[Experiment] Stopping Antidepressants After 10 Years

Antidepressants Depression - break the system

Background:

I have been on some one form of antidepressant (prescription, or herbal or nutritional) for about a decade now. It’s always been something that I’ve had mixed feelings about. On the one hand, I think we all agree some people just have some screwy neurochemistry, and the majority of my family has been on some kind of related drug at least at one point in their life, so it’s pretty clear there’s a genetic disposition. On the other hand, there is just something generally unappealing about having to rely on any particular substance, natural or man-made, in order to feel normal (read as not totally miserable). You should just be able to eat healthy, exercise, and “be happy” right??

There is this common positive psychology line of thinking that makes most people who have dealt with genuine depression feel guilty about not being able to make themselves feel good. Like it is our fault or a shortcoming. In fact I’ve had close friends more or less explicitly state this, which ironically, go figure, has a tendency to make one more depressed. In fact, openly talking about these kinds of personal problems is kind of taboo in a way.

That is why I wanted to write this blog post, documenting my experience of stopping all antidepressants and just dealing with what follows. I want to give people the opportunitiy to say “I feel the same way! I’ve been there!” I think that removes a layer of shame. After all, it’s hard not to feel shameful about feeling badly (especially as an American) since everyone is trying so damn hard to seem publicly happy!

My personal reasons for actually wanting to do this experiment are to test whether I’ve worked my way out of depression. Just “making yourself happy” is total BS, at best it’s a temporary fix. However, you can fundamentally change the way your brain and body operate over a long enough timeline – everything from leveraging neuroplasticity to improving your attention span to altering the way your body metabolizes carbohydrates. Meditation, sleep patterns, nutrition, mental habits – all of it matters over a long enough timeline, and each of these I have been working on for years now. It’s time to see if I’ve successfully fixed my brain!

I remember trying 3 times stopping antidepressants.

Trial 1 – Beginning Of High School
Once I ran out of prescription antidepressants by accident and felt uncontrollable fury the next day. Every sensory input was unbearable, every action done by anyone was 100% malicious. The thing is, you know this is a blatantly warped view of the world, but that doesn’t change the feeling that follows unfortunately. Resumed the next day.

Trial 2 – End Of High School
Another time I weaned off them, and successfully stopped taking them for a time. But I have distinct memories of trying not to cry in the middle of a graduation ceremony (no real reason why) and also looking out the window of my college dorm watching people laugh and have fun while I felt terrible inside, unable (even fearful) of going outside to be like them. This ultimately led me after about a year to switch to the herbal antidepressant 5-HTP (griffonia seed extract). It worked extremely well and with less side effects.

Trial 3 – One Year After College
A couple years later I tried to go all natural again. The next day I felt like I was moving through molasses, and had bouts of extreme anxiety. I remember walking a few blocks from my apartment, shuffling along for the slowest walk I’ve ever walked, making it only a few blocks before turning around and shuffling back inside. Went back on 5htp.

Not a great track record…

But I have grown a lot since then, and am setting myself up to be prepared to handle the waves of disorienting feelings that I know will inevitably come.

The Prep

The plan is no caffeine or stimulatory supplements (including nootropics). My depressive tendencies are of the anxious kind, so I don’t want to exacerbate this, at least not at first. Before starting this I got a good night’s sleep and will exercise the first day of the experiment (to facilitate sleep and stabilize mood).

I’m not going to work too hard, have planned my days to focus heavily on meditating, and have discussed this plan thoroughly with my girlfriend who has volunteered to be there to support me (she’s freaking amazing and I believe this kind of social support is key). I will also make sure to keep a strict diet throughout this period to make sure I am at my best.

The biggest thing is that I’m preparing to set aside some projects to be able to dedicate substantial energy to doing this battle with my mental demons. If this isn’t necessary, fantastic. But I suspect it might be, and I don’t want to have work in the back of my head. Full focus on this will be more effective.

I’ve recently switched to biphasic sleeping, and I suspect this helps with natural serotonin production. I’ve felt so much calmer already.

And finally, I have tryptophan (weaker than 5-htp) that I plan to take situationally if I start having intense withdrawal symptoms that are too intense.

