Olivia Y

Age at interview: 33

Age at diagnosis: 16

Brief Outline:

Olivia was prescribed antidepressants as treatment for a condition called Trichotillomania but the main problem with this condition are issues of self-image and self-esteem which she feels cannot be properly addressed using medication. She has also taken antidepressants for an episode of reactive depression following a relationship breakdown and felt that they helped to alleviate her anxiety and distress. She no longer takes antidepressants, but uses a natural supplement that she believes helps to improve serotonin levels in the brain.

Background:

Olivia Y is single and currently lives alone. She is studying for a PhD. Ethnic background: White British

More about me...

Olivia has a condition called Trichotillomania, which is the compulsive urge to pull out one's own hair leading to noticeable hair loss, distress, and social or functional impairment. She began pulling out her hair at the age of six, but it took until she was in her mid-20’s for this to be diagnosed.
 
During her childhood her parents struggled to understand her behaviour, and they sought medical advice. She was prescribed various medicines at the time, and saw doctors, therapists and psychiatrists but they were unable to find a cause or give a diagnosis. As she grew up Olivia found it increasingly difficult to fit in because she felt she looked different, and her self-esteem plummeted. Around the age of 16 she saw the GP and was prescribed Prozac (fluoxetine).
 
‘I just got extremely down about it, to the point where I just had the lowest self-esteem ever… I was taken to the doctor because I was crying all the time… I just absolutely hated myself.’
                              
She took Prozac for around three months that first time, but cannot recall much about it now. Some years later, when she was 22 she began to spiral into another depressive episode and feelings of despair about the hair pulling, as there seemed to be no explanation. She felt totally alone.
 
‘I remember just crashing again…. And feeling out of control, remembering… I still didn’t know the name of this thing… this abnormal behavior, this thing I was doing to myself, feeling alone, lonely, out of control’
 

She was again prescribed Prozac but didn’t take it for long ‘I think I just came off them myself….I don’t remember experiencing any badness out of it, but I can’t say I ever felt better on Prozac’. Later, when Olivia was told that the condition she had was called Trichotillomania, she began to find out more about It, but realised that antidepressants were not the answer.
 
‘I get so angry when so many people with this condition get handed antidepressants, it’s like putting a band aid on a broken leg’.
 
Olivia was prescribed citalopram following a relationship breakdown and continued on it for four years. She describes how after the initial few weeks where her sleep was disrupted, it began to ‘kick in’. After two years on citalopram she discussed the idea of stepping down the dose with a view to stopping taking it, but although she felt she wanted to try to manage without ‘I thought I needed to ‘man up’ a bit’…. Olivia says she felt worried about stopping taking citalopram in case she became unwell again. Her GP encouraged her to continue taking it until she herself felt ready to stop.
 
 ‘If you’re feeling good on them then you stay on them. When you’re ready…. you come off them, you’ll know’.
 
Some while later, with advice and support from her GP she gradually stepped down the medication until she was no longer taking it.
 
Olivia has since started taking 5HTP, a natural supplement that is thought to help to boost serotonin levels in the brain.
 
‘I thought… if I’m going to come off the prescribed medication there’s no harm in taking a wee natural something that might just be the crutch I need to maintain my peace of mind’
 
As well as taking this natural supplement Olivia has started running, and feels exercise has many positive benefits. She has also group therapy and Cognitive Behaviour Therapy (CBT) to help with the self-esteem issues she has experienced through having Trichotillomania.

Olivia Y found changing the time of day she took the tablet helped her to sleep better. She tried to find out on the internet how long citalopram might take to start working.

I’d taken 10 milligrams of citalopram that time before and I hadn’t felt any side effects, the citalopram this time around… I was taking 20 milligrams every morning as instructed and I just wasn’t sleeping, I can’t remember if it was trouble getting to sleep or if it was waking up early, I can’t remember which but my sleep cycle was messed up. So without asking my doctor I switched to taking it at bedtime, that fixed it, just simply moving it from morning to night, I don’t know how these things work, I’m not a, I’m not well I’m not a medic, I’m not into kind of stuff but I don’t know when I moved it to 12 hours later I slept better. it took about six weeks I have to say for that to get into my system that was not an easy experience getting it into my system, I don’t know maybe if it would have levelled it anyway maybe if I’d continued taking it in the morning maybe that would have just have, maybe it was just levelling out anyway or I don’t know if making the switch was what levelled it.
 
I remember I was on the internet Googling’ how long does citalopram take?’ and like everyone had written yes it takes six weeks to eight weeks and I remember thinking okay that’s four weeks, two more weeks, that’s five weeks like I was consulting these online forums.
 
And was that looking to find out how, when it was going to start making you feel better or to get your sleep back into sync?
 
