Am I hooked on happy pills?

‘Well I’m happy for you to stay on them…’ My GP peered thoughtfully at me over the rim of his glasses. ‘I’m also perfectly fine with you coming off them. I’ll set our review for a year’s time shall I?’

And thus passed the annual antidepressant prescription review, like so many of its predecessors, proving about as useful as a chocolate teapot – and that although it’s so very easy to start taking happy pills, getting off them is another story.

Happy pills. antidepressants, SSRI’s – whatever you call them – used to be the preserve of those teetering on the edge of psychosis. These days everyone’s on them. There’s no doubting that some people in the throes of serious clinical depression really need support from medication – and drugs like paroxetine, citalopram and zoloft provide a chemical lifeline to those nosediving into a serotonin-deprived abyss. However there seems to be a worrying trend towards over-prescription. Medication being handed out like smarties for the mildest cases of the blues – and patients consigning themselves to years of pill popping.

The NHS prescribed record numbers of antidepressants in the UK last year and a recent study by women’s campaign group Platform 51 found that nearly half of those using antidepressants have taken them for at least five years, while a quarter have used them for ten years or more. The statistics are frightening, but actually being part of these numbers scares me even more. I’m eight years and counting.

I have been on and off antidepressants three times now. Having never been able to tolerate more than the lowest possible dose of my particular brand of synaptic rocket fuel, I still have absolutely no idea if they help me at all. Literally none. However the emphatic explaining away of my anxiety, depression and fatigue symptoms with ‘serotonin deficiency’ has consistently led me back to a GP-endorsed SSRI prescription.

I do know that the first two weeks of cranium electrics, nausea, sandpaper mouth and night sweats feel like a grenade has been dropped into my soul. And that once these side effects have tapered off it’s impossible to benchmark what effect the antidepressants are really having. I’m just thankful to have survived. I’m told the ‘therapeutic benefits’ of my medication can be expected to kick in after six weeks or so – but at this point I’ve usually been working so hard at getting better through exercise, meditation, healthy diet and general avoidance of stress that any number of things could be bringing me back to wellness. Drugs have always been just one aspect of a very holistic treatment plan for me and I’ve never been sure of the part they’ve really played in my wider recovery story.

My uncertainty has always sat in stark contrast to the certainty with which medical professionals have recommended drug therapy to me. All roads lead back to chemical imbalance, it seems. That knowing nod in the GP room when it’s discovered that depression reared it’s ugly head again a year after ditching my medication, the inferred conclusion that being drug free was the chip in the metaphorical mental health windscreen that led to a whole world of shattered glass. Serotonin, you see. And my counter-argument that we’re all still utterly clueless around whether or not the pills actually help me? ‘Well they really can’t hurt…’

Except for some people it seems they can. Hurt, that is. Particularly for those on high dosage antidepressants, withdrawal can be vicious. Dizzy spells, migraines, aches and pains, insomnia. If you’ve watched Leo Di Caprio sweating and whimpering his way through heroine withdrawal in The Basketball Diaries think of SSRI comedown as a vanilla version. Pretty, it is not. Six months easily turns into six years on these pills when kicking the habit is this hard. Then there’s psychological dependency. Even if you’re not chemically hooked, mustering up the confidence to throw out the blister-pack-shaped safety net is terrifying.

At this stage I have no idea what to do and neither, it seems, does my doctor. It’s definitely the easier option to keep mindlessly slipping a small blue pill under my tongue after breakfast everyday. But time’s marching on and with it the ever decreasing likelihood of a chemically unaltered future. Do I really want to remain a slave to lab-manufactured serotonin? Can I put up with the tedium and inconvenience of monthly trips to the pharmacy coupled with the expense of prescription charges? It’s a sensitive subject – a decision worthy of careful, contemplative thought with due consideration for what support might be needed further down the road – and it’s going to take more than ‘come back and see me in a year’ to get there.

