Sertraline is an SSRI, commonly this class of medication is used to treat depression, this one is also used to treat anxiety. For much of my life, I have taken medication, my experience has varied between somewhat of a train wreck to quite helpful. The worst was carbamazepine, which turned my intelligence to mush. I knew I should be able to do things, but I couldn’t. I was frustrating, and as I have later found out, it could never have helped me because it was not my moods that were unstable – many abuse victims will be labelled bipolar because their abuser manipulates them, convinces them that they have the problem and so by way of explanation you have to have a mental health problem to feel the way you do.
It is vicious, you believe this person loves you, you believe they want the best for you, and so when manipulated and controlled they tell you what reality is, and you believe them. Isolated and without external references to contradict their view, along with other tactics, you believe you are mentally ill. You accept the label because the label gives you a framework with which to explain what is happening. Violence is much easier to see as abuse, but emotional control changes you, and you become complicit in your own abuse without knowing it because you are trying to make sense of the world with the wrong information. You explain you experience, and you explain it internally because that has to be true, it also fits nicely into the amorphous belief that you are a bad person, that an abuser leads you to believe.
Sertraline came much more recently, once out of the relationship, things got worse. It was not depression that struck, instead fear. People tried to hide from me what my ex was doing, this made things worse, because while using the internet, social media, and other means, even emailing where I used to get my hair cut, warning them about “I was really like”, I felt even more vulnerable and alone. I found myself trapped once again, scared, not of one person, but of everyone. At this point, I was scared of going outside, although she knew where I lived, I did feel safer in my house, with her bail conditions keeping her off my street, my broken glass was a constant reminder of course. I began to think uncontrollably about death, it dominated my thoughts. I would wake up from nightmares drenched and screaming: “I don’t want to die”. Which is where sertraline came in. Just 50mg a day, and within 2 weeks the nightmares went, the overwhelming fears withdrew. I would still have anxiety attacks, which had plagued me for years, but they lost their sting and technically were no longer full anxiety or panic attacks lacking the right number of diagnostic criteria by 1 item, this was, for me, a massive breakthrough, and I coped so much better.
Sertraline scares me, it has been a few years now, and I have like most forgotten a few doses. And miss 3 days and the nightmares are back, the fear is back, the comfort with never leaving the house is back, the thoughts of death are back. I can talk myself out of the situations, but on the drug, there are no thoughts, there is no need for coping. On the medication, no one would suspect I have any anxiety at all, except those who could see the exhaustion of it all. This drug changes my very thoughts. Imagine, going cold, sweaty, trembling, feeling overwhelming dread to paralysis, unable to watch anything where someone dies without floods of tears, and emotional engagement (comedy seemed worse somehow), or hear a talk that mentions death, let alone be in a Church – and 3 days later be unfazed, normal in your reactions, physical and emotional. Am I an addict?
A drug changes what I think; if it is changing my thoughts, it changes my beliefs, and how I relate to the world; how is this drug changing me as a person, what is long term use doing to me. I know what it is like without it, I recently tried a slow taper off and boom, right back. Even though in that time, I am very different, the stranglehold of the past is not even a grip now, it is more the marks, scars and wounds, the emotional limps left from the damage that is slowly being healed. I am certainly a prisoner of the past in so far as contact with my children requires. Dare I say, I am very much moved on, it might be slightly damaged goods that are moved on, but moved on they are. In a new town, with new people, the people of my old town left behind by their choice, in touch with friends again and making new ones, new job, new hobbies, a new wife that is understanding and supportive.
Luckily thanks to sertraline, thoughts of fear do not consume me; I am concerned about the long-term effects on me, my thoughts, beliefs as well as the physical implications of long-term use, given what we do not know pharmaceutically speaking. I also wonder, is this the grip of the past that will never go?