I began cognitive behavioral therapy (CBT) about nine months after my youngest son was born. For several months prior, I realized I likely had postpartum depression that was getting worse instead of better. Yet, thanks to the reality of depression, it took exceedingly long for me to take action in self-care. I also acknowledged that I had been dealing with anxiety since my earliest memories as a child. Similarly, I had not sought a diagnosis or treatment because of associated stigma and the fear that an official diagnosis would mean my life insurance rates would go up, or I could be denied future health insurance. Thanks, Anxiety.
My choice to finally seek help was a result of progressively worsening suicidal ideation. And while CBT was helpful, both in terms of learned coping skills and having a space to vent, it wasn’t enough to hold back the flood of negative thoughts. Although I was initially skeptical of psychiatric medication and its side effects, I made an appointment with a psychiatrist nurse practitioner who confidently expressed I would benefit from a low dose selective serotonin reuptake inhibitor (SSRI). Although the effects were not immediate, and several months of troubleshooting were required to elucidate the best dosage, I have adjusted well and the results were better and broader than I expected. Here are some of the ways that my life has changed after beginning a low dose SSRI:
1. No more suicidal thoughts.
It’s almost shocking how seamlessly I went from a mental state of passive-to-borderline-active suicidal thoughts, multiple times per day, to their nonexistence.
2. Patient parenting.
For years I’ve been a supporter and practitioner of positive parenting and child-centered learning. However, I also frequently became overwhelmed and lost my cool while seeking control in ways that were not well understood by my children. As a result of the calmness I now experience with my SSRI, my empathetic actions can keep pace with my philosophical intentions. I am better equipped to acknowledge and cope with age-appropriate, albeit sometimes obnoxious, behavior. I more consistently provide discipline through guiding and prompting what to do, instead of impulsively barking less-helpful phrases of what not to do. I often allow my children the opportunity to fall, fail or take three-times longer than I would to complete a task independently. Although it would be easier and faster for me to take control by saving the falls, intervening before failures and doing all the complex tasks for my children — I would be depriving them of valuable productive struggles. I now have the patience to allow their confidence and independence to grow slowly over time.
3. Confidence at work (speaking up).
After years of being the quietest one at the conference table, I’m finally willing to offer my ideas up for discussion. Sometimes the ideas are not well received and I’m able to brush it off without emotion; and sometimes they are seen as innovative and positively impact my work and professional reputation. I feel more confident in the areas where I have expertise, more accepting of the areas where I am still growing and more comfortable in asking questions of my colleagues.
4. Taking appropriate risks.
My willingness to take a risk ranges from small uncertainties, like spontaneously trying a new driving route, moderate risks such as attempting to coach a Lego robotics team, to the huge risk of exploring the possibility of foster parenting. It’s worth mentioning that each risk is accompanied with plenty of thought and planning. The difference I notice, now that I use an SSRI, is the ability to hold a positive perspective, and the realization that the truly great things in life come when we challenge ourselves in new ways.
5. More social.
I recently planned a ladies night and a Tupperware party just for “fun.” That is so out of my typical comfort zone where, historically, I wouldn’t even attend such events as a guest. Somehow, now I see the value and even joy that a social life can bring. During my intake for CBT, I conveyed that I felt I didn’t have any true friendships other than with my spouse. I felt as though my “superficial friends” were simply being polite but that they had no genuine interest in me, or even worse, found me annoying. Now, I view those same friends as authentic and feel confident I bring value to our shared relationships.
6. Increased creativity and ambition.
I had spent years dreading the end of my prior work contract, and the inevitable job application process that I needed to begin. I was fearful of the effort involved and the hopelessness that would accompany rejection. A few months after beginning a SSRI, I was finally compelled to sit down and search for vacancies. Not only did I find a few job ads, but I became motivated to complete application materials, quickly received invitations to interview for two well-matched positions, which then led to a job offer. My newly unleashed creatively, combined with ambition, has also allowed me to pause and get my thoughts on paper, and earn the status of a contributor at The Mighty with my first published story. I have out-of-the-box ideas on how to make innovative changes at my workplace, in my hobbies and in my personal time. I know the creativity has always been within me, but I feel as though the anxiety kept it boxed up until the SSRI made space for my ambitions. I have shown myself that if I take the time to put my creativity into a product, I am capable of great achievements.
