(I submitted this guide to starting antidepressants to Rookie. Unsurprisingly, it was rejected. I didn't want to waste all my hard work, so here it is for my hoards of blog readers to enjoy.)

My panic attacks all begin the same way.

I feel a slight pressure in the middle of my chest. I inhale deeply. I exhale forcefully. My thoughts start to slip out of control.

“Am I suffocating? If I black out, where’s the nearest emergency room? I think there’s one a few blocks south of here…”

I begin to hyperventilate, inducing yawns to ensure I get a full breath. Breathe in, breathe out.

Breathe in, breathe out.

Hyperventilating is making my blood flow irregularly. My shaking hands start to feel tingly. They’re not working like they’re supposed to.

My chest pressure is suddenly coupled with a sharp pain. I try to breathe, but it’s getting harder. My heart starts pounding and the room begins to spin.

“I’m dying. This is the end. This is the panic attack that finally kills me. I can feel it.”

I’ve battled mental illness for half of my life. Over the past ten years, I’ve struggled with various degrees of depression. My worst period was during high school. During this time, I saw a counselor weekly and met occasionally with a psychiatrist. I was prescribed antidepressants when I was 15, but made a joint decision with my dad not to take them. I tried to manage my depression without the help of medication, and it worked for a while.

My sophomore year of college, my mental health took a turn for the worse. I was working 40 hours a week and going to school full time. This led to an overwhelming amount of stress that triggered frequent panic attacks. They could be caused by certain events or come completely out of nowhere. I had no way of knowing when they would happen.

I suffered from severe anxiety for almost a year before I couldn’t handle it anymore. Living in a constant state of dread was starting to take its toll. I ended up taking a year off of school to get my mental health under control. I could barely sleep or make it through a shift without an anxiety-related episode.

I finally decided to make an appointment with my doctor. I explained my nervous, panicky thoughts and the physical symptoms that accompanied them. I broke down crying in her office almost immediately. She read me a checklist of anxiety symptoms, trying to verify the ones I’d experienced. I was prescribed escitalopram (name brand: Lexapro), an SSRI used to treat depression and generalized anxiety disorder.

Mental illness among young people is more common than you might think.

It’s very easy to feel singled out with your mental illness, especially if you don’t know anyone personally who shares your struggle. We are the most mentally ill generation in history, with one in four teenagers suffering from a diagnosable mental illness. In 2013, a survey conducted by the ACHA found that 57% of college aged women experienced “episodes of overwhelming anxiety”. Additionally, 33% of college aged women reported depressive episodes that impacted their ability to function daily. More than 11% of college students have been diagnosed or treated for anxiety in the past year.

You aren’t alone.

It's okay to be nervous.

Karen, age 20, was hesitant to start her prescription. “My psychologist's recommendations were no longer working for me,” she explains. “I was finally recommended medication. I’ve always had a fear of taking wrongly-prescribed medication, especially ones that would alter my brain.”

I was very nervous about starting antidepressants, too. I didn't actually take a single pill until about six weeks after my prescription started. Naturally, I had anxiety about taking medication for my anxiety! I was the first of my friends to be prescribed an SSRI. I didn't have anyone close to console me or share their experiences. I felt like I was taking a shot in the dark.

I obsessively Googled things like “starting escitalopram”, "escitalopram side effects", and "escitalopram success stories". I read countless anonymous mental health internet forums. I didn't find this information very reassuring, but I needed some kind of answer. It took a lot of encouragement from my friends and family to persuade me into starting them. I knew they wanted me to help myself, but my anxiety was preventing me.

...but you don't always have to be.

In hindsight, I wish I would have taken my medication as soon as it was prescribed to me. I had to do a lot of self-reassuring in the beginning. I repeatedly compared my antidepressants to long term medications that are prescribed for physical illnesses. It took me a long time to understand that doctors prescribe medications for a reason. I didn't ask to be mentally ill, just like people don’t ask for broken legs or diabetes. It was something out of my control.

The side effects can be unpleasant at first, but you'll make it through.

