Coming of Age on Zoloft (2 page)

When I first began to use Zoloft, my inability to pick apart my “real” thoughts and emotions from those imparted by the drug made me feel bereft. The trouble seemed to have everything to do with being young. I was conscious of needing to figure out my own interests and point myself in a direction in the world, and the fact of being on medication seemed frighteningly to compound the possibilities for error. How could I ever find my way in life if I didn’t even know which feelings were mine?

For me, as for many members of my generation, the process of growing up became linked to the practice of taking medication and thinking about mental disorder. In aggregate, my antidepressant story is not dramatic. By the standards of the sensational medication memoirs that I began to track down and devour in college, in an attempt to better understand what I was going through, it is positively vanilla. After the moment on Kate’s porch, though, I began for the first time to think that my story might have an interest and a relevance of its own—not because it was so very unique, but precisely because it wasn’t. Before that day, I’d been interested in tracking my experience on medication for personal reasons, but afterward I redoubled my efforts; I literally started to take better notes. I ended up using anti-depressants for most of ten years, and the story of that unfolding relationship—during which my perspective on myself, on medication, and on the nature of health all changed significantly—is part of what structures this book.

Realizing that other people my age used antidepressants too whetted my appetite to hear their own stories. I wanted to know whether others felt as ambivalent about antidepressants and about the diagnoses that came with them as I did, whether medication had raised the same difficult questions for them as it had for me. The handful of casual conversations that I had about these topics over the years always fascinated me. In order to write this book, I interviewed forty people, ranging in age from eighteen to forty, about their own experiences growing up on antidepressants, and I corresponded by e-mail with about a dozen more. Talking to them revealed common themes in the experience of using psychiatric medication as a young person and turned up many points of contact as well as divergence from my own story. Their words and points of view are incorporated throughout the book.

Part of the reason why the moment on the porch stayed with me for so long was the sheer force of the relief it brought me to connect, in person, with other people whose experiences mirrored my own. Though times have changed and it’s hard to imagine, today, any young person believing that they’re alone in taking a psychotropic medication, my research confirmed that medication use is still not something that people talk about with each other in-depth or regularly. But there is understanding to be gained in such conversations; partaking in stories of one another is one of the purest and most elemental forms of comfort available to us in our sped-up, surface-happy world. When I conducted the interviews for this book, a number of the people I talked to thanked me. They told me that they didn’t speak about these topics very often, and that they were excited to hear what others had to say. One of my highest hopes for this book is that it will in some small way replicate the effects of that moment on the porch in Portland. I hope that people who take or have taken antidepressants will find these stories recognizable, thought provoking, and ultimately affirming, and that friends and family will feel helped to a greater understanding of an experience that can be hard to put into words.

I also hope that this book will contribute something to a debate that has unfolded over the course of the psychopharmaceutical revolution. There is no question that the last twenty-five years have seen a great change in terms of how we conceive of emotional and behavioral problems, which we’ve moved decisively towards classifying as biochemical disorders. There is a lively cultural argument going on now about whether that’s been good or bad. Critics of the shift contend that the “medicalization” of what were once regarded as negative feelings or nuisance parts of life has harmed us, that mental disorder is now overdiagnosed and psychiatric medications are overprescribed. They argue that we’ve moved beyond fighting legitimate psychiatric illness and have begun to wage pharmaceutical warfare on ordinary sadness—a war that has given undue power to “experts,” lined the pockets of pharmaceutical companies, and left the rest of us feeling enfeebled, more ill than we truly are. Proponents argue that the revolution hasn’t yet gone far enough. They claim we’ve made headway in reducing the stigma surrounding mental disorder but that there’s work yet to be done, and contend that emotional problems are still, on balance, undertreated. This grand debate about the value of our turn to medication marches forward though a series of more practical ones. Prominent figures argue about whether antidepressants are “truly” effective, or merely fancy placebos, and the question about a possible link between antidepressants and suicidal behavior in children and adolescents is still open.

