Coming of Age on Zoloft…, by Katherine Sharpe – Living with It



I thought about whether part of being an adult is realizing that no one else cares as much as you about the things you do. It seemed like a lonely thought, but maybe it didn’t have to be. If it didn’t matter as much to anyone else, maybe it was time to start taking responsibility. Maybe that’s what responsibility meant. That you might as well try to make yourself happy—that nobody else was going to tell you how to, not because they were mean or uncaring but because they didn’t really know how, and anyway, it wasn’t any other person’s job as much as it was your own. I did squeeze in a few more days without doing homework, just to see how it felt. Nothing bad happened.


I found myself placing more importance on things like getting enough sleep, going home when I was through feeling social, running in the park. I made a conscious effort not to overburden myself or my schedule with commitments. In my journal, I wrote that I felt like a tightrope walker performing the same old routines, without a net this time. The simplest things felt a little more exciting, and I went around with a new consciousness that it was important to be careful.


I had to be nice to myself; no one and nothing else was going to do it for me.


I’m the first person to say that if you’re depressed, or if you’re anxious, the last thing you want to do is anything. You don’t want to eat, you don’t want to shower. You definitely don’t want to go out on a hike or go to the mall or something like that. But you have to do something. Once you isolate yourself, that’s when you’ve crossed over to letting it get you. Even if all you do is go for a walk, and say hi to one person that you pass during the walk, that’s an accomplishment. —Shannon, age twenty-six


Several people described feeling as though they had become better at noticing their own needs and taking action to meet them—a combination of being both more vigilant and more relaxed.


But now, I allow myself some, like, “Oh, if you want to chill out, that’s cool, you can just chill out for an hour,” and limit the number of things that I expect myself to do in a day. Which I often exceed. It’s not that I have to struggle through all my days, but lowering my demands on myself has been big. —Isabel, age twenty-seven


the passage of time had often acted as a powerful intervention of its own. They talked about seeming to acquire a new resilience as they got older—as if living were a skill that they were improving at with age.


I’ve gotten so much better at not mistaking a negative mood for reality,”


I do feel like life has gotten easier to manage, but I relate to the sense that while time and experience dial them back, old issues never truly disappear. And sometimes—in February, or after a breakup, or during a period of stomach-knotting stress at work—I ask myself whether another way might be better.


And I’ve come to accept that the person I wish I was is not someone I can be, at least not for longer than a couple days, a week at most. But for me, it has always been borrowing against something, in terms of both emotions and energy level. So let it level out: I’m always going to be introverted, and slightly nervous, and self-critical, and slightly scattered, and easily distracted.


Other people who are drawn to the idea of quitting will discover that it isn’t practical for them. While I think that self-care and lifestyle changes can make a big difference, I know they’re not a panacea. As a personal reminder, I sometimes think back to a moment that occurred near the end of my time in California. I was at the Berkeley YMCA, trying to “manage” my need for medication with exercise, in the last week or two before I packed it in and called the psychiatrist. A few weeks later, when I was feeling better, I tried to wring a little humor out of the memory by saying to myself, Okay, when you’re doing exercise to try to feel better, and you’re actually crying while you’re doing the exercise (crunches for me, if I remember), maybe that’s a signal that it’s time to bring out the big guns. I have a friend who had a therapist who once told her that depression is when you feel like it’s almost impossibly effortful to get through the things you need to do. By the same token, keeping yourself in an acceptable frame of mind shouldn’t feel like an exhausting, full-time job, let alone one you’re slowly failing at.


what so many people feel as they grow into their adult selves: a greater sense of knowledge about what she needs and wants, and a greater willingness to reach out and grab it—to insist on it for herself, with ever-lessening amounts of conflict or doubt.


While some of us will need medication, or want it, we all need things that medication can’t provide—things we shouldn’t overlook in our enthusiasm for easily classified problems and quick, high-tech solutions. We need things that can’t be commodified or manufactured, that can’t be rendered more efficient, and that will never make any company rich. In our society, with its glistening surfaces, we all need reality checks. We need to talk to each other, as honestly as we can. We need help sorting out what’s worthwhile from what isn’t, what makes us feel good from what makes us feel bad. We need the comfort of feeling like we’re not alone. We need meaningful work and real rest, or at least the hope of these. We need connection and love. And we need to learn, by trial and error, how to take care of ourselves.


