Diagnosed with PTSD and panic disorder four years after the World Trade Center terror attacks, I was prescribed a half dozen medications over the next decade. All this time, I’d been dutifully doing talk therapy, taking happy pills, exercising, doing yoga, meditating, eating clean, taking vitamins and supplements, all with the expectation that I’d continue to see more and more relief until one day my symptoms would disappear.
Allow me to brag for a second because around two years ago, things were looking pretty great for me: My vegetarian cookbook Toss Your Own Salad came out, and I was getting tremendous support from friends, family, and readers. Despite feeling anxious and panicky, I pushed myself (and nearly enjoyed) traveling around, doing cooking demonstrations and book signings. I felt like I was finally doing meaningful work again after my forced retirement from the police department. I even made it into People magazine! I was finally getting somewhere despite my diagnosis. The thing is, my energy would completely vanish by lunchtime. Prozac and my other anxiety medications (Xanax, gabapentin) were making me so tired that I was like a toddler who needed an afternoon nap every day. All that sleeping was cramping my new well-adjusted lifestyle.
At the time, I had the opportunity to take a pharmacogenetic test—a new type of genetic test that helps doctors figure out the best types of medicines and dosages for your genes. (Full disclosure: My father-in-law's clinical lab, Medical Diagnostic Laboratories in New Jersey, offers this test.) Surprise—it showed that I wasn’t properly metabolizing Prozac.
So, after a decade of being on happy pills, instead of switching to another SSRI or trying a tricyclic used for panic like Tofranil, I decided that I didn’t need to take antidepressants at all anymore. I felt confident that they had served me well, but that part of my life was over. From now on, I’d deal with my anxiety “naturally” with yoga and vegetables. With the help of my psychopharmacologist, I slowly weaned off Prozac over a six-week period while continuing all my other meds. Everything was great…until it really, really wasn’t.
Content warning: If you’re easily triggered, skip the rest of this column. I’m going to be honest about how terrible things can get when you come off SSRIs. Honest in a way I haven’t been with anyone before. Honest in a way that’s going to be hard for me to write about. You still with me? OK, let’s do this.
My very first night 100% off antidepressants, I was sleeping in bed with my wife. She slightly shifted her weight and I leapt awake, scared half to death like I was being attacked by Freddy Krueger. I have panic disorder, so I’m used to being startled. I’m used to having nightmares. This fear felt more palpable and it took forever to shake. I figured without the sedative effects of my usual meds, this was just me “feeling my feelings” and things would eventually even out. They did not.
Within a few weeks, a wave of anxiety hit me like a powerful Mike Tyson uppercut. I felt so jittery, like I’d chased all the Adderall in the local pharmacy with 92 shots of espresso. Worse, all that energy running through my veins didn’t do me any good when I tried to actually use it to cross a busy street. I just froze in fear like a big, bearded Bambi, as if a rabid tiger was charging at me. I didn’t realize it at the time, but this was the beginning of what would feel like a year-long panic attack at level 10 intensity. I experienced unrelenting fear and terror, worse than anything I felt in my pre-treatment days. It sounds crazy to admit, but it felt less awful recovering bodies at the fallen World Trade Center than trying to cross the street to return a library book.
Three nights in a row would pass without a wink of sleep. My bed turned into an ocean of sweat. I was always dizzy and could barely think straight. I abruptly stopped doing book events, creating new recipes, or writing anything at all. Now I was seeing two psychiatrists several times a week and forcing myself to run miles at the gym to tire myself out. I’d try to end each day on the yoga mat in a desperate attempt to find some peace.
The constant, intense terror I felt caused an unwelcome new symptom: I didn’t trust myself to be alone. I was no longer able to do anything without my wife attached at the hip. I mean this almost literally. I couldn’t do errands on my own. I couldn’t walk even one block to my writers’ group without her. I couldn’t be left home by myself if she had a client meeting or hair appointment. Without her dragging me with her everywhere, I’d have no doubt checked myself into a psychiatric hospital (and I’d have been right to do it).
And even with her support, inpatient treatment was something I considered often. I felt like I needed supervision, like I was a burden. I also considered that thing that’s most important to tell doctors you’re considering. To be very honest, I never had a solid suicide plan. But I was afraid that I was on my way to creating one because I only wanted one thing—I wanted to stop the intense feeling of someone holding down the fear button in my brain, but nothing and no one was helping me reach that goal. I just wanted the torture to be over.
After about five increasingly awful months, I knew it was time to give up on my med-free dream. I needed to feel better so I felt exactly zero disappointment when my doctor prescribed me a new antidepressant called Effexor. Effexor is an SNRI (serotonin-norepinephrine reuptake inhibitor), a different class from Prozac, which is an SSRI (selective-serotonin reuptake inhibitor); my doctor paired it with Seroquel, a powerful anti-psychotic that would knock me out before bed and allow me a brief respite. Unfortunately, I got many of the side effects and none of the benefits from my new prescription. Now I had cotton mouth and sexual side effects in addition to unrelenting fear. (I’d say, Eff me, but you couldn’t, because my penis wasn’t working either.)
After two months of trying to mitigate those side effects, my doc found an antidepressant that I was able to tolerate—Zoloft. Still, relief took much longer than I was hoping. It was another four months before I could walk down the street with my wife following less than a block behind me (just in case). Three months after that, I made plans to hang with a friend while my wife left for a two-hour brunch. Two months later, I was able to buy groceries on my own again.
So, what caused this crazy ratcheting up of symptoms? Is this intense fear what lies beneath my blanket of prescription drugs? Or was my baseline fear exacerbated by withdrawal from my antidepressants? There’s no real way of knowing for sure, but my doctors believe it was "SSRI discontinuation syndrome” (The New York Times conveniently published a great article about the syndrome just as I was seeking help, so luckily it was in the public consciousness.)
Not to sound like Tom Cruise on a rant, but I felt let down by the entire field of psychiatry. I felt like either these doctors didn’t know, or just didn’t bother to tell patients like me that it could be actual torture for a long-term user to come off of SSRIs. Shortly afterwards, The Lancet published research that found that tapering off drugs for four to six weeks isn’t “well tolerated” by patients and that it could take YEARS to fully discontinue SSRIs and benzos. Across the pond, The Guardian published their own antidepressant withdrawal piece, and the New York Times continued to investigate the phenomenon.
Now what? I’d love to tell you that things are back to normal but they’re not. This all happened over a year ago, but I’m still recovering from it. I’m maybe 60% or 70% back to where I was before I trying to come off antidepressants.
Honestly, the whole ordeal was traumatizing (and I don’t use that term without careful consideration). I’m still co-dependent AF and can’t do much of anything on my own. I feel like an albatross on my wife. I feel like a terrible friend and family member because I’m not able to be present for people without being preoccupied with my own fears. I have trouble getting around, but I force myself to travel despite how I feel. I can’t drive or ride the subway, so at this point I’ve probably contributed more money to Lyft and Uber than their shareholders. I believe I’ll probably be on antidepressants for the rest of my life. I don’t feel any shame about that, though. If it’s what I have to do to feel better, I’ll gladly do it. That’s the crux of what I’ve learned from all this.
My advice? If you ever find yourself wanting to come off antidepressants, do not rush in. Read the articles I’ve linked above and the studies they cite, voice your concerns, and keep talking to your doctor throughout the process. Do not try to do this on your own. And even if you wean off your medication under the guidance of a psychiatrist, please don’t be flippant about what might happen. Be prepared to change course if you need to, even if it doesn’t suit your narrative. Take it from someone who was 100% convinced he could treat his panic disorder with yoga and vegetables and got a reality check.