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Paulina Porizkova

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Ending a Midlife Affair with Meds

Posted: 05/18/11 09:30 AM ET

I felt guilty. I felt unnatural. I felt ashamed. Finally, I broke down and confessed my dirty little secret to a girlfriend and found that she not only knew what I was talking about, but she was doing it, too. And the more I opened up about it, the more I found that I was not alone. Women in their late 30s and 40s were all having the same affair.

With an antidepressant.

I started taking Lexapro after my anxiety attacks came back and, for all intents and purposes, practically crippled me. I've always had anxiety attacks, or panic attacks as some know them, but after years of learning how to deal with them, I thought I had them under control. While my kids were little, the anxiety attacks even subsided to the point where they hardly bothered me. But at the stroke of 40, they came back worse than ever.

I couldn't get in a car, a bus and certainly not an elevator without panic overwhelming me: a crippling, terrifying sense of dread. I couldn't draw a proper breath, my heart pounded and heat flashed through my body, making me break out in sweat. To top it off, my PMS symptoms of frustration, depression and irritability stretched two to three weeks instead of the typical one.

My doctor, fully aware of my dislike for medication of any kind (please, I had two kids all natural, I could take some pain!) suggested that I deserved a break from anxiety. Rebooting the system, he called it. He also fully supported the idea that I begin talk therapy, but in the meantime, he offered me the following analogy: you can build a house with your hands, or you could use power-tools. Either way, you're building a house, right?

I had just gotten kicked off of "Dancing with the Stars" (as the first contestant) and my ego traveled back to ninth grade, when I was the least popular kid in school and just couldn't figure out what I had done wrong to be so disliked. But I had to get over myself, quick. I had children who needed me. I had a husband who needed me. I also had my novel (that took me five years to write) to finally promote. This was no time to sink under!

I knew that unless I did something drastic (far more drastic than my new and intense exercise routine and healthy diet-plus-vitamins, but less drastic then running away from home and my life, screaming, blinded by tears and rain, down, say, Fifth Ave), I would at the very least alienate all my friends, my children and my husband.

Lexapro it was.

At first, the stuff didn't seem to work. It wasn't until a few months into treatment that I realized what had happened. My world had quieted. The constant buzz of anxiety became noticeable only by its absence. It was like spending your entire life in a room buzzing with fluorescents, and then, one day, they stop. I wasn't even quite sure what to do with this silence, how to live in it.

When I had to have a physical for insurance on "America's Next Top Model," I truthfully wrote down the only medication I took, Lexapro. Writing was admitting it, and I did so with a fair bit of trepidation. Unfortunately, this was promptly broadcast all over the "ANTM" production set. It seems I couldn't be properly insured on a TV set if I was taking an antidepressant. I had just started taking it, and this reaction was exactly what I had feared. I was judged crazy. Unstable. It was almost enough to get me to stop it before it had even had a chance to work. Fortunately, the woman in charge of all this paperwork laughed and admitted that she was also taking said medication -- weren't we all? The production could just write a waiver taking their chances with crazy ol' me. And they did.

As I got braver and dared to speak more openly about what I perceived as a terrible weakness, my girlfriends, one by one, stepped up and admitted that they were also on antidepressants. At one point, I found myself at a girls-night-out dinner and discovered all eight of us were on assorted antidepressants! One girlfriend took it because she was depressed. One took it because she got too angry. One also suffered from anxiety attacks. The reasons were diverse, but what we had in common were our age ranges and being married with children.

This shocked me. It also got me wondering. What was going on here? Was this a sort of universal malaise that hit peri-menopausal women? Without antidepressants, would we all be quietly suffering, or exercising like maniacs, having sexual affairs, turning to alcohol or drugs? Was this the female equivalent of a male midlife crisis -- Botox and antidepressants instead of the fast car and young chick?

I spent two years with my lover Lexapro; the two most mellow years of my life. My immediate frustrations were comforted, my resentments muffled, my anxiety calmed; I was wrapped in a thick, warm comforter, insulated against the sharp pangs that came with living.

But I was also insulated against or from fun things like my creativity and sexuality. I used to joke to my friends that after 24 years with my husband, we were, sexually speaking, a finely tuned precision engine. But now it felt as though I was being touched through a barrier, or, in this instance, a thick and cumbersome rug. After a while, it seemed like being intimate was just too much work for too little pay.

