Lexapro for life?
June 3, 2023 12:35 AM   Subscribe

Anxious since childhood, I had a bad episode in my mid-20s (about a decade ago) and started on Lexapro. I thought the meds would be a temporary fix while I got my shit together, but my attempts to quit have been disastrous and left me feeling worse than ever. I’m back on it again after a nightmarish meds-free year. How do I cope with the fact that I’ll be on meds for life?

I can’t remember a time in my life that I wasn’t anxious, so I come by it honestly. But it wasn’t bad enough to really affect my daily life until I was 25 and dealing with some major life stressors (I had an abortion, got cheated on and was about to go back to school) and found myself worrying so much that I couldn’t sleep or eat. My doctor put my on Lexapro; the plan was that I’d take it for a year or two to help me through a rough patch.

And it worked! I felt like my old self again, did great in school and was able to get my life together. The problem is, I was never able to stop the meds. I’d been on them a few years the first time I got around to trying. I followed the tapering schedule given by my doctor and thought things were going great until I had panic attack so bad I landed in the ER, where they put me back on the meds.

I tried again with a super-slow taper over 2021-2022, reducing 2.5mg every couple months. Again, I thought it was going fine until I had a complete breakdown 2 weeks after my last dose. I thought it was just withdrawal, so I stuck it out for an entire year, and it was a truly awful year. I had panic attacks all the time (which I never had pre-meds) and felt like my body was in fight-or-flight mode like 90% of the time. I couldn’t enjoy my life, I was unable to cope with any stressors, I struggled at work and I caused major problems in my formerly-happy marriage.

Over the year, I tried many things to address my anxiety, but nothing seemed to work. I did a course of CBT and was in weekly talk therapy over the whole time but my brain and body would not calm down. I have had SO much therapy and it never seemed to help, I feel completely burned out by it. I tried doing a shitload of exercise, CBD, microdosing, quitting alcohol and caffeine, a spa vacation…nothing took the edge off.

After a year, I was so anxious and distressed and it felt my life had gotten so difficult that I was contemplating suicide, so I went back on the Lexapro. I felt better in literally hours. It was like waking up from a nightmare. It really scares me how bad I let things get, and how stressful the past year was for my husband and family and friends.

I’m feeling so much better now, but I have to deal with the fact that I’m probably going to be on meds for life. The side effects aren’t bad (I just need more sleep mainly) but I never liked the idea of taking them forever. I worry about supply chain shortages, and long-term health effects (though the level of distress I felt off the meds must have been hazardous to my health too). I’ve read the full spectrum of opinion on antidepressants, including Mad in America, and I also wonder if the way I felt off the meds is due to the fact that I took them for so long. I really did seem to feel worse than I did before, but that was so many years ago that I’ll never really know.

So, how do I accept that it’s Lexapro for life?
posted by anonymous to Health & Fitness (27 answers total) 3 users marked this as a favorite
I am not sure why you think it is for life. It's for now. People change. Bodies change. Medications are discovered or new solutions may arise. You're in your 30s. I am around 60. My current life is nothing like I envisioned it would be 25 years ago. I have a chronic medical condition that has me on 3 medications daily. My goal is to get off of the meds. Maybe I will. I view it like mastery. I move closer to it almost daily, but I am not sure I will ever hit the end. Like dividing a distance in half every day. You will never get to the end, but I will be damn close.

I would also stop looking at Lexapro as a burden. Rather, look at it as what it is, a life saver. The Lexapro is a good thing. You yourself have listed how it has made your life easier and better. It has helped your relationships, your mood, your ability to work, etc. I would try to look at it as the magical white pill that cures whatever ails you that humans have been seeking for centuries. Embrace it. It helps you be the best self you want to be.

Maybe one day, maybe soon, when you are in a good spot in your life, you try again if that is what you want. Maybe it works. Maybe you decide go back on and try again in a little while.

