anticlimax

After well over a year, I really have managed to extricate myself from any kind of dependency on psychiatric medication. I reduced my dosage of liquid citalopram one drop at a time, got dizzy, increased it a bit again, decreased it a bit again, got dizzy again, and tried a different doctor to see if they had any suggestions. They said that if my mood was manageable (which it was/is, though I wouldn’t say the depression has gone) and the dizziness was the only problem, they could prescribe me something for the dizziness instead.

This sounded too good to be true. The doctor said there was no way such a miniscule daily dose (2 drops, equivalent to 1/8 of one of the pills I used to take) of citalopram would be having any effect on me so I could definitely ditch it, and they weren’t sure what the dizziness was about but maybe it was some ‘unresolved mental health issues’ (I may have some of those…) and anyway here were the new drugs.

The new substance was called prochloreprazine, and it’s sometimes used to treat anxiety, so it came with the standard list of terrifying possible side effects. But on the plus side I could take it only when I needed it, and it did actually make me less dizzy. I was able to do things like driving again, and the dilemma of wanting to stop taking the citalopram but not feeling like I could reasonably take time off work to deal with the consequences of effectively choosing to make myself unwell went away. And I gradually needed the prochloreprazine less and less often – I genuinely can’t remember the last time I took it.

Am I better? Not completely. Am I still having counselling? Yes. Would I take antidepressants again? If other things weren’t working, yes. Do I think doctors should not use medication as the first response to mental health issues? Absolutely. This blog has covered my 10 years of antidepressant usage, so now seems to be a good time to sign off. Thanks for reading.

Global Mental Health Resources

correction

Tags

depression, medication

My last post, it quickly became clear to me, was wildly premature. I lasted all of two weeks without the medication before the side effects became so unbearable I just had to start taking it again. I felt dizzy and sick and I started experiencing ‘brain zaps’ (google it) several times a day. The inability to focus or concentrate made me really stressed, and the fact that there seemed to be nothing I could do to feel better (lying down, sitting still, going for a walk, sleeping…) made it even worse. Not being a quitter, I spoke to the doctor and we agreed that maybe I should try coming off even more slowly than before, taking multiple weeks at each dosage level instead of just one. I did. The same thing happened. I thought I’d got away with it, then after a couple of weeks I was too unwell to work or drive and I had to start taking the damn things again.

Yesterday, I spoke to the doctor. We agreed that he would prescribe me a liquid form of the drug (Citalopram) instead of my current tablets, because the smallest tablet is equivalent to four drops of liquid so I can reduce even more gradually than before. Not being a quitter, I’m going to give it a go, but really I can see no reason why this will work when the first two attempts haven’t. Citalopram isn’t even supposed to be especially difficult to stop taking, as antidepressants go, because it has a relatively long half life. Anyway, winter is coming and everything is worse in winter – having to pay for and consume a drug I no longer want or need will fit the mood nicely. But on the plus side, maybe I’ll become so depressed because I can’t stop taking the medication that I’ll start needing the medication again and I can stop trying to stop taking it.

end of chapter one

Last Wednesday, I swallowed my last ever (for now) antidepressant pill. After nine years, I am finally no longer On Medication. I’ve dreamed about this for years, and discussed it with my lovely doctor on more than one occasion, but the time was never quite right and I was never really well enough for it to be a good idea. But now I am. It’s very strange.

If my life was a TV show (like I used to pretend when I was little, as if people would be fascinated by what I had to say, almost like I’m still pretending at this very moment as I write) then this would be cause for celebration. I would declare I’d had enough, ceremonially burn the leftover medication and arise from the ashes like some kind of positive-thinking phoenix. I’d muse poetically about the years I wasted focusing on the negative and wallowing in self-pity. I’d probably start an Instagram account filled with inspirational quotes overlaid on pictures of nature, and evangelise about my pathway to joy, which would probably involve forest bathing and reciting ‘I am radiant’ in front of the mirror twice a day.

