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Stephanie Lowry Smith was diagnosed with depression in her early 30s, but she thinks she had symptoms as a child. “I would always describe it to people as though I was wearing a coat made of rocks,” she said. “Everything was difficult, and I frequently felt like I just wanted to go lay down and curl up in a ball, no motivation to do anything. Just a real heaviness.”
Following her diagnosis came a succession of brand-name medications: Wellbutrin, Lexapro, Cymbalta, Trintellix, Prozac, Zoloft, Abilify, Effexor, and Viibryd, each with a variety of side effects. Cymbalta, she remembers, caused nausea, while another made her sleep 12 hours a day. Nothing made her feel significantly better—although she says Wellbutrin, which she took the entire time she was trying other medications, probably kept her from being suicidal. “I was real frustrated,” she said. “I wasn't suicidal at all, but I just was like, I’m really tired of this, trying another one, waiting to see if it works.” It went on this way for 15 years.
Lowry Smith, a 57-year-old living in Buffalo, is far from alone: Of people who take antidepressants, many won’t respond to the first drug they try, and some will embark on a multi-month or multi-year quest to find what, if any, drug works for them. But for others, the reality is far less complicated: Catherine Livingston, a 30-year-old mother in Kansas, told The Dispatch that, after starting a low dose of Lexapro about three years ago, she felt “so much better,” after just two weeks—and still takes the medication.
These experiences illustrate the asterisk that’s long been attached to antidepressants: a miasma of uncertainty around which drugs work for which people. Decades after the first antidepressants were discovered, researchers are still seeking to understand what depression is in the first place—and how drugs, from Prozac to the newcomer ketamine, might help the millions of people who suffer under depression’s weight.
Valerie is Ideas Editor at The Dispatch, based in New York City. Prior to joining the company in 2025, she worked at The New York Times and NewsGuard Technologies, and she is currently a Novak Fellow through The Fund for American Studies. When Valerie isn’t commissioning and editing the next big essay for The Dispatch, she is probably people-watching in a funky cafe or scheming up her next oddly-themed party.
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