In February of this year, I was prescribed 50mg of sertraline for severe anxiety that I have had for over a decade of my life, beginning in my early teens. I watched my GP create the prescription, attaching it to my medical records on the computer. He handed over the peach slip, and just like that, after a telephone consultation in the morning followed by said GP appointment, I was finally receiving specific treatment for my anxiety. I felt an immediate sense of relief, yet a heavy weight on my shoulders remained. I had a torrent of questions running through my head. I had never been on any anti-depressants, or any medication for my mental health. Would my anxiety go away completely? Having lived with it so long, it has become an integral part of my identity, what would I be like without it? Would I become numb? Would I become some super-version of myself?
I’ve been on sertraline for 6 months now. Not much has changed. My anxiety is still there. It didn’t go away. I remain to get anxiety attacks. Dissociative experiences are still present at the end of my attacks, or any feelings of anxiety. I still get nauseous. But it’s not as bad. Sertraline does not take away your anxiety, but it does take ‘the edge‘ off. That’s why you need to undertake therapy alongside medication, because medication alone may not take away the mental health difficulty entirely. After all, many mental health difficulties and diagnoses are the result of something happening to you. My anxiety comes after years of trauma, emotional abuse from a previous relationship, bullying from an old flatmate, and several other things. A lot of this is still to be worked on when I attend therapy, which I am currently seeking out.
However, this post is about my experience on the mental health medication, sertraline.
Sertraline is an SSRI: a selective serotonin reuptake inhibitor. Serotonin is the ‘feel good’ hormone. It’s the hormone that essentially is the positive influence on your sleep, mood and emotion, which is why people who have depression, anxiety, OCD, etc., experience irregularities in their mood, their sleep patterns, and their emotion. We sleep too little or too much. We experience intense sadness. Motivation can disappear out the window. Everything we do becomes magnified and catastrophised. Regarding the serotonin that exists in my brain, it doesn’t get processed properly. A ‘normal’ brain would produce serotonin, do its job by passing on a message such as “get a decent amount of sleep” or “you are happy here in this current situation and should be”, and then it is reabsorbed in a process called ‘reuptake’ back into the brain. My brain doesn’t have enough serotonin in the first place so there isn’t enough to carry messages and what gets reabsorbed is very scarce already.
When someone like me takes an SSRI, the serotonin that gets ready to be reabsorbed is ‘inhibited’ or in other words, it’s blocked from going any further. So, it’s basically locked out and it’s given the chance to build up its forces, and then get a chance to carry these messages that it couldn’t beforehand. It takes me back to a baseline, and gets me back to normal.
A lot of people may think that medication like SSRIs, namely sertraline, are ‘happy pills’ and they take away our poor mental health. However, this isn’t the case. As I mentioned, it assists us in getting to the same level as the rest of the public. Then, that’s when the psychological therapies such as cognitive behavioural therapy comes into play.
I was prescribed a low dosage of sertraline, which is a common practice, as GPs need to understand how your body interacts with the medication. It is better to start low and go up than it is to let your body try to adjust to a high dose. Because, let me tell you: sertraline is not fun to adapt to.
I began my course for that month the next day, as I had a driving lesson on the day it was prescribed and I didn’t want to experience any side effects during a lesson. Thank goodness I didn’t in retrospect, because that first day on sertraline was an experience.
I woke up as normal, took the first dose, and then got on with my day at work. I ate my porridge, and felt nothing as of yet. I got on the train. Nothing. Made my way to my first house. Nothing. Got on the bus to the office for my team meeting. Nothing. I don’t know what I was quite looking for. My GP had said to me that I didn’t know what it was like to not be anxious, when I told him I’ve struggled with the anxiety for years upon years. Therefore, you could say that I didn’t know what I could be like without anxiety.
It wasn’t until my team meeting started that it hit me. And, oh my God, did it hit me. It felt like someone had poured ten cups of coffee and a bag of sherbet sugar down my throat and then injected more into my veins. I felt high. I probably was high. I was buzzed. My whole body shook so much so that I felt unwell. My hands, which already had a shake to them, were going mad. I felt like I was having an out-of-body experience. I was over excitable. And I spoke at an incredible pace. I interrupted people, and had something to say to everything. I was also very loud.
This was fantastic for my anxiety. Especially an anxiety which is particularly triggered by social interactions and thinking I am a loud, annoying and rude person. The anxious part of my brain screamed at this sudden new burst of sertraline-induced energy to just shut up and stop being annoying.
