Some important facts to get out of the way before we dive in here:
1. I’ve been on a high (or so I’ve been told) dosage of Prozac for approximately ten years now (I’m 28).
2. I was prescribed it for anorexia and depression, though ostensibly more the latter.
3. I’m not now nor have I ever been convinced depression is a “disease,” or at the least that it’s properly diagnosed and treated (the latter’s kind of a no brainer, though). I probably blame too much of bourgeois problems on diagnostic drift.
4. The two times I’ve gone off Prozac in the past, I’ve done so of my own volition, and have quit cold turkey. Both of these attempts resulted in a recurrence of depressive tendencies, and my doctors essentially stuck their tongues out and said they had told me so, and while I didn’t totally agree with them (any drug addict going from using daily to using not-at-all will experience withdrawal symptoms, possibly dangerous ones, but does that mean he or she should never attempt to quit the drug?), I went back on Prozac basically in order to function at that moment in time.
5. My beginning to take Prozac again after each detox correlated with a relapse of anorexia. I would argue it's because the Prozac gave me the energy and flippancy needed to brush aside big issues, which allowed me to more easily engage in behavior I knew somewhere inside was stupid and dangerous.
You can probably guess, based on point #3 above, that I’ve never planned to be on antidepressants my whole life.
The big cut-off, for me and so many young women like me, has always been pregnancy. "When I get pregnant, I'll go off medication," we say. For me, it's far enough in the future that I don’t consider it a possible reality just yet, and therefore it doesn’t force me to grapple with my status as medicated and/or mentally ill.
Psychiatric medication takes the place cigarettes once held as the nasty crutch we intrinsically feel is bad for us and yet, fearful as we are, we rely on extenuating circumstances to do the grunt work quitting requires.
But I’ve been fantasizing for a while about living without medication, and finally, six months ago, after I had scraped together the $300 it would cost to visit my psychiatrist for one hour (she doesn’t take insurance, and charges nothing, I may add, to refill my prescription without seeing me), I began the process.
Six months later and here I am, down from 100 mg to 70 mg. At this rate, I will be free of Prozac entirely in another 5 months, give or take. On paper, it looks like I’m moving at a good clip, but in real life, it feels almost unbearably slow.
Let me amend #3 on the first list just a little: I do believe depression is a disease, or let us say a very serious problem that usually requires treatment; I’m just not convinced that I have it.
Why? For starters, all my major depressive episodes really took hold when I was ill with anorexia, and ergo my brain, because it was starved, was compromised. (Even just thinking about something like Yoplait Lite now is enough to make me sad, so no wonder I was ready to pop off after a year of it for breakfast, lunch and dinner.)
Had I been evaluated for depression while healthier, a.k.a. while in my “normal” neurological state, I just may not have fit the bill.
Secondly, most of my personal tendencies that doctors and therapists have always pointed out as symptoms of my depression –– namely, nihilism, obsessive thinking, fascination with death, being overly prone to analysis, particularly self-analysis –– are character traits that have been with me since day one, and are not always the source of my sadness.
In fact, a lot of the self-awareness I’ve gained as I’ve aged I credit with coming to terms with the fact that I’m just kind of a dark, obsessive person, and I don’t believe there’s anything wrong intrinsically with that. When I was in high school, I used to rent really dark dramas from Blockbuster, and my dad would always look at me disapprovingly when I came home armed with Haneke’s The Seventh Continent. I felt like a freak, sure, but what I’ve come to realize since then is that watching Pollyanna or anything in the rom-com genre actually would result in me sinking further into depression rather than feeling brightened by the formulaic boy-meets-girl-happily-ever-after narrative.
In other words, I do not feel I could ever be happy pondering happiness, and on the flip side, just because I think about death doesn’t mean I seek it out (anymore).
Some other things you should know about why I’m skeptical of psychiatry in general:
1. The theory that depression is a “chemical imbalance” in a person’s brain is only a theory –– developed as a result of the fact that Prozac, which increased production of serotonin, appears to work on mildly depressive patients (not, just as a side note, on seriously or catatonically depressed patients, or on psychotic patients).
