Emily

Age at interview: 28

Brief Outline:

Emily broke down at work one day, which she found enormously embarrassing. She went straight to her GP and was diagnosed with depression. She was prescribed citalopram, and also had counselling through a scheme at work. She took citalopram for about a year. Since that time, she feels her life has changed for the better.

Background:

Emily lives with her partner and works in financial services. Ethnic background: White British

More about me...

Emily burst into tears at work one day, ‘for no apparent reason’. Being a quiet and private person, Emily found it very difficult to have become emotional in front of colleagues. ‘For me to do that at work was to me just incredibly dramatic...’ She left work at once and went to the GP and explained what had happened, and how she was feeling – that she was tired and sad all the time, exhausted, and all she wanted to do was sleep. ‘I don’t know....nothing should be wrong, my life’s great and I’ve got nothing to complain about’. Her GP felt she was depressed, and talked to her at length about the options for treatment. He offered to put her on a waiting list for therapy to see if that would help but it would be a while before an appointment was available. He suggested she could try antidepressants if therapy hadn’t helped. Alternatively she could begin to take antidepressants straight away, but he said it was her decision. Emily felt that she wanted immediate help and decided to try and antidepressant. She was prescribed citalopram. She was also prescribed sleeping tablets to take as a short -term measure, to help with sleep problems. Initially on citalopram Emily found it difficult to concentrate, she described herself as ‘a bit of a mess’. Although she went back to work after the first week, she realised she needed more time and was signed off work for a longer period. When she returned to work her manager was very supportive and allowed her to work at her own pace. She was also offered counselling through a scheme at work and despite initial misgivings about talking about herself and her life to a total stranger, decided to try it.

Emily now feels looking back that it was the combination of medication and therapy, and a supportive network of friends and family, that helped her to recover from her episode of depression. Emily now sees depression as an illness, which needs treatment in the same way as a physical condition. But at the time she felt embarrassed about feeling depressed when her life was seemingly so good. ‘There was no event, or nothing wrong in my life, I kept feeling like I wasn’t entitled to feel the way I felt’. It took some time for her to begin to feel more herself, and through counselling has found new coping strategies and ways of thinking about herself that have enabled her to change her life. ‘I do think it (medication) gives you a certain level of detachment that firstly is needed for me to be really able to talk about things, and secondly, it helped me to ...just carry on with things ... I don’t know if I would have gone back to see the therapist if I hadn’t had the medication’.

Emily feels that the therapy was what really helped her to change her life for the better, but without the medication it would not have been as effective for her. ‘I think now I’m quite a different person, not dramatically different... but quite different to how I was then... I felt differently, and as a result things changed around me’.

Emily’s doctor suggested she might want to try [talking] therapy first, but she knew she wanted to be prescribed an antidepressant.

I just felt like I needed to come out of there with something that would do something straight away. I literally felt like I can’t go home and have another night, just one more night of feeling like this. I just needed to do something then and there.
 
So do you know that they don’t take effect straight away?
 
No.
 
But do you think it was the very fact of having it in your hand and starting to take it do you think that kind of helped you?
 
Absolutely, absolutely.
 
You felt like you’d done something.
 
It was the biggest relief, it was relief that firstly you know, there was a justification that, you know, for me feeling like that, certainly that a healthcare professional agreed with me and, you know, and was effectively saying ‘there is something wrong with you this isn’t just you for the rest of your life, you know, this isn’t just how you’re going to have to live.’

I mean he was fantastic I have to say, absolutely fantastic just very calm sort of very relaxed vibe and he just sort of said to me ‘What’s wrong?’ and again I said ‘I don’t know nothing should be wrong, my life’s great I’ve got nothing to complain about,’ I think that was my biggest problem I really felt like I was complaining about nothing but I was just, I just said I was just tired and sad all the time and I’m exhausted and just fed up with it and exhausted, all I want to do is sleep.’ And he actually said to me ‘What do you think is wrong?’ and I said ‘I think its depression.’ and so it was sort of, you know, I don’t remember intricate, because it was five years ago this happened and so the real ins and outs of this conversation I don’t remember too well. But it ended up with him sort of saying that he agreed with that and, it was very, there were lots of questions from him, I remember that and he was very much sort of ‘What do you think we should do about it?’ and so I said ‘What are the options?’ so he went through a sort of, we discussed medication he said sort of ‘we can put you in for therapy sort of put you on the list for therapy and see how that goes and then go onto medication or we can try medication straight away’. And I was like, I said to him ‘no I would like him to try medication straight away because I feel like I can’t, I actually can’t carry on without something straight away ‘and he said to me he didn’t know how long it would take before I could see someone professional about it and so I went onto citalopram that day and he signed me off of work for a week.

