Meds, Moods, and Me: The Ups, Downs, and Outcomes of Taking Medication for My Mental Health

I’ve been dragging my feet on writing this post for weeks now. Not because I’m embarrassed or don’t want to share. (If I was willing to speak openly about burning the wall of my uterus, oversharing is clearly not an issue.)

But mental health is more complicated to discuss because it’s so personal. The stories and trauma and personality characteristics that cause my anxiety may have no overlap with the stories and trauma and personality characteristics that cause someone else’s anxiety.

I don’t have trouble getting into a car and driving somewhere. Or making small talk with a cashier. Or walking through a mall. I’m not frightened by spiders or thunder. I get on planes with confidence they will take off and land safely, and I rarely linger on thoughts about someone close to me dying.

Instead, I have my own basket of things that influence my mental health. Here’s a bit more about my story.

*I hope it goes without saying (but I will say it anyway): I am not a medical professional. Family doctors, psychiatrists, and therapists are wonderful resources and I encourage anyone struggling with their mental health to use whatever medical supports are accessible. This post is not designed to diagnose mood disorders or recommend treatment plans. I am writing about my experiences in the hopes that some aspect of this discussion will be helpful to others. Depression, anxiety, and other mental health conditions come in so many shapes and sizes. All deserve attention.

WHAT CAME BEFORE

I first struggled with low mood in my tween years. It was, I think, largely because of isolation. I was nearly eight years younger than my closest sibling, so in essence grew up as an only child. For various reasons, I was schooled at home for four years using a self-taught curriculum. My mom returned to full-time work in a demanding position and I had exactly one friend (also homeschooled) who eventually went to public school.

I was very lonely. The only way through was through…and I made it! Mental health was’t something that was openly discussed, and certainly not as it pertained to youth.

I had a few periods of difficulty in my teen years and again in university, but it was mostly due to wildly underestimating my abilities. I’d call home distraught that I had “definitely failed my Chemistry midterm” – believing it with every ounce of my being – and then phone the next day to announce I had aced it. My brain defaults to pessimism, but I slowly learned to have more self-confidence. For the most part, I flourished in the academic world.

I got married while in graduate school and had my first child less then two years later. Motherhood was an incredibly difficult transition for me. I felt under-qualified and ill-prepared for this new role. I knew I was suffering from postpartum depression but stretched the truth (translation: I LIED!) on the questionnaire my doctor presented soon after delivery. Why? Embarrassment, I suppose. But mostly because I thought it was me. For years and years and years I thought it was me. It was my weakness, my inability to relax, my deficiencies. I had a doting husband, healthy child, loving family, involved friends. What was wrong with me? Why couldn’t I just buck up and be happy? I didn’t deserve to be sad. So I lied even though I was very, very sad.

If I could change one thing about those first months as a new mother, it would be to complete that questionnaire truthfully.

To speed things up, I’ll divide the next fifteen years into three segments.

Years 1-5: A new mother*, limited financial means, tiny apartment, not sure what to do with my life, bootstrapping two small businesses. It was intense and I felt sad and overwhelmed a lot of the time. I pushed through, but this was a really tough time. I had the first panic attack of my life during this period.

*I had an unplanned C-section, a very colicky infant and years later was diagnosed with “insufficient glandular tissue” which meant I couldn’t produce enough milk despite months of pumping and taking supplements. I believed, at least subconsciously, these results were all my fault. Like I could magically control the dilation of my cervix, the level of amniotic fluid inside my womb, the reflux symptoms of my baby, and the tissue formation in my breasts. Looking back I can see it was utterly asinine to blame myself, but the pressure to deliver, feed, and care for a baby in a very specific way can feel overwhelming – especially if you are physically incapable of ahdering to a specific cultural script. Which, at least where I live, included: a natural birth (bonus points if you don’t require an epidural), exclusive breastfeeding for at least the first six months, and pursuing the tenets of attachment parenting.

Years 6-10: Why not add a terrifying and complicated pregnancy to the mix (that left me with a lot of emotional scars), increasing entrepreneurial demands, continued financial constraints, and a slightly-bigger-but-still-too-small apartment that came with disruptive neighbours. Then a home (glorious space)…that immediately after move-in required extensive repairs. Plus, there was also regular solo parenting, and working several part-time jobs.

I felt anxious, exhausted, and on edge the majority of the time. Oh, and I was anemic with a decades-long bleeding disorder.

Years 11-15: A global pandemic, more solo parenting, home renovations (which included various instances of contractor misconduct), an unforeseen life-changing localized issue that impacted me daily for three years (there have been recent unexpected changes in the situation that have alleviated some of the tension and challenge, but it’s still not fully resolved). Plus, for the first time in my life, I was forced to deal head-on with what I now recognize to be formative episodes of trauma from my adolescence.

A NOTE ON TRAUMA

Trauma is a word that gets thrown around in conversation like one might casually use the word “love.” I love your dress. I love your purse. I love buttered Brussels sprouts tossed with salt and brown sugar.

Because of its prevalence in daily discussion, I never felt like I could lay claim to the term trauma. Or, if anything, I had “little ‘t’ trauma.”