All I knew was that I felt like I’d finally crawled up on dry land, and I was pleased and comforted that my friends seemed to be doing the same. Looking back, I have no sophisticated explanation for the change. I think what happened was, quite simply, that we grew up. I don’t want to exaggerate the luxuries of this new place. Sometimes there are earthquakes. Sometimes the fog rolls in and stays for weeks. But it’s fertile land, and arable too. It feels like a place where you can get some living done. While the storms aren’t over, they do feel different now. And I’m confident in a way that I couldn’t have imagined years ago of my ability to weather them. Maybe you know this feeling, this place. Maybe you see it, up ahead, as a promise. I want to tell you that you’ll get here too. Medication won’t prevent you from making the trip, but it won’t get you here on its own. You will get here by living, by engaging with the world, by loving and fighting and making mistakes, by picking yourself back up and trying again. You’ll do it by taking support where you can—from medicine, from the people around you, from your interests and beliefs. If you are lucky, you’ll find a guide who will help by listening to you and sharing the story of her own way across. The trip won’t always be comfortable, but it will feel real, unique, and yours.


Maybe you are here already. If so, maybe you have experienced how, on a good day, the breezes change direction, and the feeling in the air shifts a little. The voices inside that once asked “Who am I?” quiet down, and into the silence a different, but related voice says softly, “Here you are. What will you do?”


Coming of Age on Zoloft…, by Katherine Sharpe – Therapy



THERAPY DIDN’T CONVINCE me that antidepressants were useless, but it did move me toward a more specific estimation of the things they can and can’t do. For me, I decided, antidepressants were great at blasting through the most acute states of anxiety and sadness. When I’d lost the ability to eat and sleep normally, or interact socially without suppressing tears, medication knocked me back to a calmer, more cheerful place, and quickly. But as I continued in therapy, I saw more clearly that there were things I had needed for a long time, as much or more than I needed drugs. Antidepressants had gotten me moving, but they hadn’t given me the sense of direction I craved.


Critically, therapy taught me about the magic of cause and effect: that the things I do really affect the way I feel. I learned that emotional junk food—“shortcuts” to intimacy, or whatever kind of immaterial gratification you may be seeking—will make you feel as queasy and malnourished later as real junk food will. Emotional life is not unlike cooking or growing a plant: if you take your time and put in quality materials, chances are that you will get good stuff out in the end.


Most of all, therapy helped by making me see that some of the things I like most about myself and some of the things I like least stem from the same sources. Before I came to John, I was used to feeling two different ways. Sometimes I felt capable, well composed, on top of the world. Other times I felt abject and lost and horrible. Antidepressants had contributed to this tendency; one group of feelings meant “sick,” the other, “well.” John taught me to reexamine those assumptions, to think about the relationship of the bad to the good. Slowly I began to realize that some of the qualities I value about myself—that I feel things strongly, that I’m sensitive, that I care about doing well and about things being right, for myself and in the world—were precisely the things that made it possible for me to get cast down. But at the same time, these were the qualities that allowed me, on a good day, to be empathetic, warm, observant. A good friend, a hard worker. Some people find comfort in thinking about depression as a kind of disease, but for me, recognizing it as a potential nested deep inside me, intertwined with the traits that made me strong, made me hate my depression less, and made me hate myself less too. Depression is pretty hard to love, but I did learn to regard at least my tendency toward it with a little fondness and a little humor that, I like to think, took the edge off.


Our lives are made up of moments, brief interactions strung together into a whole. In a sense, the quality of a life is the aggregate quality of those moments; it is hard to be right in the entire picture of your life if you aren’t right in the details. Big questions can feel unanswerable because they often are. My fantasy of an equally big solution, he was saying, was never going to work. He wanted me to start by letting go of my dream of a top-down approach, and taking a clear look at the things that were right in front of me.