Emily stayed with her parents for the first few weeks and said she was ‘a complete mess’. It took about a month to start feeling some benefits.

Can you remember roughly how long it did take to start to have any effect on you at all?
 
It’s, I find it very hard to judge thinking about it, I mean at the time because of the insomnia, obviously I had no clue what was going on, I was a complete mess, I mean I remember at one point I was at my parents’ house two or three weeks after I went on medication and I was lying downstairs on the sofa trying to sleep because I’d tried upstairs and I was just lying on the sofa and I just remember seeing a wall of spiders and I thought oh no I’m hallucinating. And so I find it very hard to judge and pin point when I would say the medication and it was starting to, I suppose make me feel… maybe more detached... because I think that was what I was looking for, I wasn’t expecting it to magically fix everything I was just looking for a bit of detachment so I could sort it out myself.
 
You could escape from the thoughts?
 
Yes and that I think the, it was, the insomnia was, was pretty awful. But I was talking to my mum about doing this interview and she said she goes ‘I think it’s very good that you’re doing that because I remember you on, when you first went on medication and what a horrific experience it was,’ I think I’d kind of a little bit blocked out just how bad that first month was, it was probably round about a month.

Emily found it hard to concentrate at work when she started taking citalopram. She said sometimes hours went by and she achieved absolutely nothing.

I had a week to adjust and then I went back to work and in hindsight that was a big mistake going back to work after a week because, firstly because I was, I don’t know I was still very embarrassed about my behaviour at work, I hadn’t seen anyone since, I’d spoken to my manager who’d been very supportive but that was it, I was very embarrassed about going back to work and the side effects from the from citalopram were really, really quite bad at that point in that well effectively I had insomnia I was getting sort of fifteen twenty minutes sleep here and there and that was it.
 
And that had been going on for about a week before I went back to work so I, for a week I tried to go into work, I never did a full day and I was sitting there and realising an hour had gone by where I had just been staring and done nothing and don’t, didn’t really know what had happened in that hour. And so I went back to the doctor at the end of that week and that’s when I sort of explained it and he said to me you know, this is one of the side effects one of a potential massive list of side effects it is one of them what we need to do is break the cycle, get you sleeping again, so that’s when he diagnosed sleeping pills. He said ‘Try these for two weeks try and break the cycle and then come back again,’ and he also signed me off for another two weeks which was what I needed because I actually went back to my home town where my parents were and I moved in with them for a week and, I mean the sleeping pills they didn’t really.
 
I wouldn’t say they really worked straight away but by the end of those two weeks that I had off I was, I was sleeping better and I was feeling a little bit more positive.

Emily’s doctor prescribed sleeping tablets for two weeks to help with the insomnia she experienced when she started taking citalopram.

I had a week to adjust and then I went back to work and in hindsight that was a big mistake going back to work after a week because, firstly because I was, I don’t know I was still very embarrassed about my behaviour at work, I hadn’t seen anyone since, I’d spoken to my manager who’d been very supportive but that was it, I was very embarrassed about going back to work and the side effects from the from citalopram were really, really quite bad at that point in that well effectively I had insomnia I was getting sort of fifteen twenty minutes sleep here and there and that was it.
 
And that had been going on for about a week before I went back to work so I, for a week I tried to go into work, I never did a full day and I was sitting there and realising an hour had gone by where I had just been staring and done nothing and don’t, didn’t really know what had happened in that hour. And so I went back to the doctor at the end of that week and that’s when I sort of explained it and he said to me you know, this is one of the side effects one of a potential massive list of side effects it is one of them what we need to do is break the cycle, get you sleeping again, so that’s when he diagnosed sleeping pills. He said ‘Try these for two weeks try and break the cycle and then come back again,’ and he also signed me off for another two weeks which was what I needed because I actually went back to my home town where my parents were and I moved in with them for a week and, I mean the sleeping pills they didn’t really.
 
I wouldn’t say they really worked straight away but by the end of those two weeks that I had off I was, I was sleeping better and I was feeling a little bit more positive.

Emily might not have gone through with therapy without being on an antidepressant.

I’m quite pro I suppose anti-depressant medication alongside the therapy because I do think it gives you a certain level of detachment that firstly I think is necessary to, for me obviously... it was needed for me to be able to really talk about things and secondly it helped me just to carry on whilst I was trying to, just carry on with things I suppose whilst, because the therapy it was awful at first, I mean she was fantastic, and by the end of it I thought and still do, the best thing I ever did but it was so horrible those first few sessions I don’t know if I could have, I don’t think I would have gone back if I didn’t have the medication. You know, whether or not it was in my mind that, that the medication was supporting me in that way, whether or not it was true that it was doing that, I needed that to be able to keep going and get a sort of breakthrough in therapy.
 
