My Dog and I Take The Same Drugs Now
Lexapro, month one
My biggest fear about going on an SSRI was that it would ruin my sex life, but my therapist keeps reminding me not to worst-case-scenario. Do you ever think that something good might happen? she asks. Not really, but I’m learning to.
I’m not sobbing several times a week anymore, not asking if we left the stove on, or running back to check. I haven’t taken a benzo since I started Lexapro. There’s a subtlety to this drug that I’ve never experienced before, a slight tweaking of the knob in my brain that controls the intensity of my fear, allowing new thoughts to take root.
The other day we were on a walk and the demon in my amygdala said, What if you have a brain tumor right now? which normally would have sent me on a catastrophe spiral. But instead I said, We’re not going to worry about that right now, and then I just…moved on.
I just moved on?! I never move on!! I obsess! I drive myself deep into a pit of doom until I’m freaking the fuck out and have to be sedated! But there’s been more distance between me and my worries. They’re still there, but it’s like I’m in a boat floating on top of the ocean, instead of being pinned to the seafloor in the dark.
I told my therapist all this and then brought up another doubt from my OCDemon: What if it’s just the placebo effect?
To which she said: So what if it is? You’re doing really well.
The placebo effect argument against antidepressants bothers me, not because I deny the power of placebo — I actually find that really fascinating — but because of how it’s used to undermine knowledge gained through experience.
“Many people feel they have been helped by antidepressants; although whether antidepressants are actually effective and useful is, it turns out, uncertain,” Joanna Moncrieff writes in Chemically Imbalanced. But what is the difference between feeling you have been helped, and being helped?
There’s a limit to how much you can know about a psychoactive drug through trials and rating scales, a level of understanding that must be felt instead of counted. That is valuable data, too.
In Peter Kramer’s clinical experience, there’s a pattern to the placebo effect — immediate relief that tapers off after a couple weeks. But the pattern of an SSRI is different:
