Lexapro (Final?) Update

So, I’ve stopped taking the Lexapro, and I don’t think I’m going to be trying another anxiety medication anytime soon.

I’m going to walk y’all through my experience and reasoning, in case it’s helpful, but I want to preface this by saying I don’t actually have a diagnosis of an anxiety disorder (I *do* have a diagnosis from a psychiatrist for ADD), and I absolutely support people taking anxiety meds if they are helpful to them.

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1) I started the Lexapro because I was feeling really stressed, and Kevin thought I might be dealing with anxiety. I just talked to my regular doctor about it, rather than visiting a psychiatrist (mostly because it was easier and a lot cheaper). She was perfectly willing to have me try an anti-anxiety med, and recommended Lexapro.

2) I do not mean to dismiss her competence in any way, BUT if I could go back in time, I think I would start with a psychiatrist rather than a general physician. Once I got on a good regimen with a psychiatrist, I think my general physician would be perfectly capable of supervising it on an ongoing basis, but these meds are COMPLICATED.

3) Given all that, we’d talked to Kavi’s doctor about starting her on anxiety meds — she was dealing with a LOT of anxiety the first two months of high school — but have decided that we’d rather take her to a psychiatrist first for a full evaluation and then go from there.

[Side note: I asked Kavi before writing this, and she’s fully supportive of my writing about her mental health stuff here. Kavi doesn’t understand why I’d even hesitate — to her, it seems obvious that we need to be able to talk about this kind of thing in public. Kudos to our schools and the general culture here for fostering that attitude. The kids are all right.]

4) In particular, we’re hesitating to start her on anxiety meds because we think Kavi probably has undiagnosed ADD (we had her evaluated for it a few years ago, and she didn’t ping sufficienty for a diagnosis, but I think it might play out differently now, especially since there’s been growing understanding about how differently ADD presents in girls than boys). It may be that addressing the ADD (with therapy, executive function training, and/or meds) may alleviate her stress enough that she no longer is experiencing much anxiety. It seems to make sense to look at that first, or at least simultaneously, and that it’d be best to do so with a psychiatrist trained thoroughly in these areas, and in brain medication management.

5) Going back to me — I initially was on 10 mg of Lexapro, and kind of hated it. But I’m still glad I did it, oddly enough. It made me feel very calm, and the good part about that experience is that it reminded me of how I felt in my 20s, when I didn’t have much in the way of ambition, had a generally sanguine temperament, and was happy to go with the flow most of the time. I would sometimes be situationally stressed out (relationship problems, job/money problems), but my baseline was relaxed and happy. Lexapro took me back to that feeling, which was fascinating. I was much more patient with my family and friends, much less likely to be irritated by them.

6) The downside of that dosage for me was that I felt sedated, smothered, and generally tired. It was very hard for me to get off the couch to do much of anything. I moved slowly through my days that month, and while it was a relief not to feel stressed out (all the tension dropped out of my shoulders and back, so I didn’t need Kevin to rub them at the end of each day, and I didn’t feel like I needed a bath to wind down), I was distressed by how little I was getting done — sort of the bare minimum for the start of the semester. No writing, and no exercise — I just couldn’t seem to motivate to do either. (That dosage also pretty much killed my sex drive — I could still have and enjoy sex, and still orgasm, but had absolutely no impulse to initiate it. Very weird for me.)

7) I also gained a little weight that month. Not a lot — maybe 2 pounds. And this is not a necessary consequence of Lexapro — some people gain weight, some lose weight, some do neither. This is a good basic explanation:

“A person may gain some weight when taking Lexapro. This can happen for different reasons. Lexapro boosts serotonin, which plays a role in controlling weight. The medication may increase appetite directly, or a person may begin to eat more as their depression or anxiety lessens.

