Antidepressants

I’ve got a very, a very you know it’s not even a love- hate relationship with anti-depressants, I’ve got mainly a ‘hate’ in as much as I know that there are times where, where I have to take them and I have to try really hard to be very good and stay on them and stuff until I’m better but I really struggle with them as I say a lot because of the side effects.
 
I feel like the version of me is on medication it isn’t ‘me’. It isn’t the ‘me’ I want, I want to be because it shaves too many bits off you.
 
Right.
 
So.
 
So if you, say you were kind of put on maintenance dose, you know a low dose and told just keep taking that would that be good for you or not?
 
Well I’ve tried it, I realise it is my, I don’t like being, I don’t like being dependent on them.
 
So you’d rather get to the point where you can stop taking them and you have a period where?
 
Yes I’d rather, I’d rather have periods where I wasn’t taking them but this is what, you know, the, but on the other hand and this is, this is my big dilemma now because I feel some days, you know, more than others but I particularly feel like I don’t want to waste anymore of my life on this bloody thing, you know, it seems it takes, it takes so much out and your sort of output into life is so limited, you know, because you’re drained.
 
So the ultimate goal is for the depression to disappear?
 
Yes.
 
I mean do you in terms of sort of your thinking about the future do you expect that might happen or is that something that?
 
Well I hope to have, I mean I know I’m always going to be a person who, who does this I always have been and they, you know, there are people who manage on much sort of flatter parts because it’s how they are but it’s not me.

Yes I’d become feeling a lot better within myself and whilst that could have been the medication that was doing that I wanted to not be dependent on medication so yes that’s when we made the plan with the GP to come off of it slowly and obviously with seeing the GP regularly to make sure I wasn’t slipping.
 
And when you said that you wanted to see if you could do it by yourself without medication where you doing other things to sort of keep yourself more buoyant, did you get work out different strategies to cope with your moods?
 
No I didn’t really. I have looked into more natural forms of getting the same kind of drug serotonin levels and that, things like bananas there was a research done that pro biotic yoghurt drinks may be helpful to I started taking, I have recently started taking pro biotic yoghurt drinks and eating lots of bananas and that’s supposed to make you feel a little bit better so if I can manage it naturally.
 
So do you feel like you can notice any difference or any effect when you eat those kinds of foods?
 
At the moment I feel so much better for not being on the medication and for using the natural alternatives, I actually feel so much better within myself, I’ve been smiling.
 
Is that, do you think that slightly related to just the pleasure of not being reliant on a medication?
 
Possibly.
 
Yes.
 
It’s a good feeling not to be reliant on it.
 
People say it’s quite difficult to sort of separate out, you know, whether it’s the drug that’s made them feel better or…
 
Yes it is.
 
Or in your life, things might have improved in your personal life?
 
It’s very hard to separate it I think particularly where they were concerned this time was because there is so much going on in my personal life at the minute they were really concerned about me not taking any medication but I feel better for not taking it.

I never forget to take this tablet and I think it’s because I think it’s been so valuable in helping me feel better. My big concern is that I go to the doctor in a few months time and they say we think you should come off it because, I’m really nervous about that and I’d like to stay on it for at least a year more, you know, and I, because I know by then I will have been on it for so long that it becomes a crutch and you think I can’t survive without it. How I feel at the moment, if someone said to me to just take it for the rest of your life I think I’d say thank you very much.
 
Because it’s keeping you stable?
 
I feel it is and obviously if I came off it then we’d know and maybe I should come off it at some point and try and see how I do, knowing that if I go back to the GP and say please can I start it again they’ll let me do it. And as well I’m, worried about -like the expense of it I’m worried about becoming an expensive burden to the community because really I’m 50 I’m generally in good health, you know, I’m working and I think oh I don’t want to be a drain or, you know, on drugs that are required for cancer treatment or something like that. But the more I’m on the treatment the more I realise how ill I was and it was a physical illness and not something that I just made up to get some attention.
 
Is that something that you kind of felt quite strongly before, that it could be that yes?
 
Yes, I suppose yes because it just, when I went to see the doctor is it just that I’m an ineffectual individual who’s not good at his job and not a great dad and that I’m, you know, and that I’m pretending I’m depressed to excuse all that? And he said well that’s what the depression is doing to you; it’s the other way round.

You know there’s a part of me that still doesn’t want to be on medication just a small wee part of me that thinks ‘do you know what [name] get over it, get on with it and stop it, be more in control of your life, be more adult, be more all those things, you know, that they tell you in all those agony columns and, you know, you should do this it’ll be fine and be assertive’.
 
