It happens like this:

It’s December in New York City. I am at the window I’ve stood at so many times before. Only 5.58 seconds keep me from pushing out the rusted screen and bringing my body through. At 5’ 3” and 125 lbs., with an air resistance of .24 meters per second squared, it would take me 5.58 seconds to fall from the 30th floor to the cement below. I know this because I count everything. Because I am clear in the numbers and clear in nothing else. Quantification brings order to the otherwise disorderly, lets me measure the immeasurable, know the unknowable. How many days until I take my final breath? I can’t ever truly know. But I can curate an educated guess. I can take a dozen online life expectancy tests, sourced from retirement and life insurance websites. I can average the results and come up with a final life expectancy: eighty-three years, nine months, and five days for a total of 30,595 days on this planet. I can work a calendar, Leap days considered, and establish my day of death as November 6, 2069. I can schedule the event on my Google calendar at 12 p.m. on a Wednesday: DEAD. 

I have been alive for twenty-nine years, ten months, and twenty-seven days. 

10,922 days. 

I have 19,673 days to go. It’s a long time to wait to die. So I stand at the window. Wait for those 5.58 seconds to feel like relief. And tonight, compared to another 19,673 days, 5.58 seconds feels like freedom. 

How easy it would be to go. 

I walk to my desk drawer and grab a yellow legal pad. I’m not one for pithy notes and platitudes, so I write “19,673” across the page. 

I cross it out and write “0.” 

How easy it would be to fall. 

I close my eyes and count. One one thousand. Two one thousand. Three one thousand. Four one thou . . . nothing. Nothingness. Not like a blindfold. Not like sleep. More like trying to see out of your elbow. My mind can’t comprehend the nihility and I want to ground it in something I can touch, something voluminous to quantify, to give this impossible weight a number I can point to and say, See? It all makes sense now. I don’t have pebbles or pennies or grains or rice. Prescription drugs—those I have a lot of. White ones, purple ones, pink ones, gray ones. They mean something. They have a job. They calm the chaos. They right the wrong. They fix the broken. 

I take my legal pad into my bathroom and open the medicine cabinet. Lined up in front of me, soldiers at attention: 

Venlafaxine ER, brand name Effexor XR, 37.5mg, for depression. 

Bupropion, brand name

Wellbutrin XL, 150mg, for depression and anxiety.

Levothyroxine, brand name 

Synthroid, .05mg, for hypothyroidism. 

Levothyroxine, brand name Synthroid, .075mg, for hypothyroidism. 

Sucralfate, brand name Carafate, 1g, for bile reflux disease. 

Isotretinoin, brand name 

Absorica, 30mg, for acne. 

Ibuprofen, brand name Advil, 200mg, for daily headaches. 

A generic multivitamin, for good health and wellness. 

From age fifteen to thirty, this arsenal has varied in frequency and quantity, but not in kind. Only the isotretinoin is a newer addition, introduced three years ago in small-dose courses for a case of stubborn zits. The prescriptive party mix bottoms out at four pills per day and peaks at eight, depending on whether my headaches and bile reflux disease are raging. On average, I figure, I’ve taken six pills per day for a decade and a half. 

I scratch the math into my legal pad, rounding out the weeks and years: 

6 prescriptions a day x 7 days a week = 42 pills per week.

42 x 52 weeks in a year = 2,184 pills per year.

2,184 x 15 years = 32,760 pills. 

I scribble 32,760 above the crossed-out 19,673. My entire life is tucked into those two numbers, one so much larger than the other. I wonder if 32,760 is a lot or a little in the grand scheme of a life and pour a day’s worth of colorful allowances into my hand. They are light in my palm, a bit unwieldy all piled up one on the other. Until this moment, it has never occurred to me that I have taken three times as many pills as the number of days I have been alive. 

I drop the capsules into the sink, go straight to the window, and press my forehead against the pane. The cold glass against my clammy skin calms the swirls of numbers in my mind. I can see Long Island City and Greenpoint glistening in the distance, as if the night sky descended onto Earth just to rest on the banks of the East River. Traffic backs up at the Midtown Tunnel. As the cars move, their brake lights crawl up the glass facades of the surrounding high-rises, illuminating the windows in spots of red and white. Sirens wail in the distance, caught somewhere along Third Avenue. 

I open the window and examine the expanding wooden screen I bought during my first few weeks in New York. The wood is warped from eight years of rainstorms, blizzards, and blistering heat, and the mechanism to slide the screen wide or narrow is rusted shut. I struggle to dislodge the screen from where it sat for all those years and finally loosen it as an ambulance breaks through a wall of cars and barrels down the street in front of my building, only to get caught in traffic at the next stoplight. 

Dangling the screen thirty floors above the sidewalk, I stick my torso out the window to get a good look at the stalled traffic. The ambulance screams for space, but it can’t move. I wonder how many people die in Manhattan because the ambulance can’t reach them in time, and how many more lose their minds as they watch their loved ones perish while sirens wail so close, but so far. 

After 5.58 seconds, at least the ambulance won’t have to rush. 

A thought: One third of those 32,760 medications are for my head. 10,920 antidepressants. 

The levothyroxine, the sucralfate, even the isotretinoin—they keep my physical body in working order. Right? But the Effexor and the Wellbutrin exist only for my mind, each orange prescription bottle a subconscious reminder that I Am Depressed and I Am Broken and I Need Fixing. Everything else is secondary. The loneliness, sadness, and melancholic hum of my life all validated by 10,000 antidepressants. I don’t think about them when they get delivered to my door or when they slide down my throat. No doctor ever questions their use. No pharmacist refuses a refill. No lover lifts a morning eyebrow when he watches me from my bed, naked as I unscrew cap after cap. 

I’ve been medicated half my life—and my entire adult life. 

A gust of wind jostles the screen hanging from my hand. 

And yet I am still just waiting to die. 

How easy it would be to let it go. How easy it would be to watch it fall. 

I have taken 10,920 antidepressants. 

To let go. To fall. 

Who might I be without them? 

Excerpted from ‘MAY CAUSE SIDE EFFECTS’ by Brooke Siem. Central Recovery Press, LLC. 9/6/22.


  • Brooke Siem (@brookesiem) is a writer whose work on antidepressant withdrawal has appeared in The Washington Post, Psychology Today, and more. She is also an award winning chef and Food Network "Chopped" Champion. Her debut memoir on antidepressant withdrawal, MAY CAUSE SIDE EFFECTS, is available wherever books are sold.