And as for creativity, well, with my new sense of peace, I found I had no need to actually say anything. This, for a writer, is akin to a cook who has no appetite. Sure, it's possible to work, but the results will be uninspired at best. I no longer bothered to fight with my girlfriends, or husband; I could just shrug and walk away from situations that previously had me in endless knots analyzing and discussing. And so, for two years, I learned nothing new. I felt emotionally Botoxed. Who was I under the blankets? What did I really feel like? I began to wonder and to want me back, even at the steep price of misery.

I decided that this affair had all the drawbacks of an affair: the sexual distancing from my husband, the guilt, the lies; and the benefit -- silence from the fluorescents -- didn't seem worth the price.

The weaning was predictably unpleasant, three weeks of being tired and shaky from wrangling with awful dreams. And then anxiety came creeping back: the clamminess, the suddenly speeding heart, the heat flashes, the disorientation. But this time, I also became aware of something I may have previously neglected under the loud hum of anxiety, or failed to identify, or perhaps simply didn't have: depression. It could have been circumstantial: after all, with my career at crossroads, my children no longer needing me every minute and my face and body beginning to cave under the demands of gravity, I had something to be a little down about.

I upped my exercise routine to every day. I could finally understand the drug addicts who had cleaned up but wrestled with the urge to use every day. With the drug, I didn't feel like me, but without it, I also didn't feel like me -- at least not the me I remembered, the one I wanted to be. My kids got to know a whole other side of mommy: an irrational, frustrated, weepy woman who had previously been tightly leashed and only let out when I was alone. I felt sorry for myself and then terribly guilty because I had absolutely no right to feel sorry for myself. The world seemed to be too heavy to carry by myself, but I could not ask for help, because I had never needed help before and didn't know how to ask. There were moments of sunshine, though. And I could feel its warmth and take pleasure in it rather than just noticing it.

The years since have been categorized by a fair deal of misery and soul-searching -- but also learning. I am on some sort of an accelerated life comprehension program I didn't sign up for, but nevertheless must process. This got me thinking: could it be possible that these feelings are growing pains? Perhaps they are necessary to cross to the other side where peace and confidence of age will finally triumph. After all, it's not only teenagers who have to adjust to changing hormones, and most of us can still remember the misery.

And I'm starting to wonder whether antidepressants can often be the emotional equivalent of plastic surgery. With them, we can stave off the anguish of change; we can take breaks from the afflictions of living. But is it also possible that through the serendipitous use of these brand new staver-'off'ers, we will ultimately pay a price: the price of going through life anesthetized and smooth with all the self-awareness of a slug?

I will never cease to be grateful to live in a time where knowledge has made it possible for people to no longer suffer. But would that knowledge exist without a little suffering? I'm certainly not an anti-medicine crusader -- in most cases modern medicine saves lives. There must be a large percentage of people for whom an antidepressant makes the difference between life and death, or at the very least, the difference between a life worth living and a life to be endured.

But I also think that those who try to take the shortcuts -- the pill to lose weight, the pill to be happy, the pill to be smart, to sleep, to be awake, are just running up their tab. And there may not be a pill when you're presented with the bill. Which you will. (Sorry for the trite rhyming, I couldn't resist.)

My affair with an antidepressant reinforced what I already knew: I'm not one for affairs. I'd rather fight tooth and nail to keep and restore what I have than take a break from it. But that is so much easier said than done with a Klonopin in my pocket.

 
 
 
I felt guilty. I felt unnatural. I felt ashamed. Finally, I broke down and confessed my dirty little secret to a girlfriend and found that she not only knew what I was talking about, but she was doing...
I felt guilty. I felt unnatural. I felt ashamed. Finally, I broke down and confessed my dirty little secret to a girlfriend and found that she not only knew what I was talking about, but she was doing...
 
 
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04:03 PM on 05/26/2011
THANKS for continuing your honesty, Paulina, and for extending it to this touchy subject. I hope a lot of people will follow your example
10:54 AM on 05/25/2011
How can you trust that your doctor has not been mislead by Big Pharma.