I'll be honest with you guys. Initially, the side effects can be pretty uncomfortable. I had some of the most painful stomach aches of my life the first week I took my pills. My sleep schedule was irregular for over a month. I couldn't sleep at night, and was tired all day. I could have fallen asleep almost anywhere ...except in my bed! There can also be sexual side effects, like not being able to orgasm. Talk to your doctor about the potential side effects so you know what to expect. (I didn’t.)

After about six weeks, my body finally adjusted to the medication. My stomach aches stopped, my sleeping pattern returned to normal, and I could orgasm again (woo!). The adjustment period can feel excruciating and never-ending, but I promise it will get better.

Like all medications, not every antidepressant works the same way for everyone. Emily, 22 says, “My side effects were very minimal and tolerable. It was very much worth it for me to power through those first few weeks. Even after the adjustment period, I continued to have freakishly vivid dreams. They’re amazing.”

They can take some getting used to.

Remembering to take a pill every day can be challenging. Antidepressants were the first daily medication I'd ever been prescribed. I’ve forgotten to take them a few times. Fortunately, most antidepressants have a fairly long half-life, so you won't be affected too much if you miss a day. (The longer you take your pills, the longer their half-life will be.) Set an alarm for your medication if you're forgetful, or take it along with another daily medication like birth control, allergy pills, etc.

Generally, antidepressants aren't effective immediately. Just like your body needs time to adjust, so does your brain! Your anxiety or depression could potentially worsen before it gets better. If this persists, talk to your doctor and discuss what changes need to be made to your prescription. Starting antidepressants can be a long process, and so can finding the medication that fits you best.

You may need to experiment with different brands and dosages to find what's right for you.

I was very fortunate with my prescription. My dosage and brand worked very well for me, and I’ve had minimal problems with them so far. However, this isn’t always the case.

Kelly, age 20, tried a few brands and dosages before finding her best prescription. “I didn’t tell my therapist about my eating disorder when I was first prescribed antidepressants,” she explains. “I began taking 10 mg escitalopram. My dosage was raised to 20 mg after I confessed my eating disorder. I went back to my doctor and told her I was still bingeing, purging, and having depressive episodes daily. I was then switched to 10 mg fluoxetine (name brand: Prozac). I finally wasn’t thinking about food every minute of the day. This, in turn, made me feel much less anxious. I didn’t have any trouble switching [medications] because I was going right from one to another.”

Your doctor and pharmacist are there to help you.

The morning after I took my first pill, I woke up with an unusual headache. I called my pharmacist immediately. She reassured me that this was normal and not to worry. It's also important to make regular appointments with your doctor for med-checks. Discuss with your doctor how effective the medication feels and the side-effects you are experiencing. 

If you see a therapist or psychiatrist, they can be great resources too! Even though I see a therapist bi-weekly, my primary physician is the person who prescribed the medication. Medical professionals want to help you, and most of them are only a phone call away.

Antidepressants aren't a magic cure…

Antidepressants don't eliminate anxiety or depression completely; they exist to make mental illness easier to manage. I have my share of days where I still feel depressed or anxious. There are times when I feel a panic attack is coming on. These feelings are not nearly as destructive as they once were, but they still happen.

Karen has been taking her prescription for a while, but she occasionally battles her old symptoms. “I notice a tiny bit of anxiety when I'm by myself. However, it's nothing compared to what I experienced before taking the medication. When I acknowledge this kind of anxiety, I’m able to listen to myself when I say that it's nothing to worry about. I'm able to move on and do something to manage it.

…but they can be extremely beneficial if you have a prescription.

With the help of my prescription, I’ve been able to get my mental illness under control. I no longer have daily panic attacks, and for the most part, my overall mood has improved significantly. They’ve eased my lifelong shyness, which often fueled by my anxiety. My self-esteem is higher and I feel motivated to succeed.

“I no longer felt the need to cry. I am motivated to go out with friends and to work again. I no longer have the thoughts that I will never be happy again,” explains Karen. “I’m confident in myself again. I don’t have crippling anxiety when I’m alone.” 

Emily’s medication positively impacted her life, too. “My prescription has calmed me down immensely. My mental state is clear and calm, whereas before it was like a hurricane of colors and pain. I can be myself and not feel afraid or anxious. I’ve noticed that I care more about friendships and relationships than before. I feel better than I have in years.”

