Steve

Age at interview: 31

Age at diagnosis: 30

Brief Outline:

Steve has experienced bouts of depression since his teens but didn’t acknowledge it or seek help until recently. Over the past 10 years he has sometimes used alcohol and/or drugs to try to mask the problem, but has reached a point in his life when he would like to get things more under control. He was prescribed citalopram two months prior to the interview, and is on a waiting list for counselling.

Background:

Steve has done a lot of work in the field of hospitality and currently works for a charity. He lives with his boyfriend. Ethnic background: White British

More about me...

Steve has had experienced bouts of depression since he was a teenager. He attended a military boarding school and found life difficult when his sexuality was called into question. Friends speculated that he was gay, and he was bullied and taunted. As an amiable and social young man Steve started using alcohol and recreational drugs in social situations to boost his confidence which helped him to cover up his real feelings. As an adult Steve has worked in hospitality - running bars and cafes and living a very socially orientated life and he used alcohol to avoid thinking about his problems.
 
‘It’s a highly stressful job…. You’re doing 12 hour days…. Shifts…. So it’s the perfect job for people who don’t want to deal with their own problems or their own health because you get a lot out of it…. But you go home and everyone has a bottle of wine after they’ve done a 12 hour shift…..’
 
More recently Steve started to think about how his behavior had begun to have an impact on other people around him and he felt he needed to sort out his life. He moved back to live with his parents and for a while tried to cut out drinking alcohol and smoking cannabis. After a time though, he drifted back to using alcohol again, and recently hit a low point when a job he’d applied for fell through. A friend suggested to him that his drinking was becoming a worry and suggested he should go and see the GP. The GP prescribed citalopram. He was also referred to the community mental health team for support and is waiting to be offered counselling. At the time of the interview Steve had been taking citalopram for a few months said he was starting to feel more able to cope. He feels that antidepressants don’t solve people’s problems, but they can help by making it easier to think more positively. He was disappointed to find that there was a long waiting list for referral for talking therapy, as he pointed out ‘I think 18 weeks is a ridiculous time to wait, when you realise that someone has a problem, regardless of how big…… that’s annoying…….it can feel a bit like you’ve been ‘diagnosed and then left’.
 
Steve is feeling in a more positive mindset at the current time and is keen to capitalise on his improved mood and make a start with therapy. He has also recently begun a new relationship, and says sometimes it can feel difficult to work out whether the improvement in his mood is down to the antidepressants or to the change in his personal circumstances. 

Steve saw his GP and told her how he’d been feeling. She prescribed citalopram.

So I went to see the doctor and I told her, the next day I went to see the doctor and I told her that I was struggling, well I just told her what had happened even though it was drink related that actually my depressions are getting worse and worse and that my thoughts are darker and I’m unable to enjoy things like reading which I love and even started to get to the point where I didn’t want to watch movies anymore, I didn’t want to do anything, you know, you just get to the point where everything that used to be fun and exciting and interesting for you just kind of seems dull and.....So really because I’ve got this kind of lust for life as well and I do quite like life when it’s working nicely I just wanted to get back to that place again where I could think straight about what I was even thinking about if that makes sense, so that’s when I don’t know I got put on, put on citalopram which was about not so long ago, possibly two months ago. 

Steve hoped that an antidepressant might help him to think more positively about his life.

I couldn’t see how it was going to hurt, I mean because, rather than, I didn’t expect it to help me deal with the wider things that I’ve just kind of spoken about, I didn’t expect it to help me deal with my issues about me being bullied still or the way other people think about me. I wasn’t expecting any of that to happen from the pills but I did see how it could, well I did hope as well that it could kind of just bring back some more positive ways of looking at things if that makes sense because when you do think negatively and you see things negatively you can’t, you can’t see the wood for the trees, you can’t get yourself out of your own head and if you can’t get yourself out of your own head you can’t help yourself to even know where you need help from and that’s. So what it, to me it was hopefully going to give me that kind of boost of, not boost, boost is the wrong word, I suppose to just.
 
Shift your mood a bit?
 
Yes just to help you turn things so I could actually think straight, so if I could think straight then I could work out what it is I need and then do something about it hopefully.

Stuart stresses the importance of having realistic expectations about how far an antidepressant can help.

I think if you look at it in its simplest form, serotonin probably gets depleted over a period of time when it’s not naturally refilling itself because you’re not having a really good time and so I, this is as far as I understand it so I, I could imagine that over a period of time when you’re not enjoying yourself or you’re kind of really, you’re serotonin does get depleted and so obviously antidepressants are going to help build that back up again, that’s as simple as I understand it, I don’t know if I am right or wrong with that because I’ve never really looked into it that’s just kind of what I know. and I know that serotonin is something that’s kind of necessary for you to be able to enjoy things or for you to be able to see the light around you if that makes sense. So I think in that way it helps.

Steve didn’t realise his stomach cramps were probably side...

