private feelings, spell the end of the strange, mystical kid I’d been.
I never wanted to feel the way I had felt over the summer again, and if antidepressants were the price to pay not to have to, I would take them. But I felt angry that the choice had come to that, and I wasn’t quite ready to embrace the idea that what I had was really a sickness. Like Laura, I never stopped cherishing the idea of some future day when I’d be able to live without medication.
Most of the time, though, I dealt with the cognitive dissonance by ignoring it. Taking pills quickly becomes a habit, and there was plenty to distract me. College rolled on, in its demanding and engaging way. Jeff dropped out after our sophomore year and moved back to Texas, to my shock and sadness, but I weathered his leaving. Eventually there were other boyfriends, new friendships, a series of run-down student apartments that all seemed wonderful in their own way. I switched majors, started going to the gym, made Phi Beta Kappa at last. I worked summer jobs and turned myself into a student to contend with. I wore nylon vests, got an old road bike, and started to blend in with the Pacific Northwest. It’s not that I never felt bad; some months and semesters were better than others. But I didn’t crash again the way I had those two times. And while I never did get to like the idea of taking antidepressants, it often became the sort of habit that you can forget about, in the loud rush of life.
5 | I’ve Never Been to Me
I n April 2008, the New York Times ran a column in which the psychiatrist Richard Friedman described the case of “Julie,” a thirty-one-year-old woman who “had been on one antidepressant or another nearly continuously since she was fourteen.” Julie had recently told Friedman that because she’d “grown up on medication,” she didn’t really have a sense of who she would be without it. She wondered but would never be able to gauge how the drugs might have affected her psychological development and her most basic sense of herself. Friedman reported listening with interest. “It was not,” he wrote, “an issue I had seriously considered before.” 1
And yet, he realized, it could hardly be a unique one. Adolescence is the most common time of life for a first occurrence of depression. 2 And though no company or agency keeps data on how long individuals remain on antidepressant medication, we know anecdotally that usage often goes on continuously or nearly continuously for years, even decades. In my own interviews I spoke to a number of people who reported, like Julie, that they’d taken antidepressants throughout more or less their entire adolescence. Understandably, these people often asked themselves how those ten or fifteen years of antidepressant use had affected the people they had become.
Julie’s question to her doctor is difficult if not impossible to answer. Friedman admits that he can’t tell his patient how growing up on antidepressants affected her, except to remind her that the course of untreated serious depression is nothing to be desired. He advised readers that Julie herself, who had endured “several suicide attempts,” credited antidepressants with saving her life. But even when doctor and patient both trust that anti-depressants are the right choice, the existential questions that the medications raise don’t just go away. For many people, they linger or recur from time to time, a significant feature of the overall antidepressant experience.
EMILY WAS TWENTY-EIGHT years old, and in the outlines of her story, she could have been Julie’s twin. She had started Prozac when she was fourteen and remained on it, with only a few short breaks, ever since. Emily was raised in the Midwest by her mother and older siblings, where she attended private schools and enjoyed what she describes as a comfortable life. After college she moved to New York City and began working as a freelance writer. She has established
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