There is a well written and very relevant story in the New York Times "Drug Maker Is Accused of Fraud" about Lexaprop manufacturer Forest. According to the NY Times Forest was charged with fraud in Boston. Federal attorneys alleged that former top executives at Forest concealed for several years a clinical study that showed that the drugs were not effective in children and might even pose risks to them, including causing some to become suicidal.

Prosecutors also charged that Lexapro manufacturer Forest paid kickbacks, in the form of baseball tickets and gift certificates to expensive restaurants, to doctors who prescribed its drugs, and provided some doctors with paid vacations. The complaint also charges that the company separately ran so-called seeding studies, or trials that were really marketing efforts to promote the drugs’ use by doctors.

http://sad­nessaddict­ion.blogsp­ot.com
04:27 PM on 05/24/2011
Your article was very candid & moving -- thanks for sharing. Your problems sound almost identical to what I have experienced over the past 3-5 years (I'm 42). I don't think you are too far off base when you mention the connection to peri-menopause & feeling like you have PMS much of the time. Often, anxiety symptoms stem from hormonal imbalances. Please, please, please have your thyroid & other hormones checked -- it could change your life. I was found to be hypothyroid & progesterone deficient. Supplementation with both of these hormones (bio-identical progesterone) have helped my anxiety *tremendously*. Also consider going gluten-free -- this helped a lot as well. Best to you...
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CSDofNM
I speak lolcat
03:35 PM on 05/24/2011
Let me apologize for some of the harsh comments first. Both my wife and I are thankful for your insights and discussion of this important topic.

What do we do, when soul-searching and "talking it out" just aren't enough? How do we get back our creativity and motivation, when buried under chemical blankets?

Better living through chemistry doesn't always work. Living without chemistry can result in that one straw that breaks the camel's back, leading to self destructive acts, or even the ultimate, suicide.

We've lost people we know that way. We struggle with these issues every day, due to her mood/anxiety/panic complications, and I due to heart medication that makes me drowsy and robs me of initiative.

So we thank you from the bottom of our hearts, for sharing your struggles and insights. Sometimes, as my cousin confided to me when having to decide whether to put his mother in a nursing home, "there are no right or wrong answers, good or bad answers, just choices you don't want to have to live with every day".

May love, peace, and blessings flow to you for this act of kindness to us.
03:37 PM on 05/23/2011
"antidepressants can often be the emotional equivalent of plastic surgery. With them, we can stave off the anguish of change; we can take breaks from the afflictions of living. But is it also possible that through the serendipitous use of these brand new staver-'off'ers, we will ultimately pay a price: the price of going through life anesthetized and smooth with all the self-awareness of a slug?"

This is an incredibly closed-minded and offensive thing to say. Perhaps you and others are on antidepressants for the wrong reasons, but to assume that everyone taking them has "the self-awareness of a slug" is absolutely ridiculous. I should be so lucky to be on antidepressants solely to "stave off" difficulties in life. How happy for you that that was your experience.
01:14 PM on 06/13/2011
She's speaking from her experience of Lexapro, one which I agree with. When I was taking Lexapro (for anxiety and depression) it made me much worse, I was sleepwalking my way through life. I think it's important that people speak up about these issues because it exposes the truth that these drugs are not as amazing as people think. I have also known people who lost self awareness whilst on similar medications.
I do agree that she maybe worded it a little harshly, but still.
10:48 AM on 05/23/2011
Taught 2 tricks by old-fashioned dr from 1960's:when panic/anxiety set in 1. gag myself (usually just takes once and I don't throw up) or 2. pressure on one side of neck (pulse). Sounds gross, but the gagging works for me. My aunt and daughter also suffer. We tried anti-dep and xanax. The advice from Dr. Leroy Bursey (deceased) still works best. He said it will cause a strong contraction to heart and slow things down. He was the salt of the earth. I miss him and his no-nonsense approach to healthcare immensely. My sympathy to all who suffer. Some days, walking out the door is quite an accomplishment.
09:20 AM on 05/23/2011
I have to come back to one quote from Paulina's story.

"I used to joke to my friends that after 24 years with my husband, we were, sexually speaking, a finely tuned precision engine. But now it felt as though I was being touched through a barrier, or, in this instance, a thick and cumbersome rug. After a while, it seemed like being intimate was just too much work for too little pay".

