Urban’s hallways hum with chatter. Students discuss overdue homework, evening plans and their new crush; teachers shuffle stacks of papers and ungraded rubrics. They move in a frenzy between classes and meetings before school ends. But underneath the buzz of school life, many carry an unseen struggle: managing their mental health. And one particular treatment — antidepressants — has become many people’s solution.
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed form of antidepressants, sold by brands such as Prozac (fluoxetine) and Lexapro (escitalopram). They can ease depression, anxiety and other mental health conditions such as post-traumatic stress disorder and obsessive-compulsive disorder. Teenagers’ use of SSRIs has risen in the past decade, with adolescent girls having a particularly sharp surge in the early years of the COVID-19 pandemic.
SSRIs change the mechanisms of serotonin — a neurotransmitter that helps with mood regulation — in the brain. Serotonin typically passes messages between neurons and is then taken back into the cells through a process known as reuptake. But SSRIs inhibit serotonin reuptake, making it more available in the brain. Because of serotonin’s role in mood regulation, limiting its reuptake can lessen the symptoms of certain mental health issues.
“SSRIs take care of the chemical part of mental health,” theater teacher Maya Herbsman ’13 said. “They help take [mental health issues] from being the foremost thing that I experience in my body to being more like background noise.”
Amina Samake, director of counseling services, reported a similar pattern with clients she has worked with in the past. “[They] found that having a little bit of medicine, even if it was just temporary, allowed them to be able to better access the skills and the therapeutic tools that they were being given,” she said.
Mental health professionals, including counselors and therapists, will sometimes recommend medication to clients. Hannah Katznelson ’26 decided to go on Prozac after a suggestion from her new therapist. “We had three sessions, and she was like, ‘You need to go on meds.’ And I was like, ‘Cool, that’s kind of what I wanted anyway,’” she said.
Katznelson noted that she was the first among people she knew to go on antidepressants. For others, hearing about their peers’ positive experiences with antidepressants can motivate them to seek out SSRIs themselves.
“I was familiar with other people in my friend group using [antidepressants],” Laia Trachtenberg ’26 said. “Now I use Lexapro for depression and anxiety — I started using it in the fall of sophomore year.” Although it took several months to see the medication’s full effects, Trachtenberg now has fewer anxiety attacks and feels more clarity with anxious thought patterns.
When using SSRIs, clients are still often encouraged to use other forms of mental health treatment — such as talk therapy or cognitive behavioral therapy — alongside the medication. A 2016 study by the National Institutes of Health concluded that pharmacotherapy (antidepressants) and psychotherapy (talk therapy) yield greater benefits when paired together than either one alone.
“You [still] need to be in talk therapy, because the medicine helps to tamp down some of the symptoms, but it’s not taking away your trauma,” Samake said. “As therapists, … we’re not doing our job if we only let somebody take some meds and then not do the exploratory work around why they’re feeling the way they feel.”
For Herbsman, SSRIs enabled talk therapy to be more effective. “I was grounded enough that I was able to actually do the therapeutic work that I really needed to do,” she said. “SSRIs allow me to do the work that I need to do in therapy: to work through past experiences, to understand my own anxieties and to build coping skills around them.”
In a classroom setting, although antidepressants can help manage issues such as test anxiety and burnout, they may not single-handedly solve the problems. “The issue is that taking [SSRIs can] make the person feel that they don’t need to try other approaches,” said Rachel Herbert, director of learning strategies. “An SSRI may be very helpful in itself, but it can be more helpful if it’s coupled with strategies.”
Once someone decides they want to go on SSRIs, the process of obtaining a prescription often still poses a barrier. For teenagers, the hurdles often include asking their parents’ permission, in addition to scheduling the necessary appointments and affording the medication.
Trachtenberg’s parents worried that she would develop a dependence if she went on SSRIs. “They thought it was like Xanax,” she said. Xanax is the brand name for alprazolam, the fast-acting anxiety medication often associated with drug misconduct and recreational use.
Peer Resource member Rohan Notaney ’27 first considered using antidepressants in elementary school, but his parents did not want him to go on medication at the time. “It was deemed that I didn’t need to,” he said. “But later, I found out that it was my parents who said I didn’t need it, and my therapist actually recommended I use them.”
School counselor Joey Mintz described other barriers that can get in the way of teenagers asking their parents for medication. “If there’s a really negative attitude about having feelings [and] acknowledging serious mental health issues — like saying, ‘We’re not the kind of people that go to therapy’ — it might prevent a student from even asking,” he said.
Taboos around mental health issues and treatment are particularly intense for some families. “There could be cultural barriers,” Mintz said. “Your religion, your ethnicity or just the culture of your own personal family.”
These stigmas are particularly present for boys. Even as the beginning of the COVID-19 pandemic saw an increase in suicide attempts and rates of depression among high school boys, their rate of antidepressant use fell by 7.1% between March 2020 and December 2022. In contrast, there was a 129.6% increase in antidepressant usage among girls in the same age group.
Notaney suggested that social stigmas surrounding men’s mental health could contribute to this disparity. “I know a lot of my male friends have struggled with mental health, … but most of my friends who use SSRIs are female,” he said. “I think a big part of this is … ideas within society around who is deemed appropriate to seek help for mental health.”
For people who do end up using antidepressants, their experiences with the medications vary. Katznelson has noticed a significant improvement in her mental health since she went on Prozac. “It fixes, I would say, probably 60% of my issues,” she said. “It’s helped me make sense of what’s going on in my head. … Social interactions have gotten significantly easier, schoolwork has gotten easier [and] I feel like I have full access to my brain.”
On the other hand, many find that it reduces the intensity of their emotions. “They’ve helped me get to a pretty even baseline,” said Charley Roberts ’27, a member of Peer Resource. “But I can’t cry as easily, and I’m just kind of numb to certain things. … I don’t really feel things as intensely anymore.”
Kali Love ’27 went on a low dose of nortriptyline, an antidepressant typically sold under the brand name Pamelor, for her chronic stomach pain. She had experienced this pain for four years before her doctors suggested the medication, hoping it would take the edge off her discomfort.
But Love wishes she had not tried it, suspecting that the medication triggered her development of anxiety and depression. “It somehow rewired my brain,” she said. “I had this terrible, anxious cycle, and I am still — to this day — not totally sure what caused it. But it was most likely from starting antidepressants because that’s the only new thing I had tried.”
Love carries a textured, ring-shaped fidget toy with her to help deal with stress. “Even now, I have a little anxiety ring that I take around with me,” she said. “It’s crazy to think that antidepressants could have caused my depression. … If I were to go back, I would tell my younger self, ‘Please don’t take them — they might be ruining your life.’”
But others might give their younger selves the opposite advice. “I wish I’d started [antidepressants] sooner,” Herbsman said. “I think I had some idea that I needed something very, very serious to make it worth it. And I guess I wish I had known that’s not true, and that help was accessible to me far sooner than I realized.”