> Hopefully irreversable damage isn't occuring. But I suppose that damage is better than the alternative.

On the contrary, untreated depression is far more likely to produce long-term damage than a well-studied medication that has been in use for several decades. Untreated depression really does a number on the brain and body, not to mention the downstream effects of reduced exercise, socialization, sleep, and other problems that come from depression.

> I also wonder, since I feel so good, if I should try weaning off the Zoloft.

Be careful and only proceed with the help of a psychiatrist.

Depressive relapse is very common in patients who decide to discontinue their medication. The scary part is that the depression often returns very slowly over a long period of time, which the patient may not fully notice until they are deep within another depressive episode.

Thanks for the reply. That makes sense to me. I am totally fine with taking the meds forever.

I am one of the lucky cases where I experience basically zero side effects and it's been 2 years so far. I have heard of the horror story side effects like getting really overweight, not being able to bone, feeling fatigued, constantly napping etc. But I have never felt any of that. These last two years have been the best of my life.

I always have this concern though that these meds must be doing something sketchy to my brain chemistry.

But it makes sense that the constant terror of anxiety could also produce some neural pathways and brain chemistry that would be very bad...

> I am one of the lucky cases where I experience basically zero side effects and it's been 2 years so far.

The reality is that most (but not all, obviously) people don't have terrible side effects from modern antidepressants.

It's difficult because most people who take antidepressants without issue simply don't talk about it. Partially because they don't feel like advertising their mental health struggles, but also because there simply isn't much to talk about when you simply take a medication and it just works.

> I always have this concern though that these meds must be doing something sketchy to my brain chemistry.

Given how long they've been in use and how widespread they are, we would have seen any blatant negative effects by now. SSRIs have been in use since the 80s and the antidepressants before that were far less selective.

If anything, the research points to SSRIs being helpful in repairing or reversing damage caused by depression.

>The reality is that most (but not all, obviously) people don't have terrible side effects from modern antidepressants.

I wonder how many of those side effects might be from people put on antidepressants who may not actually be chronically depressed.

I've known people who have been prescribed antidepressants after going through periods of depression, rather than it being an ongoing chronic problem and they have sometimes had some troubling personality changes that lasted even after stopping them.

But I have met people who have taken them long term because of chronic depression that seem a lot better on them.

I really do feel like we take too much of a 'one size fits all' approach when it comes to mental health. Every person's mind and brain are unique.

I know, as humans, we like to put a factual, observable cause to things, but I really don't think mental health always works like that.

Two people who may be suffering from long term depression or any other, mental health issue(I personally dislike this term greatly, but can't really think of a better one.), may have very different reasons and causes for their depression and the same approach may not be helpful to both.

It's great we have access to medications that are helpful in improving people's lives, but I do wonder sometimes if we should focus more on addressing why someone's experiencing these mental states that are causing problems, rather than just working on correcting it.

I can't speak too much about it suppose, I don't really know.

But I had a good friend who I feel like was neglected by the system and didn't get the help that would have been good for him.

His mom was going through cancer treatments and he didn't take it well. He got pretty depressed and didn't get out of bed for a couple of years. He started getting these worries about getting the urge to walk into traffic.

So he went and tried to get some help. He was immediately prescribed seroquil, Zoloft, ativan and some other things.

And...I have no other way to put it...it fucked him up...

I'd get phone calls from him randomly asking what time of day it was, he'd forget things that happened moments before, he hallucinated watching new tron movie 3 times in a 4 hour period...the movie's like two and a half hours long or something, he managed to unplug my internet around 1am so, he wouldn't have even been able to finish it the first time.

It was really sad seeing what happened to him and I couldn't help but feel like maybe if someone had just talked to him for a while before prescribing him those drugs, they could have helped him without him ending up like that.

Being prescribed 3 drugs immediately isn't normal at all.

If antidepressants really are pervasive as you say, I'd be concerned about what it's doing to us as a species when it comes time to reproduce. Are the offspring of parents who regularly take anti-depressants any worse off than those who don't?

I think these are the sorts of questions that would be useful to know when really mass-prescribing drugs to humanity. To be clear, I'm not suggesting that the drugs are inherently harmful to offspring - but it seems like something that would be good to know. If the parents have a chemical dependency, what does that mean for the children?

All medications, including antidepressants, are studied for potential reproductive harm. This is taken very seriously in wake of the Thalidomide disaster in the 60s.

Is it possible that antidepressants have some extremely subtle transgenerational epigenetic effects? Maybe, but comparing healthy patients to SSRI-treated remitted depressed patients is a bit of a red herring anyway. The real comparison would be between SSRI-treated patients and untreated depressed patients, because healthy people aren't prescribed SSRIs. We do know untreated depression is very harmful to people and their families, so speculating about immeasurably small negative effects of SSRIs while ignoring the massive and very real cost of untreated depression would be a mistake.

