What It’s Like to Be Medicated: Beware the Sunken Shame

More readers write in to tell us how they’re living better through chemistry.

Not every reader who wrote in to tell us about their medication journey mentioned shame, but a lot did. Reading these entries what’s striking is the source of that shame: almost always it’s internal. The finger pointing back at us is — surprise — our own. Which is why, forgive the sincerity, sharing is crucial. It’s one thing to know, intellectually, that other people take meds, change meds, up their dosage, titrate off, go back on, struggling every step of the way. It’s another to read the words, over and over again: it was hard; I was scared; I was ashamed; I tried anyway; it got — maybe not quickly, maybe not permanently — better.

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There Was a Lot of Shame

“I just keep thinking . . . why did I not allow this for myself? Why did I allow myself to suffer so unnecessarily?”

By The Small Bow Family Orchestra

*****

I have treatment-resistant depression as well as anxiety and I’ve been told probably C-PTSD. I've been on medication for 11 years. I’ve tried so many. Sertraline, which was my first, made me so sick I had to stop. Celexa, helped a bit and stopped. Ciprolex made me suicidal and landed me in the ER parking lot one night (I didn’t have the courage to go in). Effexor. Cymbalta. Gabapentin. Amitriptyline. Trazodone. I am now on Seroquel and it’s not working. I feel a little less alive every day but I can’t talk about it without raising a lotta red flags in my circle. I wish things were different. I still have a lot of meds left to try, and a few procedures (rTMS, ECT, ketamine), but the sheer weight of the gray I’m lugging around is really dulling my enthusiasm for trying anymore.

*****

I’ve been on some sort of antidepressant for 14 years now, since 2010. I’m currently on 20 mg Prozac, before I was on about that much Lexapro.

In 2009, I started group therapy and started digging through my childhood. It was real hard. I wrote a lot on weekends, journaling, going back through old letters and journals and piecing it together. My therapist recommended I take antidepressants to smooth things out a bit while this hard stuff was coming up. I didn’t because I wanted to “beat this” (whatever this was) and one of my sisters had been hospitalized twice for mental illness, and I wasn’t her, right? I was the strong one. I was up all hours of the night for months going through old stories in my head and missing ex-girlfriends until finally, a year later, I told my therapist I wanted to take antidepressants because I was starting a new job. He was like “What took you so long?” I started sleeping normally. It was such a relief.

I’ve tried to quit 2-3 times, because I don’t want to admit to others, really myself, I’m on medication. It’s never stuck. I’ll run into a stressful life event and be up all night and/or have a panic attack and say “I need something, I can’t do this.” It helps. Usually I sleep better first and foremost.

Really I haven’t wanted to admit to a woman I might date that I’m on medication. There’s some validity to that. One woman a couple years ago was really concerned about it because she “beat her issues” through health and meditation and yoga. We broke up. Lately I’ve figured that I’m more an all of the above approach, and I might always take medication, or not, and someone will be able to accept that.

I also remember that I started taking medication in New York, and started laying off the alcohol per the doctor’s recommendations. A woman I dated in New York (probably the most physically attractive person I’ve ever dated) asked me “What’s up, you’re not drinking your beer?” I had prepared a long spiel about medication and working through my mom dying when I was a child etc. She was like “Oh that’s it? Everyone in New York has a therapist or is on medication.” A couple weeks later we slept together. So maybe it’s not the big shameful admission I thought it was.

*****

I haven’t always loved the process of adding these medications to my life, but there is a chance that without them I wouldn’t be here today.

Here’s my deal: I have had bouts of depression off-and-on throughout my life starting at/around age 9 — I’m now 40. Over the last 4ish years these bouts of depression became more frequent and, a few times, dipped into suicidal ideation and planning. It wasn’t until I experienced suicidal planning in 2021 that I seriously sought treatment via therapy & medication. I got lucky in that the first medication I was prescribed — Desvenlafaxine — worked pretty well for me, and we just had to spend some time dialing in (aka increasing) the dosage. I take 100mg daily. I also have Alprazolam to take as-needed if there’s a day I wake up feeling like I can't bear to live another hour let alone 24.

On top of these medications — which are managed by a psychiatrist I spend 15 minutes with about 4x/year — I see my therapist weekly. Every few weeks, I’m there for 2 hours because I do a Ketamine-assisted “solution session” where we dig through the cobwebs of my memories and habits and try to create new behaviors and pathways (aka create new solutions). This is Ketamine taken orally via sublingual lozenge, not IV. Very recently, I started taking Saffron Extract daily, because I was told it could help with low sex drive (a side effect of the medication). It’s not doing much yet and, if it doesn’t, my psychiatrist recommends that I add a low dosage of Wellbutrin instead, so I’ll probably also try that.