I highly doubt that you will be on Lexapro or any medication for life, but even if you are, it is a good thing if it continues to be a benefit.
posted by JohnnyGunn at 1:26 AM on June 3 [9 favorites]

You accept it because it works for you, and that's ok. If it makes your life work than, yay, holy shit, your life works! it's super hard so for many people to find any sort of balance, so let it do it's job. maybe someday, you won't need it, but you don't have to rush that, and you don't have to feel bad that you're using an effective tool.
posted by 5_13_23_42_69_666 at 1:38 AM on June 3 [6 favorites]

You could try some downward comparison and be grateful that you're somebody who's found a treatment that works for them, and not one of the people who wish they were dead.
posted by some little punk in a rocket at 3:24 AM on June 3 [8 favorites]

Yep, gratitude is my way round this. Thank God I live in a world that has meds to help me feel human, and eye drops to stop me going blind from glaucoma. Imagine I’d lived a hundred years ago or more and had nothing.

I also feel grateful to have the NHS, in a part of the UK where even prescriptions are free (YMMV), so I literally just walk into a pharmacy and a nice person hands me these magical, life-enhancing potions and I don’t have to hand over money.

I don’t have to research or trial-and-error my own solutions, or put my trust in snake oil salesmen fleecing me, I literally get handed the exact solution to my problem, safely dosed and packaged, in a neat little bag with my name on. Incredible.

Having dealt with long covid over the past 3 years, and seen what it’s like in those communities when sick people have virtually no medical support or understanding or solutions to a chronic health problem, makes it all the more lovely.

Also, I think there are more people out there on life-long meds than you realise if you’ve not been there before yourself. When it first happens to you, it’s a shock. Then you look around and realise there are people everywhere with asthma and diabetes and mental health problems, and glaucoma, and on and on, and most of the time you just don’t know it. Having a long term prescription is not unusual.

This is meant not so much as a: “Don’t be ungrateful!” admonishment, but a suggestion to maybe look into a gratitude practice where you regularly note one or two things you’re genuinely glad to have in your life, and some of those might include the benefits of your medication. Good luck.
posted by penguin pie at 3:43 AM on June 3 [8 favorites]

If you were suffering with type 1 diabetes you’d be on insulin for the rest of your life. You’d die otherwise, you’d not beat yourself up about it. You may not die if you stop your meds but you are unable to live a full, joyful life, you’re not your normal self. Many people rely on meds for one thing or another. It’s ok.
posted by koahiatamadl at 3:45 AM on June 3 [15 favorites]

Also: if the Lexapro is causing you side effects that make you wish you didn't need the Lexapro, you could talk to your Dr about other anti-depressants like

Brintellix/Trintellix (Vortioxetine) or Wellbutrin (Bupropion) that have less side effects.

Both the meds I mentioned are less-sedating than most anti-depressants, and also much less likely to adversely effect sex drive/sexual response.
posted by chariot pulled by cassowaries at 3:59 AM on June 3 [2 favorites]

Think of them as an assistive device. Would you tell someone who uses a wheelchair that they should risk their well-being and try everything to stop needing one for mobility? Do you tell people with glasses that they really should be aiming for life without them?

I’ve gone off and on anti anxiety meds a few times but I’ve never gone off them because I thought it was a problem that I’d taken them too long. I needed to up my dose, because my anxiety caused me to screw up my diagnosis and prescription situation and decided to taper off and spiral downward instead. Hopefully now I’ll be able to stay on them, or whatever is invented to replace them, for life. I’m also taking blood pressure meds for life, and, if my genetics have any clue to my future (they certainly have thus far) I will eventually be on diabetes meds too.

Turns out getting older means you get to be on more things or use more things until you die, which is hopefully much later than if you didn’t have any of those things at all. It’s okay to take things that help you live life better. Most people do! If you have side effects or feel like something is off with what or how much you’re taking, work with your care team to explore your options and discuss the best ways to change doses or meds. There are lots of intricacies with mental health drugs that we are just figuring out.
posted by Mizu at 4:06 AM on June 3 [4 favorites]

So I thought I'd be on anti-depressants and anti-anxiety drugs for life, and I haven't needed them for more than fifteen years even while dealing with cancer for the last seven, so things can and do change. Also, new and better drugs are developed, so there could be something that will work even better for you. I think it's pretty safe to think of this as "for now" and not "for life."

