Do antidepressants really work? The jury is still out on this.
There’s the statistical analysis showing the effect size of an antidepressant over a placebo is .03 or “clinically insignificant.” And the assumption that ‘depression is the result of a lack of serotonin, therefore an SSRI (Selective Serotonin Reuptake Inhibitor) will correct the depression’ was based on insufficient evidence and has been met with some conflicting evidence as well.
There’s also the concept of “depressive realism,” which hypothesizes that depressed individuals have a more accurate appraisal of the world and their own capabilities, while non-depressed people wear rose-tinted glasses.
Or our weariness that we’ve pathologized the whims of ordinary human experience and that Big Pharma encourages over-diagnosing to sell more product, highlighted by Harvard professor Joseph Biederman, who failed to report the majority of the $1.6 million he received in consulting fees and whose work is credited with the increased use of antipsychotic medication, as it helped expand the diagnoses of both ADHD and bipolar disorder to children. Biederman said in a deposition that after the rank of Harvard professor, there is only “God.”
It seems like antidepressants are relying heavily on the ‘acid test’ and anecdotal evidence: For some people they work and that’s great, for others they don’t and it’s not. I’ve tried them a couple times; one time they worked (I think), the other time they didn’t (I think), but what’s certain is they produce side effects.
If you’re experiencing side effects, you are not alone and they are not permanent (in my experience), so let’s take a lighthearted, cathartic walk through my own:
1. Weight Gain
I won’t sugarcoat it—I’m a huge fan of food, and it’s quite possibly the main reason I insist on exercising. I’ve never experienced food cravings like I have on an antidepressant. I didn’t just want to eat more, I wanted to eat giant bowls of pasta and multiple Texas-toast cuts of garlic bread that seemed to be coated with buttery MDMA. Nothing tastes as good as skinny feels? Hah, next joke. I wanted to be towed into this wave of fluffy carbs and get pitted, emerging from the golden grain-barrel of depression and paddling to shore with a peeled smile. Unfortunately, it didn’t happen like that. I just gained weight.
2. Incredibly Vivid Dreams
I sweat profusely and remember my dreams every night, both of which were enhanced with the addition of an antidepressant. I’d wake up several times a night covered in sweat and out of breath, and these weren’t even nightmares, they were just so intensely vivid and mentally exhausting I felt like falling asleep was taking a hallucinogen: I’d lie down, take a couple deep breaths, and think, “OK…here we go.”
The first thing that became clear was the accuracy of the film Inception, in that once you realize you’re dreaming, the subconscious ends the experience in rather violent ways. Here’s an example, and I swear on my life I’m not making it up:
My roommates and I are eating McRibs around the L-couch and I stop eating and look at them. They stare at me unflinchingly, not saying a word, and a hurricane starts shaking the side of our apartment as I realize I’ve never had a McRib, would never have one if given the opportunity, and I’m in Moscow. After I say that, the roof tears off of our apartment and I’m thrown into the sky in complete terror, then wake up. That dream happened four years ago.
3. Penis Problems
I think the best way to explain this is to show you the event in real time:
According to my playlist we’re on minute 20 position 7; this is impressive by anyone’s standards, she came three times already (2 vaginal, 1 clitoral) and I was really nonchalant about it even though we’ve had sex before and she knows we’re usually catching our breath and listening to the last 3/4 of my 22-minute playlist ending with “Poppin’” by Chris Brown by now, which is almost over and she has no idea my stamina is drug-induced so she keeps kissing me because she thinks it’s the result of a newfound and ravenous desire for her heart, she’s definitely telling at least one of her friends about this tomorrow, I’m awesome, and a douchebag, nevertheless her asking me to finish has gone from “If you want to, I’m more than flattered with your efforts thus far” to “OK, I’m legitimately tired.” What she doesn’t know is I’ve been trying to finish since “Down On Me” by Jeremih. My arms and lower back are fatigued from operating both her body and my own, I adopt a more determined demeanor of frustration and she reciprocates an expression of concern, I enter a state of shock thinking I’ll never ejaculate again…pull out and stand in the middle of my bedroom with both hands cupped over my mouth staring straight at the wall behind her, “SIDE EFFECTS INCLUDE: SEXUAL DYSFUNCTION,” this is forever, the playlist has been over for at least a minute and the only sounds are my ringing ears and the desktop fan, I imagine the rest of my life without ejaculating, she pulls the covers over her naked body and says something that doesn’t overcome my shell shock, my penis goes from hard to soft in less than three seconds and she just stares at it while it does, which to her must be a flaccid middle finger to her self-esteem. “I’m sorry,” I say after debating on whether or not to add “it’s not your fault” and deciding it was an assumptive addition, noting the irony of the name antidepressant in my impending future of sexual obsolescence, I was never as depressed as I will be, she says something else and I continue to stare at the wall and again say “I’m sorry” and remember reading The Sun Also Rises and our teacher explaining “impotence” and Kevin laughing and saying “What a loser,” fuck you Kevin, I’ll have to pursue a life of quiet solitude, she sits on the edge of my bed and puts her shirt on, how terrible I think it must be for her, too, because when I dive down this path of the Zen Eunuch and everyone else starts noticing and talking about it behind my back, she’ll be the only one who thinks she knows why, and worse yet she’ll feel responsible, my god, two lives ruined by the lack of ejaculation—that’s also ironic, on the other hand I’ll be able to redirect my focus without the intrusion of sexual impulses, she puts her pants on and collects her things, I’ll be a painter I think, but I can’t paint any nudes or women because people will start asking questions, why is it their business anyway? I’ll only paint landscapes, she’s fully clothed with crossed arms, she says something I can’t hear and I keep my eyes on the wall, the door closes and again I say “I’m sorry.”
On day three of discontinued use I successfully ejaculated and called her back.