I sat on the Metro North train headed north, gazing out the window at the platform of Harlem and 125th street. My mom and I were making our way back home from an appointment in NYC with a cognitive behavioral therapist, someone well-known for treating OCD when suddenly, I felt what I thought was a heart palpitation, but in my brain, a pulsing through my head that I had never felt before. I told my mom about it. We reported it to my psychiatrist and learned that it was something called a “brain zap,” a common side effect of the new SSRI that I’d been taking.
Earlier that year, I started taking SSRIs to manage my OCD. My father had died just a few years earlier, and I was having difficulty coping with the loss.
My parents were two very different people. My dad was a second-generation descendant of Ashkenazi Jews with roots in New York City who had become dentist. My mom was born and raised in Virginia and moved north after graduate school where she put down roots in New England. They met at a singles party, married, and settled in upstate New York. A year later, I was born.
My parents were happy for the first year or two of their marriage. But with each passing year, their marriage unraveled a little bit more. Arguments turned into fights and then into blowouts of verbal and physical abuse about things like money and my father’s job. Money was disappearing from bank accounts, and Mom didn’t know where it was going. Dad would come home from work later and later each night, saying that he was at the office finishing up his work. Sometimes I wondered if he’d come home at all.
In an attempt to fix things, my mom signed up for marriage counseling in town, in a practice just down the street from his office. But Dad was reluctant to participate. Each week, they just talked in circles but never got anywhere.
By the time I was ten years old, my parents were talking divorce. I shuddered when I first heard the word. It sent shockwaves through my little soul. My family was beginning to fall apart.
When I was twelve years old, my mom got an order of protection against my dad to have him removed from the home. He went across town to live with his brother in their family home. Two weeks later, he committed suicide.
Family and friends poured into town for the funeral. Three days later, we buried my dad. According to Jewish law, funerals are not usually done for someone who dies by suicide. There is no shiva, and Kaddish is not said. But the rabbi knew that my dad had been struggling with his mental health and felt that he should be honored with a full funeral. We had a funeral service at a local funeral home, then accompanied the casket up to a local cemetery, where he was buried next to his parents in the family plot.
That Sunday morning, as family packed up to leave, I sat on the couch thinking of all that had just transpired. As my aunt came down to give me a hug goodbye, I thought to myself, “This is too much to process right now. Trying to make sense of all of this would be like trying to fit too much sausage into a sausage casing. I need to put this away until a later time so that I can get back to school and get through school.” I made a silent vow within myself: I compartmentalized all of this away so that I could deal with it later.
The next fall, my classmates and I went across town to junior high. We were pooled in with hundreds of other kids whom we did not know from all over the school district. Junior high brought new challenges. Instead of hooks and cubbyholes, we had lockers and locker rooms. Instead of just a few teachers, we had eight class periods, and life was driven by the bell. Earlier school start times meant that instead of comfortably getting to school at 8:30 a.m., we’d have to catch a bus at 6:30 to get to school by 7:15. At a time when my body desperately wanted to sleep, I had to get up and slog my way to school. Getting out of bed felt brutal.
Peer pressure was high. Friendships changed, and some of the people whom I’d once called friends now pretended not to know me. I was constantly self-monitoring, knowing that the slightest social faux pas could cost me everything.
My inner world was dark and tormented. I started having intrusive thoughts of a violent and religious nature, angry thoughts of wanting to hurt others and wanting to curse God. We’d been seeing a group of family therapists for a while, but therapy proved to be ineffective for both me and my mom. I had difficulty trusting these therapists who didn’t seem to validate the gravity of our situation, and I struggled to put words to the thoughts and feelings inside. I longed for something to take my pain away. It was then that I began seeing a cognitive behavioral therapist in New York City, as well as a psychiatrist who started me on some SSRIs: Selective Serotonin Reuptake Inhibitors.
SSRIs work with the serotonin system. When electrical impulses travel along a nerve and reach the end of a nerve cell, they cross over the synapse to the next nerve cell by way of neurotransmitters like serotonin. Serotonin creates feelings of calm and relaxation and is then reabsorbed or taken back up into the nerve cell after it has transmitted the signal.
When doses are changed or decreased, it can cause a change in serotonin reuptake, almost like a short-circuiting of the nerve signal, thus causing a brain zap.
He started me on a medication called Luvox. After a few weeks, my first medication began to take effect. I felt a little bit calmer. It didn’t take away the intrusive thoughts, but it numbed them, muted them. It made my inner world a bit more manageable, like background noise. I was better able to compartmentalize everything away that was going on so that I could go about my day.
But after a few months, I noticed that the effects began to wear off. I didn’t feel as good as when I first started. My inner noise became too loud again.
“Let’s increase your dose,” said the psychiatrist.
Over the next year, he increased my dose a few times. When one medication lost its effectiveness, he switched me to another in the same class. By the end of high school, I’d been through Luvox, Fluvox, and Zoloft.
At one point, they tried me on a different drug: Anafranil. Unlike SSRIs, Anafranil was a Tricyclic antidepressant. It worked not just with Serotonin, but with Norepinephrine as well. It was also effective in dealing with OCD.
I took it and felt much better. Almost too much better. I felt euphoric, as if I felt no pain at all. It also made me sweat profusely. I worked up a sweat when I exercised and soaked through a whole leotard in dance class.
But I didn’t want to feel nothing, especially in such times as these. First, the death of my father, then the September 11th terrorist attacks, then our entrance into the War in Afghanistan. I couldn’t shut out all the pain; I just wanted something to take the edge off.
After a few months, I switched back to an SSRI again.
I wondered what these medications would do to my body in the long run. It seemed as if once I got onto a medication, I had to take more and more to get the desired effect. How much more medication would I have to take before I was pumped full of it? How would this affect my reproductive health? Would I ever have a relationship? Enjoy sex? Have a family? Would this worsen my condition down the road?
“What are the long-term effects of these drugs? Have long-term studies been done?” I asked the psychiatrist one day.
“No, there are no long-term studies on these medications,” he said blithely. “We simply just don’t know the long-term outcomes.”
Each day, I sat in school, holding my pain inside. In biology class, we learned about hormones, like adrenaline and cortisol, hormones that helped our bodies mediate stress. It was as though I could feel the cortisol pumping through my body with nowhere to go, eating away at me. My nerve endings felt frazzled and frayed, like a thread with frayed ends.
Numbing and suppressing my pain with SSRIs was the only way I knew to cope with grief and to manage my overwhelmed nervous system. It may have made life more manageable in the moment but only proved to be a bandaid over a festering wound. Sooner or later, I would need to learn to face my pain. It was the beginning of a long and painful journey with medication.
Lila Feldman (she/her) currently lives in Upstate NY and has worked in healthcare. She has written with Barbara Krasner and the Amherst Writers and Artists, as well as Marta Szabo of Authentic Writing. Thus far, she has been published in the Ekphrastic Review as well as The Real Life Writing Express. She also enjoys gardening and being outdoors.