But I currently struggle with "infusions for life" and one of the phlebotomists, who is otherwise wonderful, periodically asks me when I'm going to be done with treatment, and I have to tell her again and again that for my kind of cancer, there is currently no such thing as done with treatment ever. There are only changes in treatment when the current one stops working.

I deal with that in two ways. One is the continuing hope that if I can manage to live long enough, there will eventually be a cure. When I wrote an Ask right after being diagnosed, a MeFite mentioned the first people for whom AIDS treatments really began working. They would have expected to die quickly, but many are still alive now. So there are amazing medical advances that happen all the time.

The second is reading about and paying attention to people who have serious medical conditions for their entire lives and manage with that. There are so many people who deal with hard medical realities every day - some that seem much harder to me. The children's hospital near me is full of little kids who are dealing with worse. So yes, gratitude for what I have - gratitude that treatments exist at all (my mom had the same kind of cancer in 1995 and died after eleven months because there really was no good treatment then). I know this can be really hard, but maybe you can think about all the people who suffered as you do before there were any medical treatments for it. How awful that must have been in the early 20th century and before when anxiety was considered by many to be a failure of will.

If "be grateful" makes you want to throw things, I totally get that. But I also don't think there's a better answer
posted by FencingGal at 5:11 AM on June 3 [11 favorites]

To be honest with you, by the time you hit your 50s, most everyone you know will be on some kind of prescription for life--whether that be for high blood pressure, type 2 diabetes, high cholesterol, or any of the stuff that starts earlier. You're just getting an early (?) start.
posted by praemunire at 7:54 AM on June 3 [12 favorites]

I've got a bum thyroid. I've been on medication for it since I was 25 and there's no reason to think I'll ever stop needing it. I'm not thrilled about it but it is what it is and I try to look on the bright side.
posted by potrzebie at 8:07 AM on June 3 [2 favorites]

I mean, you only have to be bummed about this if you decide it's a bummer. I mostly never think about it, but when I do I am so fucking glad I have access to these meds.
posted by DarlingBri at 9:03 AM on June 3 [6 favorites]

I'm going to be on Lexapro for the rest of my life, because I've had anxiety for as long as I can remember and this is what fixed it. I am SO GRATEFUL to have this med. Barely ever think about it beyond that.
posted by bridgebury at 9:06 AM on June 3 [5 favorites]

When I was concerned about this before I started treatment for ADHD, what worked was constantly reminding myself about all the other medical interventions that I personally am on “for life.” I will wear glasses for life. I intended to take birth control for most of my adult life. I will probably take some kind of allergy medicine for life. Comparing those interventions to Adderall was my way of reminding myself that my reluctance stemmed from internalized stigma about needing the medicine at all, and reminding myself that my knee-jerk “but not for life??” reaction was just a construction I had built to shield myself from that stigma.
posted by CtrlAltDelete at 9:44 AM on June 3 [3 favorites]

Would it help to frame it as "this is just one more annoying thing I have to do?"

because humans

- have to drink water every day, for life;

- have to eat food every day for life;

- have to sleep for 7 to 9 hours every day for life;

- have to go to the toilet multiple times a day, for life.
posted by chariot pulled by cassowaries at 9:56 AM on June 3 [7 favorites]

Thing 1 is: "those sound like big feelings, and I'm sorry you're struggling with them."

Thing 2 is: Early 20th c. Homo sapiens used the phrase "Better living through chemistry" to mean.... like, "look, we invented Tupperware!"

but I use that phrase as "my anxious/ADHD/allergic rhinitis/diabetic/whetever friends and family get to live a life with markedly less suffering thanks to treatments that people would've killed for 100 short years ago." (Including me, I'm my own friend and family)

I know the science is probably inaccurate, but I like the expression "if you can't make your own neurotransmitters, store-bought is fine" in these situations.

