last pill hooray
on medication
I want to talk more about taking medication for depression.
Depression isn’t always what people expect it to look like. It’s not just crying or obvious sadness, and honestly sometimes it’s not even emotional. It can feel like nothing and everything at the same time. It sometimes feels like you’re completely drained but also overwhelmed, like even existing requires effort that you just don’t have.
Yeah, that is a good way to put it. Like existing requires effort you do not have. It is an exhaustion that makes you feel like living is hard. (And if you deep it, that is crazy guys. We are born to live. It is my biological right to live. Imagine not wanting to do what you were born to do)
For me, it showed up as this deep, constant tiredness, and not the kind that sleep fixes. It was waking up already exhausted, feeling like my body was heavy before the day even started, and slowly losing the ability to do things I used to do without thinking. I couldn’t get up in the morning, I felt useless, and eventually it got to a point where I didn’t even want to try anymore, which I think is one of the hardest parts to explain. It’s not that you don’t care, it’s that trying starts to feel impossible.
I want to study, but I cant study. I want to go out but I cant go out.
Or its, I am studying so I can go out and forget. Or I am going out so people do not suspect anything is wrong. It was weird.
And for a long time, I didn’t want medication at all. Part of that was cultural, because where I’m from, mental health is not something people openly talk about, and medication especially carries this weight of judgment, like it means something is deeply wrong with you. But it was also personal. I didn’t want to depend on anything, and I think I had this idea in my head that I should be able to handle it on my own, that needing medication meant I had somehow failed at being strong enough.
But there was a moment where I realized I couldn’t keep going like that.
I had a really bad scare on campus, and I thought I saw someone who genuinely terrified me, and my body just shut down in a way I can’t fully explain. I completely zoned out, and I don’t even remember the walk fully, but somehow I ended up at the school health center, and when she asked me what was wrong, I just said, “I’m tired.” And the thing is, she understood exactly what I meant without me having to explain it.
My therapist doesn’t usually see patients on Fridays because that’s her administrative day, but she still let me sit in her office, and I remember just feeling like I couldn’t breathe properly, like I couldn’t sit up straight, like my body was collapsing in on itself. I hadn’t slept in almost 48 hours, and my mind wouldn’t slow down, and I was just sitting there thinking about how tired I was in a way that felt deeper than physical exhaustion. I didn’t want anything dramatic, I didn’t want anything specific, I just wanted to close my eyes and see dark, to not have to think or feel for a while.
That was the moment she suggested medication again, and this time I said yes.
I started Lexapro, which is an SSRI that helps regulate serotonin levels. I didn’t really listen to her explain what it did. I just knew I needed something to help me get through the day. Before starting it, everything felt like too much, even basic things like eating or getting out of bed felt overwhelming, and it wasn’t just that I couldn’t do them, it was that I didn’t have the energy to want to do them.
And that’s the shift that medication gave me. It didn’t cure my depression, and I think that’s important to say clearly. It didn’t suddenly make me happy or fix everything, but it gave me something I didn’t have before, which was the ability to try again. It gave me just enough energy to get up, to eat, to engage with the tools I already had like therapy and routines and people. It didn’t replace the work of healing, it just made that work possible in the first place.
I’ve been weaning off it for the past four months now and I’ve been trying to pay attention to what my body feels like without it, what I need now, what actually helps me sustain myself. And I think being in that process has made me realize that taking medication wasn’t a failure or a weakness, it was actually one of the most honest decisions I’ve made for myself.
It gave me a path to actually use the tools before me like therapy. I take my final pill tomorrow night and I am really proud of myself!
The hardest part wasn’t the medication itself, it was accepting that I needed help in the first place, especially in a place where everything already feels unfamiliar, where you’re already trying to prove that you can handle things on your own.
It is something I’m still learning, that taking care of yourself doesn’t always look like pushing through, sometimes it looks like allowing yourself to be supported, even if that support comes in forms you never thought you’d accept.
This is so healing to see. I finally started Lexapro after struggling for the past two years. I judged myself for so long and I was so afraid that if I start it I’d never be able to go off it. Seeing this gives me hope that I’ll be able to heal one day🫶🏾
Hello, I am Michael and I am a forensic psychiatrist on the west coast. I ran across your graduation photo and comment and left you a comment (among the nearly 500 comments!). That led me to read this post, and I decided to leave a comment here as well.
I support & encourage you sharing this intimate information - which prompted a safe space for others to share their similar stories as well - as it breaks the stigma that medications are for only the “weak” and the “worst.” So many people share the identical situation as you, yet do not seek help out of fear of being labeled, scorned, or probably the worst, “gossiped” about, particularly if they are young and envied. The old expression is relevant here: “Haters gonna hate.” While those that seek “talk therapy” historically faced a similar dilemma, time seems to have changed this opinion significantly, and the way I see it, psychiatric medications serve for many as an additional boost - an “addendum” - for them to get past certain barriers holding you back from the next level of recovery. They often times can be essential in that aspect of treatment. Contrary to what people claim, these medications have few side-effects and are not intended for long-term use in the majority of situations. Each individual can and may react differently, however.
Medication alone, however, is rarely effective in isolation, and the “work” of recovery from depression is accomplished in psychotherapy. This may include processing issues of grief, loss, insecurities, trauma, and so on. In my comment to your graduation photo, I mentioned having learning disabilities (that were never diagnosed until my fellowship as a physician in child & adolescent psychiatry, if you can imagine) and being thought of as “stupid” & unmotivated because I struggled with writing & spelling! I literally needed tutors to make it through medical school, but I made it (with honors!).
In any case, hang in there. From the comments, you seem to be an inspiration to others, and I’m a new subscriber! All the best.