Should You Take Antidepressants for Money Worries?

My friend, a Madoff victim, took Lexapro until she found better ways to deal with her anxiety.

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While reconnecting with old friends over dinner in Miami two nights ago, I was horrified to hear that they'd lost several million dollars—nearly their entire savings—in the Madoff scheme. Faced with a substantial loss of yearly income needed to pay their mortgage and private-school tuition, my friend Loren told me her anxiety was so severe that she literally couldn't keep any food down. Just the mention of Bernie Madoff on the news sent her rushing to the bathroom with dry heaves. At her doctor's urging, she decided last month to go on the antidepressant Lexapro. As it happens, a study out this week in the Journal of the American Medical Association suggests that Lexapro is helpful for treating seniors who have chronic, difficult-to-control fears and worries known as generalized anxiety disorder.

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Woman overwhelmed by bills.

But Loren, a 42-year-old mother of four, is in a completely different category. She's normally a cheerful, do-it-all optimist—think Energizer bunny—and her crying jags and heaving were entirely understandable under the circumstances. "Having a sudden, shocking reversal of fortune is the sort of situation where any healthy, stable individual would experience extreme anxiety for a period of time," explains Jerome Wakefield, a professor of social work at New York University and author of The Loss of Sadness. "Your friend is grappling with building a new sense of her future, a new sense of safety."

Unfortunately, the Lexapro seemed to make things worse for Loren: "I had horrible shivering and sweating and would curl up in a ball on my couch after breakfast and lie there until midafternoon," she recalls. "I felt like I was in a fog that I couldn't snap out of, like all the color went out of my world." A psychiatrist friend of hers urged her to go off the medication, and within two days, Loren's fog lifted. She still feels anxious and occasionally has dry heaves but has found outlets to deal with her anxiety: talking to friends who are also Madoff victims; playing tennis; writing and illustrating a children's book (inspired by her Lexapro experience); and teaching art in a local high school. She and her husband also came up with a two-year plan for getting their family through the crisis.

Having a strong social support network, exercising, and actively engaging in work or in job hunting are all great ways to navigate through a financial crisis, says Wakefield. This applies not just to Ponzi scheme sufferers but to any of us going through a sudden loss of employment, foreclosure, or a plunge in our portfolio values. He recommends the following:

  • Get moving whenever you feel your head spinning . Exercise appears to interfere with the mental pathways that trigger anxiety, says Wakefield, lowering stress hormones and raising your level of brain chemicals that make you feel calm and relaxed. He used to play squash in grad school to keep himself from vomiting before exams, but anything that gets you really sweating (biking, running, kickboxing) will do the trick. Meditation, deep breathing, and these other easy stress relievers can also help.
    • Challenge your thoughts. Are you really the dumbest person in the world because you were laid off or filed for bankruptcy? Are you going to be truly homeless if you lose your house, or can you scrape together enough for a modest apartment or move in with your parents? Getting ripped off by a sleazy financial adviser can be particularly frustrating, but Madoff's alleged victims shouldn't blame themselves. "Large companies and financial institutions were taken in by him, so how could an individual have known?" Wakefield points out.
      • Take action. Writing a résumé, scanning the want ads, and taking on a new community project can give you a greater sense of control over the situation. "Action creates new opportunities and gets you thinking how to resolve issues and assure your future as best you can," says Wakefield. Wallowing in self-pity in front of the TV all day is the worst thing you can do because it reinforces any negative beliefs you have about yourself and your financial situation.
        • Consider professional help . "If you're so immobilized that you can't take actions to plan for your future, then you need to consider therapy or medication," Wakefield advises. It's important to monitor yourself—or have a loved one monitor you—to ensure that you're keeping things in perspective and not, say, contemplating suicide. He adds that those suffering from acute anxiety and physical symptoms may benefit more from an older benzodiazepine medication like Xanax, which works quickly to take the edge off, than from newer antidepressants like Lexapro, which often have no effect for the first two weeks. (Benzodiazepines, though, can be habit forming if used long term.)
          • Lean on others. Supportive friends and family are invaluable for getting through tough times—especially those who are in the same boat. They can increase your resiliency to stress and even offer solutions that worked for them. They can also remind you of what's really important: caring for others and having others care for you. "Financial reversals do let up eventually, even if you don't get your old life back," says Wakefield. "And overcoming these challenges often creates new career possibilities and even stronger relationships with loved ones."
            • Here's how to tell the difference between normal sadness and full-blown depression.