Antidepressants

After six weeks I got placed in the young people’s unit, during that six weeks I suppose nothing really happened at that point, there was no real services for me to access, there was no, they didn’t, I wasn’t put on any medication because they didn’t know really what they should be doing, and there was a bit of sort of drama therapy and art therapy but nothing, anything very significant. So I went to the young people’s unit and there I spent seven months as an inpatient and it was then that we had all these questionnaires that, that you have in sort of blocks of paper, a lot of questions about how you’ve been feeling a lot about writing about your experiences and by that very kind of thorough assessment of more specialised services they were able to pretty much say after about four weeks that they felt I’d been experiencing significant depression for probably the last few years anyway if not before.
 
So in many ways that was quite a relief to be actually sort of, to have that validated, that there, there was something and in other ways I still obviously had a lot of struggles to contend with. But that was the first experience of medication and I was put on antidepressants for the first time and I’d never experienced, you know, taking or knew anything about antidepressants or medication so, but I suppose the good thing was I was actually in the unit being observed and being supported, so actually it wasn’t as scary as it might be at home and being given a prescription and having to go away and take something. So I started on medication then and it did lift my mood which was, which was really encouraging, I suppose the only kind of residual part that was left was the medication was there to take the edge off things but I still had a lot of work to do.
 
What was the medication that you were given.
 
It was imipramine I can’t remember what dose I went up to but it actually worked out really, really well and after I’d going through sort of therapy and all the services that, that the young people’s unit provides; psychotherapy, weekly meetings all that kind of thing and the medication. Eventually I was discharged and went to share a flat with another young girl from the unit. But I attended as an outpatient but I think I, I was still in many ways, week by week there was, there was, I was still struggling and I didn’t maintain a level, continue to maintain a level on the medication so it was changed to a lesser sedating antidepressant called lofepramine, in the same group.
 
Is these tricyclics?
 
Yeah tricyclics and I think that’s one of the ones that doesn't have the, has the least sedation because I did, I did struggle a great deal with, with lethargy and apathy and very, you know, so although I had maybe sort of mild anxiety it certainly wasn’t something, I didn’t need the actually sleepy addition to it. That worked actually better and I was on that for probably about a year and a half whilst still attending services.

So I’m not entirely sure when I first felt that I needed help exactly but I first received help in 2002 and I would have been 25, yes I would have been 25, bit of maths there. So I would have been 25 and the way I got help really was I obviously wasn’t myself for whatever reason... obvious to my mother... and I was living on my own and one car journey I think she just said something along the lines of ‘This isn’t on,’ or something to that effect and she railroaded me to the GP. And the GP, I don’t know, I don’t know whether he was really interested or not interested but he immediately said ‘Well you’ve got private health care so why don’t you just go to the clinic?’ So I went to [clinic name] met a psychiatrist there and did a test and he said ‘Yes you need to be off work right away.’ and I was then admitted as a day patient there. That very day the topic of antidepressants did come up funnily enough and I was then a day patient at [clinic name], wasn’t taking any antidepressants and was going through CBT and a host of other courses as well, probably was there for.
 
I could have the accuracy wrong but it might have been three weeks, it might have been four weeks I had a bit of extra time off then I returned to work. All through that time I didn’t really believe I had a problem so I was at work for a little bit thereafter and then completely had a breakdown thereafter and was admitted into [clinic name] as a full time, an overnight patient and I believe that might be when I was out on some drugs, a variety of different drugs, I could be wrong though, I could have been out, I might have been put on drugs beforehand. I definitely kind of regard the second [name of private hospital] session as the one that made a difference that I might have reconciled myself to the fact that I did have a bit of a problem and needed, needed some help. And then yes that was, so I was in [clinic name] for a second time, so it went from being a full time patient to just a day patient to then, you know, I suppose being ‘recovered’ for want of a better expression, to be back in society or as I like to refer to it as being a ‘functioning depressive’. 

In some ways it was very good that I was in hospital; because I was very contained and there were some very severe side effects which they did warn me about with the MAOI and also the fact that I was on nothing for a while and I also was able to be, I was given regular and a much higher dose, I wouldn’t say a higher dose but a more effective sleeping tablet so I kind of felt that I had more support to get the kind of rest that I needed.
 
How did you feel when you actually come off the citalopram, because you felt pretty lousy on it?
 
Yes.
 
How did you feel in that interim period when you weren’t on anything?
 
