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.

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Doctor doctor

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Having been snuffling around in the pigsty of poor mental health for several years now, I’m learning to be more demanding when it comes to getting help.

A recent trip to the doctor’s more resembled a perilous voyage into Mordor than an innocent check up – I was battle-ready and prepared not to leave with just a pill prescription, but rather a more concrete and sustainable plan to wobble my way back to better mental health. Fight the power.

Except that ten minutes after shaking the doctor’s hand, I had a psychotherapy referral underway, a blood test booked and a sincere request from my GP to please come back if I felt in any way overwhelmed over the next few days. It all went so well I didn’t really know what to do with myself.

It’s not my intention to badmouth the NHS, but my experience of GPs is that they’re perpetually reluctant to make referrals to see a specialist unless you’re so far gone that your brain’s seeping out your ears like a soft, steaming mass of spaghetti. ‘Come back in six weeks’ and ‘I’m certain we can sort this out here’ are all too familiar platitudes to me. Not to mention that bloody depression questionnaire they make you fill out. Sometimes, I’ve felt like doctors are clueless when it comes to mental health.

Which is why my recent experience was so refreshing, and also why it’s so great that the campaign against mental illness stigma, Time to Change, has implemented a new project to make GPs more mental health friendly. Since October last year project workers have been leading one-to-one sessions with frontline health staff, to help them better understand mental health service users’ experiences. The results have been positive with 64% of GPs saying they were better equipped to make adjustments so that people with mental health difficulties could access their practice, as opposed to just 41% before the project began.

In times of ill health your doctor is the lifeboat you cling to and the way they react to those that reach out for help with depression and anxiety, can be life changing. So if this project has made even a shred of progress in doctors surgeries nationwide, for some people that could literally mean the difference between life and death.