Dear Laura,

I’ve had low-mid grade level depression since my 20’s. I started anti-depressants eight years ago. It finally occurred to me that I went on the anti-depressant when I was drinking quite a bit and upped my dose when I was drinking a lot. So I talked with my doctor and she agreed it was a good time to try to wean off. Under her care, I’m slowly tapering off. Two more weeks and I’m off completely. I believe many people definitely need and benefit from anti-depressants, but I needed to see how I could do without them.

Have you/do you struggle with depression? If so, how do you cope?

-Anonymous

Dear Anonymous,

I didn’t experience deep depression until I was in my late 20’s. When I crashed up against feelings I could neither manage or evade around my marriage, I went to my doctor and she quite quickly prescribed an SSRI to help reduce the anxiety, which I never took. Like many women, I drank instead. It wasn’t until I had my daughter, moved across the country and found myself unable to to eat or function that I finally went to a psychiatrist and began taking anti-depressants. As I’ve mentioned before, I never told these doctors about the amount I was drinking. And like you, my drinking increased drastically over those years. When I started to take the SSRI, I found I could drink more, and also that I needed the drinking to bring down the way the pills amped me up. You can actually find entire forum threads dedicated to how quickly an SSRI will help you bounce back from a hangover. I too upped my dose when my drinking increased.

When I read your letter, I immediately thought of the excellent book Drink: The Intimate Relationship Between Women and Alcohol by Anne Dowsett Johnston. It’s one of the best books I’ve read on the subject of women and their relationship with alcohol, and she touches profoundly on the issue of prescription medication – specifically, anti-depressants – and their role in the mix.

There’s a chapter dedicated to self-medication and reading it was one big Ohhhhhhh for me.

“Four weeks into taking my first anti-depressants, and I am losing weight at a remarkable rate.…I am revving, I need very little sleep.…I like this new energy. I begin to drink more. These pills make me rev. I can feel it in my brain.…All of a sudden, when I least expect it, I find myself having too much to drink. An aid has become a habit.”

She goes on:

“In many women’s lives, we miss the biggest part of the story if we don’t link drinking to the issue of self-medication. It’s an all-too-common reality in modern society: using alcohol for what ails us. As one beloved doctor said to me, when I used alcohol to tamp down what I call revving: “You were smart. Alcohol’s a depressant, and you were using it to slow down.”

When I read that last bit, my jaw dropped. There it was. That’s exactly what I’d done. I’d concocted my own recipe for self-medication using anti-depressants and wine (and often other drugs), all the while getting further from the underlying issues. And somewhere along the line in those years, I know I crossed into a different realm. With the aid of prescription medication I slid past the point of no return. Under the watch of a doctor (who I was lying to, yes, but how common is this?), while taking medication that is so widely accepted among my peer group it’s almost assumed, I slid too far. I find the whole thing pretty terrifying.

I had absolutely no shot at dealing with the underlying causes of my depression and anxiety while taking prescribed medication and drinking. Even more, they helped me keep up the whole charade for far longer because they worked. Really, really well.

I absolutely believe, like you, that SSRIs and other medications serve a purpose and are necessary for some. I’m still on mine, as directed by my doctor, and I’ll start tapering once I’ve reached a year of continuous sobriety. I’m okay if I need to stay on them, too. But the point is, I had absolutely no way of untangling the root causes from the effects the drugs had on my mood.

Women are 70% more likely to experience depression than men, and twice as likely to experience anxiety. It’s advertised – and not even subliminally – that wine is a perfectly acceptable and adored coping mechanism for life, what with new brands like “Mommy’s Time Out” and “Mother’s Little Helper.” At my job, we have a Thursday afternoon “Booze Boat” that travels around the office around 4pm each week, delivering wine and beer to whoever wants it. I really don’t want to be all Nazi about drinking, and I’m well aware many people can have a few to no consequence, but a few weeks ago I saw the Booze Boat go by my desk, inciting smiles and whoops and cheers and a bit of levity on a Thursday afternoon and I thought, Really? REALLY? That shit almost fucking killed me.

I don’t know. I’m not sure where I stand on it all yet. But I do know that in these cases I’m the weirdo, the odd woman out, and that feels very…precarious.

Back to the point, Anonymous. Yes, I’ve experienced the crushing weight of depression. In sobriety, I’ve experienced far more anxiety, but I’ve had brief bouts, particularly in the winter months. Both are identifiable, at least, when I’m sober, whereas when I was drinking everything was bound up in a mess of extremes: I was either “really good” or “really fucking bad.” I’m only untangling all of this now and although it’s scary to witness cold depression pass through me, or to notice I’m wringing my hands incessantly and that my jaw is locked as anxiety rears its head, I now have the tools to work through it and with it. Running, meditation, prayer, breath work, talking to a friend, sleep. I didn’t know how to manage myself before, and I fear so many of us never develop these skills because in our culture we’re so accustomed to cutting off pain at the pass, or denying it altogether.

I wish you the best in tapering off your medication, and I wish you compassion and acceptance if you need to stay on. Both are perfectly honorable paths. I hope to uncover more myself, in the coming months and years, and I welcome an open and honest conversation about these things.