SSRIs - The Good, The Bad, and the Ugly

By Maya Field

TW: Discussions of Mental Illnesses

When I was 16, diagnosed with Obsessive Compulsive Disorder and general anxiety, I was prescribed an SSRI. Specifically, sertraline. Starting off with 25mg to adjust to them, then 50mg, then 100mg. After being on it for four years, I decided randomly to go off sertraline, cold turkey style. Now, I’ve been off sertraline for about eight months. I still have anxiety, my OCD and ED crop up in batches occasionally, but unless I get seriously worse, I wouldn’t go back on sertraline. 

For those who don’t have the fortune of knowing, SSRIs are Selective Serotonin Reuptake Inhibitors. Basically, antidepressants that increase the amount of serotonin in your brain. It’s commonly used for depression and anxiety disorders. According to the Te Tāhū Hauora Health Quality & Safety Commission, ‘around 400,000 people or 8.3 percent of the New Zealand population were dispensed an SSRI or other reuptake inhibitor’ in 2018, and that ‘five percent of the population regularly received an SSRI or other reuptake inhibitor.’ Various studies since then have pointed to an increase in more recent years. 

The first months or so where I was adjusting to sertraline were not ideal circumstances. I was in therapy for OCD, I was hiding my eating disorder from my parents, and, two weeks into the adjustment period, my grandfather died. I couldn’t even try to do exposure therapy exercises while I was first adjusting to medication. I knew that at some point, I would be able to touch a doorknob with my bare hands, and I wouldn’t wash my hands so much that they bled from being so dry. Until then, I cried when a bug flew into me on a walk with my parents, and I was only okay with touching surfaces I deemed ‘safe’ - my bed and desk in my room, basically. 

I was still in a deep grief, but I managed to adjust to my medication. I think throwing myself into my academics so hard that I forgot about everything else helped somewhat. I was used to having a mind that never stopped yelling at me, and eventually, Sertraline quieted down that mind. It helped me touch doorknobs without having a panic attack; it stopped me from catastrophising about my parents and COVID. 

Because it had worked so well in an incredibly dark year, I stayed on it throughout 2022 and 2023. Years where if you had the misfortune of knowing me, I sincerely apologise. When I was recovering from mental illnesses, sertraline gave me the subduedness to follow through on practical strategies, like exposure therapy and rebuilding my relationship with food. Once I had more or less gained those skills, and should’ve started to learn to stand on my own again, my brain stayed quiet, and allowed for other influences to come in. Instead of being able to make my own decisions about what I actually wanted to do, I was basically in a state of limbo - I didn’t know my own mind. In halls of residence, that was possibly the worst state to be in. If someone suggested getting black-out drunk, I would take that as the best idea ever. Then, the next week, I suggested it, because, well, people did last week. If someone wanted to go to a room alone with me, I didn’t see any potential risk. If someone had a bag of something, I didn’t hesitate. It also didn’t help that for most of first-year, I had so much alcohol in my system that at some point, the Sertraline just stopped doing its job successfully. 

In mid-2024, something changed. I’m not sure what. I still don’t know what brought on the urge to do this. I think I had talked to a friend who went off her medication a year or so prior, and it sounded like a good idea. I decided to stop taking my prescribed 100 mgs of sertraline, cold-turkey style. What followed were some of the worst two months of my life. I fell back into some self-destructive behaviours, I was somehow miserable and lazy, while also being insane and hyper. I drank like I was a fresher on a Friday night, except I was in second year on a Tuesday night. I would talk for hours about some guy I was upset about, to anyone who had the misfortune to sit next to me. I was basically how I was in 2023, but dialled up to 100. Around August, after my parents told me how worried they were about me, I realised how much I was spiraling. I think I realised that the guys I liked would never like me back, and my friends were beginning to get tired of it. I decided to quit smoking and vaping, also cold-turkey, and I focused on getting through the rest of the university year. 

Even though the adjustment period to go off sertraline was hell, I wouldn’t change my decision (maybe I would try and do a gradual adjustment instead, actually). I was fortunate enough to be in therapy, with a therapist who worked really well with me, and who advised me on real strategies to bring into my life. I was fortunate enough that if things got bad, I had a safety net to fall into. It’s easy to say that I don’t regret it, simply because of how much better I am now: I’m fortunate enough that now, without medication, I can calm myself down, touch doorknobs, be happy in a relationship, and even drink a normal, full-sugar coca-cola, on occasion.

I’m in a place where if someone suggests something, be it a cigarette or a line, I know where my line in the sand is. I know what I want (and it’s not a cigarette or a line). I know what I’m comfortable with, I know my own mind. I definitely needed SSRIs to help me quieten the bullshit and anxieties when I didn’t know how to differentiate between my mind and my anxiety. But now, with time and with help, I don’t need them, and instead, I can rely on myself to figure out what I’m really thinking. 

I hate to sound like a mum against drugs: I’m not a mum, and I’m not against drugs. God knows that I was in desperate need of sertraline when I was first prescribed them. But I do think that, at least for me, that they wouldn’t have been so successful without the supplementing therapy, and that likewise, therapy wouldn’t have been so successful without the supplementing medication. It just came down to the question of if I still needed to be on them. I decided I didn’t.