Understanding Your Body on Antidepressants: What I Learned From My Own Experience
One of the things I love most about health and wellness work is that the more curious you become about your own body, the more empowered you feel to make changes that genuinely improve how you live. This post is part of an ongoing series where I share what I am learning through my own health journey, including the questions I am asking, the connections I am making, and the changes I am experiencing physically, mentally, and emotionally.
My hope is that by sharing openly, I can help you connect some dots in your own health story that might otherwise take years to piece together.
Today I want to talk about antidepressants, specifically what I have learned about how SSRIs interact with the body beyond their primary role in mood regulation. I have been on Zoloft for three years and more recently went through a transition to Lexapro before deciding to taper off. Throughout that process I have noticed things in my body that sent me down a research rabbit hole, and what I found was genuinely eye opening.
The Brain and Cognition Connection
One of the things I noticed during my time on Lexapro was a subtle difficulty retrieving words mid sentence and a soft, slightly foggy quality to my thinking. It was not dramatic, but for someone who relies on clear communication and presence in my coaching work, it was noticeable.
What I learned is that serotonin plays a role not just in mood but in prefrontal cortex function, which governs working memory, word retrieval, and the kind of executive thinking that lets you organize your thoughts quickly. SSRIs alter serotonin signaling throughout the brain, and for some people this can create a temporary dampening of these cognitive functions, particularly at higher doses.
This is not universal and it is not permanent. For most people these symptoms resolve within two to four weeks of reducing or stopping the medication. But knowing that this connection exists helped me understand what I was experiencing rather than simply wondering why my brain felt different.
Blood Sugar and Energy: A Connection I Did Not Expect
About a week into tapering down to a lower dose, I started experiencing sudden waves of fatigue that felt exactly like a blood sugar crash. Heavy, depleted, needing to sit down and eat immediately. It was coming on unpredictably and felt disproportionate to my activity level or what I had eaten.
Here is what the research shows. Serotonin receptors exist not just in the brain but throughout the body, including in the pancreatic beta cells that produce insulin. Serotonin plays a regulatory role in fine tuning how much insulin gets released in response to glucose. When you have been on an SSRI for a period of time, your insulin regulation has been operating with that serotonin influence as part of its baseline chemistry.
As you taper down, your glucose metabolism has to recalibrate to functioning without that influence. For some people this shows up as reactive hypoglycemia, where blood sugar rises and drops more sharply than usual because the timing of insulin release is temporarily adjusting. That sudden crash feeling is your blood sugar dropping faster than your body is used to managing in this new state.
This is temporary. It settles as the body finds its new equilibrium, usually within two to three weeks of stopping completely. But understanding why it is happening makes it so much easier to manage and much less alarming when it shows up.
The Longer Term Metabolic Picture
This is where my research got really interesting. There is a growing body of literature exploring the relationship between long term SSRI use and insulin sensitivity. Serotonin receptors in muscle tissue, fat cells, and the liver all play roles in how cells respond to insulin. Long term alteration of serotonin activity through medication can affect insulin receptor sensitivity in these tissues over time.
For me, understanding this helped explain some things I had been puzzling over. Stubborn weight that would not budge despite genuine effort. Fasting glucose sitting at the top of the functional optimal range. A metabolic picture that felt stuck even when I was doing a lot of things right.
I want to be clear that I am sharing this as context for understanding your own body, not as a reason to avoid or stop medication. SSRIs help people significantly and have helped me. The more useful frame is to think of this as information that allows you to support your metabolic health proactively while on these medications, and to understand what your body may need during and after a transition off them.
What I Am Doing to Support My Body Through This Transition
Coming off Lexapro is one piece of a much larger health recalibration I have been engaged in over the past several months. My nervous system is genuinely settling. My emotional range is returning. I am sleeping better, moving more consistently, and for the first time in a long time I can take a walk with my dogs and simply be present for it.
The changes I am making are not complicated. They are consistent and they are layered and they are working. I will continue sharing them here as my journey unfolds.
Tips and Action Steps
If you are on an SSRI or navigating a transition off one, here are things that have helped me and that the research supports.
Supporting cognitive clarity
If you notice word finding difficulty or cognitive fog on an SSRI, know that this is a recognized and usually temporary effect
Tracking when it happens and how it feels gives you useful information to share with your provider
Most people notice meaningful cognitive improvement within two to four weeks of stopping or reducing dose
Supporting your brain with omega-3 fatty acids, adequate sleep, and blood sugar stability all help during this period
Managing blood sugar during a taper
Eat protein and healthy fat every three to four hours to keep blood sugar stable
Never skip meals or go long periods without eating while tapering
Keep a protein snack with you at all times during the transition
Reduce refined carbohydrates and sugar which amplify blood sugar instability
Stay well hydrated since dehydration makes blood sugar symptoms worse
Know that energy crashes during tapering are common, temporary, and manageable
Supporting metabolic health on SSRIs long term
Ask your provider to include fasting glucose, fasting insulin, and HbA1c in your regular monitoring
Regular gentle movement like walking supports insulin sensitivity and mood simultaneously
A whole foods diet low in refined carbs supports metabolic function throughout
Insulin sensitivity tends to improve after stopping SSRIs, especially combined with these lifestyle supports
Tapering safely and thoughtfully
Always work with your prescribing provider when reducing or stopping an SSRI
Going slowly is more important than going fast
Pay attention to your body’s signals during the taper, they are giving you real information
Brain zaps, dizziness, irritability, or flu-like feelings are signs your system may need more time at the current dose
Missing doses without symptoms is useful information that your body may be ready for the next reduction step
Connecting the dots on your own health
Your body is always communicating with you and learning to listen is one of the most valuable skills you can develop
Symptoms that feel unrelated often have common underlying drivers
Working with both a prescribing provider and an integrative health coach or functional medicine practitioner can help you see the full picture
You are the most important member of your own healthcare team
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Nicole Torgersen is a health and wellness coach, yin yoga teacher, and NBC-HWC candidate based in the San Francisco Bay Area. She works with clients through The Well Health and Wellness Studio and at nicoletorgersen.com. Nothing in this post constitutes medical advice. Always work with your prescribing provider before making changes to any medication.