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���������� Note: This letter is a testament to the difficult but often liberating decision to move beyond a life in a system of psychopharmacology. The well-researched opinions approach the often uncomfortable research being achieved in the field of psychiatric medicine. Coming off of medication is not the right decision for everyone—and shouldn’t be undertaken lightly—but it can be achieved by many, and is now accepted by many treatment professionals as a valid and valuable step forward in a rehabilitation process. The behavioral health system must respond to emerging notions of psychiatry with an unbiased and open response that includes new best practices and a concerted approach to recognize the value of a life without medication for members of our community that desire it.

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As I was reading this, I was struck by how valuable the personal experiences shared are for individuals moving “beyond” many different life choices and experiences; it could easily apply to self-harm, substance abuse, treatment programs, abusive relationships, or any event that encompasses the blurred burden of what has happened to us and the choices we make to overcome it.

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Letter to a Patient

Mad in America; Meaghan Buisson, 10/20/2014

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Dear Patient,

A few months ago, Dr. C––––– asked if I’d be willing to write to you. “I’m seeing a lady patient,” he said “who says she can’t live without antidepressants. When I asked what might convince her otherwise, she thought perhaps a letter from a fellow patient would help.”

All I know of you is the following:

a) You are female

b) You are a patient of Dr. C–––––’s

c) You are taking antidepressants

d) You are considering going off meds

All you know about me, I’m assuming, is whatever I choose to tell you.

Let’s start with a confession: After saying I’d be happy to write to you, I promptly avoided do so for nearly two months. I kept putting it off because I felt like I had to be in some state of perfection in order to share my experiences. I wanted the selfish comfort of being totally healthy and problem-free. I worried you’d expect me to be the Other Patient who’s Gone Off Her Antidepressants and Now Her Life Is Perfect!

That kind of stuff.

Problem is, that’s not who I am. Besides, I realized, if you’re even remotely like me, the last thing you probably want to read is some dissertation from someone bragging about how wonderful her life is and how great everything is going. Frankly, if that was the case, I wouldn’t be sitting in Dr. C–––––’s office.

Neither would you.

So let’s be honest. My life is far from perfect. I’m writing this on a Saturday morning, wearing a cast up to my knee and with the unsettling knowledge that the longest I’ve gone in the past seventeen years of life – barring time in treatment facilities – without any self-harm or eating disordered issues can be counted in days, or occasionally, weeks. I’m writing wondering what on earth I’m supposed to say to you, and how much do you really need to know about me? I’m trying to figure out some way to explain I’ve lived through hell, and in perpetual quest for health, balance and healing, now sit in Dr. C–––––’s office on a regular basis shaking uncontrollably with terror, only to compose myself at the end of each session so I can make it through another stretch trying to fit in while pretending everything is fine.

There are days depression wraps around me like a blanket. I struggle to hold down a regular job, wage a constant battle against inner gremlins that whisper any number of nasty self-defeating thoughts, and worry every single day about making ends meet. Sometimes I find myself crying on the street, in the subway, at school, in the grocery store, and any and all other other inappropriate places for no apparent reason. I don’t have all the answers for your life, any more than I can say I have them for my own.

But when I look back over my years and the life I now lead, beyond the memories of trauma and abuse, and co-existing sadness I still feel, comes an undeniable thankfulness. I have survived much; I am quickwitted, creative, passionate, strong. I have learned to cry for my past, laugh for my present, and hope for my future. I have learned to stand up for what I think is right, to fight, to believe in myself enough to turn my dreams into reality, to take the risks necessary to do so, and above all, appreciate and benefit from the lessons along the way. I’ve discovered it’s best, if still a challenge, to focus on taking things one step at a time and not forget to breathe.

Through my years in the medical system, I have learned that depression (or whatever tentative variants and labels have been offered therein) won’t disappear with pills. Nor it is something I can just will away by inflicting pain upon myself and saying ‘never again’ with every bout. Although I loathe the inevitable ups and downs of recovery, I am starting to recognize that they are simply a fact – and that progress IS being made. Living beyond medication, I have learned that even the worst days will end, I can still hope for the sun where there seems only cloud, and that every given moment is a chance to move on and keep going.

Every day is another chance to turn things around.

Best of all, I am very much alive. And I am alive because I’m off meds. So that’s where we’ll start.

I spent seven years on psychiatric medication. From the time I was eighteen until I was 24 years old, I was drugged and labelled with various psychoses, mood disorders, and states of depression. The day I stopped taking my pills, I was on three antidepressants (Paxil, Effexor, Zoloft), and a cocktail of other psychiatric drugs: Lamotrigine, Risperidone, Valproate and Ativan. Previously, I’d also be prescribed Prozac, Wellbutrin and Lithium.

When I stopped the drugs, there wasn’t a single person in my world who supported this decision. The psychiatrist and general physician I was seeing at the time both point blank said it’d kill me. “I’d rather be dead,” I replied, “than spend even one more day living like I already am.” So I fired them both and flushed my meds down the toilet.

