Interview 05

Age at interview: 33

Age at diagnosis: 24

Brief Outline: Has very good care from his GP. Medication was somewhat effective. He recently stopped taking Lithium and Effexor.

Background: A computer programmer, married with children, who has had a number of episodes of depression, the most recent was very severe. (Played by an actor.)

Managed to hide his depression at work, but when he could no longer read a story to his daughter he knew he needed help. (Played by an actor)

I couldn't cope with, with other people at all. And also I developed coping mechanisms. I had managed quite well to, to hide it. And if someone sort of, you know at work sort of said, 'Well how's everything going?' I could snap out, 'Everything's fine thanks. It's great we're doing this, this, this and this and we're doing that.' 'That's good' and they would go.  

And boom. I'd go back and staring at my feet. So you know I could sort of put on a front at times and it was, yeah I think it was mostly, mostly a successful front. Until one evening, I remember, I was putting my eldest daughter to bed and trying to read her a child's story, and I actually found I could no longer read. I no longer had the concentration to read the book, a four year old's story book and I couldn't read it out loud. 

I couldn't follow the sentences to actually read it out loud. And that was a point where it was clear that yeah I had to, I had to seek help. And so I made an appointment with the doctor the next day. So that was, that was about three months after I, after I started feeling, feeling depressed.
 

Says he appreciates how his GP provided him with his direct number for use in an emergency. (Played by an actor)

And yeah, having a sympathetic GP who you do, can feel you'll talk to. And I'm, I'm extremely grateful for him that he gave me his direct number and so if I, if you know, if it is a problem. I still have the number in my wallet now. And to feel that I could, you know, in a'. in an emergency situation get on the phone and that is somebody who knows me. 

It is somebody I feel I can talk to, and it is someone who can provide help as opposed to some sort of anonymous phone number that you can phone. This was someone specific who I know and I trust and you know, if I am at my absolute worst I have entire faith that, that he could do something to sort me out. And to, to have that was very important and another great source of strength and actually still is.
 

Had a long wait to see a psychiatrist while suicidal, and so the psychiatrist's concern about his immediate wellbeing seemed too little, too late.

And some days would be, I would be really overwhelmingly depressed. And about then I was referred to the psychiatric hospital for assessment. Although I think it probably took about two months I believe between the initial sort of GP's referring letter and getting an appointment. Which again in retrospect was, was way, way too long, way too long. I was really, really ill and barely coping. So just before Easter I had my [laugh] first it's quite funny, my first meeting with the psychiatrist.

And to that meeting I'd gone prepared to talk about how I tried to kill myself and it was you know, really very likely I was going to, you know, try again and next time I wouldn't, I wouldn't mess up. I went prepared to the meeting with the psychiatrist and I'd actually ' the day after my suicide attempt I'd written it up and posted it to a news group and I printed that out because I knew that I wouldn't be able to talk about it, but it was something that, you know, I wanted to convey. 

So I presented him with my, with my write up, and talked about how I felt and I cried and I sobbed and I filled out the mood forms and I scored in the extremely seriously mega-depressed range. And I remember he went to talk with a professor and was actually quite concerned about leaving me on my own which was [laugh] very nice but I remember thinking, 'Well actually this is quite amusing, seeing as I have managed to struggle through these last two months and then you know, by the time I come to see you, yeah, sure realistically I am on my last legs.' And he said, 'Are you going to be OK?  Do you want somebody to sit with you?' [laugh] was actually kind of ironic.
 

Tried stopping venlafaxine (Efexor) and suffered unpleasant withdrawal symptoms, and so slowly reduced the drug over 8 weeks, and gained support to withdraw over the Internet. (Played by an actor)

Oh well let's try stopping the venlafaxine and see what happens, which actually turned out to be extremely, extremely difficult. Again the, the ants under the skin. Really terrible nausea and also sort of perceptual problems that - sort of feeling everything is too far away or it's too close and feeling off balance. 

So I had to go back onto 75mg and then try taking it one pill every other day and then one pill, leaving it as long as I could until the withdrawal symptoms became unbearable and taking another pill and they would go away. And eventually I could kind of get to about one pill every two and a half days. 

