The day I had my first panic attack, I went to the school office and told the nurse I felt like fainting. I was in fourth grade, and my parents had just finalized their divorce. I knew, intellectually, my mom and dad loved me, and that trading off weekends at their houses wouldn’t change that. But my body didn’t quite understand what my mind could logically grasp. Deep down, I was afraid. So, I panicked.
The nurse called my mom, who took me to the emergency room. When the shortness of breath and dizziness passed and my lab work came back normal, the ER doctor suggested I see a psychiatrist for anxiety. I was diagnosed with panic disorder and generalized anxiety disorder (GAD) at a child psychiatrist’s office a few weeks later, and I left that appointment with a prescription for a selective serotonin reuptake inhibitor (SSRI), a type of medicine commonly used to treat anxiety and depression. With the exception of a couple months, I’ve been on an SSRI since that day 23 years ago—and I have no plans to stop.
My experience is far from unique. Nearly 17% of American kids and teens ages 6-17 experience some type of mental health disorder, and mental illness impacts more than 20% of U.S. adults. Of the many treatments available, antidepressant medication. is one of the most common, scientifically proven ways to help people with conditions like anxiety and depression function in their everyday lives.
Yet many people see antidepressants and anti-anxiety medications as a short-term solution—something they’ll stop taking when they start feeling better. While that might be the case for some people, others—including me—will be on mental health medication for the long-haul. And luckily, as long as the benefits of the medication outweigh the potential side effects, there’s no strong evidence that long-term use of SSRIs poses any major problems.
“These medications have been around for decades,” says Dr. Jin Hee Yoon-Hudman, a psychiatrist and medical advisor at Minded. “There’s really no evidence that people have had serious side effects or adverse effects from being on SSRI medications for too long.”
Psychiatrist Dr. Jerry L. Halverson, chief medical officer at Rogers Behavioral Health, agrees. He says he’s seen plenty of patients taking SSRIs for decades, and he doesn’t know of any data that suggests it’s not safe.
Now, that’s not to say they’re without potential side effects: Halverson says people might feel nauseous when they first start taking an SSRI, and patients commonly experience changes in weight and sex drive. (If you are concerned about the side effects of an SSRI, don’t hesitate to talk to your doctor, prescribing nurse, or a provider at Minded.)
Untreated mental conditions can come with risks of their own. Depression, for example, is shown to increase a person’s risk of heart disease, stroke, and type 2 diabetes, and anxiety comes with a higher risk of heart disease and substance abuse. Chronic stress, including that from mental illness, also can interfere with the immune system, leaving people more susceptible to sickness. Plus, both conditions can be uncomfortable and debilitating on their own.
These medications have been around for decades,” says Dr. Jin Hee Yoon-Hudman, a psychiatrist and medical advisor at Minded. “There’s really no evidence that people have had serious side effects or adverse effects from being on SSRI medications for too long.”
I’ll admit, I’ve wondered whether my daily dose of Lexapro contributes to my bigger jeans size or affects my long-term health in any significant way. But for me, it’s obvious the benefits majorly outweigh any potential risks or negative side effects. After I got married, I decided to taper off my SSRI to see how I’d function without it. I’d been feeling stable (read: panic attack-free) for a few years, and I was curious if I even truly needed the little white pills I’d relied on for so long. The social stigma around mental illness didn’t help, either. So, with my doctor’s approval, I slowly tapered down from 20 to 0 mgs.
I quickly realized my brain needed the medicine. My panic attacks came back with a vengeance within a few weeks of tapering off the pills. Even though I continued with coping mechanisms and lifestyle changes like talk therapy, exercise, and a healthy diet, I worried so much I hardly left my apartment. Once, I even went to the ER because my panic attack felt like a heart attack, and I truly wondered if I was dying. The trial of going off medication lasted fewer than three months, and I never considered trying again. I even stayed on the medication during both of my pregnancies, without hesitation—becoming a mom was a big enough change, and I didn’t want any other reason for anxiety to rear its head. (Note: Always consult with your doctor, prescribing nurse, or Minded provider if you are pregnant or planning to become pregnant and are taking any mental health medication.)
My experience with going off medication is not unusual. According to Dr. Halverson, recurrence of a mental condition after stopping medication is relatively common. Once you’ve had a mental health issue, you’re more likely to have it again, so it’s important to self-monitor for returning symptoms (and routinely see a doctor) if you decrease your dose or stop it altogether. As a general rule, Dr. Yoon-Hudman says if a person tries to taper off mental medication once or twice and the condition returns, that’s a good sign they might need to be on it indefinitely.
In retrospect, I knew I needed help, but my pride stood between me and a healthier life. I worried medication was a crutch, keeping me from living fully. Dr. Yoon-Hudman says those types of worries usually reflect stigma around mental illness rather than any major concern about the medication’s safety. “There’s a lot of work we need to do in society to help people understand that taking care of mental health is just as important as taking care of physical health,” she says. If you had asthma or diabetes, you’d take meds the rest of your life, so why is mental health any different?”
With guidance from my doctor and a few good friends, I realized medication wasn’t a crutch. For me, it’s a life preserver. I needed—and still need—the medicine to function in a healthy way: to be a good mom to my kids, to have a successful career, to make healthy choices in other areas in my life. What good things can I do in the world if I’m stuck in my house, debilitated by worry?
My story doesn’t apply to everyone, and what you decide about medication is up to you and your health care providers. But if medicine is helping you, don’t feel ashamed—and don’t worry about something terrible happening to you because of it. “As far as we know, there are very few risks of taking an SSRI for either short-term or long-term periods of time,” Dr. Halverson says.
He encourages anyone who’s starting a new medication or considering tapering off an existing med to consult with a psychiatrist, who can help you weigh the pros and cons for your unique situation. Either way, he suggests keeping a doctor involved and letting how you’re feeling guide you to the right choice about medication. For me, that choice is obvious: to continue taking Lexapro for as long as I need it, even if I need it forever.
Getting help with Minded
If you are taking, or are interested in taking, medication as part of your anxiety, depression, or insomnia treatment, Minded may be a good fit for you. Minded is an online psychiatry practice that offers customized medication treatment plans for people 18 and over with anxiety, depression, or insomnia. We offer same- or next-day video appointments with experienced, board-certified psychiatric providers for $65/month. Sign up today and get your first month for just $10.