If you have any other questions about your prescription, do not hesitate to contact your doctor. I am not a medical professional of any kind. These are my personal experiences that I wanted to share with other young people starting to take prescribed antidepressants. 

(I submitted this personal essay to the New York Times' Modern Love column. Unsurprisingly, it was rejected. I didn't want to waste all my hard work, so here it is for my hoards of blog readers (sike). Enjoy.) 

It’s a rainy day in Milwaukee. A tall boy and I are in the same record store, both looking to add to our already extensive collections. We both reach for the same dusty copy of Neil Young’s “On The Beach”. Our hands touch and we lock eyes. Immediately, we know we belong together.

My true love shares my obsession with middle aged rock stars who could be our dads, like Richard Hell and Jim Carroll. He agrees with my theory Kurt Cobain was unjustly murdered. Our combined record collection is in the hundreds ...no, thousands. He squeezes my hand when our favorite bands play our favorite songs at shows. We bask in the glow of love under the blue and purple stage lights, feeling so lucky we found each other.

I've spent the first 20 years of my life completely romanticizing relationships. I've harbored many fantasies about meeting the love of my life in a record store. This idealism stems from films like "High Fidelity" and "(500) Days of Summer" - films about male protagonists exploring relationships using music as their guides. As a girl who can attribute very specific musical memories to every boy I've ever been interested in, I've always been frustrated with the lack of music-inspired love stories told by women. I longed to someday have my own romance told through songs, albums, and concerts.

My music infatuation led to my first music industry job when I was 19. After six months of scanning tickets, folding chairs, and hanging posters, I met (name withheld). Yep, his name was ****, just like many of my favorite musicians - **** Westerberg, **** McCartney, **** Collins, and **** Simon. We were only scheduled together because one of our coworkers broke her ankle and needed me to cover her shift. My obsession with fate wouldn’t have it any other way.

We learned we both work three jobs and struggle with mental illnesses. He shared with me his lifelong battle with OCD and depression, and I told him about my own depression and severe anxiety. He revealed that shortly before we met, he tried to commit suicide for the first time at age 24.

We became boyfriend and girlfriend not even three weeks later. Even though it was extremely uncomfortable, waiting until I was 20 to kiss a boy did have its perks. The first time we kissed, we were listening to Big Star. He played them because he knew they were one of my favorite bands and he wanted to impress me. I don't remember what song was playing (I was a little distracted), but it was off of No. 1 Record / Radio City. After telling my best friend Lulu, she laughed and said "Aren't you glad you waited and didn't waste your first kiss on some sweaty teen boy?"

Uh, yeah.

Between the excited jitters of my first relationship and starting a new anxiety medication, I could barely sleep the first night I stayed at his house. My choice of ambient music was The Stone Roses' self-titled first album. I woke up around 2 AM, frustrated I couldn't stay asleep. As I laid there next to him, listening to him calmly inhale and exhale, I heard "This Is The One" playing quietly beside us. Even my iPhone agreed *** and I were perfect together.

Going to concerts, seeing movies, and laughing at way too many internet memes were the activities that defined our relationship. One show we attended was Peter Hook & The Light, where Hook and his band performed Joy Division's compilation album Substance. We learned we share the same favorite Joy Division song, "Disorder". I was overjoyed to learn we had yet another trivial but substantial thing in common. My idealistic teenage dream was finally come true.

Two weeks after the Peter Hook show, **** told me he was starting to have suicidal thoughts again. They went on for about a week until he decided to go into the hospital. I left work early and took him into the emergency room on a Friday night. I listened to him explain in great detail his suicide plan, in the event he would go through with another attempt. We spent a few hours in the ER, and after some intense psychological questioning, he told the nurses he felt better. They let him go.

We went back to his house, watched the Bee Movie, and fell asleep. Everything seemed fine. His choice for ambient music was Joy Division's Unknown Pleasures. I quickly fell asleep after only the first song on the album played - "Disorder". I kissed him goodbye on Saturday morning and told him I would see him on Monday.

