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Small Town Therapy: The Journey to Getting My Meds Right

It took a lot of convincing to get my mother to take me to see a therapist. In my Southern Baptist hometown, sadness was viewed as a symptom of doubt. If you trusted in God enough, he would pull you out of your suffering. If he didn't, well that was just a part of his plan. I had been feeling as if I was being punished for a few years at this point. Getting out of bed in the morning seemed just as impossible as lifting 300 pounds. I was crying a lot. Basically, the waterworks flowed any time I was alone for more than a minute. I felt like I was wearing a mask around everyone I knew, and it took up so much of my energy that I barely had any left. The woman I met with my junior year of high school was more like a Christian counselor than anything else. A lot of the focus was on what I had done wrong, which compounded with the shame I was already feeling. When she eventually referred me to the doctor to talk about medicine I was extremely hesitant. I felt like I was the problem, not my brain chemistry, for choosing to be difficult.

I had known my pediatrician my whole life. He was there for the chickenpox, pink eye, tonsillitis, and he sang baritone in our church choir. He told me that symptoms of depression could be caused by hypothyroidism. We did bloodwork, and my thyroid levels came back “borderline.” Whether these tests were an attempt to avoid looking my mother in the face and telling her that her daughter had a mental illness, I’ll never know. I wanted a second opinion, but I was prescribed medication that my mother insisted I take. I didn’t take it. I was having an internal battle over whether or not I was even ready to feel better. Didn’t I need to feel what I was feeling? Didn’t I deserve it?

Eventually, I stopped trying. I didn’t want to argue with my mother about why she was trying to fix me. I embraced the sadness for a few more months, before approaching my mom again to see if she would take me to see a psychologist. I had found someone on the web, in the next town over. My mom wanted to be in the room with me for our first meeting, so I didn’t do much talking that day. I was hyper-fixated on traumatic experiences that my family knew nothing about. They didn’t know I had lost my virginity, that I was sexually assaulted by the love of my life, that I lost every friend I had to unfair rumors, and that my faith had been shaken. I was eventually alone with my new therapist, but she would ask me not to focus on my abuser or even my symptoms. I felt like she was passing the same judgment on me as my teachers, youth group, and family. That I was just a girl upset about a breakup. Was this a projection? 100 percent. She asked me a lot of questions about my childhood, about my relationship with my father. I wasn’t into it. I saw her four times, then she referred me to a psychiatrist. I saw the psychiatrist once. She mentioned the word “Bipolar,” and I got so spooked that I never went back.

I learned to cope by sleeping. I had abused medication before, after I got my wisdom teeth taken out. The painkillers they gave provided me with a sense of relief I really hadn’t known. I would take a few more than what was prescribed, but they soon ran out. The first time I abused sleeping pills was on the 4th of July. It was a great day filled with ribs and the thrill of keeping a secret. I fell asleep that night without shedding a tear. After that, it was my first response to a trigger or racing thoughts. Go to bed, don’t think about it. I was already chronically fatigued, but for a time my routine was wake up, take some sleeping pills, go back to sleep. I started to miss school because I just could not lift myself out of bed. There were some scary moments. I realized that the reason I wanted to be unconscious was because I didn’t want to be alive, but I didn’t want to die. I knew I had to find a way to stop. I approached my mom one last time about getting help. She said she had a friend.

A few months before I graduated high school I started seeing a therapist in her home office in my town. She didn’t see many clients because her rheumatoid arthritis had gotten pretty difficult to manage. I felt like I was repeating myself in our sessions. On our fourth visit she leaned back in her chair and said, “Katie, you can keep coming and talking to me for as long as you want, but if you don’t want to get better, you won’t.” I was furious. I left the meeting early, tears streaming down my face. Looking back, I appreciate the risk she took in confronting me like that. At the time, though, I did not appreciate getting into a fender bender on my way home because I couldn’t see through my tears. I wrote her a letter that week. How dare she imply that I wanted to feel this way when I had been suffering and struggling so hard to get help. When I read it out loud to her, it was the first time I had admitted that I wanted to be happy and actually meant it. This realization gave me the strength to keep going.

I went back to my pediatrician. I said, “Look, I am D e p r e s s e d.” He gave me a prescription for Prozac. I took it for two weeks and started feeling some serious side effects. It made my highs much higher and my lows much lower. I remember driving in my car and being so happy that it terrified me. I would cry from happiness, for seemingly no reason. I couldn’t even remember what it felt like to be sad until I got home and collapsed into a spiral on the floor. I flushed the pills down the toilet. I went to an endocrinologist in a nearby town to get a second opinion on my thyroid levels. Perfectly normal for my height and weight. At this point, I was just confused and still very tired. My therapist gave me a book about cognitive therapy that would really help me. It’s called Feeling Good, The New Mood Therapy by David Burns. I wasn’t thrilled with the idea of homework after my Christian counselor pal gave me books about sexual boundaries in dating and asked me to burn a letter to my abuser, but this homework helped. She gave me some other resources about mindfulness, and it helped me challenge my thoughts and think more rationally about my illness. I now had resources to cope with my diagnosed Major Depression and Chronic Anxiety.