Thing 3 is: If you didn't have a treatment that worked, what would you trade for a chance to feel better? Hey, good news! You can keep that, because you found a treatment that works for you!
posted by adekllny at 10:46 AM on June 3 [3 favorites]

I am wondering…is there a reason you want to be off of Lexapro?
posted by hellochula at 12:20 PM on June 3 [1 favorite]

Perhaps you feel there is a stigma attached to taking this. Drop that idea. A person I am close to had bouts of depression and sadness for years, until finally consulting a therapist who prescribed Lexapro. The therapist framed this similarly to the examples cited above such as, if you had diabetes you'd have to be on insulin, saying, in effect, "in your case there is a glitch in your brain chemistry, which causes your depression, and this medicine regulates that chemistry and eliminates your depression — so you need this to be yourself, and there is no stigma attached to that." That was 30 years ago; she has been on it ever since, depression-free, and expects to be on it the rest of her life, happily.
posted by beagle at 2:16 PM on June 3 [5 favorites]

Oh hey, I am you! I have on two occasions weaned myself (with doctor’s guidance) off of SSRIs and both times it was fairly disastrous. At the time, I think I had bought into the idea that “I *should* be able to fix this myself.” Well, I can’t and that’s okay. I got from there to here by realizing just how crucial my medication is to allowing me to fully function in life. I didn’t choose to have anxiety and depression, but thank cats I am able to take medicine that gives me an actual life to look forward to, rather than thinking that I could continue to subsist on the lies my brain chemistry was telling me. We have both discovered the life-changing reasons for these medicines to exist—there is no shame in that.
posted by sugarbomb at 2:26 PM on June 3 [2 favorites]

I started Lexapro in 2016 after a VERY bad episode of panic/anxiety, and about 6 weeks in, the turn-around was so startling that it truly convinced me that my brain is missing some kind of chemical that my SSRI can provide. I woke up one day and was like, "Wait, is this what NORMAL PEOPLE feel like?!" I'd had years of therapy/CBT, and while it helped some, Lexapro was literally life-changing for me. I can't IMAGINE wanting to go off of it. I can take a pill with no discernible side-effects once a day and no longer have to grapple with anxiety all the time?! SIGN ME UP. Y'all can pry my Lexapro out of my cold dead hands. To nth many others, I think this is about reframing your attitude so that you feel gratitude and relief that there's an accessible, effective treatment for what ails you.
posted by leftover_scrabble_rack at 3:19 PM on June 3 [3 favorites]

So, how do I accept that it’s Lexapro for life?

If we accept the premise, then: you're disabled, with a chronic, currently-incurable illness. You can get by in society but you need this very specific kind of help. That's hard, and that's a lot. You may want to try and find a therapist who specifically works with that kind of population, or try and find a disability community.
posted by curious nu at 5:17 PM on June 3 [3 favorites]

Also, as part of that road, I'd recommend looking into "social model of disability". I don't think "gratitude" is a helpful framing here; face it head-on, say, "Shit, my brain/body needs this this to function when and where I live." Be honest with yourself and things will likely go better, long-term, than trying to have some kind of "mindfulness practice" where you tell yourself you're lucky/blessed/whatever. (I am also a person with Brain Problems so I get it.)
posted by curious nu at 5:20 PM on June 3 [4 favorites]

I'm another person who is on Lexapro for life. I just think of it as I would do any medication. For me, it's more puzzling as to why so many people think they can just come off their anxiety meds.
posted by thereader at 1:26 PM on June 4

You are just slamming into the age where life is about to hand you an unending conveyor belt of opportunities to appreciate that the "for life"s (as well as the "no more"s) are even an option instead of just an early grave or extraordinary suffering that was normal sometimes just a few years or a decade ago.

Take the wins where they come. There was a time when people with serotonin quality/quantity issues like you and me and a bunch of people we know and love was a death sentence, or at least a significant hindrance to having the life we wanted. You GET to take Lexapro for as long as you need to, and maybe one day you don't need to or there's a better drug and then you GET to take that one.
posted by Lyn Never at 4:24 PM on June 4

I'm late here, and admit I didn't read all the previous replies. But when I balked at being permanently on a much more "serious" anxiety med long term, my neurologist said "look, you need this med like a diabetic needs insulin". And I repeat that to myself whenever I feel like I'm somehow "weak" for using meds that are helpful to my quality of life.
posted by nixxon at 4:33 PM on June 4 [1 favorite]

I am simply thankful that this medication exists and I am actually sad that I had to spend most of my life thinking this constant state of anxiety was normal. It's a relief to know that my brain can now work without that level of anxiety in the background all the time.

