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| source : health.harvard.edu |
When the Side Effects Feel Worse Than the Symptoms
Years later, Julie was still on Prozac, but she wasn’t thriving. Her insomnia worsened, she felt emotionally numb, and more disturbingly, thoughts of suicide crept in, something she hadn’t dealt with before. All of this while she was actively working through past trauma in therapy.
“I just continued taking it, sort of without questioning,” she told Salon. “But over time, I came to believe that Prozac was causing more problems than it was helping.”
Her story isn’t unique. I’ve read dozens like hers in forums, research journals, and firsthand interviews. There’s even an entire online subculture now dedicated to people trying to safely wean off their antidepressants, many without enough medical support.
The Science Is Complicated, And Evolving
Let’s get something straight: Antidepressants save lives. For many people, they are a vital bridge to stability. But we also need to acknowledge the other truth, they are often overprescribed and under-monitored, especially for mild to moderate depression.
“There is no one-size-fits-all,” said Dr. Mark Olfson, psychiatrist at Columbia University. “It’s about balancing the protection the medication offers with the burden it creates.”
SSRIs like Prozac were introduced in the late ‘80s with great fanfare. By 2020, nearly 1 in 4 Americans were on some form of antidepressant, often not just for depression but also anxiety, OCD, eating disorders, and insomnia.
Yet the rate of people on medication far exceeds the rate of diagnosed depression. That gap raises questions, are antidepressants being used as a first-line treatment, rather than a last resort?
The Withdrawal Nobody Talks About
Julie decided to taper off Prozac in 2022. Under her doctor’s guidance, she reduced her dose over eight weeks. But what followed hit her like a truck: anhedonia (the inability to feel joy), chronic fatigue, and a sense of being detached from herself. These symptoms lasted nearly two years.
Many people mistake these withdrawal effects for a return of depression. It's what makes some patients cycle back onto the meds, not because they need them, but because the withdrawal is unbearable.
Dr. Awais Aftab from Case Western Reserve University puts it bluntly: “Sometimes we use antidepressants as a matter of structural convenience.” Translation? They’re easy to prescribe when therapy is too expensive or unavailable.
The Flawed Serotonin Theory, and What That Means
For decades, we were told that depression was caused by a “chemical imbalance” mainly low serotonin levels. That’s what justified SSRIs, which increase serotonin in the brain.
But newer research suggests this theory is oversimplified at best and misleading at worst. A major 2022 review led by psychiatrist Joanna Moncrieff found no consistent link between serotonin and depression.
“The public thought it was an established fact, but it never really was,” Moncrieff said.
Yet antidepressants can still work, even if not for the reasons we initially believed. Just like asthma inhalers don’t treat the root cause of asthma but help you breathe, SSRIs might simply help reduce suffering, and that’s not nothing.
So… Should You Be On Antidepressants?
That depends.
If you’re dealing with severe depression, medication might be a critical part of your recovery. But if you’re facing mild to moderate symptoms, experts like Aftab say therapy and lifestyle changes should be the starting point.
The real problem? Therapy is expensive, and mental health access is unequal. Often, people get a prescription not because it's the best option, but because it's the only available one.
We Need a New Culture of Care
Julie’s biggest regret wasn’t taking Prozac. It was doing so without a clear plan, check-ins, or a timeline for reevaluation. “I wish antidepressants were treated more as a last resort,” she told Salon. “Then maybe I would have made a different choice.”
Now, she’s exercising again. She’s more mindful of her body, her stress triggers, and her boundaries. Some issues, like sexual side effects, haven’t fully gone away, but she feels more in control.
“I think getting better is now a bit more under my control,” she said. “So there’s potential for things to keep improving.”
Final Thoughts: It's Not About Blame, It's About Balance
As a culture, we need to move past the binary of “antidepressants good” vs. “antidepressants bad.” The truth lies somewhere in the middle. These medications can be powerful tools, but they are not magic bullets. And for many, they are prescribed in ways that ignore root causes or delay deeper healing.
The key is informed choice, ongoing support, and a healthcare system that doesn’t default to quick fixes. Until we get there, people like Julie, and thousands more, will have to do the hard work of figuring it out on their own.