I see a lot of memes going around defending the use of medication for mental illness. And I agree with these memes: mental illnesses are genuine physical ailments, being on Prozac for depression is no different than being on insulin for diabetes, etc. Absolutely.
But…maybe it’s just the circles I move in, but I don’t actually hear a lot of people equating taking psych meds with being weak or whatever. I am seeing a bad trend of people thinking that being on psych meds magically makes everything great forever.
I have a FetLife acquaintance I’ve been texting with and when I told him about my issues with anxiety and depression he was like “so why don’t you go to a doctor and get it fixed?”
I am in fact planning on going to a doctor and getting medication for this. Sometime. But not just yet. Allow me to elaborate:
The first time I sought medical treatment for my shitty brain was in my early 20s. My doctor put me on Prozac.
Prozac worked. I was more functional than I’d ever been in my life – energetic, happy, able to socialize, able to deal with people, not afraid to leave the house anymore.
Prozac also short-circuited my clitoris so that I couldn’t orgasm. Please note that I did not say it killed my sex drive; only my orgasms. My sex drive was still very much alive – ravenously, all-consumingly alive – and had no outlet. I sort of got addicted to porn and erotica because I was hoping that if I could get myself turned on enough, I might be able to get over the edge finally. But it didn’t work. I would walk around for literally weeks at a time feeling five seconds away from coming, but if I actually tried to touch myself the feeling immediately receded as though my fingers had snuffed out the flame.
It was during this time that I started to get squicked out by my own genitals. Before Prozac when I masturbated I was mostly registering the sensation in my crotch; now, with my clitoris no more sensitive than my elbow or nose, I noticed what my clit felt like to my hand. I remember trying to masturbate one day and reeeeally noticing the rigid feel of my girl-boner under my fingers and thinking “I’m basically just massaging a clump of blood right now.” It grossed me out and kind of put me off using my hand after that. From that point onward I preferred to use a vibrator, and that persists to this day.
So, sexually, life was a living hell for me because of Prozac*. But I really liked not being depressed and anxious anymore, so I stayed the course.
Then the Prozac stopped working. It was hard to know for sure at first because depression can be sneaky and also it’s hard to tell a normal bad day from “Oh shit it’s back I’m doomed” sometimes. But I was really pretty sure that my brain was backsliding, and then one day I successfully masturbated to orgasm and that clinched it. I went to my doctor and said the meds weren’t working anymore. He said “that is not a thing that happens” but then immediately contradicted himself by prescribing me a higher dose. Eventually that stopped working too though and I asked to be put on something else.
Incidentally, while on Prozac I started having this weird tic where my eyeballs would randomly zip back and forth. Years later I happened to be reading up on the side effects of Prozac and one of them was “uncontrolled movements of the eyes or tongue that can persist even after treatment is discontinued” or something like that. My doctor never mentioned this to me when he prescribed the Prozac to me. I’m certain that’s where my eye spasms came from. They started when I was on Prozac and continued for 10-15 years after, although mercifully they’ve stopped now.
Anyway. Paxil, Effexor, Zoloft, and Celexa (and I think there are one or two others I’m forgetting) all did the exact same thing to me: killed my ability to orgasm and then stopped working after a couple of months. Also, when I’d ask about side effects my doctor would only say “Meh, dry mouth or maybe a lowered sex drive.” He did not mention that, for instance, quitting Paxil cold-turkey can cause horrible withdrawal similar to going off heroin. If he had told me that ahead of time, I probably would not have consented to go on it. As it was, I quit Paxil cold turkey when it stopped working and luckily did not go into withdrawal. Anyway my point is that my doctor didn’t seem to keep me properly informed and it pisses me off.
I began to think that it was impossible for my crotch and my brain to function properly at the same time and I’d always have to choose either/or. This depressed me in its own way, even while I was on meds and they were working. I mean, what a grim choice to have to make. For a few years I went off antidepressants entirely.
Then shit inside my head got really bad again and someone told me that family doctors are actually pretty clueless about treating depression, and only know to throw SSRIs at it (there are medications that work for depression in different ways, and SSRIs are just one category). So I saw a psychiatrist who would allegedly be able to really fine-tune my meds and dosage for maximum effect. I forget the name of the non-SSRI he put me on, but the first time I took it I immediately felt dizzy and fucked up and ended up lying on the floor crying in the foetal position because my brain and body felt so strange and out of control to me and I didn’t know when or if it would ever stop.** That only happened with the first dose, though; I guess my body just needed to get used to it.
This new drug made me gain weight. Which was weird because it also reduced my appetite and I was eating a lot less than before. Plus of course it helped my depression so I was up and about instead of lying around all day. But yeah…I put on twenty or thirty pounds despite eating less and being more active. It kind of distressed me but I decided once again to stay the course. It felt shallow to prioritize being thin over being mentally healthy. Although the weight gain did bother me, and I wasn’t thrilled by the prospect of paying a hundred bucks a month for medication and having to spend money on a new bigger wardrobe.
But then that medication stopped working after about a month. And when I told my shrink, he said “Well, it usually takes four to six weeks for an antidepressant to take effect, so let’s just give it a little longer.”
“But it’s not that it hasn’t kicked in yet,” I argued. “It’s that it started working and then stopped. I don’t see how continuing with it would be productive.” He told me to keep going, anyway, and handed me a prescription for a refill.