Really terrible nausea and also motion sickness that I haven't taken a pill the day before. I'm driving in the car really making me quite nauseous. And then eventually I started to take, you know, I'd take a pill and when the withdrawal symptoms got too bad, I broke it open and I would take half a pill and then again leave it for as long as possible and then take another half pill and eventually I weaned myself off' That took a long time. 

It took about eight weeks and it was very unpleasant and so there was part of that you know, I started looking on the internet for other people who had effects of withdrawal symptoms' and actually a lot of people have had effects of withdrawal symptoms and a lot of people are quite pissed off with the makers for not really saying what the withdrawal is like. But you know I got through it.
 

Says he did not like taking lithium because it stopped him doing things he enjoyed, and so he decided to slowly come off lithium with his doctors knowledge.

After that I started more or less on my own, sort of uptake, dropping my dose, halved my dose of lithium because I didn't, I didn't want to keep taking lithium. I didn't enjoy it. Also I didn't like having to go and have blood tests with lithium. The first time I took a blood test, I collapsed, I fainted'. Poor nurse had to drag me to [laugh]'. to a couch and lie me down. I don't know. It might have had something to do with the pills. I really don't know. But I felt really sick doing that. I didn't want to do that again. 

But I'. I didn't enjoy taking lithium because it stopped me doing things which I did enjoy, the few things that actually did give me pleasure in life, such as writing music. The lithium robbed me of that pleasure. So I started dropping my dose and found that I could halve my dose and feel OK. So I did that for a few weeks and then stopped taking it altogether and felt OK. And then sort of reported back to the doctor and said '. to my GP and said, 'Well look, this is what I am doing. If I start feeling depressed again I shall take it again. This is my disease, it's part of me, and I want to control it and I want to be in control of the pills I'm taking. If I am feeling that the pills aren't helping me then I want to have the power to stop. If I get depressed again, well I will realise that, you'll realise that. I'll take my pills again.' So I stopped the lithium and was actually OK slightly depressed but not, you know nothing, nothing drastic and stayed with that for a while.
 

Explains how he became suicidal while on antidepressant medication. (Played by an actor)

And whilst initially (after starting antidepressant medication) I started feeling better. I then started feeling, I started feeling depressed again and I started feeling, essentially because I'd got my capacity of thought back, I started feeling introspective. In the, before then really I'd lost the capacity… 

I just think I was a zombie and I started feeling, I started sort of thinking again and started thinking that, “Well, actually yeah the world would be a better place without me. Then, I think my family would be better off without me. You know, because of the life insurance, think of life insurance and they'll be more secure then you know. If I did lose my job I'd be unemployed.”

While he can be very creative and productive while manic, he consciously decides to stick to important routines like sleep to prevent subsequent depressions. (Played by an actor)

You know in the best of moments, I can do more than somebody who hasn't been brushed with the madness stick. You know, I have, sort of, my art that I do, I like writing music, I've made films, I make animations, I write software in my spare time. I can do lots of things and you know, when I go through the things that I do in my spare time, people look at me as if I'm mad. Yeah, probably am, but you know, this is madness in a positive sense in I can pull the energy that's within me to doing something positive and doing something creative.

But I do feel that every good day has to be paid for by a bad day, and yeah, sooner or later it catches up with you. And that's when you get depressed and you have to be aware of that and sometimes I have to make a conscious decision. Why get engrossed in a project and stop going to bed at bedtime? Making sure I don't miss meals, you know, make sure that I don't get up at three o'clock in the morning because I've got this crazy idea that won't go away. You know, stay in bed, get up at a sensible time and yeah, I have to look after myself like that or'. I believe when I'm on a high, I'll lose it, and I will lose my grounding in reality.
 

Found a suicide discussion group, which exposed him to extremely depressed and suicidal people at a time he was also suicidal, but he gained comfort from not being alone or judged. (Played by an actor)

It's a discussion group of people talking'. of essentially extremely depressed people talking about suicide. And talking about suicidal feelings and suicidal methods and yeah, from time to time people die on it. But in a weird perverse way it's a source of strength and a source of comfort. And it's been more of a source of comfort actually than a lot of the other resources about depression, which I found on the Internet, they sort of tend to be quite factual and well meaning. 

People say, you know, you can phone the Samaritans or whatever but you know, while I was there, I didn't know what to say. And in any case, I didn't want to talk to anybody. But, you know, just the feeling that' you aren't alone. It was a great source of comfort'. And to find that in fact your weren't the only person to feel like that was actually a great relief. It was also a great relief to find that' to find people who were non-judgemental.
 

