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Sep 19, 2023Liked by Owen Scott Muir, M.D

Just curious, and you are under no obligation to answer! Did zoloft trigger your only manic episode or just the first one?

I am wondering if zoloft possibly did you a backhanded favor by revealing bipolar sooner than it might have come out otherwise? Or is it possible you would have never experienced mania at all without a trigger like that?

My SIL and my 7 y.o. son take sertraline, and they have anxiety, not depression. My SIL affectionately calls it her "don't be a bitch" pill! We joke that zoloft missed a major marketing opportunity. I vaguely remember a depressed oval with a face bumbling around in the zoloft ads of yore (I was a child at the time, so my memory could be off). It could have been something much spicier like, "Have you been a raging bitch lately? Ask your doctor if zoloft is right for you!"

My son is a whole other story. After experiencing an abrupt personality and behavior change just shy of turning 5, he went from happy-go-lucky to angry all the time, sprinkled in with contamination fears and that come and go (or respond to meds? Idk!). He started Fluoxetine when he was 5. It helped until he plateaued, and then at age 6 he made suicidal statements, so bye bye Fluoxetine! We started sertraline after that was all out of his system.

What did we learn from "rock bottom" before he started Fluoxetine and "rock bottom 2.0" when he was between medications? Without an SSRI on board, my son's life is literally the Limp Bizkit song "Break Stuff" on repeat. I hate that our youngest son is the first person in our family to take a daily med, but it puts a floor under him so he can meaningfully participate in therapies. I hope with brain maturation and increasing ability to express what is going on in his internal world, he can come off it completely some day.

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The Zoloft days. I remember. It was 1994, I was living with my long-time girlfriend in a bee hive apartment complex in Hollywood off Hollywood Blvd, on the west end. By Bee hive, I mean an acoustic fish bowl built in a square around a swimming pool which facilitated even the most hushed conversations to be amplified throughout the entire building. Each apartment was a sweltering sauna in summertime and the only thing good about the bee hive was that pool.

Zoloft did not make tolerating heat any better. I was at 25 mg which would not long be increased to 50 mg. For insurance reasons to justify payment of Zoloft, I had to ride the SSRI train to show no improvement in order to get the deluxe pill.

After about a week after taking it, I felt restless. I checked into a nearby gym to offset it, but it didn't. Then came the intense craving for carbohydrates, pizza, pasta, potatoes, breads and SUGAR! Lots of sugary products. I recall drinking my favorite grapefruit bev at the time that you may not know of, Fresca, a citrusy grafefruit beverage sweetened with L- phenylalanine sweetener, aka, Equal, the blue packet. I noticed that I was sleeping less and had a "floating angst" connected to no particular cause. I also noticed that I felt less subconscious, that things didn't bother me, thoughts, outside stimili, yet there was this angst that seemed to accumulated in the sinews of my muscles and shoulders. There was also a latent feeling of sexual arousal and ideation, which was never relieved by masturbation, because it took ages to cum, if I could maintain the erection.

I didn't feel down and I didn't feel up. I was in the "I don't seem to mind" state of mind. I would often say to my girlfriend, it's not that I don't care, it's that I don't seem to mind about not giving a fuck about not caring.

Observed, I found myself watching inordinate amounts of television. Things I would not watch today. I was easily entertained, it seemed. But, that angst. I started Valium 5mg. I took it daily. It was the name brand too, the pills with the "V-shape" in the middle? That 5 mg, graduated to 10 mg. back then when 10 mg, 1 T p.o. qhs & PRN for panic was $30 dollars. Today, this amount of brand name is $532 dollars.

Enter white wine. Did I mention I was not an alcoholic? White wine became a daily thing. It took care of the angst. I noticed I didn't talk much while on Zoloft in social settings, just sort of held up the wall, until wine. It wasn't until years later, after being off all antidepressants that I read the insert and discovered that one of the side effects of Zoloft, was alcoholism. I was quite taken aback by this. Did I mention the weight gain? I was gaining weight with some muscle, I believe the majority was from water retention.

