This is a transcript of an IGTV video posted to my Instagram account on 13th March 2021. The video itself was recorded on 10th March 2021.
Disclaimer #1: This is not eloquently written at all because it is literally a (very lightly edited) transcription of my speech. Apologies for any headaches the colloquialisms & tense inconsistencies may cause a reader.
Disclaimer #2: My (admittedly politically-incorrect) use of the word “normal” is meant to signify, “not mentally ill” and nothing more. Again, apologies for any offense caused, no harm intended.
Hello, hello! It is your girl Akotz, also known as The Spider Kid, coming to you live from my bedroom in Accra.
A few days ago, I asked via Instagram Stories if people would be interested in a video about my journey with medication, and the answer was a unanimous yes. So, this is that video. I am going to be talking about my journey with medication.
Just to start, here is a brief timeline:
My depression started in 2012. That is as early as I can remember the onset. I did not go on antidepressants until 2019, and this year, 2021, is when I started coming off the medication. As of right now, I’m less than a week free entirely of medication and I haven’t been doing too badly, so that’s a good sign.
Why is there such a long gap between when my depression started (2012), and when I got on medication (2019)? It’s because I resisted medication for a really long time. I didn’t like the idea of something messing with my brain chemistry. Because I felt like if I put strange chemicals in my body that changed the way my brain would work, then it would change me as a person. I didn’t want to not be myself in any way.
Here’s the irony: I didn’t want to change my brain chemistry because I didn’t want to become unrecognizable to myself. But without medication, my depression worsened, and I did eventually end up becoming unrecognizable to myself. Long story short, I am really glad I got on board with the medication thing, because frankly, it’s possible that without the medication, I wouldn’t even be here today. When I tell you my depression was severe, I’m not lying. Just believe me. I’m not lying.
What Changed My Mind?
Hhow did we go from “I don’t want to change my brain chemistry” to “Okay, I’ll do the medication thing”? Well, I had a massive breakdown in the latter part of 2018. At that time, I was studying abroad in Cape Town, South Africa. After my massive breakdown, I basically told my parents, “If you make me go back to school for the next semester, I am going to kill myself. No bend, no curve. Like, it’s just… I’m not going to come back alive.”
So, my parents agreed to let me take the semester off. I’ve written about how I felt about that in a blog post called “Terror + Taking A Semester Off.” And the idea was that being home would make me feel better, and I wouldn’t have the demands of school upon me, and I would get or behave healthier.
But that wasn’t happening. I wasn’t getting better, and a month or two into my semester off, it got so bad that I would go to sleep crying, I would wake up crying, and I would go to my mummy’s room and be like, “Mummy, I don’t want to live anymore, I don’t want to do it anymore.”
I think my mother was really scared for me. She has been scared for me for a long time. But she decided at this point that, “You know what? My daughter needs help, I don’t feel that I have the capacity to give that help, let me get her professional help.”
So she contacted this therapist who eventually ended up seeing me for the remainder of my time in Ghana during my semester off. And I was lucky enough to get a therapist who treated me for free. It’s her way of giving back to the community, according to her, and I really appreciate her for that. But she was immensely helpful.
Honestly, this was not my first therapy attempt. (That’s an aside.) And not even my first therapy attempt with this woman. I had tried her before, although not very regularly. I’d seen a number of other people as well, but none of it ever seemed to work for me. So, at this point, me, I didn’t really believe in the ability of therapy to help me. I think the only reason that I agreed to my mother’s recommendation was because, well, I felt like I had nothing to lose at that point. It was like, “Well, if nothing is going to help me, it doesn’t make a difference whether I do it or not, does it?” So I was like, “Okay, I’ll go and see the therapist… again.”
So I did.
Now my therapist treated me with Cognitive Behavioral Therapy. But she insisted on this two-pronged approach. So there’s the behavioral side of things, and there’s the brain chemistry side of things. She directed me to a psychiatrist that she partners with, and it is that psychiatrist who diagnosed me once more with severe depression, mild anxiety and basically determined that my case was severe enough to warrant medication.
