Melanie

Age at interview: 44

Age at diagnosis: 43

Brief Outline:

Melanie struggled with some difficult life events for some time before finally seeking help from her GP. She was offered counselling but there was a waiting list. In the meantime she was prescribed fluoxetine and at the time of interview had been taking it for around 4 months.

Background:

Melanie worked as a retail manager until recently. She is divorced. Ethnic background; White British.

More about me...

Melanie had experienced a number of difficulties in her personal life and was finding it difficult to cope at work, although she was usually a very competent and confident person. She said she felt overcome with angry and aggressive feelings. She began to feel worried and concerned about how she was feeling and realised eventually that it was depression. It took her a while to seek help because she had always been able to cope with life and was usually a very positive person and she found it difficult to accept that she needed help. Looking back she feels that the symptoms she was experiencing were her body’s way of telling her to stop and take a break from the stressful situations that she was experiencing. She took the opportunity to see a counsellor through a workplace scheme, and through talking to the counsellor decided that she should seek help from the GP. Her GP prescribed fluoxetine, and referred her for counselling, but there was a waiting list. She worried about taking an antidepressant.
 
‘I obviously knew that there was antidepressants available but they’ve kind of got a stigma and I was worried that I didn’t want anything I could get addicted to. And, you know, I know they only kind of mask the problem but I thought I’ve got to do something because I’m clearly not coping’.
 
Her GP told her that antidepressants could help her feel more calm and lower her stress and anxiety symptoms. Melanie had been taking the medication for about 4 months at the time she was interviewed and said she felt a noticeable effect after the initial few weeks although she was still struggling to cope. As a result of her illness she has left her job, and some days she finds it difficult to go out or spend time with other people and often feels emotional.
Melanie feels that GP’s don’t have time to help with depression, and she often ends up seeing a different doctor each time she goes for a review.
 
‘When you’re not seeing the same person they can’t tell whether there’s any change in you or, you know, if I was seeing the same doctor and they would say ‘Oh well you look like you’re having a good day today,’ or ‘How are you feeling you look a bit chirpier,’ or ‘Oh look you’ve bothered to put some make up on today’. But when you see a different doctor they don’t see that’.
 
She would have preferred to be able to access counselling before being offered antidepressants.

Melanie collected the prescription but took time to read...

And whose suggestion was it to have the antidepressants, was it the doctor who suggested it to you?
 
Yeah.
 
Yeah.
 
Yeah it was the doctor.
 
And how did she explain to you what they, how they might help?
 
She just sort of said that, you know, they would calm me down, they would just make me feel a little bit more in control of things, they would reduce my anxiety and my stress levels and to be honest at that point I was just ready for anything that would do that. I couldn’t think of anything else to do I mean I certainly didn’t want to go down the drinking avenue because I’m sensible enough to know that that doesn’t cure things. but at the same time I did still have a worry that I’m taking medication and what’s going to happen when I have to stop taking it.
 
Were you worried about how they would make you feel, how did, what did you think about that?
 
I was a little bit worried because you know obviously I am fiercely independent and, you know, I have heard people have said when they’ve taken antidepressants that they go all fluffy and they don’t really know what they’re saying and what they’re doing and I didn’t really want to be like that and obviously with being on my own I didn’t want to put myself into any situations where, you know, I wasn’t in control of myself or I could fall over or I could injure myself because of the medication. So to be honest when I did get my first prescription I read the leaflet inside, front and back, to make sure I knew exactly what could happen to me in the course of taking them.

Ideally people would like a ‘quick fix’ when they start taking...

I was worried about the fact that I knew the tablets would take some time to have an effect.
 
So you were worried that, you wanted some immediate relief and it wasn’t going to happen that quickly?
 
Yeah I kind of thought that and to be honest the counselling, even though it was only an hour a week, was medication to be honest. And that did give me a little bit of relief before the tablets started working because it just confirmed that it was, it was alright to be the way I was.
 
It is unfortunate that the antidepressants take a little while to work because you do get that box and you do sit down and think I’m going to be alright tomorrow and you’re not.
 
It’s not that simple.
 
And in fact, I suppose it’s like antibiotics they always say you get worse before you get better, I wouldn’t necessarily say I got worse by taking the antidepressants but obviously I had to suffer some of the little side effects but then now I can think well it was worth persevering because obviously my body’s accepted them now and they’re doing what they should be doing instead of; I suppose when you take something like that and they say you’re going to feel sick it could be your body saying ‘whoa hang on I don’t want this medication inside of me, let’s make you sick’.
 
So your body has to get used to having it inside.
 
Your body gets used to it and then it starts doing what it should be doing.
 
So you’ve now realised that’s it’s a much more gradual process than what you first thought?
 
Yeah but you do want, you do want that quick fix.

Melanie was worried about the side effects listed on the leaflet...

I was a little bit worried because you know obviously I am fiercely independent and, you know, I have heard people have said when they’ve taken antidepressants that they go all fluffy and they don’t really know what they’re saying and what they’re doing and I didn’t really want to be like that and obviously with being on my own I didn’t want to put myself into any situations where, you know, I wasn’t in control of myself or I could fall over or I could injure myself because of the medication. So to be honest when I did get my first prescription I read the leaflet inside, front and back, to make sure I knew exactly what could happen to me in the course of taking them.
 
Did that reassure you, how did that, how did the information seem?
 
There were certain bits of it that I thought you know a lot of the symptoms were things that I, a lot of the side effects of the medication were things that I was already suffering with symptoms of the depression.
 
Which sort of things were they?
 
Well sickness and dizziness and palpitations and things like that.
 
What did you think then when you read that?
 
