We Need to Talk about Antidepressants

The fall of my senior year in college, I had a nervous breakdown. Until recently, I didn’t even know what happened to me could be considered a nervous breakdown. When I hear that term, I think of a padded cell and a 5150 hold. I think of a complete psychotic break — like running around the streets naked and smearing feces on cars, or something. That didn’t happen with me. Instead, I spent a week huddled under my electric blanket, feeling like my heart was going to beat out of my chest, convinced I was dying of Swine Flu, crying and eating cereal and watching Frasier on an endless loop. This was triggered by the PTSD I developed after studying abroad the previous semester.

Accurate.

A “nervous breakdown,” according to MayoClinic, refers to a stressful situation when someone is unable to function in day-to-day life. It’s really helpful for me to read that definition out loud to myself. It helps me realize, to this day, that yes, things were that bad. Until recently, I kind of just referred to that time in my head as the week I binged on Lifetime Original movies and drank a lot of wine and missed a lot of class. As it turns out, I wasn’t just “having a bad week.” I wasn’t just “feeling stressed” or “feeling sick.” I had completely ceased to function in the world. I had a full-on nervous breakdown. And maybe had I known I was careening toward a breakdown, I wouldn’t have been so reluctant to start taking some medicine.

Pretty much verbatim what I told my roommates and coworkers

So after my full-on, hiding-under-the-covers nervous breakdown, I finally admitted that yeah, maybe I wasn’t doing so well with just therapy and a bottle of wine. And perhaps — just perhaps — I needed to kick it up a notch.

Up until that point, my therapist had been cautiously suggesting that I try an anti-depressant. And for months she had respectfully nodded and hadn’t pressed me when I all but laughed in her face. Well, I didn’t quite laugh in her face, but I made it clear that the thought of taking medicine was ridiculous. Hello? I thought. Haven’t you been paying attention? I freak the fuck out when I have to urinate, and I’ve been urinating for my entire life. If I start getting weird symptoms because of these pills, I’m going to have a heart attack. I’m going to start obsessing every time I take them. I’m going to start feeling imaginary symptoms. I’ll over-think every twinge, every cramp, every unfamiliar ache. It’ll make my anxiety worse. So for months we’d do a cat-and-mouse where the subject of meeting a psychiatrist (for medicine) would come up and I’d awkwardly try to side-step. And by side-step I’d be like:

But after that week in October, I felt like it was very literally my last option. Either I could take some medicine and hope that it worked, or I’d cease to function like a normal human. And that kind of panic — that flu-like feeling of sickness — is simply unsustainable. I’m not saying I was suicidal. But I really don’t know how much more of that I could have taken. So when I went crying to the campus nurse about how I had the Swine Flu and all my “Swine Flu” symptoms turned out to be anxiety induced, that blessed nurse scheduled a therapy session for me immediately. And from there I saw the psychiatrist.

Psychiatrist guy gave me two things — and I feel like it’s important for me to tell you what they were, at the risk of sounding like a druggie, because every week or so I’ll get an e-mail or an instant message with someone asking me about anti-anxiety drugs and what they’re like. There’s a definite undercurrent of shame, and fear, and, well, anxiety about what the side effects are going to be — which was totally my preoccupation before I started trying them. So. Psychiatrist guy (who looked curiously like Tobias Funke) gave me xanax, which has short-term effects and calms you down in the midst of an anxiety attack, and started me on Zoloft, which is an anti-depressant. Basically, untreated anxiety or PTSD feels like you’ve got your hand on a hot skillet and you can’t take it off. You’re expected to function as though everything is fine, but inside you’re thinking HOLY SHIT THIS HURTS I CANT FOCUS ON ANYTHING ELSE BUT THE BURNING IT BURNSSSSSSS!!!! Xanax is like splashing some cold water on the skillet — a temporary relief, but your hand is still on the skillet, and it’ll heat right back up again in a few minutes. Zoloft is like someone coming up behind you and turning off the burner — gradually, the anxiety goes away, and you start acting and feeling more like your normal self.

Seriously. Can you tell I was an English major?

