I was prescribed Sertraline (Zoloft) in 1998 when I had postnatal depression. I was told to take it for a year to 18 months. I went from deep depression/anxiety to euphoria in the space of about two weeks, I felt pretty damned fantastic, there was nothing I couldn’t handle. As time went on I continued to feel well but my emotions were dampened down, so I was functioning well, no depression, but no “joy” either. After a few months of feeling well I decided I didn’t want to be on Sertraline anymore, didn’t read the patient information leaflet or talk to a doctor, not that that would have helped anyway. I just stopped taking them. My head felt terrible, it began to feel water logged, if I turned my head there was a time lag between my eye balls catching up with the fact that my head had turned, so dizzy, gradually intense sadness would kick in, really really intense sadness and anxiety, oh the anxiety, pumping adrenaline and nerves shot to bits. I went back on the Sertraline.
The doctor told me to do the alternate day thing, alternate days for a fortnight,then every third day for a fortnight, then one tablet a week, I did this various times over the next few years to no avail. I tried a pill cutter and halving the tablet, it wouldn’t break down easily without crumbling so that was unsuccessful. Every time I tried something, I ended up in worse shape than the time before, it was all getting steadily worse. I tried meditation, healing, exercise, cognitive behavioural therapy, counselling, fish oil capsules, NOTHING touched it. I pressured my surgery to refer me to a psychiatrist for advice,but the psychiatrist had no clue and could only recommend switching to another drug. I did switch to Citalopram for a while, and Mirtzapine, I felt constant fatigue on Mirtzapine, and then back to Sertraline. Yet another psychiatrist recommended halving my dose of Sertraline and taking diazepam to mitigate the withdrawals, so replace one powerful drug with an even more powerful addictive drug.
This is my description of how withdrawal felt from my blog, I only recently found out that what was happening had a name,akathisia:

“5am and for about the 3rd night in a row I’ve barely slept, I can’t stop the adrenaline pumping round my body, my stomach is tightly knotted, I’ve barely been able to eat properly it makes me feel sick. I’m clammy, sweating and crying and P is trying to reassure me, but he has to go to work. I get up and drag myself through all the motions of the day and making sure boys get to school, I feel like the living dead, I make sure they get fed and make sure they and no one else is aware of what’s going on, I don’t hang around at the school gates. Oh I do kind of tell a few people I’m not really feeling right but I play it down.
The constant adrenaline is tormenting me on the inside and I can’t stop it.It’s been building up over a period of months and I’ve been fighting and fighting the feelings but it seems to have reached a peak of exquisite torture.It’s like being at the top of a roller coaster that never stops. Someone else mentioned birdsong, and it was a funny thing, the torture was worse in the mornings and over the summer months while it was slowly building, birdsong in the morning outside the window had become a kind of torture as well. I had to go to work part time and God only knows how I managed it. I had taken my last Sertraline tablet months ago, and come off it as per the doctors instructions, and now my depression/anxiety was back tenfold to punish me for daring to presume I could stop taking it. I must be wired up wrong, no one else feels like this do they? What is wrong with me? Maybe I really am insane, maybe I just can’t cope with life without my tablets, how come everyone else can cope with life, and I can’t? There must be something fundamentally wrong with me. By now the Orwell Bridge was beginning to look a bit attractive and I just wanted to escape the adrenaline surges torturing me, my nerves were in shreds”.
This was 2003,at the end of 2003 I gave in and went back on the sertraline.

In 2006 I attempted another withdrawal, but at the same time we found ourselves going through a stressful life event, I tried to tough it out but ended up back on the Sertraline again.
So here I was, several years later and no further forward, and not for wont of trying! Everytime I went in a book shop or library I would try and find anything I could about antidepressants and depression, but nothing really enlightened me. I rummaged around on the internet but couldn’t find the answers. Until one day, I was browsing around Waterstones, and “Coming off Antidepressants” by Joseph Glenmullen jumped out at me, (this book is now called "The Antidepressant Solution"). I read it avidly, and discovered TAPERING!!! But, all the examples in the book referred to liquid Seroxat or Prozac, I was really upset to find Sertraline was not available in liquid form. Armed with my new information about the simple concept of tapering, further digging led me to Dr Healy’s protocol of switching to the equivalent dose of liquid Prozac. These two pieces of information became my secret hope, I latched onto them. I decided to take a leap of faith and switch to liquid Prozac. At the beginning of 2007 I marked up my calendar with a schedule, I was going to go down from 5ml to 4.90ml the first week, 4.80ml the next week and so on, as my sons would say “epic fail”. By about mid February the nightmare was unfolding again and I had to give in and go back to the top of my Prozac dose, I was devastated.
Still I hadn’t given up hope, P was sympathetic but he couldn’t understand why I didn’t just give it up and accept I “needed” the drugs like a diabetic needs insulin. After lots more research, and P having interesting and enlightening conversations with a client who was a pharmacist about my problem, I started my taper again in May 2008, this time much much slower and here I am four years later down to 1ml liquid Prozac and still sucessfully tapering. It has needed a lot of self-discipline. I kept this blog/diary of my progress; I’ve been amazed to meet a few others who have been tapering longer than me. Nowadays my withdrawals are fairly benign, but I still feel a bit scarred from the experience,the akathisia has left me still feeling like my nerves are quite raw and very close to the surface but I can live with that now.
There is a huge assumption that these drugs are benign and harmless, they are not; they can cause extreme agitation and internal torture. They are dished out like smarties and people left to deal with the results. Starting them is like playing a game of Russian Roulette, you might be a lucky one who can take them and come off them with ease, or you might not. My understanding was that they were meant to be taken for only a year or so after you feel “well” but many many people are stuck on them for years or forever, I know many people who’ve given up hope of coming off SSRI’s and I hear many people say “oh I’ll be on these the rest of my life”. There is NO support or advice in place through doctors or psychiatrists on how to taper safely off the drugs.....if anyone does find any help in the UK, please let me know, although it’s a bit too late for me now as I’ve almost done it myself, but I know a lot of other people who might like to know!

