Greg

Age at interview: 34

Age at diagnosis: 34

Brief Outline:

Greg has three episodes of depression where he has taken antidepressants. He didn’t respond well to fluoxetine, but found citalopram was more effective at improving his mood, although he experienced side effects with both. He feels it can be difficult to know whether improvements in mood can be attributed to the drug itself and how much the passing of time and changing circumstances have played a part. He sees antidepressants as a useful crutch to help you get back on your feet, but doesn’t feel they are a long-term solution.

Background:

Greg is single and works as an artist and photographer. Ethnic background: White British

More about me...

Greg first experienced depression in his early 20’s after the breakdown of a relationship. His doctor prescribed fluoxetine after a very short consultation and he was undecided about taking an antidepressant. Eventually he decided to give it a try but described it as a negative experience as they didn’t fit in easily with his lifestyle at the time, particularly because he wanted to be able to continue to socialise with friends.
 
‘I want antidepressants to help me live my life normally, and normally means going to the pub, it doesn’t mean excessive drinking , it’s just social drinking’... if I had one drink when I was on them I would feel like I’d had about ten drinks. They didn’t work well with me and my lifestyle I think at the time.... and I didn’t persevere with them... I was feeling very odd and strange and I’d black out quite a lot so I just came off them.’
 
After stopping taking fluoxetine Greg gradually managed to get his life back on track. But a few years later he experienced another depressive episode, again coinciding with the breakdown of a relationship - and was prescribed the same antidepressant, but found he experienced the same issues. Although he found over time there was an improvement in his mood he felt ambivalent about how effective they were.
 
‘I’m not sure they helped me.... I found them confusing, whether I was getting better or whether it was time, or the pills.... I found that very difficult to understand’.
 
Earlier this year Greg found himself feeling severely depressed once again, and this time felt that the consultation he had with his GP had been more constructive than previous times. Greg was reluctant to take fluoxetine again and the GP suggested he try citalopram, which he found suited him better. However, he only took it for a few months as he had concerns about the way it made him feel.
 
‘It really helped me a lot, it was completely different from fluoxetine... I guess it was like a crutch that I needed at that time, it gave me the energy to get out of bed, it kind of made me feel like I was wrapped up in cotton wool in a way and I was very happy... towards the end of my time with citalopram I got a bit concerned that I wasn’t really myself, that I was too wrapped up in this cotton wool and... so I cut down and weaned myself off them’. 

Greg felt his doctor handed out a prescription for Prozac...

I guess I must have been 23, around about that and I think it’s always linked, with me, with the end of relationships. I noticed that I always get very low, very down. I think I was in an intense relationship when I was 23 with a lady who actually had mental health issues and got sectioned. And I remember that was a really difficult thing for me to deal with and it really kind of shook me up and so I went to the doctor and it was really, it was really strange, I went to the doctor and had a, literally had a minute chat with him going ‘I feel a bit down’ and without even thinking or chatting to me he just signed me off these pills. I got home and I looked down on the sheet and it was like fluoxetine and I was like ‘what’s that?’ Anyway, so when I was 23 that must have been 19…, when was that? 199…, 23 so yeah about 2000 and Prozac was a massive kind of thing around that time, a bit before. And then I sort of looked on the internet and was like ‘oh he’s prescribed me Prozac’ and I was like ‘really, am I mental?’ and I left them on my top shelf for ages and I just didn’t want to take them because I was a bit confused as why I; he’s prescribed me that after like a really short chat, just me saying I was down and maybe at the time they were handing them out left right and centre, I don’t know.
 
When I was 29 I again, another relationship as these always seem to be, I split up with a girl that I really loved and was having a real tough time so I thought I’m going to try these again. My doctor was a very big believer, he didn’t prescribe them after like a mini chat, I spoke to him for about an hour and a half, really lovely doctor.

Greg felt scared about taking the tablet for the first time...

For me you know taking the pill kind of was basically saying ‘I’m not going to cut myself’ and it was a decision and I was being proactive, I was picking up the pill and I cried before I did it, this time I cried a lot because I didn’t want, I was scared of it and. But you know that, taking that was basically going right I am being proactive, I’m doing something to help myself and I had to have that confidence knowing that you know if I’m going to take this pill it’s going to help me or have belief it’s going to help me.
 
So when you’ve got that sort of moment trepidation taking the pill.
 
Yeah.
 
Is that a feeling of failure or something like that?
 
Yeah, yeah and like, yes like sort of saying to yourself over and over again ‘what am I doing to myself, why do I need to do this, what’s wrong with me’, in all honesty you feel quite low about yourself I think, like ‘oh I need this, do I need this, do I need this?’. You know ‘am I mental, am I?’, you know all those connotations of all those stigmas I think of mental illness and, you know, and I think it takes a braver person to actually do it and go ‘okay I’m going to commit to doing this’ than not.
 
So yeah, yeah but it’s not a nice thing to do the first time you take it. For me I got emotional about it because it’s like okay this is a journey I’m going to have to go on and I’m going to have to try and see it through as much as I can to help myself.

Greg believes that depression is a mixture of a chemical...

I think it’s a mixture of, I think it’s a mixture of both isn’t it, it’s repeated patterns in your life that you can, that underlie and that underlie the situation and you don’t know how to cope with them or your brain doesn’t produce enough serotonin is one way of looking at it, I don’t really have an opinion on depression of how, why it’s there, is it something that’s always going to happen to you as a person because you’re built that way and your brain doesn’t produce enough serotonin so you need these helping hands or is because you put yourself in situations that, that make you depressed. I think it’s probably for me it’s always a mixture of both.

Greg feels it’s a good idea to have counselling or therapy...

