Are You Ambivalent About Your Psychiatric Medications?

It was love at first swallow.

The year was 1988. I’d been going through a terrible depression for several months, which was nothing new: Depression and I had been intimate for as far back as I could remember. But it was the first time I’d ever seen a psychiatrist about it. I was 28 years old, on the rise as an entertainment lawyer, and utterly miserable about everything: my love life, my career, my future, and the world. My therapist was growing increasingly concerned and, I suspect, frustrated, so she referred me to Dr. Davidson.

After meeting with me a few times to gauge the severity of my mood, he said he thought I’d be a good candidate for a new medication that had just come out on the market. “Not much is known yet about how it works,” he said, “but it’s done well in clinical trials. The best guess is that it allows more serotonin to be released into the brain, resulting in an improvement in mood. That’s why they call it an SSRI—a selective serotonin reuptake inhibitor. The brand name is Prozac.”

I was so desperate I didn’t care what was known or not known about the drug; I’d have swallowed fire at that point if someone had told me it would help. Plus I liked the scientific neatness behind Dr. Davidson’s theory that depression was caused by a chemical imbalance in my brain. Little did he know, of course, that in truth I was depressed because I was such a horribly flawed person. If he wanted to believe serotonin was at fault, who was I to disillusion him?

So I filled the prescription at the pharmacy and popped one of the little green-and-white pills as soon as I got back in my car. I was hoping for some kind of immediate relief, which of course I didn’t get. But I faithfully took my pills every night, because I’m a good patient and that’s what good patients do: They have faith in their doctors.

Three weeks later, I bounded into Dr. Davidson’s office. Yes, you heard that right: I bounded, which was astonishing because up until then, I’d barely been able to move. The worst symptom of my depression is paralysis—what doctors call “psychomotor retardation,” a slowing of the physical and mental processes. I’d been calling in sick to work for weeks because my body was holding me hostage. No matter how hard I tried or how much I desired it, I simply couldn’t get out of bed.

But now look at me, running up the stairs to Dr. Davidson’s office because the elevator moved too slowly! I remember everything about that day: I was wearing a bright green cashmere sweater, Dr. Davidson was wearing cowboy boots, and the world was again a fit place to live in. I couldn’t believe it, and told him so.

“I don’t think this is medicine,” I said. “I think this is a miracle.”

And it was miraculous. It wasn’t that I was happy all the time; after all, I was still a lawyer and how many happy lawyers are there, really? But bad things didn’t send me spiraling down into despair and suicidality. My feelings were less intense, which was fine by me—I’d seen enough Technicolor emotion to last me a lifetime. I prospered at my work. I dated all the time. I took art classes, joined writing groups, and even began a novel. And every day, I blessed that little pill for giving me back my life.

Until the day it stopped working.

Just like that, out of the blue, the demon depression came back to claim me. I started to cry—I hadn’t cried in two years—when I realized what was happening. My veins felt like they were injected with lead, and my heart was so heavy I couldn’t imagine how it kept beating. I called Dr. Davidson, and he upped the dose. Nothing. He upped the dose again. Still nothing. We maxed it out, and still, I suffered and continued to suffer for many more years, until another brand-new drug, Abilify, lifted me out of the depths.

But my experience with Prozac had traumatized me so deeply that it colored my relationship with psychiatric medications. I know that I need them to stay sane and stable, but I’ll never again believe that they can work miracles—or that if they do, the miracle will last. Such ambivalence is not necessarily a bad thing, according to experts. In fact, it can be a virtue, psychiatrist William R. Miller says: “It allows you to see various options and possibilities and to choose among them. Ambivalence is actually a process of evaluation, comparing the relative positives and negatives of possible choices.”

That’s exactly what happened in my case when Prozac betrayed me. It ultimately made me realize that I had counted too much on one drug to “fix” me. It made me more reliant on other sources of help, like individual psychotherapy, peer support groups, and mindfulness meditation. Having more options in my bipolar arsenal has only enhanced my recovery.

I still believe in medication, and I still believe in dreams. But it’s important to remember that both can be ephemeral. I continue to take what I’m prescribed, but I take it now with a grain of salt. I’ve learned the hard way that doctors aren’t gods, and that one may wake from even the sweetest of dreams.

To find a therapist, please visit the Psychology Today Therapy Directory.