Antidepressant Discontinuation Syndrome: If I’m Not Addicted, Then Why Do I Feel This Way?
Antidepressant discontinuation syndrome occurs when a person abruptly stops or drastically reduces the use of antidepressants after an extended period time. The symptoms may not be as dramatic as withdrawal from alcohol or other drugs, but it is decidedly unpleasant and worrisome. And I am speaking from personal experience.
In 2003, my doctor prescribed me Zoloft for the first time. I had come into her office with complaints about rosacea, heartburn, and feeling “toxic.” Understandably, she didn’t really know what to do with me. She suggested I try an antidepressant to take the edge off my symptoms. I agreed to give it a try.
I noticed the difference in my mood relatively quickly. You see, I suffered from both anxiety and depression, much of which manifested itself in some form of body dysmorphia.
Both my mother and grandmother were commonly referred to by others in the family as having hypochondriasis – a term used to describe someone who falsely but truly believes they are ill or sicker than they actually are.
Now in my case, body dysmorphia (obsession or a real or imaged physical flaw) involved my appearance much more than any internal problem I could possibly manifest. I obsessed over spit ends, teeth that weren’t perfectly white, and my waistline. But it wasn’t until the rosacea set in after a skin irritation caused by chemical skin lighteners that I ultimately found myself going bananas.
And so, this is how it went for 15 years. And I was not alone. According to the National Center for Health Statistics, more than 1 in 10 Americans (13%) reported having taken antidepressants in the past month. And one-quarter of people who used them said they had taken them for ten years or more.
But I had wondered for some time what it would feel like to stop taking SSRIs. What would I be like? What would I think and feel? Do I really need them anymore? Did I ever need them? A few weeks ago, I decided to give it a go.
How Do Antidepressants Work?
Most antidepressants, including MAO inhibitors and serotonin reuptake inhibitors (SSRIs), work by boosting the levels of certain neurotransmitters in the brain, such as serotonin, by stopping them from being broken down and reabsorbed into neurons.
This action results in neurotransmitters remaining in the synapses longer, producing more activity, and therefore working harder to compensate for otherwise perceived lower-than-normal levels of mood-regulating chemicals.
Still, despite knowing this, researchers do not fully understand why they work to ease depression and in some cases, anxiety. In fact, antidepressants, like many drugs, were discovered almost by accident. Moreover, Swiss researchers were looking for a treatment for schizophrenia in the 1950’s and instead found that an experimental drug altered brain neurotransmitters and produced euphoria in their patients.
The Sudden Realization
It took a few days, honestly, before I really began to notice a difference. All of a sudden, I was feeling unusually keyed up, argumentative, and irritated. Then the crying jags started.
But what came next was the worst – tingling and burning sensations in my head and body. Chills. Insomnia. Decreased concentration and confusion. Most, if not all of these crazy symptoms could be easily explained away by withdrawal – more aptly known as antidepressant discontinuation syndrome.
Of course, medical experts say that you should never abruptly stop using antidepressants, but taper off. How this happened to me, however, was a bit of a different story. I realized that I had forgotten to take them for a few days (as had happened before) and I somehow I brazenly believed that that was enough to get over the hurdle of use.
You see, antidepressants are not considered to be addictive in the same way as drugs such as opioids or benzodiazepines. That is, the discontinuation effects of antidepressants are not associated with addiction, but rather reflect the physiological consequences of cessation – just as if someone who stops taking medication for hypertension would likely see an increase in blood pressure.
Have I Changed In 15 Years?
I’m still trying to answer the question – what, if anything, has changed about my psychological state in during all time. My guess is, not much. Feelings that I had apparently suppressed to an extent started coming back. Then I remembered why I went on antidepressants in the first place.
I will say my coping skills have improved a bit, but overall, I realize now how much SSRIs masked the true nature of who I was. It hasn’t been all bad – I’ve found that I feel love and emotion a little more intensely again. I am crying at things that I haven’t cried over in years, including bittersweet moments in movies and songs about longing and heartbreak.
And sometimes, I wonder if it’s all been worth it. Moreover, should give in to the unpleasant and sometimes anxiety-inducing feelings that I have developed in the past month or so? And yet, I haven’t given up. I continue to work through these feelings and sensations regularly every day.
I will, however, reiterate to any and all of you out there who have been on antidepressants for a long time, that abrupt cessation is not the best way to go. Instead, please talk to your doctor about a tapering schedule. Antidepressant discontinuation syndrome is not the same as withdrawal from say, opioids, stimulants, or alcohol, but it is highly unpleasant and most often, unnecessary.
~ G. Nathalee Serrels, M.A., Psychology
References For Antidepressant Discontinuation Syndrome