Therapy is one of the many tools in the arsenal we have to fight depression, anxiety, and other psychological disorders. If you’ve followed along with me for any time, you may have seen that it isn’t the first line of defense. I believe in creating a personal foundation that includes physical, mental, social, and spiritual aspects. A therapist can help you get those into place. For those who have tried to make this work, added therapy, and are still suffering, it’s usually time for medication. Last week I explained how and why a Christian might use medication for mental health concerns. This week, I’m going to pull back the curtain on my own personal experience with medication.
Most therapists have their own history with counseling, which sparked the desire to help in this way. My first counseling experience occurred in my senior year of high school. My therapist, physician, and parents agreed that therapy combined with a low dose of an SSRI antidepressant would help curb the depression that was marking the last months of high school for me. I don’t remember thinking much about it. I was the first person in my family to go to therapy or to take medication, but they seemed confident. The picture at the top of this blog shows me headed out late for school, carrying a heavy load of books and a clarinet. The depression hadn’t quite hit yet.
After graduation and moving to Stanford, I did not have therapy any more, and I didn’t seem to need the meds anymore, either. Freshman year was full. I had new friends and a busy academic life. I took trips on the weekends to San Francisco and Monterey, and loved (almost) every minute of that year. When I returned home the next summer carrying my Freshman Fifteen (pounds) and feeling lonely for my friends, the depression returned. I remember crying a lot that summer.
College was like that for me. Sometimes I needed help keeping my mood out of the toilet, and other times I was just fine. At times I took the SSRI for six months or so, and other times it was ok not to take it.
Major Depressive Disorder is the name that is given to clinical depression (whether it feels major or minor). Before February of 2004, I would say my Major Depressive Disorder was very minor. That month, one month after my wedding, is when it really turned major. I had all the classic symptoms. Lots of crying, sleep disturbance, brain fog, feelings of hopelessness and worthlessness, loss of motivation, weight gain. I found a new doctor in a new city and explained that I had responded well to meds in the past. My doctor quickly wrote a new prescription for the same medication. It took some months of therapy in addition to my medication, but I slowly came back from the pit of despair.
What I learned during this time is that I typically have a response to major transitions that includes a depressive episode. It made me wary of future transitions. I became vigilant about my mental health around these times. In the following years, I worked through various doses of the same medication, continually trying to achieve the maximum benefit with the smallest dose. I also visited a string of therapists who both helped me carve my future path as a therapist and address different issues that came up for me emotionally.
When I became pregnant with my first child, one of my big concerns was whether I could stay on medication. I consulted with my OB and she reassured me. “A depressed mother is far more dangerous than a medicated mother,” she said. Just to play it safe, we lowered my dose. The lower dose continued to be just fine after the birth. A few years later, another baby came along, and I was confident that I could stay at that same dose. My doctors were fine with it.
When my third pregnancy came, I had a new doctor who had less experience with maternal mental health. She wanted me to have additional ultrasounds and to see a specialist who could do an in utero echocardiogram to ensure that my baby’s heart was developing properly. The specialist was surprised to see me. She realized that my depressive symptoms were not diminishing my functioning right now and that my antidepressant was a very small dose. The baby was fine of course. The extra trips to the specialist probably created more anxiety than was necessary.
I don’t know if it was because of my medication or my therapy skills or my excellent support network, but I never struggled with Postpartum Depression or Anxiety. Thank God. Becoming a mother was hard enough without that. Sleeplessness, fussy babies, and unproductive, painful nursing was enough. If anyone tells you having a baby is not that bad, they are either lying or they received a special dispensation of God’s grace that I did not receive. (He gave me enough grace to get through, just not enough to think it was easy.)
Since my youngest is now five years old, I am removed from those early days of nursing and sleeplessness. My course of depression is about the same. Every six months or so, I have a low period. I see a therapist for a handful of sessions to start feeling more like myself. I continue on the lowest dose of medication possible, but I don’t go off of it.
As I’ve come into my own a bit more, I’ve learned things about myself and my body that help me manage my depression. I’ve learned that regular exercise is really helpful, even if it doesn’t change my pants size. I go to bed and wake up at regular times and prioritize sleep for myself and my family. After Christmas and my birthday, I know that I might have an episode of depression. It’s not the let-down or getting older. It’s all the sugar I ate–it wreaks havoc on my mood. I make time with God a daily priority and I see my friends and family as much as I can.
I feel fortunate that the first medication that my pediatrician tried when I was 18 is still working for me now. Any side effects have been manageable and by now are just a part of my life. I couldn’t tell you what they are. I know that many people have to try several medications to find one that works and doesn’t bother their systems.
Some people argue that they don’t want to take medication because it makes them feel numb. They worry that they won’t feel real emotions or ups and downs. Let me tell you: I feel ups and downs. If you are someone who has experienced depression or anxiety, you know that sometimes life’s emotions are just too extreme. For me, my highs are kind of medium, and my lows are really low. Medication helps me get to the average range of emotions instead of everything being lower.
Is there a time when I will go off medication? I honestly don’t know. I might be able to now. Only God knows. I’m turning 39 next week so I know menopause will be around the corner in no time. I’m ok if I never go off medication or if I need to make adjustments.
I’ve had many opportunities to appreciate my own struggle with depression and my choice to medicate. My clients know I’m for real, and that I get it. As a Christian, I have the opportunity both to trust God to get me through and to appreciate the common grace of medical science.
What has been your experience with medication? Do you know someone who might be struggling with a decision about medication? I hope you share this post and last week’s post to help encourage them!