Imagine standing in the middle of a bustling city during rush hour. Cars zoom back and forth, and pedestrians weave their way through the streets. In this scene, the traffic lights play a crucial role. They guide traffic flow, ensuring everything moves smoothly and safely.

Now, let's take this picture and shrink it down, way down, until it's happening inside your brain. The "cars" and "pedestrians" are now messages being sent between brain cells. The "traffic lights" are a group of chemicals that help these messages move from one cell to another. One such chemical is serotonin, which helps us feel good, regulates our mood, and even affects our appetite and sleep.

So, what happens when these traffic lights, or chemicals, don't work as well as they should? We might feel persistently sad, lose interest in things we usually enjoy or struggle to sleep. This is where Selective Serotonin Reuptake Inhibitors, or SSRIs, come into play.

SSRIs are a type of medication commonly used to treat depression and anxiety disorders. They work by adjusting the serotonin levels in the brain, acting like a traffic cop who steps in when the lights aren't working correctly.

In the brain, serotonin is released from one cell, travels across a tiny gap called a synapse, and then latches onto another cell, delivering its message. Once the message is delivered, the serotonin is typically reabsorbed or 'reuptaken' by the first cell, ready for the next round of message sending.

When someone is suffering from depression, it's thought that this process happens too quickly. The serotonin gets reabsorbed before it can fully deliver its message, leading to lower overall serotonin levels in the brain.

SSRIs work by blocking or inhibiting this reuptake process. They act like a barrier that stops the first cell from taking back all of the serotonin it releases. This leaves more serotonin in the synapse, allowing it more time to latch onto the second cell and deliver its mood-boosting message.

By ensuring that more serotonin is available to transmit messages between brain cells, SSRIs can help alleviate the symptoms of depression and anxiety, effectively boosting the mood.

Remember, though, that SSRIs aren't instant fixes. It often takes several weeks for their effects to kick in. This is because they gradually change the brain's chemical balance over time rather than immediately boosting serotonin.

It's also important to note that every brain is different. What works well for one person might not work as well for another. Therefore, treatment with SSRIs is often a process of trial and error guided by a healthcare professional.

SSRIs, like all medications, can also have side effects, including nausea, dry mouth, and changes in appetite or sleep. These usually disappear after a few weeks as the body adjusts to the medication. If they don't or become severe, talking to a healthcare provider is essential.

In conclusion, SSRIs work as traffic controllers in the brain, ensuring that serotonin, a key happiness chemical, has enough time to deliver its mood-boosting message. They play a vital role in helping those with depression and anxiety disorders, restoring the smooth and orderly flow of our brain's messages.

Let's now look at some commonly used SSRIs and their potential side effects:

1. Fluoxetine (Prozac): This is perhaps the most well-known SSRI. It's used to treat depression, obsessive-compulsive disorder (OCD), and some eating disorders.
2. Sertraline (Zoloft): Zoloft is often prescribed for depression, social anxiety disorder, and post-traumatic stress disorder (PTSD).
3. Paroxetine (Paxil): Paxil is used for depression, social anxiety disorder, and panic disorder.
4. Citalopram (Celexa): This medication is typically used to treat depression.
5. Escitalopram (Lexapro): Lexapro is also used for depression, as well as generalized anxiety disorder.
6. Fluvoxamine (Luvox): This is primarily used to treat obsessive-compulsive disorder (OCD).

While these medications can provide significant benefits, they can also have side effects. It's crucial to remember that not everyone will experience these side effects, and in many cases, they may subside after a few weeks of starting the medication.

Some common side effects include:

• Nausea and vomiting: This is often temporary and may decrease as your body adjusts to the medication.
• Increased appetite and weight gain: Some people may experience these changes, but not everyone does. Regular exercise and a healthy diet can help manage this side effect.
• Sleep disturbances can range from insomnia (trouble falling asleep) to excessive sleepiness. Sometimes, taking the medication at a different time of day can help.
• Dry mouth: Drinking more water, chewing sugarless gum, or using a saliva substitute may help alleviate this side effect.
• Sexual side effects: These can include decreased sexual desire, problems with arousal, or difficulty achieving orgasm. If these become bothersome, a healthcare provider should be consulted.
• Nervousness or restlessness: While SSRIs are meant to reduce anxiety, they can sometimes cause feelings of restlessness, especially when you first start taking them.

I took the top five in the list, usually up to the maximum dose, without much positive effect. I didn’t take Luvox, which is indicated for obsessive-compulsive disorder. Yet after 29 years of being so overmedicated, one of the two meds I’m on is a 20mg dose of Prozac for obsessive-compulsive issues.