Most people I've noticed don't do reviews on the prescription drugs they take.  Which is a shame because most adults at some point are on some sort of prescription drug and sharing their experiences with others could be very helpful.  This is particularly true with regards to drugs that are used to treat the myriad of mental disorders out there.

Before I was 21, I had never had any substance more heavy duty than an antibiotic.  I hadn't even consumed alcohol.  I have never tried smoking.  Throughout my 20s, the most experimental I got was drinking the occasional margarita while dining out.

But now I'm in my 30s and as an American, it is my God given right to feel perfect all the time in all ways. As any doctor will tell you, Americans tend to start to discover prescription drugs in their mid 30s. And by the time they're in their early 40s, they have either come to terms with whatever changes are occuring in them or they develop life-long dependencies on them that can lead to death.  Sometimes it is sooner (many famous men overdose on various types of drugs starting in their early 30s to early 40s). 

Many people start to really feel the bite of physical depression. That is, depression that has no known rational cause. It's not just about being in a bad mood. Depression is not the same as "I feel depressed".  It is different for different people.

Depression is often slow to be recognized. Denial is powerful. Usually, there is some triggering event that makes the person realize that they are feeling utter despair.

In my family, the trigger is usually the recognization of "is this all there is?".  This can lead to a sense of hopelessness and eventually utter despair in which nothing is enjoyable anymore.  A good way to tell if you have depression is if you sit down and itemize the things you generally find enjoyable and discover that none of them "taste" fun. 

In my case, it was that feeling of "taste" (this probably won't make sense to most of you) that was the key. I would list the things that brought me joy or fulfillment and none of them "tasted" fun anymore. This led me to discover the role of serotonin in regulating mood.

My situation is complicated that the feelings of despair were not constant. They were cyclical in which parts of the month I'd have what is called hypomania. The unique combination of temporary despair and hypomania in my peculiar circumstances were beneficial for most of my adult life.  Let me explain that below:

During the times of despair, I fully believed that if I simply accomplished a set of objectives that I would find the joy I was looking for.  Hypomania, by contrast, made me feel that I could accomplish anything I set my mind out to do.  Hypomania, in moderation, can be the catalyst for great success. And in my case, despair motivated me to make full use of the capabilities I had when I was in hypomania mode.

And so throughout my 20s and early 30s, I simply assumed that my moods had a rational origin. I felt despair simply because I had not yet accomplished my goals yet and simply needed to work harder. I didn't really understand how much of our behavior is controlled by brain chemistry. I believed my depression would go away once I had rational justification to be satisfied with my life.

So it is important to stress that physical depression is not rational.  If you lose your job or your wife leaves you or your dog dies and you feel depressed, that's rational and you will either get over it in time or you can seek counseling or therapy to work through the problems.  By contrast, physical depression is caused by something in your brain. It won't go away unless the chemicals in your brain change.

As someone who is happily married with 3 beautiful, healthy children. A wonderful and lovely wife; lots of friends; the ultimate dream job (I make computer games and desktop experience software); all the material comforts I could possibly want and a low stress lifestyle; etc., I knew if I wasn't in the land of joy, there had to be something else going on.  At some point, even a dullard such as myself could see that there was no rational origin to feeling despair.

And that made me take a hard look at my life: "I don't want to miss out on appreciating and enjoying my wife, family, friends and life that I have. It is time to do something."  And after a visit with my doctor led me to Celexa.

Now understand, I owe my material success to my pecular brain chemistry.  The certain belief that joy was around the corner if I simply accomplished more(tm) motivated me to work extremely hard and constantly work to improve myself.  And coupled with the magical hypomania with strong personal discipline gave me the capability to accomplish these improvements and objectives. 

Since college, self improvement has been a major goal. Self improvement would give me the skills necessary to accomplish the life objectives that I believed were the rational cause of my occasional feelings of utter despair.