It has been empowering to finally admit to myself that I have experienced trauma. I do not have to hold my experiences up in comparison to anyone else. Trauma and mental health are not competitions. I do not need to classify my trauma as “big T” or “little t.” I have experienced trauma. Full sentence. Full stop.

For context, here is a definition: Trauma is the lasting emotional response that often results from living through a distressing event. Experiencing a traumatic event can harm a person’s sense of safety, sense of self, and ability to regulate emotions and navigate relationships.

Trauma is about the long-term emotional response, not the event. While some situations are far more likely to cause widespread trauma (living in a war zone, experiencing a natural disaster), two people could go through the same experience – say, a car accident – and only one be traumatized.

MEDS FOR MENTAL HEALTH

After 15 years of floundering for various reasons (see above) and lying on mental health questionnaires (perhaps “stretching the truth to its breaking point” would roll off the tongue more palatably?) because I felt so much shame for not being stronger and more resilient, I finally gathered the courage to talk to my family doctor about medication.

I was in a living nightmare. It was a horrible cocktail of pandemic isolation, an incredibly intense and stressful period of work for my husband, two young children and a neighbourhood situation that left me in near-constant emotional distress. (At various points we considered moving to avoid the issue, but that came with its own plethora of potentially stressful outcomes.)

In December 2021 – for the first time in my life – I was prescribed a medication for anxiety and depression (Lexapro, or escitalopram). After six weeks, I had to stop taking Lexapro due to side effects which included early signs of serotonin syndrome. I went off – and stayed off – meds for the next year and a half.

In the summer of 2022 I started having panic attacks almost every night, waking in the middle of those attacks frozen in bed. They were horrific. At the time I tried CBD oil, then THC (accessible now in Canada at liquor stores), and combos of both. I didn’t find either effective in helping my mood, reducing panic attacks, or helping me to relax although I know many users find them incredibly effective.

By the summer of 2023 several personal challenges had reached a fever pitch and the range of emotions and fear I felt was crippling. I had to make a change. I had to get help.

• This post by LagLiv was instrumental in motivating me to reach out to my family doctor about pursuing a new medication.
• Also, the book Managing Worry and Anxiety by Jean Holthaus. It is a faith-centric book and for me this was a key component lacking in many other mental health resources. As a Christian, there tends to be an added layer of guilt over suffering from any mental illness because we’re called to “cast our cares on God” and “not being anxious about anything“. While this book is unequivocally geared toward Christ-followers, it is also the single best book about mental health I’ve read – and I have read many – though I acknowledge my reading experience was undoubtedly heightened by how I could relate to the spiritual underpinnings of the book.
• I will also put in a plug for The Happiness Trap by Russ Harris which explains the steps involved with Acceptance and Commitment Therapy. This has also been a helpful resource.
• When I spoke with my doctor, she agreed it was wise to start medication but she also insisted I find a therapist. I wasn’t overly thrilled by this recommendation. I had met with a few mental health professionals in the past with limited success. I begrudgingly attended one session with a new therapist and immediately recognized we were not going to be a “good fit.” I am so glad I didn’t give up after this initial discouragement. And, providentially, the next therapist I worked with was a perfect fit for my needs; she has ended up having a tremendously positive impact on my life!

I started on a low dose of Prozac (fluoxetine) late last summer and the darkness slowly began to lift. I know with absolute certainty it is only because I coupled medication with weekly therapy sessions. My therapist helped me see the gravity of some of the situations I’d experienced and granted me permission to feel grief, take action, and sink into all the other emotions I’d been bottling up.

Prozac worked well for me. The main side effect for me were night sweats. I hated night sweats, but I hated anxiety and panic attacks more! I also started regularly having nightmares, and there was some weight gain. But I was feeling much better mood-wise. None of the side-effects in isolation were overly problematic, but after about 9 months on the medication – and with the encouragement of my doctor – I made the decision to stop taking medication in March. Almost the very day I stopped taking Prozac, another highly emotional event happened and I was left spiralling.

Which is why I made the decision to ask my doctor to go back on medication several months later. I specifically requested trying Wellbutrin (bupropion) since it has a limited side-effect profile. Unfortunately, Wellbutrin left me exhausted – so tired I could hardly get out of bed. One common evaluation for mood is a PHQ-9 questionnaire…which I answered truthfully this time. After a month on Wellbutrin, I scored two points worse.

I stopped Wellbutrin and went back on Prozac (better the devil you know than the devil you don’t?) but eventually added in Wellbutrin – taking it in the evening to help alleviate the exhaustion – to mitigate the side effects of Prozac. When I added Wellbutrin, the night sweats dissipated, my weight stabilized, and I stopped having nightmares.

READER RESPONSES

I so appreciate the insights I received on my last post about mental health and want to highlight a few points that blog readers so perfectly articulated; italicized segments in quotes are other’s words and the bulleted sections below are my responses.

