In the spring of 2022, after seven years off psychiatric medications, I once again found myself staring at a little orange bottle filled with escitalopram, the generic form of Lexapro, one of the most prescribed medicines in the country. I was 43, the mother of two children under five, and, over the previous few years, a low-grade depression had settled over me like a fog, obscuring the beauty all around me. Maybe it was the hormonal chaos of perimenopause, which had snuck up on me, or the exhaustion of juggling small children, a career, and a husband who was traveling weekly for work. Maybe it was my DNA betraying me: my mother's depression had swallowed her whole in her forties; at 50, she died by suicide. Whatever it was, I was desperate for something that might return me to a more positive, less anxious version of myself.
I was wary of psychiatric medications. In the mid-2010s, it had taken me two hard years to get off Zoloft and Klonopin, prescribed to me in my twenties for depression and anxiety. I tried all the things: breathwork, sound healing, and consulting with an integrative psychiatrist to identify any underlying nutritional deficiencies that might be causing my unease, of which there were none. I abstained from alcohol, exercised nearly every day, and spoke to a therapist twice a month. When all that failed, I popped 10 milligrams of Lexapro in April 2022 and hoped for some sunshine to pour in.
The same week I started Lexapro, two friends told me that they too had recently started the medication. This was no coincidence. More women than ever are on antidepressants, over 20 percent of us, according to the CDC. For many years, therapists, doctors, and Big Pharma have told us that depression is caused by a chemical imbalance, primarily of the neurotransmitter serotonin—a theory that many psychiatrists dismissed long ago as simplistic, but one that some 80 percent of the general public still believes. However, recent studies have called into question the chemical imbalance theory of depression, and in turn the safety and efficacy of antidepressants, leaving many of us wondering where to turn for relief.
Yet while more of us are medicated than ever, rates of depression, anxiety, and suicide have surged over the last 20 years. "There are only two possibilities," says neuroscientist Thomas Insel, former director of the National Institute for Mental Health. "Either the treatments don't work, or whatever's driving those results is getting worse at a much higher rate than the treatments are going up. I think it's a bit of both."
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