I haven’t always loved the process of adding these medications to my life (acclimating to the antidepressant made me feel like I was going insane AND made my teeth hurt), but there is a chance that without them I wouldn’t be here today. I’m glad they’re available, I’m glad I had the strength to seek help and the perseverance to find what works, and I hope sharing this helps others to be strong and open in those same ways.

*****

I’ve been an addict since I was 10, an anorexic since 14.

I started huffing chemicals from under the sink to avoid the fear a child couldn’t explain. Starved myself for the same reason.

I was on Pristiq, then Wellbutrin, for a few years between a long stint in ED rehab (admitted the night of Trump’s first win) and sophomore year of college. During those years I was smoking maybe 2 or 3 grams of weed a day, popping painkillers, tripping random lab drugs yada yada. So the meds didn’t work, but I was sufficiently numbed regardless.

I stopped smoking weed around the same time I relapsed into my anorexia in 2020. I had gone off the meds a few months prior and had felt pretty fine.

With the relapse, though, things changed. A brain changes with starvation. The human as an animal comes out. High alert, intense, irrationally irritable. Scared.

I lived with roommates who were my friends but who my brain told me I feared. A loud noise outside my door and I would prepare myself for someone coming in with a baseball bat. Whispers in another room and I would expect a plot on my expulsion.

I was terrified, and this fed the anorexia, creating a perfect perpetuation.

In January 2021, while visiting my dad in a mountain town of California, I convinced myself that I had AIDS. I did not have AIDS. In fact, I was not having sex. A healthy libido and malnourishment do not go hand in hand.

This absolute certainty of a fantasy danger reminded me of a time when I was a teenager when I locked myself in the bathroom, curled up under the toilet and whimpering for my mother, because I was so convinced mummies were going to come and eat me.

I went back on meds.

Zoloft, and the Ween song was an anthem for a beautiful few months. Initially, the pills felt similar to the painkillers I had been trying to quit, and I welcomed the substitution.

The fear was gone, but the cycles of mania became more apparent. In 2022 I had entered a relationship with someone I cared about, so they had to be addressed.

I won’t get into the details but I was convincing him to let me do some crazy stuff and rationalizing not telling him some other crazy stuff on the side.

A psychiatrist diagnosed me with cyclothymia and I started Lamictal, an anticonvulsant made for epilepsy but also used to treat bipolar disorder.

I knew the diagnosis was right. It fit like a glove, and the meds worked (and have been working) wonders.

But the feeling that my diagnosis had been escalated to something so much more serious than “intrusive thoughts” was hard to digest.

There was a lot of shame. A lot of disappointment in myself that time and again, after backbreaking effort in recovery of both drug abuse and anorexia, I couldn’t just sit down and be still and be normal for my family. That there would always be something. That the mental issues that came out in me with puberty wouldn’t recede into their cave with adulthood.

That shame has largely gone away now. I’ve accepted it, and better accept myself.

It is still hard to disclose with people who I want to love me. Unconditional love is something I have a deep distrust for, and exposing my shames one by one is terrifying. I think to the person, “if you want to run away, please do.” And I worry that they’ll see me as weak and needy and unable to help them carry the heaviness of their own lives.

In the past this may have been true, but it certainly is not now. I’ve hit the sweet spot with meds: fully able to embrace life without being addled. I feel the empathetic, curious little me here again in full force. And even though it would be cool if I didn’t have to go to CVS once a month and wait in line for pills I worry I’ll eventually run out of, I don’t think too much about them anymore.

