I often explore mental health in my writing, and part of that is because I’ve struggled with my mental healthy for most of my life. I was a melancholic kid. The thing about being suicidal is it feels a lot like alcoholism – it never really went away for me. I have learned coping methods, and I’m not a danger to myself, but the ideation still exists as a type of compulsion in the back of my mind. The only thing I’ve found that allows me to get the thought out of my mind – and body – for months at a time, has been SSRIs.

And they say that alcoholics are always alcoholics
Even when they’re as dry as my lips for years
Even when they’re stranded on a small desert island
With no place within 2,000 miles to buy beer
And I wonder
Is he different?
Is he different?
Has he changed? What’s he about?…
Or is he just a liar with nothing to lie about?

Ani DiFranco, Fuel

I started taking SSRIs in 2017 for a variety of reasons:

1. I was living in Bulgaria, where I could afford to see a psychiatrist. In the United States, I had never been able to afford long-term psychiatric care. I cycled through emergency care, during which I would get “better” and promise I’d sign up for private care. But I could never afford private, long-term care. In Bulgaria, even out-of-pocket care was not unreachable.
2. The cost of the actual medication was negligible. We’re talking less than five dollars a month. (It’s gone up a lot since then, but it is still within my reach).
3. I had become a mother. Pregnancy and childbirth drastically changed my hormones, and not for the better. My anxiety overtook my depression as my primary symptom. I started experiencing bouts of rage and panic attacks. For the first time in my life, I felt out of control.
4. I had become a mother. I needed to be coherent enough to take care of my children, and I couldn’t allow myself to slip into a long-term depressive state or to be hospitalized.

Since 2017, I’ve been off and on a variety of medications. Bulgarian psychiatry focuses on healing as opposed to long-term treatment. SSRIs are generally prescribed for six months to a year, during which you’re expected to go to therapy and dig yourself out of your hole. It works well for me, because around the six month mark, a certain dissatisfaction creeps in. I am guessing this probably happens with everyone, but I am particularly attuned to it because it affects my writing.

The Six Month Dissatisfaction

Let me preface this by saying everyone is different. I have met plenty of people who hate the way they feel on SSRIs from day one. I have also met plenty of people who take them long-term with no issues. One of the most difficult things about sharing issues with psychotropics is that it feels like everyone has an opinion and leads with “this is what you should do.” But often, when I am struggling with my meds, I don’t want solutions directed at me. I am looking for:

• Comraderie: yes! I have felt that, too. You are not alone.
• The solutions that worked for you: I went through that and I did this, this, and this. The first thing worked, the second didn’t.

What I get instead tends to be:

• Have you tried this?
• Go to a psychiatrist/endocrinologist/other specialist
• You should, you should, you, you, you

I get it, people are trying to help. But one thing to keep in mind is that my psychiatric issues constantly make me feel like I am struggling at adulting. The last thing I want is a bunch of people giving me basic suggestions about what I should do (many of which I have already tried) that make me feel like they also don’t see me as a capable adult. It makes me clam up every time, which isn’t productive when it comes to figuring out mental health as a society.

My ask: if someone opens up about their struggles with mental health or medication, think carefully about whether the questions you ask or solutions you give work towards infantilizing them. Is there a way you can be supportive while honoring that they are a capable adult?

Keep in mind that most people who have long-term mental health issues have done a lifetime of research.

With that giant preamble, let me describe the six month lull I feel when I’m on SSRIs.

• Month 1: Either this feels amazing or this feels terrible, depending on the medication. For me, the first month most often feels a little bit like coming up on ecstasy. My skin tingles and feels alive. I love touch. Colors become more vibrant. Sunshine is absolutely luscious. I love the world. On one of my meds (my most recent) I didn’t get any of the feel-goods. Instead I got a month of stomach problems. No fun, but it’s not about those first fun weeks, is it? It’s about long-term stability. During this time I’m not writing. But then, I’m not the type to write when I’m on ecstasy, either. I’m too distracted by being in the moment.
• Month 2-4: I feel capable. I wake up in the morning with energy. I’m able to sleep at night. I have fewer intrusive thoughts. My work and parenting productivity skyrocket. My family is happier because I’m able to support them the way they need. Fewer arguments with husband because I’m not shirking my half of the housework. Fewer arguments with my son because I have more patience. It’s a win-win. During this period I’m not writing either, but I still don’t mind. I’m making up for all the things I let fall into disrepair: both emotional and physical. Clean the house. Make an empathetic bridge with a friend I haven’t spoken to in years. There’s too much to do to write.
• Month 5-6: I start to miss writing. I realize I haven’t written anything in months. I feel like maybe I’m missing a key part of myself. Keep in mind that writing was the way I kept myself sane from a young age. It is not just something I do, it is part of my identity. And I miss it.
• Month 6 and on: The initial excitement of being capable has worn off. Everyday tasks are possible but boring. I feel like I am missing “joy” in my lie.

Then I come off the meds, have a great year, until I fall into a pit of anxiety. And I’m back on them.