So I started the zoloft that day. And I’d be lying if I said I had about a million tiny little anxiety freakouts and IBS flareups wondering what the side-effects would be. And I did get side-effects — nausea, primarily — for a few weeks until it started to kick in. And boy, did it kick in.

About a month after I started taking it, sometime in the first week of December — about ten months after the incident that spurred my PTSD — I woke up one morning and I felt lighter. Physically lighter. My limbs were looser. And the biggest difference was that I could breathe. It was a totally unparalleled feeling and I’m sure I looked like a complete dumbass, because I would just walk around campus and take deep, long breaths, sucking all the cold air into my lungs that I possibly could. It felt wonderful. I hadn’t even noticed until the anxiety went away how completely crushing it was. A weight had literally been lifted, and I felt joyously free. Right in time for finals. And then winter break.

When I went home for winter break, the primary feeling I felt was utter bliss. I’m not kidding. It always really irks me when people refer to anti-depressants as “happy pills,” because they make me functional, not happy. But this period was the exception — I had been living under the crushing weight of PTSD for so long that I had forgotten what it felt like to just feel normal. I could take big, deep breaths. I could  hear the doorbell ring or the blender turn on without hiding under my covers. I could wake up and actually feel excited about the day, instead of dreading all the millions of little noises and random events that would trigger an episode. I spent the whole winter vacation in my parents’ house, absolutely blissed out, reading books and lying on the couch and just feeling like I had gotten my life back. I could talk about my anxiety triggers without actually feeling triggered. I could think about India without feeling like I was dizzy or short of breath. I could ride in a car or a train without willing myself not to jump out of it. It was heaven.

Oh, it felt so good

I kind of sound like a druggie, don’t I? Obviously, anti-depressants aren’t for everyone. And Zoloft, specifically, is not for everyone, I’m sure. I wasn’t high or anything, but getting your life back after ten months in hell? Oh, it was wonderful. I couldn’t breathe deeply enough.

And then — I got depressed.

Stay tuned.

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What a Nervous Breakdown Looks Like

IV. Fall Breakdown

That fall, after suffering through a kidney stone obstruction, coming home early from my semester abroad, and having weird anxiety symptoms for the next six months, I went back to college on the north side of Chicago. I was still having panic attacks, but in my mind, there was nothing else to do but grit my teeth and get through them. I still didn’t really fully understand what was causing them.

I was glad to get back in the swing of things. I was still having weird bouts of anxiety where I would feel like I’d have to run away and hide in a cave somewhere. I was still having shortness of breath when someone would ask me how my semester in India had been. I didn’t want to travel very far outside of my campus-work-apartment radius, in case one of those bizarre attacks came on again. And if a cab honked too loud or my doorbell rang, I’d have to run to the bathroom so I didn’t literally shit my pants out of anxiety. But other than that I was getting back to normal. A new normal. I felt frustrated because whatever happened in India had happened months ago. It was no longer a part of my life and I wanted to move on. I felt like my mind had moved on — but my body hadn’t yet.

I started seeing a therapist at the Wellness Center. I’ll call her K. K was very calm and sweet and talked about her kids and husband even though she didn’t wear a wedding ring which confused me to the point of distraction. I told her I had been struggling with anxiety and slowly we began to unpack all the shiz that had gone down in Bangalore. More than once, she’d raise an eyebrow at me.

“This doesn’t sound like run-of-the-mill anxiety,” she’d say. “It sounds like you went through something incredibly traumatic. Maybe you’re having PTSD?”

“Yeah, I guess, or maybe something else,” I’d say. I knew, deep down, that if this were a “serious” diagnosis and not just some run-of-the-mill panic, I’d have to go on antidepressants and I couldn’t stomach the thought of having side effects. I couldn’t stomach the thought of being on medicine for something like this. Medicines were for sicknesses. I wasn’t sick. I just wanted to move on. I was just biding my time until my body caught up with my mind. My mind had moved on. I wanted to put all of this behind me. There was no way I was going on drugs.

One week in October, everything changed.

