After spending my teenage years with a normal amount of acne, the real stuff hit in my early twenties. I had gone through years of countless topical treatments and oral medications before realizing none of it actually worked. My last resort was Accutane. So when I graduated college, I went straight to my dermatologist and told her I was ready to start the process, no matter the stakes. Which I didn’t realize the extent of until I started doing my research.
Hours into YouTube videos of other young women on Accutane, I started making an extensive list of everything they told me I would need to help with the side effects. This list ranged everywhere from eye drops to SPF 70 sunscreen to Excedrin Extra Strength.
One thing I was not told I needed? An up-to-date prescription for my anti-depressant.
I started taking Lexapro my junior year in college as an anti-anxiety medication. I moved to a different state for school and didn’t know anyone in my classes. I was so riddled by anxiety and panic attacks that I struggled making friends, participating in class, and going anywhere by myself. This had always been something I struggled with, but after wrestling it for two years in college, seeing a counselor and starting medication was my saving grace when it came to finally allowing the nerves to subside.
Everything – my counselor, my nurse, and my prescription — was done through my school. I truly felt safe and understood among my team. Not to mention it was all free. I knew graduating meant losing this team, and I got anxious every time I was faced with the fact that I didn’t have a doctor outside of school.
Nevertheless, I put my skin as my top priority instead of my mental health. I started Accutane a couple months after graduating. At that point, I still had plenty of Lexapro since my nurse had written a three month prescription to give me plenty of time to find a doctor before I ran out. I was able to dodge all of those claims that Accutane makes you depressed or maybe even suicidal. And then the fall season rolled around, and I used all my mental strength to make an appointment to see a doctor.
I quickly learned that this specific doctor was not for me. When I told her that I had been on 15 milligrams of Lexapro for about 2 years, she scoffed. She told me I was too young to be on that high of a dosage. She questioned my medical diagnosis without even asking me about past trauma. She unwillingly wrote a prescription for 10 milligrams of Lexapro and told me to come back in a month. I drove home in tears. It took everything in me to even go back to my follow-up appointment. The doctor was a little more approachable the second visit, but she was still hurtful enough that I decided to never see her again. I told myself I would find another doctor.
I pulled myself together and called an office that was recommended to me by a friend, but they told me that they weren’t accepting any new patients at the time. Instead of trying elsewhere, I told myself that I would rather run out of medication than go back to the first doctor. So I started weaning off of Lexapro. This should always be done with the help of a medical professional, but I thought I knew what I was doing.
Lexapro withdrawal symptoms include irritability, dizziness, headaches, nausea, and vomiting. There are more, but these are the ones I experienced the most. On top of these side effects, I was beginning to notice those infamous Accutane side effects – the ones involving depression and suicidal thoughts.
I’d experienced depression before. But this seemed different.
Never in my life had I been so sure that everything wasn’t going to be okay than during this time period. Hope had eluded me. My panic attacks were back. I didn’t sleep. I couldn’t concentrate. People told me that I would zone out when they were trying to talk to me. I was convinced that life should continue on without me.
Suicidal thoughts and suicidal ideations are very different. Ideation doesn’t necessarily mean that a person is in danger. It’s just contemplation on how one might commit suicide. For example, when I would take a bath, I would think about how I could drown myself right then and there and it would take the pain away. I thought about how I could run a red light, or smash my car into a tree. But I never almost did it, and I never necessarily wanted to follow through. Regardless, taking my own life was on my mind a lot more during this time than it had ever been. And I was constantly either crying or trying to disassociate using a distraction like Netflix.
I had heard stories of people who immediately stopped taking Accutane once they started experiencing these side effects. But as someone who is fairly familiar with depression and anxiety, it was hard for me to tell if these side effects were even related to Accutane. It could’ve been that I was off my antidepressants. It could’ve been that I was going through a rough patch. Most likely, it was a combination of all these.
I finally got a new therapist and a new prescription of Lexapro, right around the time I was done with Accutane. It wasn’t perfect timing, but I’m glad I got help when I did.
Everyone’s experience with Accutane is different. I don’t regret taking it for a second. It was quite the exhaustive journey full of ups and downs. But in the end, I’m happy with my skin, and I have a new therapist and psychiatrist that I love.
For those who have a history with mental illness, I highly recommend seeing a psychiatrist or doctor to discuss it before going on Accutane. Even just having someone to talk to during the 6-8 month time span that Accutane takes would be helpful. I don’t necessarily believe that everyone needs to be on antidepressants while taking Accutane, but having an outlet to discuss the shifts in emotions and feelings can help tremendously. Instead of a licensed professional, I spilled all of my thoughts into a journal when I was experiencing insomnia. Writing has always helped me, but I still wish I’d had someone real to talk to in addition.
Every medical professional knows that Accutane is a serious drug. It truly is meant as a last resort. While I wish I would’ve taken better care of myself while I was on it, I’m glad to have taken it. My skin is better, and my confidence has never been this high.
My advice: Remember first and foremost to take care of yourself (not only physically but mentally as well), and go in with expectations that it won’t be easy. But it could very well be worth it.
The National Suicide Prevention Lifeline is 1-800-273-8255. Other international suicide helplines can be found at befrienders.org. You can also text TALK to 741741 for 24/7, anonymous, free counseling from the Crisis Text Line. Apps like Headspace or other guided meditation apps can also help steer away negative thoughts and feelings.