Weight loss is a less common side effect, but it can happen as the body adjusts to the medication. Some people may also find that they have more energy or more desire to exercise as the medication relieves their depression. This symptom relief could also put a stop to unhealthy patterns of behavior, such as binge eating, which could lead to some weight loss.”

https://www.medicalnewstoday.com/articles/322444…

8. I actually think what happened with me was that my eating habits stayed mostly the same (I keep a pretty close eye on that), but that dropping all the exercise led to a little weight gain. Which they don’t actually address in the article, interestingly, but I do think that’s what was happening with me.

9) The second month, I asked my doc if I could cut the dosage in half, and she agreed. I switched to 5 mg (and I should note that I took the Lexapro a little before bed, because taking in the morning made me too sleepy during the day). Definitely better balance, from my point of view — a little tension returned to my shoulders, but not too much; I still felt pretty calm. But it was also still harder than normal to motivate to exercise, write, or have sex.

10) At the end of the second month, I talked all this over with my doc, and she suggested trying switching to Welbutrin. I agreed, but after coming home and thinking about it for a few days (and starting to wean off the Lexapro), I decided against that, at least for now.

Okay, that’s the summary so far.

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Where I am now is that:

a) Although it helped some, I don’t like most of the effects Lexapro had on my brain / body.

b) My overall anxiety levels are actually not that high.

c) I feel physically and mentally better when I manage my mild anxiety with exercise, massages, long, hot baths, reducing my work commitments, scheduling fewer work meetings, slowing down my ambitious plans, reading more books, spending more time gardening, cooking and eating healthy food, regular meditation, snuggling with my loved ones, taking time for meals and chat with friends, taking vacations, etc.

I want to be more intentional about that last step going forward. I’m not sure what to call it all bundled together — ‘healthy lifestyle’ sounds sort of cheesy. But I don’t have anything better right now, so I guess we’ll go with it.

For me, right now, a healthy lifestyle just feels better in my body overall than Lexapro did. By kind of a lot. (Kind of the difference between calm and actively happy?) So it seems like trying to turn more healthy lifestyle practices into habits is a better long-term solution for me than anxiety medication.

I’m glad I tried the meds, though, as it was an enlightening experience; I learned a lot. (Apparently I make a good lab rat.)

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BIG CAVEAT: I’ll take an occasional Valium if I’m anticipating a spike of situational anxiety — it really helped me get through some painful procedures during cancer treatment, when I’d developed something of a needle phobia by the end of the process. (So many needle sticks.)

AND if it feels like I’m not in a space where I can motivate to do the healthy lifestyle stuff, OR when that feels insufficient even when I am regularly doing it, I’m definitely going to call up a doc and say, hey, I think I need to try anxiety meds again. (Although as I said up top, I’d start with a psychiatrist next time around.)

ALSO, I want to reiterate that I was only a little anxious. I wasn’t deep in a pit of depression or anxiety, so it should be relatively easy for me to work on building better habits. NO ONE should take this post as me saying that just because I’m doing this, means I’m saying you shouldn’t take your meds.

TAKE THE MEDS if they help you, please. Sometimes the meds can pull you up to a place of being able to build healthy habits, and sometimes the meds are just exactly what your brain needs. I adore my ADD meds. (I take Vyvanse daily, and I probably couldn’t have written this post nearly so coherently without it.)

FINALLY, I want to note that both meds access and practicing healthy habits can both be very much affected by money access. Having time to exercise, or rest, or cook. Having money to buy quality food ingredients. Paying for doctor access and meds. Etc.

I’m currently in a place where we have enough money on hand to help with either path (though I can’t actually afford daily professional massages, which would be so splendid). If you aren’t in that financial place, all my sympathies, and I hope you have friends, family, and community who can afford to support you until you do have financial access.

If you’re reading this and you’re in Oak Park with me, let me point you to NAMI, a great organization that offers a lot of varied supports for mental health: https://namimetsub.org

We also have Thrive and SmartLove Family Services locally, if you’re looking for more resources.

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That’s all I have for now, folks. Hope it was helpful.

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