Very, very depressed and not anxious at all I lost the anxiety really I was just an extremely depressed extremely an extremely black dark place and the only thing that I felt hopeful about was the fact that I was being contained and also there were no pressures on me, suddenly I didn’t have to pretend to cope, I didn’t have my son to look after, I didn’t have to wash up, cook, try and maintain house sort of act normal to neighbours and that was a relief. but also not having to do that meant that I, it was much easier to fall into an even darker place because, you know, to some extent having to do these things kind of keeps you going in some respect.
 
So then you started on the new drug?
 
Yes.
 
And did that build up slowly or?
 
Yes very, very slowly they gradually tried, gave the dose and then increased the dosage and the immediate side effects really were quite, they were quite obvious and that was like my blood pressure dropped considerably a lot and I would faint quite a lot and it would be quite overwhelming and they said that was one of the side effects something to do with how fast the blood could get to the brain and. And so that was difficult and that was difficult because sometimes I was trying to access something, a service within the hospital to do an activity and someone would always have to be with me and I felt, you know, I found that difficult . And so apart from the, that physical time and that took about two or three weeks and they were monitoring it quite closely and they, there’s a certain period of time frame that if it didn’t improve they would stop me using it because I always did tend to have low blood pressure anyway and it was obviously causing me, you know, I was hanging onto the wall when I was walking, it was quite bad and sometimes I had no inclination it was coming so next minute I would find myself on the floor.
 
You couldn’t really take that outside the hospital environment then could you, quite unsafe.
 
No, no exactly so it needed somebody to be around or it is in a safe place sitting mostly. But after a while I continued to take it and that passed and… something eventually changed for me, shifted for me.

An overwhelming feeling of relief more than anything else, I actually felt safe for the first time in years when I got there, I just thought oh God like, you know I’m actually safe here now and you know it was like I felt like nothing bad could happen to me anymore, more that I was safe from myself if anything else, you know, I was hoping finally something was going to be done about this, something finally, I don’t know what I wanted them to do but it was just thankfully, you know, somebody’s taking me seriously, you know? They weren’t really it’s just because they were getting money from the insurance company but whatever... that doesn’t really matter, I don’t really care about the motivation.
 
Yes so it was like, you know obviously just sort of starting off on what’s brought you here and the whole history of it and everything and what you’re doing, what you’re taking, you know yes it was just that whole thing. And the first couple of days, you know it was just sort of, I was just sort of spent trying to catch up with sleep and, you know matching me up with the psychotherapist and thinking about what groups I might want to be in and stuff and just and trying to get a medication that worked for me and of course like keeping me away from the booze.
 
So you were de-toxing at the same time?
 
Yes.
 
Did they help you with that?
 
Yes, yes I didn’t get any physical, apart from sweating; I didn’t get any sort of nasty physical symptoms.
 
What were you drinking and how much?
 
Mainly vodka, wine you know anything I could get my hands on basically, out of the bottle as well, it weren’t social drinking.
 
Did you drink on your own?
 
Oh God yes, yes.
 
So then they put you on the antidepressants?
 
Yes.
 
And how long did it take for it to start to work?
 
I was already on something I can’t remember what it was when the psychiatrist I saw said no don’t take that anymore take this and that was the venlafaxine.

Between having my daughter and going into hospital I did do some rather, you know, I’d take the car out and drive erratically and my husband took the keys away from me I couldn’t stand my daughter screaming one day and I put her out into the road I don’t know, that was a terrible thing to have done, I mean the traffic didn’t go as fast then but then when I went into hospital I just rushed out of the house and caught a bus and went to the doctors surgery and one of the doctors who had seen me before said ‘well she needs some proper treatment’ and I went to hospital, but I was quite.
 
What was your experience like of being in hospital was it a psychiatric ward?
 
Yes it was the [name] hospital it no longer exists but...
 
Did you go in as a voluntary patient?
 
Yes, yes actually I was there for six weeks and I enjoyed that, I enjoyed it because there were no responsibilities and it was nice being among the other people so for the first six weeks but then when I took the overdose it was different, I went to a different ward and I hated it.
 
What was the difference? Between the times when you thought it was good and the other time?
 
Well I think that I felt terribly ashamed of what I’d done; I think that made a difference.
 
Did you take an overdose of tablets?
 
Yes.
 
The ones that you’d been prescribed?
 
Yes and so I think that had a lot to do with it.