Look, I didn't like the idea of being on the medication for life, but I realized I was using my anxiety as a crutch to motivate myself (it turns out I have ADD, too). I also don't want to blow up more relationships. The drugs are there to help others and maintain relationships and keep myself going professionally.

Other notes: I would consider looking into wellbutrin to mitigate the side effects of sleepiness that come with Lexapro.
posted by bright colored sock puppet at 7:38 AM on June 5

the idea that you could be correct about your experience with this drug, that you could be worse off when you stop taking it now than you ever were before starting, is so threatening to people that they will just flatly ignore you or pretend you didn't say that rather than come up with any kind of response to it.

it is obviously possible that that is true. you would not be the first person to report this experience or to be upset about it. you do not have to shut up and be grateful. pretending things are fine when they are not fine is anxiety-provoking for many people. dwelling on it is bad for you too, but it's better to distract yourself than to pretend. it is completely normal and understandable to feel trapped and at the mercy of prescribers and supply chains now, because you are. realistically you will be fine, there is not going to be a crackdown on antidepressants the way there is on pain meds, stimulants, etc. but it isn't hard to understand why you still feel this way. don't let anyone make you feel like you're being irrational. it is reasonable to be bothered. it's ok, it's fine, but it sucks.

it is also possible that your very slow taper wasn't slow enough, or that you can (if you want to) taper down again at some point without going all the way off. it might be possible to eventually be less dependent on it, if it continues to bother you, even if you cannot be fully independent of it. or to switch to another drug that has less severe discontinuation effects. you don't have to try doing that right now to have realistic hope that someday you can.
posted by queenofbithynia at 6:11 PM on June 5 [1 favorite]

I take a couple medications daily, for a disease, for about 15 years now. Every time I’ve tried to go off the meds, I experience enough disease issues that I have always had to go back on them. This used to be pretty demoralizing to me. I have tried very specific diets to replace the work the meds are doing—some people with my disease have been able to do that. I have experimented, like you, with lower dosages, but haven't been able to go completely off. I have tried alternative meds and therapies. At the end of it all, here I am, still on that same med that knitially got my disease under control all those years ago.

I had so many reasons why my main goal should ever be, get off those meds.
- long term side effects, not good!
- short term sides effects and hassles like fatigue, lab draws, etc
- supply chain
- what if there’s an apocalypse/i get stranded in the wilderness/i forget my meds on a trip, i will be the first one to die!!! (Ok only sort of kidding on that last one, guess I probably had(?) some untreated anxiety there)

I wish I could tell you what changed for me, but I don’t know. I think my priorities have shifted a bit (family and child-health stuff) and some of that has physically limited my rumination time. I think I am living a lot more in the present right now. But that is pretty specific to me. Most days I think about the meds as “these are the things that keep me functioning as I need to, and I know thru experience how right now, medically, that is not possible without them.” Or like putting on my pants.

I still worry about longterm side effects, i still try diet experiments, i take part in studies and keep in touch with my doc and occasionally try switching to a new med if one becomes available, or think about surgical options. But I feel like this is what I need to function. I got comfortable with it but not complacent. (Maybe I stopped caring about the apocalypse?) I like the analogy someone made above to adaptive tech. I think it is more about acceptance that bodies need assistance or adaptation a lot in this life, and in the society I know there isa lot of assumption/pretense that imperfectly functioning humans are strange, abnormal, or not visible. It was very much in my brain.

Sorry this is a long ramble, but I really felt I could've written your Q some time ago.
posted by pepper bird at 8:33 AM on June 11

« Older How to handle an awkward referral request   |   I'm thinking about taking another stab at trying... Newer »

You are not logged in, either login or create an account to post comments