But I do think if I only had the medication and not the therapy I’d probably still be on it now because I think if I hadn’t actually learnt about these coping mechanisms and got to, I wouldn’t say the root of the problem because there was no real individual root but it was more about how I coped with stress and how I coped with sort of unravelling that, I don’t think, I don’t see how medication could have, I could come off medication if I hadn’t dealt with that.

Emma’s doctor signed her off for a week when she was first...

I went onto citalopram that day and he signed me off of work for a week so I had a week to adjust and then I went back to work and in hindsight that was a big mistake going back to work after a week because, firstly because I was, I don’t know I was still very embarrassed about my behaviour at work, I hadn’t seen anyone since, I’d spoken to my manager who’d been very supportive but that was it, I was very embarrassed about going back to work and the side effects from the from citalopram were really, really quite bad at that point in that well effectively I had insomnia I was getting sort of fifteen twenty minutes sleep here and there and that was it.
 
And that had been going on for about a week before I went back to work so I, for a week I tried to go into work, I never did a full day and I was sitting there and realising an hour had gone by where I had just been staring and done nothing and don’t, didn’t really know what had happened in that hour. And so I went back to the doctor at the end of that week and that’s when I sort of explained it and he said to me you know, this is one of the side effects one of a potential massive list of side effects it is one of them what we need to do is break the cycle, get you sleeping again, so that’s when he diagnosed sleeping pills. He said ‘Try these for two weeks try and break the cycle and then come back again,’ and he also signed me off for another two weeks which was what I needed.

Emily took an antidepressant for a year and gradually began to feel better. Since she stopped taking the antidepressant she has developed new ways to manage her feelings.

Because I was on medication for a year and I think, because I kept thinking I was better and I don’t know if that’s the right word really, better.
 
Improving?
 
Yes improving and oh everything’s fine and dandy now, brilliant. And so a couple of times I tried to go back to work full time and just, you know, be normal I suppose and then that would set me back because I was trying to do too much, I was trying to take too much on. And I think I was just expecting because I felt like there was no event or nothing wrong in my life, I kept feeling like I wasn’t entitled to feel the way I felt even though I was being told, you know, sometimes it can be a chemical imbalance it just, you know, it can be something long buried form a long time ago and there’s various reasons for it I still kept thinking well I’m not entitled to feel this bad. So it took me, and so yes I kept assuming right I’m better now, I’m better now, I’m over it, I’m over it. So I was very up and down and then I would get as far as to say it did, it was obviously more gradual than this but it almost just clicked and I actually chose to stop taking the medication myself a year later by that point I was down to twenty again and I just stopped taking it and I haven’t actually been, I haven’t, I didn’t go back to the doctor and discuss it I just stopped taking it and I haven’t, I didn’t go back to see the doctor at all actually.
 
And since then I think I’m hyper aware of the potential of going back so I try to talk through the help of the therapist I was seeing at the time, the counsellor she really helped me to sort of understand coping mechanisms different ways of looking at things. And so it’s things like when I feel, because I still every now and then I do, it’s hard to judge whether it’s, you know, ‘normal’ or something else because.
 
A low mood, or actually depression?
 
Yes because obviously I can’t judge how other people feel, you know these experiences when they’re sad how sad is sad and what’s depression and what’s just sad. but I’ve got things were, you know, I go to the gym a lot regularly, structured and, you know, if I start to feel really down I do something and I make myself talk as well and make myself talk to my current boyfriend and make myself talk to my friends and my family and sometimes I find that very difficult because I still think it’s slightly in me to, to keep it inside and it does build up so I think it’s those coping mechanisms that the therapy gave me that have been a long term solution but the medication I guess I could say I needed straight away.

Emily thinks she may not have coped if she hadn’t felt able to trust her doctor. She valued his support.

I think the way my doctor went about it was very good. Just open discussions, you know, providing the options but asking how you felt. He asked me how I felt about each option, he took the time and he was, I was in there a long time, I dread to think how long I pushed back the appointments that day but he took the time to explain the different options and asked me how I felt about each one and so we could actually discuss openly. And it just, and I think because it was so important that, it was the first time I’d met him and he became such an important part of my life so quickly I don’t know how well I would have coped without knowing that I had that support and I could go in each session each appointment and not feel judged but literally give the facts this is how I’m doing and trusting the response.