Wednesday, 4 December 2013

The way through

A month ago I finally came off anti-depressants. It's meant - despite a gentle withdrawal period that lasted many months - a lot of change for me but all in a positive way. My ability to get to this point was helped a great deal by being able to find online the voices of others who've gone before me and so it feels important to me that I write a bit about this process. Even if one person reads it and feels better informed and able to move forward themselves, then it's worth it. I know there are issues that others deal with waaaaaay beyond the situation that I found myself in and I am not for one minute suggesting I have answers for them. This is about my experience with anxiety, depression and SSRIs.

A bit of background. I first took antidepressants (citalopram or Cipramil) in 2002. I came off them about 18 months later and stayed off until early 2007. That winter was a hard one. I was buoyed by the arrival of Evie but physically I was exhausted and SAD hit me particularly hard. Despite my deep happiness at being a mother, I fell into the black hole. Cipramil got me out. I tried giving it up a couple of times but went too fast and - as is typical in such circumstances - rebounded into an even bigger black hole. Back on the pills I felt safe, functional and disinclined to repeat that last mistake.

My depression takes the form of anxiety. Intolerance. Despair. Loss of all hope. Withdrawal. Disconnection. Topped off with a big old dose of apathy. It was a combination of reaction to events in my life - and a perceived lack of control over them - and, I truly believe, my naturally low levels of serotonin. This is implicated in migraine, SAD, PMS, anxiety, OCD, depression...all things I'm familiar with to varying degrees. I am exactly the type of person SSRIs were invented for.

I'm not going to write the thousands of words it would take to outline how I built myself a structure that supports me without SSRIs. Or rather, how I discovered that it was there all along. That's a whole other thing and probably far too subjective to be of use. What I want to talk about is what happens when you stop taking them.

I cut my dose from 20mg a day to alternating 20mg/10mg about six months ago. Maybe even longer. I was in no hurry so I didn't have a time limit and I wasn't watching the calendar. When I was certain that I was absolutely fine on that dose, I cut back to 10mg a day. I went back to 20mg a day for a while and repeated the process above. My doctor trusted me to know what I was doing and knew about all the changes I made. After three months on 10mg daily, I cut back to 10 mg every 48hrs. I stuck with this for about two months before going to 10mg every 72 hours. I think it would have been better to keep cutting the dose not the frequency but I worked with what I had and stayed aware. This lasted for about a month and I began to feel as if I were simply renewing the cycle every three days. I felt stable and strong, so I stopped completely.

There are three levels of side effects when you come off SSRIs: physical, mental and emotional. Physically I experienced the typical 'brain zaps' - little buzzing feelings in your head as if your brain is short circuiting, which in effect it is. I had them quite badly despite my long tail off period but I knew what they were and knew they would fade. I'm still getting them now, a month later. Mostly if I'm very tired and nowhere near as frequently. I also experienced quite extreme light-headedness. The first two or three days I might have been better - and safer - to just stay in bed and wait it out but life goes on and so did I. The physical stuff is annoying but if you're aware of the causes and their temporary nature, it's not a big deal. It's a bit like being very slightly drunk while totally sober. Which is clear. Sorry.

What was most important for me this time was a better awareness of what to expect mentally and emotionally. A common occurrence is that you feel incredibly anxious. Naturally, the tendency is to mistake that for your new/old normal and go running back to the pills. But! Wait up! Turns out, coming off these things makes you anxious and it passes. I read this on many forums so I was ready. It didn't make it any easier to get through but I was able to grit my teeth and do it.

It was bad. Every time I left the house WAS my last. I WAS going to die in a car crash and/or so were Charlie and Evie. Probably as they accidentally ran over both dogs as they tried to get away from our house which was going up in flames. All my family were in mortal danger. Even the ones I haven't seen in years. I was almost certainly riddled with various terminal diseases. My mantra concerned my imminent departure from Evie's life and went,"BUT SHE'S ONLY EIGHT!". Over and over. Day and night. My brain's reaction to this was to get all OCD. People needed to UNDERSTAND that if they didn't do things the way I understood they could safely be done then people were going to DIE. Or be horribly scarred. Or spill something. My way or the highway of doom, Dude. Seriously. WTF? If it wasn't my way of doing things I was thrown into a spin of panic and intolerance. Inbetween times I was mostly crying because OH...it's so SWEET, so SAD, so HILARIOUS, so AMAZING, so TRAGIC. You get the picture. One day I'll look back and laugh. And probably walk straight into a lamp post BECAUSE WHO DOES THAT??? Don't look BACK and keep walking. Oy. Your lizard brain is superb at protecting you. Give it chemical superpowers and it will protect the heck out of you. Take away those powers and it freaks out.

So yes. That. That happens. And then one day you wake up and it's gone. Mostly. It's only been a month and I am almost entirely non-ridiculous (for someone with my basic personality which is INFR - The Ridiculous Idealist).

Here's the thing. I would go back in a second if I felt I needed the help. I am always a supporter of SSRIs as a tool for recovery because for most people, they work. Of course they're not to be taken lightly and anyone using them needs to monitor themselves and keep their doctor informed at all stages, but they just work. They saved me when I felt as if I was beyond saving. Twice.

