My 10-year retrospective on trying SSRIs

In 2014 I got on SSRIs the first time, and they were amazing. I wrote online about how I suddenly had energy to do things, could concentrate on stuff, and generally just felt better and happier.

I now got a message from someone who'd found my writings and was wondering what my experience with antidepressants was now, 10 years later.

I wrote this reply to them, and thought I might as well share it with others:

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Hi, that was indeed me!

I was on SSRIs for about a year after writing that comment, after that it felt like they started losing some of their effect but I also thought I felt better for other reasons, so I stopped using them. Then I was off them for about a year or two and started feeling bad again, so I got back on them. They had similar effects so I kept using them for a year, until I again got to the "I think they're losing some effect and I'm also feeling better for other reasons" stage, so I again stopped them.

Eventually my old problems started coming back again, but I also started making more progress on those problems with therapy. By this time I had the feeling that even though the SSRIs were great, to some extent they suppressed my problems rather than solving them.

For example, deep down my self-esteem was still based on getting others to like me to an unhealthy extent - of course everyone wants to be liked, but *most* of the things I was doing had some undercurrent of "how could I get others to like me more this way". The SSRIs didn't really change that, but they shifted me from being very pessimistic about that ever working, to feeling more hopeful that "okay I just need to do this thing and then more people will like me", and then I had more energy to keep doing things again. But the things that I was doing, still had an unhealthy obsessiveness going on.

Since then therapy-type approaches have helped me fix more of that underlying issue. (I had one particularly big breakthrough in 2017, which I described here, and a later follow-up to it here.)

I still struggle with some of my old problems - particularly anxiety, loneliness, and occasional depression - but quite a lot of them have gotten better to the extent of being non-existent, e.g. my self-esteem is much better and on more healthy ground these days.

On a few occasions when I've had particularly rough patches I've tried antidepressants again, most recently for a brief period last year, but they don't seem to have the same effect anymore. Maybe I could have just increased the dose, but I was afraid that that'd make it harder to access the core of the problems therapeutically, if the SSRIs ended up burying it deeper.

I'm still very glad that I originally got on them though, since they viscerally showed me that life could be much better and gave me hope!

One thing worth noting is that at some point, the level of physical pleasure I experience from orgasms seemed to have dropped quite a bit. I'm not entirely sure when exactly that happened - I was single for a while, and then at one point when I got into a relationship again, I noticed that sex with my next partner didn't feel as satisfying as it did with my previous one (and this never recovered), so the decline must have happened sometime between those two relationships.

I can't know for sure that it was caused by the SSRIs, but a long-term loss of sexual pleasure is a known side effect and the timing would roughly match. Another side effect that I got, that persisted even after I stopped using them, is grinding teeth at night (but I got a mouth guard from a dentist that prevents the worst off it). Personally I feel like these side effects were worth it - I was really, really badly off when I got on the meds - but I could easily imagine someone feeling differently, if they weren't equally miserable.