Coming of Age on Zoloft (36 page)

When I think back to that time, it seems to me that one thing I needed was a message almost completely different from the one that antidepressants delivered. Instead of being told that my feelings were meaningless mutations, I needed some help identifying what those feelings really were. I needed to be told that I wasn’t the only person to have them. I needed to hear that I could be excited about college but still miss home, that I could miss home but not be a wimp. Just as the best thing to do when you’re losing control of your car on an icy road is to make the counterintuitive move of steering into the skid, I needed someone to tell me that it was all right to be upset, that I could even steer into it a little bit—that it was likely I would feel better soon and that if I didn’t, there were other things we could try.

SOMETIMES, IN MY
imagination, I travel back to Sam’s office. I play our first meeting over again, but I make it go differently. Our conversation starts out the same: she asks me what’s wrong, and I cry, and tell her. But then, instead of reaching for her pad, she talks to me. She tells me that moving all the way across the country for school is hard. I listen to her, swabbing at my eyes, interested and slightly incredulous. She asks about my life and tells me that it’s good that I’ve made friends, good that I seem to be doing well in classes. I choke out the story of Brendan, and she remarks that even if I can’t see it, it seems to her likely that he has some problems of his own. She tells me that in her opinion, I’m making a pretty decent transition, and by the time she says it, my breath is flowing in and out of my chest more smoothly. She advises me to go away for a few days, to try to take it easy on myself. Spend time with friends, keep her number nearby, call her if I need to. I thank her, she opens the strange double door of her office, and I clatter down her stairs and tumble out into the brightness of the day.

This too is a fantasy. I can’t know whether it would have made the difference, whether I would have revived in a couple of days and never gone back. Maybe I wouldn’t have recovered, and we’d have started medication eventually anyway; or if not then and with Sam, it would have happened somewhere else. In either case, having such a conversation would have given me a different perspective on my problems from the one offered by drugs. It would have made those problems seem less strange and disturbing. And it might have planted much earlier a seed of the compassion for myself and the acceptance of vulnerability that ultimately made feeling bad so much easier to deal with, and that in the end it took me a long time to learn.

SEVERAL YEARS AGO,
when I first started to get serious about writing this book, I was thinking intently about what it means to grow up. Over the course of a few months, I kept getting involved in the same conversation with different friends. We were all in our late twenties, and we remarked to one another that life felt different than it had just a few years before. We noticed it in ourselves and in each other too. People still went through rough times: they lost jobs and had breakups; some years and seasons were better than others. But we all agreed on one thing—no one seemed to be falling apart the way they had with regularity, in college and directly after.

Neuroscientists say that the brain keeps developing until we reach age twenty-five, that the circuits that produce fear and anxiety grow less excitable. Maybe that explains it: perhaps we’d finally myelinated our prefrontal cortices and were reaping the rewards. Or maybe we’d gotten used to the workings of the real world at last, and were gratefully watching our quarter-life crises fade into the rearview. I don’t know what it was. All I knew was that I felt like I’d finally crawled up on dry land, and I was pleased and comforted that my friends seemed to be doing the same.

Looking back, I have no sophisticated explanation for the change. I think what happened was, quite simply, that we grew up.

I don’t want to exaggerate the luxuries of this new place. Sometimes there are earthquakes. Sometimes the fog rolls in and stays for weeks. But it’s fertile land, and arable too. It feels like a place where you can get some living done. While the storms aren’t over, they do feel different now. And I’m confident in a way that I couldn’t have imagined years ago of my ability to weather them.

Maybe you know this feeling, this place. Maybe you see it, up ahead, as a promise. I want to tell you that you’ll get here too. Medication won’t prevent you from making the trip, but it won’t get you here on its own. You will get here by living, by engaging with the world, by loving and fighting and making mistakes, by picking yourself back up and trying again. You’ll do it by taking support where you can—from medicine, from the people around you, from your interests and beliefs. If you are lucky, you’ll find a guide who will help by listening to you and sharing the story of her own way across. The trip won’t always be comfortable, but it will feel real, unique, and yours.