In hindsight, I wouldn’t ever recommend anyone stop as abruptly as I did. The horrific withdrawal I went through�� could have easily be avoided had I been willing to do a safer, gradual reduction¹, or, frankly, if I’d had a supportive medical professional in my life to oversee such a thing. As that wasn’t the case, however, I did it on my own the only way I knew how. Regardless, while I would now do it differently (i.e. slowly and ideally with support), my choice would be the same. Going of psychiatric medication was the single best decision I have ever made.

I’m now in my early 30s. Although I still struggle with the iatrogenic aftermath of my toxic past, not a day has gone by when I haven’t given thanks for going off meds. Even my worst days now are better than my ‘best’ days before. When I look back, the only way I can describe what it was like being on medication is like living as a hollow shell, simply going through the motions of life. It still scares me to think how much drugs changed me – and the fact I had to go off medication in order to appreciate this; on the drugs, I couldn’t see how blunted and berefit of hope I’d become. Equally, while taking antidepressants, I had no chance to recover–the drugs kept me locked in the prison of my mind; unable to think, I was buried by depression. Worst of all, “that’s just the way it was going to be,” my doctors said. I was told I’d require medication for the rest of my life, that there was something wrong with my brain and I needed antidepressants “like a diabetic needs insulin.”

When I think about this, the memories of who I’d become on the meds, how close I was to staying that way if I hadn’t been willing to take a risk and fight, it absolutely chills me. The person I was while taking antidepressants is a complete stranger to me now.

That doesn’t mean that it’s been easy. There’s a part of me that still sometimes wonders if my life would be better with meds; or more precisely, what it’d be like to just go back on medication without knowing as much as I do about what it’ll do to me–wanting to be trapped in a cage, I suppose, without knowledge of the bars. In the rare moments I think about this however, the answer, for me, is always a quick, vehement “no.” In knowing what it’s like to actually be getting healthier, well away from medication, I will never again take another antidepressant and I’ll continue to fight with everything I’ve got to stay well away from any other psychiatric drugs. I will never again lose who I am, or accept feeling as if I am in some way emotionally dysfunctional, broken, and in need of ‘chemical repair.’

The person I am now is far better than who I ever was, or could ever hope to be, on antidepressants.

Coming off medication, for me, was like emerging from a fog. Consequently, one of the challenges I’ve found is that rather than being numb, emotionally, there are times I feel like I feel everything in hypersensitivity–and the world can be a scary, chaotic place. There are days when I’m overwhelmed, and I wish I could somehow just numb myself into not feeling anything, if only for a moment, rather than feeling too much all at once. But when this happens, I’ve learned to step back and take a break until I can regroup from whatever stimuli is slamming into my brain. I like this. I’m proud of the fact it’s me, not some drug, creating my own wellbeing.

Equally, while I still occasionally struggle with episodes of feeling depressed, it’s far less than I did while actually taking antidepressants! Even more importantly, perhaps, is the fact that with a clear drug-free mind, even when I’m having a rough spell I’m learning to actually deal with my moods and, increasingly, self-regulate. Things like journalling, meditation, and practising yoga has brought far more healing and health to my life than any chemical toxicity ever did. Numbing an emotion doesn’t make it go away.

Taking a drug is not a solution. NO antidepressant drug creates you. All they can do is mask your true being.

Ultimately, the decision to continue–or stop–one’s psychiatric medication is a wholly personal choice. All I, or Dr. C–––––, or anyone else can do is provide you with our expertise, opinions, and evidence-based medical facts upon which to base your choice. At the end of the day however, whatever you decide to do with that information is up to you. If you’re content being on medication, that’s a choice you’re perfectly justified in making–it’s your life. Given the precious nature of what’s at stake, all I’m saying is, please, make an informed decision.

Regardless of whether you stay or go off your antidepressants, base your actions on a rational, objective, well-thought choice. Don’t let fear of the unknown–life beyond meds–frighten you into thinking this is all you’ll be. You are not doomed to be on antidepressants for the rest of your life any more than going off antidepressants means you’ll wind up even more depressed. Indeed, if anything, the latter is true.

Despite the enormous increase in antidepressant prescribing over the last decade and a half, the prevalence of depressive episodes in Canada remains at an all-time high². If the drugs worked as well as they’re touted, this wouldn’t be the case. Instead, findings suggest:

• Individuals using antidepressant medications tend to have longer and more frequent episodes of major depression³.
• Patients treated with antidepressants do less well than people who are not treated with them and are “significantly less likely to have recovered (32.3% versus 51.4%) than those not on antidepressants”³.
• Long-term use of antidepressants actually increases a patient’s vulnerability to further episodes of depression⁴.

Putting it bluntly, antidepressant drugs worsen the progression of the illness which they are supposed to treat.

Secondly, far from correcting chemical imbalances in the brain, antidepressants create them. They’re a foreign noxious substance being directly introduced to one’s body. The brain doesn’t know that antidepressants are “supposed” to be helping. Instead, when exposed to them, it responds as it should, treating their presence as a pathology.

