When M was three months old, I was diagnosed with postpartum depression. My treatment plan included a low dosage of sertraline (Zoloft) and therapy. A year later, I moved to Atlanta, which affected my treatment plan and led me to go off antidepressants before I had planned.
At this point, I had stopped therapy (under the guidance of my therapist), and I was on a lower dose of sertraline. When my family decided to move, I had also decided I would seek a therapist who would support me during a big life transition. Then, once life settled down, I would also wean off the sertraline. Instead, I did not seek a therapist and I weaned myself off the medication. Let me be very clear:
This was not a good choice and not one recommended by medical professionals or myself. Always wean off antidepressants under the guidance of medical professionals! Therefore, I will not specify how I did it.
I Decided It Was Time
There were three reasons I chose to wean 1) access to a psychiatrist 2) my new health insurance 3) the desire to start fresh in a new city with a new job and a new life.
Access to Professionals
Work affected my ability to seek help in Atlanta. I had no time off, my health insurance wasn’t as good as it had been, and traffic. Since I had accrued no time off and was not supposed to take time off the first six months, getting a psychiatrist or therapist appointment was impossible. My commute time was 45 minutes, which is average for Atlanta. Having a long commute also means a long trek to a doctor and back, resulting in needing more time out of the office. In Iowa, I could just zip to and from the clinic. I-75 does not work that way. Not seeing a professional meant no refills. Before leaving Iowa, I had requested additional refills to account for lag-times in insurance and services. The pharmacist never got the request, which I did not know until I had left Iowa and had different insurance. I take responsibility for not being more assertive to get what I needed both at my work place and through my psychiatrist, but that is the reality of my postpartum depression. It impedes my ability to advocate for myself. In addition, the stigma around mental health conditions deterred me from fully advocating for myself. Even if I had successfully received refills, the cost would have deterred me.
Unfortunately, in the United States, cost is often the driving factor in medical decisions. In Atlanta, my new health insurance was inferior to what I had in Iowa when I originally sought treatment. Instead of having no co-pays for either my therapy or my prescription, now I would have expenses for both. That adds up! Here is a conservative example: weekly therapy sessions for a $10 co-pay each visit, plus $50 for a monthly prescription refill. This equates to $100 extra at minimum to budget each month. The median family income for Atlanta is $55,000. If this estimate was true for the “median” family, that adds up to 2% of the family’s gross annual income.
While access was the primary reason I chose to wean, there was a less tangible reason nagging at me. We had moved and left behind our life in Iowa, and I wanted to leave behind postpartum depression too. I was feeling better and just wanted a clean break from the stress of 2015-2016.
I Just Wanted to be Done
After we moved, I began to wean myself without guidance from a medical professional. Later in fall, I decided I was done taking it. I informed my husband and asked him to keep an extra eye on me. There are side effects from weaning, even when done properly.
Side Effects and Withdrawal Symptoms
- Brain Zaps
- Suicidal Thoughts
Fortunately, I experienced very few side effects. I felt physically felt great, and I was not exhibiting and symptoms of depression, however it was not perfect. I did have two side effects: dizziness and brain zaps. A brain zap is a bizarre phenomenon. Imagine you are walking down the street and your whole vision starts to look fuzzy and warped, like dream sequences on TV. Occasionally, I would be walking down the street and feel all woozy. Everything blurred together and my legs felt like a 100lb Jell-O mold. At first, I thought it was just the fall Atlanta heat and my relatively low blood pressure. After a few days, I realized these were happening regularly since I quit taking my meds. I talked to B about my symptoms and through a quick internet search (again, I do not recommend doing this without a doctor), he agreed these were side effects. Further research concluded they were harmless would subside eventually.
How I Feel Now
The brain zaps did eventually subside and I continue to feel great. However, I wish I had been able to get back into therapy and continue my medication a little longer. The transition to Atlanta was very difficult on me. I was lonely, homesick, and felt lost. Antidepressants cannot cure these emotions, but the combination of medicine and therapy would likely have helped me manage it better. I also wish I had consulted someone about how to stop taking it. I am confident I did not do it properly, and I wonder if I could have further limited side effects. Plus, when changing medication (especially antidepressants), follow-ups with a medical professional are key.
Access to therapy and medicine were determining factors in my decision to wean, as well as my own feeling of readiness. When it comes to weaning off antidepressants, always seek professional help. Do as I say and not as I do.