> The real comparison would be between SSRI-treated patients and untreated depressed patients, because healthy people aren't prescribed SSRIs.

I see it very differently, as you are focusing entirely on the parents and completely ignoring the children. If the untreated patients weren't going to have kids, the question is only whether or not the children are happy. If the children of parents with antidepressants are more likely to require antidepressants themselves, I'd say that's indicative of a serious problem.

> If the children of parents with antidepressants are more likely to require antidepressants themselves, I'd say that's indicative of a serious problem.

I'm not aware of any evidence that this is the case. Do you have any evidence, or are you speculating worst case scenarios?

Regardless, I think it's shortsighted and in poor taste to suggest that there is a problem with parents on SSRIs having children, particularly without any evidence to support your claims.

Everything I'm saying is speculation. I'm asking questions, not providing evidence one way or the other. I never said there was a problem.

So it is now verboten to ask questions?

SSRIs vs Untreated depression is a false dichotomy. There are many treatments for depression.

Some cases of depression and especially bipolar disorder seem to have a genetic component. Parents that are on SSRIs, SNRIs, antipsychotics and atypical antipsychotics are probably already much more likely to have children who have the same conditions and need antidepressants, as the underlying condition often has a genetic component.

You don't think having a parent with untreated depression is bad for child development?

This highlights what I feel is the real issue with such medications... over prescription. You, clearly, need(ed) it and it was a literal life saver. I was also put on some of these medications and while they evened me out that meant they killed the highs as well as the lows. I feel like they altered my personality and not in only good ways (overall creativity took a hit... I was in a creative field at the time, libido took a massive hit). Now I see my daughter and (pretty much) all of her friends being given these medications for what seem like relatively superficial reasons and years after the initial, "Wow, I have less X" many of them are starting to wonder if it is worth it as they experience periodic "brain fog", disassociation and other possible side effects.

My own opinion... these are powerful tools. Critical to some. Overprescribed for most

My story with SSRIs is largely similar, anxiety and PTSD almost at zero. One of the things I didn't realize is that my base level of anxiety was through the roof. I thought that was "normal" and that times when my anxiety really kicked up a notch was anxiety.

And then within a month and a half of taking meds, the constant feeling of impending doom within my spine that was always there, gone.

I had side effects for the first month or two but they're long gone. I also had first sleeplessness and then fatigue, but I found taking meds at night made all the difference, making that issue a thing of the past.

I don't worry too much about my long term dependence on it: even if it lowered my life expectancy, which there isn't really any proof of, but even if it did, I'd take it as a fair trade-off.

It's crazy! I never realized I was anxious until I started anti-anxiety meds. Modern mental health is pure quackery in my experience so far. It's been "let's try it and see what happens"

It’s the same with all medicine. Pain medication, antibiotics and so on. Doctors try stuff until something works. You may have overly positive views of science if you don’t think it’s being made up as we go. The body/mind split is artificial too.

Is it at all possible that there were other confounding factors?

I ask this because I've struggled with depression my entire life. I took fluoxetine (prozac) in 2012 and had similar experience that you describe.

I stopped taking it because I really hated the idea of being a med all my life. After about a year, the depression was back. I never returned to prozac, but I've wondered year after year if I should. Nearly a decade later, I still don't know.

Why? I still have my doubts though whether or not the medication was doing anything. I had also coincidentally had a ton of success in life around that time. I had learned some new exciting skills, landed a sweet job in my dream city, and was socializing a ton and meeting people.

I reflect on that time (roughly 1.5 years worth) and to this day I can't really decide whether that joy was from the meds, or from learning something I was finally good at, landing a great job, feeling confidence from that and meeting people, etc.

The return of the depression did seem to correlate exactly with discontinuing the meds, but, it could also have been that the excitement of the year's events was beginning to wear off too.

Have you considered the medication helped you learn new skills, land a great job, and meet people?

Diabetics hate the idea taking insulin all their lives. Paraplegics hate the idea of using a wheelchair all their lives. What makes your chronic illness different?

> I also wonder, since I feel so good, if I should try weaning off the Zoloft.

The problems with ADs, is that people feel better, they think they're cured, but no, it's because the meds are working, and treatment should not be stopped.

Exactly. Before I understood I had life-long condition, I tried to wean myself off multiple times over the last 2 decades, only to come back to the original symptoms months/years later.

I now understand I have a chronic condition and I need to treat it as such. It would be awesome to be off antidepressants in the future and I'm trying to train my mind with meditation and other healthy practices but I don't fool myself with thinking that alone will be enough.

And you know what? I'm fine. I'm glad antidepressants exist because otherwise I wouldn't be here anymore.

Well I am really glad you are here and i'm also glad they worked as well for you as they did for me.

Out of curiosity, why even have the desire to get off the meds? do you experience side effects?

I think it's a desire to live free. I don't know how to explain it but the thought of depending on something sometimes gives me anxiety about my ability to function as a human being, to experience life as-is, etc.