The psychiatrist that I saw I was quite resistant too and I thought that he was making some snap decisions he initially thought I had, well he, I was definitely emotionally dysfunctional so he initially said bipolar disorder but I was, couldn’t accept that as a diagnosis, I just said ‘No I’ve got the divorce, I’ve got this shitty situation at work, it’s not that - it’s the situation I’m in, it’s not me - it’s all these things I’m having to deal with,’ and so he wanted me to go on olanzapine and lithium and I have a friend who’s on lithium clinical trial and I didn’t want to touch the stuff so I said no because I want to look at what the toxicological l issues are, I want to look at the side effects, you’ve not taken my blood pressure, I’m feeling quite wired and tense, I probably have got high blood pressure, you know. There’s all these physical things you haven’t, nobody’s looked at and also I had had no periods for like two months so I said maybe this is menopause, nobody’s looking into this. and I had also had my breasts were making milk a little bit as I had a three year old, my son was three at the time but I had stopped breast feeding at six months so it was all a bit peculiar that my breasts were making milk. So I said all of these things should be looked at because I could be physically ill or it could be a hormonal thing. And so I was bit challenging to the psychiatrist which I think he didn’t really appreciate.
 
This has escalated so quickly and had been so extreme. And I mean that episode still haunts me to this day, how quickly something, your liberty can be taken away, shocking, shocking, absolutely shocking. I actually believe it’s against the law what they did, you know, because I didn’t really feel like I got any consenting. It was just like you’re ill we’re having you that’s basically the way it was handled, and then we’ll put you in a place that isn’t even therapeutic, you know, I would have been better off at home with my parents pissing off and leaving me alone, you know, that’s basically what would have been better for me. And some were all being sent on a nice little holiday to a hotel somewhere in the countryside, that would have been therapeutic, this was not therapeutic, it was prison; I was in prison as far as I’m concerned. So if you, if I have any advice to anybody it’s like take super care of the power that the psychiatrist has because I had no concept that this was, if I’d, if I’d said to the psychiatrist I don’t believe your diagnosis, I don’t want to take your medicine I didn’t know that he could do that to me, you know, absolutely shocking.

Then basically I stopped taking it. I kept being prescribed it, but it wouldn’t, I wouldn’t actually take it. Because I thought well if on paper I’m being prescribed medication and sort of I say I’m taking it, then it makes me less likely to be sectioned. You know, I thought well if I can be seen to be compliant to treatment and this is fairly common for people who are actually prescribed psychiatric medication. Almost half would say they don’t actually take them.
 
But you would say you were taking it? Is that right? You would tell the people that were prescribing it…?
 
I would be prescribed it. I would pick it up at the chemist and that would be that. So I did take quetiapine for a while but again I noticed no real difference, benefit.
 
So your concern about that again was that kind of stigma but also the, the fact that you felt it could send you further down that road of psychiatric treatment?
 
Well no. My motivation behind saying I was taking it was I thought that it would make me appear to be compliant with treatment. And therefore I would less likely to be sectioned, you know.
 
And was that a fear that you had at that time, that you might be sectioned?
 
Very much so. My, my psychiatrist had on one occasion sort of said, “Are you asking me for a hospital appointment?” That was the time that she sent the crisis team after me and again I said, “Could I leave?” And she was sort of went, sort of like that, and that kind of, that was the first kind of moment that I felt the system kind of really, kind of coming in on me. And I didn’t want that.
 
And what was it about that that made it feel that didn’t feel like it would work for you?
 
It felt like I’d have to give up my PhD. If you’re sectioned you will be in hospital for months. Again it was my worry about my studentship, my housing, everything.

So the psychiatrist then felt that I ought to go under observation and go into an acute hospital so I got sectioned for assessment which was shocking in itself because two police turned up here and I, and another psychiatrist and a social worker and I just found the whole thing really shocking and I was like shouting at them because I couldn’t believe the intrusion, the way it was done was just mind blowing.
 
I got taken to an NHS secure hospital which was mind blowing as well... because the people in there are just like all different state of affairs and the facilities are pretty rudimentary so you don’t have very much privacy I was in a six bed unit there weren’t that many resources there so there was nothing, you couldn’t go outdoors, there was nothing entertaining to do. You literally were in this sort of bubbly vacuum of nothingness really. The people in my ward were in various states, the woman next door to me wanted to kill herself, the woman on the other side of her was so, me, was so demented she kept falling out of bed, I had a book that I took with me and she couldn’t even turn the pages. You know it was just going into the most incredible situation with people you are never likely to normally meet.
 
There were a couple of guys that were stalking people and just didn’t have, you know, they were so psychotic they didn’t know that that wasn’t right, it was terrifying, absolutely terrifying to be on this ward.
 
