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.

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Are you sitting comfortably?

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I remember my first smear test. I skipped into the nurse’s room without a care in the world and was greeted with a somewhat matronly, steely stare.

‘The important thing to remember with this procedure is you have to relax. You have to relax or it will hurt,’ she said with an inflection not dissimilar to a schoolteacher giving you a good telling off.

Confused, and now about as relaxed as a clam, I clambered onto the couch, then it was legs akimbo and off we went. Unpleasant, yes, but it wasn’t impossible and I went on with my day.

Three years later and I was due for another check-up. Obviously having a complete stranger poking around in your nether regions is no trip to the zoo, but I’d done it before without fuss so this time round shouldn’t be any different, right?

Wrong.

I woke up this morning with a cold sense of dread that squirmed in the pit of my stomach and raised the hairs on the back of my neck. I felt upset and dizzy before I’d even reached the GP surgery. I felt the rational part of my brain making a desperate bid to surface, trying to remind me that there was nothing to worry about here and that I needed to relax.

Unfortunately, this was the crux of the problem for me. Telling someone with clinical depression to ‘just relax’ is about as clever as brewing Tetleys in a chocolate teapot. You get nowhere. The procedure was extremely painful, we had to stop before a sample could be taken and I was in floods of tears by the end of the whole sorry experience.

I felt ridiculous that I couldn’t even go through with such a simple procedure. Smear tests are generally not a big deal, at least they haven’t been for me in the past, and as a woman they’re an essential component of my general health MOT. And yet if it’s not bad enough to have been through such an ordeal, my depression even had the cheek to make me feel guilty about it afterwards. Arsehole.

I feel ashamed and pathetic not to have been able to withstand a little discomfort and pain. On top of that I feel bad for wasting the nurse’s time – this one was actually very sweet and friendly and, unlike her predecessor, didn’t make me feel as if I was about to voyage into Mordor. But I’m also aware that’s just the depression talking.

And talk it will. For if I’d been a little kinder to myself I might have realised that this kind of invasive procedure would be tricky for anyone feeling as anxious and vulnerable as I do at the moment, and that it might have been better to wait. And that today doesn’t constitute a ‘failure’.

It’s very difficult for anyone suffering from depression not to beat themselves up when these sort of things happen. Falling short of your own expectations of what’s ‘normal’ and what you ‘should’ be capable of can feel horrendous. You can re-hash the day’s events/failures over and over, picturing how you should have behaved.

Or you can try to forget about it, and eat some chips. Today, this is what I’m choosing to do.

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.