Like Ozempic for Your Brain

Please invent a drug with no side effects that makes me stop feeling scared all the time

“So, what brings you in today?” the psychiatrist asked me.

I suppressed the urge to groan.

The last time I had visited a psychiatrist was in college, but I still remembered that particular air of detachment they all seemed to have.

That glazed over look they got after asking you how you were feeling, as if it were just a formality.

“I have a lot of anxiety,” I told her.

My anxiety is crippling in a functional sort of way. It compels me to take a picture of the stove before I leave for a trip so that I can look at it and know that I didn’t decide to turn on the broiler before driving to the airport at 6AM.

It’s the kind of anxiety that propels me back into the house if I haven’t said a proper goodbye to my most prized possession—a snowy white teddy bear that I have had since I was a baby. And this is after I have already done the same little dance I always do, trying to decide if it is safer to leave the bear at home where he could be burned up in a fire or take him along on the trip where he could be lost in some cold, unfeeling hotel room.

Usually, I decide to leave him. A talisman to protect the house. But I have to say goodbye, or I will worry that I have somehow jinxed us, and all but guaranteed the house will turn to ash in our absence. I snuggle my face into the well-worn fur and breathe in, memorizing the slightly dusty smell of over 30 years of affection, trying to seal some protective spell around us.

Lately, my anxiety had coalesced around a single, pulsing fear.

“Anxiety about what?” The psychiatrist asked. As she spoke, the earthquake simulation that had been stuck on a loop in my mind for months began to play.

Where I live they call it the “Big One,” the legendary quake that will inevitably rip through the West Coast, right before drowning it in a massive tsunami.

“The Earthquake…?” I replied, embarrassed. “Generally, I worry about the people I love dying a lot.”

That’s really what the Earthquake is about, right? I am afraid that someone I love will die. I’m afraid of not knowing if my friends, or my boyfriend, or my dogs are alright. I’m afraid of being inside a brick building. Of having only fifteen seconds to locate and get underneath the sturdiest looking piece of furniture in the room so that, if I manage to survive the building collapse, I will have a pocket of air to keep me from suffocating before someone finds me.

“Death?” the psychiatrist asked, surprised. “What do you think that’s about?”
It struck me as an odd question, as if death isn’t the most cliché fear of all time.

“I think it’s just a reminder that I don’t have control,” I explained, lamely, trying to point up the fact that it shouldn’t need explaining at all.

Except, it isn’t exactly death, is it? I’m not afraid of dying—although I’d prefer it not happen to me, personally. What I am really afraid of is living after someone I love has died.

I’m afraid of suffering.

After we had moved on from the “why,” she started talking about the thing all psychiatrists love to talk about: drugs.

That is why I was there. I wanted to be prescribed something that could turn off the part of my brain that wouldn’t stop running disaster preparedness videos against my will. But I was hoping for something new.

SSRIs? Been there. Kind of a let down, if I’m honest.

Beta blockers? Tried them! I swear to God they made me MORE anxious.

Vitamins, supplements, quitting caffeine, drinking water, getting enough sleep? Aren’t those the first things everyone tries?

I know some people feel skeptical of medication, and in general, I do too. I would prefer not to take something everyday, for any kind of ailment. I would rather pretend that whole foods and Vitamin D can cure everything (they can’t).

But I do love the idea of a magical fix. I keep a single blue Adderall pill in a ceramic box on my desk, bestowed on me by a friend. I tell myself I’m saving it for the right moment. But the truth is, I just want to keep the possibility that it will “fix me” alive.

I wanted the psychiatrist to tell me about a new wonder drug, like Ozempic for your brain. Instead, she asked me about my family, about any medications they’ve taken in the past that had worked for them.

“I’m not sure,” I said, trying to recall any particular drugs my family members had found effective. “I could ask though.”

“Would you like to call one of them right now?” She asked, looking at me expectantly. I laughed, but she wasn’t joking.

“Uh, no,” I replied, thankful that I had managed to wrestle my desire to please every person within 200 yards of me into some kind of submission over the years. “I will call them later.”

I didn’t call them later. Because the psychiatrist prescribed me an anti-anxiety medication, another SSRI. I decided it couldn’t hurt to try again.

Instead of flipping off my anxiety like a switch—one second the inside of my mind all noise and heat, the next, a cool dark room—it made my hair start falling out and turned the idea of sex into something distant and philosophical. A concept, instead of a desire.

“This isn’t working for me,” I told her at our follow up the next month, explaining the adverse side effects.

“Hmmm, well, usually what works for your family also works for you,” she replied. “Did you find out what medications they have tried?”

“Oh, not yet.”

“Would you like to call them right now?”

Oh my god, what is this woman’s problem?

“No, that’s ok.”

“Are you sure? I just don’t want you to forget again.”

“I won’t forget,” I told her, already mentally writing the essay that would immortalize her request forever.

“Well, find out,” she said. “And if SSRIs don’t work for you we could try some other things!” She cheerfully rattled off a long list of drugs, ever increasing in severity until she arrived at lithium.

“As a last resort of course, if nothing else seems to do the trick!”

I was already standing up off her couch. In no world, would I be accepting a prescription for lithium because of my (normal?!?!) human fear of death.

After the appointment, I sat in my car and let tears run down my face—a guilty pleasure. It was a sunny autumn Friday. The trees lining the office were a warm, Braeburn red. I was finished with work for the week and headed to dinner with my boyfriend later. My life was good.

But I have that disease where good things trigger terror because you are convinced that nothing good will ever last. Good is never just good. It is always pre-bad.

I knew then, as I have always known, that there is no magical fix for these things.

A few years ago, I learned about this concept called the Upper Limit Problem.

The idea is that we have a limit to the amount of happiness or goodness that we are comfortable with, and if we exceed that limit we will find a way to “limit” ourselves, often through self-sabotage. Thus, returning ourselves to the range we feel comfortable with.

I think this was framed as a salve for being dumped—don’t worry girl, you just made him too happy! (whatever you gotta tell yourself to get through it, right?). But I think it’s more relevant for me now, in the context of being in a relationship.

About two and a half years ago, my life got exponentially better and more exciting when I met my boyfriend. For a time that excitement overshadowed my anxiety, but as the initial high wore off it returned with an even more keening pitch.

When the psychiatrist asked me why death was bothering me so much, the real answer was that I suddenly have so much more to lose.

I had exceeded my upper limit. So, obviously, it was time to start obsessing about when the Earthquake would hit.

There is some malformed part of me that thrives on starvation, and it feels threatened by happiness. As if the joy itself will become a beacon for pain, drawing it in like a ship off a stormy coast.

Not all apprehension is premonition. And the universe doesn’t have heat-seeking missiles closing in on every pulse of happiness. I know that.
But sometimes I don’t really believe it.

Hopefully one day they will invent a drug for that.