On Autumn and a recent visit to the ER

It’s autumn.

If I were still in Tennessee, I’d be watching the trees transform from their enchanting emerald hues to a blaze of phoenix fire, ruby and citrine dancing together, the grand finale before winter comes. Traces of oak and sap sojourning in the wind.

It occurred to me that life can feel a bit like this at times. There’s a grand bolt forward, new growth, a sweet spot in that summery limelight — everything feels perfect for a moment. And then it isn’t. Life comes in waves, peaks, highs, and lows.

I was sitting across from my psychiatrist just a few weeks ago, recounting to him how I felt in desperate need of finding a rhythm to life that didn’t include the lows I so frequently experienced from having PMDD. We celebrated that I’d already overcome OCD, anxiety, bulimia, and most of my struggles with PTSD.

He prescribed me Zoloft, and then all hell broke loose.

Less than a week later I found myself lying on a hospital bed trying to recount to the doctors at a local hospital what was wrong and not being able to string sentences together to articulate what I was experiencing.

I felt like I was watching myself die in slow motion. My muscles were cramping and wouldn’t relax. I was dizzy. My mouth was extraordinarily dry despite having had plenty of water that day. My eyes were dilated and ached. My face was flush. My abdomen had a sharp stabbing pain. I had the worst headache I had ever had in my life, and I was sweating like I had just run a marathon.

The only thing I really remember from that night is the ER doctor saying, “You have serotonin syndrome.” Everything else is a blur.

So what went wrong?

I was already on Vyvanse for ADHD. There is only one known serious interaction between Vyvanse and Zoloft, serotonin syndrome. The Vyvanse became a catalyst for the Zoloft.

Approximately 10% of our serotonin is made in the brain. The other 90% is manufactured in the gut. Zoloft disrupts this process by telling the brain to manufacture serotonin 24/7, but it also inhibits the process that the body has in place to dump serotonin out of the brain so we can’t OD on it. So, when you’re taking both medicines, it’s not that hard to poison yourself, and that’s what happened.

I look back on this experience, and now I can’t help but see everything that was wrong with it. Why on earth would an SSRI be considered an acceptable treatment for PMDD? The decline of estrogen and progesterone in the luteal phase of the menstrual cycle is what leads to PMDD. Some women are hyper-sensitive to these changes, and it gives them a whole array of problems ranging from irritability, migraines, joint pain, etc. to feeling suicidal. It’s not caused by a lack of serotonin, but it is severely debilitating at times.

When I was still in high school, I would drive this gravel road deep into the woods to go and sit on a boulder near the edge of a bluff and watch the lights twinkle in the valley below, just to breathe for a moment. The scent of freshly fallen pine needles clung to the dew in the air. Every so often I’d hear an animal rustling in the leaves nearby. Cars would drive the windy road up the mountain, headlights disappearing around the sharp curves. Growing up in dysfunction and then adding a mental health diagnosis on top of that wasn’t an ideal pairing. I’d escape by going here to pour my heart out to God when life felt too heavy, when the thoughts would creep in. When I was the most vulnerable.

This is too much.
I’m too much.
What is wrong with me?

That’s what Satan does. He comes to steal, kill, and destroy. He tempts us and dresses up death to look like a shiny, perfect answer to the pain we face in life and tells us that this is too much for God. He can’t make anything good come from this.

But the Bible paints a different picture. Our weaknesses point to Christ. God is glorified in us when we are most reliant on Him.

But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me.

— 2 Corinthians 12:9

So whenever the valleys come my way, I’m thankful to endure them, to be able to draw closer to God. Even darkness is not darkness to God. It is a light. There isn’t a linear path to healing and wellness, but there is a Savior that walks this path with us and strengthens us to endure these trials.


I am not a doctor or mental health professional. This site and all of the content on it is not a substitute for professional medical or mental health advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical or mental health condition.