I have this vision that without a maintenance dose I’m going to continue to go through the rollercoaster ride of being well, being unwell, being well, being unwell. I said it’s become clear to me when I look back over the last 30 years that there is something about my being that does not cope as well as other people with life’s ups and downs but when life’s ups and downs become quite, you know, controlled I deplete my serotonin, I lose my, you know, my coping strategies much quicker than other people. and so that’s why I’m on what I now refer to as a ‘maintenance dose’ of antidepressants and as someone who doesn’t take medication I have chronic arthritis and I have to take tablets for that as well and it really sticks in my throat that every morning I have to throw two tablets down my throat. but I know why I take them… but I don’t take paracetamol, you know I don’t take pain killers I have other ways of coping with those kinds of. But this, this thing that helps me to cope with everyday life I think.
 
I think it’s allowed me to, actually I think it’s allowed me to be the kind of person I would, more of the kind of person I would want to be.
 
Yes.
 
You know so it’s yes it has it’s actually it’s different to other people’s experiences it’s actually my kids have told me they, they like the ‘me’ that is when I’m well, you know.

Looking back I don’t think I had any, I don’t know, I would have been scared to stop taking it because I feel I would be really ill but I’ve always had the fear of not taking it because I’ve seen what happened when some people do stop taking it and I’ve always had a fear of not taking it and through all the ups and downs really bad, okay, I still carried on taking it without question really.
 
But you can never tell can you, what would I have been like without them, I don’t know. I don’t know what I would have been like without them. I fear that I would have been a lot worse without them. But I don’t know whether that’s true or not, do I, but I believe, I believe that I would rather kill myself rather than be totally depressed without them, I believe that really.
 
Do they give you a feeling of safety?
 
A feeling of safety that’s propping me up its, it’s a prop I’ve felt it’s been a prop. While I’m taking these I can survive, I can go on.

I actually came off them in September so I took them for just under a year. and I can’t honestly say that I found them to be, to have a discernible impact beyond, they definitely had an impact but I think their biggest impact was psychological I felt a kind of, a nervousness around taking them initially in the sense that this is a really powerful drug I felt a very initial kind of high followed by a kind of low but I can't honestly separate out whether that was the way I was thinking and therefore feeling it or whether that was actually what was going on in a kind of chemical level.
 
I remember feeling quite kind of stressed out at the time that if I missed, because I was, I was sort of sustaining a working environment and I was feeling like I was making progress through the kind of therapeutic work that I was doing and I was very concerned always that if I missed the day of the pill that I would nosedive and that, you know I didn’t, I had no way of gauging what was making me feel better, you know, was it the pills, was it the psychotherapy that I was doing was it my circumstances, what was it I didn’t know and pills were at that moment part of that mix and I’d always felt quite uncomfortable by the fact that antidepressants where often prescribed and then you just continue on them for long periods of time, my sister’s been on antidepressants for almost ten years and there’s something deeply unsatisfactory about that to my mind.
 
So I was as I say I didn’t know if it was part of, what part of the mix was helping me, I had a sense that it was the discussions I was having through the therapy but I didn't really know so over the summer when I wasn’t working because I had the summer off I felt, I’d felt better for a fairly sustained period of time, certainly compared to how I was feeling so I decided I would come off them and I had quite a lot of trepidation and as it turned out I came off them and I was absolutely fine I really was, there was, I did a kind of over a period of a month I went from 50 milligrams to 25 so I was alternating days but the main feeling that I had was a fear that if I come off them it was a kind of psychological almost like a sort of dependency, like the only reason I’m feeling okay is because of this pill, it’s a kind of external sort of feeling. And I felt that and I was actually kind of possibility quite negative because I wasn’t taking responsibility for my own health in a way, or my own.
 
What just that reliance on a pill?
 
Yes just like I’ve now, I’ve come to a point where I’ve sort of stopped engaging with how I might feel and I’m just kind of now saying this pill will just kind of get me through the day and then I developed a fear whereby I would be like if I stop taking this pill I’m not going to, I’m going to be back where I was which is quite a disempowering thing in that, in the way that I sort of experienced it and felt it.

I think I’ve, you know, if you look at the research on drugs if you look at the clinical trials which are done comparing drug treatment to placebo has two thirds…. is it two thirds of the effect of the drug so, you know, most… I think the medical profession is now coming to understand although the pharmaceutical companies aren’t keen on it, that a large part of the effect of the drugs is the placebo effect. Either through the, the feeling of relief that, you know, providing some hope that things are going to change or through not just and that, and that can just reduce, just by reducing the stress hormones in your body can be beneficial or just by if you’ve got more hope you’re more likely to do things that are going to help.
 
Is that where you fall into that category?
 
I seem to yes.
 
Its sounds like it from what you’ve spoken.
 
