On antidepressants

A devilish drug, the SSRI. Selective serotonin reuptake inhibitor. What a semantic mind-bender. Selective I get, serotonin – sure, inhibitor I can guess. But reuptake? Even the machine I’m writing this on seems baffled by the term. It has underlined it with little red lines, and the only suggestion spells out “repute”. Hopeless. Only pharmacologists can stack two prepositions before a verb. Take we can agree on. I don’t feel like looking up the exact etymology, but uptake seems to me as one of those beautifully simple words coined by someone who wished to express ideas too complex for the readily available language. It has been explained to me that serotonin reuptake is the process by which a working brain recycles the serotonin it has already produced. I can’t say that I understand what that means, even though I nodded affirmatively in the moment. I didn’t really care for the elaboration when it was prescribed to me, just how I don’t ask the teller at the gas station how is it exactly that my car doesn’t blow up in flames every time I turn it on. I just wanted the engine back up and running. I guess what I’m writing here is, in internet jargon, a six-month review of my life with an SSRI. For full disclosure, this is my second time I’ve underwent this specific treatment, and it just might be that I shouldn’t have stopped in the first place. But that’s a story for another time. I don’t remember reading the leaflet that came in the box the first time I started taking it, but I recall vividly reading it six month ago. I found it both hilarious and alarming. The list of adverse reactions is rather long, so I’ll stick to listing the common ones, along with a short parenthesised note containing my experience so far:

• Suicidal thoughts (better than before the treatment)
• Heart palpitations (only when presented with warm waffles)
• Visual impairment (already wearing glasses to hard to tell)
• Nausea (no)
• Diarrhoea/Loose Stools (hard to tell whether it has to do the medication or warm waffles)
• Dry mouth (no)
• Dyspepsia (don’t know what that means)
• Constipation (see above under Diarrhoea/Loose Stools)
• Vomiting (ibid)
• Fatigue (better than before the treatment)
• Decreased appetite (yes, thankfully)
• Dizziness (no)
• Somnolence (don’t know what that means)
• Tremor (no)
• Insomnia (better than before the treatment)
• Agitation (ibid)
• Libido Decreased (yes, thankfully?)
• Ejaculation failure (haven’t tested)
• Erectile dysfunction (ibid)
• Ejaculation disorder (ibid)
• Male sexual disfunction (aren’t the these the same thing?
• Hyperhidrosis (don’t know what that means)

Looking back, I think the drug seems to be working. When I sought treatment, I was having to deal with suicidal thoughts, a two-year bout of insomnia, severe agitation issues, and an increased libido. The thoughts came in slowly, and presented themselves in disguise. Their presence dawned on me only after having extensively written fictional pieces centred on death and/or suicide. I thought they were just a creative outlet for a certain melancholy je ne sais quoi. I thought writing about it would help. It didn’t. I just became obsessed. Not to the point of doing something about it, but I guess that’s not a point you want to reach and see what happens. I also didn’t know that my sleeping issues, which manifested themselves in my being able to fall asleep but being woken up by panic attacks before dawn. Truth be told, I had stumbled upon the definition of “cortisol insomnia” but dismissed it as a made-up fad. I tried all the, let’s call them natural, sleeping aids: adjusting my sleep schedule, eliminating screens, coffee, food for hours before bedtime, working out – nothing helped. Agitation was the most obvious one. For no apparent reason, I would so easily snap into a raging fit by something so simple as my loose shirt sleeve getting caught on the door knob. I would be thinking about that knob for hours after the incident. At one point I’d started having suicidal thoughts after dropping a spoonful of sugar on the kitchen counter. Finally, not that I was promiscuous but sex seemed to help with all of the above, if only very temporarily.

The seemingly infinite and ever present sadness is something I had kind of learned to live with. But when combined with these daily functioning impairing ailments, something told me I might be dealing with an underlying condition. I say something, because it’s very rarely going to be a someone. Although it can certainly feel like that, it’s not that nobody cares. We have made some positive strides in the public discourse around mental health, but I’m still to meet someone who talks about mental issues as fluently as they talk about their constipation, asthma or types of diabetes. Laxatives, inhalers and insulin shots are also somewhat less complicated to explain to a casually interested party. I started with saying that the SSRI is a devilish drug. By this point it should be obvious that I’m only talking from personal experience, so when say that I feel like taking the medication amounts to making a faustian pact with the pharmacological gods, take it as one individual’s limited account. In simplest terms, the drug seems to be working in a way that cuts out the lowest of the lows by taking the highest of the highs along with it. In my case the low lows have been dealt with so effectively that it sometimes occurs to me I might not be suffering from depression at all. Then I start feeling like an impostor and an emotional vampire and then glimpse the bottom of the well again. Best not to get ahead of myself. Naturally, I wonder whether it’s worth sacrificing the highs. Feelings of excitement, elation and arousal are on an indefinite hiatus. Alcohol seems to help, so I think that’s why it’s strongly advised to stay dry while on medication. I wouldn’t want to add on a serious disease to my imaginary one. While holding my anxiety by the waist on really romantic evenings of self I soothe us by saying that anything is better than the hell of before. But I don’t for a moment assume that the drug is a stairway to heaven. Anyways, be sure to follow for my one-year review.