In CBT, it doesn’t matter so much why you jump to a given conclusion, just that you notice yourself doing it; in psychodynamic therapy, understanding why would be seen as essential to creating change. Which approach will work best for any given person probably depends on what kind of investigation appeals most. Are they more comfortable isolating and zooming in on the problem, or would they rather start by taking a slow, meandering walk to get the whole lay of the land?


(Commenting on the inappropriateness of talk therapy to achieve “an immediate transformation of general mood,” Andrew Solomon wrote, “When I hear of psychoanalysis being used to ameliorate depression, I think of someone standing on a sandbar and firing a machine gun at the


incoming tide.”24) Antidepressants, the reasoning goes, may be able to blast somebody out of an entrenched depression and put them in a place where they’ll be able to properly do the work and absorb the benefits of therapy. Therapy, in turn, can help that person cope with symptoms that remain. It can make them better able to take care of themselves and recognize their triggers, so that they become less likely to get depressed again, or quicker to seek help when they do.


One thing that the cultural representations of therapy hadn’t led me to expect was how much mental energy it takes up. Especially in the first months, therapy was always there, like a program that runs silently in the background, hogging RAM. I began to watch myself in the world with a new kind of attention, and bring to John any detail that seemed like it might help.


While psychiatrists used to provide psychotherapy along with medication, now prescriptions come from the doctor, and talk therapy, if it’s wanted, from a different practitioner altogether. The situation leaves psychiatrists less able to monitor their patients’ progress, because they see their patients less frequently and talk to them less extensively. It has also contributed to a shift in which psychotherapy, because it’s generally no longer provided by medical doctors, has come to seem increasingly less like a medical ser-vice. The issue isn’t quality—nonpsychiatrists can be excellent psychotherapists. But pushing therapy to the periphery of medicine strengthens the rationale for insurance companies not to fully cover it. Talk therapy joins the ranks of other “nice but not necessary” ser-vices, like acupuncture or massage, that can seem vaguely alternative and that consumers often expect to have to pay for themselves, while medical care for emotional problems becomes increasingly synonymous with pharmaceuticals.


Coming of Age on Zoloft…, by Katherine Sharpe – Finding Relief



And then one day, the Zoloft started to work. At first all I felt were some of the side effects I’d been warned about: headache, dry mouth, a new and different kind of sleepiness. A day or two later I stopped crying, just like that. The tragedy I’d been watching came to an unexpected end, and I collected my coat and walked out into the street, surprised to find myself thinking about something other than life, death, the infinite. Not only was I free not to think about them, but for the first time in weeks they didn’t seem any more interesting than anything else: plans for the weekend, say, or conjugating Latin verbs. In the mornings, my stomach rumbled for breakfast.


I found this private research soothing. The idea of having depression made my life feel out of my hands in a way it never had before, and trying to master the topic seemed to go partway towards restoring the missing sense of control. Sam had upped me to a stronger dose by then, the pills not blue but a pale, pleasant yellow, a color that would have looked right on the walls of a guest bedroom in the country.


I started taking [Lexapro], and within a week, I felt like a human being again. I could feel something changing inside of me. I could feel this different kind of light, this support, this capability that I didn’t have before. It was very supportive. It was kind of like someone was holding my hand the entire time. —Shannon, age twenty-six


To me, I haven’t changed at all. I’ve just shed the tremendous weight of depression and anxiety that was stifling my actual personality.”


The people I interviewed also reported taking on new activities and having new feelings about old ones. Often they did this consciously, out of a sense that they could try to make up for the effects of medication with modified habits. Many said that exercise had become vital to them, and that it made a difference: Shannon did yoga; Isabel and Abby signed up for gym memberships. “Exercise has helped me a lot,” said David. “This summer I’ve been running, and it’s been amazing. I don’t know what I’m going to do when winter comes.” Quite a few people had used trial and error to arrive at a belief about what kinds of changes made the biggest difference for them. Shannon was trying to eat fewer processed foods, and Alexa said that she’d moved getting enough sleep to the top of her list of priorities.