7. Better problem solving.
At the height of my depression and anxiety I would catastrophize and jump to conclusions with every little mistake and hurdle. I felt stuck in a feeling of worthlessness. With both my CBT skills and my SSRI, I can now consider challenges or mistakes without panicking. I am able to calmly assess a situation and rationalize appropriate next steps. Most importantly, I am able to move forward and actively address problems instead of avoiding them or feeling immediately defeated. When my mom asked what does my SSRI “feel like?” I responded, “It feels like not freakin out over stressful situations and instead being able to calmly deal with them.”
8. I can be relentless when I want to.
I now acknowledge the power of taking action. I may not have control over everything I want, I may not get everything I try hard at, but I certainly won’t get close unless I make attempts. I have shown myself that I can make both small and great accomplishments when I am focused and determined. And even if I don’t achieve the desired outcome, I realize I have a few different options: continue pushing to see if I can still change the outcome, or take a perspective that I tried my best (for now) and likely made a small gain in the desired direction.
9. Changing my perspective.
Speaking of taking a perspective, my CBT and SSRI combo has allowed me to become fluent in changing my perspective for the better; with practice of course. It’s amazing to recall, how a year ago, every challenge felt devastating; yet today, I can find the silver lining of almost every situation. Not only do I tell myself and my family that there are ways to grow stronger from setbacks, but I really believe in this philosophy.
I have become better at accepting situations for what they are (when relentlessness, see above, isn’t in my best interest). Of course SSRIs are not magic pills that suddenly make everything in the world easy and happen in your favor. Yet post-medication, I’ve found new ease in choosing to with go with the flow. Not only has the choice to go with the flow become easier, but sometimes relinquishing control of a situation can also bring relief (see changing perspectives above).
11. Selflessness and generosity.
Celebrating Christmas or others’ birthdays used to make me cringe because I have a lot of money-related anxiety. Similarly, I used to be very possessive of my belongings and reluctant to share, for fear of something being lost, broken or just not available for my own use or benefit. Since beginning my SSRI, I finally feel comfort and satisfaction in indulging someone else or donating something, while not fixating on the financial “loss.” I continue to behave responsibly with my finances; the difference is that I now see the value in charity and altruism.
12. Minimal side effects.
I used to be one of those judge-y, uneducated, unexperienced folks who assumed psychiatric medication was for the weak. I was also swayed by some lines from some TED talk that highlighted how little scientists and doctors really understood about how psychiatric medication worked or impacted the brain and body. While I originally shared these attitudes with my CBT therapist, she encouraged me to address my concerns with a psychiatrist she trusted, who also pointed me to some non-biased literature to review. As time went on and CBT wasn’t enough to help my symptoms, I reached a place where I was willing to try something new. The psychiatrist nurse practitioner clearly described the common side effects of a low-dose, well-researched, commonly-prescribed SSRI. The first 24 hours after I began the medication, I experienced a headache and some insomnia, but those symptoms faded as quickly as they came on and didn’t return.
As far as I can tell, my particular medication and dosage does not cause any overt negative side effects for me. The one inconvenience is the inability to drink more than one serving of alcohol; but that is an easy tradeoff for enjoying the color that has come back into my life.
Overall, I have to agree with the therapists and psychologists who provided the disclaimer that an SSRI doesn’t magically make you happy. But for the reasons above, I have found that my
SSRI allows me to be happy. I still need to work at the balance and trajectory of my life, but now I feel better equipped to do so.
Please be advised that only a discussion with a properly licensed psychiatrist, perhaps in consultation with other therapist(s), is the safe route to determining whether starting, stopping or changing psychiatric medication is the right personal decision. While I have documented my positive experiences believed to be partially attributed to using a SSRI, medication is not necessarily the best or only therapeutic solution for others.