The sexual dysfunction attributable to antidepressants are under reported by Big Pharma and patients are not clearly warned of the impact of this side effect. Prescribing medications like Effexor that have a 60% chance of erasing a woman's libido is simply irresponsible.

How can an antidepressant that wipes out intimacy help a woman who is in a positive healthy relationship with a man when neither is informed of the likelihood that while the woman partner is medicated her desire for sex and intimacy will shrivel and die? How is the man to be treated when he is surprised by the loss of his partners intimacy. He feels frustrated, angry, suspicious and loses his self esteem when his beloved partner rejects him.

Should he be on antidepressant medication to counter the emotional devastation of this rejections? Does he have a right to be warned at the beginning of his partner's antidepressant prescription of what he will lose?

http://sadnessaddiction.blogspot.com
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06:21 AM on 05/23/2011
All I can say is, thank you, Paulina. Well said.

Anti-depressants are over prescribed. A small minority of people need them to function, but most of us simply need to work through the problems of life. A pill will never do that for us.

I say this having suffered from severe anxiety attacks. My doctor gave me one sleeping pill. That's it. I had to force myself to engage in life and work through the anxiety. Today, I've been free of anxiety attacks for years, I thank God my doctor didn't lead me down the road of medication dependence. It wasn't easy overcoming anxiety -- and agoraphobia -- but it was worth it. And, yes, I learned much by taking the journey.
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pghperson
Be yourself; everyone else is taken.
06:36 AM on 05/23/2011
That's wonderful and I'm glad for you that you managed to overcome your panic attacks.
I think what we're missing here, is that what works for one person may not work for another. There should be no stigma attached to either choice - choose medication ot choose other avenues. I can't see anyone's personal path to wellness should be of any interest to others - the goal is to get and feel well; and live life as fully as possible.
Severe mental illness will probably never respond to trying to engage in life alone - the sufferer may not be capable of the attempt; and need support. Both in medication and in therapy. I have a feeling if your doctor had been concerned that you were suffering from a severe mental break - it would have been a kindness for them to prescribe a medication to alleviate your symptoms. You didn't fall into that category.
Congratulations on your journey to wellness; by the path you chose that was right for you.
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07:04 AM on 05/23/2011
My point is that we are over-prescribing medications. Most people who take these drugs are uninformed, and when they report depression or anxiety, the first line of treatment is a pill. So they take it. These drugs have their own side effects. They often block solving the problem and just treat symptoms. The majority of people prescribed do not suffer from crippling mental illness. We are at a time in our society that the idea of not using psychotropic meds to deal with life problems is almost taboo.
01:19 PM on 06/13/2011
The sad truth is though, that if you go to your doctor with mild or moderate problems (rather than severe mental illness), you'll more than likely walk away with a prescription. And these drugs can be addicting and have horrible withdrawal - something that can be far worse than what you went on the medication for to start with. Medications are way over-prescribed.
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03:01 PM on 05/24/2011
"I thank God my doctor didn't lead me down the road of medication dependence­."

Then you should pray to God that you never develop diabetes, congestive heart failure, or any number of other serious health problems that require lifelong treatment.
06:25 PM on 05/24/2011
Well put.
08:21 AM on 06/04/2011
Depression isn't like any of the diseases that you describe for most people. Most need temporary support and then it's over. Some have recurrent episodes. Some are chronic. I don't think she meant it as you imply. In her case it appears that she did not need it long term and she's glad that her doctor didn't lead her to believe that it was necessary for life, as many doctors do. I know this from long, personal experience. Many doctors only care about getting you 'stable' and then they don't make any real effort to optimize your care after that.
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01:30 AM on 05/23/2011
While it's generally great Porizkova opened up about her personal experience, she's done NO favors for the mental health community or those suffering with brain disorders and mental illnesses.

While she states "I'm certainly not an anti-medicine crusader", everything else negates and puts the lie to that professed belief:

“my dislike for medication of any kind” (>>> this says it all right here)

“guilty”

“unnatural”

“ashamed”

“dirty little secret”

“terrible weakness”

“guilt, the lies”

“drug addicts”

“emotional equivalent of plastic surgery”

The whole article seems biased in favor of ANTI-medication - that going cold turkey and white-knuckling it sans-meds is somehow morally superior, more noble, that going it alone is some holy grail of mental virtue. The last thing alot of people need is even MORE pain and soul-crushing anguish in some misguided effort to buck up and tough it out.