My mom called my phone when I was waiting in line at the campus cafeteria. “You want to know something crazy?” She said, mid-conversation. “Steve [our neighbor] thinks he might have Swine Flu.”

In an instant, everything went still. I felt my stomach drop to my knees. I felt a warm rush of anxiety crawl across my skin, very much in the same way it would crawl across my skin four years later, when we got the news that our son had Spina Bifida. I had just seen Steve over the weekend, and he hadn’t seemed sick. I vividly remembered taking a sip of his wine to test it out.

At that point, my biggest fear was that something would happen regarding my body that I couldn’t control, and I would have to go back to the hospital. Now, in my anxiety-riddled mind, my worst fear had come true. It was inevitable. The virus was already inside me. And the most terrifying part was that I wasn’t showing any symptoms now, but inevitably I knew I would be. I didn’t know when. Or how. But surely in the next two or three days, it would attack. I’d have to go back to the hospital. I would wake up in the middle of the night, sick and incapacitated, and have to navigate my ass all the way to an unknown hospital — again. I had to fight to keep from vomiting right there in the cafeteria line.

And hadn’t I heard that Swine Flu was potentially deadly? Hadn’t a few people died from this thing? I fought off a fresh wave of panic. I could die. This could be my last week alive.

I got off the phone as quickly as I could and high-tailed it back to my apartment. I climbed into bed, got under my electric blanket, and willed myself to fall asleep as fast as I could. It was the only way I
could shut off the thoughts that kept forcing themselves inside my head. I slept for hours and woke up exhausted. Here it is, I thought. It’s beginning. Swine Flu. 

I didn’t go to class the next day. What was the point? I was going to get the Swine Flu symptoms any minute, and I had to be ready once it hit. I stayed in my room all day and watched Frasier. I felt sick. I got a headache. Swine Flu is starting, I thought. Here it is. I was nauseous. I had the chills. I packed a bag in case I had to go to the hospital, and waited. It wasn’t serious enough for me to head to the hospital yet, but soon enough, it would be. I couldn’t take the chance of getting suddenly sick in class, or on campus, around a hundred other people — that would be humiliating. So I just sat in my room under the electric blanket and watched season after season of Frasier. I emerged once to go to the Dominick’s across the street and got a huge bottle of wine, some pierogies, and a romantic comedy. I watched the movie back to back for the next twelve hours.

Meanwhile, I had exhausted the supply of xanax my doctor had given me a few months before.

I believed so many lies when I had anxiety, and writing this, I think that’s one of the saddest things about the whole situation. Anxiety lies. I knew — I knew — that if I called the doctor back and asked for more xanax, the doctor would think I was a drug addict. Or a scammer. I cried. I can see now, in hindsight, that my brain was truly sick. Only a crazy person would think that a terrified twenty-year-old, who had carefully rationed 20 pills of low-dose xanax for the past six months could possibly be a drug addict. And knowing my doctor, who is a wonderful, kind-hearted woman, that would have been the last thing she would have thought. She would have helped me. But I was convinced otherwise. People would laugh at me. I’d get in trouble. They’d call me a liar. I couldn’t call the doctor. I was trapped.

Instead of calling and asking for more xanax, I just bought wine. But in my weird, altered reality, if I drank before 5 pm, I had a problem. Never mind the fact that I had been holed up in my bedroom for the past few days, crying and watching The Proposal, waiting for the Swine Flu to kill me. I bought wine as a cheap substitute for xanax — something to calm me down — but I vowed that I wouldn’t drink it before it was socially acceptable. Five o’clock.

For the next three days, I did nothing. I stayed inside. I cried. I waited for the Swine Flu to kill me. I watched Frasier on a loop. And I white-knuckled it until exactly 5 pm, when I would emerge from my room, pop open a bottle of wine, and drink the entire thing by myself. Totally rational, I thought. I mean, what else could you do, when you were waiting for the Swine Flu to kill you?