*****

I felt strange and melancholy even as a young child and especially as a teen but declined to share it with parents or teachers, assuming it was representative of either some congenital character flaw or a unique artistic sensibility, and anyway I got good grades. At 19, I no longer just hated myself, I was actually hurting myself, so something had to give: Armed with mid-2010s mental health awareness, I finally got on 50mg of Zoloft. I was terrified but took comfort in the fact that I had a chemical imbalance that was being corrected. About two weeks in, just as promised, I became myself again with basically no side effects. I stayed on that drug through some dose increases up to 150mg for a few years until I began rejecting the idea of a chemical imbalance, realized I missed my libido, changed my health insurance, and felt generally restless — so I took myself off it. I did okay without it but also smoothed over any rough patches by isolating and drinking. I spent five years unmedicated that were objectively successful — all positive growth in my career, family, and relationship worlds — but the depression came roaring back in 2021 and 2022. A new job didn’t help, talk therapy wasn’t helping, and self-medicating wasn’t doing it, but I felt inexplicably stubborn about trying meds again; it felt like a failure. (My beloved, medicated spouse was very patient with me while I was being an ass.) Finally started on 50mg of Zoloft again in January of 2023, after going cold turkey on substances for the month and nose-diving into tremendous depression, so it’s been about a year. I’m embarrassed to report that after all my kicking and screaming, two weeks in I felt so much better. Once again, I’m restored to the real Me, free from (most) days of paralyzed inaction, self-harm ideation, and self-hating spirals; I’m a better spouse and friend, ruminating less and able to give more, and I’m incredibly grateful. I don’t know why I feel so ashamed: I’m in all the demographics that most accept taking care of one’s mental health, and my self-image is that of someone who believes in psychiatry and congratulates people on the vulnerability and strength shown by getting help. I realized the other day that perhaps the reason this dry January (my fifth!) is passing so easily and without grief is because I’m actually medicated during it for the first time ever. Maybe this time the spirit of sobriety or at least of temperance will stick . . .

*****

2014-2015: Adderall 20mg. I’d been diagnosed with ADHD as a child, but never given access to medication (the consequence of having a father who distrusts psychiatry). Sought it out in university because I couldn’t handle anything longer-term than a same day deadline. I was on for the first time in my life, also very irritable and angry. Adderall helps a lot of people, but it felt like a pharmaceutical sledgehammer. Ditched it after a year.

2016: Vyvanse 20mg. Much smoother than Adderall, without the emotional side effects. Felt like I was mentally slowing down (but my long-term relationship was slowly disintegrating at the time). Drinking out of control. First attempt at sobriety after an ultimatum from my partner. Developed paranoid delusions and severe rumination issues. Didn't seek treatment.

2017: Ditched all meds, started drinking again the day after we broke up.

2019: Escitalopram 10mg after quitting drinking, 18 months of hellish ruminations and depression while working halfway across the country, and an OCD diagnosis. Worked like a charm on the OCD symptoms after just two weeks.

2024: Still very bad at managing my time, handling chores, emotional outbursts (mainly anxiety or worry, not anger), and focusing. I was a full-time freelancer drowning under the weight of my work and unable to do anything more than zone out at night. My partner was shouldering the brunt of our chores and was understandably frustrated. Found an incredible therapist, started on Vyvanse 30mg. Bumped up to Vyvanse 30mg + a 10mg 'booster' in the afternoon. Attention, motivation, and emotional state all improved drastically — although I seem to suffer OCD lapses a little more often (once a month, rather than 2-3 times a year).

Today: ADHD and OCD are 90% under control. Still prone to impulsivity, inattentiveness, and rumination at times, but to a far lesser extent than when I was unmedicated. I’m working a job I could never have handled without chemical assistance and attending an online MFA course in the evenings. My desire to drink has completely evaporated. I used to dream about drinking as a fire escape if my loving partner (now fiancee!) and I broke up. That’s no longer the case.

*****

The meds have started to work — but every time I take them, I feel almost ashamed of needing them.

This fall, I was finally diagnosed with ADHD after about 20 years of being told that I should get screened, and when I started Ritalin (100mg daily), I immediately freaked out. I’d been trying and failing to quit drinking for about 8 years without a program, and couldn’t believe I was willingly adding another controlled substance to the mix. It’d been about 6 years since I had filled any prescription, let alone a 1st cousin of meth. My mindset flipped within a week after I saw the impact it could have on my life, and Ritalin has become essential to my life.

At the beginning of this year, I finally got myself into a meeting. After my second meeting, a guy found me outside and, after asking what drugs I was using, told me point blank to stop my Ritalin. A pretty long chat left me feeling good about keeping Ritalin in my life. It also brought back all of the questions I’d been asking myself about it.

In the past two weeks, it went a step farther when my psychiatrist and therapist prescribed me Trazodone (150 mg), Celexa (30 mg) and Naltrexone (not really planning to fill this one). His voice keeps creeping in and telling me that I really need to be clean of all chemicals. The warning labels and online drug information keep taking me back to my internal voice that keeps asking "Do you really think you won’t be dependent on this one too?"