I did not fill the prescription. Instead I went home and Googled the drug, and found out that it’s never had a clinical trial that lasted over six weeks. So there’s no scientific reason why my shrink thought it would suddenly resume working if I kept on taking it, because nobody knows what happens when you’re on this drug for more than six weeks. I threw the prescription paper out and abandoned the idea of medication again for over a decade.
Which brings us pretty much up to now, when things inside my head got bad enough that I found myself in a doctor’s office again (a different doctor this time). She prescribed me Celexa, saying that she knew I’d taken it before but bodies change and maybe this time it would work out differently. It kinda did – I was still able to orgasm, this time around, just with difficulty. It did seem to kill my sex drive, though (so the doctor gave me Wellbutrin to try to boost it up, but that did nothing as far as I could tell). Also it made me unable to sleep. I’d go to bed and then sproing awake four hours later for no reason. It was driving me mad.
“Sometimes when you stay on a drug, the side effects ease up but the good effects remain, so let’s just keep going with this,” the doctor said. So I did, and the sleep thing did get a bit better. But of course the Celexa stopped working after a couple of months, as everything always does. My doctor upped my dose a few times but ultimately I was like “fuck it, put me on something else.”
I can’t remember what she put me on next but the same thing happened.
Then I decided I wanted to try a different tack and treat the anxiety first and foremost rather than the depression. The doctor prescribed me Lyrica, which is officially used for nerve pain but one of its “off-label” uses is anxiety control.
Holy shit, Lyrica was awesome. It’s possible that time is skewing my memory but I think I liked the effects of Lyrica more than any of the other things I’ve tried. And because it works differently from antidepressants, I hoped that maybe it would keep on working for me and not poop out like everything else has.
I gained thirty or forty pounds during the time I was on Lyrica, but I’m not sure if that’s correlation or causation since I went through a phase of eating like a total pig for a few months at around that same time. What the Lyrica definitely did do was make me retain water. My legs swelled up so that I couldn’t zip up my favourite knee-high boots anymore. My knees began to feel kind of…waterlogged, one of them to a point where something felt pushed out of joint and it hurt. Which isn’t great considering the highly physical nature of my job. My eyeballs even felt waterlogged; my vision began to blur. But I could still orgasm like usual, and my brain was functioning great, so…I stayed the course. I did wonder whether I would eventually suffer a permanent knee injury. But for the time being I just kept on taking my meds.
Until it became clear that they too had stopped working, and I was like fuck this, I’m sick of my entire body feeling like an unsqueezed sponge anyway, and I stopped taking them. Which, as it turned out, caused a brutal withdrawal that my doctor had never mentioned (I mean she never mentioned the possibility when she first prescribed the the Lyrica so that I could make an informed decision on whether to go down that road. If I’d consulted with her before stopping the drug I would imagine it would have come up then). By the way, I was on a pretty low dose – about 150mg per day. Some people take up to 800mg. My withdrawal process was awful and I can scarcely imagine how bad it would have been if I’d opted to keep upping my dose until it worked again and then quit when I hit that final wall. You can supposedly avoid withdrawal by tapering a drug down slowly, but who has the money to do that?
Oh and after the fact I was talking to my pharmacist and he casually mentioned that Lyrica is more similar to a tranquilizer like Lorazepam than it is to antidepressants that change your actual brain chemistry. My doctor had not mentioned this. I’m pretty afraid of getting onto tranqs and becoming addicted, and if she’d fucking told me what exactly Lyrica was then I may have chosen to avoid it. But hey, why should I be fully informed about what goes in my body? I’m only the lowly patient.
So. For those of you who want to keep score at home, psych meds have:
- Given me eyeball spasms that continued for over a decade after I stopped taking the meds
- Killed my ability to orgasm while I was on them
- Killed my sex drive while I was on them
- Indirectly made my own genitals seem alien and gross to me
- Put me on a terrifying “high” on the first dose
- Made me gain weight while I was on them
- Made it so I couldn’t sleep more than four hours at a time while I was on them
- Made me retain so much water that it started fucking up my joints and vision while I was on them
And there’s no way to predict what special new surprise a different drug will inflict on my body, and everything I take stops working after a few months, anyway.
Would you be in a big hurry to get on something new if you were me?
*Nowadays I can have a craving for orgasms but just kind of ignore it if need be. It seems as though most women are like that. But back then my sex drive was more like what we associate with a man: I needed to come. Couldn’t think of anything else. Was basically a walking hardon all day – just a big ball of tension clamouring for release. I can’t tell you how awful it felt to need that release and be physically unable to get there. Being backed up would actually start to hurt after a while. I felt like I was walking funny.
**Funny story: I was married at the time and my husband just sucks at dealing with things (hence his alcoholism, I think). We were watching a rented movie when the meds started to kick in and I was like “…Oh. Ohhhhh fuck. Something feels wrong with my head. I don’t like this.”
“What exactly are you experiencing right now?” My ex asked, in a kind of awkwardly clinical tone and seemingly only because I was looking to him for support.
“I’m just…dizzy and…I don’t know. My head doesn’t feel right.” I tried to stand up but ended up sliding right off the couch and onto the floor, where I curled up and cried. And my ex didn’t comfort me or ask if I needed to go to the hospital or anything. He just…kept on watching the movie like I wasn’t even there. Awesome.