The Beginner’s Guide to Behavioral Medication, Part 1: Antidepressants
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Note: This series is not meant to diagnose or mollify mental illness or provide medical advice—that responsibility lies with psychiatrists and physicians. The author is not a licensed medical professional.
Nine years ago I started taking antidepressants and entered a world of side effects: dizziness, fatigue and forgetfulness. Selective serotonin reuptake inhibitors (SSRI) also introduced me to a surge of anxiety that made me contemplate suicide. My doctor added a mood stabilizer to the mix, and from then on I managed, sacrificing my body for my brain.
If a medication doesn’t necessarily work, you’re supposed to adjust or try something new, but I hesitated for years. Eventually I was ready to live again, so I cut my dose of Lexapro in half. Conducting experiments on my brain (more of this, less of that, switching medicinal classes), I slowly came back to life. Managing mental illness is a process, and going on medication isn’t a quick fix—almost a decade later, my mental health has improved greatly, but I still haven’t found the right balance for both my brain and my body.
The Rundown
Nearly one in five Americans suffer from mental illness, especially young adults and teenagers. The stigma of mental illness and medication is fading. However, doctors are often too busy to discuss side effects, and in the case of behavioral meds, that can mean the difference between managing illness and contemplating suicide.
Antidepressants are the third most commonly prescribed medication in the United States and currently have four classes: SSRIs, SNRIs (serotonin-norepinephrine reuptake inhibitors), NDRIs (norepinephrine-dopamine Reuptake Inhibitors) and TCAs (tricyclic antidepressants). (MAOIs, the oldest class of antidepressants, are virtually unprescribed these days.) Because anxiety and depression are both caused by a serotonin deficiency (and often exist simultaneously), antidepressants are used interchangeably for both illnesses.
SSRIs
SSRIs work by preventing the brain from reabsorbing serotonin, a neurotransmitter that carries signals throughout brain cells. Because the serotonin isn’t being reabsorbed, SSRIs help combat serotonin deficiency, the main cause of depression. Common SSRIs include Lexapro, Paxil, Prozac and Zoloft. Drowsiness and dizziness are the most common side effects of SSRIs, and they can also increase nervousness or agitation and decrease both sexual desire and ability. From my experience, I’ve found that certain SSRIs take a harder toll on my sleep cycle; on my original dose of Lexapro, for example, I transformed from a morning person to a somnolent creature that took five-hour naps and struggled waking up in the morning—I often felt like I’d been drugged the night before.
SNRIs