Hooked on Happy Pills

‘Well I’m happy for you to stay on them…’ My GP peered thoughtfully at me over the rim of his glasses. ‘I’m also perfectly fine with you coming off them. I’ll set our review for a year’s time shall I?’

And thus passed the annual antidepressant prescription review, like so many of its predecessors, proving about as useful as a chocolate teapot – and that although it’s so very easy to start taking happy pills, getting off them is another story.

Happy pills. antidepressants, SSRI’s – whatever you call them – used to be the preserve of those teetering on the edge of psychosis. These days everyone’s on them. There’s no doubting that some people in the throes of serious clinical depression really need support from medication – and drugs like paroxetine, citalopram and zoloft provide a chemical lifeline to those nosediving into a serotonin-deprived abyss. However there seems to be a worrying trend towards over-prescription. Medication being handed out like smarties for the mildest cases of the blues – and patients consigning themselves to years of pill popping.

The NHS prescribed record numbers of antidepressants in the UK last year and a recent study by women’s campaign group Platform 51 found that nearly half of those using antidepressants have taken them for at least five years, while a quarter have used them for ten years or more. The statistics are frightening, but actually being part of these numbers scares me even more. I’m eight years and counting.

I have been on and off antidepressants three times now. Having never been able to tolerate more than the lowest possible dose of my particular brand of synaptic rocket fuel, I still have absolutely no idea if they help me at all. Literally none. However the emphatic explaining away of my anxiety, depression and fatigue symptoms with ‘serotonin deficiency’ has consistently led me back to a GP-endorsed SSRI prescription.

I do know that the first two weeks of cranium electrics, nausea, sandpaper mouth and night sweats feel like a grenade has been dropped into my soul. And that once these side effects have tapered off it’s impossible to benchmark what effect the antidepressants are really having. I’m just thankful to have survived. I’m told the ‘therapeutic benefits’ of my medication can be expected to kick in after six weeks or so – but at this point I’ve usually been working so hard at getting better through exercise, meditation, healthy diet and general avoidance of stress that any number of things could be bringing me back to wellness. Drugs have always been just one aspect of a very holistic treatment plan for me and I’ve never been sure of the part they’ve really played in my wider recovery story.

My uncertainty has always sat in stark contrast to the certainty with which medical professionals have recommended drug therapy to me. All roads lead back to chemical imbalance, it seems. That knowing nod in the GP room when it’s discovered that depression reared it’s ugly head again a year after ditching my medication, the inferred conclusion that being drug free was the chip in the metaphorical mental health windscreen that led to a whole world of shattered glass. Serotonin, you see. And my counter-argument that we’re all still utterly clueless around whether or not the pills actually help me? ‘Well they really can’t hurt…’

Except for some people it seems they can. Hurt, that is. Particularly for those on high dosage antidepressants, withdrawal can be vicious. Dizzy spells, migraines, aches and pains, insomnia. If you’ve watched Leo Di Caprio sweating and whimpering his way through heroine withdrawal in The Basketball Diaries think of SSRI comedown as a vanilla version. Pretty, it is not. Six months easily turns into six years on these pills when kicking the habit is this hard. Then there’s psychological dependency. Even if you’re not chemically hooked, mustering up the confidence to throw out the blister-pack-shaped safety net is terrifying.

At this stage I have no idea what to do and neither, it seems, does my doctor. It’s definitely the easier option to keep mindlessly slipping a small blue pill under my tongue after breakfast everyday. But time’s marching on and with it the ever decreasing likelihood of a chemically unaltered future. Do I really want to remain a slave to lab-manufactured serotonin? Can I put up with the tedium and inconvenience of monthly trips to the pharmacy coupled with the expense of prescription charges? It’s a sensitive subject – a decision worthy of careful, contemplative thought with due consideration for what support might be needed further down the road – and it’s going to take more than ‘come back and see me in a year’ to get there.

Shades of Kefalonia and the Reality of Recovery

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A restless butterfly whirls about the pine trees; flashes of yellow and white amidst fir-clad branches. Perched atop a rocky outcrop overlooking the Ionian Sea I hear the distant murmur of surf tickling the sandy shores below. My eyes blink closed and, for the first time in what must be years, I feel completely at peace. Everything is OK.

At the apex of my sickness if someone had announced that in three years time I would happily hop on a flight to Kefalonia, by myself, to spend a week at a Greek yoga retreat with a throng of total strangers, they’d have got a smack in the nose. I would have felt a likelier candidate for space travel – that I was being taunted with a delicious, but unrealistic, dream.