Note: Medication is NOT compulsory!
I just want to add that medication is not compulsory for any depressed person. Unless your diagnosis determines a need for medication, you will not have to be put on medication. That’s one of those things I want to throw out there.
See a psychiatrist! If they tell you that you need medication, you might want to go with it. I wouldn’t recommend going on any medication if you have not been expressly told to by a medical professional.
Therapist/Psychiatrist Meeting Rhythms
I was seeing my therapist biweekly, I was seeing my psychiatrist biweekly.
For two years, 20mg of Fluoxetine daily was my dosage. I was taking the medication, I was going to therapy biweekly. When I started improving—and I did start improving—my psychiatrist meetings ended up becoming more sparse. It was like, instead of every two weeks, it was every one month and so on.
Note: Your Medication Depends on Your Diagnosis!
Another thing that I want to add is, the medication that you are put on is also dependent on your diagnosis and the way your mental illness is manifesting. For me, my illness was manifesting in the form of low energy, perpetual tiredness, oversleeping… There was this constant lethargy, like I feel like I couldn’t be awake. My brain was not alert. And that was the reason my psychiatrist deemed Prozac to be the right medication for me. Because according to him—I’m just quoting him here—Fluoxetine has a component of alertness. So that was supposed to counter all the lethargy that was coming about as a result of my mental condition.
The 2-Week Delay in Effects
So, here’s what happened: When I was being put on the medication in the first place, I was informed that it’s common for antidepressants to take up to two weeks to actually start doing what they’re supposed to do, which is anti-depressing you. What I mean is that, you will be taking the Prozac every day, but for two weeks, you might not see a change in your moods. It doesn’t mean it’s not working. It’s just a delayed release, your body getting used to the medication, and so on and so forth.
However, medications have side effects. The side effects vary from person to person depending on how your body receives things, and even though the actual anti-depressing can take two weeks to start working, the side effects can start immediately. Changes in appetite, changes in sleep—which could both lead to weight gain or weight loss—mood swings, stuff like that… All these side effects. They can start immediately, even if you don’t start feeling better.
I was there taking the Prozac for two weeks daily. I took it every night. And the reason I was required to take it in the night was because of the things I just mentioned: the lethargy, the oversleeping, and so on. Because Prozac had an element of alertness, it was supposed to be helping me to be less tired and sleep less. I took it closer to my sleeping time so that, you know, I could hopefully sleep for like 8 hours—you know, a normal amount of time—instead of like, thirteen, which is the kind of thing that I was doing quite regularly.
When I first started on the medication, I was as bad as ever. Things were going exactly as they had always gone. I still felt like there was a weight in my chest, that the world was dark, that I was sinking in a pit…
And then the miracle happened.
Rapid Improvement After Delay Period
The miracle happened in the third week, as was predicted. My goodness. I could not believe the change in myself. I became normal. And when I tell you that I had been depressed since 2012—I didn’t know what normal felt like. It had been years—like, seven years—of not knowing how to function like a normal person, and suddenly, I felt normal.
Let me tell you something. I have had chronic headaches for pretty much my whole life. As soon as I reached adolescence, these headaches started. And they would be triggered by different things. Sometimes, it would be staring at a screen for too long, because I have photosensitive eyes. Could be staying awake for too long. Could be PMS. Basically, anything and everything that could possibly give me a headache gave me a headache. It was the sort of thing that could incapacitate me for days. As in, like, an entire weekend, you’ll not see me because I’m stuck in my bed, because my head dey bash.
So I had all these problems with watching TV or watching movies or what not, because I know that if I spend too long looking at the screen, I am going to have a massive headache. But I started watching a TV series—multiple TV series, actually—and I would binge-watch them. Let me tell you, binge-watching is not something I can, or I could, comfortably do, because of the whole headache business. Like, unless I want to be incapacitated for a week, binge-watching anything is a terrible idea.
