A cautionary tale about antidepressant prescriptions among young adults

Jake had never had mental health problems until stressful experiences during his extended church service. When he felt even worse on medication, the recommendation was to ‘keep upping the dose.’

What you’re about to read represents a single story, and should not be read as constituting medical advice. Everyone is different, and it’s always best to follow your own deepest sense and intuition, in counsel with family and professionals you trust.

My friend Jake began his Latter-day Saint mission five months after COVID lockdowns were implemented. While sharing the gospel is soul-stretching in the best of circumstances, pandemic restrictions added unique emotional strain: no approaching anyone in public, 15 minute restrictions on in-person interactions, and many hours of daily online interaction.

What made this more emotionally “grueling,” Jake told me, was an early companion who was abrasive and unkind — and who ignored important rules, which put this new missionary in uncomfortable situations.

This is precisely where it may have been helpful to reach out to other mission leaders, who I hope would have been eager to support. Yet Jake didn’t feel comfortable doing so. “For the first time in my life, my mental health began to crater,” he said.

After a great new companion offered him a “breath of fresh air,” Jake was then paired with someone else who “thrived on conflict” — generating “constant tension” that sent him over the edge physically, prompting significant weight loss and stress-induced vomiting.

The continued stress left his nervous system on “high alert,” Jake recalled. Mission numbers weren’t measuring up, and he described working with his companion to be creative in using their time well every day.

Jake remembers feeling “constantly exhausted from it all” — especially by “so much stress.”

When medical tests showed nothing physically wrong, he took a mental health evaluation that highlighted “anxious tendencies.”

Jake tried various things to help “calm his nerves” throughout his mission — from weighted blankets to cold showers — which “helped a little.”

Yet over the coming months, these emotional struggles worsened due to continued isolation and interpersonal conflict, combined with a sincere desire to “do the right thing” as a committed missionary, while being unsure whether or not he was.

Little things began to set him on edge — at one point, he remembers crying almost every day. Even with significant efforts to get feeling better, Jake felt discouraged to still be really struggling — thinking, “I’ve done everything and nothing is working!”

A new solution?

“Tell me a little bit about yourself — tell me why we’re meeting here today,” the new mission therapist shared with him on a Zoom call.

After Jake explained for a few minutes what he was struggling with, the therapist shared how she had read over his surveys and files and had spoken with the mission president as well: “It definitely sounds like you have depression and anxiety.”

Jake was told they had decided it would be best if he went on medication — a step she said they had prayed about and all felt good about. Additionally, they were recommending that he meet weekly with this therapist.

After being “desperate to feel any better,” Jake remembers feeling hopeful that medication may be able to “fix” the problem. Yet when he called his parents regarding the plan, they tried to pump the brakes a little: “Gosh, this seems so quick, Jake. Maybe we should think about this more and look at all our options?”

When his mom and dad said, “This is only one answer. Have we not looked into anything else?” Jake remembers responding: “They told me that they prayed about it and they told me that this is the right answer.”

The confidence these leaders had in sharing these recommendations mattered to him— all of them feeling assured this treatment would make a meaningful difference. Jake decided his parents simply didn’t really understand “what’s going on” with mental health problems generally.

Jake was quick to add that his parents remained an incredible support to him throughout his mission — describing how their constant communication offered a “solid foundation” for the ups and downs of his whole experience.

‘This will fix it’

Jake had seen medication make a difference for some other people — and for the first time, he felt like this was a “real answer.”

“I just remember being so desperate to not be stressed and sad anymore,” Jake recalled, thinking at the time: “This is the only way to fix this. There are no other options lying down in front of me.”

Jake has no memory of the treatment risks ever being explained to him. “I was not really told any of the risks … I was just told this is what will fix it.”

“Once I finally got some sliver of hope, I just ran with it,” Jake said, reiterating: “This is what everyone keeps telling me is the right way to go about this.”

Other sisters in the office were especially kind to him during this time, he said, helping him “feel the love of Christ.” Together, they even decorated a pillbox to make the experience feel “fun.”

‘I don’t feel good’

As Jake started the medication, however, he didn’t feel so great. Fatigue had been part of his experience before — with stress building up until it felt like he had “shut down” for a period.

Eventually, he would feel enough energy to pick himself back up again. But when he started taking the medication, Jake said he “lost all energy” and was in a state that felt consistently “zero energy,” with less breaks or bouncing back: “I would wake up tired, I would go throughout the day tired, and I would go to bed tired.”

“I couldn’t wake up before 9:00 a.m.,” Jake recalled. He kept meeting with the therapist — telling her: “hey, I don’t feel good. I don’t have any energy. I still feel awful.”

Although Jake wasn’t feeling the same sadness and stress after starting the medication, he described earlier discomfort morphing into something else: “I was so numb: no emotion or feeling, just kind of blank.”

“I would feel these things, but they wouldn’t stick. I wouldn’t care — but I would still care at the same time. I was just there — but still in it. Things felt gross,” he said.

Feeling worse, taking more

When his mental health support team found out he was feeling worse, Jake said they recommended that he increase the dosage.

The original plan had been to slowly increase the dosage over a period of months, but given how poorly he was feeling, they ended up raising the level to the full prescribed dosage over 3 weeks.

Pretty soon, Jake recalled having “zero energy — I couldn’t get out of bed.”

That’s when he started to notice several other uncharacteristic side effects. Jake started noticing gaps in his memory — where his companion would remind him of a visit or conversation he had no recollection of.

