But side effects do become an issue, for example, when they are more debilitating than the original problem the drugs were prescribed—sometimes inappropriately—to treat.
Megan McCoy (not her real name), 34, who has four children under the age of 9 and works part-time, wrote on a post to 0prah.com that she had been on various antidepressants for the past two years. All of them made her numb and apathetic. "I felt like I was sleepwalking through my life. I had no drive of any kind."
After reminding her that I was only a journalist, not a mental health professional, I took a wild guess and suggested that rather than depression or the drugs, maybe the pressure of raising four young children while working was causing her problems. (To confuse the issue, chronic stress can wreak havoc with mental abilities, exposing the brain to relentlessly high levels of cortisol, a hormone that slowly impairs the hippocampus, which controls learning and memory).
"Not really," she said. "My kids are great. It's my husband. His primary care doctor put him on a stimulant for adult attention deficit disorder. And then a psychiatrist put him on antidepressants and antianxiety meds. When he comes home from work, he goes directly to bed. He used to do the yard, clean the garage, play with the kids. Now the man is barely functioning. The only decent time we have together is in the morning, when we have coffee.
"The reason I want to be off these drugs is so that I am not—ever—like him. But I feel I have to stay on something so I can stay above water and keep everyone happy." Her misery was palpable.
Becki Kurschinske, 20, also wrote in. The mother of an 18-month-old daughter, she had been taking one of the SNRIs. "I stopped doing the laundry and the cooking. My husband had a lot of trouble getting my attention. My mother often asked me what was wrong because I would sit on her couch, spaced out. I could stand in the middle of the living room for five minutes staring at the door, trying to remember if I did everything I needed to do to leave. I couldn't read a book for more than ten minutes before I realized that I'd stopped turning the pages."
As with Megan McCoy, Kurschinske first assumed that her problems were drug side effects. But when I phoned her, she told me that in the months that had elapsed since she posted on the Web, things had changed. A 120-mile round-trip commute to her job as an administrative assistant for Boeing had kept her away from home 12 hours a day for the first year of the baby's life. Her time with the child consisted of waking her up and putting her to bed, and then getting up to feed her in the middle of the night. The symptoms had abated when Kurschinske found a new part-time work arrangement. "I thought the drugs were making me feel so spacey," she says, "but now I think it was the way I was living my life."
Many of the people I talked to, it seemed, were medicating themselves to accept difficult situations they felt powerless to change—family problems, financial pressure. The drugs were supposed to buck them up and help them move on, but ironically the resulting low energy and lack of motivation worked against them.