2. Even if, let’s say, the chemical imbalance theory of depression was found to be correct, who is it out there who is determining what the chemical balance of a “normal” brain is? Is it the ultimate idea to create a goal baseline chemical production for each brain and medically modify each individual neurological system in attempt to reach that baseline? What dangers are we ignoring by declaring pathological or “wrong” certain brains that do not meet our standards of “normal?” Have I lost you in this Brave New World-esque conspiracy theory rant?
3. There is a whole lot more psychiatric support for a patient when he/she is in crisis, but surprisingly little information is offered over the course of treatment as to how to get off medication. Part of this is understandable, as disaster requires more attention than stasis does, but part of it strikes me as a little too self-perpetuating. After all, who would be at risk for loss if you were encouraged to eventually re-evaluate your medication? (I’ll let you answer.)
4. And the final reason to be skeptical of psychiatry and/or a pursuit of happiness: Why the fuck should anyone be happy? Have you seen the world?
Despite all this quibbling, I’m not even all that interested in debating my own status as mentally ill or not.
Fact is, I saved up my money, I went to see my psychiatrist, and she said I could go off my medication. So far, I’ve been fairly diligent about texting my psychiatrist (a pretty surreal experience, but a free one, so we’ll go with it) and giving her an update on how I feel, which is pretty much fine? Normal?
I mean, Syria is still war-torn, Katy Perry still enjoys success, and I still analyze. So, all in all, feels like just another day up in my dome. When I communicate with my psychiatrist, I’m always careful to show that I’m very aware of the fact that pure giddiness was never the goal of medication, and I’m also always careful to try and keep her aware of the fact that she should never expect sunshine and rainbows from me. Perhaps I overcompensated. Here’s our conversation from last night (edited for grammar):
Me: Feeling pretty good! I feel like my life is rather complicated but it's life that makes it that way, not my own mental machinations, and so while I don't feel happy always, I do feel in charge of my own existence (usually)
.Me: Does that make sense?
Psychiatrist: Kelsey, happiness is different than content. Most of the time we are content. Sometimes we are really happy. Does that help?
Me: I know the difference... just trying to drive home the point that I know the goal of medicine, on or off, is not to make life "easy" per se. Or is it?
Me: Of course it's not. I think I'm destined for a full, and therefore complex, existence. So far, being on different dosages hasn't seemed to make much of a difference in terms of my quality of life.
Psychiatrist: Don't change dosages. You're too existential.
… to which I wanted to respond, “… the fuck?” but of course I didn’t because being more argumentative with her would just make me look more existential and like I was trying to make excuses for why I’m not happy and to justify my living with low-grade and yet still-painful melancholia so as to prove a larger, more impersonal point, i.e., that antidepressants are not as necessary as the psychiatric establishment wants us to believe they are.
Is there a chance that perhaps this is exactly what I am doing?
The most difficult thing about this process so far has not been any actual withdrawal symptoms, or any jarring shift in my demeanor or outlook on life, but rather confronting the real distrust I have of my own feelings. I don't know if it's my overly analytical nature, the depression trying to sabotage and psychologically mutilate me at every turn or the fact that I've proved myself incompetent in this context by virtue of having such a tarnished record of taking care of myself.
This tortuous thought looping could go on for thousands more words, but I’ll stop here before you decide yourself to track down my psychiatrist and tell her that maybe she should consider bumping up the ORIGINAL DOSAGE.
There is no conclusion to this article as there is no conclusion to my conundrum at this moment. But I will continue to try and go off my medication, which means also continuing to take care of myself in natural ways that ward against depressive thoughts (such as: abstaining from alcohol and drugs, sleeping regularly, eating regularly, exercising and all that other boring regular shit that I hate doing).
I have to continue to do this under the auspices of a doctor, despite the fact that I have mixed feelings about it. It’s okay if I need to stop tapering off, or go back up again, and it doesn’t mean I’m a failure.
I will probably write another meandering piece for xoJane in which I evaluate how I feel back at 90 mg or down at 50, depending on how all this pans out.
And here's the one thing I'm very sure about: I’m deeply afraid I won’t be able to live without drugs.