The meds have started to work — I slept through the night without alcohol for the first time in years last week, and the scary voices inside of my head have become a bit quieter. But every time I take them, I feel almost ashamed of needing them. I’m assessing daily what I want to do with my medication going forward, and am slowly learning to just trust the results and trust my program. My sponsor, doctors and friends are encouraging me to give the drugs a full test. I’ve got NO idea what’s going on in my head most of the time right now, so I'll just sit and trust some people with more than my 41 days of sobriety. I’ll also trust whatever higher power brought this newsletter to my inbox this morning. But none of that stops the questions that have dug in about what is “right” or “allowed” as I’m trying to get and stay sober.

While I was drinking, I had periods of taking Escitalopram, and it did not help me very much. I also was sometimes prescribed Lorazepam for anxiety, which for some reason, I used sparingly, in contrast to my heavy drinking. I got sober when I tried to get on Lorazepam again and the psychiatrist saw that my anxiety was connected with drinking. A doctor who had never seen me before telling me in so many words that I had a problem got through to me in a way that subtle hints from friends and family had not.

So, when I got sober, I was off all meds. That worked for about a year, and then I fell into a deep depression in sobriety, which lasted about a year. By the end of it, I had stayed sober but was not able to function very well (this was also in the height of the COVID pandemic), so I saw another psychiatrist — endless inventories and gratitude lists were not helping me very much and I was crying all the time at meetings and in psychotherapy. She prescribed me 20 mg Fluoxetine, which has done wonders for my sobriety. “The work” of the steps isn’t so scary, and while I have a sponsor and close friends in the program, I don’t lean on them so heavily for validation like I was before I got back on meds.

I have come to think that my alcoholism was a symptom of depression: A way to medicate away the feelings I didn’t want to feel when I was depressed. I’m still a garden-variety alcoholic, but that framing has helped me forgive myself for years of heavy drinking.

*****

It was exhilarating to feel the out of control giddiness of being reckless in a family that was always so carefully controlled; being raised by two Marine parents where structure, obedience, and respect was paramount felt oppressive. My first real act of rebellion (smoking a cigarette at 11 at the bus stop) gave me a rush I spent the next decade running after to feel alive.

I didn’t think I was depressed, didn’t brood, wasn’t melancholy, didn’t self-harm like some of my friends. Pain wasn’t my jam. I needed the thrill most people would think was too taking things too far. I LIVED off the highest of highs like a maniac. The act of taking something questionable sent me over the edge. With the onset of hormonal changes and discovering sex at 15, a psychologist “diagnosed” me with Bipolar II. The meds paraded in.

I was super allergic to Prozac, breaking out in hives; Lithium — I think we were tired of taking me for constant labs; Paxil made me feel dead inside but this was the winner until I left home at 17; then self-medicated with sex, alcohol, my codependent boyfriend, choice narcotics; then the one that made me feel like a warm and cozy dream world: heroin. By the time I was 19-20, I didn’t think that was suicidal but there were instances that I’d have been okay with OD’ing.

After a stint in state prison and halfway house, I got clean at 23, went to counseling, college, got married, a career, etc. the whole American Dream. I was doing well. Nothing to be depressed, angry or unsettled about, right?

At ten years sober, my husband said I needed to get help. It wasn’t fair to my family to walk on eggshells and wonder if today was a day they were getting a crazy mommy or a nice mommy. I’d never been so devastated. He said just because I was sober didn’t mean that my bipolar went away and it was time to consider meds again. I’d been self-medicating but this time with recovery stuff, out-of-control buying for shiny new hobbies, and food.

That was about 10 years ago, now 21 years sober. I’m still sick and take matters into my own hands. I get on and off meds for various things, like Contrave for weight loss that has Bupropion and that helped a lot. The Naltrexone also puts a damper on the addictive behaviors. Cherry on top for this addict. Weight loss meds are expensive so I’ve been on Bupropion for nearly two years mostly consistently, I miss a couple days a month from sleeping in on the weekends. Yet for the first time in 30 years (I just turned 45) I feel settled. Happy? Content? Some days I still get a hedonistic itch to do something really exciting and sometimes it’s hard but I can temper myself better. More importantly, my family doesn’t fear if I’m gonna rage at them for no reason.

*****

It’s funny how the names blur after a while.

At first you work to learn the pronunciation of the generic sobriquet on the orange jar for the newest solution to Not Feeling Like a Piece Of Shit Forever. You invest a prayer-hope energy in the made-up words: a new mantra that, taken daily, will make a new you.

But more often than not, the drug would make me want to kill myself, or after nine months I couldn’t get hard and still hated life, and then I’d spend thousands more dollars getting the name of a new spell to cast on my problems.