Advertisements

Shades of Kefalonia and the reality of recovery

20170602_160629-e1501948038608.jpg

A restless butterfly whirls about the pine trees; flashes of yellow and white amidst fir-clad branches. Perched atop a rocky outcrop overlooking the Ionian Sea I hear the distant murmur of surf tickling the sandy shores below. My eyes blink closed and, for the first time in what must be years, I feel completely at peace. Everything is OK.

Except it wasn’t OK.

At the apex of my sickness if someone had announced that in three years time I would happily hop on a flight to Kefalonia, by myself, to spend a week at a Greek yoga retreat with a throng of complete strangers, I’d have punched them in the nose. I truly would have believed myself a likelier candidate for space travel and being taunted with such a delicious but unrealistic dream would have infuriated me.

But I made it. Several hundred miles on from a bleary-eyed and anxious morning at Gatwick Airport I’d boarded a plane solo for the first time in years, thrown off the shackles of bad health and opened myself up to a whole seven days of new experiences, growth and, well, just good old fashioned…fun. Nestled in the idyllic paradise of Vigla Village I started to realise what recovery looks like. I allowed myself to languish in the acceptance that illness doesn’t rule my life anymore.

But I got cocky. I came home feeling invincible. I stopped bothering to do any of the things that keep me on the straight and narrow – my healthy diet degenerated, I drank more, rested less. And guess what – I wasn’t, in fact, bullet proof. A few hiccoughs at work, a disastrous romantic encounter and one house move later found me feeling less than fighting fit. Fatigue crept in. A dark cloud swept over my head. I felt awful. Not to mention incredibly foolish for daring to entertain the prospect of a new, symptom-free reality.

I pulled through. A month on as I sit tapping away at this blog, I’m feeling much better having focused on eating well, getting the right balance of rest and exercise and just giving myself time to digest various recent life events. Nourishing myself – body and mind. And simultaneously feeling pretty damn sheepish – at how naive I had been to think that chronic illness can simply vanish into the night.

My health is something I have to manage. It’s not perfect and sometimes I live alongside some pretty unpleasant ailments, aches, pains and difficulties. The ever-present spectre of tinnitus buzzes gently between my ears, intensifying in times of stress and acting as a strange sort of barometer for how well I’m looking after myself. It’s a constant work in progress and never, ever again will I allow arrogance to shake my commitment to staying well.

Fatigue and depression are dual forces of torment and destruction that can ruin lives – but they’re not unmanageable. I can honestly say that despite my struggles, I’m generally in a happy place now.

Joy finds me on a far more regular basis than gloom – and if that sparks hope for even just one reader out there walking their own dark path, I’ll be a very happy lady today.

Should we talk about suicide as ‘freedom’?

robin williams

Yep, that’s right, I used the S word. I want to talk about that most scandalous of taboos, the one only discussed in hushed voices in darkened corners in the wake of tragedy – that of taking one’s own life. Wilfully and deliberately choosing to take an early exit from earthly existence in favour of whatever might be waiting after the human body expires, as beloved actor Robin Williams so sadly did on Sunday.

As fans began to mourn the loss of one of the comedy world’s brightest lights, the Academy of Motion Picture Arts and Sciences tweeted a well-known image of Disney’s Aladdin wrapped in an embrace with Williams’ hilariously voiced Genie, alongside a simple message: ‘Genie, you’re free.’

The emotional farewell hug, the starry-sky backdrop, the sense of hope and liberation – it seemed a poignant and fitting tribute, on the surface at least. But the viral tweet – while well intentioned, shared by over 300,000 people and viewed by countless others – has suicide prevention experts worried, and rightly so. The American Foundation for Suicide Prevention has warned that the image violates well-established public health standards for how we talk about suicide. They’re concerned that romanticising Williams’ death risks contagion of vulnerable children and adults – meaning the phenomenon of ‘copy-cat suicide’ where media coverage of one death can end up encouraging others already contemplating suicide to take that final leap.