Meeting over. I got on the bus to my next person. Cue one of the biggest anxiety attacks I’ve ever taken. My head drowned with worries that everyone thought I was disrespectful, horrible, rude, and mean. I’ve taken some pretty bad anxiety attacks in my time, but this was one of a kind. I could feel it in my entire being. I remember thinking there is just no way I can cope on this medication. Maybe I’m untreatable. Maybe my body and my mind is going literally insane! Maybe I’m better with anxiety, because I don’t like this version of me.
Eventually, that feeling began to dull as the day went on. But I was still unfocused, feeling shaky, and didn’t feel like I was in my own body. It would ebb and flow. I was exhausted when I got home and couldn’t train on the track as I felt strange, so I had a small meal, and lay down upstairs until I was ready to go to bed.
This intensely shaky, out of body experience continued for two or three weeks. I could sense when the sertraline was about to hit. A few hours after taking the medication, I was buzzed. I’ve never taken a drug in my life, but I’m sure that’s what it feels like to be on cocaine. It’s no lie that I didn’t feel entirely like myself for a good while. My appetite disappeared throughout the day. I was able to eat my breakfast, but when the sertraline really took effect I couldn’t eat my midmorning snack or my lunch, but come dinner I wolfed it down. I really had to force myself to eat my lunch, as without food I then felt dizzy. Caffeine was absolutely hellish, which was frustrating as I love a Greggs cappuccino. Oh, and every time I yawned, my whole body buzzed and shook and shivered like I had a strange fever or I was trying to burst out my own skin. Which I wouldn’t have minded so much if it wasn’t for the fact I couldn’t stop yawning. I literally had to prepare myself for the oncoming intense sensation about to course through my body when I could feel a yawn coming on.
Once I started experiencing side effects, I messaged a relative, as I knew they had experience of anti-depressants. They were on a separate one to what I was prescribed. However, they confirmed that what I was experiencing was normal. They even related to the strange yawning sensation and the unfortunate continuous need to yawn. This is thought to be rare, but has been seen across many other SSRIs such as fluoxetine and citalopram. So, I made a joke out of it later on an Instagram story, and I had a slew of messages from people I knew saying they had the same experiences, and affirming that it would take a few days, maybe even a few weeks for your body to adjust.
That felt comforting. I didn’t feel alone, and I didn’t feel like I was about to die on this medication. I felt normal.
It’s important to know that taking an anti-depressant, or even any other medication intended for mental health, is a big adjustment to your body. My brain has been struggling to produce enough serotonin for many years, and then all of a sudden I’m ingesting something that aims to stop my body depleting my resources of serotonin and causing more of it to stick around in my brain chemistry instead of being reabsorbed. That’s a big thing for a brain like mine to get used to. Eventually, your body as a whole gets used to it, and stops going into a state of freaking out after a few weeks. Trust me.
The first few weeks on a medication like sertraline are horrible, and it really shows you how powerful the medication is. If you require a higher dosage, your body may experience a similar reaction, but it does pass. Then your body will begin to make a climb up towards the baseline you should be at to carry out a healthy lifestyle. My anxiety is certainly not gone, by any stretch of the imagination. And I still experience a strange dizzy sensation that I describe as someone grabbing my head and swinging it like a conquer on a string. Others have described it as a brain wiggle. I still leave conversations thinking I’m annoying and blame myself for a lot of stuff and worry over every little interaction. But it’s less so. I think I’m more confident. Or maybe I’m more relaxed. I’m able to go to sleep at a good time now and often can’t stay up late. Sure, I sometimes experience brain fog and still sleep in late when I can. I have heard people experience a numbness, which I haven’t experienced myself. Generally, I feel the same but better. I am still me. Something I didn’t want to truly lose.
The rest will be supported through therapy. Your medication will not erase any trauma, or the triggers behind your mental health. It won’t completely stop your reaction and your coping mechanisms. It settles you down and offers you a helping hand. It can control some of your worst symptoms, and it can help to improve some of your body’s attempts to decrease your physical health.
For all I know, I may need adjustments on my medication. I could go up, I could go down, I could change the type of anti-depressant, I could come off them altogether. But I feel safer on them. I feel somewhat happier in myself.
Medication is not something to be sneered at. It’s not something to call someone weak over. Trust me, try a couple weeks on sertraline and you’ll realise it takes some perseverance and toughness to be on it.
This is my experience on the anti-depressant sertraline. It is not an attempt to scare you off taking any type of anti-depressant, but rather an attempt to normalise the initial physical and psychological reactions you may have in your first weeks in adjusting to it. There are many different types of anti-depressants and other types of mental health medications like anti-psychotics. Each person is different and not every experience may be the same whether they are on the same medication as me or not.