In real life, this is not a sudden transformation. The transition off medication is a milestone, but possibly not an especially significant one. I’m not suddenly better, in fact I’m suspicious of the concept of ever being better because this is probably a lifetime condition that will just come back at some point. This, whatever it is, is just a reprieve, and it’s not even that good yet because they weren’t lying when they said citalopram was addictive and I’ve been feeling dizzy and nauseous for a few weeks now as I reduced my dosage. Apparently this could continue for another couple of months, so I’ll continue to be reminded of the whole sorry saga every morning when I wake up feeling like I’ve just got off the Spinball Whizzer at Alton Towers. I haven’t ‘beaten’ depression, nor will I have done when the withdrawal finally ends. I just happen to be experiencing a combination of lifestyle factors (and a lack of horrible situations I can’t handle) which mean that I can manage it to the point that it’s almost, but not quite, not there.

On the plus side, I’ve taken one single mental health sick day in the whole of 2021 to date, after averaging one a month for the past few years. I’ve also only had one episode where I was capable of nothing except eating biscuits and staring at the wall. In spite of being battered by the deaths of four loved ones in a recent 12 month period, moving house during a pandemic and putting on a load of weight so that I really feel quite disgusted by myself at times, I am functioning. I eat healthy food, I interact with people, I meet expectations at work, I feed the cat. And I do it without any medication. But I probably couldn’t have done a lot of the last nine years without it, and that’s fine. Much as I hate the stuff, I’m not going to ceremonially burn the leftovers just yet.

grief

Lots of things have changed in the past year, but one of them is not that my dad is dead. Or that he died alone in a care home, about an hour after I last saw him, or that I wasn’t brave enough to say ‘I love you’ before I left because our family don’t really go in for verbal displays of emotion. He was too ill to come and watch me run my first marathon, even though I was partly doing it for him, and now he’ll never see me even if I do another one. He’s never been to the cottage where I live now and he’ll never see the house I’m in the process of buying, or even know that I’m buying it. He’s just dead. He’s in a box in the ground, without even a headstone because presumably the funeral directors have all been a bit busy in the last few months.

Grief is like depression in some ways. With depression you can’t fix it because your sadness doesn’t have a concrete cause, and with grief you can’t fix it because the cause is irreversible. You can question all sorts of things, like whether you should have been there when he died or whether he didn’t want that and was waiting for you to leave, or whether it was great timing really because there were no Covid restrictions back then and we could have a proper funeral with lots of people, or whether it’s a blessing (I felt so angry any time someone used this phrase) because he’s not suffering anymore, but it’s like throwing screwed up pieces of paper at a brick wall – it doesn’t change anything. He’s still dead.

And it hurts, it hurts so much. Sometimes I don’t think about it, but then other times it’s all I can think about. Today isn’t even a special day, the anniversary of his death is next week, but today I’m sad. Before he died, however sick he was there was still hope. There might be a visit with one last lucid conversation, one last smile, one final happy memory to make, but now there won’t be. The stock of memories is finite, like some limited edition painting, and we just have to try to dredge up the good ones and squash the bad ones. Sometimes the good ones bring despair, because we can’t have them back, and sometimes the bad ones bring relief because they can never happen again, but sometimes it’s okay. All of these things are grief, and that’s not going to change ever.

not my party

For as long as I can remember, I’ve been a crier. Books, films, charity campaigns, broken objects, news items, you name it, it’s probably reduced me to tears. One thing that never fails to get me is seeing someone I care about in pain or upset – at school, if a friend was crying (which happened a lot at my all-girls secondary school in particular) I would invariably burst into tears at the sight of them, causing people to rally around me asking what was wrong. I would have to fend them off, explaining that the only thing wrong with me was my emotional stability, and that they should go and care for the person who actually needed it.

I’m in a magnified version of that situation now. For those following along at home, Person (who, fuck it, is my dad. My dad, who has been happily married to my mum for over 30 years, who I grew up in a normal, stable home with, who played football with me on the drive when I was little and drove me to school and was so proud that I’d chosen to study maths as part of my degree) was out of hospital for a while but has just been sectioned again. He wants to die. He talks about our family’s future as if he won’t be in it, hoping my mum will be happy in the new house they’re in the process of buying.

