“Medication has no doubt played a central role in helping me manage my psychosis, but what has allowed me to see the meaning in my struggles–to make sense of everything that happened before and during the course of my illness, and to mobilize what strengths I may possess into a rich and productive life—is talk therapy….It is, at the heart of things, a relationship, and for me it has been the key to every other relationship I hold precious.”
Elyn R. Saks, The Center Cannot Hold: My Journey through Madness, Hyperion, New York City, New York, 2007, p. 331
When the panic attacks got so bad in college that I started having thoughts of suicide, I admitted myself.. I was diagnosed as clinically depressed and put on an antidepressant called Elavil. I had been working part-time on basketball games for the university with the audio hook up and maintenance. I remember having a panic attack when I went to one game. These panic attacks freaked me out. The feeling of losing control just hit me. For days afterward, I could not snap out of it–I am not sure why. These panic attacks would just happen out of nowhere.
I went to the student counseling center where there were a couple of clinical psychologists who worked with students. Their counseling was either individual or group-oriented talk therapy only. And it was free. But this just dis not seem to be enough for me. From there, I went to a Jungian psychiatrist. Teeing the psychiatrist was helpful at first. The first diagnosis I got was “anxiety neurosis.” That at least provided me some temporary relief in that I had not been defined as crazy. I was convinced I was losing my mind. All the talking we did for the next few months did little, and I seemed to just get worse. My depression deepened and I started feeling suicidal. That was scary. I felt hurt when others would say that I should just be myself–whatever that was. That only angered me. The psychiatrist said that this suicidal ideation was about issues related to responsibility. He called it a delayed adolescent reaction and said it would pass through talk therapy.
Later, I admitted myself into the hospital where they used an allegedly therapeutic milieu therapy process. You would go around the group in a circle, and everybody, including the staff, would tell the group how they were feeling and what is going on. Everybody was feeling like crap, so the exercise was silly. My take was that this version of talk therapy was a waste of time. What I needed was a quick fix for these feelings I was having. I was put on an antidepressant called Elavil.
There has been significant improvement with the development of a new class of antidepressants called selective serotonin receptor inhibitors (SSRI). The first SSRI on the block was Prozac. It was quickly followd by similar drugs – Zoloft and Paxel. While they may not work on everybody, there is more than adequate documentation that they work. When used with talk therapy, the improvement in patients, including myself, can be rather remarkable. The only problem is that they are not “silver bullets.” Generally, they take a few weeks before a therapeutic dosage builds up in one’s body. Some people develop a tolerance to them, and withdrawing from them has to be treated carefully.
I always commented to the the most recent psychiatrist that antidepressants were nothing but a “witches brew.” As I was transitioned from one to the next, I felt like a human guinea pig. Frankly, some of the side effects were as bad as the depression I was experiencing. I experienced most of the side effects everybody else complains about who has been down a similar path. I had vertigo and could barely stand up, let alone drive. I remember having double vision, dry mouth, strange dreams, and feeling even more crazy than before I was taking anti-depressants. I remember not remembering. I had, and still have, short-term memory loss. I remember walking around like a zombie and people commenting about my glazed eyes. I could not write because of the trembling. I remember the electric zap type of sensations trying to get off the SSRI’s.
I admit, there times when I had no intention of listening to my psychiatrist. I can understand why people want to drop their medication. When the medication did not work, I simply had to stop, and that was terrifying. Being warned not to stop “cold turkey” had no impact on me. When I was told that SSRI’s are not addictive, I felt lied to. Any medication that causes withdrawal symptoms, which SSRI’s certainly do, should be classified as an addictive drug.
You don’t talk to people whey you’re engulfed in depression–and they don’t talk to you. And when your isolation gets bad enough you start thinking thoughts of suicide, what it would take. Eventually, I was given a whole new level of antidepressants, which I didn’t like because they turned me into something that was not. I could not maintain a relationship. I became convinced that recovering one’s mental equilibrium from depression can not be achieved by drugs alone, that it also takes talk therapy, and understanding, and exercise, and good nutrition, and balance.
Unless one has been through a major depression, it is difficult to understand the utter helplessness associated with it. I feel that it is inappropriate for any person who is not a professional or who has not experienced depression to give advice. For those who are not depressed, it may seem easy to think that the depressed person can make clear decisions. There are no quick solutions. Every depression is unique. The depressed person needs a lifeline and needs to know that people care. Talk therapy partnered with medication, to my way of thinking, seems to be the best option for treating depression. After attempting to find the right medications, Paxil (paroxetine hcl) seem to be the best for treating my depression. For anxiety and sleep, this was complimented with a light dosage of Klonopin (clonazepam). While off the medications for quite some time, I am still working on the talking.