When the, with the kicking in, basically when the getting it into my system was going to finish. it definitely took a while but apparently this is common with citalopram it’s a tough one to get used to and I hadn’t noticed it with the 10 milligrams but oh yeah, with the 20 definitely.

Olivia Y felt that citalopram suited her because it helped with anxiety.

I’m not a naturally depressive person I’m a naturally anxious person. My mood drops when something happens whereas my anxiety I would say is more part of my character and it turns that into depression or they go hand in hand just on separate hands. So for me the citalopram actually gave me some little bonus’s in terms of my, my anxious side. very often just if you’re an anxious person it’s quite normal to have intrusive thoughts just like nasty thoughts pop into your head like for example if I see a dog without a lead I’ll assume it’s been abandoned and it’s starving and no one loves it or if I hear a child crying in the supermarket I’ll assume it’s being abused at home. These thoughts were just… on citalopram, I wasn’t having the same nasty thoughts and that was actually a big bonus so that was why I preferred this one, I felt citalopram fitted better with an also anxious personality.

Olivia Y found that changing the time of day she took the tablet helped re-establish her sleep routine.

I’d taken 10 milligrams of citalopram that time before and I hadn’t felt any side effects, the citalopram this time around… I was taking 20 milligrams every morning as instructed and I just wasn’t sleeping, I can’t remember if it was trouble getting to sleep or if it was waking up early, I can’t remember which but my sleep cycle was messed up. So without asking my doctor I switched to taking it at bedtime, that fixed it, just simply moving it from morning to night, I don’t know how these things work, I’m not a, I’m not well I’m not a medic, I’m not into kind of stuff but I don’t know when I moved it to 12 hours later I slept better. it took about six weeks I have to say for that to get into my system that was not an easy experience getting it into my system, I don’t know maybe if it would have levelled it anyway maybe if I’d continued taking it in the morning maybe that would have just have, maybe it was just levelling out anyway or I don’t know if making the switch was what levelled it.

Olivia Y takes 5HTP (hydroxytryptophan) now she has stopped taking citalopram.

I’d heard reports of 5HTP, do you know 5HTP, you might want to look this up 5HTP it seems to be a better, it’s not St John’s Wort it’s significantly better it’s a sort of herbal antidepressant/ antianxiety helps you sleep, it contains a hydroxytryptophan, tryptophan.
 
Is this on prescription or?
 
No health food shops, health food shops and as I came off my citalopram it’s, it’s apparently so successful that on the label you don’t take it with antidepressants so I didn’t. And then when I came off my antidepressants I started taking this and I’ve been on that since March and I feel pretty good.
 
Did you speak to your GP about that?
 
I think I remember asking him yes I’m pretty sure I told him about this and I think he said, I think his words were ‘if you can buy it in the shops then you’re not buying anything bad’ and yes.
 
Is there any evidence base on that do you know?
 
I didn’t do an academic search but I did Google search it and I’ve just been taking that.
 
Is that something you take on a daily basis?
 
Yes I take it; I take one capsule at night time yes.
 
And does it have?
 
It’s an amino acid.
 
Okay. Does it have any noticeable effect or do you think it just?
 
Noticeable effects or the ones that it claims to have?
 
Noticeable side effects or the ones that it claims?
 
Side effects not one, not one. The benefits that are from various people are it combats anxiety, combats depression.

Olivia Y was worried about coming off the antidepressant but her GP helped her to taper things down gradually and encouraged her to keep a box of citalopram at home ‘as a safety net’. She said ‘I was terrified to ‘go it alone’.

Yes I just knew that I was feeling okay and I think it must have been about two and a half years later or something I went back to my doctor who I absolutely love he is amazing, and I said, I said ‘I think it’s probably time to come off the citalopram, that’s been two years’. And he said ‘Yes absolutely’ and then I said’ But I don’t want to, I’m scared’ and he said ‘So why are you here then, stay on them’ and I said ‘I just thought two years I thought I needed to ‘man up’ a bit’ and he said ‘if you’re feeling good on them he said then you stay on them’. He said when you’re ready you come off them you’ll know.’ He’s so cool when I say he’s great. So I remember I went back like about January or something I think, yes I think I waited for Christmas to pass, the back of January that’s okay I’m ready this time I said let’s do it, let’s do this. So we did it gradually like one every two days then one every three days, you know, and then he gave me, he gave me he prescribed me 10 milligrams and I said ‘I’ve no need for that I said I’ve still got my boxes of 20 at home’ I said ‘I could just cut them in half’, he said ‘You keep your 20’s you might need than in the future he said just keep them in a safe place if you ever need them again he said we’ll just prescribe you boxes of 10’s.’ so he was like, we were just really cool kind of working together and I think also knowing that I had my wee box of twenties if I needed it was like, it was quite nice. And he obviously trusted me to manage all this he knew that I wasn’t going to do anything silly with them.