But I started watching TV—five or six, seven episodes a day, which was unheard-of for me, and I felt absolutely fine! For seven years, it was rare for me to even go three days without a headache. And here I was, counting the days like “Eighteen, nineteen, twenty, twenty-one…” I was like, “This is not possible. This cannot… How… How is this happening? How am I functioning like a normal human being?” I was so happy. Herh. Is this how the rest of the word lives?
Because my brain was now getting accustomed to this new thing that had been introduced to its chemistry, the effects were very, very strong, very noticeable, very strange to me. That’s what happens when your body is introduced to something new. It’s like a shot of adrenaline kind of thing.
Good Effects + Bad Effects
I began to even out in the coming weeks. I started to feel less superhuman and more human. I was able to recover a lot of my energy in the coming days and the coming weeks.
And then I stopped being able to sleep.
Basically, the Prozac was doing too good of a job at combating my depression lethargy. At my meeting with my psychiatrist, I mentioned the changes I was going through. He instructed me to stop taking it in the night, start taking it in the mornings instead. So I wake up, and hopefully, the alertness lasts me through the day and then I’m able to sleep normally at night. And that is exactly what happened.
I started becoming more stable, more functional, more normal…
Self-Rediscovery + Mourning Lost Time
It felt like I was re-discovering myself. It felt like I had been the wrong version of myself for the last seven years and I was only now starting to discover who I was. Because the last time I felt like I knew myself, I was a child. So it was a kind of bittersweet thing. It was like, “Oh my God, thank God I’m finally normal” and also like, “I’ve never been a normal teenager. That is tragic.” That’s time I will never get back. Sometimes, I still regret that I was depressed my entire teenage life, because nobody wants to waste all those years, you know?
Regular Life & Regular Depression
Once I became stable, my therapist and my psychiatrist declared me fit to return to academia. I went back to school, and I was meant to continue on the Fluoxetine daily, every morning, until at least graduation. So that would be two full years of medication. And that’s what I did. From 2019 to 2021, from February to February, I have been on Fluoxetine daily.
Something happened that drove me back into a terrible depression, and that thing was the slow, agonizing process of breaking up with my best friend of four years. But at the very least, that depression had an identifiable trigger. It wasn’t like, “Oh, nothing has happened, and I’m sad.” You know, it was more logical.
Aside the whole best friend thing, there was also a lot of drama happening with my family. You could say it had been going on my whole life, but it worsened significantly the semester I was off from school.
I kind of dreaded coming home, for one because I felt like my whole social circle had shattered because of my separation from my best friend. And also, I didn’t want to come home because I didn’t like the state of my family. I felt like it was going to be oppressive, unhealthy, and toxic… In the end, I only had to worry about one of those two things, and that thing was my family, because it really was bad… Ahaha.
And then, there was a pandemic. Hm-hmm.
The pandemic affected my mental health the way I assume it affected a lot of people’s mental health. The idea of uncertainty, being kept in all the time, separation from your loved ones, the lack of physical intimacy, all of those things, you know. They were taking a toll on me.
But then I started to get significantly worse, even though I was still on the medication. So about seven months into the pandemic, it felt like I was getting close to losing it again. It was that sort of thing where I’ll just be there, then I’ll start crying, and I don’t understand why I’m sad, that sort of thing.
I was stranded/quarantined/being generously housed in my family friends’ home in Maryland. (Shout-out to the Amate’s!) My uncle thought that it might be homesickness. I don’t know if it was, but I did know that being at home had worked to restore my mental health before.
Once Kotoka opened its borders back to travelers, I was able to return home. And then I felt better, and then I graduated, finally!
One day I will talk about the stress and what a miracle it is that I actually graduated at last, because it’s not a trivial thing. If you know me, if you know anything about me, the fact that I graduated from college is not trivial at all. But that’s for another day!