The written implication that Williams’ death meant freedom from his suffering paints suicide in far too celebratory a light, said Christine Moutier, chief medical officer for the foundation. And let’s face it, anyone that’s dealing with persistent suicidal thoughts, who may already have made plans to terminate their own life, really doesn’t need much of a trigger to put these plans into action. I don’t believe that the Jumanji star’s untimely demise will have people lining up to throw themselves off bridges, but glorifying his release from a turbulent life as ‘freedom’ is certainly unhelpful – especially considering his status as a well loved and highly respected celebrity.

Rather than any intentional insensitivity or ignorance on the part of those that initiated this social media storm, what this highlights more than anything is the thorny, delicate and somewhat confusing nature of the public discourse we have when it comes to suicide. For those facing terminal illness, rapid degeneration of mind and body, chronic pain and relentless misery, ending life may actually represent freedom and liberation. I’m pro choice when it comes to suicide and the right to make a dignified exit from a life that, for whatever reason, is sliding into an intolerable abyss that really isn’t going to improve. But depression doesn’t have to be a life sentence – even though it seems that way when you’re in the throes of a bad episode – and that’s why we need to be so careful when considering those at their wits end. Suicide may seem like the only viable option when the black dog bites, but many people facing severe depression and thoughts of harming themselves can and will go on to make a full recovery. This is the optimistic and hopeful message we need to be spreading when it comes to mental illness.

We need to focus on the life and works of a fantastically talented and ferociously hard-working creative, whose bright light was extinguished far too soon, rather than romanticising his death as anything other than incredibly sad and tragic. Thanks for the laughter, Robin, and may you rest in peace.

My depression demolition team

friends

Depression can be very isolating. Soaring stress levels can severely impede what you can do on a daily basis and trying to keep up with social niceties is exhausting, then there’s the reclusive nature of the illness. Why go out and meet people when you can completely withdraw and spend the evening at home weeping in front of an endless conveyor belt of Mad Men episodes?

Depressed people are no picnic to be around and there have been times I certainly wouldn’t hang out with me.

Because of this the pool of people I spend time with has slowly but steadily shrunk over the last few years, leaving a very select few friends and family members splashing about in the shallows with me. Since I stopped being ‘fun’, my wider circle of acquaintances has drifted away to the point that these days the most intimate window into their lives I have is through Facebook.

It’s not the worst thing in the world to be forcibly reminded who your real friends are. I’ve got some pretty good ones. I’d be lying if I said I didn’t miss my carefree and frivolous partying days – having a big network of mates can be ridiculously fun. But they’re not the ones who will sit on the phone with you at 3am when you can’t sleep, or take you to the doctors when you’re too anxious to go alone.

So I thought I’d take the opportunity to spotlight a few of the people in my life that are helping me through this relentlessly awful time, and some of the incredible things they’ve done for me over recent years. My loved ones have become a fearsome force of destruction when it comes to battling my depression; picking me up every time I fall and refusing to let me to give up. Without them I doubt I’d still be standing today.

First there’s my parents. Pushing 60 and not without their own troubles, they’ve been my rock throughout this ordeal. They’ve taken me in and looked after me when I couldn’t cope by myself and put up with numerous tantrums when frustration made me lash out at those I love the most. I know they’d do anything for me, that this journey has been horrific on them too, and they’re my main motivation for getting better.

D, my best mate from school, although having no way of conceiving what depression is like – being the most joyful, positive and energetic person I’ve ever met – has never stopped trying to understand what I’m going through. She’s made it very clear that there’s no time limit after which she’ll cease putting up with my hysterics, and is the first to correct me when I question why she’d still want to spend time with someone who has become so tired and boring. I’d be lost without her.

W, my best mate from University, is a flaming ball of positive energy. When I’m about to fall down the well, she rugby tackles me back into reality and forces me to think positive. She once travelled all the way from London to my parents’ home to drag me back to the city on a train because she knew I couldn’t do it alone.

My brother M. He seems to have stolen all the wisdom genes in our family, for there’s no-one else who can shift me from completely panicked to calm, in the space of a phone call, like he can. He takes no prisoners in his approach to dealing with my illness and knows exactly when to call me out on my crap, but I trust him implicitly.

