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Feb 19·edited Feb 19Liked by Freya India

And the amount of girls and women on antidepressants because...... they are on hormonal contraceptives(!!!) Seems like that decades-long experiment of messing with female hormones kinda sucked and came with the worst trickle-down effects (which then needed to be treated with other drugs.)

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People are so quick to slap labels on themselves. I used to be an active member of the big asexual forum, AVEN, back in the day -- late 2000s, because despite being in my early twenties I didn't have a sex drive and was searching for information. Then I lost a bunch of weight in a short window of time, got really active, and my hormones woke up. The modern body is so distorted from the weird lifestyles we live, the questionable chemicals in our food, etc, but the mainstream opinion is to declare that rampant mental issues and identity issues, etc are all perfectly normal. It's bizarre and damaging.

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THANK YOU for writing this!! I'm in my 60s, but I was on both antidepressants and birth control pills when I was younger, and I can tell you the side effects are nothing to ignore. With one antidepressant (SSRI) I gained an "instant" 30 pounds, which took me DECADES to lose, and I SMILED (literally smiled!) through my mother's funeral because I had no feelings. I was a robot. Another SSRI (Zoloft) had me sitting at my computer at work, drooling, while I was supposed to be supervising 50 employees. I told the doctor I would rather be in pain than drooling at my desk! I called myself a Zoloft Zombie. I won't even go into what the birth control pills did to my body. I am now 100% drug-free and very happy (and very against Big Pharma, but that's a comment for another day).

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I started taking an SSRI when I was 16. To this day, I am fairly convinced that there was no choice for me but to receive medical treatment, due to the severity of my anxiety. I was entirely debilitated, cowering, struggling to make it out of bed or communicate.

I think that the boom in these prescriptions is a trend we have seen often before with psychotropic drugs. They are necessary for some, but then become culturally normative and are over requested and subsequently overprescribed. All medicine requires a cost-benefit analysis. I took SSRIs and was able to get out of bed again. I probably was not going to have sex with my crippling anxiety...if anything they have empowered my sexuality as a possibility. But, I recognize there are thousands where that won't be the case, and thus, people should be extremely thoughtful in weighing their options. I think that my parents rightly determined that medical treatment was worth the risk for me...but my experience is not one that can be generalized.

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You did it again: such an interesting, well researched, and powerfully written essay! 💥

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I agree that this is an important issue and I think it's likely that many self-identified cases of asexuality have medical origin, especially in SSRI treatment. But there's some needless conflation here between the kind of sexual dysfunction that occurs during and shortly after SSRI treatment, which is incredibly common, and the kind of sexual dysfunction that persists long after treatment is discontinued, which is rare. Only the latter is post-SRRI sexual dysfunction (PSSD); the overwhelming majority of cases of SSRI-induced sexual dysfunction will be found in people who are still taking the medications. I know you clarified the rates of each at the beginning of the piece, but sentences like "So my fear is this: you might not be asexual. You might be suffering from PSSD" elide the distinction. This isn't the only piece that I've read recently where I've worried that readers will come away from it thinking that a single dose of Zoloft has a good chance of leading to lifelong sexual struggle, or that having sexual problems while you're on SSRIs means they will never go away, when neither is the case. It's important for people to have realistic senses of these odds so that they can make appropriate risk-benefit determinations for themselves.

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Yeah, this is probably partially a reason. On the other hand, I think we might also look at the fact that our society, in general, is veryyy over-sexualized. Even normal, everyday ads seem to have an element of “sexiness” to them. Social media is full of influencers urging girls to be provocative. And it seems like kids are dating younger and younger and getting into sexual situations they should not be in.

I’m not advocating for no sex ed, fyi… I just think we need to take a good look at what we as a society are showing young people about sexuality. This and the medications may very well be working in tandem, too. Who knows. But there’s a lot that needs to change.

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My wife has been SSRI's for a few years now, and the effects have been really defeating. Sex drive has gone to zero, gained a huge amount of weight. Went from an energetic, lively, stressed out, overwhelmed woman full of anxiety and optimism and turned her into an asexual, lethargic, stressed out, apathetic, anxiety-ridden hoarder.

The worst part is the open-ended was of it all. This is a forever drug. You are on it for life. There's no point at which you are "cured" and can wean off.