The way I have described it is this: if I see life as a house on four floors, including the basement, I fell into that basement. It was dark, cold, damp and entirely lacking in light or hope. I have never been suicidal but I already felt as if life were over. The apathy is the worst. I had no motivation to try to reach the stairs out of there because I KNEW they had rotted away. I was stuck. And I didn't care. About anything. I could pretend to my nearest and dearest by shouting extra loud so they thought I was just in the ground floor kitchen and okay. But I was not okay.

Cipramil came along and gave me some extra serotonin and one day I just woke up in that kitchen. It was light and airy with lots of windows and cupboards full of goodies and a radio playing happy songs. I wasn't ready to try going upstairs to the next floor and certainly not the one above that but it didn't matter. A good life was to be had in that there kitchen. Occasionally I would think about sneaking a peek into the basement but I couldn't find it. It had been filled in and the door bricked up. Going back was no longer an option. The sense of security that gave me was immense. I had metaphorical new foundations.

In these early days I am experiencing some really good things. For a start I appear to have regained a good 20 IQ points. My brain is functioning - steadily - in a way it hasn't in years. I'd put this loss of ability down to age but no, it's back. I can do tricky sums again and this week at work I grasped and used a concept in data navigation that has eluded me since forever. Being a bit of a geek (I know, I cover it well. Ahem.) this made me very happy.

Emotionally I am stable. I believe my timing has been good. I'm looking into getting hold of another SAD lamp to help keep the blahs away and I'm taking Vitamin D and a very good B-Complex.

What I didn't expect was that I can feel....more. I wasn't aware that the medication was limiting me and yet of course it was. It was holding me safe, wrapped in a cosy blanket. A blanket that restricted my movements and stopped me hurting myself. Suddenly I have a whole new/restored range to my emotions and it's kinda fun. For a week or so I was a bit mad...running around the new space like a dog with the zoomies. 'WOO HOO!' and then 'Oh nooooooooooooooo!' and then 'SHE HULK SMASHES PUNY HUMANS!' and then 'SQUEEEEEEEEEEEEE!'. All the colours in all the sizes.

That passed too. And I wasn't arrested even once.

So look, if you think you need help - and many MANY of us do from time to time or even permanently - science has good guys and they found this stuff and maybe you do not need to feel hopeless. These pills will not fix your life, they will not make you rich or happy or find the love of your life or the best job ever or make you thin if you're not already (in fact be prepared to gain 20 pounds and that often just falls off when you stop taking them so don't worry). They can get you out of that damn basement.

The rest is up to you. And you will be good with that.









6 comments:

  1. Thank you so much for writing this, I started taking these in April and I finally feel more steady, which is a huge relief. I dont think I'll be coming off them any time soon as I've only recently gone from 10mg to 20mg with citalopram, but its good to know what to expect definitely.

    I actually would be really interested in knowing the structure you've built for yourself to cope without them and I totally understood your house description as that's exactly how I've felt too, my foundations were totally destroyed by a series of events and I haven't - and still don't really know - how to rebuild them, but the tablets have definitely helped with lifting me up off the damp floor and out of the darkness.

    I did actually notice that I am feeling less though with the tablets but actually that's helped bemuse I used to think things that would deliberately upset me/stress me out - and once the tablets started to kick in - I'd notice the thoughts and think 'why on earth am I thinking that' rather than falling deeper into the thought pattern - its almost like I've had to become a bit more practical in myself rather than letting my emotions - and ultimately my depression and anxiety lead my thoughts.

    Anyway, this is a much longer comment than I expected but thank you again x

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    1. Wow thanks so much for your reply, Rhianne (and for the retweet by the way). I'll think about putting another post together. I nodded my head through all your wrote here. yes, yes...that's how it was for me too. Some of that 'practical magic' seems to have stayed which, as a great believer in learned behaviour and our ability to map new routes/write new stories for ourselves, makes perfect sense to me. Good luck, and I'm so pleased you're feeling a bit better. x

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  2. I am so very, very happy for you in working to be in this place where you can be healthy and strong without your meds. That's amazing. :-) Thank you for sharing your story. I too have healed from Depression but am still working through PTSD. It's discouraging sometimes but it helps to look back, doesn't it? :-)

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    1. Thanks so much for commenting, I'm happy to see you here : ) While I would never underestimate the impact of depression, I think - in my uneducated, inexperienced way - that PTSD must be a whole other ball game. But the level of awareness you've gained from healing from depression must be a positive thing as you work your way through. I hope it gets easier for you. I wish you peace and a clearer path. xxx

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  3. I'm so glad you posted this, I love blogs but every now and again a post like this makes me really, really love blogs, the people they bring together and the sharing of knowledge and experience is so valuable, as Martha (Stewart) would say "its a good thing".





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  4. SO SO SO SO powerful. I am so deeply glad to know you are feeling so good, so strong, so supported. You have done the world a great service in sharing THIS. xooxox, e

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