This book won’t settle those debates, but it does speak to them. Twenty-five years after the introduction of Prozac, we are still collectively attempting to figure out what an appropriate use of medication would look like, in our culture and in our individual lives. We are trying to figure out what our sadness and pain mean—if they mean anything at all—and when they attain the status of illness. We’re trying to figure out when to turn to pills, when to go another route, and how we might be able to tell. This book isn’t a polemic or a self-help title. It can’t tell you whether you need help or what kind to get. But it does believe that good answers to the big questions about medication are likely to proceed from careful attention to the actual experiences of the people who have faced them. Stories like the ones collected here may help us to a more realistic assessment of what antidepressants can and can’t do, when they are a good idea, and when the detriments might outweigh the benefits. And it is in that spirit that I offer the story of my own decade of antidepressant use and how it intersected with my path to adulthood, and the stories of many of the forty-plus people who spoke to me about the same thing.

1
| The Diagnosis

T
o describe how I got started on antidepressants, I could reach way back. I could tell you about my earliest memories, or give background on my parents or even my grandparents. But the best place to start is the summer of 1997 in Arlington, Virginia, a hot one even by the standards of the Washington, D.C., area. In the suburbs, the air itself often seemed to sag around street level, holding the smells of grass clippings, car exhaust, and barbecue in its thick embrace. People moved slowly, and once in a while someone made the old crack questioning the wisdom of our founding fathers’ decision to build their capital city on a malarial swamp.

That summer I was seventeen and, like other seventeen-year-olds I knew, I used my car to get places. I had access to an ancient, bright orange Volvo sedan that had belonged to my grandfather, which I loved almost as fiercely as the act of driving itself. Most days, I drove to the coffee shop where my best friend, Sarah, and I both worked. Early-morning drives to the shop were the best, before 6:00
A.M
., the streets empty, the sun already blazing up like a pink rubber ball over the rolling hills of Arlington. After work I drove to Sarah’s house, took myself on shopping errands at strip malls lined with big-box stores, or went to the parklike cemetery to read or write. Sometimes at night we would drive just for the sake of driving. We’d aim Sarah’s Cutlass Ciera down the George Washington Parkway, which runs alongside the Potomac River. I liked the way the lights of the city’s bridges seemed to float like jewels in the water, the humid night air pouring in the windows, the feeling of the road ahead all clear.

SCHOOL HAD ENDED
in the middle of June, an occasion marked by a graduation ceremony complete with tears, hugs, yearbooks to sign, and a pool party afterward. My parents surprised me by giving me a camera as a graduation present, and in the weeks that followed I used it to take pictures of every familiar thing: my mom’s tuna fish salad, glistening with red onion; my father standing in the kitchen, drinking coffee; my younger sister at the diner, saying something funny, mouth open, a cigarette in her hand, her blue eyes big and bright. I added older pictures I’d taken of friends—Huey, Josh, Ellie, and Anne, even a couple of my ex-boyfriend, Scott—and pressed them all between the pages of a small photo album to take away to college at the summer’s end.

It was hard to imagine a world past school and Arlington. Some people hate high school, but I hadn’t. The small, public magnet school I’d attended since sixth grade had suited me well; at best, it had felt like a real community, and I’d been that rare kid who is happier and more social as a teenager than as a child. I had even picked my future college, a small liberal arts school in Oregon, because its culture reminded me of my old school in many ways. Still, the idea of really leaving H-B Woodlawn and the life I’d known behind made me feel sad. Sad, and though I tried to block it out with excitement, more than a little scared.

At first, fear and anxiety came in the guise of nostalgia. I decided to spend the summer commemorating everything I’d loved about the past six or seven years. I would revisit every place I’d ever been to, go to every restaurant or park or coffee shop I’d ever liked, one last time, return to the scene of every milestone or event or fight that had seemed important. I would soak it all in thoroughly, fix it in my mind forever, revel in the bittersweet intensity of a phase of life nearing its end. And somehow, I imagined, that would make me ready to face what was next.

