What are SSRIs?
Look man, I don’t think I have to go too deep into this. If you want a scientific explanation of the brain chemistry, I’ll refer you to the Wikipedia page. The very very short version is that serotonin makes you feel good, sort of, and these little pills cause the reuptake of it into your brain to go down. That means more serotonin floating around and potentially making you feel better.
Table Of Content
Some scientist if probably foaming at the mouth at that explanation, but the bottom line is that you’re probably not here to learn all about brain synapses and shit. You are here because you feel bad. Bad enough that you’re considering popping some pills to feel better. That’s usually pretty bad.
My SSRI journey: Hate at first sight
My very first confrontation with SSRIs was when I was seeing my first therapist. We had been talking for a few months at that time and I wasn’t really feeling any better. There were many reasons for this, ones I’ll explore later on when I dive into my therapy journey, but the main ones were me not doing the necessary work and my therapist just being pretty bad. But, as per usual, his solution for therapy not really sticking was to refer me to a psychiatrist and talk meds.
I had the talk straight away. The guy told me a little about the pills and literally an hour later I was at home with a box of SSRIs in my hand. In this case, Sertraline had won the “which SSRI will we put in this patient?” wheel of fortune. I opened the box and made my very first mistake: taking out the little leaflet. I don’t know about other countries, but here any medicine is forced to include a leaflet stating all the possible side effects, no matter how small the chance.
So there I sat, an already anxious, fearful person, reading through an endless list of the most horrible things imaginable. The list just kept going. From night terrors to headaches and from total sexual dysfunction to suicidal ideation. I talked myself out of it real fast and told my therapist I wouldn’t be taking them.
What caused me to change my mind?
Fast forward about eight years. I had not beaten my depression at all, but I had sort of settled into it. It just became a normal part of my everyday life. I didn’t know about my personality disorder yet and I had sort of just accepted that I’d be depressed for most of my life. I could hold a job and had some hobbies that I could enjoy from time to time on the good days, so it was sort of fine. I didn’t need meds or therapy because they were too scary.
And then, in 2019, I lost my mother to stage 4 breast cancer after a yearlong fight. This caused a sudden wave of intense grief and depression to wash over my life. I lost my job months before the COVID pandemic hit and forced me to be be locked inside, without a job and mostly alone with my thoughts, day after day after day. I did that for about a year and in some ways, it helped me grieve my mother in a healthy way. In every other aspect of life, I was useless.
This was my absolute rock bottom moment. At the end of 2020, my girlfriend gave me an ultimatum: either I’d start working on myself or she’d be gone. I made her a promise to at least try.
My second try at the SSRI
The first workday of 2021, I was sitting in the doctor’s office. I don’t remember exactly, but I think I specifically asked them to talk about antidepressants again. I was pretty sure I wasn’t going to climb out of this pit alone. Once again, getting from talk to having pills in my hand was way too easy. Doctors, even in the Netherlands, really give out these heavy psychiatric meds like candy.
So there I was again, this time with the SSRI named “Citalopram” in my hand, making the very same mistake I made before: reading the leaflet all the way through. The same fun side effects were all there: anal bleeding, chronic diarrhea, demonic posession, that sort of stuff. This time, I decided I’d find out for myself and eventually stuffed my very first SSRI down my throat.
For hours, I sat there waiting for my dick to stop working and my head to explode. Hours ticked by and I remember clearly trying to feel things that just weren’t happening. Nothing was happening.
The first side effects
A few days went by and the first side effects were starting to show. I was sweating a lot, especially at night. This continued for almost a year if I remember correctly and it is very annoying, but definitely not a reason to avoid SSRIs altogether.
Another thing is that you’ll have almost permanent cottonmouth. That fun feeling when you’ve been hitting the bong too much? Yeah, get used to that, it’s permanent now. Once again, this isn’t the worst thing and I got used to it pretty quickly. It caused me to drink more water, which was actually a good thing.
Another side effect you can pretty much count on happening is that it’s going to upend your sex life, even if your only partner is your hand. Your drive is going to be down and your dick will go numb, pretty much. There’s not much fun to be had there, but as someone who tended to use masturbation as an unhealthy coping mechanism, this actually wasn’t so bad for me. Yes, it sucks if you’re in a relationship and my girlfriend had a hard time with it for sure, but it’s not all bad for young men who can get distracted by their high sex drive.
But did it work?
So, your mouth is now dry, your dick is numb and you sweat a gallon during a five minute nap. Not the best but at least you’re not bleeding out your asshole. The important question is: is it worth it? Do these things actually work?