Lastly, there’s my friend A, a qualified psychologist who I know, at times, has found it difficult not to overstep the boundary between friend and therapist, but time and again has provided much needed advice and support with infinite grace and compassion. Despite having to spend most of her day dealing with other people’s problems, she always has time for me.

When I start to feel jealous of my 20-something peers whose colossal social spheres seem to involve nothing but having the time of their lives (damn you, Facebook, DAMN YOU) I only have to think about my little pocket of loved ones. I only need to remind myself how truly privileged I am to have these people in my life, and to hope that one day I can show them the same unfailing loyalty, love and respect they’ve shown me.

And then I remind myself to switch off Facebook.

Photographic memories

old photo

Anyone with clinical depression who has been told to ‘think positive’ and ‘remember the good times’ will know the creepy, forced smile you offer the purveyor of said well meaning sentiments. Because trying to explain to anyone that actually has access to the happy part of their brain that you don’t really want to be miserable, you’ve just lost the ability to feel good, is like being repeatedly slapped in the face with a trout.

Depression is a negativity dump truck, unloading its toxic cargo of sad thoughts, self doubt and unpleasant memories into your cranium every hour of the day. The reason sufferers can’t just focus on happy thoughts is that, temporarily, they don’t exist. All that was once joyful and light has been squirrelled away deep in the annals of your consciousness, to be uncovered once depression’s done playing it’s sick and twisted game. Sometimes it’s impossible to comprehend that happiness was once physically possible.

Enter photography. Photos are genuine, bona fide happiness EVIDENCE. Even when you can’t remember what it’s like to feel joy, you can certainly look at an old photo that captures a moment of happiness and know that it really happened. Is that me grinning like a deranged meerkat as I jumped out of a plane in New Zealand? Yes. Am I actually laughing in that surfing shot? Looking calm and relaxed on holiday with my family? Yes and yes. It happened. Was I on mind bending drugs or under the spell of a magical unicorn? Nope, just enjoying myself.

If the only memories I had were what’s locked inside my head, I’d be in trouble right now. But these glossy, dog-eared snapshots represent a time when I knew what it was like to be happy, and they’re playing a critical role in keeping me hopeful at the moment. The camera doesn’t lie.

So when I’m feeling hopeless, my mind is clouded with ‘I can’ts’ and ‘you’ll nevers’ and I’m convinced the depressed version of me is the only person I’ll ever be, I leaf through some old photos to remind myself of who I was before the big D. A girl who travelled, socialised, danced, laughed, lived and who had fear but jumped anyway. And I tell myself that if I was her once, then I can be her again.

It’s OK to be an ostrich, sometimes

ostrich

Recently I’ve been having some problems with a friend. The issue was trivial, my reaction astronomical. It turns out that when you’re feeling fragile, no matter how aware you are of your colossal over-reaction to a situation, it’s really difficult to slow down the stress train.

I won’t go into microscopic detail but essentially I feel like one of my close friends isn’t being overwhelmingly sympathetic to my current poor health. Then when I dropped out of a music festival the two of us were going to this Saturday her reaction was less ‘I’m sorry you’re feeling shitty, how can I help?’ and more ‘Are you going to refund me for my ticket if I can’t find someone else to go with?’

I was upset, to put it mildly. Adrenaline coursed through my veins, there were some tears and I felt so stressed and hysterical I had to spend most of the next day in bed spooning a hot water bottle and watching crap TV. A ridiculous reaction to something that, although a little upsetting, wasn’t an impending apocalypse. For me, selfishness is one of the most abhorrent qualities a person can possess, but I’m also aware my friend has her own problems and she probably didn’t mean to act like a dick.

My mother had some words of wisdom to impart. “Sometimes, Claire, it’s OK to be an ostrich,” she said.

“An ostrich? What?”

Turns out she meant it in terms of burying your head in the sand. Stepping away from an issue, not even attempting to deal with it until a later date. Sometimes when you’re not strong, the wisest thing to do is walk away. I don’t feel like this situation has been resolved, there’s still a lot to say, many Britney Spears ‘Toxic’ lyrics to be quoted, but now isn’t the time for any of that. Now is the time to make like an ostrich.

