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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Going public about going private

fatigue

“So,” said my GP, peering at me expectantly. “What do you want to do?” in a tone that suggested I might have the foggiest clue as to how my exhaustion and inability to cope should be fixed. It was that precise moment, as I resisted the urge to throw my chair at him, that I completely and utterly lost faith with the NHS’s capacity to deal with mental health issues.

After a further fortnight of sleepless nights and listless, exhausted days I did what anyone who can beg, borrow or steal money off family would do. I sought private health treatment. And that was the day things began to change for me.

Within 20 minutes of meeting a new doctor I heard the words ‘my diagnosis is’ and ‘this is what we need to do’. Someone was finally taking control for me, and I literally wept with relief.

It’s not that she has access to vast libraries of information that the NHS is cut off from, nor that I have three-hour long appointments with her – my new doctor simply takes me seriously and instils confidence in me that she knows what she’s doing. I may have to sell a kidney to pay off her bills but to me that’s a small price to pay for renewed hope.

Depression is a physical illness but I have yet to come across an NHS doctor who even vaguely entertains the idea that it may have physical causes, beyond the bog standard thyroid and diabetes tests that are carried out. I’m currently being treated for poor digestion – something I seem to suffer from that stops my body absorbing essential nutrients and causes me all manner of problems. Don’t get me wrong I’m still taking antidepressants and following all the usual protocol for poor mental health, but this is the first time in four years of suffering that any medical professional has moved beyond throwing pills at me and sending me to therapy. All the CBT in the world won’t get you far when your body lacks the basic nutrients required to fight everyday stress.

It’s not a relief to see a doctor that doesn’t look at me quizzically before muttering “shall I refer you to a psychiatrist then?” when I desperately try to assert that my fatigue has non psychological roots. It’s life saving.

I know that, in essence, our health service does wonderful things and it’s under enormous pressure at the moment. I know that not all GPs are ignorant about mental health in fact many are fantastically clued up. But in an age where stress is such a large part of normal life, the two-pronged ‘medication vs psychotherapy’ approach to depression treatment isn’t always enough. Sometimes we need to dig beneath the surface to seek out the niggly little ailments that are contributing to poor physical and mental health so that we treat the root cause of depression, not just the symptoms.

Waiting room woes

GP stress

You really have to feel for GP receptionists. With sweeping healthcare cuts and a ballooning population, especially in London, they face more disgruntled patients than ever before. I should know, I’m one of them.

“Four weeks? I have to wait FOUR WEEKS for an appointment?!” I found myself hopelessly bleating across the desk of my local surgery recently. The tired looking receptionist held my gaze with a mixture of exasperation and sympathy.

“No that’s for your registration appointment. Then once you’re registered you can book a consultation with the doctor,” she explained.

I must have looked as broken as I felt, as she gently pushed a slip of paper across the desk. “But don’t worry, there’s a drop in centre down the road – you can go there and queue for an appointment if it’s urgent. Here’s a map.”

And queue I shall. Although I’m warned that there could be up to a four hour wait. I’m lucky as I have an extensive and amazing network of family and friends, many of whom have offered more than once to come to medical appointments and wait with me if I don’t want to go it alone. But what if you don’t have this kind of safety net? Some of the most uncomfortable experiences of my life have been the minutes and hours I’ve spent hanging around in GP waiting rooms, or at the hospital, while in the throes of depression. Fidgeting, sweating and in a general state of agitation. I don’t know if it’s the claustrophobic environment, being around other sick people or simply having to face up to medical woes, but I can’t stand these kind of appointments at the best of times, let alone when I’m mentally ill.

Today I scoped out the drop-in health centre, as a soldier might check out a possible route into battle. I figured out where it was, went in to have a look at the waiting room and asked what time I needed to get there to avoid queues and crowds. Because these are the lengths I go to to squeeze the potential stress out of anxiety inducing experiences.

All in all the outlook is good. The staff are friendly and it’s a pretty swish, shiny looking place, albeit dumped in the middle of a really grotty estate. Our health service is obviously doing something right, it seems the more deprived the area, the better the medical facilities are.

So tomorrow, 8am sharp I’ll be camped outside the clinic with my raincoat and portable stove. Once again, I’m turning to Auntie NHS for some more help and I really hope that instead of having pills thrown at me, we can find some sustainable solutions this time.