Humans are NOT super heroes, able to withstand anything with enough steely "will power". All we have to do is read the newspapers to realize that.

What she has unfortunately done is to influence those who may desperately need meds the most to potentially shun the midlife "affair" - to prove they are not "weak" - the very thing that may turn their lives around and even save their lives.
08:14 AM on 05/23/2011
007... she's hit your sore spot. I can relate to her opinion. Everybody is different.
11:00 PM on 05/23/2011
Thank you, gmb007, I couldn't agree more.
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10:27 PM on 05/22/2011
I totally agree that antidepressants are almost certainly over-prescribed nowadays. I personally think this phenomenon is akin to what was happening with antibiotics a few years back. A patient would go see his primary care MD with a cold and say, "Doc! You've got to help me; I'm truly miserable." Now, antibiotics do nothing for a cold. But no doctor wants to anger their patients or risk having him switch doctors. So many doctors would prescribe antibiotics basically to reassure them that their distress was being taken seriously.

Jump ahead to 2011. A patient goes to his primary care MD and says, "I'm really miserable, Doc ... a lot of the time it just seems like life isn't worth living anymore". It's a rare doctor that is going to listen to the patient's concerns at length - there simply isn't time in a typical office visit. Furthermore, they aren't truly qualified to diagnose clinical depression; that's why psychiatrists get additional training.

Consider this: Two patients walk into the doctors office with the same "life isn't worth living" problem. One is going to forget all about it as soon as he gets home and hugs his child. The other is at the end of his rope and will go home and commit suicide without unless he is offered some help. And it's not always obvious which is which. In which direction do you think the doctor should err with these patients: to give them both antidepressants, or not?
07:45 AM on 05/23/2011
Regarding the two patients: doctors are supposed to do something called "taking a history" before deciding on treatment. The first patient you mention will have a less serious history of depression than the second one; that will suggest a different diagnosis and treatment. Doctors are also supposed to ask about suicidal feelings and intent when presented with a person who seems depressed. If the doctor is trusted, then the second patient will report the suicidal feelings and intent, and that will affect the treatment decisions. Everything I've said is pretty basic stuff to a trained medical professional.
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02:48 PM on 05/24/2011
You are very naive if you truly believe that the diagnosis of major mental disorders is so simple. It's not. Again, why do you think that psychiatrists have training that primary care doctors don't?
08:22 AM on 06/04/2011
Antibiotics don't do anything for colds which are caused by viruses.
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charon
Earth, love it or leave it!
09:11 PM on 05/22/2011
As Aristotle used to say, Homou est bios politikos--humans are social creatures. We are products of our society. The massive use of these sorts of meds is evidence that our society itself is very sick--there is something or some things fundamentally flawed about it. It is a pathological society--it sickens its members to an degree unprecedented in history.

