By Alicair Peltonen
I am a medicated woman. I take 50mg of Sertraline (the generic form of Zoloft) a day. I don’t take it to be more tolerable to my husband. I don’t take it because I’m embarrassed by my emotions. And I definitely don’t take it to quietly fit into a polite societal mold. I take an anti-depressant every day to quell my anxiety simply because it feels better. I feel better.
I grew up in a talk therapy household. My father began group therapy for anger management issues in 1984, when I was 10, breaking a cycle of rage and avoidance that tends to swallow people whole, particularly men. He would come home feeling calmer and then he would implore my sister and me to explore our feelings and talk about our problems. Begrudgingly at times, I learned to think analytically. And thankfully, I learned that asking for help is not only acceptable, it’s downright healthy.
I started seeing therapists here and there in my 20s and then regularly several months after my first daughter was born. Medication had never been suggested by any of my previous therapists but this time was different. I couldn’t shake the feelings of inadequacy, the certainty that my daughter didn’t like me and I was just a glorified dairy cow. Post-partum depression is a hell of a thing.
When my therapist suggested I see a psychiatrist to discuss the possibility of medication, I went home and cried for an hour. I felt ashamed, defeated, embarrassed, weak. Even though I had seen medication transform my father from a man who growled and dragged to one who laughed and hugged, it still stung to feel like I couldn’t pull myself together.
But, remembering my father’s bravery, I thought I should at least give it a try. If I didn’t like it, I could always stop taking it. The first pill was swallowed through tears. And each successive pill went down easier. For a full year, I could go days without yelling or wanting to break things and entire weeks without crying. And I felt better.
After a year, I decided to go off the medication. Things had been much better and I wanted to see if I could “go back to normal.” And things did go back to normal. But it turns out my normal wasn’t very comfortable.
There have been many discussions and articles recently asking if modern psychiatry is over-medicating women. A recent op-ed in the New York Times by psychiatrist Julie Holland suggested that many of the symptoms for which women are treated with antidepressants are natural and healthy. “We have been taught to apologize for our tears,” she writes, “to suppress our anger and to fear being called hysterical.”
Here’s the thing, though. Breaking down into uncontrollable tears because you stubbed your toe and it’s the straw that broke the stress-camel’s back doesn’t feel good.
Seeing your daughter’s terrified face as you scream at her to put on her shoes doesn’t feel good. And not being able to stop destructive behavior even though the voice in your head is begging you to calm down and be rational, feels awful.
Both genders in this modern society deal with an enormous amount of stress, but mothers, in general, tend to have a lot on their plates at any given time. Any addition to that plate can cause an avalanche. For my mother, the trigger was the car. Any time anything would go wrong with the car, she would get “buggy-eyed,” which my sister and I knew meant she was about to start yelling at us and irrationally railing against the world, ending with a rant about what a horrible mother she was.
My trigger, in case you’re wondering, is clumsiness. I have worn glasses since I was a toddler and I have horrible depth perception. I tend to bump into things, break things, drop things, and stub things. When I’m not medicated, these little accidents can send me into tantrums that make no sense to my husband and scare my children. By the time I became pregnant with my second daughter, I was ready to feel better again. My doctor suggested I wait to get on the Sertraline, and not take it during pregnancy, but the OB nurse had an order in my birth plan for 50mg that first day in the hospital.
A year after I started, I pondered going off the medication again. I was lucky, physiologically speaking, in that I had no sudden weight gain, no headaches, and none of the horrible digestive side effects that are listed quickly during pharmaceutical commercials. But the lack of sex drive isn’t fun, and I could do without the constant metallic taste in my mouth. In general, being constantly medicated at 38 isn’t ideal. In the end, I decided that, for the moment, the way I feel with meds is better than the way I feel without.
The ordinary highs and lows of life shouldn’t require medication, says Dr. Ronald Pies, professor of psychiatry at Tufts University School of Medicine and author of “Psychiatry on the Edge.” “Ordinary tears, anger or emotionality in men or women would rarely trigger a clinical diagnosis, if the intake evaluation is done carefully by someone with appropriate training,” he told me in a recent email. The problem is that many people with major depressive symptoms see their primary care physician, and might never see a mental health specialist. “Most prescriptions for antidepressants come from primary care doctors,” writes Pies.
My initial prescription for Sertraline came from a psychiatrist. I spoke with her twice. Since then, my primary care physician refills the prescription. I am fortunate to have health insurance through my job and access to one of the most advanced medical communities in the world, here in Boston. But a majority of the country isn’t so lucky. “The main problem in the U.S. is inadequate access to psychiatrists and other mental health specialists for people with depressive symptoms,” says Pies. “The ‘over-medication’ narrative is, at best, oversimplified with respect to both men and women.”
I have been in therapy since 2009. I am a much more self-realized person now than I was six years ago. I owe it to my therapist for talking to me every two weeks or whenever I need her. I owe it to Sertraline for quieting my brain just enough to hear my own voice. But most of all, I owe it to my father, for teaching me to recognize, request and accept help, no matter where it comes from. Because it just feels better.
Alicair Peltonen is a part-time administrative assistant at the Harvard School of Public Health and a journalism student at the Harvard Extension School.
Correction: An earlier version of this story said that Sertraline isn’t safe during pregnancy. The statement was based on the writer’s experience during pregnancy, when she was told by her doctor not to take this medication until after the baby was born. Studies are mixed on this and the entire topic of taking medications during pregnancy is complicated and personal. Women should consult with their doctors on the matter.