Scott had broken up with me the week after graduation. He walked from his house down the block over to mine, and we sat on my parents’ gray couch and talked about how it wasn’t working out. In one sense, the breakup was no big deal. We had barely even seen each other all spring. When I was honest with myself, it was easy to see that it was right for it to end. We had drifted together during early senior year when we were both working on a school play. But we had always been an odd couple. Scott was straight edge, I wasn’t; he did wholesome things like improv theater and Model United Nations, while I read Beat poetry and sneaked cigarettes in the parking lot behind the school. Beyond a shared sense of mild outsider status, we had never understood each other well. By dumping me he was only giving voice to what was already obviously true.

Still, the breakup created a space that seemed to attract all kinds of negativity into itself. My mind began to curdle, and my nostalgic agenda for the summer started to take on a nihilistic edge. I didn’t want to do anything new or meet anyone I didn’t know already.
What’s the point?
my mind would ask.
We’re all just leaving anyway
. Abstractly, I knew that leaving home for college meant a fresh start, a rebirth. But most of the time I couldn’t see past the part that felt like dying, everything I’d known collapsing in on itself like an exploded star.

On the night of my eighteenth birthday, I walked into the darkened playing field behind my high school, a few blocks from my house. The air was warm and sultry, shorts and T-shirt weather even well after dark. Grass and clover tugged at my ankles. I sat on the split-rail fence, held my face in my hands, and cried. Whatever life was, I wasn’t sure I was up to it. Normal things had begun to feel unbearably poignant: the last time I hauled a heavy garbage bag of coffee grounds out to the Dumpster in the sweltering parking lot behind work, the familiar action, never to be repeated, almost reduced me to tears. The future seemed unimaginable; I felt like I was about to be pushed into the Coliseum with a bunch of wild animals. Was I ready? Could I possibly be ready? Would I ever do the things I wanted to do, would I ever be normal? Would anyone ever love me? Dear god, would I ever get laid? It all seemed terribly impossible to visualize.

When I look back from today on my mood that summer, it’s not hard to see reasons why I felt unsettled. I think that I was suffering from lack of daily structure, and a straightforward fear of leaving home, probably compounded by a lack of self-confidence. But from the inside, it didn’t seem clear or understandable at all. I didn’t feel afraid of school, exactly; I felt flawed—in some way so strange, complete, and unique that I couldn’t even fathom it, let alone do anything on my own behalf. I exaggerated in my mind how wonderful high school had been. The truth was that after all those years I was sick of it. I needed new challenges and new people. But most of the time I had no access to those yearnings. All I felt was a penetrating fear of loneliness, and deep grief for all that I would leave behind.

In the evenings I consigned my fears to the pages of my journal. In purple pen, I wrote:
I’m scared shitless of going to college, but this is such a big subject it’s hard to get started. I go crazy. But how to be specific? Wild moods. Frantic, or complete apathy.
And a few days later:
It’s when I think about all the things left to do in life—big and small things equally—that I think I can’t go on. Everything makes me want to throw up today.

SARAH DIDN’T UNDERSTAND
my frame of mind. She seemed to be flourishing: working at the coffee shop, getting to know all the patrons, dating one of them, and then another. She couldn’t be happier to finally be free of high school. With her long brown hair and her nose ring and her newfound aura of indomitability, she looked beautiful.

“You need to relax,” she said to me one afternoon. We were sitting in her bedroom, me on the bed, Sarah in a desk chair beneath her enormous Pink Floyd poster. “This is a summer for having fun,” she continued. “We did it. We’re on top of the heap. We’re going to college. This summer is our
reward
.”

“I know,” I said. “I know! I shouldn’t be taking things so seriously.” Sarah’s point of view sounded reasonable and wise; I just couldn’t make it stick in my own case.