I texted him about ten times on Monday, and received no response. I messaged him on Facebook, thinking maybe his phone was broke. Still, no answer. I started to get nervous, but told myself I was being too paranoid. He’s probably fine.

I finally got a reply around 5 PM. His mom messaged me from his Facebook account informing me he was admitted to the hospital Sunday morning. He tried overdosing on his medication and drinking an excessive amount of alcohol - the exact suicide plan I heard him tell the nurses on Friday night.

I didn't cry. I felt like I knew it was going to happen, and I didn't want to admit it. Lulu and I went to watch the supermoon that night, and we talked about death.

I visited him in the hospital the next day. His body was covered in cuts, presumably from a glass bottle. He told me, through tears, I didn't deserve to go through this because of him. He didn't want me to see him this way. He didn't want to lose me, but we just couldn't be together anymore.

I walked out of the hospital and cried the entire car ride to a work function right down the street from his house. I wiped my tears as I walked in the restaurant and broke down in the middle of dinner. I rushed to the bathroom, unable to control myself. I ran out, drove past his house, and continued home through a blurry fog of tears.

What did I do to deserve this excruciating heartbreak? I didn’t know who to blame. I was annoyed with myself for indulging in my delusional boyfriend fantasies for so long. I was angry at him for hurting himself, and therefore hurting me. I felt betrayed by my records and the countless musicians who made them. They taught me love was exhilarating and convinced me it was worth the risk.

I didn’t believe them anymore.

Despite being broken up, I still tried to maintain as much contact with him as possible while he was in the hospital. Because he couldn't use his cell phone, this was almost exclusively through writing him letters. I wrote to him daily and dropped the letters off on the seventh floor, right outside the psychiatric ward. He also wasn't able to listen to music, so I took it upon myself to hand write him some lyrics. My song of choice was the Modern Lovers' "Hospital". Jonathan Richman's words were painfully relevant:

"So... When you get out of the hospital

Let me back into your life

I can't stand what you do

But I'm in love with your eyes

...

Last time I walked down your street

There were tears in my eyes

Well these streets, we all know

They help us cry when we're alone late at night"

A few days after he was admitted, I was spending the day with Lulu. We were antiquing and thrifting, because there is no greater form of therapy than digging through dead people's unwanted stuff. I immediately noticed a mannequin wearing a 1960s cheetah print coat - an item I have lusted after since first hearing the Arctic Monkeys' "Arabella" way back in 2013. At first glance, it looked too small. I decided to try it on anyway. It fit perfectly, as if it was made for me.

After admiring myself in the mirror for a few seconds, Jimmy Buffett's "Margaritaville" started playing loudly over the speakers. Lulu and I have been obsessed with Buffett's yacht rock masterpiece since seeing Milwaukee band Sat. Nite Duets cover it at a street festival over the summer. We looked at each other with wide eyes and dropped jaws. The universe was speaking to me, telling me everything was going to be okay. I was trying to listen.

I bought the coat, obviously.

Two days later, I picked **** up from the hospital. I took him back to his mom's house. We played with his cats and gave each other a hug goodbye. This was the last time we saw each other.

All tragic breakups need a good breakup band, and mine was ABBA. ABBA celebrated two marriages and survived two divorces during their time as one of the most famous bands in the world. Even after the divorces, the band continued to perform. They sang songs about falling in love and falling apart while sharing the stage with their former lovers. I screamed the lyrics to “Knowing Me, Knowing You” every morning on my way to work. If Agnetha and Frida could smile through their sorrow, so could I.

As I tried to heal my heart, I replayed the story of our relationship over and over in my head. I couldn't stop thinking about how "Disorder" was the last song we ever listened to together. Joy Division broke up in 1980 after frontman Ian Curtis committed suicide at age 23. The irony was almost laughable. After Curtis' death, the remaining members of the band continued making music under the name New Order.

My life is in a new order of its own. I finally realize I’ve spent far too much time longing for someone to laugh, cry, dream, and grow with. I was desperate to sing a duet, not realizing how resilient I am performing solo.

However, I’m not without a backing band. I have a significant other always by my side. When we’re together, I feel comforted and encouraged. I’m already very familiar with the most passionate relationship I will ever have in my life. I have music, and it’s my greatest love of all.