To Antidepress or Not to Antidepress? That is the Question

To put it bluntly, 2019 hadn’t been a particularly great year for me.  My son was 5 years old and still wasn’t sleeping through the night.  I was working as a clinical nurse practitioner but was also the Lead APP (Advanced Practice Provider) in our office.  The practice was ridden with arduous and complicated issues and quite frankly, I wasn’t coping well.

I woke up most mornings around 3 a.m. and immediately logged onto my laptop, sending out neurotic emails and compulsively working on the schedule.  I cleaned my house obsessively, even prompting one of my friends to tell anyone who would listen that my house was so clean, you could perform open heart surgery on the countertops (she was not lying). 

I was running on nothing more than the most noxious of fumes.  I literally felt like I was carrying the weight of the world on my shoulders (and this was even before COVID-19 reared its putrid head!).  I used caffeine in the morning to wind me up and alcohol at night to calm me down.  In the middle of the day, I was fueled by the nonstop adrenaline that goes along with having a painfully stressful job and a child who never sleeps.

Now all of this was very confusing to me because on paper, I had everything I had ever wanted.  More than everything, really.  A loving husband, healthy children, a beautiful home filled with animals, and a successful career.  I had everything I wanted and SO MUCH MORE.

So why the hell was I so fucking miserable?

Oh, the thirst trap of success.  We all know it well.  I mean, we are the children of baby boomers for crying out loud!  We watched Mom and Dad chase the good old American Dream and we vowed to do the same.  Climb the corporate ladder!  Work hard and get promoted!  Promotion equals bigger paycheck which allows for bigger home, nicer cars and fancier vacations!  What could possibly go wrong?

Well if you saw me in 2019, you knew that many things, in fact, could go wrong.  I had developed a deeply unhealthy martyr complex, convinced I was the only one who could successfully achieve the myriad of tasks that encompassed my day.  How dare my husband suggest he was capable of packing the kid’s lunches—the audacity!  I had seen his lunches and was deeply underwhelmed.  My little angels deserved four course meals packed to perfection and it would be a lot to unpack in therapy someday if all they got was a bag of Doritos, a pouch of applesauce and an unpeeled orange (that they didn’t eat the day before).  So I did it all myself, miserable every step of the way. 

Back to November of 2019.  Silas and I were going on our first vacation together since 2010.  It was actually a work conference but there was going to be sand and there were going to be drinks so dammit, it was a vacation. 

Unfortunately, the thought of leaving the kids and the office behind for four days sent me over the edge and less than a week before we left, I developed what looked like a cigarette burn on the left side of my chest.  “I think its fungus,” my coworker Bunny said disgustedly.  “You really shouldn’t use those free yoga mats at the gym.  My daughter got a fungal infection and it took her seven years to get rid of it.”

Great, I thought to myself dejectedly, just when I thought things couldn’t get any worse.

But it wasn’t fungus.  I know this because the very next day I broke out in a head to toe rash, just what everyone hopes will happen days three days before they leave for a tropical vacation.  I raced to my doctor’s office and the young, redheaded Physician’s Assistant named Riley diagnosed me immediately.  “It’s called pityriasis rosea.  It’s a harmless rash that will go away in a few days.  But just out of curiosity, have you been under a lot of stress lately?”

I eyed him suspiciously.  Did this ginger haired sage own a crystal ball?  “Why do you ask?”

“It’s just that these skin conditions are often triggered by emotional distress.”

Wouldn’t know anything about that, I thought to myself sarcastically, making a mental note that the last time I had slept through the night Obama had still been in office.  But I wasn’t about to bore poor Riley with the details.  He worked in health care, too.  He understood my pain.  I was surprised he didn’t have the exact same rash.

“Bring some Benadryl on your trip and try not to scratch the lesions.  Oh, and be sure to stop at the check-out desk on your way out and schedule a physical with your PCP,” Riley said somewhat bossily.  “It’s been four years.”

Fortunately for me, Riley was right.  The rash went away and I went to Florida.  It was amazing.  The only thing pinker than the drinks were the sunsets.  I did yoga on the beach and had vacation sex with my husband (not to worry, we left a very generous tip for the housekeeping staff at the end of the week).

But then I came home and went back to my normal life.  My son still didn’t sleep through the night.  Work was still completely unmanageable.  And just a couple months later, COVID-19 came sweeping through the world faster and hotter than a slap on the face.

After that, things completely fell apart.  I remember packing the kids into the back of my SUV and looking out at them from the conference room while we had meeting after meeting after meeting, trying to figure out how on earth our practice and our patients would survive.  The people we cared for were often incredibly sick and in tremendous amounts of pain and we could no longer serve them.  All we had were questions and there wasn’t an answer in sight.

Things were so busy at work I almost forgot about my physical with Dr. Grassman.  It had been ages since I had seen him.  When he came into the room with a warm smile on his face and asked how I was doing, I just about came unhinged.  I didn’t want to and certainly hadn’t expected to fall apart, but I just couldn’t keep it in any longer.  I simply could not go on pretending like everything was ok, pretending that I was ok.  Because I WAS NOT OK, and I knew it with every fiber of my being.

“I….I’m struggling,” I admitted tearfully.  And then the words I had been tossing around in my head for months came tumbling out.  “I’m wondering if I should start an antidepressant.  But it’s just so incredibly hard for me to admit that I need help,” I said as I looked at the floor, too embarrassed and ashamed to make eye contact.

“Well guess what?” he replied kindly.  “You just did.  It wasn’t so bad, was it?”

And it was like every shred of hair on my body stood erect.  It was as if the clouds had parted and for the first time in a long time, the sun shone through and warmed my skin.

He was right, I thought to myself incredulously.  It hadn’t been that hard.  What had been hard was the suffering I had endured over the last five years.  What was hard was trying to convince myself and everyone else that I was Superwoman, that I was infallible, and that I could do it all.  That had been hard.  Admitting I needed help had actually been pretty damn easy.  

Dr. Grassman wrote me a prescription for sertraline that very day and I will tell you this—I have never looked back.  Antidepressants have helped me immensely.  I had always been afraid that they would dull me, that they would rob me of my ambition and flatline me into some kind of zombie.  But none of those fears turned out to be valid.  Since I started antidepressants, I have written a book, become a Pilates instructor and created this super cool new blog.  Antidepressants didn’t rob me of my dreams, they just robbed me of my anxiety and insomnia so that I could see them more clearly.

I also credit antidepressants for helping me quit my management position.  Once my body stopped pumping out stress hormones 24 hours a day, I gained the internal clarity I needed to realize just how much the positon had affected my mental health.  Now I’m back to being just a regular old nurse practitioner, which I love.

Unfortunately, I think there is still somewhat of a stigma around taking these medications.  And sure, they might not be right decision for everyone, but they were certainly the right decision for me.  These days, I’m up on the mountaintop telling anyone who will listen:  “Call your doctor!  Ask about antidepressants!  You don’t have to go at it alone!  There’s no shame in admitting you’re not ok!  You don’t want people thinking you have a fungal infection!”  I am the proud poster child for antidepressant medications. 

There is one downside, though.  If you need open heart surgery, you’ll have to go elsewhere.  Stay tuned for future blog post “I started taking antidepressants and now my house is a total FREAKING mess!”