Art by Katie Wilkerson

Unfortunately, I had to stop seeing this therapist when I left for college. Finding someone I connected with in a new town was painful. I saw a handful of people that disappointed me in this way or that. I was looking for that Robin Williams/Matt Damon connection that only happens in the movies. I wanted someone to tell me what to do, how to get better, and what I was doing wrong. I had some shitty experiences. The first male therapist I visited interrupted me over and over, said I didn’t need to be sad because I was a pretty girl who someone must want to hug and kiss, and while trying to differentiate between wants and needs proudly said, “Well I need to stay loyal to my wife, I want to bang a bunch of supermodels.” One therapist canceled, showed up late, or rescheduled almost every meeting. I saw a school therapist for the allotted six free appointments, and she hooked me up with a friend of hers off-campus.

My new therapist still wasn’t what I thought I needed. She did so much listening, and I did so much talking. She helped me realize that a therapist wasn’t going to fix things for me. I needed to do actual work on my own time to process my emotions and experiences, and she would be there to sort through what I found, challenge delusional thinking, and encourage me when I found a path that was working for me. The first few years of college I was still self-medicating. Whenever I was stressed or depressed, I knocked myself out with weed. My brother-in-law had given me his prescription Xanax that he thought I needed more than him. He was right. It was still hard for me to get out of bed, and the neurons in your brain that produce serotonin really only do their thing while you’re awake. I would take one in the morning just to calm myself down enough to get to class, but I would come home and immediately pass out. My brain had gotten used to super-low levels of serotonin, and so it regulated back to those levels it saw as normal. Even when I was happy, I didn’t stay that way for long. When I finally got a primary health care provider that accepted my insurance, I started seeing their in-house psychiatrist. I had a really great relationship with her, and she introduced me to the drug that would change my life: Lexapro.

Lexapro is an SSRI, which is a Selective Serotonin Reuptake Inhibitor. It keeps serotonin from being reabsorbed back into the body, so you can rebuild your stores of happy. I started out at 5mg a day, which is pretty low, but within the first few weeks, I could feel a sort of buzzing in my brain. Something was happening up there. After 5 weeks, I couldn’t believe how much easier it was to jump out of bed in the morning. I was getting up and making breakfast! Doing Yoga! Getting to classes early! This was leaps and bounds ahead of the student that had to petition the Accommodations Department not to fail me just because I couldn’t get out of bed. After I got used to it, my psychiatrist and I agreed that I should up my dose to 10mg. A few months later symptoms would reappear slightly and we upped it to 15. Two years later and I’m leveled out at 20mg a day, which has really worked for me personally. Medications affect everyone differently. What works for me might not be what’s best for you, but Lexapro is typically an SSRI that people experience fewer side effects from.

During the beginning of quarantine, I was living with my parents while I finished school online. This, as I’m sure many people can relate, was stress-inducing. I had been learning how to communicate better with my family, but during a global pandemic, an election, protests, and deciding to come out to my family as a genderqueer bisexual in the heart of The South, my anxiety was at an all-time high. My energy levels were still okay, but my heart wouldn’t stop racing. My psychiatrist prescribed me 5mg of Buspirone twice a day. Within the first few days, I was feeling completely spaced out. I could barely finish a sentence. I would say a few words, look off into the middle distance, and then shake my head and give up. I started taking it only once a day and that seemed to work alright for me. Why not?

Currently, I’m still on 20mg of Lexapro and 5mg of Buspirone once a day. Getting out of Georgia, moving to LA, finding a new therapist, and getting my own health insurance were all really great steps towards maintaining my mental health. There are new challenges, like employment struggles and continued drama with family, but I feel so much better equipped to handle ups and downs. I have tools I never imagined I’d have at my disposal at this point in my life. I may still revisit my buspirone prescription once I find a psychiatrist near me, but for now, it’s working. Medication is a tool that makes it easier to get the work done you need to do for yourself. Learn to be your own advocate. I was really angry and hurt for years that no one was helping me, but I wasn’t helping myself either. Once I started talking to the people in my life about what I was going through, the shame dissipated, whether or not they were understanding or supportive, because I was standing up for myself. Depression is something I will always struggle with. It’s a part of me, but it’s not who I am anymore.

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