Day 1

I take 5-HTP at night because it helps me sleep. My biggest concern is being able to sleep well, especially during the adjustment period. So I am temporarily taking double doses L-theanine and PS (two other supplements I take for stress/sleep) at night so that I sleep soundly. Just woke up from the first night of this and slept great. Mood feels normal, was surprised to have vivid dreams (5-HTP can cause these so I expected these to stop). I am feeling hopeful that this experiment will actually be quite easy.

I will work out later as one of the strategies to balance my mood and stress levels and encourage sleep tonight. The only other major variable is just keeping the next few days as low-stress as possible. When I move too fast in life that my mood suffers and I find that I am too busy to even think about how I feel!

Tangent: I was just thinking about the depressed period of my life. How slowly I moved, how much time I spent laying around “doing nothing” especially when I contrast that with how I am now. I like the interpretation Dr. Weil has that there is a kind of purpose behind “normal” depressed feelings – to force you to stop and reflect, and it only becomes counterproductive when you constantly get “stuck” in that state. Although, as I reflect back, there are so many things that I have now – motivations, positive habits, certain aspects of my character that have matured unusually quickly – that I would at least partially attribute to sitting around thinking all the time. There’s always a silver lining I suppose.

It’s mid-afternoon and now I’ve officially started experiencing some initial noticeable effects. It’s just a general sense of lethargy, disinterest, and apathy (towards both things and people). I hate these feelings because they influence me in ways which don’t mesh with who I am/want to be. So far it’s actually very subtle but still noticeable. I suspect it will gradually increase in intensity. I just hope I don’t start feeling too apathetic to update this journal!

A really interesting potential realization just popped into my mind. Often times late at night if I am around other people they always tell me that I start to look sad. I always thought I must have a sad face when tired, but I feel that same kind of slump right now that I feel at those times. And I just realized that always happens right before I take my nightly 5-HTP (ie about the time it’s completely worn off from the night before). Something to think about – there is a strong link between sleep and depression. But does this merely mean my mood dips with fatigue, or that my ability to intentionally wind myself and brace myself against depressive tendencies starts to fail?

I think this will be good though. I don’t think my thoughts have fundamentally changed. The negative ones are just more intense, so now the idea is to systematically de-root them as much as possible so they aren’t knocking at the door whether I am on 5-HTP or not. I think the specific plan to do this will reveal itself with time as the experiment progresses.

This experience has renewed my respect for anyone who deals with depression. I’m remembering what it is like to feel this way all the time. I imagine my immature-teenage-kid-self struggling to deal with it, or any other adolescent trying to as well, and I just think wow! If I felt this feeling every day I don’t think I’d handle it all that well even now! There’s this positive psychology idea where you just stop being negative and focus on the positive. Easy right? Just stop being negative! Stop feeling depressed. Look how beautiful it is outside…

But people who are genuinely dispositionally depressed have to manage a slightly more complicated situation. I hate most drug company commercials, but I like one analogy I remember from an antidepressant commercial of a woman talking about having to “wind herself up” to be able to get through life, let alone trying to be positive. You hear this while you watch a wind up toy drooping but struggling to wind itself up to stand up straight, all while it has a pained expression on its face. That’s a perfect analogy for what it feels like. Even the most depressed person can wind themselves up to be happy, sociable and positive temporarily, but this is an entirely different situation than what’s “normal” for most people, and I think this is where it is difficult for a non-depressed person to empathize with a depressed person.

If you feel ok most of the time, of course you can just “think positive” to keep yourself from getting too upset, curtailing negative thoughts, etc. because fundamentally you are preventing yourself from getting depressed, as opposed to actually starting from the set point of being depressed and having to constantly wind yourself up to be at least neutral. In fact that’s one of the most interesting observations about how I feel now, is that everything seems so daunting and like such a huge effort. Summoning the words to talk to people, getting out the door, going to get food, brushing my teeth… Logically, it doesn’t make any sense. But it’s a strong feeling that physically feels like a heavy weight, and so it is difficult not to let it slow you down, compelling you to avoid what feel to be monumental tasks.

