Adventures in Medication
It’s better than worse.
I touch on some topics that might trigger you. Just be aware of that. Nor am I a medical doctor. I’m no more knowledgeable than your average podcaster so take what I say as just a retelling of my experiences.
Almost fifteen years ago I was diagnosed with depression.
I had always been antisocial, but my mood had become destructive. My parents grew increasingly worried, and my friends became less friendly. I was a menace to those around me, harboring the kind of thoughts that remain difficult to utter without significant warning tags.
Eventually, thanks to my father, I was able to get an appointment with someone that “specialised” in my then symptoms. I finally had a diagnosis: Chronic Depression.
Living in Fiji at the time, it wasn’t the most common ailment, or rather, it wasn’t commonly diagnosed.
What follows is my journey with medication, from that fateful day in Fiji to the present, in Australia.
Paracetamol
If you’ve ever lived in the Pacific Islands you’ll know this isn’t strange. Palliative care in the Pacific often means Paracetamol. Maybe it’s because one of my symptoms was a type of brain fog, where I had trouble focusing and remembering. Or maybe it’s just what they knew to use when they didn’t know what to use.
I can laugh about it now, but there are likely still people in Fiji taking the same thing for the same reasons. Antibiotics and paracetamol are all that most doctors know and all that most patients feel comfortable taking. In fact, I partly attribute this practice to the ‘late’ in my late father, but that’s a story for another day.
Just know, I count Panadol as my first prescribed anti-depressant.
Fluoxetine
Panadol didn’t work, so I returned to that “specialist”, this time with my father in tow. I had expressed more concerning symptoms and was now granted the privilege of a psychiatric evaluation. This involved a list of standardized questions that asked me to rate my feelings on a scale from “None of the time” to “All of the time.” If you’ve been through this process as often as I have, you’ll likely know it quite well.
It’s as standard as Panadol is to headaches.
Being an overachieving student, I excelled in my score and was granted my first true anti-depressant: Fluoxetine, otherwise known as Prozac.
What followed was the most intense brain fog I had ever experienced. At the end of the customary two-week onboarding, the brain fog continued. The natural solution seemed to be to increase the dosage. It never improved; it only became foggier
Everything felt slow around me, so much so that I once turned too slowly on a right turn and ended up on a sidewalk, inches from a tree.
My confidence was now at an all-time low. Not even a tree would hit on me.
Citalopram
You might know it as Celexa. With this one, there were no near misses on the road, but my enthusiasm for relationships waned along with the relationships themselves. Fortunately, my dwindling interest in romance was replaced by the next best thing: food. What started as a fleeting romance with food escalated into a full-blown obsession.
Paradoxically, Citalopram made me more depressed. It deepened my self-loathing, not only because of the changes in how I felt and looked, but also because, despite these changes, it did nothing for my mental health.
Ultimately, Celexa just left me with more problems than solutions. My stomach would grow in size while my penis wouldn’t.
Xanax
It wasn’t long before I was given another diagnosis: Generalized Anxiety Disorder (GAD). One of the benefits of moving to a modern country like New Zealand is that modern medicine is readily available, even when perhaps it shouldn’t be.
Maybe it was the move to a new country, the painful breakup, or trying to launch a startup while studying full-time at university. What I do know is that I often found myself in a state of panic, constantly agitated, catastrophizing, and fearing that the ground would disappear from beneath me.
Xanax helped alleviate the constant thoughts in my mind, it helped me relax and it did it so well. So well that I used it often and so often I needed it often.
Xanax + Alcohol
But doctors don’t like it when you ask for an addictive drug too often. So, I created my own solution with what little I had to make it last longer. Alcohol was a key ingredient.
It enhanced the sedation, but at a cost. The cost included monetary expenses, significant memory loss, and increasingly abusive behavior. If taken frequently enough, you’re left with less money, fewer memories, and no friends.
I realized this too late, but fortunately money can be replaced and friends can suffer their own memory loss.
Effexor
Celexa and Prozac are SSRIs (Selective Serotonin Reuptake Inhibitors), primarily aimed at improving mood by increasing serotonin levels. However, Effexor introduced something different: it’s an SNRI (Serotonin-Norepinephrine Reuptake Inhibitor), affecting both serotonin and norepinephrine—the latter being one of the most difficult words to pronounce, but you’ll feel smart when you do.
Given my history with anxiety and my risk profile with benzodiazepines, it made sense to opt for Effexor as a more long-term solution for anxiety and depression. This time, it worked. The side effects were nothing new to me:
Drowsiness? Been there, I can live with it.
Nausea? Sure, but it’ll pass. It always has.
Insomnia? Paradoxically, yes. I said I was drowsy. I didn’t say I slept well.
Dry Mouth? Drink water, don’t smoke pot.
Decreased Libido? Saves me from having to date.
Weight gain? This was inevitable.
Suicidal Ideation? No more than usual. Maybe even less.
I finally had something that felt like it was working. Things were looking up and I didn’t mind if my penis still wasn’t.
Effexor + Lithium
Eventually I reached the maximum dose and they gave me a new label. I had “Treatment-Resistant Depression”. The Effexor was working but it needed some help. I needed some help. I had done something silly.
Enter Lithium and many nights without sleep. It may seem almost comical thinking about it now, but the most prominent side effect was a constant desire to urinate, leaving me with incomplete sleep and the moniker: ol’ tired eyes Nav.
I slowly weened myself off the medication over time, frustrated with the costs as a non-resident of New Zealand and the constant side effects. I found religion or rather the next best thing: combat sports. I made friends, I ate healthy and I found better jobs. However, depression slowly crept back in, as one small misstep led to a precipitous tumble down a cliff.
It’s been fifteen years since my initial encounter with Prozac and nearly eighteen since Panadol. Now, I’m back on Effexor. The side effects persist, but I handle them and perhaps the depression — better. Depression is not a simple linear journey, not for me and not for many. It’s a constant struggle to find the right doctor, the right medication, and the right psychologist. Almost two decades later, I am better, though not the best.
But better is better than worse and that’s how I view anti-depressants.
It’s better than worse.