Everyone is an expert. Everyone has an opinion. Everyone has a view. Some are well-informed, borne from personal experience, including of close family and friends. Some are based on prejudice, fear and long-standing stigma towards taking these “happy pills” – pills for weak people. Some simply are looking for a quick fix or easy solution; a silver bullet. Whichever it is, you cannot avoid the vocal judgments and views of those around you if take anti-depressants.
Every week there appears to be a new report or survey that proves either a) anti-depressants don’t work, or b) they do work but at a high price – mostly the pain of coming off them or the high risk of addiction or long-term dependancy. This is hard enough to process for the general public, but spare a thought for those of us who are recipients of the 70+ million prescriptions for antidepressants handed out each year in the UK NHS. Some estimates put the figure of individuals on this medication at around 20 million people across the four countries of the UK.
My own journey with anti-depressants is very common and pre-dates popping my first tablet from its foil holder. It had been suggested to me for several years by well-meaning close family, friends and others (often bar-stool experts or – as our American cousins brilliant call them – Monday morning quarterbacks!). They were also suggested to me by my GP nearly four years ago. I – like so many people – resisted their suggestions. I did so for all the usual reasons that people have; I want to manage this on my own; I don’t need pills; I am afraid of becoming addicted; I am frightened they will alter my personality; I’ve read the online side effects horror stories (note to self: never read online accounts of anti-depressant use – if you weren’t depressed before reading them, you would be afterwards!); I want to try other things first, notably talking therapies; I am afraid of what people will think of me; that taking them would be an admission of defeat, that the depression has beaten me; I felt too the stigma of the tablets – that I was weak and had reached for the tablets because I was too lazy to tackle it alone.
What changed my mind was a particularly difficult December – last year – the second painful Christmas period in succession – and a growing acceptance that despite all my best efforts – all my lifestyle changes of exercise, rest, sobriety and good wellbeing habits – I was still falling under the spell of dark clouds of depression that were lingering for longer and longer once they arrived. I eventually gave in to the pride that was stopping me seeking this extra help – the pride of “I am can do this on my own”. The exact moment that I accepted the advice of my psychiatrist and agreed to accept the dreaded piece of paper with the word “Citalopram” on it, I couldn’t hold back the tears or swallow the lump in my throat. They were tears of defeat but also tears of relief as the pressure of dealing with my depression alone – I wasn’t alone as I had the support of my extraordinary wife but I felt alone – depression is a cruelly isolating and dehumanising condition – was lifted. I had a new tool in my toolkit in tackling this awfulness.
My experience since then has been mostly positive. As I have written here before, I’ve had many, many positives from taking one tiny white tablet a day; I am calmer; more settled; less anxious; more patience; more in control of my emotions; more restful; with more perspective on the things that matter in life. But there are downsides too. The edginess of emotions that makes you feel alive are dulled; less excitement with last minute LFC goals; less moved by music, literature or films and TV; no lump in throat or goosebumps when I stumble across something that would have once impacted me (whether a piece of Barry Davies commentary, a RFK speech, a West Wing scene or a glimpse of Liam Neeson saying he should have done more); the disrupted sleep and vivid – at times distressing – dreams. The downs have been reduced, but so too have been the ups. Less low lows but much lower highs.
I reflect on this today as I’ve spent a week or so contemplating whether the time is right to start the move to come off my 20mg a day dosage. Why? Well, I miss the highs. I miss the excitement. I miss the sharper feelings and the brighter colours. I miss some of the old feelings of joy. I even miss the odd tear and rawness of all my emotions. I would like the missing good bits of the old me back. But I also am afraid.
I am afraid of the process of coming off the medication – the withdrawal effects and the side effects of giving up the chemical boost – and I am afraid of how I will feel without the tablets. Will I go backwards and see the daily feeling of anxiety return; the sweats; the pain in the chest; the worry; the edginess; the jumpiness to sudden noises; the tetchiness; the general feeling that not all is well in the world and I am on the edge of something unpleasant.
As I am proving with every word I write here, I am not ashamed of either my mental health or the things I do to try to manage it – including taking medication. I am confident enough in my choices and am happy to reveal those and help in a very small way to tackle the stigma of mental health and taking medication by being open about my experiences. But I am also clear that in my ideal world, I wouldn’t need the tablet; I would be able to handle the cloudy days alone. I don’t want to keep taking tablets for the rest of my life – I don’t even want to be taking them now – nine and a bit months since I started. But I know that the only thing that matters is how I feel and what I think the right answer is. It is my life. My body. My broken head.
I know that much of the world around me doesn’t approve of my medication choices and that deep down I would rather have been able to avoid making them – but I live in the real world. A world where the views of others – whether in the form of reports from the medical profession or big pharmaceuticals – or from the know-it-alls online or those slumped against bars giving forth with their views on the world – I am not ready yet to make the break; to go it alone. For the foreseeable, I will continue to take the tablets because, in the end, the only judgment that matters is mine – and my twenty million fellow travellers.