So I got to the private hospital which is a famous one, all very glamorous and well obviously it was much more comfortable and much more therapeutic and you have a lovely hotel -like room and, you know, you feel more civilised and, you know, you feel more sort of cherished and I got put on suicide watch. Now I’d not even mentioned suicide to anybody but it’s like this super acceleration of if you’re behaving badly then suddenly you’re suicidal which I’d never, I’ve got kids, I’m not, you know. So that happened for three days they kept on checking me every hour through the night, all my stuff, you didn’t have anything sharp that sort of thing. So I just went with it, my periods started and I instantly felt better so maybe there was a PMT issue going on here as well. and basically I just behaved like a good little girl, went to all the relaxing things, the psychotherapy which was like being with a gay best friend, and took the Seroquel which I was told to take by the psychiatrist there who thought I was hyper manic or a paranoid psychotic and took that, started to take that and I think a few days later you did start feeling this sort of, it makes you sleepy and I asked her can I not take it during the day can I just take it at night because I can’t see the point of me being this sleepy during the day when you’re wanting me also to, to take part in group therapy and one to one therapy and swimming and yoga and all sorts of lovely jolly things, you know. So I took it at night and it did help me sleep more and obviously the dose sort of slowly ratcheted up and I’m quite small so I think I got 200 milligrams really because of my size which isn’t very much because I know people who have taken 600 and something like that. So and that just took me to a level where I was getting consistent sleep and my moods were just becoming more regular.

Yes, I have yes, I mean my GP is brilliant you know, the woman that I saw for two and a half years, the psychologist again is brilliant and the psychiatrist that I’ve had is brilliant but some others, I mean the nurses in the hospital were just useless, you know, I mean it was like, you know, I’m not anti -staff but I’ve had some poor experiences, you know, but also I’ve been lucky.
 
Is it to do with not feeling listened to or not joining in and being able to make decisions together?
 
Yes, yes and not, for example in the hospital it’s like, you know, there was no interaction there was no interaction with the patients, you know, the only time when there was interaction was when they were administered drugs and, you know, the rest of the time, it was mostly with the unqualified assistants that there was some interaction but the others were just, you know, sitting in this room which was the nurses office drinking coffee and looking at a computer. I mean I know they have a lot of work, I know they, they are pressurised, you know, I know all that but on the other hand it was, I mean the whole environment it was totally un-therapeutic.

I’m not against psychiatry I mean, you know, I guess I am critical of a lot of practices of psychiatry but I’m not necessarily and I’m not necessarily against medication but I think especially, you know, especially with the sectioning if I didn’t want to take medication when I was sectioned they would have injected me because you can’t refuse so I guess there are some serious violations I think of human rights if you take it to that kind of, well yes because so there are these things with medication, you know, where people are not given a choice. And of course there’s all this stuff with community treatment orders now where, you know, people are put on community treatment orders because, okay they don’t want to take their medication but if they are under the community treatment order they are really in reality sectioned but under the community. But if, so they have to take to the clinic and have the depot and, you know, if they don’t do that they can be revoked then, you know again.
 
It’s controlling.
 
It’s very controlling, I mean it’s very and there was no as I said there’s no negotiation, of course I mean there’s the politics of it and there is the big pharma and, pushing from all this. I mean I don’t I’m not saying that, you know, sometimes I guess for some people and I guess I’m included in that apparently with the lithium medication works. So, but I guess people need to be able to be more informed, need to be able to have alternatives and given other ways as, you know, like more psychological or kind of treatments to get at… with the medication because I think if I hadn’t asked for it I wouldn’t have been offered, so you know, I think there are quite a lot of, a lot of complex kind of issues with medication. Especially when, you know when somebody’s detained and, you know, you don’t have any choice.

Did you ever have to be admitted to hospital because of your condition, no?
 
Oh you mean the brain?
 
That yes...
 
Oh God several times.
 
So when you were in hospital for that illness how did they manage, how were you able to take, were you able to just take your antidepressants into hospital and take then as usual?
 
I actually had to take them in because they don’t have sertraline or the citalopram on hand.
 
Oh really?
 
Yes.
 
So you had to bring your own?
 
Yes.
 
And then did they manage you taking those or where you just able to carry on?
 
Yes I had to take them in I had to give them to them for some reason I don’t know why that is, who had to hand over all your medication.
 
Right.
 
So I used to carry them in my handbag but I don’t anymore.
 
Yes, that must have felt strange having somebody else take over your, something that you do every day.
 
Yes it’s like I’m going overdose, you know. That’s another thing I think people always assume with depression is the suicide risk. You know I think that’s.
 
What overdosing on the tablets do you mean or?
 
No I think, I think that people whenever they’ve been depressed or have depression or something that they always think that you’ve tried to kill yourself or that you want to.
 
Oh I see.
 
I think that’s another taboo, you know.