I think counselling is something that I should be doing but it’s one of those things it’s the first step isn’t it of doing it, it is kind of the hardest and I think it’s easier to not go and do that. So you know, I guess, you know, I chose medication this time because I wanted something instant, I wanted a quick fix I guess and I was thinking ‘Oh I’ll just take these pills and I’ll be better,’ but that doesn’t obviously solve the deep rooted issues that I may have or one person may have. So, you know, I’m more of probably advocate of going to counselling, I would tell my friends to go to counselling but doing it myself is a different thing isn’t it so I think I don’t take my own advice necessarily.
 
I love talking so I would love to go to a counsellor and, you know, chat but I, my life, again my life I make excuses like my life’s so full, you know, I’ve got my full time job I do and I’m an artist, I’m a photographer, I‘ve got this relationship, I’m doing this, I always make excuses that I’m too busy to go and probably do the thing that I should.
 
But the medications quite convenient to fit in with all of that?
 
Yes because you’re just, it’s swallowing a pill in the morning isn’t it and it’s, it’s kind of, you know, it’s an instant hit, well not an instant hit but it’s something where you don’t have to go and spend some time seeing someone and thinking are they judging you or, you know, all those things that you may think but they’re not but, you know, yeah so you know I think counselling’s something that I, I personally probably should be looking into.

Greg used several websites to compare the two SSRI’s...

From reading the, reading online, you know, we’ve got the internet it’s just, there’s so many reviews of everything and you can read negative reviews and, you know. I went for citalopram because it was more of a positive kind of review that I had, it was saying this was amazing and it was more mainly for mild depression that I’d seen, that drug.
 
So how much research did you do on the internet?
 
I did, yes I did loads.
 
Where did you look?
 
You know just, just go to forums, antidepressants things, just searching citalopram, searching fluoxetine, just seeing alternatives to antidepressants.
 
And what kind of information interests you is it the kind of clinical stuff or where you more interested in finding out about peoples experiences?
 
A mixture of both, I think you know, I think I want to read it the clinical, you know, the clinical make-up of the drug, what it’s doing, what it actually does, you know, SSRIs, receptors, all those things that you read about, what they‘re actually doing to you physically. But yes I think more people; the biggest sway is people’s experience.
 
Do you think it’s, how easy is it to find reliable information would you say?
 
I found it okay, I found it okay I think, you know, I top and tail everything I read of like ones that are extremely positive and extremely negative, I kind of ignore both of those because you can easily focus on the negative and it’s just, you wouldn’t do anything or you can focus on the positive and your just being blind to everything.
 
So you were doing it, you were making comparisons across different sites?
 
Yeah, yeah I’ll do, I did about four or five different sites and kind of just went to like the comments box of forums and was seeing how, how, what it was like to take them initially and what it’s like to get off them, they were my two main things. Seeing what the side effects were during, throughout and also the coming off them was a big one I looked at.
 
So you were looking at citalopram and making comparisons about the kind of reactions that you’d had to the Prozac?
 
Well no I was looking at citalopram and seeing how. Yeah I was, in a way I was and also looking at individual ones. I got the citalopram because he recommended that one, before I took I went and did my research and had then in front of me and I was looking at the research and thinking okay is this the right one. And seeing basically I did citalopram versus fluoxetine or whatever and seeing the difference and most people had said they preferred citalopram but that seemed to be the more mild depressant, for people with mild depression. Where there were loads of people that didn’t like citalopram as well and they were like pro fluoxetine.

Greg said he would be wary about telling a prospective...

Legally I’m meant to, I find it really, I find it such a hard one to work out whether I should or not, you know, even legally I’m meant to, do I really want to say that I’m on citalopram. I kind of have and I haven’t in certain jobs because I think it’s my own business so I don’t know, legally you’re meant to aren’t you, if they ask for it.
 
What do you think might be the repercussions if you did disclose that?
 
I think the fear is that you’re not going to get the job, you know, the fear is if you’re going for references that you know, they’re going to think A you’re not going to get the job, B ...oh he’s, you know, a bit mental, you know, and it might, it might happen in the workplace that you feel like people know stuff that you don’t want them to know about. Yeah it’s a tough one isn’t it because, you know, if you’ve been signed off from work you’ve got to declare that because in the future if you haven’t said you suffer depression and then you suffer from depression you’ve put yourself in a bad position, if you’ve got it on your history at least they know that this could happen. So you know it’s hard to work out whether you have to tell them because it’s for your benefit of it’s because they’re trying to find something out.
 
Yes or maybe labelling you as possibly unreliable.
 
Yeah, yeah and all those, yeah it’s a tough one. I think, you know, no one wants to really declare that they’ve been on, no I mean I’m happy to talk about it but I wouldn’t really want to tell a future employee that I’m on it, employer that I’m on it because I think that’s a negative.

Greg feels that there are lots of pressures on GP’s. One doctor he saw was ‘amazing’ and spent time talking things through, but another one ‘just dished out pills’.

I’m realistic enough to know that people who don’t have that much time, doctors don’t have that much time to sit down and speak to every patient and I was very lucky with one that he was an amazing doctor, he would always take his time over me whether that was personally, I think he was like that with everyone he would just take his time and he was amazing doctor and I’ve had another doctor who just dishes it out straight away and maybe he was under a lot more pressure, he had a lot more patients, so it’s hard to judge.
 
Yeah in an ideal world we should sit down with someone and talk to them for half an hour and find out why they want to take them and what the history is, whether that’s feasible, I can understand there’s probably pressures to see all these patients get these patients through the door . Yeah I think, you know, a conversation is the best thing for mental health issues alongside pharmaceuticals as well. I think pharmaceuticals alone are probably not great, and I think conversation alone possibly is not great as well. So it’s just whether there’s time for people to be able to converse with someone about their issues.