Is anti-anxiety medicine too good to be true?

It’s crazy: almost everyone I know is taking anti-anxiety medication.  They’re not crazy, though. Hardly. They’re normal people with normal stresses (jobs, kids, money, aging parents). I should know: I’m one of them.   As a widow and mom of three boys—two of driving age—I have plenty to worry about.

But I was late to the party.  I’d always figured that drugs like Prozac or Lexapro (the drug of choice amongst my friends) were only for people diagnosed with true clinical depression.  Turns out, antidepressants are also being widely prescribed for everyday anxiety, since they have a calming effect on the mind.  One in ten Americans now take antidepressants, and for women in their forties and fifties, the figure jumps to one in four, according to Jennifer St. Sauver, PhD of the Mayo Clinic Center. 

Why the uptick?  “The stresses of daily life and relationship problems can all cause feelings of upset or sadness that may not last long.  But Americans have become more and more willing to use medication to address them,” says Ramin Mojtabai, MD of the Johns Hopkins Bloomberg School of Public Health. 

What kind of medication you take depends on what kind of emotional stress you want to extinguish.  There are two types of drugs for anxiety: short-term and long-term.  If you’re having a panic attack on a plane, say, you’re best off taking a benzodiazepine, such as Xanax or Klonopin, which slows down the central nervous system within about thirty minutes, and wears off after five hours or so.  But because “benzos" make you sleepy and can be addictive, they’re not typically advised for everyday use.

The long-term type of medication, originally developed for depression, is the go-to drug for generalized anxiety. SSRIs (selective serotonin re-uptake inhibitors), such as Lexapro and Zoloft, and the newer SNRIs (selective serotonin and norepinephrine re-uptake inhibitors), which include Cymbalta and Effexor, both increase the amount of feel-good brain chemicals called neurotransmitters. They carry a low risk of dependency and are designed to be taken every day, so they build up in the system and have a leveling effect on mood.

Was I a candidate for one of these popular meds? I’d been feeling increasingly high-strung—quick to snap at the kids or get all OCD over a messy kitchen. Yoga wasn’t doing much to mellow me out. After months of hearing my friends sing the praises of their meds—“I don’t know how I lived without it!”—I was swayed. 

Turns out, mood-altering meds are fairly easy to come by. You can get a prescription from your OB/GYN or your regular doctor, which is what I did.  After a quick chat—I simply said I’d been edgy of late—my doctor wrote a script for Lexapro. Why that one, I asked.  It seems to work well for most people, he said, explaining that all these medications are variations on a theme, each with its own side effects (including low libido, dry mouth, weight gain or loss) that affect different people differently. It’s a matter of trial and error to find the right one for you. 

I was excited to start my experiment in mellowness, and pleased to find out that a one-month supply cost only me only $10 with insurance co-payment. I popped a pill—10 mg as prescribed—immediately. The next day I felt like I was walking through mud. My mouth was cotton, my appetite was off.  I wondered if the dosage was too high, or the drug all wrong. I decided see a real expert in psychopharmacology—a psychiatrist—to oversee my medication.  She lowered my dose by half and said that I should give the drug six to eight weeks to judge effectiveness.  Which made me wonder about long-term effects. Are there any? 

We don’t know yet. According to Charles Raison, MD, professor of psychiatry at the University of Arizona and CNN’s mental health expert, “It's hard to say. But millions of people have taken antidepressants for many years with no obvious difficulties. This is reassuring because if their use was often associated with longer-term problems, these problems would be obvious by now.”

After a couple of months on Lexapro, I began to feel glimmers of a change: My heart didn’t race with a late-night call from one of my sons; I didn’t freak out over a fender-bender.  And most of the side effects had abated. But one was lingering. A cognitive one. I often found myself searching for the right word, mixing up people’s names, losing my train of thought or thread of speech.  

My psychiatrist said that this particular side effect was fairly common, and might or might not go away. We should give the drug more time, she said, then possibly try a different one. 

Or perhaps not. I’d rather be a little bit anxious and have my brain back.  Maybe I’ll just up my yoga dosage.