TW: This post is about the use of anti-depressants and their withdrawal process. I am not a medical professional; therefore, anything I do say should not be taken as fact. If you are in a similar position in considering the process of withdrawing from medication, please consult a medical professional. This is an opinion piece meaning all views are my own.
I have been on the antidepressant Sertraline, otherwise known as Zoloft, for eight years as of June 2023. Sertraline belongs to a group of drugs known as Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs block reuptake, meaning serotonin Is available to pass further messages between nerve cells. Diagnosed with anorexia nervosa and clinical depression, I was put on Sertraline to alleviate my presenting symptoms: low mood, suicidal thoughts, self-harm and insomnia. I fit the criteria perfectly for including Sertraline in my day-to-day life. Or, that’s what I was told.
I want to make it crystal clear that I am by no means criticising the use of antidepressants. Quite the opposite. They can hugely benefit those who have decided to be on them. I am also sure that I would not be able to cope without some form of medication at this point in my life. What I have a problem with is the overprescription of them, the inability to address what an individual may need (therapy), and, instead, the treatment of least resistance. Just Pop A Pill. It Will All Go Away. What if it didn’t? The other problem I have is the lack of medical professionals who fail to inform their patients about the entirety of the situation when beginning to take the drug. By “the entirety of the situation”, I mean a cohesive, considered explanation for the reasons why said professional deems the individual suitable for beginning the process of medication (as opposed to them being a readily available treatment option for anyone and everyone presenting to a GP with low mood). Further, a full report on the potential and most common side effects need to be addressed, as well as the problematic withdrawal process and the long-term risks of taking medication.
I certainly was not informed of any of such things that I have mentioned in the aforementioned paragraph. This is a complicated blog for me to write for numerous reasons. The main reason is that it was never my decision to go on Sertraline. I never willingly asked or agreed to be on the drug; instead, the decision was made for me. As an (in)voluntary patient in a specialist eating disorder unit and as a vulnerable fifteen-year-old, I was told that if I did not consent to take the drug, I would be sectioned for refusing treatment. Terrified of what might happen if I resisted, I, of course, began taking the drug without ever considering the long-term effects.
At that point in my life, I had no control.
At that point in my life, I had given up all hope.
At twenty-three, eight years down the line, I cannot produce a watered-down response to that memory. It devastates me to think of that fifteen-year-old. How on earth do I reconcile treatment that was supposed to help keep me alive against the awareness that I was being medically castrated? That I was being medicated to the eyeballs to make me an “easier patient”. I was in a mental health hospital, being faced to regain nearly a third of my body weight it is unsurprising that my mood was at rock bottom.
Yes, there have been some amazing benefits to taking the drug, including the stabilization of my moods, an ability to manage my anxiety better, but a lot of that has also (I believe) come with my decision to choose recovery. How about I, Isabella, not a patient with anorexia, was given a chance? Equally, like so many variables, medication has worked as part of a treatment plan. It does not and has not ever cured my anxiety. I resolutely believe that it is only with a combination of approaches such as psychotherapy, medication, and support that some form of recovery can be achieved.
It has struck me that there has recently been a surge in survivors of antidepressant withdrawal speaking out and also calling out medical professionals who mis-sold them a miracle drug to cure their depression. After watching the BBC Panorama: “The Antidepressant Story”, I decided that enough was enough and that I would utilize my voice and experience to speak out. Part of this messaging was fuelled by advertising campaigns fed with misinformation on what depression was, one of the key false points being that people with clinical depression are likely to have a lack of serotonin. This is not scientifically proven. Therefore, those taking antidepressants wishing for a “normal” amount of serotonin may not have even had a deficiency in the first place. This is particularly alarming given the high percentage of individuals taking antidepressants on the basis that they have been advised by medical professionals that they lack serotonin.
For a long time, I felt humiliated and ashamed to be on medication. If ever asked by professionals if I was on medication, I frequently found myself being reluctant even to mention that I was taking antidepressants. I feared their judgement, looks or questioning my need to be on an antidepressant. Of course, much of this was my shame, but I attributed it to the overarching societal stigma towards mental health. Another huge judgement I faced would also be on the dose I was on. “How much?!” would be the frequent response I received when asked about my dosage. Is it any wonder I began to shy away from admitting my own reliance on the drug?
I am currently in the process of withdrawing from Sertraline. I am not in a stable enough position to want to come off the drug altogether, but I am in a place where it is safe to lower my dose under the supervision of my GP, psychotherapist and family. Well, I say GP, but then again, that response was also shocking. When I called to have my six-month medication review, I was instantly given the go-ahead to start coming off the drug. I was encouraged to completely withdraw within three weeks, which, in hindsight, would have been dangerous. The GP’s last words, also being: “Be sure to give us a ring if you feel that you might kill yourself”, did not fill me with hope. Completely mortified, I knew I had to entrust my family, my own research and therapist to support me.
The next question is: why? Why now? It is too longwinded a response to thoroughly explore my “why”, but put briefly because I want to reclaim my authority and my ability to choose what is suitable for my body.
Starting dose: 150mg
My personal side effects of being on this particular dose long-term:
- Improved mood. Lack of mood swings (compared to how they used to be).
- Improved sleep.
- Inability to experience emotions fully. I have barely been able to cry.
- Restless leg syndrome.
- Extreme sensitivity to heat.
- Extreme sensitivity to alcohol.
Weeks 1-3: 100 mg
I was so anxious to begin this process. I had no idea how my body might react. I was also inundated with variable messages online. Some spoke of the absolute horror of coming off Sertraline; the others articulated having no side effects. Sertraline has a half-life of 22 hours, meaning that if you forget a dose, your body goes into withdrawal very quickly. With that being said, I knew that the very early symptoms I thought I might be experiencing were more likely to be psychosomatic. It was more of a waiting game of finding out how my body would respond.
- Mood swings.
- Headaches.
- Sleep unaffected.
- Increased anxiety.
- Brain fog.
- Confusion and occasional dizziness.
- Ability to experience more intense pangs of emotions – crying more. More irritable.
- Restless leg syndrome.
Weeks 4-7: 75 mg
Here is where I really began to notice the effects of withdrawal.
- Mood swings
- Sleep unaffected.
- Ability to experience more intense pangs of emotions – crying more. More irritable.
- Brain zaps
- BAD anxiety and paranoia
- Confusion and occasional dizziness.
- Restless leg syndrome
- Able to tolerate alcohol better (though, I should note, I rarely drink – probably only once every couple of months for special occasions. However, I did notice a significant improvement in my ability to metabolize alcohol on the night).
Weeks 8- the foreseeable: 50 mg
The same side effects as of 75mg, just more intense.
It is clear that the more I decided to lower my dose, the more side effects I experienced. However, from the research I have done, this is relatively normal.
I am relieved to be on the other side. To be maintaining at 50 mg of Sertraline is something that I never could have envisaged a few years ago. No, I have not come off the drug, but I have lowered my dose by a third. That’s right, a third.
What about future plans? Again, I hope to reduce my dose to the 25 mg mark in due course. But there is no pressure. Well, I am hoping to, one day, ultimately come off antidepressants for good. It would not be realistic for me to put this into place today, but it does not mean I cannot strive for it in the future. I can, hand on heart, say I am so proud of myself for regaining my authority and getting to a place where I no longer need to rely on a higher dose of medication. Of course, that is not to say that I can rule out ever needing to re-jig my dose, but for now, I am in a place I would never have imagined eight years ago. For, at the end of the day, there is no shame in taking medication. What I do think is incredibly important is choice. Having the ability to choose what is right for you. This was my choice. And I am saying to the medical professionals: this is my body.