“I think the important callout is that medication is a powerful tool, but there is a lot more to it than just popping a pill – you have to find the right medication, you have to wait for it to kick in and start working and you have to find the right balance of benefits vs side effects, yada yada yada. And you have to do all of that on top of having depression/anxiety to start with, so it’s a lot harder than it looks.“

• There is sometimes a faulty assumption that taking medication for mental health is like hitting an “Easy” button. I used to think this too – before I started taking meds myself. It is hard to ask for help, almost all medications for depression and anxiety come with side effects, and most people on these medications are dealing with challenging life situations. Even if asking for medication would make me weak – and it doesn’t – I’d rather be considered “weak” yet feel content versus being labelled “strong” but inside be languishing. A pill is a small piece of the puzzle. It helps pave the way for gaining the head space needed to tackle the very real memories, circumstances, mental triggers, and physical experiences that shape our current mental health. And, for me, I recognize that medication alone would have been of limited help. Thankfully, in combination with regular therapy, it has been effective.

“…each adjustment takes another 6 weeks to see if it helps or hurts. Because the rest of life doesn’t stop while you wait to see how it goes.”

• The trial and error feels hard and frustrating because it is hard and frustrating.

“There’s no shame in accepting help, in fact, I think it’s a sign of strength.”

• Our culture has built up a stigma around asking for help, showing vulnerabilities, or being raw and authentic. That culminates in shame. For women especially, shame over the shape of our bodies and the state of our minds. Seeking help must mean we’re deficient. And who wants to be left wanting? When I asked for help I felt ashamed. But now I look back and recognize it was one of the bravest things I’ve ever done and one of the best decisions of my life.

“As someone who has always been high-functioning, I’ve felt like “what’s wrong with me.”

• Flipping that narrative would be “what’s happened to me.” Understanding that I have reasons why I’m feeling low – not that I need reasons, as brain chemistry and genetics play a big role – shifts the burden off my own shortcomings or lack of willpower and mental fortitude to understanding that life events happen and impact us in unique ways. In short – there are reasons I’m weary and struggling emotionally and it’s okay to get help!

“I think there has been so much more acceptance of mental health, therapy, and asking for help in recent years, but the discussion of medication and the trial period of waiting for the meds to work is something we don’t really talk about! So thank you for talking about it. I got really lucky and the first anxiety med I tried (Lexapro) worked really well for me without any side effects. But my mom has had to try many different types of medication AND trying to figure out how to pair the different meds she needs together. That’s when it really gets tricky because sometimes one medication isn’t enough!”

• I did not realize medication success could vary so wildly. While some pills have distinctive treatment and side-effect profiles (e.g. preferred medications for people suffering from post traumatic stress disorder, premenstrual syndrome, anorexia, panic attacks, agoraphobia), there is a murky middle with a lot of highly tolerated medications that can still have dramatically different effects depending on the user. For example, Wellbutrin is supposed to be energizing. For me, it was cripplingly exhausting. I had no idea it would take trial and error and that what worked for family or friends wouldn’t necessarily work for me.

RESULTS

• Rumination. If I had to sum up the single most noticeable change in my mental health since starting medication for mood, it would be lack of rumination. I used to get fixated on a situation or problem and find myself cycling through a negative spiral on repeat. I still worry and stress about things, but they no longer play in a non-stop loop.
• Disappearance of PMS symptoms. I had intense mood swings in the lead-up to every menstrual cycle. I would feel “off” for at least a week, sometimes more. These days…my periods surprise me! If I’m not actively tracking the dates, I’m oblivious until the day it starts. I used to be very weepy and extra impatient. Everyone in the house is happy with this development.
• Patience. I’m a lot more patient with myself and others.
• Mood. The medication is doing what it’s supposed to be doing. My mood is improved and the change in my PHQ-9 scores are incredible.
• I do still struggle with energy levels and think Wellbutrin contributes to this, at least in part. I’ll continue to monitor all side effects with my doctor so we can make informed decisions moving forward.

CONCLUSION

I’m coming to view my mental health journey as though I’m preparing to run a marathon. Medication? That’s nutritious food. Therapy? That’s training under the supervision of an athletic coach who can encourage and guide me. And my brain? Well, she gets to run the race.

Just as eating fruits and veggies doesn’t automatically prepare someone for the demands of running a marathon, medication doesn’t magically turn your world into a universe filled with cupcakes and butterflies (wouldn’t that be nice.) As any marathoner can attest, in addition to healthy eating habits, you need to train and plan your route and have a race-day strategy. You need to prioritize sleep, slowly increase your mileage, and schedule in rest days.

If I subsist on a diet of Mountain Dew and chocolate cake, that doesn’t exclude me from being a marathoner. Some people can power through despite their fuel source. But I am more likely to run my race efficiently and without injury if I am fuelling my body with nutritious and satisfying options. And I’m more likely to cross the finish line with a smile on my face if I’ve had a coach cheering me on from the sidelines.

So, where am I in my marathon journey? Honestly, I don’t know. The long-term statistics on low-dose antidepressant and anti-anxiety meds are reassuring. I’m fortunate to have seen results with commonly prescribed medications with limited side effects and that should have very limited withdrawal symptoms when and if I chose to taper off medication. For now, meds are one part of my path toward ongoing mental wellness. And for that I’m immensely grateful.

Header photo by Jordan Wozniak on Unsplash