Maybe you are here already. If so, maybe you have experienced how, on a good day, the breezes change direction, and the feeling in the air shifts a little. The voices inside that once asked “Who am I?” quiet down, and into the silence a different, but related voice says softly, “Here you are. What will you do?”

Acknowledgments

Many people helped in the making of this book. On the professional side, I’d like to thank my agent, Eva Talmadge; Allison Lorentzen; Suzanne Rindell; Emma Sweeney; Shelly Perron; and my editor, Michael Signorelli, who saw the project through with a winning blend of wisdom, clear-headedness, and good humor.

I am immensely grateful to everyone who took a chance on talking with me about their personal experiences, as well as to the psychiatrists, psychologists, and academics who shared their expert perspectives, both those whose words are captured in the book and those whose input provided valuable background—the latter group including Gabrielle Carlson, Joe Hewitt, Bradley Lewis, Sue Marcus, Benedetto Vitiello, and Julie Zito.

For answering questions, providing leads, and other acts of research largesse, I thank Andrew Boyd, Benjamin Cohen, Christina Dunbar-Hester, Andrew Lakoff, Jacks McNamara, Mark Olfson, Ken Paul Rosenthal, Lauren Russo, Nikhil Swaminathan, and Virginia Vitzthum; and at the U.S. CDC, Sheila Franco, Amy Bernstein, Richard Niska, and Jill Ashman. I also thank Rachel Prentice, whose course at Cornell first helped me discover my fascination with pharmaceutical advertising.

For places to work, I thank Jay Barksdale and the New York Public Library; Stephanie Harad and Anne Hinton; and the Sharpe and Towns families, which each put on a truly formidable DIY writer’s retreat.

Close to home, I sing the praises of Jared Greenfield, Jessica Stults, and Alison Towns for their smart manuscript reading; Anna Bond, Stephanie H., and Meg McIntyre, my family of friends, for helping in ways concrete, ineffable, and every conceivable gradation in between; Sarah Jackson; Jesse Kraai; and with special honor, Susan Sharpe, whose encouragement, care, and incisive attention to the text were essential to the book, and its writer too. Thank you, thank you, thank you.

About the Author

Katherine Sharpe’s
writing has appeared in
n+1, GOOD
, and
Washington Post Magazine
, among many other publications. She lives in Brooklyn, New York.

Visit
www.AuthorTracker.com
for exclusive information on your favorite HarperCollins authors.

Notes

INTRODUCTION

1.
Olfson and Marcus, 848.

2.
Ibid., 848.

3.
National Center for Health Statistics.
Health, United States, 2010,
19.

4.
Gu et al., 5.

5.
Ibid.

6.
National Center for Health Statistics.
Health, United States, 2010,
19.

7.
Kirby.

8.
Olfson and Marcus, 851.

2: A SHORT HISTORY OF MEDICATION

1.
Laurence, 1.

2.
Ibid.

3.
World Health Organization, web.

4.
Stewart et al
.

5.
Greenberg, 183.

6.
Healy,
The Antidepressant Era
, 53.

7.
Ibid.
,
47.

8.
Ibid., 58.

9.
Ibid.
,
47.

10.
Ibid., 43.

11.
Ibid., 46.

12.
Ibid., 52.

13.
Ibid., 54.

14.
New York Times
, April 7, 1957, “Science Notes: Mental Drug Shows Promise,” 86.

15.
Healy,
The Antidepressant Era
, 116.

16.
Luhrmann, 236.

17.
Healy,
The Antidepressant Era,
61.

18.
Ibid.

19.
Ibid.

20.
Ibid., 154.

21.
Horwitz and Wakefield, 168–69.

22.
Ibid.

23.
“Professor Joseph Schildkraut.”
Times
(London).

