Medication

Medicating depression is all about getting a foothold on the ladder to recovery. No one out there is going to tell you that medication is the answer. But depression is an all consuming illness and it leaves you feeling incapacitated both mentally and physically. Sometimes medication provides the leg up needed to start dealing with the other issues that gave rise to depression, after all… there aren’t many problems you can solve whilst curled up in a ball under the duvet.

On my page, Everything I Know (Almost) I talk about the chemical origins of depression and how commonly prescribed antidepressants (SRI’s) work.

I went undiagnosed for a long, long time. Even when I suspected that I was suffering from depression I resisted going to the doctors because I didn’t want the label… and I didn’t want people to look at me differently. So my earlier episodes of depression were hidden from others… I was just someone who didn’t have a great attendance record and seemed susceptible to bugs. In fact, the flu like physical symptoms and the fact that many of us will feel down if we are not on top physical form, means that it can be easy to delude yourself at first.

When I did present with depression it was to my then GP who lacked the expertise in mental health to be of much use to me. Not her fault I guess. When you are desperate, and you are hanging onto the small part of you that wants to stay alive… and that part of you summons the energy to go and see somebody for help… you really don’t need to be met with a hard arsed apathetic GP. She reached for the prescription form before you could say a word… and the drug everybody seemed to be on back then was citalopram, also known as Cipramil.

Citalopram (Cipramil)
I’m guessing this antidepressant was cheap because everybody seemed to be on it. When I was interviewed by various different health professionals over time they would always raise an eyebrow and give a knowing nod when I mentioned this drug. It didn’t work out for me. All medications have side effects and you don’t know until you take them how you’ll be affected. My anxiety levels hit the roof and the next thing you know, I was presenting to the Crisis Team. A single red sock belonging to my then 1 year old son, Xavier, was stuffed in my pocket and it rarely left my hand. It was what I used to remind me there was a reason to stay alive and that part of me wanted to fight.

Mirtazapine (Remeron, Soltab)
Seeing the gaunt, lifeless man in front of them, staring down into his lap, avoiding eye contact and struggling to stay concentrated on the conversation before him, the Crisis Team had me meet with one of their doctors. Mirtazapine was prescribed to stimulate my eating again and get that serotonin working for me. At the time it was what I needed to kick the anxiety into touch, but it came at a cost. It had a tranquilizing effect on me, so I became a sort of disconnected from things. My concentration was affected too…and focusing for any length of time at my white collar job in teaching became really hard. I hated people seeing me like this. It made me feel stupid in front of them… I couldn’t keep up. I lost my mental agility… so I seemed to lose my usefulness to the team. I relapsed.

Cymbalta (Duloxetine)
When I started on this drug I was delighted with the side effects. I’d put on a lot of weight on Mirtazapine; the stimulating effect it had on my appetite meant I was now eating for two. Cymbalta had the opposite effect on my diet and I lost all the weight I had put on with other medications. I was on a big dose, but it seemed to be working out for me. Whilst on this drug my family saw me return to being the person they knew and loved… the person I loved. It was great being me again. Whist on this medication I: changed my GP; had therapy; took the decision to leave my job in teaching; took steps to sort out our financial difficulties; rekindled friendships; started a business; and got married to my amazing wife, Alicia. Over time though I started to feel like the effects were wearing off. Mornings were becoming more difficult again… I was missing appointments… sleeping too much, beating myself up mentally, putting on weight again.

Fluoxetine (Prozac, Sarafem)
Things were complicated now by a dodgy thyroid, which was slowing me up physically and making it harder to push through the physical demands of each day. My confidence took a knock and I started to fear the return of depression. Depression feeds on itself, so anything you can do early on to head it off is time well spent. I sought help early. I’ve done a lot of work in therapy, and now know the early signs that things are not well. I could apply the tools I’d picked up from therapy, but I still felt myself sinking. I lost faith in meetings with my GP… he didn’t seem to understand that I couldn’t wait around, that I was self employed and each day I struggled I had to also watch my business go to the wall. I sought a second opinion at the surgery and that’s when we agreed to switch anti-depressants again. I took the prescribe dose for a bit, it wasn’t working out so I doubled it up (not a good example to follow). The early and welcome signs of progress were that I seemed to wake up at 5 am like clockwork. I had gotten my mornings back. I started this blog in those early mornings and it helps. Things are improving, but having doubled my dose I ran out of pills and had to switch back to the Cymbalta to keep me going between appointments. I’ve been taking the Cymbalta again for a couple of days and almost instantly I’ve become ‘punch drunk’ in the mornings again. Sleep on Cymbalta is amazing, transcendental… but trying to shake the sleep off in the mornings is a real challenge. Feeling the best I can feel in the mornings is really important to me… I can usually take it from there. So I’ll be going back to my GP tomorrow and asking for more Fluoxetine. I’ll keep you posted on how I get on with it.