farewell, sertraline

on embracing pain and finding the light in between the cracks

When the psychiatrist informed me that if I wanted to, I could start taking a smaller dose of my medication and eventually stop all along, I smiled politely, nodded my head, and asked questions. In my head, I couldn’t make sense of anything coming out of his mouth. In classic doctor behavior, he proceeded to type on his keyboard for what felt like ten full minutes. I began to panic. My heart was beating along to the sound of his clickety clack clickety clack. All I could think was, “I can’t do it. I can do it. I don’t want to do it.”

It felt like a huge step, and I wasn't sure I had the courage to take it. How could I stop my medication now if every time I stopped taking it I had awful withdrawal symptoms, including fatigue, suicidal ideation, irritability, crying outbursts, trouble sleeping, and a low mood?

Breathing slowly in and out through my nose, I looked around his office and tried to distract myself. I thought about why clinics have such depressing decoration. If their goal is for people to recover, they should put more effort into making the rooms look warmer. Less sterile. I guess there are more pressing issues. Starting with their attitude. Maybe medicine is a business just like any other, and in this case, the suffering of people fills their pockets and keeps the industry alive. Still, they should paint the walls a different color. Maybe add some vessels with flowers; even fake ones would do the trick.

Before I left, he gave me a new prescription and told me to come back in three months. I never did.

When I called my mom to tell her the news, she was hesitant. Same as me. She asked a lot of questions. I assured her it would be fine, but I said I wanted to speak to my therapist first.

On my next session, I laid it all out to MP: my reservations, fears, the times I had stopped taking it and had gone mad. As always, she was supportive and told me I was capable of doing it. At the end of the day, we had spent two and a half years mastering self-regulation and discomfort tolerance techniques. Just follow all his recommendations and don’t miss the check-ins, she said. I had this, she said. I didn’t fully believe her.

This was almost six months ago, and at that time I wrote this:

“For the last two years, I’ve been on medication that helps me manage my mental health. I have become so used to it that I forgot how it feels to be alive when there aren’t chemicals producing extra serotonin in my body. I am currently on a lower dose of my medication, and it has been hard getting used to it. Suddenly, I can cry easily. I can feel my emotions more intensely. It is overwhelming.

I won’t dive into why I started psychiatric treatment, but I’ll tell you one thing: The road to mastering self-regulation is uncomfortable. Navigating life as a person with depressive tendencies is hard enough while medicated. I have gotten used to the numbness. Now all I had was myself. No more relying on pharma. Chills.

When you decide to stop your medication, the first thing you should do by doctor’s orders is start by taking a lower dose every day. Then you start taking that smaller dose every other other day. All of this to avoid discontinuation symptoms. The bad news is that there is no turn-away from withdrawal. Even after doing what my doctor advised me to, I had to endure the symptoms.

I wanted to rip my skin off. I felt the most depressed I’ve felt this year—ramdomly crying at the most banal things. Irritated at the slightest shift in voice tone or temperature. It was almost unbearable. I almost gave in.

One day, I was boiling water for my afternoon tea. I grabbed the pot, watched the bubbles sticking to the bottom, and thought, “What if I drop this water on my leg?” How much would it hurt? Would it hurt as much as I hurt right now?” I got scared. It wasn’t the first time in the past few weeks that I had similar thoughts. But I didn’t want to hurt myself. I knew the feeling, and this felt different. Where were these ideas sprouting from? I was stable. I was being a functional person; going to class, exercising, and eating three meals. Yes, I was crying at everything slightly emotional and lashing out to people who were trying to help. But I was trying my best. What else does one have to do to not go insane?

I didn’t know at the time that my pain was looking for a way out. I didn’t know all I had to do was feel.

Here’s what I’ve learned these past few weeks:

Most times, pain is localized. There’s always a reason, or a name. When physical, you ache in a specific part (or parts). When emotional, the outline can be obscure. You might have to step out of your body and look through the blurry lines to find the source. But sometimes pain is everywhere, like cancer spreading all over your organs. It moves fast, contaminating your liver, your gut, and even your lungs, making it hard to breathe. Hard to stay alive.

I took my final half pill of sertraline one day, and for the next month, I was in constant pain. I wanted to make it stop. But I didn't want to find out why I was hurting. It was too much to handle. The pain I experienced those days wasn’t coming from a singular wound. It was a collection of badly healed wounds from the past.

I realized I couldn’t look forward without looking inward. What was preventing me from moving on was that I was stuck in the belief that I needed medication to manage depression.

I’m hesitant to live a life free of SSRIS. I’m scared that I won’t be able to manage and process my emotions in healthy ways without the help of medication. Even when I know that the only reason medication has worked so well for me is due to therapy and all the work me and my therapist have done together to help get me to the place I’m in.

When you have a history of emotions feeling like a burden, you tend to run away from them. I used to think that if I ignored my emotions, they would eventually go away. But they never did. They would grow into something sinister, with a life of its own, making me feel incapable of handling them.

I was being inconsistent in my inconsistency. Antithetical. I wanted to stop hurting, but I refused to do anything about it.

I remember I would lay on the floor and cry silently, wishing it would all stop. Thinking it would be the perfect time to believe in a god I could reproach for punishing me like this. Hoping it would all go away. But when it didn't, I felt defeated. I had to make a decision. I could stop complaining and choose to change my reality, or I could go back to what I knew. I decided to give in to the pain, looking at it in the eyes and allowing it to boil inside me until rupture. I let it find its way out.

One day the pain was less noticeable. I started to feel more put together, less reactionary. I could claim it was my body finally adapting to my new reality. Or that the worst of the withdrawal was over. Instead, I decided to give myself credit and acknowledge that the only reason I feel stable is because of me and the people that held me, even if they didn’t know how much I needed them at the time.

I wish I could tell you there is a magic trick to make the process less painful, but there isn’t. All you can do is acknowledge that you are going through changes and embrace them. Stopping your medication is a personal decision that I wouldn't advise anyone to take alone. Talk to your doctors before; ask them all the appropriate questions. Hell, ask even the inappropriate ones.

So far, going off my medications has been the right choice for me, but it might not be for you, and there is no shame in that. Eleanor Lucie wrote an amazing essay on this subject that I loved and highly recommend if you are hesitant to start pharmaceutical treatment. If you are struggling, reach out to a friend, a family member, or anyone else you trust. Tell them how you feel. I know it’s scary and overwhelming, but hiding your pain doesn’t make it disappear. It makes it grow.

Running away from pain never did me any good. Instead, it made me mean. To get better, I had to let go of the idea that being “too” sensitive was a burden no one wanted to deal with. I had to feel all of the ugly emotions that I was denying myself from feeling. I had to feel bad to feel good.

It’s been six months in the making, but I can finally say:

Farewell, Sertraline. Thank you. You did good, but I did better.

Love,

Luisa <3

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P.S

I’ll be posting my monthly post for paid subscribers next week. It’s an essay about the state of cinema as an art form+my favorite movies of the year+the RECAP series, where I tell you everything I loved, hated, and obsessed over in the month of November. Keep an eye out for it. It’s going to be worth it, I promise.