24.
Luhrmann, 213.

25.
Healy,
The Antidepressant Era
, 66.

26.
Luhrmann.

27.
Manners, 79.

28.
Greenberg, 260.

29.
Manners, 79.

30.
Luhrmann, 223.

31.
Horwitz and Wakefield, 85.

32.
American Psychiatric Association.
Diagnostic and Statistical Manual of Mental Disorders
,
Second Edition
, 40.

33.
Healy,
The Antidepressant Era,
38.

34.
American Psychiatric Association.
Diagnostic and Statistical Manual of Mental Disorders
,
Third Edition
, 1.

35.
Healy,
The Antidepressant Era,
167.

36.
Manners, 80.

37.
Healy,
The Antidepressant Era,
168.

38.
Pfizer, Inc.

39.
Carlat, 40–43.

40.
Kirsch.

41.
Horwitz and Wakefield, 169.

42.
Kirsch, 96–97.

43.
Horwitz and Wakefield, 188.

44.
Luhrmann, 228.

45.
Curtis, “The Lonely Robot.”

46.
Kirn.

3: STARTING OUT

1.
Karp, 57.

2.
Stutz.

4: DECADE OF THE BRAIN

1.
Paxil commercial.

2.
Bush, George H. W.

3.
Chocano.

4.
Elson and Horowitz.

5.
Elmer-DeWitt et al.

6.
Ibid.

7.
“Rasagiline,” MedlinePlus.

8.
Critser, 6.

9.
Kaiser Family Foundation. “Impact of Direct-to-Consumer Advertising on Prescription Drug Spending,” 4.

10.
Kaiser Family Foundation. “Public and Physician Views of Direct-to-Consumer Prescription Drug Advertising.”

11.
Ibid.

12.
Goetzl.

13.
Coupland, 27.

14.
“Homer Badman.”
The Simpsons
.

15.
“The Sopranos.”
The Sopranos.

16.
Dennis.

17.
Albarn.

18.
Jagger and Richards.

19.
Garden State.

20.
Kramer, 18.

21.
Ibid., 10, 19.

22.
Ibid., 15.

23.
Ibid.

24.
Ibid., 14.

25.
Martel.

26.
“Depression Hurts.” Commercial.

27.
O’Neal and Biggs.

28.
Elliott, xvi.

29.
Ibid., 35.

30.
“Barb’s Golfing Again.” Commercial.

31.
“Sue’s Playing with Her Kids Again.” Commercial.

32.
Cymbalta commercial.

33.
Celexa (Citalopram).
Rxstories.com
.

34.
Ibid.

5: I’VE NEVER BEEN TO ME

1.
Friedman.

2.
Koplewicz, Harold. Telephone interview, June 17, 2008.

3.
Mayo Clinic.

6: TWO RED CHAIRS

1.
Harris, “Study Finds Less Youth Antidepressant Use.”

2.
Zito, “Off-label psychopharmacologic prescribing.”

3.
Ibid.

4.
Marcus, interview.

5.
Horney, 359.

7: FLIGHT OF THE DODO BIRD: EVALUATING THERAPY

1.
Luhrmann, 204–5.

2.
Greenberg, 300.

3.
Luhrmann, 204.

4.
Ibid., 206.

5.
Greenberg, 300.

6.
Ibid.

7.
Ibid.

8.
Luhrmann, 205.

9.
Ibid., 206.

10.
Quoted in Greenberg, 300.

11.
Luhrmann, 207.

12.
Ibid., 57.

13.
Ibid.

14.
Ibid., 75–76.

15.
Freud and Jung, 10.

16.
Luhrmann, 60.

17.
Greenberg, 288.

18.
Marcus, Sue. Personal interview, November 2, 2010.

19.
Greenberg, 302.

20.
Ibid.

21.
Burns, 42.

22.
Freud and Jung, 10.

23.
The TADS Team.

24.
Solomon, 103.

25.
Olfson, “National patterns in antidepressant medication treatment,” 848.

26.
Horwitz and Wakefield, 185.

27.
Ibid., 184.

28.
Olfson, 854.

29.
Harris, “Talk Doesn’t Pay.”

30.
Whitaker, National Institute of Mental Health.

8: QUITTING