Here’s the scary thing: Normally, I could drink half a glass of wine before I started to feel woozy. Get more than a couple beers in me under normal circumstances, and I’d be climbing in my roommate’s Ikea wardrobe yelling about going to Narnia. But not this time. Now I was in such a heightened state of hyper-arousal, it took three or four big glasses of wine just to get me feeling like my ‘normal’ self. I didn’t feel drunk. I could drink two bottles and barely feel it at all. It should have been a big red flag that I was going out of my mind with anxiety, but it barely registered. I was just doing what any normal person would do if they didn’t have anti-anxiety medications and they were twelve hours away from dying of the Swine Flu. Right? And it wasn’t like I wasn’t functional, right? I mean, I could wait until 5 to start drinking. So I was fine. I was in control. Right?

The terrifying thing about anxiety, too, is that it completely changes your brain. You think in a way that’s not rational, that’s totally illogical, that’s completely unlike how you’d think normally. That fall, at my school, three students died in unrelated ways, all within a two or three week span, right around the time I was convinced I had the Swine Flu. One died after a long battle of leukemia. One after a horrific bike accident. Another I think had some infection. This solidified my belief that I was going to die. I was next in line. Death was hovering over my school like a cloud, and the fact that three students died in random ways unrelated to each other made it even more sinister. Like Death was just picking kids at random. And now I had the Swine Flu. I was definitely next. I literally didn’t leave my apartment unless it was absolutely necessary — I was next to die, after all. It didn’t matter if it was Swine Flu or something else — I could be crossing the street and get hit by a truck. It was going to happen, in one way or another. There was no way out.

About four days after I had received the phone call from my mom, I woke up at midnight shaking. Okay, here we go, I thought. Swine Flu for real this time. I went in the other room and threw up. I had awful diarrhea. I was freezing, aching. But to my surprise, I didn’t even have a fever. From what I heard of the Swine Flu, or any Flu, you had to have a fever. The thermometer’s broken, I thought, because OBVIOUSLY I had the Swine Flu. I suffered through the symptoms until the next morning, when I dialed the college wellness center and told them what was going on.

“I have the Swine Flu,” I said, crying. “Can you give me Tamiflu right now or should I just go to the hospital?”

“Hold on,” the nurse said, after hearing my symptoms. “If you don’t have a fever, you don’t have the Swine Flu.”

“That’s wrong, because I definitely have the swine flu,” I insisted.

“Honey, people who have the Swine Flu say that their body aches so bad their hair hurts. What you’re describing doesn’t sound like you’ve got the Swine Flu.”

“I PROBABLY HAVE A SLOWER-ACTING STRAIN,” I screamed. Was everyone in the world incompetent? Would I die alone, in my apartment, and have nobody find me for weeks after?

Somehow, the nurse was able to finagle me into calming down and coming over to the wellness center for an appointment. I don’t remember how I got there. But I remember very vividly sitting in the doctor’s office and crying and mumbling about Sanjay Gupta and how he got the Swine Flu and almost died and had to go to the hospital and so I just don’t want to go back to the hospital so if you just give me Tamiflu I can go back to my apartment and hide under the covers, okay? OKAY?

The nurse held my hand, and what she said next shook me.

“I can tell you right now, you don’t have the Swine Flu,” she said, and her eyes were very sad and very kind. “By any chance, do you have problems with anxiety?”

I was floored. How could she possibly know that? I mean, sure, I was a little nervous, but who suffering from a deadly strain from the Swine Flu wouldn’t be nervous? If you asked me, I was handling this pretty goddamn well, considering I was at death’s door. I walked all the way to the Wellness Center and I was still alive, despite the Swine Flu decimating my healthy blood cells, slowly shutting down my organs.

“A little bit, I guess,” I told her. Was this bitch going to call an ambulance or what? “Why do you ask?”

“I think all of this is anxiety-related,” she said, and dug out a small white bag filled with losenges and tylenol. Seeing that bag, it hit me. I didn’t have the swine flu. That wasn’t something you’d give someone with the Swine Flu. That was something you’d give a hypochondriac who was convinced she had the swine flu, to assuage her panic. I deflated like a balloon. My face burned with shame.

“I’m going to pop in next door to see if your counselor is available,” she said. I hardly heard her. She disappeared out the door and I burst into tears.