IMAGE: Genevieve Pizzale
There is no definitive cure for depression and for many people like me it will be a lifelong battle. Here’s my story, and why I still have hope.
*Trigger warning: Depression and suicide
I distinctly remember my first bout of depression, even though I wouldn’t have called it that at the time. I was 12 years old and my uncle had committed suicide—December 13, 1999. We weren’t particularly close, yet the impact his death had on my life was extreme. I returned home from my grandparents’ house, where my family had gathered after receiving the news, and screamed and cried because I didn’t know what to do with my pain.
Over the next few weeks, my fear and sadness increased. I couldn’t be alone in the house because I would obsess over the serrated edges of the steak knives in their drawer, imagining how they would feel pressed against my wrists. I spent Christmas Day sobbing in my grandma’s arms because I thought I would never feel normal again. In the months that followed, I relentlessly researched Bipolar Disorder, lithium and suicide. I was just a child, but feared I was doomed to an early death.
Depression: Round two
I can’t remember how the issue resolved, or if it ever fully did, but my next serious brush with debilitating sadness happened after I graduated high school. I had received the top marks in my grade and was excited for university, but I was isolated from my friends for much of the summer while running the swim program at my cottage. Crushing hopelessness and exhaustion returned, as did my obsession with death. Even though I was a healthy 17-year-old with a full scholarship and a Miata convertible as a graduation present, everything seemed pointless. I didn’t know why I was alive. I accidentally totalled my car on the highway one Sunday night and wound up in the hospital, then developed severe anxiety and flashbacks. It was that incident, and not my depression, that brought me to a psychologist’s office for the first time.
My first antidepressants
After several appointments (and driver rehab), I thought I was cured, so I stopped seeing my psychologist. But three years later, the darkness found me again when I started dating my first serious boyfriend. After that, it never really left and escalated after I moved away from home to work on my master’s degree. It became so bad that I went to the emergency room for the first time—terrified that I was going to throw myself off my balcony—and was referred to a psychiatrist who diagnosed me with Generalized Anxiety Disorder (GAD) and clinical depression, which he suggested was recurrent, meaning it will likely affect me for my whole life. He then prescribed talk therapy and a selective serotonin reuptake inhibitor (SSRI) called venlafaxine, with a brand name of Effexor.
Though I still struggled, my mind quieted to some degree and life became bearable again. Prior to my diagnosis, I don’t think I would have said I had depression. I simply thought that I was a bad person with major character flaws and that my sadness, lethargy and hopelessness were a result of my personal failing to cope with stress and difficult life events. I experienced a lot of relief when I learned that my feelings finally had a name and felt like I had a bit of insight into that part of myself for the first time.
Coming off my antidepressants
Even though I felt much better with my antidepressants than without them, I had a few side effects including brain shivers or zaps, which sort of feel like your brain is being electrocuted when you make sudden movements. I also experienced a lot of guilt for taking medication because I felt like it was a crutch that weak people use to cope with life. I attended weekly therapy sessions as well, but believed I was lazy and chastised myself for failing to do the real work of getting better like eating healthy, working out, journaling, meditating, practicing gratitude, getting quality sleep—all of the things I thought my therapist, my parents and the world wanted me to do instead of relying on medication as a quick fix.
My mixed feelings about my pills didn’t come from nowhere. There’s a lot of negative press for antidepressants, even though (or perhaps because) antidepressant use is so common. In 2006, anthropologist Helen Fisher expressed worry about the effects of long-term use of antidepressants on love and sex drive in her TED Talk “Why we love, why we cheat.” In 2016, Cara Delevingne told Esquire that she’d prefer to cope with her depression without medication because she “would rather learn to figure it out [herself] rather than be dependent on meds, ever.” Those are just two tiny instances of women who I admire expressing disdain for medication that helps so many people.
Due to my ambivalence, I convinced my psychiatrist to wean me off after a year and a half of taking my daily pill. But it didn’t go well. Every time I tapered the dose, my sadness increased and a little bit of my joy ebbed away. Once again, I found myself crying daily, ruminating about death and struggling to motivate myself to get out of bed or shower. My doctor recommended that I try a different antidepressant, so I started taking a SSRI called citalopram (brand name: Cylexa). I had no side effects and my mood improved drastically.
Depression: Round five
By the time I reached my late twenties, I had started to understand my biggest depression triggers: stress, the completion of an important project, the end of a trip, big life changes and traumatic events. To some extent, I could cope by getting extra sleep and reducing my workload when I knew depression was waiting in the wings. But when I called off my wedding and ended the most significant relationship of my life, I found myself unable to deal. I had to take time off work and my doctor increased my dose of citalopram, then added bupropion (brand name: Wellbutrin). I also tried a new psychologist and psychiatrist and eventually received a Borderline Personality Disorder (BPD) diagnosis, in addition to clinical depression and GAD.
Trying to come off my antidepressants a second time
A few months before my 30th birthday, I became convinced that I needed to wean off my medication again—even though I wasn’t feeling stable. I had been taking antidepressants for five years without a break and continued to feel a lot of guilt for relying on meds to get through my day-to-day life. I also believed that my psychiatrist was judging me for being weak, so I told him that I was ready to taper. It took me several months to get off the medication and by the time my 30th came around, I was a wreck. I spent hours crying every day and could barely complete my work. When I’m depressed, I have trouble getting the image of slit wrists and blood-soaked bandages out of my mind, so those thoughts followed me everywhere. My family doctor and one of my best friends convinced me that I needed to take citalopram again and I agreed because I felt like I was barely surviving. For me, SSRIs always seem to work fast, so I started to feel somewhat normal again within a couple weeks. That was a year ago, and I’ll continue taking citalopram for the foreseeable future.
I still dream about life without antidepressants (my guilt won’t quit me), but I’m trying to come to terms with the fact that there’s a possibility I’ll need them for the rest of my life. And besides my guilt, there’s no reason why I should stop. Though antidepressants may not be for everyone and they’re not tiny magic pills that take away the hard things we all have to go through, they significantly improve my quality of life. I still experience a wide range of emotions (yes, I still cry!)—they’re just a bit more bearable—and I have zero side effects.
This year, I also discovered that exercise greatly improves my mood, but I can only actually bring myself to exercise if my mood is in an OK place to begin with (thank you, citalopram!). A combination of rigorous exercise several times a week and a daily dose of meds means that my mood has been at an all-time high for the past eight months. I can honestly say that I’m mostly pretty happy… at least for now.
I have a lot of hope
Even after 20 years, I don’t have depression all figured out. As I finish this article, I’m having a rough mental health week despite the fact that I worked out today, paid off my credit card and even cleaned the bathroom. My life is ticking along smoothly, but I feel sick to my stomach because there’s a part of me that still thinks I’m a bad person, not a sick person, and if I could just work harder and be more disciplined then I wouldn’t have to tell myself what a little shit I am. But at least now I have enough awareness to know that my brain lies and that I probably won’t feel this way tomorrow or the day after that.
Yes, I might always have depression, and it’s possible that I’ll take antidepressants for the rest of my life, but I’m able to tell myself—even when darkness has its stranglehold on my brain—that every day is a new day. Every life has its ebbs and flows, whether or not a clinical diagnosis is involved, and I’ve learned that it’s possible to ride that wave. Because nothing, not even depression, stays exactly the same.