Yes, yes that rings very true with me I haven’t seen great benefits over the years apart from venlafaxine that I can put down to ‘that was the drug’. and so I think most of my, my benefit has been a placebo benefit and I think the big problem with drugs at the moment is that the pharmaceutical companies don’t like to acknowledge that and so we’ve still got this view that ‘if I take this drug it’s going to be some kind of wonder cure’ you know, people believing that. And I think it’s just not, we don’t maybe one day we will have that drug but we don’t have it now and it seems. Well from my personal experiences it seems to be, it’s one of those illnesses that needs a protracted period of time and effort, a combination of drugs and therapy to really knock on the head, if you ever can, and certainly sort of chronic depression and that's not the message of course that the drug companies have put out over the years. and I think there is still this, there is still this big problem of relying too much on the drugs and having to because the doctors only got ten minutes and their limited, counselling service although it’s getting better is limited counselling on the NHS.

It’s always hard to know with depression because different things make your mood go up and down anyway and there are so many other factors going on, changes in life, changes in kind of level of workload, things I’m coping with kind of relationships with people, I don’t know to what extent.
 
I remained quite ambivalent when I was on it I think it worked well again I was doing other things as well. I went over to [city] once a week for to see a life coach for a period of eight weeks I was referred to see a psychiatrist who did an assessment but nothing, nothing really found out I was on a waiting list for psychological therapy as well so lots of other things were going on as well.

I don’t feel any particular shame or any, I don’t, any kind of....in fact I that the more people talk about antidepressants as a positive thing, the better it is that people don’t end up, you know, people don’t end up not taking something they need because of the stigma.
 
And do you still, do you think the stigma is still quite a big part of the whole thing?
 
I think for some people, I think some people just have a real mental block when it comes to taking antidepressants, you know, they’ll merrily have ibuprofen if they’ve got a headache or whatever and it’s like but you know... but depression no, no, no I don’t really like taking medication, all of a sudden, you know, people are suddenly become quite pure about it even though they’re drinking like a fish!
 
Why do you think that is?
 
Why do I think that people have a stigma about it? Well I think that people think that it might change your essential self or people might think it might turn you into someone that you’re not and I think, I would say that was a valid thing to think if the only antidepressant available was Seroxat but my latter experiences say that, you know sertraline’s a bit like Berocca, it’s you on a good day.
 
It’s the good version of you.
 
Yes it’s the good version of me or the version of you that you always thought was there but was kind of being weighed down by depression.
 
Your authentic self....
 
My authentic self... I don’t feel that I’m anyone different just that I’m unburdened really.
 
And coping?
 
And coping and, you know, and then able to kind of do the other things that I need to do, you know in order to then maybe stop taking the antidepressants, you know to put the other structures in place so that I don’t need them anymore but without the crutch if you like of the antidepressants you’re never going to get to the point at which you can... not take them anymore.
 
So it sounds like they’re a stepping stone to help you through and get you to another place.
 
Yes.
 
Where you can.
 
Yes or, you know, I mean I guess like I’d say to people it’s like, it’s a bit like you know if you have really bad migraines all the time it would be like having pain relief to give you enough time to then not have this dominant headache while you try and work out what’s triggering you migraines. You know, it’s a lot harder to do something if you’re in a lot of pain; well psychological pain’s the same.

If I ever felt like things were going downhill again I would like 100% take them again because yes I mean if you’re diabetic you’ve insulin, like if you’ve got depression you take anti-depressants if that’s the treatment that’s suitable for you I’m not saying it’s suitable for everyone but for me it is and so I’m not going to feel ashamed that I need them because like it’s just an illness like anything else.
 
And so when you’ve talked to your flat mates and your friends about it have you come across other people who are in similar situations?
 
Yes a lot of people have come to me, a lot of people have asked me questions and I’ve told them how I feel and they’re like ‘oh I sometimes feel like that’ and actually a couple of them have gone to the doctors and, I think university is like an incredibly stressful time and in some ways to be able to... I mean when I talk about my experience and people relate, I think for some that gives them the permission to go to the doctors. I think like when you’re younger you go to the doctor because you’ve got a cold or because you’ve got some kind of physical... and I think it’s very difficult to go to the doctors and be like ‘I feel sad’ because it feels like that’s the wrong reason but it’s like some people need the, you know, it’s okay to do it that’s what they’re there for.
 
So in a way it kind of, I’m using ‘inspired’ in a sort of way that by talking to other people you’ve kind of given them that open idea that it is okay?
 
Yes and also to be able to say… if you tell people, like I personally, like other than my parents I’ve personally never come across anybody who I feel has treated me differently or anything because I’ve told them. And, you know, if someone has ever done that I think that’s more of their problem than my problem and so I think yes to just kind of get the word out there and so people know that they’re not alone in what they’re feeling and not, you know, it’s not wrong it’s just what’s happening.
 