He cut off his friends when he was depressed because he did not want them to see him depressed, and he felt he couldn't cope with talking to anyone.

When I was at my worst, I had completely isolated myself. I completely isolated myself from my group of friends who, you know, we meet up, friends from university, friends from a long time and we are always firing e-mails back and forth. And I actually use one e-mail account only for my friends and I didn't check it, I purposely didn't check it when I was depressed. And it was actually subsequently when I started feeling better and did check my e-mail account and found one of my best friends had actually come back from the States and had offered to meet me, because he was going to be in town and he had got no reply because I wasn't reading my emails. There was a whole load of things that I missed out simply because' well partly I didn't want my friends to see me like that. I knew I was really, really low and I didn't want my friends to see me. I also didn't feel that I could even cope with talking to my friends. I wouldn't go near the telephone. I would not telephone. I avoided speaking on the telephone as much as possible. I didn't want to talk. Certainly didn't want to talk to anyone face to face. Even my wife, I really didn't want to talk to her. I just wanted to be left alone. I didn't want to talk to anyone. Again, as I say, partly because I didn't want people to see me as I was, partly because I didn't feel, I didn't feel like communicating, I didn't feel as if I could communicate. I just wanted to sit, sit in a darkened room in silence.
 

Says that depression is less stigmatised nowadays and believes that disclosing your depression to a trusted friend is helpful. (Played by an actor)

And depression, albeit it is still stigmatised I think.... Is less stigmatised among young people that it was... You should tell someone now, it doesn't have to be the doctor or a therapist, it can be a friend you know. The older I've got, the more I've found that it's acceptable to say to people, "I'm depressed at the moment," and they know what it means. And you don't want them telling everyone, and there's me as the great sort of I don't know you know I tend to preach the gospel of, 'Hey depression is no different from anything else, blah, blah, blah...' and I do believe that. And you know, you wouldn't make a secret of it if it were a diabetic would you.... Hang on, actually you would, you wouldn't want to go tell everyone, but you wouldn't mind telling your best friend who you can trust, "Look I feel shit and I really think I'm depressed and I need some help.
 

Antidepressant medication helped him to feel better, but he did not initially recover fully. (Played by an actor)

But my mood, started lifting. I did start feeling better, more energetic, less tired, more able to concentrate and more able to function. One of the, one of the most striking things that struck me the first time I took antidepressants and the second time is all of a sudden you realise how much colour is, there is in the world. 

But I think when I was depressed my, my perception of colour had really diminished. In fact I was sort of progressively seeing, you know, everything in a monochrome world and all of a sudden you know, you take antidepressants and you think, "Wow, aren't trees green", you know. Or, "Wow, apples they are red and they are sort of yellowie." 

And you sort of start noticing colours and things like that, which was great. But the pills weren't strong enough and although I felt much better, I didn't, I didn't stop feeling depressed and that was shortly before, before Christmas....
 

He needed a lot of help when very depressed, and says that friends and family can assist the depressed with practical help. (Played by an actor)

I think realistically in the stage that I was, I was not capable of doing anything. It needed somebody around me to do the initiating... Say look, here is somebody who needs help. If someone could actually come and said you know, "Are you depressed?" "Yes." "Are you feeling suicidal?" "Yes." "Do you feel capable of initiating contact with anyone and asking help?" "No." That would have been the total of what I was capable of doing at the time. It really needed somebody else to make that contact for me and ultimately yeah, it was my wife saying, "You must go to the doctor, I will make the, the appointment. I will drive you there. I will take you there. I will sit in the, in the waiting room with you", but, "you need the help". It really had to come from somebody around me because I was incapable of doing it myself. 

And I wanted to finish by saying that the worst thing you can say to a depressed person is, "What have you got to be depressed about?" It is really as useful as saying to someone with hayfever, "What's the point of sneezing at flowers?" Depression is an illness over which a person suffering has no control. 

Instead of searching for a possibly non-existent reason for a person being depressed, if you know someone who is having problems, offer them positive help. Offer to help them open their mail, offer to help them with their daily correspondence, check that they are able to get up in the morning. When I was depressed I was unable to cope with many daily tasks, it was only with the help and support of those around me that I was able to function at all.