My dad wants to be dead. I’ve wanted that for myself a couple of times, but only in a fleeting way that someone could lift me out of after a while. Wanting to be dead is so abjectly hopeless, so final, so agonising – it’s the firm belief that everyone around you would be better off without you, that you’re worthless, maybe even you have negative worth, and that nothing can ever change that, there is no possibility of anything, ever, making it better. And that is the kind of pain my dad is going through. Maybe not constantly – Mind says it can vary in intensity and duration – but probably every day.

And for me, that is heart rending. It can be physically painful to think about, and of course it’s never far from my thoughts. I’m so upset I’m having trouble holding on to normal life – my depression is flaring up in a way it hasn’t for some time. But, this is not my party. My depression is mild to moderate. I’m not cutting myself, or plotting my death, I’m just running out of energy to manage my emotions. Someone today reminded me of the cliché that when a crisis hits, it’s your own oxygen mask you have to put on first. I am no use to anyone, least of all the family who need me the most, if I go to pieces now. I know where the oxygen mask is, I have done this before. I have tools and a support network and the kinds of things that make mental health issues maybe a little bit more bearable to someone who was growing up 20 years ago rather than 60.

I’d love to just leave the mask off and crash for a bit, let go of responsibility and stop exercising the resilience I seem to have built relatively recently, because I don’t remember having much of it before – but I can’t. I need to let people focus on the person who actually needs help, and pick myself back up.

keep going

I suddenly realised today that the anger and stress I’ve been feeling for the last few months have mostly been about something. I’m angry because Person’s incarceration keeps going, with no end in sight; I’m angry at the irony of Person’s incarceration being the solution to a problem which I never wanted solved – that there is someone else close to me who just doesn’t understand mental health issues because they haven’t experienced it, except now that person is on anti-anxiety medication, just like Person; I’m angry with myself for going over a credit limit; I’m stressed because I love management and my team at work has gone from three to one, one who isn’t even in the office most days; I’m stressed because we’re moving house soon.

What if all these things weren’t there? Or only a manageable subset? Would I still feel so tense and out of control when I try to explain honestly how I am that I give myself a headache? Would I reach for the comfort food and glare at my husband and make snarky remarks when something annoys me at the office? When I ran the marathon I actually felt proud of myself, and I can still get that feeling back sometimes if I think about it hard enough. I might be acceptable. I might be worth something. Maybe if there wasn’t so much I can’t deal with, I could believe that again.

But what if these things are just life? Maybe it’s life that I can’t deal with. Things happen, and I sulk because they don’t happen my way and I feel stupid and embarrassed and I can’t abide feeling either of those things so I channel it all into hatred of myself. I was able to flatly reassure a friend earlier that I’m not suicidal though – I sometimes wish I was dead, but I’m not going to do anything about it. So it just keeps going. I just keep going.

mental health awareness week

The person I mentioned last time I wrote (for the sake of privacy, let’s call them Person) is still in hospital. Having taken the huge, brave step to self-admit into the dark and lonely place that is their local mental health unit, Person got steadily worse and was sectioned just over a week later. Sectioning is where a medical assessment by two independent parties deems that you are a danger to either yourself or others (or both) to such an extent that you must a. go to a mental hospital and b. not be allowed to leave. Ironically, Person was on the list of people for whom I was running the London Marathon (raising money for Mind). I was looking forward to Person cheering me on on the day, but they couldn’t come because they weren’t allowed out of hospital. I wanted to call when I crossed the finish line, to say how the thought of them kept me going when I wasn’t enjoying it at all, but my courage failed me and I haven’t spoken to Person since. Someone else passed on a ‘well done’ from them.

