I Had No Idea Going Off My Antianxiety Meds Would Make Me So Angry

I was 17 when a psychiatrist first prescribed me Prozac for anxiety. I’d been struggling with an eating disorder for two years and wasn’t making much progress. After seven more months without any improvement, I ended up at a residential center for eating disorder treatment, where another psychiatrist upped my dosage. That’s when I felt a weight lift, literally and figuratively. I was finally eating without panicking or making myself throw up.

I was so focused on my eating disorder recovery, I didn’t give much thought to the other changes that occurred after my dosage increased. I went from being extremely high-energy to sleeping around 10 hours a day. I had to study in the library because I’d end up taking a nap if I stayed in my dorm room. And just as I was starting to explore my sexuality, it became extremely hard to orgasm, which was no fun. Once I learned these were both effects of Prozac and put two and two together, my psychiatrist switched me to Zoloft. But it affected me the exact same way. We went through what seemed like every antianxiety drug out there—Wellbutrin, Neurontin, you name it—but all any of them ever did was make me cranky.

After four years of experimenting with different meds, I decided to try going off them altogether. So, as is usually recommended, my psychiatrist gradually decreased my Zoloft dosage. That process was hell—but not for the reasons I expected. I didn’t feel particularly anxious or depressed. I’d just get extremely angry. About nothing in particular. Then I’d find things to attach that anger to, sometimes lashing out at people. When a friend emailed me to request a favor, I chastised her for asking. After my roommate made an insensitive comment, I went into my room, slammed my door, and screamed into my pillow. My psychiatrist reassured me that “irritability” was a common side effect of going off SSRIs, but that word was too weak to describe what I was going through. Fury would have been more accurate. It took me only a few weeks to decide that the ability to orgasm or stay awake for an extra few hours was not worth all that. I went back to my old dosage.

Two years later I moved to start a new job and couldn’t get my act together in time to find a new psychiatrist before my prescription ran out. The intent to eventually go off my meds was still in the back of my mind, and I figured this could be my opportunity. Maybe I just had to rip the bandage off and do it all at once, I thought. I should note that this is not recommended, and I can see why. Once again the anger set in. I spent every walk to work reliving random episodes from my past that had made me angry. I occasionally fantasized about hurting people I was angry with, though I never intended—or wanted—to act on those fantasies. Sometimes I’d start running—still wearing my work clothes—just to get all that rage out.

According to Richard C. Shelton, M.D., a psychiatry professor at the University of Alabama School of Medicine, there’s a name for what I was experiencing: rage attacks. They most likely result from decreased production of serotonin—the neurotransmitter that SSRIs increase in the brain—which can lead to aggression, says psychiatrist Steven P. Levine, M.D.

“Rage would be an uncommon, although not rare, experience after SSRI discontinuation,” Dr. Shelton tells me. “Rage attacks are often accompanied by anxiety and can be similar to panic attacks.”

It took around six months for these feelings to subside, and in the end, I was glad to be off the meds. The lethargic version of myself I’d become after starting SSRIs gave way to the intensely driven version I knew before going on them. I went from being complacent with a 9-to-5 I didn’t really enjoy to wanting more out of my work, and I started building my own career on nights and weekends. Another plus was that I could orgasm with relative ease again.

But the anger never totally went away. I’m not reliving every infuriating moment of my life every morning anymore, but I do get incredibly pissy at random times. Dr. Shelton and Dr. Levine both tell me this is pretty rare, since SSRI withdrawal symptoms usually go away after a few weeks or months. But for largely unknown reasons, a small percentage of people experience them for years. Often it’s a sign that the SSRI was really covering up a preexisting emotional issue that got worse over time.

Some of the coping skills I learned during withdrawal still work for me now. I go on daily runs (in my exercise clothes this time!) to get out my aggression so I don’t take it out on anyone else—though sometimes I do, usually by picking fights with my boyfriend. Having a good cry also helps get it out. I’ve noticed it’s more likely to flare up when something else is wrong—like I didn’t get enough sleep or I’ve been pressured into doing something I don’t really feel like doing—so I treat it as a sign to take better care of myself.

But perhaps my best coping strategy has been to realize this anger and aggression aren’t really me. A feeling has less power when you view it as a chemical imbalance, not your true personality. Whether my rage fits result purely from SSRI cessation or something more innate, I know my desire to form caring relationships is bigger than them.

So recently I apologized to my boyfriend for the fights I pick with him. “Sometimes I’m not even mad at you. I’m just already mad and then find something to be mad about,” I explained.

“I already knew that,” he laughed. “I can tell when you’re just grumpy.”

“But thanks for admitting it,” he added. “You’re a good girl.”

“Yeah,” I said, “I guess I still am.” For a while, I’d really believed I wasn’t. But at that moment, I saw my rage for what it was: just another battle I’m fighting—and beating.