Over the years, I have had a complex relationship to medication. Specifically to the types of medication that are intended to reduce the effects of depression and anxiety. Now as a student of psychology, I have more information about the science behind medication and other ways to treat depression and anxiety, but still no clear perspective.
So I have, perhaps foolhardily, decided to use myself as a test subject for deeper understanding. After taking Celexa/citalopram on a near-daily basis for over six years, I have spent the last several months without it, with mixed results.
This is not my first attempt. In July 2024 shortly after my salpingectomy, I stopped taking birth control pills (because I no longer had a use for them), and rather casually figured I could stop taking Celexa while I was at it. Part of me wondered if I had been taking this selective serotonin reuptake inhibitor to counteract the side effects of my birth control pills (mood changes including anxiety and depression), and that if I stopped taking everything at the same time, I would be back to a baseline, neutral level of mental wellness.
Am I a doctor? Did I discuss this with a medical professional before proceeding? Did I do any research beyond my own cognitive reasoning?
No, absolutely not.
Nor did I anticipate the intense levels of awfulness I would feel in response to reduced serotonin available to my brain and body. Approximately two months after halting the medication entirely, I had a particularly bad episode in which I could not see a path forward, and so I went back on it.
Fast forward one year to the 2025 fall semester: treatments for depression and anxiety are being discussed in my psychopathology class, and 20 minutes of exercise three times per week is said to be – in some cases – more effective than medication for treating depression. Science tells us that there is “no difference between exercise and pharmacological interventions in reducing depressive symptoms in adults with non-severe depression” (2022).
That’s where I found the motivation for my second attempt. Far from being a sedentary person, I am no stranger to exercise and creative movement, but it had always been a challenge for me to make it part of my routine. So I decided that I would tackle this in several ways:
- Instead of immediately cutting out the medication, I would taper off more slowly this time: I had been taking 10mg per day, so with the pills remaining, I would break them down further and take only 5mg per day for two weeks, at which point, there would be nothing left to take.
- At the same time, I would commit to 20-30 minutes of exercise (including yoga and weight lifting) every morning before doing anything else, as my anxiety tended to be strongest upon waking.
- I would communicate with friends and my therapist about what I was doing, share updates, trepidations, and small successes.
Those first two weeks felt great. I woke up at 6:30am most days and texted one of my best friends, who also gets up early to do exercise, sharing selfies of myself ready to get moving. There didn’t seem to be any negative changes to my mood, and in fact, I felt confident and powerful in attempting this feat I had been previously afraid to attempt.
And then there was the third week. This was my first week without any medication whatsoever, and it was the week where the topic of suicide seemed to come up several times. The first time it came up, I felt discomfort. The second time it came up, I felt sad. And the third time it came up, I felt despondent. After that, it seemed like there were triggers everywhere, thrust upon me relentlessly, and I had limited capacity to manage them. There were no threats per se, but there was always the threat of a threat. A conflict with a friend, a poor parenting moment, a delayed start to an assignment felt like failure of the highest degree. I was failing at everything – including life without medication.
It’s okay to be on medication, you could always start taking it again, was the refrain I heard from people who cared about me. And of course it is. And of course I could.
But I wanted to give it more time. After all, it had only been a few weeks. I reasoned with myself that withdrawal was natural and it would take my body and mind some time to work through these physiological and psychological changes.
There were also socio-political reasons for my resistance. I had read statistics about the large number of people in North America who are prescribed anti-depressants, and how much pharmaceutical companies profit from these sales. I didn’t want to contribute to that, if I could avoid it. In the same way that I didn’t want to shop at Walmart or order on Amazon if I could acquire things locally or second hand, or just manage with what I already have.
I thought about people who experience alcohol or drug dependency and the level of willpower it takes for them to stop using. I compared myself to them, reasoning, if they can exist in this world without these highly addictive substances, then why can’t I without this low dose of medication? And how could I, whether as a counsellor or a friend, ever support someone going through intense withdrawal, if I wasn’t willing and able to do it myself?
I wondered, too, if my medication was doing what I really needed it to do. Even when I was taking medication, I still had bouts of anxiety and depression, periods of loneliness and neediness, and frustration with various things. I understood that medication is not a cure for anxiety and depression, but rather a tool to manage it. But couldn’t I manage without it?
Since I’ve stopped taking it, I’ve still been able to attend classes, go to work, take my daughter to school, hand in assignments, and look after myself and my home. Though, in between my daily tasks, I do find myself crying a lot more and experiencing feelings of hopelessness. At the same time, I am starting to address those feelings in therapy, letting myself be a messier version of myself, rather than showing up to monthly sessions with an organized list of things to talk about and priding myself on (perhaps) being my therapist’s favourite patient. Maybe my medication had all this time been masking these distressing feelings that I had intellectualized previously and now needed to face head on.
So what conclusions can be drawn from this experiment? Am I learning that medication plays a necessary and positive role in my life? Am I being given the opportunity to proactively address the traumatic events of the past few years that, until now, I had only been ‘managing’ through medication? In my case, is consistent exercise a sufficient substitute for medication, or could I be employing it in partnership with medication? Would I benefit from being on a different medication entirely?
Obviously, I entered into this experiment with an agenda: I wanted to prove to myself that I could thrive without medication. I wanted to prove that, for some people, physical exercise, creative expression, and community connections could be just as effective, if not more effective, than a tiny white pill. But I also have enormous respect for the medical profession and appreciate the fact that I live in a place and time where medication, both preventative and mitigative, is readily available to those who need it.
Seven months later, I’m still off the medication – and I’m still not sure if I made the right decision. There’s a reason why researchers seldom use themselves as test subjects; the subjectivity is just too unscientific. All I can say is that I stay in regular communication with my therapist and people who care about me, and I try to reflect honestly on what I’m going through, while aiming to maintain stability in all aspects of my life. This may simply be one of those infuriating situations in which there are no right answers. It’s simply whatever you choose to do.
Jessica Ruano 