When Antidepressants Cause Mania

I’ve been thinking about an experience I had a little while back that might be worthwhile to share in this blog. Who knows what the purpose of this blog is… eating disorders? Food? Mental health? In any case, what I’m going to share was a significant, and frightening, event in my life, and might inform those of you who are considering or taking SSRI antidepressants.

A few weeks into starting Zoloft in 2015, something strange began to happen to me. I felt wired. I wasn’t sleeping very much, and found that I couldn’t sit still. For the most part, I kept this under control, and it didn’t disrupt my life– it was only a few days, after all. Except that within this 5 or 6-day long episode, a number of stranger things did happen to me. I remember studying in a center with my friends, and being unable to focus. My brain and body were buzzing. I started doing somersaults on the floor. Yoga (downward dog). I couldn’t stop moving my body, even though we were in a semi-public place, and I shouldn’t have been. The feeling got worse. I took off my socks and shoes and ran outside (it was nighttime, and about 30 degrees Fahrenheit, or quite cold), and I ran around the outdoor track at school a dozen times until I couldn’t breathe. I returned to my friends with frozen feet embedded with grit, my eyes darting back and forth frantically. I felt totally manic. And this kept on happening.

Unfortunately, this isn’t the only time this has happened. The following year, I stopped taking the Zoloft for several weeks. When I resumed, there soon followed a similar period that felt like a form of mania, or probably hypomania. I was racing, and felt out of control. I felt manic, and suicidal. I jogged around campus, and then around town, at night and without a coat despite the cold, frightened and yet exhilarated by the idea of jumping into the street. After one of these panicky jogs, I came home and began to destroy my bedroom. It was midnight, and I was dismantling the wooden boards of my bed, tearing down pictures from my walls. The next day I crashed, and didn’t leave my bed, or shower, or go to classes, or eat a meal for about two weeks.

To be clear, what I experienced was probably not a full manic episode, like the ones that occur in bipolar disorder type one. From what I understand, those episodes often result in reckless sex, violence, crime, or other harm. They’re extreme. Maybe I’m misguided, but that’s what I’ve learned. Contrastingly, hypomanic episodes, like those in bipolar disorder type two, match more so the experiences that I had. Racing, out-of-control, and perhaps engaging in some reckless behaviors, but to a lesser degree. I’m not bipolar, to the best of my knowledge, which is affirmed by the fact that starting Zoloft preceded both major events of hypomania. Which is why I want to talk about Zoloft, and the risks associated with it.

I’m not the only person that has had a manic or hypomanic episode upon starting antidepressants. It’s one of the side effects they don’t tell you about so much, and one of the particularly dangerous ones. The majority of people don’t experience this side effect, to be clear, but for those who do, the experience can be frightening, overwhelming, and down right exhausting. Also, let me mention a few misconceptions about mania following antidepressants that misguided me and made me afraid to seek help right away:

  1. Mania does not occur because you “didn’t need the antidepressants” and so they are making you “too stimulated.” Actually, the chemicals in our brains are far more complicated than that, and a manic episode can be an indication that the drug is being administered in the wrong amount, or that a different drug would be more suitable.
  2. Because mania is not a sign that you’re “not really depressed” (I was quite afraid of this), nobody is going to just take away your medication and not provide you some kind of substitute. If you’re having mania on Prozac, for example, your doctor will probably advise you to stop taking it gradually, but don’t worry– you still deserve, and will still receive, treatment for the depression/anxiety that you were trying to help in the first place.
  3. Mania does not necessarily or even usually occur because there is underlying bipolar disorder. As a matter of fact, if an episode occurs in conjunction with antidepressants, bipolar disorder should not be considered as a diagnosis at all at that point in time, because the antidepressants can significantly alter brain chemistry on their own. This is a major misconception that I had. I thought that I had bipolar disorder, and ignored the fact that I had just started medications which alter serotonin and other neurotransmitters in the brain that are similarly affected by mental illnesses.

I want to share this experience in the hopes that someone who went through, or is going through, the same thing can relate and know that they are not ‘crazy’, they are not alone. And if you think you had a manic or hypomanic episode, don’t ignore that fact. I’ve never told anybody about these episodes, because I’ve diminished them in my head (“It was probably nothing, I was probably just depressed, or hyper”), but thinking back on those times I’m troubled by how erratic and disturbed my behavior was. And above all else, I’m grateful that the episodes did end on their own, and that I didn’t have any lasting harm. Please, be cautious when taking or considering antidepressants, and if you do experience an episode, get immediate help.

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