Memoir: Jan Wong’s search for the right antidepressant

Memoir: Jan Wong’s search for the right antidepressant

Even with sedatives, I couldn’t sleep. I kept losing weight. I was crying every day. One night, I lost my temper with my son Ben, then 16, because I wanted his attention and he wouldn’t get off the phone with his girlfriend. Blind with rage, I grabbed his most precious possession—his laptop—and tried to throw it out the bedroom window. My 13-year-old, Sam, wrestled me in a bear hug and made me stop.

For months, I had been clinically depressed. Like something out of an Ian McEwan novel, a single incident had destroyed the clean plot lines of my life. A story I’d written for my employer, the Globe and Mail, on a school shooting in Montreal had sparked a nasty backlash. The Globe failed to stand behind me, and when I fell ill, the paper and its insurer ruled I wasn’t sick.

At home, I was out of control with pain and anger. My doctor recommended I go on anti­depressants, but I refused. I was terrified of taking meds that would affect my brain. I thought of myself as a strong person, but strength of personality has nothing to do with who succumbs to depression. After eight terrible months, I had only partially recovered and was back at work when I suffered a severe relapse. I capitulated. I went to the drugstore, clutching my psychiatrist’s prescription.

Every day, I swallowed 10 milligrams of Cipralex, one of the newest SSRIs—selective serotonin reuptake inhibitors—in the same family as Prozac. My throat felt parched no matter how much water I drank. My eyes became so dry that the conjunctiva, the clear membrane over my eyeball, actually wrinkled when I looked sideways.

Worse, my reflexes went haywire. At Monday night rehearsals for the North Toronto Community Band, where I play flute, my fingers became unresponsive and I could no longer keep the beat. I couldn’t remember the key signature, either. At home, I became clumsy, knocking over coffee mugs and brushing cutlery onto the kitchen floor. While talking or eating, I would accidentally chomp down on my cheeks until the inside of my mouth was swollen and raw.

Choosing the right antidepressant is a random, messy business. Half the time the first one doesn’t work—although it takes four to six suspenseful weeks to find that out. Nevertheless, insurance companies would rather pay for drugs than for talk therapy because drugs are cheaper. As doctors, patients and insurers all search for a chemical solution to every problem, antidepressants have become one of the top-selling drugs in North America.

Nine weeks on Cipralex failed to lift my mood. I had terrible thoughts. Suicidal thoughts. Suddenly I could understand the allure of leaping in front of a subway train. The rails looked so invitingly shiny, an efficient way to put an end to my workplace troubles and—as I then perceived it—the damage to my family.

My psychiatrist began to wean me off of Cipralex while simultaneously starting me on 20-milligram doses of Celexa, an older SSRI. Unfortunately, the side effects were the same, with the addition of hot flashes that left me breathless. My memory lapses worsened. Even before I started on medication, depression had affected my short-term memory. On Celexa, I felt as though someone had stuffed cotton balls into my brain. I lost my mind. Correction: I misplaced my mind and couldn’t remember exactly where I’d left it. I neglected to lock my front door. I lost my chequebook. I forgot that my woodwind trio was coming over to rehearse and went out to meet a friend instead.

I would find mysterious events listed in my datebook and have no memory of arranging them. I began using a highlighter to mark every important item in my datebook. I reviewed my schedule hourly, but my brain could not retain data for more than a few minutes. Despite anticipating every session with my psychiatrist like a junkie awaiting her next fix, I twice forgot to show up.

Journalists need facts, context, history and vocabulary at their fingertips. My memory loss terrified me. At one session with my psychiatrist, I searched for a word to describe a friend’s brother. “He’s, um, what do you call it? An alcohol addict.”

“Alcoholic,” my doctor reminded me.

After a month on Celexa, I remained deeply depressed. My psychiatrist doubled the dose. I still felt very low. My situation at work was getting worse. My employer had already cut off my sick pay. Now they were ordering me back to work, on pain of dismissal. Perhaps without the Celexa, I’d have gone over the edge. It’s impossible to know how effective it was. But four months on double doses did not cure me. My doctor tried another common antidepressant, Effexor, which also failed to improve my mood. Ten months and three meds later, he switched me to Wellbutrin. I stayed on it for five months, taking 200 milligrams a day. It gave me heart palpitations, but to my relief, an earlier side effect—severe constipation—disappeared.

I write this as if the sequence of meds was clear. It wasn’t. At the time, I couldn’t have told you what I was on. I had round, Smurf-blue pills; tiny white ovals; large, flesh-coloured blister-packed gel capsules of fine white powder; teensy, dull-white lozenges. In all, I spent 15 months on antidepressants. Would I take them again? Probably. Did they help me? I’m not sure. The first three drugs may have kept me from being bedridden. It’s possible the last one had some salutary effect. Then again, my recovery might have been the result of months of talk therapy. Or perhaps, after two hard years, my depression had simply run
its course.

Jan Wong’s new book is called Out of the Blue: A Memoir of Workplace Depression, Recovery, Redemption and, Yes, Happiness.

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