But I made it. Several hundred miles on from a bleary-eyed and anxious morning at Gatwick Airport I’d boarded a plane solo for the first time in years, thrown off the shackles of bad health and opened myself up to a whole seven days of new experiences, growth and, well, just good old fashioned…fun. Nestled in the idyllic paradise of Vigla Village I started to realise what recovery looks like. I allowed myself to languish in the acceptance that illness doesn’t rule my life anymore.

But I got cocky. I came home feeling invincible. I stopped bothering to do any of the things that keep me on the straight and narrow – my healthy diet degenerated, I drank more, rested less. And guess what – I wasn’t, in fact, bullet proof. A few hiccoughs at work, a disastrous romantic encounter and one house move later found me feeling less than fighting fit. Fatigue crept in. A dark cloud swept over my head. I felt awful. Not to mention incredibly foolish for daring to entertain the prospect of a new, symptom-free reality.

I pulled through. A month on as I sit tapping away at this blog, I’m feeling much better having focused on eating well, getting the right balance of rest and exercise and just giving myself time to digest various recent life events. Nourishing myself – body and mind. And simultaneously feeling pretty damn sheepish – at how naive I had been to think that chronic illness can simply vanish into the night.

My health is something I have to manage. It’s not perfect and sometimes I live alongside some pretty unpleasant ailments, aches, pains and difficulties. It’s a constant work in progress and I felt ridiculous for allowing arrogance to shake my commitment to staying well.

But despite this realisation I know that I’m in a good place now and that I’m lucky to inhabit the life that I have. Many live with much, much worse. Joy finds me on a far more regular basis than gloom these days – and that will do just fine for me.

How depression made me realise I’m going to die

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One day, hopefully many years from now, I’m going to snuff it, kick the bucket, pop my clogs, if you will…die.

This shouldn’t be a colossal revelation – we all know that our lives have expiry dates. That our boarding pass on planet earth is temporary. Yet even with this glaringly obvious knowledge most people sleepwalk through their days without truly believing that their future has a finish line.

Death is something that happens to other people, an unfortunate feature of existence you needn’t concern yourself with until you come face-to-face with it. Why else do we waste so much time toiling away to earn money we don’t really need to buy things we don’t really want, engage in stupid, petty quarrels, languish in toxic relationships or spend hours watching cats on the internet?

In the absence of anyone I’m particularly close to departing this world yet, I haven’t really had to confront death. In England we’re very stiff upper lip on the subject and rarely use the D word. My darling grandparents all passed away in their 90’s after long and fruitful lives – their deaths were sad but expected. A couple of health scares in my life have certainly given me a fright, but I was hardly tap dancing with the grim reaper. It was only when depression struck and catapaulted my mind into the dark that I really began to grapple with the only real certainty in life – it’s end.

Thanks to depression I am acutely aware of my own mortality. Having the spectre of death loom over your every waking moment makes it very difficult to ignore, even when you understand that your doomed and negative thinking patterns are merely a byproduct of warped brain chemistry. For some reason clinical depression makes you obsess about death, in fact persistent thoughts about your end of days are a hallmark symptom of the severe form of this cursed illness.

However, provided the cloud eventually lifts, it’s not the worst thing to be forced to face up to the facts of life. I had to come up with some pretty solid counter-arguments to my depression’s tiresome “I’m-going-to-die-so-life-is-pointless” mantra. Wouldn’t it be awful if life went on forever? You need darkness to be able to see the light. What if the point in living was something as simple and awesome as ham and cheese toasties? Rainbows! Cats on the internet!

And thanks to my time living in the black dog’s shadow, I care less and less about the banal trivialities of life we all get caught up in from time to time. I really couldn’t give an badger’s gonad how many followers I have on Twitter, whether the guy I fancy knows any famous musicians or if my job title makes me sound interesting. Part of this is due to simply growing up and shedding my self conscious skin but I also owe a large portion of my more nonchalant self to the blinding realisation that life is perilously short. When I’m circling the drain I’m really not going to give two shits about these things – I’ll care about whether or not I was happy and a decent human being. So that’s what I intend to focus on. Depression has gifted me with this life outlook.

Obviously this fly-by-the-seat-of-your-pants approach to living can sometimes make planning for the future very difficult, and hopefully as I continue to progress towards good mental health my awareness of death will become a less dominant feature of my life. I just hope that the lessons I’ve learned will stick. In general – and I truly say this without having to throw up in my own mouth – I’m a better person now, and I don’t want that to change.

I wouldn’t wish depression on my worst enemy, but I’m glad that it hasn’t taken losing someone I love to realise that every moment is sacred. I know that this will happen at some point, hell I might even be the first to go, but until that day comes hopefully I’ll waste less time getting bogged down in unnecessary trivialities and just enjoy the moments. After all, they’re really all we have.