Anyone who visits my home will probably notice almost immediately our "library".  I read a lot.  A book or two each week. History. Business. Anthropology. Biology. Physics. Self-Improvement (particularly in building empathy skills) and of course lots of Fiction.  It has not always endeared me to my extended family as some of them think I'm a know it all (not that they've said it but empathy is the closest thing I've found to a magical power -- if you build up your empathy skills and combine it with a reasonably objective mind you can practically read minds as long as you can see their face and body language but that's for a different discussion).

But like I said, at 35 having accomplished the major objectives I had set out to do and feeling only worse and worse, I knew that the feelings of despair weren't ratonal.

It is with this background I review the prescription drug Celexa. Celexa is one of the selective serotonin reuptake inhibitors that have come out in the past decade or so. They work by allowing your brain to keep more of the serotonin that is floating around your system. It is commonly believed that depression is largely caused by a lack of serotonin in the brain.

Celexa is a pill you take once a day. You have to take it every day.  If you don't, the effects will start to wear off.  You should not take it if you are bipolar as it can greatly affect your "manic" phases. 

Since I am somewhat bipolar (the hypomania part), I am not the ideal candidate for this.  But as individual adults, we have to decide for ourselves whether we can excercise the awareness and self-discipline to control manic aspects of our personalities.  My interest was in taking care of the despair. I would do my best to control the hypomania side. More specifically, what I have is called Cyclothymia (for those of you into this kind of thing). That is my self-diagnosis anyway.

My doctor has kept close tabs on this as I made him aware of this situation. When I first informed him that I have hypomania (after being on Celexa for 2 months), he asked me if I had done anything reckless? I responded "Well, not today. I just dropped off my mistress on the way here. Then I'm going back to the casino in the car I stole. I'm feeling lucky."  Suffice to say, you shouldn't joke about this because it is a serious issue -- if you are bipolar, SSRIs are not for you in general. Only you can judge if your manic phases are something you can control.

The Effects of Celexa

In the 5 months since I have been on Celexa I have noticed significant changes in my personality. Whether they are good or bad is very subjective.  Below are the changes I've seen:

1. I am happier.  I am significantly more satisfied with life in general.
2. I appreciate my kids and my wife significantly more.
3. I have poorer impulse control than before (i.e. I will tend to do and say what I want, when I want).
4. I have become significantly more materialistic. This is a change I don't particularly like. It's worth noting that in the 5 months I've been on Celexa I've purchased a Porsche 911 Turbo, got HDTV service, an iPod Touch, a very high end digital camera, a new 24-foot boat, a high end cell phone, and numerous other things.  These kinds of purchases would have been unthinkable a year ago even though I could easily have afforded them.  My friends would look on with amusement for years as I cheaped out on getting HDTV service and didn't even get a decent TV until my ancient 35 inch TV finally died.  Instead, I simply invested and invested and invested my earnings (literally saving the vast majority of my yearly income in various mutual funds, stocks, bonds, and other assets).
5. My productivity is significantly lowered. Much of my success in life can be put towards my ability to do "un fun" things in a timely manner. Now, I'm much more like normals where I simply avoid doing things that aren't fun.
6. I have to actually put effort into doing things that aren't fun. Whereas before, everything was equally fun or not fun so I had no problem doing the things that needed to be done because I didn't find those things "not fun".
7. I have started listening to music more.
8. My stress level is somewhat lower and more consistent.
9. I'm a lot nicer to people.
10. I'm a lot more candid to people - the hypomania is controlled but more present: I come across more conceited and smug (whereas before I might have come across more as an arrogant jerk instead).
11. I'm more patient.
12. I sleep a lot better.
13. I have a harder time staying up and working, even when I need to.
14. I'm less energetic overall.
15. I'm a lot more social.

As you can see from those 15 things, there's some good and some not so good results.  The bottom line question is - is it better to be happy or capable?  Because that's the net result when you get right down to it.  My capability to do things is significantly less than it was but I'm a lot happier with life. If I had been on Celexa 10 years ago, there'd be no company, no big house, no vast investment portfolios, no summer lake cottage, etc.  But I probably would have been a better dad and husband.

Your mileage will vary.