So that’s what I’m going to do, and I feel pretty good about it. Who knows, I might even be able to save a friendship this way.

Coming out of the depression closet

public speaking

“You should be writing about your experiences in the Guardian or something. You know, show people it’s nothing to be ashamed of…” a friend said to me recently.

I nodded. “Yeah. Maybe in a few months. Think I’ll just do the anonymous blogging thing for now though.”

Putting your name to an illness like depression is brave, courageous and generally bloody awesome. It shouldn’t have to be, but thanks to prevailing bad attitudes and stigma towards mental health, it is. Considering the Victorians thought depression in women was down to the ‘wandering womb‘, we’ve certainly come a long way in terms of how society views the depressed and anxious. If only curing my affliction was as simple as shrieking ‘Wench! Back in your box!’ at my nomadic uterus.

Campaigns like Time to Change and the wealth of celebrities speaking out about their experience of mental illness are doing brilliant things to oil the wheels of change when it comes to stigma. But there’s still a lot of work to do.

It’s definitely important not to hide your illness in the shadows. Talking about it helps and self shame and stigma only serve to reinforce society’s misunderstanding of depression. I do believe that those who have experienced a walk with the black dog are the ones who can truly debunk and stamp out unhelpful depression myths.

But often while we’re fighting the good fight we forget about the people behind the illnesses. And that reluctance to go public with your problems isn’t always indicative of shame. Depression and anxiety are physiological conditions in the same way heart disease and broken bones are. But they’re more personal. 

People have very different ways of dealing with their emotions – some will reveal their problems to all friends, colleagues, bus drivers and woodlice within a ten mile radius, whereas others (me) are more private and need a bit of time and space to crawl out of the hole and heal first. Explaining what it’s like to go through depression to those that know you can be cathartic, and of course helps dispel mental health misconceptions, but it’s also exhausting.

Which is why the people that matter to me know what I’m going through, but everyone else is none the wiser. It’s why I’ll be writing about my experiences here, but I won’t be revealing my full name.

As long as I’m still in poor health and vulnerable, I plan on burying my head in the sand just a little bit longer. And I think that’s alright. Just as it’s OK to tell the world you have a mental illness, if you’re not ready it’s also OK not to.

Once more into the breach

Cloud_of_Depression

After over four years of doing battle with depression and anxiety, punctuated with dizzying peaks and catastrophic troughs, I was just starting to feel like I was figuring it out. Back in stable employment, taking a few holidays here and there and even considering dating again, I couldn’t believe my luck. Could the black dog actually be retreating from my world once and for all?

Then spring arrived and with the change of season came a change in mood. For no apparent reason my hormones went beserk, hypomania and anxiety set in and now I find myself, once again, crushed by the weight of my failing nervous system and left cowering under a frightening black cloud. Feeling like there’s an axe wedged in my chest and that the sky is literally pressing down on my head. That creeping chill and a sense of impending doom wherever I turn. Dread. Feeling nervous before doing something as simple as doing the food shopping, or going to the dentist. I even find trees scary. TREES.

It’s disappointing, to say the least. But I’ve done it before and I shall endure it again.

I don’t think there’s anything more frustrating than feeling like your life is passing you by. Seeing all the possibilities before you, trying to grasp at the tendrils of something real but having it escape you. Depression truly is a cage. Your 20s should be a time for fun, frivolity and exploration but unfortunately for many it’s also a very confusing, high pressured and anxiety inducing stage of life. But it’s also a time for growth and if there’s one thing that grappling with mental illness gifts you with, it’s strength of mind as well as a space to grow as a person.

Little comfort to someone in the midst of a black fog, I know. But to anyone else experiencing the quarter-life-crisis, as I like to call it, I’d wager that it really is more common than you think…and if others can crawl their way to the other side, seeing in their 30s with a renewed sense of wellbeing and inner strength, then so can you. And so can I.