warning Hi, we've moved to USCANNENBERGMEDIA.COM. Visit us there!

Neon Tommy - Annenberg digital news

Life On Antidepressants

Carrie Poppy |
September 23, 2014 | 5:57 p.m. PDT

Staff writer

(Pranjal Mahna/Flickr)
(Pranjal Mahna/Flickr)
The day Peter planned to kill himself, he knew he needed to check himself into a psychiatric hospital. 

“I had just hit a bottom with my depression,” he told me, cutting the air with his hand for emphasis. “I was like, ‘I’ll do whatever it takes. I cannot live like this. I will kill myself if I have to live like this any longer.’”

Peter, a 40-year-old standup comedian and carpenter, has major depressive disorder and bipolar disorder. In other words, he has sort-of high highs, and really low lows. His condition is so severe that it took several doctors, countless prescriptions, and many years to get the perfect combination of medicines to treat him.

This year, he found what he was looking for in a drug called Celexa. Celexa is in a class of drugs called SSRIs, or Selective Serotonin Reuptake Inhibitors. But you might know this drug family by its most famous member: Prozac.

SEE ALSO: Mental Demons Afflict The Creative

Antidepressants were born in Switzerland, when scientists looking to treat schizophrenic patients accidentally made a drug that gave them euphoria. Like Alexander Fleming scraping the first penicillin off a neglected petri dish, the doctors realized that a happy accident was going to change depression treatment forever.

The first antidepressants, tricyclics, had entered the world. And though they were not perfect (common side effects include blurred vision, lightheadedness, lethargy, and weight gain), they summoned a new class of drug, the SSRI, in 1987. Today, about 1 in ten Americans uses an antidepressant, and SSRIs are the most common. This week, researchers found that these drugs work much faster than they had thought. In fact, they start showing their footprint in the brain about three hours after the first dosage.

Doctors recommend waiting at least two weeks for the medicine to take a noticeable effect, but some people, like Peter, feel the results in days. “It’s, dare I say, life changing,” he said. Peter wishes he had used the medicine sooner, but others say it should be a last resort. With 10 percent of Americans taking SSRIs, many reasonably question whether all these drugs are necessary.

SEE ALSO: A Troubling Question On The Neglect Of Veteran Health Care

The L.A. Times reported in 2011 that of all the people who were prescribed antidepressants that year, only 44 percent were formally diagnosed with depression and anxiety. Still, some of these cases may have been for short-term circumstances, like a death in the family. For those with chronic depression, the medicines are no different from treating a diabetic with insulin.

“To me, SSRIs are validation,” said Melissa, a 34-year-old clinical social worker from Minneapolis. "Look, it's not just me being melodramatic! The med changes my brain, and I'm feeling better now! You have a doctor backing you up, research backing you up.”

Melissa focuses most of her work on people with serious and persistent mental illnesses, and she knows what they go through all too well. One of the worst parts, she says, is the backlash people with depression receive when they seek treatment. She compares it to any other illness: “Few rational people would say, ‘I hear you've got cancer. Try not to tell anybody that, and don't take medications. That stuff will kill you!’ Why do we judge anybody for taking an SSRI to get serotonin levels evened out? Especially when it keeps them from, say, killing themselves.”

And that’s exactly what SSRIs did for Peter. These days, he’s making jokes at comedy clubs across L.A. and running his own carpentry business. “The amount of times I’ve been depressed in the last few months have been literally hours,” he said, emphasizing that for him, “hours” is a huge reprieve from days or weeks of despair. “And it’s never that catastrophic darkness,” he added.

SEE ALSO: Is Suicide Selfish Or Selfless?

SSRIs are not without their drawbacks, however. Common side effects include weight gain, lethargy, and decreased sex drive. For some people, and especially children, SSRIs can increase or introduce suicidal thoughts, one of the great ironies of the “happy medicine.” For many patients, finding the right antidepressant can be a rocky road with as many valleys as peaks. 

Dr. Kimberly Finney says that’s why a doctor’s supervision is so critical when a person starts or stops an SSRI. As a clinical psychologist with a subspecialty in psychopharmacology, Finney has treated hundreds of people with SSRIs, and seen nearly miraculous recoveries. As we sat in her classroom at the University of Southern California’s School of Social Work, she tried to recall all of the people whose lives had been changed by the medicine. She searched for words and then shrugged her shoulders and shook her head. “Too many to name,” she said.

But Finney warned that only a small subset of people need SSRIs for their entire lives, and that the first time a person tries them, they should have an end date in mind. “But what happens sometimes is, patients will start medications and just continue to take them and sometimes there's never a discussion of ‘When do I stop?’” Others, she said, endure relapse after relapse. These people, it seems, have brain mechanics that simply produce depression as a matter of course, oblivious to the fact that there’s a human being riding inside them.

SEE ALSO: Mental Illness: The Challenge Of The Revolving Door

Finney’s face brightened when I mentioned the new research on SSRIs’ stamp on the brain. “Well, it's exciting! This new data that points to brain anatomical changes or functioning changes is helpful and it allows us a better understanding of exactly what's going on when someone is prescribed an SSRI or any antidepressant.”

I asked Peter what downsides came with taking Celexa, and he admitted that the sexual side effects were the biggest issue. “But I’m 40 now,” he added, “And really, sex can be so boring!” He laughed and paused to think.

“I don't think it has changed my creativity,” Peter said, as he looked off introspectively. “It has only improved things. Cause I'm not someone who finds comedy from a dark place.”

Then he told me a really, really dark joke.

Reach Staff Reporter Carrie Poppy here. Follow her on Twitter here.



 

Buzz

Craig Gillespie directed this true story about "the most daring rescue mission in the history of the U.S. Coast Guard.”

Watch USC Annenberg Media's live State of the Union recap and analysis here.

 
ntrandomness