Ultimately it’s not about thinking positively. That’s not the point.  While that’s important, it’s the happiness set point that makes the sustainable difference, but that’s difficult to change. The only thing I know of that has been shown to do this is years of certain kinds of meditation and dramatic lifestyle changes. But that’s the challenge, and I hope maybe this experiment will reveal some insights. I’m still hoping that after this initial adjustment period I will find that I’ve worked on my happiness set point enough so that it’s tenable against depressive tendencies.

Key insight #1 – Feelings Are Not You!

I feel the depressive feelings, but I’m keeping myself from getting too wrapped up in them. I approach this in a mindfulness meditation kind of way. This is in stark contrast to in the past when I associated it with my identity (as in “I am depressed” versus “I feel depressed”). Maintaining this perspective is invaluable.

Day #2

Felt really terrible in the morning, and it seemed to be tied to taking ALCAR. It is a nootropic which I wasn’t supposed to take (oops). It’s not super stimulating so I thought it would be fine. I will drop this tomorrow. Definitely seemed to intensify the black cloud feeling after taking it. And I became super irritable and sensitive (but 100% did not act on it in any way which I was proud of). It was like being hungover – senses were intensified to the point of being too much to handle, slightly inconvenient aspects of life all of the sudden seemed to loom large and insurmountable, making me feel angry for what I knew were completely irrational and arbitrary  reasons. The past few years of different meditative exercises gave me the ability to at least change the perspective, despite being unable to rid myself of the feeling, to understand that this was an unfortunate subjective experience that I shouldn’t react to it. I viewed the negative feelings and sensations somewhat similarly to stubbing a toe – you say “ouch” and you move on with your day while the pain gradually fades on it’s own.

I keep noticing how feelings are deeply amplified, even in my dreams. Sometimes good feelings, but more noticeably the bad. I think I am starting to see potential for actually being happier off 5 htp. It’s like it shifts your mood up, or maybe is the emotional equivalent of Ibuprofen, dulling mental pain, but a side effect is the narrowing of emotional experience. I suspect in a way it might have been preventing me from fully experiencing certain positive moments in my life.

The experience of intensified negative emotions was hard to manage at times but I’m eternally grateful for my girlfriend who has been insanely helpful. We would talk about things, and when a topic that hits a nerve came up, it would strike so deep, and in a way that I wasn’t always prepared for. But having her there with her infinite compassion and patience made it a productive rather than an embarrassing or dark moment.

I think this might already be one of the biggest takeaways:

Key Insight #2 – Social Support is Everything

Depression helping depressed friend

I don’t think you can fully handle depressive tendencies by yourself, and it takes someone special to help you with it. You have to trust them fully (a surprisingly rare situation). Find that person at all costs and ask for their help.

There’s all kinds of mental BS that can cause unhappiness, and unfortunately the triggers are usually buried too deep to productively deal with inside oneself, especially if they happened during one’s formative years. They are built into your experience of the world in a way that is almost imperceptible to you unless pointed out by another. I feel incredibly lucky to have this opportunity now, and I know how much easier this has been because of her.

Throughout the rest of second day there was a fairly wide oscillation of my mood that was completely independent of my surroundings. One of the arbitrary low points happened by an insanely beautiful lake with my girlfriend. An amazing moment, and yet I was unable to feel appreciation for it, despite much concerted effort to do so. I could intellectually acknowledge the reasons why it was a great experience, but I couldn’t actually feel it. The best I could do was 1) not spread the negativity, 2) keep it in mind that this feeling/sensation should be kept separate from my self-identity, and 3) understand that it was just a temporary, passing low point that would soon lead to a high point. And it did!

Key Insight #3 – Feelings Are Temporary

After failing to actually be able to alter my mood, I just accepted it and didn’t let it affect me. More importantly, I reflected on how both positive and negative emotions are always temporary, so the feeling would pass. This is also the technique I used to remove my (formerly extremely intense) fear of public speaking – viewing anxiety as a temporary and physical experience rather than one associated with me or my actions. Sometimes I still feel anxious, but I barely even notice it, spending about 5 seconds thinking about it, just like I spend 5 seconds thinking about that stubbed toe before moving my awareness to more important things.