Has your parents attitude changed since you’ve been, become older about you having these problems or the medication?
 
They, I think they’d like me to not take the medication but because they want me to be better not because, you know, my medication implies there’s an illness and I think they just don’t want me to have the illness and so they sort of get that feeling about the anti-depressants and it’s like you know a bit of a backwards way round of doing it but nowhere near as much as when I was younger because I think they know now that going back on them and, I mean obviously when it was the death of our close relative they were very much involved, I mean it really shook the whole family and so you know I think they really, you know, they understood how hard it was and I don’t, you know, I think they’ve become much more accepting now. And I think what they really want is just for me not to be ill anymore.

I think for me it’s that realisation that I can’t do it by myself anymore.
 
But there is a quite a drive that you want to?
 
Yeah I do, there’s still a part of me that feels like a failure for not being able to manage my life without chemicals. And I came to a realisation, it must have been probably, I don’t know about five years ago maybe, where yeah, no it was probably around 2009 actually because I tried, 2009 I’d been on the sertraline for about four years by that point in time, sorry three years, and I’d been doing so well and I’d been doing really, really well and I wanted to see if I could live without antidepressants. And I actually did it properly, I actually spoke to my GP, we came up with a plan we said fine we’re going to withdraw from a 100, 75, try 75 for two months, if that’s working cut it down to 50, if that works give it up for 25, if that works take 25 every other day. We had it all planned out and I kind of started and reduced to 75 and managed on that for a couple of months and then started to withdraw to 50 and realised it was, it wasn’t going to work.
 
So how, how did you realise that what was it you noticed?
 
I started to get agitated, I started to get very, I guess it was the symptoms of depression coming back, I get very irritable, certainly it’s one thing I notice a lot because working in a busy office I get very agitated by noise, by people talking and by the fact that people have the audacity to breath, which is not really, not really helpful. And I think I kind of started to notice those signs, notice those signs and very quickly, I’d said to myself when I started to come off them, I said to myself ‘you’re not a failure if you can’t do this and everyone else said that to me but I’d never, I didn’t believe it and I did feel like a failure when kind of I realised I had to go back on them. And then after that I kind of felt, I came to a bit of realisation that actually you know what I will have to live on them and that’s absolutely fine. And I think I go through phases sometimes I think yeah its fine that I have to live on these and then sometimes it really annoys me.

A very large portion of people if they went to their GP could get a diagnosis for depression or anxiety, a very large proportion I would say. so these things are quite common I think.
 
And there’s such a wide spectrum of experience within that diagnosis.
 
I’m sure, I’m sure yes but you know I just seems important that we kind of, I don’t know just have a slightly more honest engagement about the fact that life and the prospects of death are upsetting and difficult and the kind of relationships are fraught and, you know, that effects the way we live our lives and we can call them mental health problems and then get a pill to manage our condition but that just doesn’t seem to square with my understanding of what it is and I think that over medicating is a real risk.

I wish I didn’t have to do it mainly because I’m so full of chemicals anyway and I used to have a massive phobia of taking pills so when I was first diagnosed with the Crohn’s having to get over that was quite a hurdle. And so it is just quite annoying, you know, that part of my breakfast is all these little pills but I suppose I’ve just kind of accepted it and because I already take mediation to make me feel physically okay, to take medication to make me feel mentally okay doesn’t seem like that much of a leap. but I do sometimes worry about all the chemicals and bits and pieces and manufacturing that goes into it and stuff like that.
 
But it sounds like the only affect you’ve had has been a positive one I mean you haven’t had side effects or anything untoward associated?
 
No I’ve been quite lucky yes.
 
And do you talk to other people and tell them that you take antidepressants, is that something you keep personal?
 
No I generally tell people I’m always really open at school people always used to find out like the boy that I fancied or whatever before I ever did and it was kind of a bit like walking in and having like the Sun newspaper doing a feature on me every day so I just kind of got used to it so I’m not really a very private person I sometimes wish I could be but I’m just sort of used to. And I’ve got to the point where I am so open about so many things if I’m not open about something else it feels a bit wrong.
 
And what sort of response do you get from other people when you tell them about?
 
Everyone’s pretty much has been fine, one of my friends was like ‘Oh well we’ve got to get you off them straight away,’ and I sort of went ‘Well no because I’ve only just been on them and I need them for a bit,’ so I don’t think we’re quite, I don’t, I think he was acting like I’d told him I’d got addicted or something like that it was really strange. But everyone else is just ‘oh yes fair enough okay, is there anything you need?’ And actually a lot of people have turned around and said ‘I take them too welcome to the club!’