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Living Through Chemistry

August 2007  |  Issue #1  |  Gray Beltran

Depressed people rarely like to talk about their depression. As my study doctor says, many people "suffer needlessly," going through life without ever seeking the treatment they need. I know several people my age who should be getting help, but aren't. Up until recently, I was one of them.

It all started with a late night television commercial. Soon I was on a webpage, filling out an online questionnaire. It was amazing how few questions I had to fill out before pre-qualifying for the depression study. There were more questions about pregnancy than about depression symptoms. I checked several, including "Reduced interest in activities that used to be enjoyed," "Difficulty concentrating, holding a conversation, paying attention, or making decisions," and "Thoughts of worthlessness or guilt." I pre-qualified for the research study based on these answers and a vow not to conceive.

When the time came for my first clinical visit, I began to have second thoughts. Was I really that depressed? Though the office looked legitimate, I was worried I was going to get victimized somehow. Lucky for me, depression had only intensified my paranoia. In the end, I decided I could not let this opportunity get away.

Once I met with the study doctor, it was clear I was going to have to sell my depression. We sat in her office for an hour as she asked me questions about my emotions and mental health. Besides overall melancholy, I told her I felt my life was empty and meaningless. It was a good thing, too. I would not have qualified for the study if my depression was any less severe.

After the interview, I went into a tiny examination room. I took off my shirt while the doctor's assistant adhered several small electrodes across my chest. I inhaled several times as she worked the electrocardiograph. With my shirt back on, the doctor handed me a water bottle and a small plastic cup. They needed to confirm that I was healthy and clean. They tested me for ten different types of drugs including opiates, amphetamines, and cocaine. Once my drug test came back negative, the doctor prescribed me an unidentified antidepressant.

For the last few years, the Food and Drug Administration has warned of the adverse effects of antidepressants when taken by children and adolescents. Many researchers claim that these drugs actually increase the risk of suicide, at least in the initial stages of treatment. For this reason, antidepressant medications are required to carry "black box" warning labels to inform patients about possible risks.
In May, the FDA proposed extending these warning labels to young adults ages 18 to 24. The Administration now believes that even young adults may suffer from "increased suicidal thinking and behavior" when starting treatment for depression.

I was well aware of the antidepressant controversy before I began the clinical study. What is astonishing is that the FDA's extended warning to young adults coincided with my first week of treatment. I was suddenly thrust into an "at risk" patient category.

Of course, my doctor never informed me of any of this. Because I'm on a clinical trial, my medication does not even bear a warning label. To compensate, my doctor continually asks me whether or not I feel like harming myself. On the weekends, her assistant calls me to make sure I haven't offed myself (Though, she would never admit that's the real reason). Regardless of my mental state, I always assure them such thoughts are far from my mind.

I have now been on medication for nearly two months with varying degrees of improvement. My doctor has changed my dose and altered my medication schedule from morning to night. It is even likely she has switched which particular antidepressant I take. All this manipulation has made my mood unpredictable. I can feel a gamut of emotions within the 24 hours that separates my doses. I sometimes find myself in despair once the chemical excitement fades.

As my clinical experiment nears its end, I cannot help but wonder about life after antidepressants. Though the medication definitely has its drawbacks, I have been on it long enough to experience some improvement. The daily life which used to distress me has become more tolerable. And while despair has not disappeared entirely, I find myself more capable of enjoying life.

Soon, I will have to stop taking antidepressants altogether. My doctor will gradually "taper off" my medication to prevent my body from going through debilitating withdrawals. With this precaution, my body should be able to adjust to life without medication. Unfortunately, there is still no telling if my improved mental state will remain without the aid of an antidepressant. If my chemistry is like most people's, my experiment with medication is far from over.

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