I remember when my Pill Lady said the word “lithium” and my brain immediately pulled up images of Kurt Cobain and the Periodic Table of the Elements.

I felt like my problems were becoming Official, like I might need to wear a sign around my neck that let passersby know I was truly and deeply fucked. (She also switched my sleep med from Trazodone to Seroquel and did me the gentle kindness of not telling me for months that Seroquel is a powerful anti-psychotic that they feed you when you go in on a 5150.)

She shared what probably is an entirely apocryphal tale of lakes with high lithium content — it is a naturally-occurring element — and how the people who lived around them and swam in their waters had lower rates of depression. I dove in.

Just a bit over two years after starting that program, I cycled off of both drugs. It’s been 7 or 8 months since I’ve been on nothing but a dash of Ritalin for the ADHD, and I’m healthier, sounder, and stronger than I was before. They quieted storms that raged for years and gave me the peace and space to build a better me.

Probably won’t work for everybody and may not work for anybody, but that mix helped save my life and my mind.

*****

I recently went back on Wellbutrin after coming off it since it’s not recommended if you are trying to get pregnant or have had miscarriages. I stopped taking it, got pregnant, had a pretty gnarly miscarriage (my 5th one, which made all of this so much more unbearable and furthermore, I didn’t get the care I needed due to our abortion laws where I live) still went to work with a diaper strapped on right after, pretending everything was okay, and then, proceeded to have one of the darkest years of my life where I just thought about how much easier it would be to be dead. I don’t think I really wanted to die, I didn’t have a plan — I just thought death would be so much easier — for all of us. I think that’s the thing that’s so terrifying about mental health — you sometimes can’t see how far down you are until you aren’t there. And then it’s bewildering to think that you went all that way down and yet . . . everything continued on as normal. I went back on Wellbutrin almost a year to the day I went off it and it’s like I can hear myself again. I feel like myself, recognize myself. The incessant chatter of anxiety and doubt and self-hate just . . . gets so much quieter. I don’t want to die. I just keep thinking . . . why did I not allow this for myself? Why did I allow myself to suffer so unnecessarily? Every day I pop my Wellbutrin, I think to myself, thank god, thank god, thank god.

*****

I’ve been on and off medication for depression and anxiety since I was 18. I’m 44 now. At the moment, I’m in an “off” phase with my Zoloft — not because it wasn’t working, but because I feel like a fraud.

I’m a naturopathic doctor. I know what supports mental health: movement, nutrition, nervous system regulation. These are the very things I recommend to my patients — most of whom are women navigating perimenopause and experiencing anxiety for the first time. But when I’m not consistently doing those things myself, I tell myself I haven’t “earned” the right to take medication. That I should be able to fix this on my own because there is more I could/should be doing.

I didn’t even realize I felt that way until I started reading other people’s stories and reflecting on my own.

The reality is, not taking the medication only hurts me. My anxiety becomes hyper-focused and turns the world into an adversary. The person making an ill-advised left turn slowing traffic? Clearly, they have no regard for others. The woman who bumped into me at the grocery store? A menace to society.

And the worst part? These tiny moments take up absurd amounts of space in my head. I’ll ruminate on them for days.

When I’m on medication, those thoughts still pop up, but they don’t take over. The inner crankiness softens enough to give me some perspective. The feeling of being “constantly attacked” by life mostly fades.

Without these shared stories and this opportunity to write it all out, I don’t think I would have recognized any of this. The truth is, I’d never want my patients to feel the world the way I often do. So why wouldn’t I give myself the same grace? Why wouldn’t I allow myself to take the medication, feel better, and maybe — just maybe — find the motivation to take that walk in the fresh air?

*****

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MORE IN THIS SERIES:

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ZOOM MEETING SCHEDULE

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Friday: 10 a.m. PT/1 p.m. ET and 4 p.m. PT/7 p.m. ET

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A POEM ON THE WAY OUT:

I Taught Myself To Live Simply

by Anna Akhmatova

I taught myself to live simply and wisely,
to look at the sky and pray to God,
and to wander long before evening
to tire my superfluous worries.
When the burdocks rustle in the ravine
and the yellow-red rowanberry cluster droops
I compose happy verses
about life's decay, decay and beauty.
I come back. The fluffy cat
licks my palm, purrs so sweetly
and the fire flares bright
on the saw-mill turret by the lake.
Only the cry of a stork landing on the roof
occasionally breaks the silence.
If you knock on my door
I may not even hear.

*****

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All Illustrations by Edith Zimmerman