Day #3

Skipping ALCAR definitely helped. Not sure if that means I’ll have to permanently stop using nootropics, but for now they are a no-go! Surprisingly, some experiments with caffeine don’t seem to cause any problems with mood. So many of my assumptions about this experience are proving to be incorrect (which makes it a great learning experience!)

Today it seems there is no obvious black cloud, and I’ve had super positive interactions while meeting new people – something that typically requires a lot of energy for me. It feels like there is still some lethargy and a lack of motivation however, and despite 2 strong coffees I feel like I could take a nap (so unusual for me, as I am relatively sensitive to caffeine and struggle with insomnia). But it is not a depressed lethargy, and still seems less intense than before. Although this begs the question of whether I am adjusting to this experiment biologically or psychologically.

My girlfriend left to travel for a week today, so I won’t have quite as much direct support now. But I feel good about being able to handle it from here. I am so thankful she was here the first 2.5 days, but now I know what I am dealing with and it seems the most consistent obstacle is that I feel the content urge to take a nap and will be more lazy for the time being.

Days #4 and Beyond

Certain aspects of daily life feel qualitatively different. It’s hard to describe, but some things have changed about the way I feel about things or the way I approach situations. It really brings up interesting philosophical questions about identity. Maybe for years you are a “compassionate person” partially because you are on antidepressants, then you stop and you are short-tempered and apathetic. Is the latter the “real” you? I suppose it relates to the subjective nature of all statements, because maybe it’s both. Maybe in reality you are “compassionate when happy but apathetic when depressed”. Actually this paragraph is a perfect illustration of my initial point. I am normally very concise and efficient, but I keep finding myself on long, spacey philosophical tangents. No idea why, just hoping that none of these changes involve me getting substantially worse at things (like writing). Do let me know if this is terribly written please!

It seems going forward there is no more constant black cloud to deal with. First time in 10 years that one wasn’t held at bay by antidepressants. I do know that I am still more emotionally vulnerable – I can clearly tell that I will have more difficulty handling emotionally challenging situations. All part of the experience of continuing growth and adjustment.

Summary

Recap of Key Insights from this experiment:

  1. Feelings are not you (but rather you experience your feelings)
  2. Social support is everything in life
  3. Feelings are always temporary (good and bad)

To those who are depressed or on antidepressants – the biggest takeaway I hope you get from this is: it is not a permanent state of existence! You can fix the underlying tendencies over time. This is NOT something you can do instantly, but something to continually work on and improve and then one day you wake up and find you are actually happy, and in a way that is not dependent on external circumstances. Antidepressants are great for making depression more manageable, but it really doesn’t fix the underlying problem. There is no one-size-fits-all answer to what does, but I can tell you it can be done. If you don’t believe me, start doing a bit of reading about Matthieu Ricard to see how your happiness set point can change over time. Becoming a monk may not be your dream solution, but the point is that it shows what is possible.

To those who have never experienced long-term pervasive genuine depression (and I don’t mean your grandma died and you were sad) – hopefully this has given you some insight into what the experience is like. Please try to be empathetic to people who are struggling with these types of situations. Some people who know me are reading this right now and thinking “What?! No way! He seems happy! I had no idea he has spent half his life wrestling with anxiety and depression”. Similarly, people oftentimes are convinced I am an extrovert. Each time I laugh and try to explain that not only am I definitely an introvert, being in crowds used to make me feel extremely anxious and uncomfortable. Now I regularly get in front of audiences to run interviews, webinars, do live dance performances, or teach classes. But that’s one of the purposes of life I think – to face obstacles, overcome them, and then be stronger for it.

The truth is, it’s hard to know or understand the kinds of challenges other people have, but it is always meaningful to them when you are empathetic. The understanding and compassion shown by my girlfriend over the past several days was indescribably helpful, whereas comments in the past from loved ones (who have never dealt with genuine depression) essentially saying to “get over it” is incredibly hurtful. When you meet someone and they seem harsh, aloof, uninterested, cold, lazy, quiet, stupid, or judgmental, most people will assume that is just an unpleasant person. But do you know that person’s life story? Do you know what is going on inside of them?

Here’s to all of us taking a moment to not make assumptions, but as a rule give compassion  towards others. Try to to empathize, to understand where they are coming from, despite that first instinct to judge.