I finished my 2nd step about the same time that my psychologist referred me to a psychiatrist to do a medication check. After the separation and divorce, Doctors prescribed Wellbutrin for me which changes patient’s moods by affecting our dopamine and norepinephrine. Wellbutrin is a unique medication as it does not fit nicely into other anti-depressant categories. While it is a second generation antidepressant, it does not address serotonin levels and so is unique in its field. There were several good reasons my psychiatric nurse practitioner prescribed it. I was obviously overweight, and Wellbutrin is an appetite suppressant as well as an anti-depressant, and it would help alleviate some of my ADHD symptoms as well.
The issue for me, however, was Wellbutrin is a sexual stimulant. As a sex addict trying to get clean, taking a sexual stimulant is probably not a good idea. It certainly wasn’t for me. When my counselor did extra reading on my case and discovered that Wellbutrin was a sexual stimulant, he was astounded that my nurse practitioner prescribed it for me and wanted to see if a psychiatrist would approach my case differently. As a lay person in the field of medications, he thought that eliminating the extra sexual stimulation, and perhaps even adding a sexual depressant could help me.
Though it is hard to find a psychiatrist who could fit me into their schedule; once I did, he agreed with my therapist and began to search for the right medication for me. It was a long process. As nearly all psychiatric providers explain. Prescribing psychiatric meds is as much art, as it is science.
My psychiatrist wanted to find a drug in the SSRI anti-depressant category. SSRi stands for “Selective serotonin reuptake inhibitors. SSRi’s are “Second wave” antidepressants and are generally more effective with fewer side effects than first wave anti-depressants. They work by inhibiting serotonin levels in the brain. There is an extensive list of SSRI’s to try. They all work slightly differently to achieve the same ends, and effect different people in different ways.
First, we tried Prozac. I do not remember if it didn’t work, why I didn’t like it, or why we decided to try something else, but we did. We tried Paxil which I took for nearly 2 years. it had the desired effect of creating space and slowing my mind but slowly, its effects waned. So we pivoted to Zoloft. I hated Zoloft. It made everything fuzzy. It was as if my mind was running through knee-deep, wet cement. This surprised me because most of my recovery friends were on Zoloft. Indeed, it could have been that fact that led me to urge my psychiatrist to take me off Paxil to try it. My friends referred to Zoloft as “Vitamin Z;” and it worked for them. So, I wanted to try it too. It didn’t work for me like it did for them, though.
Celexa ended up being my long-term solution. I stayed on it for over eight years. It took a few weeks to find the right dosage, but once we found it, I noticed, just like with the Paxil before it, that I had immediate freedom from compulsions of any kind.
My shrink told me that his goal was to give me a split-second gap between my thoughts and my actions. The speed on which I moved was one of my biggest strengths. It helped me get ahead. I was afraid to lose it and gave voice to those fears to both my Psychiatrist and therapist. But they convinced me that what I relied upon on as a strength and viewed as integral to my being was also killing me. My ADHD mind didn’t provide me the psychic space I needed to overcome my compulsivity. That needed to change and I needed to surrender my quick thinking if I was going to survive.
Looking back, I understand now that my early traumas led to some neural disruption and/or disconnections in my prefrontal cortex where my behavioural inhibitors and filters reside. In prescribing the SSRi’s my psychiatrist attempted to help stimulate those neural connections enabling them to give me clarity about my actions and their consequences. And while medications were not the whole answer for me, they were a major piece of my sobriety pie.
My parents and church raised me to be suspicious of medications being a reasonable response to mental and emotional issues. In their world view, the need for medication somehow diminished humanity’s moral responsibility. We blamed original sin for peoples’ poor choices and felt that people needed to take full responsibility for their actions. While we were not completely anti-psychiatry; seeing the need for people struggling with psychosis, schizophrenic disorders and the like; we frowned upon antidepressants as medications that displaced the Holy Spirit’s role in discipleship, etc…
I needed to repent of that belief. And I hope that cultural reality is shifting given all that we know about the mind/ body connection. It is surprising to me how much the suspicion of psychiatry exists in AA & NA 12-step recovery rooms. Anyone that was addicted to a mood altering substance has every right to be suspicious, and yet they also need to heed what research is revealing. While neurobiology is still in its infancy; I, for one, can hardly wait to see what advances we make as we unlock more of our mind’s secrets.
Please note that I do not want to suggest in any of this that I was not and am not entirely responsible for the choices I made before seeking medical intervention. And without medical intervention, I would not have been able to enjoy long-lasting sobriety.