I was a little bit concerned that I didn’t want any of my symptoms to get worse but then the doctor explained that, you know, it would calm a lot of things down and to be honest that’s what has happened.

Melanie made a mistake with her tablets and felt really unwell...

I have a routine on a morning where I take my antidepressants and I take my multi vitamin tablets and some other tablets had appeared in the same area and I must have run out of my anti-depressants and I just picked the blister pack up and I saw that half of the tablet was blue and I know my antidepressants are half of that colour as well. So I had taken those for about four or five days and I ended up in bed like really ill.
 
Where they tablets that you’d had previously for something else?
 
Yeah, yeah I’d had spasms in my stomach and they were like a relaxant and I had had an upset stomach and, you know, I was running to the toilet quite a lot and I thought oh well maybe I’ve eaten too much fruit or too much vegetables or something like that and I just this one morning I got up and I was only out of bed for about an hour and I just, I could hardly move, I could hardly motivate myself and I thought I’m going to have to get back into bed. And I just, I didn’t feel right at all and I went back to bed and I was asleep for six hours and that was after sleeping for the full night.
 
So they completely knocked you out.
 
And I had a really bad headache which, you know, I haven’t had a headache for a long, long time and then I woke up sort of mid to late afternoon and thought oh what happened then and I think I was due to go to the doctors that week for a review so I thought I’d better see where I’m up to with my prescription so I think that’s when I went back in to the drawer to find my tablets to see if I had any left and I looked and I thought ‘oh they’re not the right ones’.
 
And you put two and two together and realised what you’d been doing.
 
That’s when I realised what I’d done.

Melanie sees her doctor regularly to discuss how she is feeling...

And you talked about going for a review then you, do you go to see the GP, how regularly now just to check out how you are?
 
Well I go every month to get my new prescription.
 
So it’s not on a repeat, you actually go?
 
Yeah to get a sick note, every couple of months they go through a questionnaire with me.
 
What’s the questionnaire?
 
It’s sort of asks me how I’m feeling it’s kind of like how many times or how often do you feel hopeless, so it’s like every day, every other day, once a week or never.
 
How helpful is that, something like that for you to fill out one of those questionnaires?
 
I would like to see that I’m improving but I haven’t seen that I am at the moment. I’m constant, I’m consistent with my replies and maybe I’ll be due to do it the next time in like three weeks and I would hope then that I am feeling a little bit more hopeful about things.
 
You’ve been on the antidepressants for about four months now?
 
Yeah.
 
And has it remained at the same dose, has the doctor suggested increasing it or changing it at all in any way?
 
Well I think the last time he had suggested that we increased it because, you know, I didn’t really, he obviously didn’t feel like we were getting anywhere with my symptoms changing but I said I didn’t want to.
 
What was your reasons, feelings about that?
 
Obviously I’m worried that I might get more side effects from the medication if I increase it and I don’t feel I want to be that dependent on the medication.
 
So you stayed on the same dose?
 
Yeah.
 
And is that something that you might think about again if things don’t improve or are you really sure that you don’t want to do that?
 
Because it was my decision this time I suppose if I go back for a review and the doctor impresses to me that we really need to change your dosage then I would accept his guidance on that.
 
It sounds like you also like to be in control and help make those decisions yourself?
 
Yeah. So I’m hoping if I can stay on the smaller dosage and get some benefit from the counselling rather than keep increasing my medication.

Melanie found follow up appointments impersonal because...

When you’re not seeing the same person they can’t tell whether there’s any change in you or, you know, if I was seeing the same doctor and they would say ‘Oh well you look like you’re having a good day today,’ or ‘How are you feeling you look a bit chirpier,’ or ‘Oh look you’ve bothered to put some make up on today’. But you see, when you see a different doctor they don’t see that so it would have probably been beneficial to see the same person so they could have ,maybe said to me, you know, ‘Well you seem to be pulling yourself together’ and ‘How have you managed to do that?’.
 
I think it would help to see the same person. And I know they could see hundreds of people in that period so they mightn’t necessarily remember you but I would hope that if they did they would be able to see whether you were worse than when you’d previously been in or whether you were a little bit improved.
 
Do they tend to, you know, have notes that they look at before you’ve been in the room or do you find that they just kind of on the spot and asking you questions?
 
They do have your records on the computer, I mean gone are the days of written doctors notes now it’s all on the computer but again it depends, you know, if the previous doctors typed anything up.
 
Whether it’s just a note of what you’re taking or more about how you’re feeling that sort of thing.
 
Yeah so, you know, I suppose that’s why they sit there and say well, you know, how are you feeling or do you think you’ve improved or. And I kind of want them to tell me if they think I’ve improved or moved on, it is very impersonal. I mean I appreciate the setup of GP’s surgeries and stuff like that and resources and, but you kind of want a little bit more when you are poorly or when, you know the fact that I feel like I’m waiting that long to see the counsellor and God forbid I was of a lesser constitution I could have thrown myself off the bridge by now because I could have thought nobody wants to help me.

Melanie checked with the pharmacist about side effects

They said, the pharmacist said to try and take them at the same time every day, so, because they didn’t say a specific time, you know, I take my multi vitamins on a morning so I might as well take my antidepressants on a morning.
 
Like a routine?
 
Yeah.
 
You mentioned the pharmacist I mean what; did you find the pharmacist was helpful at all in talking to you?
 
Oh yeah, yeah.
 
Did you talk to him or her about that prescription when you first picked it up or anything like that?
 
Yeah and I’ve talked to them since as well and...
 
In what way have they been helpful would you say?
 
Just sort of confirmed things that I’ve said that I’ve suffered as a side effect and they’ve either confirmed, you know, that that’s what a lot of people say or, you know, one particular one that I mentioned they said oh that’s interesting.