I am not dealing with this well at all. The hospital stay was supposed to be a blip, a sensible precaution whilst medication was changed, something we (Person’s close friends and family) wouldn’t have to think too hard about and could just move on from. There is no measurable progress, there are no metrics, there’s no data I have access to about how Person is doing other than second- or third-hand via others on the phone. And I’m angry. It took me a while to realise it, but I’m really angry. When I found out how serious the situation was, I couldn’t process it – I was exhausted from the marathon training, and now this. It wasn’t fair. I was supposed to be the centre of attention here, the marathon was my moment. And, worse, I would have given (and still would give) anything for it to be me instead.

I cannot bear to think of Person alone in their horrible, bare, suicide-proof room, day after day, with most of their company comprising health professionals whom Person views as captors, or other fellow captives who are in just as bad a state. I can understand now why hospital staff suffer abuse – I want to go and scream at them until they explain what is happening and when Person will be better and why it’s taking so long. I want to scream at them for letting Person get worse, for labelling Person as ‘aggressive’ and ‘paranoid’ and ‘delusional’ and ‘psychotic’ when Person has never been any of these things before. I want to scream at them extra for not providing anything beyond the bare bones of keeping Person washed and fed, for not offering therapy, for the fact that without family and friends to provide a Kindle and a radio and puzzle books and art materials, Person would just be stuck in this hole with no distractions for the vast majority of 24/7.

I also want to scream at God, for not answering my prayers to make Person better. And I want to scream at the other people who also care for Person, for being so stoic and British about the whole thing when it’s a crisis and there should be melodrama because how else can you express the amount of anguish and confusion we’re all being subjected to? And for not telling me everything, immediately, because how can I feel in control and okay if I don’t even know how much I don’t know? Person threw a table at a wall, Person actually left the mental health bit of the building (under escort) for a couple of hours and it was okay, Person snapped their mobile phone in half, all of these are things I found out hours or days after the fact.

Like Person, I know I need help. I’m going to the doctor, to ask for counselling or maybe just permission to take more of my drugs. I should have done this weeks ago when sh*t not only got real but also went down and hit the fan, but I was too busy wading through it, trying to see a way out. But there isn’t one, for now. I just have to start looking after myself again, which is particularly difficult when all I want to do is call down unnumbered curses on myself in the hope that it will somehow deflect the suffering from Person. And there will be an end, Person is safe where they are if not exactly well, and the doctors say things should change for the better soon. Things for me aren’t exactly looking bright but I’m slowly (and resentfully) coming to terms with the fact that depression is a chronic condition I just have to manage, like diabetes, rather than a thing with an end where one day I’ll have an inspirational story of my epic journey to recovery.

It was last time I had counselling that I realised anger could be a mental health issue, and it definitely is for me now. Is it better than the numb emptiness that’s cost me several hours of work over the last few weeks because I just couldn’t drag myself out of bed? I don’t know. What I do know is that mental health isn’t all about nice fluffy success stories. It’s not a thing we should only talk about when the worst is past. It can be horrible and violent and scary and sad (I have family members who don’t read this blog because they find it too upsetting), but it’s reality for lots of people and it won’t get any less scary until it’s brought out into the open and discussed and understood and accepted. For Person, and maybe for myself, I want to help make that happen.

power

Yesterday I was by a river, and I saw a small gosling trapped against a branch in the water, struggling to paddle away but unable to because the current was too strong. It was too weak, or too young, to make a noise to attract the attention of its parents, and though they eventually saw it , whereupon I left the scene, they apparently weren’t able to help. When I passed back that way later, the gosling was still there, no longer moving. It had given in to exhaustion.

Both parties in this story struck a chord with me. Work is particularly busy for my team at the moment, I’ve just done my longest training run before the looming spectre that is the London Marathon, and I’m still helping at two Rainbow units. The training is so intense I’ve had to sacrifice church on a Sunday morning, to fit in the longest runs with time to recover before work on Monday, and Zumba, because the risk of injury is too high and also I’m just too tired. Those are the two weekly activities I love the most, which bring me joy. And, let’s face it, I don’t even handle things that well when I do have more of the joyful activities and less of the difficult ones. So I feel like that gosling, paddling hard but getting nowhere, without much hope, only circumstance preventing me from being swept away entirely. Powerless.

