Sobriety & the prevalence of long-term SSRI For anxiety

Today I want to talk about coming off long-term prescription SSRI usage for anxiety disorder and potential links to an issue of sobriety in its length of use.

If we talk about sobriety as the absence of drugs or alcohol in our system then it's perhaps easy to see why we might tie the coming off of long-term SSRI use as a journey into sobriety. However, you and I both know it is a lot more complicated than a dictionary definition. But it is more the length in terms of years of usage of such a class of prescription drug that we are interested in here today.

If in the Western world, SSRI or Selective Serotonin Reuptake Inhibitors are the go-to drug class for not only depression but for anxiety, then so to can we say in the Western world that we also place a lot of trust in these drugs. Rightly or wrongly most of the ones on the market today work for either depression or anxiety, or both and some (not all) will work for the majority of people.

As tailored medicine is a very new field and SSRI drugs predate that, they go for a broad spectrum appeal so the most benefit to a wide group of people. This does not mean that all SSRIs will work for everyone, this is why there is so much trial and error involved on an individual basis. They simply cannot say beforehand which tablet will work for which person, only which tablet will work for which issues, e.g. for depression and/or anxiety, usually some sort of SSRI.

What am I talking about above? Quite simply, the individual. There are of course systems in place in most first-world Western countries to ensure there is a certain amount of oversight. But you are likely aware that there are pressures the world over in health care and it is not an excuse but it is one of many reasons why someone may get left on SSRI long-term.

There are also individual views and medical professional views on what is best for the successful treatment of the above issues. Your medical professional will know what tablets work for what issue but they may not know what works for you. Until you feedback to them. You may know what works for you but you may not know what your options are regarding various tablets for various issues.

This is why it takes the two of you. Your medical professional with all their knowledge on various issues and drugs to treat and you with all your knowledge of your own experience. 

Beyond that, we can also say that this is but part of the picture. It is not the only method because there is of course therapy and other things that may help too. So now you have you, plus your medical professional, plus your therapist and whomever else may be in that holistic chain to remedy your anxiety and or depression.

I think we can both agree here that there are a lot of people involved in the process and only one who can feel what you feel and report back. The medical professionals, your therapist and anyone else involved in that chain all need you to communicate with them how you feel so that they can tailor a best-fit approach for you, the individual. Magnify that by the amount of people seen in one day by a medical professional, the amount of people a therapist might see in a week and whomever else is in that chain and who they might see then gaps can form in how well they may know you etc.

What am I saying here? Well, I'm saying that the person closest to you, the person that is in the best position to know you how you feel, what you're thinking at any one given time is... you. To get the most from your care or your therapy, you really have to be your own advocate. This includes if you have been on tablets for a while and have not had a tablet review, then being the one to check in with your medical professional first. Booking that appointment, discussing what is going on for you, how you feel and most importantly if your chosen method of help is working for you or not and if not, what next?

If your team don't communicate with each other the solutions will not necessarily be forthcoming. Therefore I cannot stress this enough, you have to be your own advocate where possible. This gives you the best chance of keeping on top of your SSRI usage so that you can continue to reap the benefits and not be on them for longer than you need to be for you personally.

It's very easy to end up not communicating with anyone in that holistic chain of people, to not have tablet reviews or regular check-ins and to end up where the benefits no longer outweigh the negatives. There of course various negatives to SSRI usage long-term which can include, but are not limited to, numbing of feelings, restriction of libido, erectile dysfunction, weight gain, weight loss, temperature fluctuations, trouble focusing, and more.

This may be ok in the beginning but as time goes on it may become unacceptable to you. There are more options available to you than you might know so please do seek medical advice if you are considering an SSRI or even coming off an SSRI.

The latter cannot be stated loud enough either, it is so so important to talk to your medical professional before any such journey to coming off tablets can occur, to make sure it is right for you personally.

To conclude being your own advocate and having regular meetings/reviews are the most important things to take away here beyond any such personal journey decisions. It is also the length of time on such tablets that would look at it as a journey to sobriety and we are likely talking years of usage here but could be less, again this depends on how it affects you.