Once again, I feel the need to preface this by saying that I am not a doctor. I did not go to medical school. While I have a degree in psychology, I did not pursue it further, so I am certainly not a psychiatrist or psychologist by any means. What I am is a writer and a person who has been taking antidepressants for over a year now. What I am is someone who has struggled with both an eating disorder and depression for years. This piece is fuelled by those experiences, rather than an expertise or degree, and it’s not the place to get any dosage advice, that’s for sure.

I’ve struggled with depression since the age of about fifteen, and things got really bad again just under two years ago. There was no specific reason for this, as depression isn’t kind enough to provide a scientific cause-and-effect. I couldn’t point at a toxic boyfriend or a shitty job and unmask it Scooby Doo-style to reveal the villain, “Aha! It’s Old Man Withers, he’s the one making me want to kill myself!” Too dark? Sorry, I hoped the cartoon reference would ease things.

My depression was bad. I was back in therapy, doing the work, as I had been for years, and yet there was no end in sight. I couldn’t tell you why I found it so hard to get up every single day, or why I randomly cried in the middle of the afternoon while my deadlines loomed. I was just sad, and I wanted to be okay, as I’d accepted that happiness was out of reach.

My therapist brought up the topic of antidepressants. She said that it might be worth considering since nothing else seemed to be working. We’d continue our Acceptance and Commitment Therapy alongside it, but she wanted me to speak to the psychiatrist about it. I was nervous about the idea of medication and the judgments that accompany it, but I also felt too tired to keep rawdogging my depression. And I was not interested in hearing people recommend yet another herbal remedy to me.

After weeks on a new waiting list, I met with the psychiatrist. She was an all-business kind of woman who got straight to the point. She had my case file, she had my medical history, and she wanted to put me on escitalopram, also known as Lexapro. This is particularly recommended for people with borderline personality disorder, like me, as it helps to alleviate mood swings as well as general depressive symptoms. We decided to start me off on 5mg per day, and I’d meet with her again in two weeks to see how the side effects were hitting me.

Then she asked how much I weighed. I looked blankly at her, hoping I’d misunderstood the question. Only moments earlier, we’d gone over my medical and psychiatric history, including the eating disorder I’d managed to get under control for now. But she was waiting, fingers hovering over her keyboard, for me to tell her how much I weigh.

“I don’t know. I don’t weigh myself,” I managed to stammer.

“At all?”

She seemed disappointed. I felt like I had failed her in some way. The people pleaser in me wanted to rush out, buy a weigh scale, and give her each digit down to the decimals. The rationalist in me wondered why it was assumed that someone could tell you how much they weigh at any moment. She hadn’t told me to weigh myself before coming, not that I could have or would have. I didn’t keep any weigh scales in my home, except for tiny baking ones, as I knew they were extremely triggering for me. I hadn’t weighed myself in years, and I needed to keep it that way.

“I find it difficult, with my, erm… eating issues.”

She nodded without seeming like she agreed in the slightest, “Okay, that’s going to be tricky. Do you have a good handle on how your body looks? Will you be able to tell if you’ve put on weight? As if you do, we’ll need to stop the medication, of course.”

I mumbled that I did and quickly left her office, shaken by the experience. The next morning, I picked up my new prescription, although I waited another day to take it. I had managed to score tickets to a Lana del Rey concert, and I didn’t want anything impacting that, silly as it may seem.

The thing is, I do have a good grip on how my body looks. I can’t help but body check every single day, a remnant from my eating disorder I can’t seem to shake. I know how my body looks, how soft and fleshy it is, how it fills my clothes, and I resent it for it. But I don’t want to return to who I was, to the life of loneliness, calorie counting, hours at the gym, exhaustion, brittle hair, a burning throat, and everything else that accompanied that dark time.

Fast forward, and my dosage was increased to 10mg. I went through a barrage of side effects, including hot flashes, fatigue, nausea, and, of course, weight gain. At my two-month checkup, the psychiatrist went through her checklist and discussed how I was finding my medication.

I told her that everything felt so much easier. I felt okay for the first time in a long time, or like I had the tools to be okay. My emotions were far more stable, and I didn’t cry randomly anymore. I was sleeping a regular amount and eating an average amount. I was able to exercise again, as this had been difficult when my depression was an anchor pulling me down.

We got to weight, and when asked, I admitted that it seemed like I had put on weight. I could see it on my stomach.

“Ah, okay, let’s look at other options. We need you to stay healthy,” she immediately said.

“I want to stay on this medication. I like it, and I feel better.”

She seemed surprised but shrugged and said to watch my weight gain and other side effects. We left it there, and I exited her office, both nervous but glad I had said my piece.

Many of the side effects passed. I can now get through a whole day without feeling completely exhausted. The sexual issues thankfully left after a few months. I’m not nauseous anymore and gagging at the slightest thing. Some side effects stayed, like excessive sweating and the weight.

I’m a bigger size than I was before starting medication. I think I’m the biggest I’ve ever been, which isn’t too hard as I spent years as a starved, sick person. I’m also the happiest, and dare I say it, healthiest I’ve ever been. I don’t drink alcohol, I go on runs, I see friends, I have quiet nights at home, I don’t self-harm, I don’t starve myself, and I get to do the thing I love most: writing.

My psychiatrist saw weight as the most important thing in determining my health, despite this bigger weight being healthier for me both physically and mentally. I may be a bigger dress size, but I no longer find myself plagued with thoughts of self-harm or overwhelmed by the smallest of things. I enjoy pizza or cookies or whatever else I’m craving, but I also no longer drink or smoke to numb the pain of existing.

My bigger size was a direct result of my medication, a very common side effect, and yet it was immediately dismissed as ‘unhealthy.’ It was deemed more important than my mental health, as that was clearly in shambles. It’s been over a year, and I love my antidepressants and what they do for me, yet I still feel plagued by that psychiatrist’s prioritisation of my wellbeing. I still feel disappointed that a mental health professional chose the appearance of my body over my debilitating depression. I can’t be the only one who has struggled with an eating disorder and depression, and yet the conversation is shockingly poor.

When I see the conversation around antidepressants, I see the same negativity surrounding the weight gain. I get it. I still find myself getting self-conscious about my body not looking like it once it did, but I also wouldn’t trade it in, as now I get to be mentally hot, which is way better. I choose my mind over my size, every single day when I swallow that little pill. I hope that others can make the right choice for them, and recognise that your mental health is worth more than abs or a thigh gap.