**Content warning: The following text describes depression and substance use and can be disturbing and/or triggering for some readers. Please find resources listed at the bottom of the article.**
An orange pill, 100 milligrams, chased down with the half–empty La Croix on my windowsill, and a bitter aftertaste stinging the bottom of my throat. This ritual, completed daily in my Quad single, is how I started my mornings as a freshman at Penn.
In the months leading up to my arrival on campus, I cultivated a fantastic image of my college experience: finding a best friend in my hall, working at the school newspaper, joining a sorority. Only one of those things panned out. At first, it seemed normal for me not to have many friends in college—I was adjusting to a new environment—but after a few months my family became worried about me. While other kids I knew would spend their weekends together at expensive restaurants or partying in newly purchased outfits, I ate stale Fruit Loops at Commons and practically lived in Van Pelt, overstudying for exams and rewriting essays. I was frustrated and sad, but also consumed by a mental fog.
I was high–functioning in that I showed up to class and did my homework and responded to text messages from home. But Penn wasn’t turning out how I expected it to, and I blamed myself. Instead of trying to make new friends, I would spend Fridays curled up in my comforter, researching transfer admissions and googling how to drop out. For the first time in my life, I felt like I was failing and I didn’t know how to fix it.
The evening of the homecoming game against Princeton, I went for a walk down the river, near Penn Park. I remember burying my hands in my red and blue wool sweater, wondering why I wasn’t happy here. My few friends, who didn’t know me very well, weren’t in the position to heal me. I went on a walk without a destination, and considered checking myself into the emergency room where maybe someone could ease my pain. Instead, I paused by the Schuylkill River, called my father, and told him I needed help.
As I confronted reality head–on, I became so wrapped up in hurt that my only concern was the immediate future. Side effects, withdrawal symptoms, and how much treatment cost my family weren’t considerations. I was desperate for help, to feel like the eager 17–year–old I was before I came to Penn. After the phone call with my dad, I consulted a therapist and psychiatrist, and started taking antidepressants. Healing myself meant therapy, but also prescription medication that was hard to stop taking.
Mental health issues are an epidemic on college campuses, and ours is no exception. Fourteen Penn students have died by suicide since 2013. In a spring 2018 study from the American College Health Association, 41.9% of college students reported having felt so depressed it was difficult to function, 63.4% reported having felt overwhelming anxiety, and 12.1% reported having seriously considered suicide in the 12 months leading up to the study. It’s also no secret that many seek help through long–term use of antidepressants. About 15.5 million Americans have been taking them for five years, as shown by an analysis of federal data by The New York Times.
We’ve begun to destigmatize discussions about depression on campus as well as the prescription medications that treat it. What’s less frequently discussed is what happens when it’s time to stop the drugs. Treatment for mental illness might seem as simple as showing up to therapy sessions and picking up your prescription from CVS until you decide to taper off medication.
I continued to take medication throughout my sophomore year. For a while, antidepressants saved me. That cannot be discounted. But eventually the side–effects—weight gain, nightmares, nausea—outweighed the benefits. As I practiced self–care rigorously, found friends I love, and a purpose at Penn, I wondered how much I needed the medication. So I talked to my doctor, tried to stop taking the drugs, and experienced constant physical and emotional distress.
Treating mental illness is different for everyone. There’s no one solution. While I found that they weren’t the right choice for me, some, including people in the narratives below, need antidepressants to function. But, in various forms, we all experienced the pain that can accompany going off of them.
During her freshman year, Margaret Zhang (C’21) would often wake up after blacking out, as a result of interactions from two prescription medications she was taking. Her eyes would be puffy — she would have spent the whole night before crying, which she believes was due to an increase in depressive symptoms following her discontinuation of Prozac.
Margaret, a former 34th Street Magazine writer, believes this was partially a result of increased depression after abruptly stopping Prozac.
Margaret had been taking antidepressants since her junior year of high school. She decided to stop in college without consulting a psychiatrist because she didn’t feel that the Prozac was working beyond a minimal placebo effect. Then came a sudden decline in her mood, missed class, and poor grades.
“During that time I probably had more suicidal ideation,” Margaret said. “It was just like a worsening of depression that was already there.”
According to Dr. Michael Thase, the director of the Mood and Anxiety Disorders Treatment and Research Program at Penn Medicine, stopping medication without planning is common among young adults.
“When people stop medication, they generally do it abruptly without a kind of careful, planned discontinuation scenario,” he said. “So that’s why young adults taking antidepressants are among a group of people who are more vulnerable to [experiencing] discontinuation symptoms.”
Margaret admits that stopping Prozac was “impulsive” and a “bad idea.” The summer after her freshman year, she sought the help of a psychiatrist and began taking Wellbutrin, which she has since continued.
Grace Ringlein (C’20) has also experienced abrupt discontinuation of antidepressants—but it was accidental. There were a few instances when Grace would forget to take her medicine before class or lose it for a few days. Withdrawal ensued, mainly causing dizziness and depression.
“It seems like it makes so much sense looking back, but, at the time, when you’re not taking your medication it just seems like you’re just feeling worse,” Grace said. “But then you know. Eventually it's like, ‘Oh, maybe this is something else.’”
Grace recently decided to go off of antidepressants permanently. She followed her doctor’s advice, gradually reducing the dosage, and the transition off was fairly smooth.
“I have no regrets about [taking antidepressants]. I think it was a great idea. It’s just unfortunate that I’m one of the people that haven’t had a lot of success taking medications,” she said.