Fear of Life Without Medication
I graduated. And, having achieved what I was meant to achieve on the medication, it was now time to reach out to my psychiatrist and be like, “Hello! Yeah! I’m done—what do we do next?”
But then, fear set in, and I procrastinated reaching out to my psychiatrist for at least a month. Because I was like, “Okay, I feel okay. I graduated. But I’ve been feeling okay because I’m on medication, right? So if I go off the medication, I’ll probably return to the depressed state, right? So maybe I shouldn’t go off the medication. Maybe I should just stay on it forever. Ooh!”
Of course, I didn’t like this train of thought either. Because I never want to be dependent on anything—not even if that thing is “good for me.” I don’t want to be dependent on medication, but it didn’t change the fact that I was terrified of what might happen if or when I got off it.
I procrastinated reaching out to my psychiatrist, but my mother kept being on my case. Up until this point, she had been the one collecting my prescriptions from my psychiatrist because I was in the abroad. She would collect my prescription and fulfill it, and then send it with whichever family member is coming to America. (When the pandemic set in, she sent my medication through FedEx.)
Weaning Off + Withdrawal
I finally reached out to my psychiatrist in January. And then, throughout February, I began the process of weaning myself off the Fluoxetine. I switched from daily to alternating days. So, every other day, I would take the medication.
The most obvious side effect of the Fluoxetine for me has been the changes in my sleep. There have been times where I have missed a dose by accident, either because I had missed a dose, or I had run out and hadn’t received my replacement. But, whenever that sort of thing happened, it was my sleep that was first to go haywire.
What happened when I started weaning myself off the Fluoxetine is that my sleep, energy, and mood levels went all over the place. The lethargy started coming back full force. Once, I slept for like, thirteen hours. Another time, like eleven? Twelve?
I started working out less, you know… Sleeping ridiculous amounts. And I would have these mood swings. Like, I’d be super exhausted, and I wouldn’t sleep, but two hours later, then I’m suddenly full of energy, and then not too long after that, I’m back to the exhaustion state.
I’ve generally been sadder than usual… I’ll just be sitting there, then I’ll start crying. This happened at least three times during the month that I was doing alternating.
Here’s something that I noticed about the alternating days. I felt better on the days when I didn’t take the Fluoxetine. I think the reason for this is that the Fluoxetine has a slow release. When I take it, it doesn’t work until the next day; I would be happier or more energetic on the days that I didn’t take the medication, rather than the days that I did.
Since last month, which is when I started weaning myself off the medication, there have been a few tragic events in my life, in my family. And that has contributed to a lot of sadness in my whole demeanor. But to a large extent, that sadness is rational, because, you know, there have been sad things happening.
Warning: Going Off Meds Can Be Initially Tough!
My psychiatrist in agreement with myself [decided] that we will try to see what I am like when off the medication entirely. So, last week was my last meeting with my psychiatrist. Since Sunday, I have not taken any Fluoxetine, and I seem to be doing well.
Once again, there was a warning that for the first two weeks or so that I go off the fluoxetine completely, it might be rough. Like, I might experience a serious downhill turn and it might be frightening, but I should be prepared for it. Hopefully, it should even out in the coming weeks and days.
Surprisingly, I haven’t had that low dip yet, and it’s been a few days. But I still feel okay. I still feel stable—thanks be to God.
But I still feel kind of scared that it is going to happen, that it might happen. And I won’t lie, I am still absolutely terrified that I will return to the unrecognizable version of myself, the depressed version of myself, whom, frankly, I never want to see again.
So Far So Great? 😊
But, so far, so good. And I am out here telling myself, trying to make myself believe what I think is true in this moment, that my God is bigger than my depression. I keep trying to tell myself that and banish the fear, because I don’t want to be afraid, much less of myself. I don’t want to be afraid of myself.
Yeah, to anyone who might be considering the whole medication thing, here’s my story. Hopefully, it helps you in some way. If it doesn’t… sorry?
Spider Kid out!