I didn’t really take notice of how I was meant to take them so I what I was doing I was waking up in the morning and taking one because it’s 20 milligrams that I take taking one and then eating about lunch time so for quite a while I was feeling really sick and I didn’t really understand why. I’m not clever enough at all to have worked out that my sickness was probably to do with the fact that I’d been taking antidepressants and that’s what was new, I just kind of was going through day by day going ‘Why does my stomach feel like this, it’s never like this,’ because I’m quite fit and healthy in general but it was actually my step mum that turned around to me and she said ‘Well when, haven’t you just started taking a new drug?’ I said ‘oh yes.’ So it wasn’t like forgetting about it I just hadn’t like, I hadn’t associated the side effects with what I was doing. Then when I told her the way I was taking it she said well ‘Did the doctor not tell you that you should take them when you’ve had something to eat?’ and I was like ‘Yes they did.’ So then I just realised that it was probably just the way I was taking them and I’ve not really had that many side effects since then.

Steve didn’t realise his stomach cramps may have been caused by taking the antidepressant on an empty stomach.

I didn’t really take notice of how I was meant to take them so I what I was doing I was waking up in the morning and taking one because it’s 20 milligrams that I take taking one and then eating about lunch time so for quite a while I was feeling really sick and I didn’t really understand why. I’m not clever enough at all to have worked out that my sickness was probably to do with the fact that I’d been taking antidepressants and that’s what was new, I just kind of was going through day by day going ‘Why does my stomach feel like this, it’s never like this,’ because I’m quite fit and healthy in general but it was actually my step mum that turned around to me and she said ‘Well when, haven’t you just started taking a new drug?’ I said ‘oh yes.’ So it wasn’t like forgetting about it I just hadn’t like, I hadn’t associated the side effects with what I was doing. Then when I told her the way I was taking it she said well ‘Did the doctor not tell you that you should take them when you’ve had something to eat?’ and I was like ‘Yes they did.’ So then I just realised that it was probably just the way I was taking them and I’ve not really had that many side effects since then.

When the first month’s supply of citalopram ran out Steve hadn’t realised he needed to go back to see the doctor to get another prescription.

I called him because I wasn’t, he only gave me a month’s prescription to start off with and then so I took the month and then I actually didn’t take them for a week and then I thought, oh sorry then I had an appointment to talk to the counsellor and I said to her, I said ‘Look I’ve ran out of these,’ he didn’t call me or do anything in the meantime which that’s interesting considering they know you’re meant to be on them for six months. You very much have to do it yourself otherwise it doesn’t happen yes that’s very true. But yes so she said to me, I said ‘Look I’ve ran out of them’ she said, ‘Are you on any medication?’ I said ‘I was but kind of my course ran out about a month ago.’ She said ‘What are you taking?’ I said ‘citalopram,’ she said ‘No you’re meant to be on that for six months,’ I was like ‘Oh, oh I’d better go and get some more then.’ so then I called my doctor, my doctor called me back rather than having to have an appointment and I said ‘Look I don’t understand, my therapist just, well not my therapist, my counsellor has just said that I should be on these for six months,’ and he said ‘Oh yes you should be on, you should be on a repeat prescription,’ and then he said ‘It would be ready for you later on today if you want to come and pick it up,’ so I never even saw him I just went in and picked it up.

Steve felt led down when he was told he’d have to wait 18 weeks for talking therapy.

I think it’s awful, I think I’m ready to do it now, I didn’t think it wouldn’t happen for 18 weeks and well you know that’s, and I’m also aware of the fact that there are people that have worse, worse cases if that makes sense so for me in a selfish way I think it’s rubbish but in another way they wouldn’t be like that if their case load wasn’t so much. But actually I know what’s going on and that actually it’s much more political than it is about people and volume so I know what’s going on because I was involved in it for a while.
 
But when it’s affecting you maybe that changes how you feel about it?
 
It’s just that, just, I mean I’m ready to do this kind of now and everything seems to be set up for it to happen now and the drugs are kind of working, you know, and the citalopram seems to be working, I’m in a good relationship that’s just getting to a point where I either fix it or it’s probably not going to happen and I don’t want that to happen. But the actual therapy counselling side of it I can’t have for 18 weeks.

Steve thinks it’s worth giving an antidepressant a try, it won’t ‘fix ‘everything but might help you get a different perspective on life.

I’d say if your doctor has told you that it might be good for you to be on antidepressants then go on antidepressants. Actually I just don’t see any bad in them other than potentially the stigma that other people will think and you don’t have to share it with the world you can do it yourself, it’s a tiny little pill that you take and nobody ever needs to know about. and if it is going to make you, like I said earlier on, trying to get it across to anyone anyway, if it’s going to make you see things more positively so that you can then work on what you need to work on or look and see things from a different angle. It’s very easy for us all to get very used to the way that we already see things and think that that’s right but actually it could just be that you’ve been down for so long so if they can help you kind of come out of that and almost kind of out of the clouds as it were so that you can actually just see what’s around you and then, I’m not saying they fix everything, I don’t think they fix everything I just think they just give you another, another, another place to come from to be able to look at things. But I would say yes they’re not, they’re not bad.