Jake also described more unusual emotional numbness, feeling generally “out of it.” He said, “I literally had zero emotion,” he said. “I felt absolutely nothing.”

“I kept telling the therapist, ‘I don’t think that this is working,’” he recollected. “And she would tell me to keep upping it.” Once he reached the maximum dosage allowed, the medical team turned to some recommended vitamins, such as B12.

“It got to the point where I had like this pill case with my meds and about six or seven other supplements that I was taking that she had recommended to me.”

“And I kept, just, not feeling good,” he said.

‘Feeling like a ghost’

After Jake returned home, he stayed on the antidepressant (Prozac). He assumed the medication was important to continue for his basic emotional well-being.

But he continued to feel poorly. His “zero energy” fatigue continued — struggling to get out of bed. At the family business where he worked, Jake was supposed to be there by 10 a.m., but he would miss shifts sleeping in until 3 o’clock in the afternoon.

Relationships were affected too, he said, as family members got more confused and concerned — asking: “what is wrong? What are we going to do?”

“I was not feeling great, I was constantly sick and tired,” he remembers — recalling a different doctor appointment each week, which included treatments to try to get his energy back through additional medication.

This made it “really hard to sleep and calm my brain down,” he recalls. “Like my brain wouldn’t stop” — which seemed to contribute to an increasingly “constant state of anxiousness.”

This prompted additional medications to “try to help put me to sleep.”

When Jake struggled to wake up, they tried to find another medication to help him “wake up.”

Eventually, his doctor said he had a “problem with turning his brain off” — and suggested that he consider an antipsychotic to help, in small amounts.

“It will kind of be like your brain is turned off,” his doctor cautioned.

“I remember I would cut my pill — a little baby pill — and I would cut it into fourths, and I would ingest that piece and I would lay in bed and it was like someone had switched off consciousness. It was one of the craziest feelings.”

“I remember staring into space, my mind completely blank, feeling like a ghost.”

‘I didn’t used to be this way’

Jake found himself getting angry at everything that had happened to him — especially when he compared it to back when he had felt better. “I’d never been like this in my life,” he remembers thinking.

“How did I get here? When did this start?”

Although he had struggled with stress and anxiety on his mission, Jake realized the feelings of hopelessness and heaviness had emerged later.

“I was like, ‘where did this start?’ … it was once I started all of these medications.”

‘I’m done’

At a doctor’s appointment, Jake recalls struggling to remember when to take each pill. “All the stuff had been bubbling and bubbling, and things were getting worse and worse, and worse,” he said, to where he finally reached a “breaking point.”

That’s when he remembered looking at his family doctor — this trusted support who had filled out his papers to help him get into the mission field — and telling him: “I’m done — I can’t keep doing this.”

“I’m just sick and tired of being sick and tired,” Jake remembers saying. ”I cannot keep doing this because it’s obviously not working.”

Jake had only been on the medications for six months, so he and the doctor felt it was safe enough to stop the medication without tapering [note: going slow is almost always the best way].

His doctor responded, “yeah, maybe we just kind of stop. We’ve tried all these different things — nothing seems to be working. Everything just kind of seems to be making things worse.”

“Why don’t we just kind of stop for a while and see how your body reacts,” this physician said.

‘Slowly the fog lifted’

Jake still struggled with energy for the first couple of weeks — and said it took about a month and a half to “get myself out of it.”

In our interview, he twice said that the best way to describe this experience afterward was like an “unthawing” or “de-thawing,” where “I slowly remember gaining consciousness.”

“Slowly, the fog lifted,” he said.

“I had been in such a deep hole with just everything,” Jake said, emphasizing how low his mood had been. And after stopping the medications, he described how he stopped getting into that darker place.

It wasn’t easy, and there were stressful times when he’d “kind of nosedive,” Jake noted. But overall, “I was slowly waking up and gaining my energy back.”

Finally, it got to a point where one day, Jake remembers saying: “oh my gosh, I feel normal again. Like, I don’t feel exhausted 24/7 and I am starting to feel these emotions again.”

His mood, he said, “just like crazy improved — like I wasn’t as sad anymore.”

Jake is quick to acknowledge the benefits he’s seen others receive from medication. But for him, he said that going off the medication was “one of the best decisions I’ve made.”

Looking back, Jake also learned some other things: “Maybe this isn’t the chronic condition I was told it was,” he remembers thinking. “Maybe it was more situational.”

“I’m learning now that I wasn’t crazy, and that there are many paths to healing.”

Today, Jake still feels some frustration about what happened — both towards his unhealthy companionships in the mission field and how quickly he was encouraged to start medication.

In retrospect, he feels like there was too much hurry to try and fix the problem quickly. But now, Jake is looking forward to what the future holds. He’s training to be a counselor himself — and he is grateful for the growth and lessons he’s gained through these experiences.

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Two notes:

• This story cannot be syndicated or excerpted without written permission. I felt a trust by Jake to be able to publish his experience — and want to make sure it’s shared in a way that invites more awareness and thoughtful conversation about mental health and faith — ensuring that the story is not used in any other way.

• If you decide it’s right to begin tapering off any medication, that should ideally be done with the supervision of a medical professional — and very gradually and carefully (at 10% decrements, according to best practice). If you’re on multiple medications, the tapering usually needs to be one medication at a time — never all at once and certainly not “cold turkey,” which can be dangerous. Too often, even professionals believe a psychiatric medication can be discontinued quickly (“let’s cut the dose in half”), which can inadvertently lead to withdrawal effects significant enough to convince someone that getting of the medication is impossible.