A friend who is rightly sceptical about psychiatry asked me recently to chart my pharmaceutical journey, as I leave behind anti-depressant pills for the world of mood stabilisers. So, here goes.
The first tablets I was prescribed for the malady of depression was 20mgs of Prozac – back then this was the silver bullet of psychiatry, the panacea for all sorts of ailments. Anorexics were swallowing them, depressives, and people suffering the crippling effects of panic attacks. However, I lasted a mere fortnight on this prescription. The main side effect listed against this medication sounds innocuous enough: nausea. This comes no where near what I felt during those first days. Anyone who has been bent over the side of a ship rolling in the high seas will understand the impossibility of feeling or doing anything other than wanting to vomit, and the misery of heaving the contents of your stomach into the sink, toilet or onto your clothes with no respite from the symptoms as reward for your efforts.
I can’t remember if it was my G.P., or my (first) psychiatrist who prescribed me Venlafaxine, but these pills accompanied me on my journey through the frozen wastes of depressionland from 2001 until I thought I was cured, and gave them up towards the end of 2008, and the beginning of 2009.
The dose varied during those years – from a high of 300mgs, down to about 100mgs. In the first year or so, I don’t know if it was the medication or the illness that meant that I slept industrial amounts. My memory of that time consists mainly of the view out of my bedroom window – a block of flats, and a strip of sky.
My bicycle stayed in the shed.
A friend regularly picked the chioldren up to take them to school when I couldn’t face walking the mile to drop them off myself.
At one stage during that first year I was prescribed some sort of tranquillizer – I forget which one – it didn’t last long. I remember that it made me hallucinate. I was walking down a pedestrianised shopping precinct and I felt as though the whole street was moving in front of me. Although that pill didn’t work for me, I can defend the use of tranquillisers to soothe the pain that depression can cause. Yes, they are designed to turn your brain to mashed potato, but when that organ is making you want to walk into the sea, drink a bottle of bleach, or step in front of speeding truck, it can keep you on the planet for the time when you can face the rigours of what the literature coyly calls ‘talking treatments’.
One of the most striking things about anti-depressants is the effects of stopping taking them. We confuse anti-depressants with the likes of paracetamol and aspirin at our peril. I have known several people who benefited from taking anti-depressants, and when they thought they were better simply stopped taking them. They all suffered relapses so serious that they ended up in hospital. As a mental health worker, I have often counselled people who want to come off their psychiatric medication because they feel better, to do so gradually, and under medical supervision.
However, when it came to me feeling that I had recovered towards the end of 2008, did I take my own advice? Captain Sensible I most certainly was not; I simply stopped taking the Venlafaxine I had been prescribed. Fortunately for me, I recovered my senses soon enough and confessed to my G.P. after a few weeks. Under her supervision I started taking the tablets again on a low dose, and gradually stopped taking them.
I felt like I had recovered. I left my job in a charity call centre and found my way back into the mental health field, and my current job. Now, I wish I had stayed on the medication, even when I felt fine. I can only ponder the what-ifs of what would have happened if I had stayed on the medication – would I have avoided relapsing so severely as I have this year?
I don’t dwell on it.
This year has been pharmaceutical fantasia. Mitrazipine made me feel sick – I held out for three days before going back to my G.P. Trazadone has zapped the acute anxiety that crippled me at the beginning of the summer, but at 150mgs I couldn’t concentrate for more than five minutes. Even at my current dose of 50mgs per day, my concentration is seriously impaired. Usually a book worm who reads a book a week, I have not finished a book since July.
This week I will finally stop taking anti – depressants for good, when I stop taking Citalopram. My appetite has returned, and I will have to take care that I don’t put on all the weight I have lost over the past few months. Thankfully, the 150mgs of Quetiapine, a mood stabiliser tablet I have been taking for the past couple of weeks, has had no side effects to speak of, other than the almost complete disappearance of the daily suicidal urges I have suffered since July.
Do I want to take medication? No.
Does taking medication mean that I can emerge from the sludge of depression, and curb dangerous, impulsive behaviour? Yes.
Given that equation, I will keep taking the pills.
Better than anything I can get on prescription is poetry.
One monotonous day is followed
by another monotonous, identical day. The same
things will happen, they will happen again —
the same moments find us and leave us.
A month passes and ushers in another month.
One easily guesses the coming events;
they are the boring ones of yesterday.
And the morrow ends up not resembling a morrow anymore.
C.P. Cavafy (1863-1933)