And there are people in my life who are a bit like the parents. Not in that they’d leave me to die, but in that although they want to help they just don’t understand what sort of help I need. The solutions they offer are for a different problem than the one I have. Their best efforts, the best intentions, will not fix it. And now someone close to me is in hospital because their own mental health is very bad, and I feel like one of those well-intentioned people too. There’s nothing I can do – all the marathon training and fundraising in the world isn’t going to make this person I love a single bit better, and it’s breaking my heart. There is a support group on Facebook for all of the Mind marathon runners and it’s full of positivity and inspirational quotes and encouragement, but none of it is ringing true now. I feel like I was stupid to think I could make things better.

So I can’t fix other people, and I certainly can’t fix myself. I’m too busy feeling bitter and indulging in short term solutions like wine and chocolate to even be able to offer any kind of solidarity. I wanted to beat depression but it’s beating me, and worse, it’s beating people I love. It’s like trying to stop a tank with a stick. I don’t know what I was thinking.

snow

For maybe the first time in my life, I’m not excited that it’s snowing. It isn’t due to any inconvenience – yes, it’s not really cycling to work weather, but the buses are running; yes, my zumba class is cancelled, but getting there would have been dreadful anyway; yes I’m off work, but that’s because I’ve got a cold. I usually love snow – even hearing the phrase ‘it’s snowing!’ makes me excited, and I love just looking at it because it’s so beautiful and bright.

It’s the same with some of my other favourite things – I’ve got a new, bright orange, woolly dress which is really warm, and there’s a vase of flowers on the table from one of my best friends, and my husband just bought me some new loose leaf tea, but somewhere a connection is down and the joy from these things just isn’t getting as far as my brain. Can having a cold affect your ability to feel things? I’m just numb and spaced out and I don’t know what to do with myself. I don’t know what might help. I want to feel something so much it almost hurts.

burnout

Ironically (and so many things about depression are ironic), as the weather gets colder, I have managed to burn myself out. The combination of work, housekeeping, marathon training, two Rainbow units and preparing for Christmas has finally got to me and I am exhausted. Things came to a head on Thursday evening where nothing went to plan at Rainbows and there were eighteen excitable children running rings round me, all vying for my attention. We reached the end of the meeting and I felt wrung out, and to my horror I started crying and had to hurriedly go and pretend to look for something in the cupboard as they all left.

There were a series of small disasters during the meeting, most of which I should have been able to deal with, but after a day where I had gone for a run in my lunch break and forgotten to bring a snack to give me some energy to face the children, it was too much. The things that went wrong pile up in my head and clubbed together to point me at one conclusion: I had failed. Failed to keep control, failed to make sure the girls all had fun, failed to prepare activities they would enjoy even though I’d tried so hard and everything was planned out. And when I fail, it’s a small step to the certainty that I am a failure.

I’m doing too much. I can’t cope. Yesterday afternoon at work I just started crying at my desk, for no reason except fatigue. None of these things I’m doing (except buying the Christmas presents) are going away any time soon, and if I let one of the spinning plates drop I can’t pick it up again without the others crashing to the floor as well. I have to keep going. But it’s too late – I’ve got a cold, I’ve posted in the online support group for other people mad enough to be running the London marathon next year for Mind asking if it’s okay to rest at all or if I just need to carry on regardless. I’m kind of hoping the response will be carry on, then I’ll know it’s just laziness and I’m being pathetic and I can beat myself up accordingly.

That isn’t what’s happened so far though. Someone has been kind to me in a way I couldn’t to myself, and said it’s okay to stop completely for a bit. If I’m burnt out then I need to look after myself, because I matter, and I need to get better. Getting better won’t happen if I don’t let it. I have permission to recover, from a virtual stranger, but it’s the permission I needed. Now all I have to do is not feel guilty about it.