Sophia Schulz-Rusnacko (C’21), a Street staffer, remembers waking up daily with no energy, asking herself why she was trying to stop taking Zoloft: “Why did I go off this? Is it really worth it just to say I can?”
Before coming to Penn, Sophia struggled with anxiety, but when her depression became unbearable freshman year, a doctor at Counseling and Psychological Services recommended that she go on medication.
“It was definitely hectic, like, I didn't really know what was going on,” she said. “I'm from Minnesota so I came a really long way, and that was really hard for me, and I didn't really know anyone.”
She said that she wasn’t warned by her doctor about any side effects or withdrawal or the consequences of drinking on antidepressants.
Once Sophia had more of a handle on things and felt less anxious, she consulted her doctor for instructions on how to stop the medication. She followed his guidelines, weaning herself off of Zoloft slowly.
The symptoms: vivid dreams and nightmares, abnormal increases in anxiety, and fingers so numb that she would grab something and be unable to feel it. Sophia experienced these both going on and off of Zoloft. She eventually was able to stop taking medication, but recently started on Lexapro to help with her anxiety.
Sophia doesn’t regret taking antidepressants. Still, she believes that people struggling with depression and anxiety deserve more information about risk factors before going on medication. “People need to have firsthand stories of what it’s really like rather than just googling it,” she said.
It was Sabrina’s* (C’21) New Year’s resolution to get off of Lexapro. She wanted to remain anonymous because she felt her experience with withdrawal and mental illness was deeply personal. Around Christmas time during her second year at Penn, Sabrina’s parents, who had always been against her taking medication, started asking when she was planning on stopping. She’d been taking antidepressants since sophomore year of high school.
“It really really helped and I felt as though my life would be very different if I wasn’t on them,” she said.
Sabrina had tried to stop taking Lexapro in her senior year of high school, after she had gotten into Penn and felt more stable. Trying to stop the pills gradually was met with serious symptoms.
“I just started to get really really sad again,” she said. “I felt like I would never be okay without my antidepressants.”
Sabrina didn’t manage to get off of her antidepressants until she tried the second time. Still, she was met with serious physical challenges like brain zaps—shocks in your brain that are a common symptom of discontinuing antidepressants—and nausea.
Sabrina recalls lying in her bed one day at Penn, cradling her head because it was hurting so badly. She was experiencing some of the worst pain she had felt in her life.
“It feels like someone’s [sending] electric shocks to your brain,” she said.
Sabrina has been off of Lexapro since January. Although she hated the drugs and wished she'd never gone on them while she was going through withdrawal, she now is thankful for how they helped her.
“I would say it changed my life,” she said. “I was convinced I was gonna be sad forever, and felt really helpless and very very very depressed and the antidepressants did wonders for me.”
This summer, a few weeks after I decided to taper off my medication, I went to Washington, D.C. for a meeting. I woke up in my hotel bed, uncontrollably sobbing. I felt helpless and alone, like my body could never function without drugs.
I cut my prescribed dose in halves and then into quarters. But I’d get to work and feel so dizzy and nauseous that I couldn’t concentrate. As a result, I had to switch to a different medication, and then taper off of that slowly.
Two weeks later, I was taking the subway home after dinner with a friend, and I nearly passed out on the platform.
I still have some of the messages with my doctors. One time, I was “sick and sweaty.” At the start of the summer I talked about vivid dreams and feeling nauseous. I kept asking: “How long will the withdrawal symptoms persist for?”
I am now completely off of antidepressants. No half or quarter or eighth doses or taking the pills every other day. Being on campus and off medication has been challenging, and I still struggle with my mental health.
Last week was my 20th birthday—something I had been dreading for a while. As trivial as it sounds, I didn’t want things to change. I didn’t want to get older or to be more of an adult. Still, like most other Wednesday nights, I went to my office at the newspaper to prepare for print production, put in inch counts for stories, and made final edits. I found my desk covered in gifts and cards: flowers from my best friend from home, birthday cake, kind handwritten notes. And I realized that for the first time since I’ve been at Penn, I’m in control of my body and emotions. I felt lucky.
*Indicates name has been changed.
Isabella Simonetti is a junior in the College from New York, New York studying English with a concentration in Creative Writing. She is the Opinion Editor for The Daily Pennsylvanian.
A previous version of the article misstated the name of Grace Ringlein as Grace Ringling.
This post was updated on September 12 at 11:10 p.m. to reflect additional comment.
The HELP Line: 215-898-HELP: A 24–hour–a–day phone number for members of the Penn community who seek help in navigating Penn's resources for health and wellness.
Counseling and Psychological Services: 215-898-7021 (active 24/7): The counseling center for the University of Pennsylvania.
Student Health Service: 215-746-3535: Student Health Service can provide medical evaluations and treatment to victims/survivors of sexual and relationship violence regardless of whether they make a report or seek additional resources. Both male and female providers can perform examinations, discuss testing and treatment of sexually transmissible infections, provide emergency contraception if necessary and arrange for referrals and follow up.
Reach–A–Peer Hotline: 215-573-2727 (every day from 9 p.m. to 1 a.m.), A peer hotline to provide peer support, information, and referrals to Penn students.
Penn Violence Prevention: 3535 Market Street, Mezzanine Level (Office Hours: 9 am – 5 pm), (215) 746-2642, Read the Penn Violence Prevention resource guide.
Sexual Trauma Treatment Outreach and Prevention Team: A multidisciplinary team at CAPS dedicated to supporting students who have experienced sexual trauma.
Public Safety Special Services: Trained personnel offer crisis intervention, accompaniment to legal and medical proceedings, options counseling and advocacy, and linkages to other community resources.