DISCLAIMER: The following post is merely reflective of my personal experience and not intended to be used as medical advice. Every action described has been taken in direct consultation with medical professionals. If you have mental health concerns and would like to know more, please consult with your local GP or other mental health services offered through the NHS.

I had been on Escitalopram (Lexapro) for nearly a decade before my GP asked, Have you ever considered coming off it? This was in October. I had only started my PhD a month before. Well, I have been off it before, I reply, and it wasn’t very pretty…

Important Context

In 2024, it is reported that nearly 9 million patients were prescribed mental health medicines in England. That’s about 15% of the country’s population. Additionally, the Center for Disease Control (CDC) in the US reports that ‘the prevalence of depression in U.S. adolescents and adults increased 60% in the past decade‘ and that ‘Women (15.3%) are more than twice as likely to take medication for depression than men (7.4%)’. This is a highly multifaceted issue that takes more than just one blog post to unpack: those in the medical field will tell you that big pharmaceutical companies have a role to play, others will suggest we have a mental health crisis on our hands– perhaps in reaction to the loneliness epidemic or the fact that young people are losing critical skills in socialisation, thus negatively impacting their social health.

It’s important to clarify that mental health is an extremely complex issue, and everyone’s experience of it is unique. I don’t intend to speak for everyone by sharing my own experience, but I do hope that this will be useful insight for anyone who may be going through anything remotely similar.

My Diagnosis

As you can probably already tell, I do not shy away from my mental health. That is for reasons that will become very apparent soon. I was first diagnosed with generalised anxiety at age 9. I was so young that I had to look up ‘anxiety’ in the dictionary (yes, the actual, physical dictionary). I didn’t know what it meant. And I was in denial that I had it, too. But I knew I was depressed. I felt increasingly negative about almost everything- including the future- and would cry at least once a day, sulking around waiting for anyone to come by and ask, What’s wrong? I wasn’t the most assertive back then, and there did end up being a few people who voiced their concern. As I grew older, I gained more perspective and realised that it was, in fact, my incredibly heightened anxiety that would trigger my depression. Once I was a legal adult, I made an informed decision to trial a very mild antidepressant: Escitalopram. After 6 months, I felt like an entirely new person. I felt much more positive about the people and the opportunities around me. I felt more gentle in my demeanour, less aggressive and annoyed. This was a fantastic version of ‘me’. But after a few years, I started to feel dependent on the medication. Without it, I thought, I couldn’t be ‘me’.

I was not optimistic about the effects of coming off my medication, but I was curious: Would the version of me that I knew before come back? Or had I grown up enough to be able to harness these emotions?

Coming off of SSRIs during the PhD is an interesting decision, and it is certainly not one to take lightly. I should clarify that I have a stellar support system, both in Scotland and back home. This helped the most, as I was surrounded by so many people who only wish for my happiness. Some of those knew me before the medication, but many more did not.

Here are just a few takeaways I have from this process…

1. The Perfectionist is back.

Back in my childhood, I was incessantly fixated on always going above and beyond. This could be crippling at times, as it often meant that whatever work was in front of me took priority above all else– my friends, my family, time I could have spent doing something that actually ‘mattered’ to me.

This little voice is back inside my head now. But I only let it in at select times. For instance, I realised that my writing had fallen just a bit by the wayside. The cool and casual voice I had developed while I was caring just a bit less had become too extreme, and this was manifesting in my writings sent to my supervisors. Initially, I thought this was about adopting a particular academic voice. When I came off my medication, however, I realised this was about rigour. With the Perfectionist back in my mind, I could more easily find and address the holes in my arguments, where I lacked credibly and demanded sources. I could more easily admit where I didn’t know what I was talking about, as opposed to pretending I did out of sheer optimism.

2. Emotions are heightened.

Even though I was on a small dose of a fairly mild SSRI, it was enough to significantly dampen all of my emotions. I know this because I felt the effects after gradually waning myself off. It became apparent to me when a couple being voted off of Love Island elicited a stream of tears that, in all likelihood, I have been holding in so much for several years.

You might think that this would be a detriment and distraction to the PhD. In actuality, this keen sensitivity actually allowed me to see things more clearly and focus on what matters. In the previous semester, for instance, I would attend talks, networking events– anything going on within the University whether it was a valuable use of my time or not. After weaning off my medication, I began to see everything more clearly. I started saying ‘no’ to more things, but this was more of an ’empowered no’ than previous, ‘disappointed’ no’s. My gut feeling, more sensitive than ever, was able to tell me what I enjoyed and what I didn’t care for. In turn, this has given my research more focus and more drive than ever before. Now, I can begin to answer those crucial questions that are sure to pop up from time to time: Why does this research matter? Why should anyone care?

3. I needed a network more than I thought I did.

We all get told to ‘find our people’, especially when beginning the PhD. Before weaning off my medication, I was definitely seeking ‘my people’, albeit in a more detached mode. I would meet lots of people that I found interesting, follow up, etc. My sense of curiosity about others was acute, and I always thought I had plenty to ‘give’ to others in terms of contacts, organisations, academic resources, etc. But what about what I needed as well?

I always assumed I had the opposite problem (that I wasn’t as invested in others as I was in myself), so I moved in the complete opposite way. In any networking situation – but especially those in the PhD – you want to have a clear sense of, what am I getting out of this? That voice has been a little more present in my head lately, and it has made me realise that those connections require me to open up a little more than I would have liked previously. Don’t ask, and you don’t get.

Final Thoughts

In summary, I discovered that the version of me before medication is not all bad. As a matter of fact, I realised that I was missing parts of myself that I have probably needed for quite some time. This was not just in relation to the PhD, but also, my partner, my friendships, my hobbies and activities. I also realise this may not be the case for everyone, and I did think at several points I would likely have to go back on my medication. Even if I do at a certain point, there is no shame in that. Ultimately, as long as I am focussed on my own wellbeing and aware of when it is tanking, that is all that matters to me.

Thank you for reading, and if you have any questions about this topic or would like to discuss this further, I am happy to chat more about it.