Let's talk psych meds (Part 1)
Or, my two years with Lexapro
Welcome back!
I haven’t had the chance to write in a while; it’s been an eventful month, with my partner moving up to my city and me starting a new part-time job. But I’m back, and I’m excited to start a new mini series- about mental health drugs!
I’ve always been curious about medications because of my own experience with Lexapro and what I know about the commercial determinants of health. I have friends who say it changed their lives, but I also know of all the terrible withdrawal and side effects that come with the “treatment”.
This week, I will dive into why I stopped Lexapro and my reasons against medication as a primary treatment, for myself, at least. Then, I’ll spend a week or two discussing the “pro” side and how, perhaps, medications are necessary in some cases. We’ll see where we go after that. I’m considering addressing some RFK Jr. discourse that's circulating and interviewing people about their experiences with medications, but this will be determined. Without further ado- let’s dive in.
Disclaimer, as usual: This newsletter is a notebook guided by my curiosity, not a scientific publication. Nothing is “scientifically” verified; everything could be true or false, or we could believe in different versions of truth. Think of these entries as reading notes of sorts. I welcome discussion.
I started Lexapro in the fall of my junior year, around the time I began recruiting and realized all the limitations that came with my student visa. I felt frustrated and anxious almost every day. I returned to therapy, but the therapist at the time wasn’t working for me.
(To give you a sense of what the frustration was like, she told me “you gotta meet me where I’m at” after I told her about suicidal ideation, and I replied “I’m trying! Do you not see it?” feeling incredulous and exasperated.)
Amidst my helplessness, my provider suggested trying medication since my baseline anxiety seemed to be too high, and I agreed— because I thought I needed an extra boost to stay sane and be productive to get a job. I was fortunate that, at least, I was able to talk to a provider before deciding, and I recall that there wasn’t nearly enough evidence about withdrawal and addictive properties, two things I was the most concerned about. But then the provider told me that she takes medications, and it helps her get through the day more easily. And honestly, I was so desperate for some relief that I decided to go for it.
I started with 5 mg, and then when I said it wasn’t helping, the prescription was raised to 10 mg, and then 15mg. But then I started getting heat flashes in the middle of the night, and I lowered it myself back to 10 mg. That was my dosage until December 2024.
There were four reasons why, after a few years, I decided to go off psych meds.
Firstly, here’s how I would describe myself on Lexapro: my baseline anxiety is down, my entire emotional range is flattened, but somehow, the anxiety spikes still. After spending my whole life crying during most movies, I suddenly couldn’t cry at all, even when I saw animals die in a video. But then somehow, on bad days, I could still have panic attacks- and those felt like all the emotions I had suppressed with medication would flood through the gates. I felt like I missed the highs and lows. I did not feel like I was “living,” even when I spent a semester in Copenhagen and solo-traveled through Europe; I dissociated for most of it (I am aware these are all privileges!).
I was learning more and more about the commercial determinants of health. I could rant for a whole newsletter about this —and I will —but essentially, I find the power that pharma companies have over medicine and science a little unnerving. If one couldn’t guarantee that the diagnoses were clear of pharma influence, I didn’t want to be taking medications that were given for those diagnoses.
I worry, still, for the long-term effects and addictive properties of the drugs. Perhaps I could read enough papers and maybe they would convince me, but the answers given to me felt entirely too vague and uncertain to take these meds forever.
And finally, I was finding it hard to justify putting myself on medication when my stressors were so clear. I would say half of my stress and frustration came from immigration stress and concerns about the future. If it could be so explicitly named, it felt wrong focusing on medicating myself instead of actively dealing with and getting out of these situations.
Please make no mistake: quitting medication without medical supervision has significant risks. These reasons are entirely mine, and I do not recommend that people go off without consulting a medical professional first, since people react to withdrawal so differently.
I have since successfully quit. In the first few weeks, I had a lot of dizziness; I would randomly feel the room moving, but that subsided. My baseline anxiety is back up to what I consider uncomfortable, but I’ve been more actively working with a new therapist to manage it.
That’s it with my own experience with meds. Next week, I’ll pick up right where we left off and share some discourses and what science says about all this. Stay tuned!
Professional & Personal Notes
I officially started my part-time job - I actually wrote this on a shift at a mental health house in Dorcester. Being in such proximity to patients is making me rethink all kinds of beliefs I had about mental health. Public health, critical psychiatry, social determinants of health- all these things I am so passionate about- are so far away from the residents in this house, and yet they are the most in need. I’m still grappling with what this means for my career, but at the very least, I will have to volunteer or have a part-time job like this if I were to focus solely on public health, so that I can stay in touch with the patient population and remain grounded.
In my personal life, I finished three books in April and May: Annie John, Cold Enough for Snow, and Butter. Highly recommend all three. Annie John has a subtle mental health theme, which I didn’t expect, but it was interesting.
Also, I spent my birthday in New York and saw Hamilton! It was amazing. I’m legitimately scared “Original Broadway Cast of Hamilton” is going to be my top artist of 2025. It’s gonna be so embarrassing, but I can’t stop listening to it.
As always, thanks for reading!
xx Fiona