Discovery: It Isn’t Misery That Drives My Art

It’s that concept of emotional flattening that I want to explore today – missing the “joy” in life and not being able to write, and there are a few related conceptions that I want to write about.

You Can’t Feel Highs Without Experiencing Lows

With SSRIs, there is the common thought that they simply dull you to all emotions. They protect you from lows and, if you can’t feel the lows, you also can’t feel the highs. For about half of users, that is the case. For me, it’s not quite that. While on SSRIs before, I’ve felt more joy than I’ve felt in many years. Moreover, I felt joy at smaller things. My children drawing a picture or giving me a hug as opposed to chasing a high through drugs or “big wins” such as selling a story or getting a publishing deal. It isn’t that I can’t experience highs so much as I don’t feel the need to chase them because I am generally satisfied. That being said, this is the first time I’ve been on a long-term mood stabilizer along with SSRIs, and one of the major side effects is emotional blunting. So, yes, this time I am having difficulty feeling joy and excitement, and I might need an adjustment or change in meds.

But what I’m getting at here is that it isn’t necessarily the inability to feel the lows that makes me unable to write. It’s the inability to feel the highs. Yes, for many years I’ve used writing to claw myself out of depression. But I’ve actually done my best work when I was happy. Sipping a beer at a cafe with sunshine on my shoulders, feeling the energy from the world around me — that is what drives my writing. In other words, even if the meds cause an emotional flattening for me, it is not the deep, dark places that drive my writing. It has always been a thing of joy.

With the darkness of my stories, this may be hard to believe. But my writings come from the place of epiphany. The excitement of understanding. There is beauty and thrill to that. My stories contain misery because my life has had plenty of it, but my engine is joy. But what if it isn’t emotion that’s causing a problem?

The Sledgehammer of Psychotropics: Healing What Doesn’t Need Fixing

Along with depression, anxiety, and the occasional mania, I’ve gotten a lot of positive mental “weirdness.” Perhaps the most significant is that I am synesthetic. I experience taste, scent, and sight through motion. It’s a bit hard to describe because it isn’t as clear as “Six is blue.” But imagine you are on a rollercoaster. Always. A bite of sushi can spiral into you. A sip of bubbling soda can make you rise. The entire world tilts and sways around you. Overwhelming at times? Sure. But mostly, for me, it’s wonderful. It gives me a close sense of embodiment and sensitivity to touch. I have never, not once, wished I didn’t have synesthesia.

But, unfortunately, my synesthesia is greatly reduced while I’m on meds. Where I used to feel it every time I ate or drank something and often when smelling, while I’m on meds I may feel it once a month or less. Sometimes I go an entire treatment stint (6-9 months) without experiencing it. It’s something I have to give up to be “a productive adult”, and I 100% know a lot of my writing is based on my kinesthetic synesthesia. My metaphors and description are based deeply in that reality. Without them, I have to relearn how to write, and I often feel like I’m a stumbling newbie. Part of this is because I have no visual imagination. Even when dreaming, I rarely visualize things. The closest I get to visualization is the ability to draw the curves of an object in my mind. Guess what a curve is? It’s motion. With a blunted sense of motion, my entire conceptual understanding of objects need to be rebuilt.

Is my synesthesia an illness? Is it misery? I don’t think so. Neither is it joy. But apparently it’s “treated” by the same things that treat my depression and anxiety, and so when I’m medicating, I have a difficult time accessing my personal lexicon.

The other thing my meds “treat” that don’t need treating is my sense of time. This may be related to my synesthesia or perhaps an unstable childhood. But I often experience the world through a collapsed timeline. Again, difficult to describe. But when something happens in the present, it can trigger memories of the past. Fairly normal. But these memories are so overwhelming that I feel like I am experiencing the past and present at the same time. When I’m slow to speak, it may be because I am having three conversations in my head – the one we’re having, and two from my past. It sounds like a trauma response, but it is the only way I’ve known the world and it has always felt robust. This type of experience definitely informs my writing. Each of my characters experiences flashbacks interwoven with their present. That’s not a literary device, it’s the way I see the world. Unless I’m on SSRIs. Then my timeline gets super linear. In life, and in writing. And it feels unfamiliar and, for me, less robust. It makes writing feel monotonous and as if it’s missing a layer.

Will It Get Better?

The big question for me is will this pass or will I have to go off my meds? In the past, I’ve chosen to go off my meds. Every time. Only now am I realizing it isn’t my misery I was missing. It isn’t even the highs and lows. It is the way I see and relate to the world around me. So when I’m saying “I miss my writing,” it is actually me saying “I miss myself.” It isn’t me longing for the misery that creates art. It’s me longing for a very beautiful aspect of myself that was tied up in a brain that made it difficult to live in this world.

People tell me I just need to give myself time. My brain needs time to heal. And maybe it does. But I’m also afraid of losing myself. So these days I’m trying to write. I’m “pushing through” not just because I need to keep writing, but because I want to discover who I am without those core aspects of myself. Forty-two seems damned old to be discovering myself, but life is nothing if not work.