“Yesss!!! Finally!!! I did it!!!!”
That’s what I thought at the time. It was a combination of extreme excitement, relief, and optimism. That moment was about three years ago. I had just told my doctor that I have social anxiety disorder, and he wrote me a prescription for the antidepressant, Zoloft.
My doctor said the medication may take some time to work, and it might not work at all. Certain patients respond to different antidepressants at different dosages. He started me at a low dosage (25 mg) of Zoloft at first to see how it affected me. The doctor tried to temper my expectations, but I couldn’t help but get my hopes up. I’d been dreaming of that moment for years. I finally had access to the medication to cure my social anxiety.
I went straight from the doctor’s office to the pharmacy to pick up my medication. As soon as I got home, I read the directions thoroughly, then popped my first pill of Zoloft, a.k.a. sertraline, a selective serotonin reuptake inhibitor (SSRI).
I swallowed the tiny pill, then I waited…
Does it work right away? How do I know if it’s working or not?
I re-read the instructions, which were about six pages long, listing all of the known possible side effects. None of the dozens of side effects concerned me more than “suicide”. I’d never had suicidal thoughts before. Would the Zoloft make me start contemplating suicide?
I researched Zoloft extensively online… WebMD, Wikipedia, websites, blogs… I got all the facts and figures and learned how the medication worked. SSRI’s like sertraline supposedly work by balancing the levels of serotonin, a necessary neurotransmitter, in your brain.
I also read lots of personal anecdotes on social anxiety forums from people who had taken Zoloft for social anxiety disorder. Some said it worked perfectly. Others said it worked but had too many negative side effects, like sexual dysfunction. Some said it did nothing at all. Others said it made them feel like zombies.
After reading about all the negative side effects, I started to feel more anxiety about taking the medication for my social anxiety than anxiety from social anxiety disorder itself.
Yet I remained optimistic. If Zoloft worked for someone— even just one other person like me— then I was willing to give it a try, no matter the side effects.
I didn’t care about sexual dysfunction. My social anxiety was preventing me from ever meeting anybody and getting close enough to them to have sex in the first place. If the medication actually worked and got rid of my social anxiety to the extent that I was able to get a girlfriend and find myself in a situation to have sex, then, well, I’d cross that bridge when I got there.
Another downside of antidepressants was that they don’t mix well with alcohol. The directions warned not to drink while on the medication, but I wasn’t much of a drinker anyway, and I’d happily give up alcohol forever in exchange for curing my social anxiety.
Some other Zoloft side effects that worried me were overconfidence, recklessness, and talking fast. I feared that the medication would change my personality and turn me into an obnoxious loud-talking extrovert. I didn’t want that. I wanted to stay the same. To still be me. I just wanted to be able to be me in front of other people and be able to talk to them when I wanted to.
As for the other side effects, (allergic reactions, abdominal bleeding, seizures or convulsions, restlessness, manic episodes, changes in appetite or weight, low sodium, fast heartbeat, hallucinations, loss of coordination, severe dizziness, nausea/vomiting/diarrhea, black/bloody stools, muscle cramps, tremors, and more), I wasn’t too concerned. They list stuff like that for pretty much all medication, even aspirin.
The only side effect I was truly concerned about was the risk for suicidal thoughts or actions. I was willing to take on any side effect to cure my social anxiety, but killing myself would kind of defeat the point. You can’t talk to anybody if you’re dead.
I kept the suicide risk in the back of my mind. I was generally happy and never felt depressed. I had a loving family and dreams of a writing career. I never contemplated suicide and couldn’t imagine I’d start, but if I did, I’d alert my doctor right away, as instructed.
So I took my pills, following the directions to the tee. I wanted to do it right. I didn’t want to mess anything up. I took my pills the same time every night, never missing a single dose, and a month later, I went back to see my doctor for a follow-up appointment.
My doctor asked me how I’d been. I told him that I didn’t really feel any different, as far as the social anxiety went. He asked if I experienced any side effects, and I said no. He said that was normal. He had started me on a lower than normal dose to make sure I wouldn’t have any negative side effects, and he would now bump me up to the regular dosage (50 mg). He once again said that it may take a couple months to take effect, if at all, and once again, I got my hopes up.
I received the same instructions from the pharmacy, with the same long list of side effects, and I took my pills as directed, again, never missing a dose.
On the 50 mg dosage of Zoloft, I started to feel some slight effects. I felt a little happier, not that I was depressed before, but it just gave me a slight feeling of content. It also made me sleepy. About fifteen to twenty minutes after taking the pill, it would knock me out cold. As someone who used to occasionally suffer from insomnia, that side effect was just fine by me (except when I was trying to stay up to watch a movie). But insomnia wasn’t why I was taking the medication. As far as my social anxiety went, I didn’t feel any different. I was still just as shy.
Three months later, I returned to see my doctor and told him how I felt. Once again, he said that my experience was normal. The regular dosage works for some people, but others require a higher dose. So he bumped me up to a higher dose (100 mg) of Zoloft, with the same caveats about it taking a couple months to work.
On the 100 mg dosage of Zoloft, I started to feel definite effects. I had a more pronounced feeling of that contentedness that I felt before. It made me feel like I didn’t care… Just generally… About everything.
I also started to feel almost buzzed and a little dizzy, especially after standing for extended periods of time. As a writer, I’d been using a standing desk to be healthier, but I had to return to a chair because of the dizziness.
The medication also made my brain feel foggy, and I couldn’t quite think straight. Ditching my standing desk was one thing, but I couldn’t write at all if I couldn’t think. I still wrote, but I struggled more to do so, and because of the care-free feeling I had, I also lost the desire to write as much as I used to.
