The “Solution” Became a Problem

At age 19, I had been taking 10 mg of Prozac daily for approximately seven years, originally prescribed for “attention” and “impulsivity”—though, in hindsight, anxiety was probably the main character. I carry diagnoses of generalized anxiety disorder, treatment-resistant recurrent major depressive disorder, and PTSD. When my symptoms did not improve, my primary care provider increased my Prozac dose to 20 mg, and subsequently, a psychiatrist increased it further to 40 mg. Unfortunately, this was not the turning point we had hoped for.

Throughout most of my treatment, I was prescribed the maximum recommended doses of medications, including Prozac, Zoloft, Abilify, and others. Not surprisingly, the side effects arrived in full force.

My condition continued to deteriorate. After six sessions, my outpatient therapist terminated treatment due to the severity of my symptoms—never exactly a confidence booster. While awaiting placement in a residential program, I received care through a hospital outpatient team. During this time, psychiatrists added trazodone for sleep, tapered me off Prozac, and initiated Zoloft.

I later underwent evaluation through Amen Clinics, including brain imaging and psychiatric assessment, and was prescribed Trileptal as a mood stabilizer. Side effects became more pronounced—fatigue, weight gain, and a general sense that my brain and body were no longer on speaking terms. Zoloft caused an initial weight gain of about 10 pounds, and Trileptal caused significant sedation, making basic functioning feel like running a marathon with a backpack full of bricks.

Due to worsening suicidal ideation, I admitted myself to the emergency room and spent 19 days inpatient. Multiple sleep medications were trialed without success. I was prescribed 15 mg of Abilify, which initially improved my symptoms—but the improvement lasted only about a month.

At a subsequent residential program, I experienced ongoing mood instability, with brief periods of improvement followed by rapid emotional decline and exhaustion. We attempted to reduce Abilify by 5 mg, but this led to a return of suicidal ideation. Around this time, I also developed extreme and persistent hunger: I could eat a full meal and be starving 15 minutes later. Over six months, this contributed to a 40-pound weight gain, managed in part with Metformin—though apparently my body missed the memo.

I also experienced emotional blunting while taking Abilify and SSRIs. Sadness and anger were still allowed into my emotional “VIP section,” but happiness and excitement were turned away at the door. At one point, while on a combination of Abilify, Cymbalta, Buspar, and Lexapro, my depression became so severe that I would spend hours looping the same song on Spotify and staring at a wall. About a year prior, even while severely depressed and actively suicidal, I had maintained A’s in college and worked two jobs, so this represented a substantial decline in functioning.

Additional medication trials included Seroquel, which was discontinued after I experienced an eye hemorrhage. There was no other cause for this hemorrhage other than the initiation of Seroquel a few days prior, and my treatment team could not explain this temporal relationship. Cymbalta was later discontinued due to muscle cramps.

At age 20, I was admitted inpatient again for one week. The psychiatrist recommended lithium to address my suicidal thoughts, but after discussion with my mother and primary psychiatrist, we decided against it. During this hospitalization, I was instead started on Wellbutrin XL.

Shortly after, I developed a tremor in my dominant hand, which significantly impaired my ability to write and forced me to essentially relearn how to take notes.

Most recently, I completed a full round of transcranial magnetic stimulation (TMS), which did not result in improvement. My psychiatrist and I agree that my nervous system is essentially stuck in multiple trauma responses—though insurance coverage only allows a very narrow set of interventions. I sometimes feel like my nervous system has it's own stubborn personality—and insurance refuses to negotiate. Still, I feel fortunate to have a psychiatrist who listens, believes me, and works creatively within these limitations.

At present, I am taking Trintellix. Now at age 21, I experience significantly greater mental clarity. Medication likely contributed to stabilization, but therapy and behavioral strategies did the heavy lifting—developing purpose, engaging in activities even when it felt impossible, and actively evaluating and challenging my thoughts.

These experiences have had a profound impact on my life, including severe physical side effects (rapid weight gain, tremor), emotional blunting, persistent depression, and major disruptions to my education, daily functioning, and overall quality of life.

While I was informed that these medications could cause side effects, I was not adequately informed about the severity, functional impact, or potential extent of these risks. I was not made aware that antipsychotic medications could result in rapid and substantial weight gain, that neurological side effects such as tremor could significantly impair daily functioning, or that emotional blunting could meaningfully reduce the capacity to experience positive emotions. Additionally, the occurrence of an eye hemorrhage following Seroquel was entirely unexpected, had no other identifiable cause, and my providers were unable to explain it. Had I been fully informed about the potential magnitude and impact of these risks, I would have made different treatment decisions.

I want to note that I am not anti-psychiatric medication—I recognize that for some patients, these medications are essential. I genuinely do not think I would be alive if I hadn’t been prescribed them. However, my concern is that doctors should be more forthcoming about potential risks and, where possible, offer other interventions alongside medication. Transparency and a collaborative approach could help patients make informed choices and mitigate some of the severe consequences I experienced.