Depression Is Not Linked to Serotonin, But I’ll Keep Refilling My SSRI Prescriptions

antidepressants. illustrated person in pink sweater holding a flower surrounded by abstract black shapes.

The main areas of serotonin research provide no consistent evidence of there being an association between serotonin and depression. Hence, how could an antidepressant help?

How it all began…

Doctors pushed antidepressants on me for half my life. Either they weren’t taking the time to explain the concept of serotonin reuptake, or I wasn’t listening. Let’s be honest, I was so turned off by the idea of being medicated, that nothing they said could have convinced me. 

When doctors blamed anxiety for my physical complaints—gastrointestinal, menstrual, neurological—I balked. No, the root cause had to be something else. I was “fine!” I had a regular school/work life, with friends and fun. 

Except for the persistent little voice in my head telling me I wasn’t enough, or worrying about getting X, Y and Z done, or else. I thought the invisible problem made me weak or damaged, and I wanted to “fix” it myself. Through a true Descartes-style mindset–I think I’m normal, therefore I am–I believed healing would result from willpower alone. 

Maybe if I meditated, went to therapy, and got better sleep, something would click and I would wake up “normal.” I knew others had success with antidepressants, and while I fully supported them, I constantly resisted medication as a treatment option for me. After two decades resigned to the invisible struggle, the symptoms became unbearable, the voice too loud. 

The reality of living with mental illness

Mental illness can start at birth or arise from trauma. I was predisposed to anxiety and later battled anorexia. It doesn’t matter where you come from, your age, job, size, or family, anyone can face mental illness and avoid treatment. Some, like me, are convinced that if physical aches and pains disappeared, so will the invisible problem. Some fear side effects, stigma, or don’t understand how the drugs work. 

Having mental illness disrupt any part of your routine, self-worth, relationships, or well-being, is sick enough. It is enough to seek help. There is no such state as “sick enough.” I wish I knew that sooner, but I’m grateful to know it now.

After a year of weekly therapy, daily meditations and journaling, decent sleep, and gastrointestinal pills (sometimes the physical stuff is a real and unrelated problem!), my recovery plateaued. I had restored physical health, but the invisible voice still lurked. 

Instead of celebrating my efforts, I felt like a failure because my willpower wasn’t enough to solve the problem. On top of that, I feared a relapse. Meanwhile, a friend’s mental well-being had transformed after their first few months on an antidepressant. Witnessing their experience made me more receptive to trying the stupid little pill. Having them as role models quieted my skepticism.

My experience with antidepressants

Burnt out, I began searching for a psychiatrist. After finding an in-network specialist, I faced massive wait lists. For those who want to try antidepressants, but think they can’t afford them—there are options. General practitioners can prescribe antidepressants in most states. Generic medications will cost a few dollars monthly if covered by insurance. Mail-order generics without insurance are less than $20. 

Starting medication felt like forfeiting my control of recovery to the stupid little pill. When the voice became quiet in just a few months, I started viewing the antidepressant as a happy brain boost in my morning routine. 

This isn’t the case for everyone. Some need to try different brands and dosages. Other people are discouraged by the fact that they will not feel better the same day or week they start taking it. If the invisible problem is still there, no matter what you’ve done to make it better, I know how it felt to be hopeless. But for a few dollars a month, hope is worth a try. 

Now I celebrate the medication for all the things it taught me. I now accept that my mental illness is just that, an underfunded medical mystery. It’s not my fault, and certainly not a measure of my self-worth or strength. That acceptance has changed me. No longer am I bitterly willing to suffer for the sake of stubborn struggling. I am open to receiving help and also giving. I’ve published tens of essays on my eating disorder experience. Blast Numb Little Bug, get creative to distract yourself, and try to stay off Reddit subs about side effects. Trust your doctor, your loved ones, and that deep down want to be “normal,” but knowing there’s really no such thing.

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