The only side effect I have from taking Venlafaxine is my libido is crap but I can live with that.

I'm a Buddhist (even if a crappy one, that's debatable) and in some circles, taking antidepressants feels like "cheating". I was just researching this topic a few hours ago and it seems that's not taboo anymore and even various teachers have come forward and shared they too were on Prozac or other drugs. That was a relief. I'm lucky that in my community that isn't seen as cheating at all but there's that innate feeling that, if I'm trying to control my mind, that an antidepressant would be messing with that, or hindering my practice.

I don't think like that anymore. Even if it was cheating, I'd rather be alive and only get some benefits from meditation in this life rather than be dead.

So yeah, coming off meds is a bit subjective for me but I'm coming to terms with that. Life is better this way.

> I'm trying to control my mind

I'm not Buddhist but I've studied a bit and I do meditate. Isn't it not best to "try to control the mind"? From what I've learned, it seems like the opposite of what to aim for.

By becoming more present we are able to better see the mind and its endless judgments for what they are. We can become more in tune with reality as it is (including our own minds) and this helps us act and think more wisely, instead of based on programming, perspectives, and expectations that we aren't even aware of. I'd also add that compassion is a really important ingredient.

All this to say I don't think anti-depressants are "cheating" in any sense :). Especially if they are the best tool you've found to help you live a good life. I'm really glad you have something that works for you. This stuff is no joke...

I do think we can find better tools and that the field is on the cusp of some really great steps forwards that we desperately need. For me personally, I've recently discovered that trauma has played a big role in my well-being over the past 10 years and I've trying to learn more about that. There are a lot of promising developments seeking to help people actually heal from trauma. I've been particularly excited by the work that MAPS, Saj Razvi, and many others have been involved with.

I think of it like insulin for a diabetic. They aren't cheating, and neither are you. I'm also buddhist, and can say that it's unfair to yourself to compare yourself to austere monks old. We live in a modern world full of toxic chemicals, processed food, polluted air, and sedentary lifestyles. There are things you can do to improve your physical situation, and many things that are beyond your control. These things effect us, our body, mind, and soul. If this is what you need to achieve a baseline level of normal, then have gratitude that you found it! Use it as a platform to build your religious practice on. Go even deeper into peace and gratitude.

The meds were originally indicated as a temporary measure to help a person escape a mental state, not as a permanent fixture... prescribing and indications have changed, but there is still very much such a thing as a mental state treated by ssri drugs which is “cured”.

This isn't correct. Cured means the defect or underlying problem was solved, requiring no further treatment. The mental stated provided by SSRIs for some is called "treated" not "cured."

I weaned off my AD medication once a few years back. I felt guilty about needing a medication to keep my head straight.

I was fine for maybe 5-6 months. And one day I literally woke up with the familiar, heavy depression. It was very sudden and I knew I needed to resume treatment.

If you need treatment, it's good to get it and maintain it.

Same story here. But in my case, Zoloft gave me really bad tinnitus that persisted even after stopping. I switched to Intuniv that got rid of the panic attacks but not the depression or the new tinnitus. Added Lexapro and that reversed the tinnitus and kept all the positive benefits of Zoloft. Brain chemistry is different for everyone, so it's worth trying more than one if the first doesn't work for you. It's truly life-changing when it works. No one should have to live with daily panic attacks.

This is my experience with Paxil. I can't say I would be here today if it weren't for that. Everyone has different brain chemistry and you have to try different things until you find something that works. Now, I can finally get out of bed and exercise which I never thought possible before.

There are risks to some of these medications, but they mostly come from not tapering off properly. Cymbalta wrecked my memory for a few months for that reason.

To reinforce your point, I started Paxil many years ago and had terrible side effects that pushed me away from ssris altogether leading to a long struggle before giving in and trying Lexapro which has given me my life back.

If one doesn't work, try others before trying nothing.

I've tried 4 different SSRIs and none of them did anything. Ecstacy has no effect on me. Nor do magic mushrooms. Took me until I was 40 ish to find something that worked. Turns out my issue is too little gabba or at least over excitable neural tissue. Pregabalin fixes me. If I can't get that then CBD helps.

Gabapentin is a very widely prescribed drug so arguably very safe, certainly safer than ssri, but you won’t hear about this outcome from CBD: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314910/

CBD can be hepatotoxic so not a perfect solution even if it’s highly effective.

TNSTAAFL— the stoics were on to something. Also, research falls apart when it comes to rare events, otherwise we could predict and prevent mass shootings, which coincidentally might themselves be a side effect of psychiatric medication. If only there were more data points we could know things we don’t know.

I also started taking Zoloft (50mg once a day) this past year. I've had zero side effects, besides becoming way more mellow and less anxious. It's weird as hell but it's definitely changed my life for the better.

I wish I had started it earlier.

Same, with escitalopram (lexapro in the US)