I was still having lows. I attribute this to boredom and not having a job. My girlfriend & I were "ambulance chasers" for a PI attorney who helped us gain substantial sums of money for fender benders, among other things. My friend in the bee hive who lived downstairs had a reliable cocaine dealer. It was the first time in decades since I tried it. It was an instant lift and I made an instant friend, and supplier. He had connections with cartels, police and three-letter agencies in the intel community. I lived with him for three weeks. By this time you're guessing if I am taking Zoloft with cocaine? No. In fact, they didn't work very well together- at all! After turning gray and losing almost 50 pounds I had to sever ties, carefully. I was facing death. I moved in with my mother, my girlfriend & I were estranged, gee, I wonder why? I lived with her temporarily while I cleaned myself up. I mended my relationship again. My girlfriend & I found a nice apartment in Sherman Oaks, California. It was a total reset. We agreed to change our "vibe." We stopped all network news TV, only listened to ambient meditative music and lived peacefully. I went to Narcotics Anonymous and started my journey in 1998 to become a recovered addict.

I went into therapy with a Ph.D. therapist who championed me through affect regulation and re-parenting therapy to clean the lens of perception and learn a new way to sooth myself by creating my own inner-subjective, affording me some reliable perspective within my psyche to tolerate change and emotions by identifying, naming, and putting them in a place where I can can deal with them so they're not overwhelming. Many times it's like looking at a giant elephant through a microscope, I don't see the whole picture, lose perspective, become overwhelmed, anxious turning to repressed anger to numbing technologies to cope.

We've learned a lot about Zoloft. Depression had made a reprise again in 2007. My psychiatrist, a very good fellow who was a bit of a rebel himself and trusted, who knew he was being gaslit by pharma, as we could discuss it openly, gave me Zoloft to appease the disability insurance- in other words, I got the Rx filled, but didn't take the medication, it was a look good on paper thing.

I took it one day, 50mg overkill in my opinion, and for the entire day I felt like a 2 dimensional piece of cardboard in terms of personality and a "horny zombie." It was rather disgusting and I never took it again.

The world has changed politically, socially, culturally and economically, all factors that can affect the human psyche by relative degrees. A pill will help us accept and tolerate being the proverbial frog in the slowly boiling pot of water, but it won't change it, it won't make it a world where we no longer need "Mediocrity Tolerance Intervention" MTI, whose side effects are seemingly tailored to be treated as separate conditions requiring more mitigation through pharmacology.

It is an EXPECTATION- not a hope, not an idea, that this peek behind the veil will quash these gaslight attempts to ease our suffering because we ARE responsible for making this a better world, but not by being pharmaceutically incarcerated, sequestered into a silent corner because we cannot SEEMINGLY adapt to this loathsome circus, having our normal reactions to an unsafe, fear-mongering protracted state of anxiety pathologized into an abnormality in a billing bible (ref. DSM) I expect cohesion, tolerance of the emotions of our own and of others through empathy and not by avoidance. We don't rent friends to listen to our deep, deeps. In an era of emphasis-lacking text communication we have become spineless and maladaptive, resorting to positivity gurus who teach us to avoid negative people- negative people are "food sources for predators". Well, what service do positive people have if not for themselves, but other positive people who have no needs? This is fallacy, idealistic self-deception. Even positivity will degenerate into negativity, the Law of Physics demands it. How can being positive have a difference save not for the negative. Society has again polarized the already polarized!

We live on a fragile sphere, on the edge of a whirling galaxy spinning in a cosmos, how arrogant to believe that such a reality can be so self proclaimed. That, in the grand scheme, the grandiose can be almost imperceptibly miniscule, to the point of invisibility. How an antidepressant, can somehow create comfort and relevance in such an expanse defies imagination.

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