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Lexapro, Kanye, & Me: Molly Lambert On The Ghosts Of SSRIs

Putting Kanye's Twitter "rants" in the context of pharmacology.

When I first heard Kanye talk about going off his Lexapro in "FML," a shiver ran through me. No person who takes a drug prescribed for mental illness is prepared to be betrayed by the drug if they stop taking it. One is prepared only to go back to the earlier, unmedicated state, not to go to a deeper, darker state worse than the initial one that made them seek the medication. I would probably not have gone on Paxil in the first place if I'd known what happens when you stop taking it. But I was 17, I'd been struggling with anxiety my whole life, and I trusted the doctors who told me it was going to help. I'd lived through the '90s and read Prozac Nation, but I wasn't worried about the rumored personality-dulling effects of antidepressants. I just wanted to be able to take elevators without having panic attacks.

I didn't think to obsess over potential side effects, because almost every prescribed drug has a long list of terrifying side effects. But I did think it was bizarre that none of the prescribing doctors could explain exactly how the Selective Serotonin Reuptake Inhibitors (SSRIs) worked. The terminology they used was so vague: Your brain makes the happiness neurotransmitter serotonin, and in a person who is depressed or anxious the serotonin gets absorbed back into the brain (where?) too quickly. SSRIs ostensibly slow down the reabsorption process. It was described to me in a way that implied it was too complicated to explain, which also sounds suspiciously like someone who doesn't fully understand what they're talking about. Sure, I didn't really know how the chemicals in my brain worked. What was I, a brain scientist? But it worried me that these brain scientists also didn't seem to know. I just figured that SSRIs were like sufficiently advanced technology, indistinguishable from magic. They didn't say what kind of magic.

At first, the drugs worked great. I was calmer, less depressed, and I no longer felt sick to my stomach all the time. As a freshman in college I was the happiest I'd ever been, living the kind of life I would not have considered possible for myself before I got on the drugs. Maybe it wasn't just the drugs; I was living away from home and making cool new friends — of course I was happy. But I credited the Paxil at the time. I felt invincible. And in that flush of invincibility, I decided to stop taking the Paxil. I took it sometimes, just not all the time, because I was out late or I forgot or I was just testing whether the drug had really been the thing that was doing the work. This was a mistake.

That summer I was back from college, living at home with my parents, when the withdrawal really set in. I experienced the phenomenon known as "brain zaps," which feels something like it sounds — like a chill down the spine but in the brain. I felt crazier than I had ever felt in my life, alternating between feeling terrified of leaving the house and leaving the house and then feeling terrified to be there. I felt scared to be alive, all the time, and lucidly aware of how mentally imbalanced I felt. I self-medicated mostly with bong hits and tried to get back on the Paxil, but it no longer worked. When I told the doctors about the side effects I was experiencing, they essentially told me I was not experiencing anything like that, and I felt like I was dealing with the gaslighting "in on it" doctor from Rosemary's Baby.

I had thought about it last year, when an article came out in the New York Times with the headline "Antidepressant Paxil Is Unsafe for Teenagers, Analysis Says." A quote stuck out: "Over the years, thousands of people taking or withdrawing from Paxil or other psychiatric drugs have committed violent acts, including suicide, experts said." Duh, I thought as I read through the article stating that the multiple studies assuring prescribing doctors the drug was safe for teenagers had been funded by the makers of Paxil. I went on a different SSRI and felt better, but never as good as I first felt on Paxil. I mostly tried not to think about this entire episode in my life because thinking about it made me feel embarrassed.

But hearing Kanye talk about going off his Lexapro, I started to reframe his recent run of Twitter sprees as something other than just record promo. By the time the audio of Kanye blowing up backstage at SNL was released, it no longer seemed funny. Any speculation about Kanye's mental state is just that: speculation, the stuff of a thousand personal essays disguised as thinkpieces like this one. When it comes to mental issues, there's a stigma, and I've always been too ashamed to talk about what happened when I went off Paxil, because I was already ashamed to admit that I needed to go on an SSRI to begin with. People are afraid to talk about mental health because it's traumatizing, and nobody wants to be seen as a nut. Like Tony Soprano's, Kanye's mental health is wrapped up with his machismo and specific mother issues, but it feels universal nonetheless. I never talk about my summer of going off Paxil because I don't like to remember feeling so out of control. I'm still on an SSRI now and I still feel ambivalent about it, but now I'm too terrified to ever go off of them again. Writing about this makes me feel tiny and exposed, but if Kanye can do it...