Utterly pernicious. The people responsible for drugging entire generations of young women will have a lot to answer for in the next life.

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I was on antidepressants for 4 years in college, and although there may have been unintended side effects regarding sexuality (I will have to give this more thought) I am also 100% sure without medication at that period I would have failed out of school and not had the courage to get regular counseling and make a lot of necessary life changes that allowed me to eventually get off the medication. It leveled the playing field so I wasn't starting from way back at the 1 yard line. I think doctors need to be more proactive talking with patients about this, but I hope your piece doesn't scare folks away from getting help if they need it. Suicide is a huge issue in America and in my mind is the one "side effect" of depression you can never rebound from...

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Feb 19Liked by Freya India

I was on various antidepressants for years. Definitely an issue. And the insurance dictated doctors Blame The Patients!

It’s been well over ten years since I was on any & still rather numb.

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I totally agree that too many young people (and people in general) are on SSRIs and similar medications. Many reasons why it's happening—financial incentives, cultural shifts in how we view human distress, etc—and it's a complicated issue. It is also true that sexual dysfunction of one sort or another while taking SSRIs is common and absolutely underappreciated by psychiatrists.

However, I think it is important to separate sexual dysfunction while taking SSRIs (a common and a well-known phenomenon, and one that has some remedies) with post-SSRIs sexual dysfunction. Mainly because PSSD is a relatively new and still poorly understood thing with some big unanswered questions, eg a plausible mechanism for that kind of effect. I've still never met someone who had really long-term post SSRI dysfunction that wasn't easily explainable by other glaring causes. The longest I've heard reliable reports of PSSD lasting is around one or two months at most (again, this is just the people I've seen and talked to). The point is that if it is real, it is thankfully rare.

Generally, though, I absolutely agree that we should be cautious about the side effects of these meds, especially when given to children, although I suspect the link between SSRIs and anything resembling permanent "chemical castration" is probably a stretch. Could be wrong, but that's my sense.

It's also interesting to think about the following scenario: let's say PSSD is rigorously established to be real, beyond a reasonable doubt. I could easily see large numbers of false positive PSSD cases from those who tend to glom onto the currently in vogue diagnosis, whether it is multiple personalities, anorexia, gender stuff, etc. The intersection of this side effect with culture (i.e. sex, and lack thereof) could easily make this a big cultural or even political issue.

Anyway, enjoyed you work as always. Seems I'm less concerned about widespread catastrophic consequences than you are perhaps, but I do agree it is a very big problem.

(Also, your reference to Sarafem reminded me of a fun game I played with a co-resident a while back. Create a fantasy novel narrative but everyones' name is a psych med. eg: We received instructions from the three Elvish princesses, Sarafem, Saphris, and Seroquel. We were to cross the plains of Nardil and head north until we reached the Zenzedi temple. There we would speak with the ancient Sorcerer Atarax, who could provide us with his “Abilify” spell, which would grant us increased strength and fortitude for the battles ahead. We would pass near the Geodon canyon, eventually reaching the port city of Pamelor, you get the idea)

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Wow had no idea about this, asexual dating apps isn't that an oxymoron?

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I continue to be appalled at the extent of the medication of children - and especially the number of young women on multiple long-term prescriptions, including the pill, anti-depressants, anti-anxiety medication and painkillers. Then there are the medications for ADHD etc. Parents and young people seem to be quite content with this - just grateful for an answer to a problem, without any curiosity about the roots of their distress or what they might be doing to themselves in the long run.

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I just want to advise anyone who reads this post and decides to come off their SSRI to //do so gradually//. Seriously, don't go cold turkey.

Personally, I've found a tricyclic far preferable for dealing with my OCD after many, many years of being on SSRI. But if you make a similar move, do so with medical supervision and not just overnight.

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When I read this , I remembered an episode on House more than 10 years ago about an asexual couple. Back then it was still possible to say that there may be a medical cause. Of course I had to google it now and boy oh boy. The asexual community is not happy about that episode.

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I was always curious as to why so many of my peers identified as "ace." Being a late bloomer couldn't be the explanation for ALL of them. Many of us didn't watch porn, oddly enough. But given that depression was so rampant among us, I wouldn't be surprised if they were on medication.

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