If we don't change our society, it will continue to rot and fester in the minds and lives and families and communities of its members, and the suffering will get worse and spread until change is forced on it by other forces. I am not without hope for the future, but I am not optimistic, either.
08:30 AM on 06/04/2011
There's a lot of truth to that but some people do genuinely suffer from the 'illness' of depression and would suffer regardless of their social context. There's a lot of evidence that some people have a genetic predisposition for the illness. Their lives would certainly be better if society were healthier but they still need medical treatment
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assumetheopposite
Capitalism is sin. Acts 4
07:05 PM on 06/08/2011
Why is it whenever I demand a sequencing gel for all these neo-eugenic claims that mental illness is genetic, the comment is deleted? Undeterred, I am trying again. All of the *real* hereditary diseases have been long since cloned and sequenced, such as sickle cell, CF, hemophilia, Huntington, Tay-Sachs, color blindness, PKD, etc. I repeat: where is a single sequencing gel that any of these "mental illnesses," even voice-hearing, has been cloned & sequenced? I make this demand knowing full well that no clone or sequencing gel exists, nor will it ever exist. I demand nothing less than a sequencing gel and not PR flackery from wikipedia or a blogspot. These lies must be stopped before there are more drug-induced suicides, school shootings, or other violence, and before our freshwater ecosystems are wiped out by these psychiatric drugs and their metabolites in people's urine.
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assumetheopposite
Capitalism is sin. Acts 4
05:01 PM on 06/08/2011
A quick read of the political, environmental, financial posts and so on and so forth dramatically reveal some of the problems: failed economic theories, Repugnicans and Repugnicans Lite, illegal, immoral foreign wars, enough nukes to blow up the world 14 times over, climate being pulverized, oil spewing all over the place, tap water catching fire from fracking, obscene, irrational hatred of women, Blacks, immigrants, creative artists, etc., ad nauseam. To this cesspool of overwhelming social catastrophes I boldly add something even more fundamentally wrong with society: most Americans are anesthetized patients, which causes depression, as published in the Jan. 2008 issue of ANESTHESIOLOGY, although they assumed hideous contortions to minimize this statistically significant correlation and sweep it under the rug. This is why the only students who are academically succeeding anymore are immigrants who are unanesthetized youth. Change will most likely be forced by the tender mercies of the Chinese Communist Party and the proliferating gangs and mafias. It will not be a pretty picture. I am not optimistic at all.
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Todd G Chavey
08:53 PM on 05/22/2011
You waste you time and life away taking drugs to cope with life. Weakness.
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dumosumo
Try finding a plumber on Sunday
10:23 PM on 05/22/2011
On the other hand, you're the pinnacle of success when you stand in merciless judgment of others, eh?.
07:46 AM on 05/23/2011
Well put.
11:42 AM on 05/23/2011
or when curled in a ball unable to leave the house and wishing you could die, yes, the height of strength

(love your comment)
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spinotter11
Spinning through life and trying to understand it.
10:50 PM on 05/22/2011
Weakness and strength are relative, and there is a very large genetic component involved in the consumption of psychoactive agents. Judge not lest ye be judged.
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RJWalkerStuff
08:50 PM on 05/22/2011
So she tried one anti-depressant and thinks her experience can be applied to all?

I hope folks don't think that all anti-depressants are alike or that everyone reacts the same to any given AD

Under the supervision of a caring doctor who took time to listen to her patients, I tried 3 different ones before I got one which worked for me.
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Draekia
Open-minded thinker and traveller
08:54 PM on 05/22/2011
I don't think that is what was said here at all. It sounds instead like you are letting your own issues cloud your judgement/understanding here.
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09:48 PM on 05/22/2011
I am not sure just what you think is being "misunderstood" here. Porizkova has experience with ONE antidepressant which she stopped taking because she didn't like its side effects. RJWalkerStuff is advocating trying a different antidepressant if you do not like the side effects of one you are taking. And you have a problem with that because ... ?

I do believe that your post is a prime example of the kind of prejudice that Porizkova is talking about. Consider two people who have differing amounts of experience with a subject - let's say Person A has more experience, Person B less. Generally speaking I think most would agree that Person A speaks more authoritatively on the subject.

But since we are talking about antidepressants here, you immediately jumped to the conclusion that RJWalkerStuff (Person A) has "issues" and "clouded judgment". Au contraire, my friend; I do believe that the person here that has issues is YOU.
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Nym22
08:06 PM on 05/22/2011
I've always said we need to put serotonin in our salt supplies. Seriously though, something's amiss. Gregg Easterbrook calls it 'the progress paradox' - standards of living are getting better and yet people are feeling worse (the book of the same name is an interesting read).

I will say this, however. without SSRIs I probably wouldn't be alive. Yes, many people abuse them to 'take the edge off,' but there are also those who legitimately suffer from chemical imbalance.
08:57 AM on 06/04/2011
That's funny about salt! I'm like you. I would be alive if it weren't for a combination of drugs that took twenty five years to find. You have to distinguish between situational depression which society can definitely contribute too and can lead to the illness and the illness itself, I think.
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TheSarge
Armed Crawdad BodyGuard
08:02 PM on 05/22/2011
Cymbalta helped me regain control of my anxiety after I was wounded in Iraq. I take it still and I understand your dislike of being tied to a pill emotionally, but one must do whatever it takes to take charge and give life your a kick in the @ss.
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Draekia
Open-minded thinker and traveller
08:56 PM on 05/22/2011
Yep. I think the author was discussing a very different place in her life than where you are, though. Best of life to ya!