The drugs don’t work

Zoloft for depression

Three decades ago, in the mid-90s, my friend and I managed to get our hands on a prescription for Prozac. A single box, I don’t remember how. We were giddy with excitement, sweaty-palmed and flushed-faced, and trying to arrange our features in a suitably sombre/casual expression as we handed the script over to the pharmacist; we had a whole elaborate backstory ready to deliver if challenged – but nobody paid us any attention. The reason being – apart from a slightly liberal attitude to the dispensing of drugs – that a single box of Prozac, even in the hands of impressionable and rebellious teenagers, could do no harm. No harm and equally no good. It was the stuff of legends, pain-ridden songs and cult movies and cutting-edge literature; it was the wonderdrug that defined our generation – Generation X, generation Prozac Nation – but it wasn’t a drug in the sense that we imagined, and a single box of Prozac, especially split two ways, could have absolutely no discernible effect on our psyche. We split it, regardless, and swallowed a couple of pills.
    Perhaps we thought we were depressed, perhaps we aspired to be: depressed was synonymous to interesting, in those days, and a happy disposition clearly meant you hadn’t understood how heavy a burden this life truly was. We idolised the troubled souls of the grunge and indie rock music scene, and our own souls were reared on complicated emotions that we weren’t yet ready to understand, but we knew all the lyrics by heart, anyway, and the pain we felt was real enough as we sang them, as we swayed clumsily in damp, sticky nightclubs. When Kurt Cobain killed himself, we mourned him as a hero; nevermind the example he set, nevermind the wife and daughter he left behind: that devastated, heroin-chic look was made for Courtney Love. She was a style icon to many of us, nevermind that she was actually a junkie. There was glamour in that, the dark lure of really terrible lifestyle choices, scary-attractive, because the world was fucked up anyway and, as Cobain put it in his suicide note: “it’s better to burn out than to fade away”. Also: Trainspotting. Also: Pulp Fiction. I mean, come on.
    While all this was taking place in LA and Seattle and the mean streets of Manchester, in middle class Athens we had to make do with warm vodka and orange, cans of Heineken, and rumours of ecstasy tabs with the original smiley face stamped on. We gathered in parks and smoked Marlboro Reds and bad weed that made us throw up in the bushes. While teenagers in the enlightened land of America had therapy to deal with their existential angst, we had curfews. While they bravely bared their souls and got prescribed antidepressants, we got a slap around the face and told it was our hormones. Nobody understood and it was all so unfair. So to get our hands on an actual box of Prozac was really something. It would have been better, of course, to be prescribed the thing, to have a professional acknowledge our pain, legitimise it with his signature, but failing that, fuck it, we would self-medicate. So we took a couple of pills each, and told each other we felt changed. And, being slightly nerdy rebels, we had studied the enclosed leaflet of side effects, and reported a few of those, too. Our serotonin levels, I am certain, remained blissfully unaware.
    The point is, as The Verve sang over and over again and nobody listened, the drugs don’t work. Not the way we imagine. Not the way popping an ecstasy tab works, or even drinking a cup of coffee. They do work, but in their own, slow time, and there is nothing you can do to rush them. What I found out, three decades after swallowing 40 mg of fluoxetine and expecting it to change my life, is that when you’re prescribed antidepressants, you are also prescribed patience. And if you’ve ever been depressed, you know that patience is one of those virtues you don’t have a lot of. When you come to a psychiatrist begging to be saved, when you submit to taking a pill to make you feel like yourself again, even though that sounds inherently, fundamentally wrong, you do not want to wait. It’s a fucker. But then again, no one – except teenagers in the 90s – said depression would be fun.
    My teenage self would be delighted: she’s finally had her wish. Three decades on, I have been prescribed antidepressants; I have been found, legitimately, in need of medication. Funny that I don’t share her joy. Not funny, no: I can’t find joy in anything, hence the drugs. But I’ll admit, there was an echo of her when the doctor told me I’d be taking Zoloft, and I felt a tinge of disappointment that it wasn’t Prozac. I allowed myself a small, ironic smile at the thought, before it fluttered away to be replaced by the thump of gravity: this is serious. But I am grateful, really – or I would be, if I could access that function (time; patience). I am grateful that it isn’t more serious, and that Prozac – shimmering magical wonderdrug – isn’t called for, because Prozac is a much stronger medication, whereas Zoloft, I am assured, is just like taking painkillers for a headache.
    If the headache were a black, swirling void that kept growing until it swallowed you whole. And the painkillers took two weeks to work.
    I have been prescribed patience, and 50 mg of sertraline daily. This is day seven, and it’s clearly a case of things getting worse before they get better. I didn’t read the side effects this time. Being depression’s plaything is hard enough; I have no interest in adding hypochondria to the mix. My survival instincts may be dulled, but they are still capable of sidestepping a trap as giant as that one. But experience quickly makes up for lack of knowledge, and it seems depression is just as eager to survive, if not more. It’s come under attack, and it is fucking angry. It would amuse me, if that function were available to me, to imagine the battle taking place inside my brain, depression growing darker and thicker and more monstrous and roaring with rage as the noble (if unsung) Zoloft builds its army of sertraline soldiers, one 50 mg dose at a time. It would amuse me, if it weren’t for the devastation it causes. But the landscape of depression is actually very mundane, and I won’t bother describing it. Suffice to say, yesterday I congratulated myself for putting on clothes.
    The drugs don’t work – until they do. And it is slow, it is relentlessly slow, when you’re desperate to be saved, when you’ve just about accepted, so reluctantly, that you need to be. But I have to hope – though hope is another thing depression doesn’t hold with – that they will. That by day twelve, thirteen, fourteen, my sertraline army will be strong enough to make its presence felt, and the black, swirling void will subside, and I’ll be able to see my way to getting better. And that I’ll know, once again, that smudged mascara might look good on some people, but there is nothing heroic about choosing to die, and that, actually, Kurt Cobain’s iconic last words make no sense, because both options are just as bad and living is the only possible choice; once I know that for a fact, only then will I begin to contemplate the implications. Of balancing my brain’s chemistry from the outside, of needing a pill to bring me back to who I am. The fundamental wrongness of it, and why, at times, it may be right.
    I have to hope.

P.S. For the sake of clarity, and so my parents don’t get blamed, retroactively, for neglect: my teenage self was not depressed. She was a teenager. And she grew up to be an adult of a (mostly) happy disposition, despite being aware of the heavy burden of this life.