It took a few weeks before I started seeing small changes appear. Like the parting of clouds, letting in a single ray of sunshine now and then. At first you’re not sure if it’s the pills, a placebo effect or just random chance, but then it happens more often. I found myself going outside more and sometimes even talking to people. It was strange, but kind of amazing.
Now, don’t expect a miracle. You’re not gonna go from severely depressed to joyful optimist in a few weeks. The changes are pretty subtle and they come at a cost. SSRIs tend to cause emotional blunting. I am not going to pretend I know the chemistry behind it, but I most definitely felt it. Yes, you’ll be less sad, but you will also be less happy. Less angry but also less excited. It just puts a blanket of peaceful numbness over everything.
Painkiller
I always compare my experience with SSRIs more to a painkiller than actual medicine. When you break a leg, you need to go into surgery and do physical therapy to heal. But first, you’re probably going to get a bunch of painkillers because you’re hurting way too fucking bad to even think about any of that.
An antidepressant is pretty much like that. You take it not to heal your issues, but to feel numb for a bit so you have the capacity to start healing your issues the way you’re supposed to. It gives room for things like therapy, positive habit forming, working out, exposure therapy and other things that will actually fix the underlying problem that made you take the pill.
If you don’t do any of that, the pill will be a letdown. You’ll just get used to the new baseline of emotional numbness and you’ll now live a neutral life instead of a sad one. Besides, for me the 10mg I started on lost it’s touch pretty quick and I was quickly up to double that dose to get the same effect. That’s when I knew I needed to make an exit plan. And you’ll probably want one too. There are exceptional cases where people will need to be on SSRIs all their life, but in my personal experience that’s not desirable.
Quitting the stuff
About 18 months after I started taking Citalopram, I decided it was enough. I had built up some good habits, I’d completed another round of (bad) therapy and I had done a lot of good work bettering myself through exposure and learning. I was sick of the emotional and sexual numbness and I wanted to get off (ha, get it?).
So I asked my doctor what I should do and she told me I needed to very slowly decrease my dosage over a course of six months. This is a pretty good way to go about it, but the thing is… I’m not a patient person.
I did that for about a week before I decided to go full cold turkey. I stopped taking my pills entirely and braced myself for the weeks to come. And trust me when I say it was bad. If you’re not familiar with the term, “Brain Zaps” are pretty much what they sound like. They’re a common effect when quitting SSRIs suddenly and they happen all the fucking time. Everytime I turned my head: zap. Everytime I closed my eyes: zap. A small jolt of what feels like electricity goes through your head, from spine to brain.
It was terrible. I also felt like there was a lag between my eyes and my brain, like everything was a second behind. It was very trippy and most definitely miserable. But I still do not regret taking this path. It took about a month for everything to be back to normal. I could feel my emotions and my cock again and life was jolly and good.
This is most definitely not medical advice. You’ll probably want to go the six month route if you’re not like me.
What about AvPD?
So, we’ve established that SSRIs work well for depression. At the time I took them I wasn’t yet diagnosed or even aware of AvPD. SSRIs are known to work pretty well for Social Anxiety Disorder, so you’d assume they work for AvPD. And in a way, they do. But once again, do not expect a miracle cure. It’ll numb your fears a bit to the point you can go outside and maybe even have shallow conversations with strangers. It’s great if you’re going to use it to force yourself into exposure therapy like that.
If your AvPD is bad enough, any little edge you can get is welcome and I feel like SSRIs have very much been an integral part of my journey of managing my AvPD. Sometimes you need a painkiller, there is no shame in that. But only do it if you’ve exhausted your other options first and be aware of what you’re putting into your body and brain. Make an exit strategy.
Conclusion: Would I do it again?
Personally, yes. If I were to go back in time with the current knowledge, I would choose to take SSRIs again. I feel like they gave me the little edge I needed to get going again and I am very thankful for them. The side effects suck but for me were not as bad as I expected them to be.
If a situation ever comes where I lose control of myself and my emotions completely again, such as depression, I would consider restarting Citalopram or another SSRI. There is no shame in taking these pills if you need them. It’s actually something you should be proud of, especially if you have a plan going in and use them to do the work to heal.
Final thoughts and disclaimer
This is purely my own experience and should never ever be taken as medical advice. Do your own research. Find out how these things work in your brain, look into your specific type and read up on it. Sleep on it and consider the pros and cons. Do not take the decision lightly.
If you have any questions regarding my specific experiences, feel free to drop a comment or contact me.
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