehabilitation neuropsychologist to make lists of each step needed to complete a task, that before I would take for granted my brain would automatically know.
When I had my stroke, I’d already terminated therapy with Dr. Lev, but I returned to treatment with her to address this new episode of depression and continued for eighteen months. This is when she added the second antidepressant that I’ve stayed on. Why mess with something that is working?
I’m not a researcher or a scientist, but I wonder if this is somehow all connected. Regardless, for me, it proves one thing. I have to remain vigilant and proactive about my mental health, which has been hard-won. One definitive action I can take is to stay on my psychotropic medications. For the rest of my life.