Here’s how it works: Selective serotonin and serotonin-norepineprine reuptake inhibitors⁵��are prescribed on the (unfounded) supposition they are make more of these neurochemicals available in the brain, in keeping with the (disproven) belief that “low serotonin causes depression.”

While nice in theory, this doesn’t actually work in real life, simply because the brain responds to the drugs by protecting itself against the introduction of a toxic chemical: It shuts down. Consequently, instead of increasing serotonin in the brain by blocking its removal, antidepressant drugs cause the opposite to occur. The body senses there’s something wrong with serotonin pooling in the brain and subsequently shuts down production of this neurochemical. That is, the body produces less, not more, serotonin when exposed to SSRIs.⁶

Of course, facts like these about antidepressants aren’t what we’re told in every day life in the industry-driven rhetoric given over the internet, on television, in print ads, or in the pharmaceutically-based hype bought by the average physician. But just because something’s published doesn’t mean it’s true – and no where is this more true than in antidepressant marketing. Doctors’ prescribing habits are heavily based on information received from reported drug trials. Problem being, the vast majority of these trials, published as “fact” in medical journals, are run entirely by pharmaceutical manufacturers, essentially arbitrary, readily manipulated, and for all intents and purposes, unreliable.⁷

Consider the drug trials that got Prozac on the market, for instance. Drug manufacturer Eli Lilly and Co. claimed that between 6,000 to 11,000 patients were given Prozac during the approval process. Individual review these studies, however, later determined only 286 patients actually completed the 6 week clinical trial that led to the drug’s approval.⁸��Even more disturbing is the fact depression was actually listed as a frequent adverse effect of the drug throughout the duration of its approval process. This was removed from the drug’s label prior to it being marketed; indeed, “depression” went from being listed as a frequent adverse effect in the proposed label to being wholly unmentioned in the final, approved label.

Consequently, when a patient became more, not less, depressed while taking an antidepressant, the physician was likely to increase the dose, rather than to stop or taper the drug. It was only in 2003—a full 17 years after SSRIs were introduced—that doctors were formally alerted to the fact antidepressants can in fact make patients more depressed and worsen their overall conditions.⁹Unfortunately, the information took so long to surface, most remain habituated to the idea that antidepressants cannot cause such adverse response, let alone depression.

When you peel back the layers of media hype, here is the real truth about antidepressants: Regardless of however convenient it is for pharmaceutical companies to convince the general public–and many doctors, sadly–otherwise, there isn’t a single conclusive proof that depression is caused by a ‘biochemical imbalance in the brain.” No research has conclusively demonstrated that individuals diagnosed with depression suffer from abnormally low levels of serotonin or norephinephrine, or any chemical imbalance for that matter. We don’t even know what normal chemistry is in the brain yet. Without this basic understanding, on what grounds can anyone say they know what constitutes abnormal?

American psychiatrist Peter Breggin explains,

(The brain) lives in a delicate harmony with itself, an organ with complexity far beyond our current understanding and imagination that provides the biological basis of our humanity. It contains approximately one hundred billion neurons… Some of these individual neurons make ten thousand or more individual connections with other neurons. These neurons and their connections are ignited by a couple of hundred different neurotransmitters… The neurotransmitters we know best we nonetheless know little about; most of the others we know nothing about and haven’t even as yet identified… Tampering with the human brain to influence human emotions and actions is not a good idea.¹⁰

Lastly, from a patient-to-patient perspective, having been on antidepressants and knowing what it’s like to come off them, here’s my advice to you: Give yourself a chance. Fear of the unknown is no reason to avoid all that might be. You’ve got a supporting physician who’se willing to help you every step of the way. And you can do it. So give yourself a chance. Give yourself a chance to live. Give yourself a chance to heal. Give yourself a chance to love and BE yourself.

Regardless of whatever causal factors precipitated your starting antidepressants in the first place, there is no denying depression leads to a vicious cycle of physical and emotional suffering causing feelings of inadequacy, hopelessness, and despair. I get that. I’ve been there. I’m still sometimes there. There are a lot of different things than can lead to bouts of depression; like family conflict, problems at work, chronic physical health problems, childhood events, and financial hardship to name but a few. But these underlying issues that precipitate, magnify, and maintain crises of depression are not solved with drugs. Rather than addressing complex psychosocial origins, antidepressants merely serve to flatten emotional response. This is not a cure; it is a chemical lobotomy.

Abraham Joshua Hershel once wrote:

Remember that there is meaning beyond absurdity.

Every deed counts, every word has power.

Build a life as if it were a work of art.

Start working on this great work of art called your own existence.

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When you look at the canvas of your life, how do you choose to paint? Do you want your colors dulled by antidepressants, or to shine with the richness and wonder of all that creates you?

It’s your choice. AlI I can say is I know what I picked. And given the choice between taking antidepressants or going off meds, I’d make the same decision again in a heartbeat.

Peace, and grace to you,

Meaghan

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