Since starting the antidepressants, I also felt a loss of sex drive. Because of my social anxiety, I had no prospects for a sexual partner, but I’d also lost the desire to masturbate. On the first two dosages, I would try masturbating despite the lack of desire to, just to see if I still could. And I could. But on the higher dosage, when I tried, I found it much more difficult to orgasm. At that point, it was more of an inconvenience than a serious problem. I was willing to put up with minor sexual disfunction if I no longer felt social anxiety.
As for the social anxiety, I finally started to feel some effects there as well. I didn’t seem to feel the physical symptoms of social anxiety as much as I used to. When in a social situation, I didn’t feel the racing heart, the butterflies in my stomach, the blushing face, the sweating palms, and all the rest.
But that was it. I was still just as shy. The medication didn’t make it any easier for me to talk. Even without the physical symptoms, I still had the same fear of talking to people.
Months later, I returned to my doctor and filled him in on the results. Once again, he said my experience was normal. Different medications effect people differently. There were numerous antidepressants to choose from, and it was a matter of finding the right one for me. So he switched me to Effexor, a.k.a. venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI).
SNRI’s are similar to SSRI’s, except they balance the dopamine levels in your brain, as well as serotonin. Once again, I got my hopes up. The Zoloft didn’t work, but maybe the Effexor will… My doctor instructed me to start on a lower dosage (75 mg), then to increase it (to 150 mg) after a few weeks. So I did as he instructed.
I didn’t notice much of a difference between the Zoloft and Effexor at first. Maybe the one benefit I noticed was that I started to have better bowel movements, after previously suffering from constipation. That felt nice, but it wasn’t the primary reason I was taking the medication. I wanted to talk, not shit.
Once I increased the dosage to 150 mg, I felt the same side effects as I did from the Zoloft, only now, they were more pronounced. I felt more dizzy. More brain fog and fatigue. Less thoughts, both positive and negative. More of that blank contented feeling. I finally understood what those people on the forums meant when they said antidepressants made them feel like a zombie. I had no desire for sex, but when I tried to masturbate, I wasn’t able to orgasm at all. On the bright side, I never started having any suicidal thoughts… So at least there was that.
Yet even with all the negative side effects I was experiencing, I was still willing to continue taking Effexor if it cured my social anxiety.
But it didn’t.
Just as with the Zoloft, I had less of the physical symptoms of anxiety on Effexor, but I was still just as shy as I’d always been. The SSRI didn’t cure my shyness. The SNRI didn’t cure my shyness. I faced the facts. Antidepressants won’t make me talk.
Soon after I first started taking Zoloft, I saw the documentary Foodmatters, and I learned how diet and natural supplements can heal you. I was pissed off that I hadn’t seen the film earlier and tried that first. Then I read the book, The Mood Cure by Julia Ross, and learned that 5-HTP and Tyrosine were natural alternatives to antidepressants that increased serotonin and dopamine. I wanted to give the natural path a try, but I couldn’t take 5-HTP while I was on antidepressants, or I’d risk having serotonin syndrome, an overdose of serotonin in my system. So I held off on that, but I started eating healthier by following a plant-based diet, and I noticed immediate improvements.
I decided I didn’t want to go back to my doctor and have him prescribe me a third antidepressant, or some other prescription medication, and go through the same cycle of false hope again. I wanted to try healing myself the natural way. So I slowly weaned myself off the Effexor, while I practiced daily meditation and listened to cognitive behavioral therapy audio programs.
When it was time to return to my doctor, I told him I no longer wanted to take antidepressants. They weren’t working. I forget what he said then, but I think he suggested I try cognitive behavioral therapy with a psychologist.
Once I weaned off the Effexor, I started on 5-HTP and tyrosine, and I didn’t suffer any withdrawal symptoms. The negative side effects of the antidepressants went away, but I still enjoyed all the benefits with the natural supplements that I had received from the antidepressants. I feared my insomnia would return, but I continued to sleep great every night. And my improved digestion improved even more. I felt increased energy. I lost the dizziness, and I could think clearly again. My motivation and creativity came back. And it was all natural.
I would still feel the physical effects of social anxiety in certain situations, but thanks to mindfulness and cognitive behavioral therapy, it didn’t bother me as much as before. The natural path wasn’t a complete cure. Like the antidepressants, it didn’t suddenly make me talkative, but I felt more comfortable and open to talking. I realized the final key to get over that remaining shyness was exposure, which is something I’m still working on.
Perhaps antidepressants could be useful in combination with cognitive behavioral therapy because talk exposure might be easier without the physical anxiety symptoms, but for me, that slight benefit isn’t worth all the negative side effects. I’d rather sweat a little and feel some butterflies in my stomach when I’m nervous or scared— feeling fear is healthy, after all— and I’d rather overcome that fear the natural way, by facing it.
So antidepressants didn’t work for me, at least in the way I hoped they would. They weren’t some magic pill that made me talk, but that was probably just wishful thinking to expect that they ever would. Antidepressants were fool’s gold for my social anxiety.
In the end, despite the lack of results and all the negative side effects I experienced, I’m still glad I took antidepressants. I had to know for myself. I had to try the medication and see how it made me feel. Now that I know, I can say for sure that I’ll never take antidepressants again.
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Note: This post is only about using antidepressants for social anxiety. They may be more effective in treating depression. Also, I am not a doctor, so don’t use this as medical advice.
Read more on this topic: The Evolutionary Advantage of Shyness and Social Anxiety