“This drug saved my life. What do you say to that?”
I get this challenge a lot, and my answer surprises people: I believe you. If you are crippled by anxiety or depression and a drug turns the volume down on it, you become more functional, and it can genuinely feel life-saving. The suffering that leads people to these medications is real, and I never deny it.
But here’s what I’ve watched over and over in my practice: there is a life cycle to being on these drugs, and “it saved my life” is usually what the beginning sounds like.
First, understand what the drug is doing. There is no chemical imbalance being corrected. The low-serotonin story is a myth. An SSRI produces a drug effect that masks symptoms, and your body pushes back against it, because serotonin isn’t just mood. It runs your heart, your digestion, your immune system. So the body downregulates receptors and produces less serotonin naturally, and over time the effect wears off.
Then the stages appear. Stage one: it works, where has this been all my life. Stage two: I don’t even know what this drug is doing anymore. Stage three: fatigue, brain fog, no motivation, and a doctor calling it “treatment-resistant depression” when it may be the drug itself. Stage four: after twenty years, the brain has built itself around the medication, and coming off makes life fall apart.
So when someone says these drugs are life-saving, and someone else says they wrecked them, they can both be telling the truth. They’re just at different points on the same road. The question worth asking isn’t whether the drug helped you once. It’s where you are in the life cycle now.
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