Thursday, 29 September 2011

Chill Pill

A conversation with a friend who is in exactly the same boat as me tapering off prozac, made me realise that yes I am feeling a consistent low level anxiety (bordering on depression) the past few weeks. The big positive thing about being on Prozac full dose is that it really is like taking a chill pill, it makes you so you really don’t give a damn. That was the only thing I DID like about it, and it’s STILL not enough to make me ever want to go back to the full dose because I don’t want the unwanted side effects that go with the “don’t give a damn feeling.

Lately however I have been noticing like I said this consistent low level anxiety which is sometimes hard to shake, we are under a lot of pressure in our life at the moment and so it is hard for me to unravel this feeling, is it the “real me” how I am anyway without Prozac? Is it purely circumstantial and if the pressures we’re under at the moment disappear in time will my low level anxiety also disappear? This is the really confusing thing about having been on Prozac so long, you never really know what the “real you” is, you forget and you never know if what you are feeling is “you” or “Prozac you” or a mixture of both. I suppose the only way I may ever find out is when I eventually get off it completely, but even then my brain chemistry may have altered from years of Prozac so that I never know what the “real me” ever was or is. Confused? So am I LOL

I’m finding it really hard because I feel like I am constantly chasing my tail, never quite on top of things, and like I am doing lots of things “ok” and in a bodgy way when I’d rather be doing less things but doing them well and completing them, I sometimes feel like the boys are being short changed because I don’t give them as much undivided attention as I’d like, and I wish there was more time to cook decent healthy meals. Housework gets me down, that’s the thing I find hard to keep on top of, so I just concentrate on laundry and food and the rest I have to try and let go, but I find it really really hard to turn a blind eye to dust piling up and a bathroom that needs cleaning. That’s when I really wish I could take a chill pill and just not give a damn. That’s maybe one of the reasons why I was prone to depression/anxiety in the first place because I find it hard to “chill” and let things go. I’m always having to tick that list off.

So any tips on how to chill and not sweat the small stuff will be gratefully received.

Perhaps I should just not wear my contact lenses anymore then I won’t “see” the dust!

Prozac Reduction Timeline

Monday, 26 September 2011

Struggling with the Elephant in the Room

David guest posted my essay about Bob Fiddamans book "The Evidence However is Clear" on his blog:
Struggling with the Elephant in the Room
It will be interesting to see if it raises some debate. I enjoy David's eloquent writing about his situation.

Friday, 23 September 2011

Chased by the Black Dog

A good friend who reads this calls it “being chased by the black dog”. I think Winston Churchill used the expression “black dog” to describe his depression. I’ve had a mahusive mother of all anxiety attacks, luckily it doesn’t happen often and as I look back over my blog archive it really isn’t too often, but I wouldn’t wish it on anyone. I think lots of different stressers in my life at the moment culminated in triggering something big in me, I spent about the past week feeling really quite depressed and anxious generally and just not myself. The last couple of days I felt pretty bad, and I could feel adrenaline pumping and stomach tightening. It finally culminated in not being able to sleep last night, and we all know how everything seems far worse in the middle of the night when you can’t sleep than in the cold light of day. I spent all day today feeling shattered, exhausted but all the anxiety slowly subsiding and flowing away from me, like a fever had broken. I know I’m on the mend now (apart from a cold)

I don’t know if it’s some kind of withdrawal, or the “real me” surfacing and I have to learn how to deal with the” real me” when this happens. At least I know it passes.

All this resulted in a conversation with P in which we went through all these things and neither of us could conclude what caused it specifically, Prozac withdrawal or real me, but I did realise again what an absolutely fantastic, supportive and encouraging husband I have and appreciated how lucky I am.

Some phrases that help me through the nasty patches:

This too will pass.

If you’re going through hell, keep going – (Winston Churchill (also a friends blog title))

Ships in safe harbour are safe, but that’s not what ships are built for

The best way out is always through (Helen Keller)

I’m not a failure if I don’t make it...I’m a success because I tried

A Mums Madness

Tuesday, 13 September 2011

Why are more women depressed? Is this a real epidemic - or the result of cynical marketing by drug giants?

This was in the Daily Mail newspaper and website today (don't normally read the Mail I prefer The Sun & Dear Deidre early in the morning but it was already taken)

Link to the article in Daily Mail

Why are more women depressed? Is this a real epidemic - or the result of cynical marketing by drug giants?

By John Naish

One in three of women polled had taken antidepressants during her lifetime
More women than ever are reaching for the happy pills, it was revealed last week. New research suggests there has been a massive increase in the number of women with depression.
Women are twice as likely to suffer from the illness than they were 40 years ago, and as many as one in seven will be affected by the condition at some point in their lives — more than double the number of men, according to a study published in the journal European Neuropsychopharmacology.
And the result of these soaring depression levels is becoming all too clear — a massive rise in prescriptions for antidepressant drugs.
Newly released figures from the Office for National Statistics show that more than four times as many prescriptions for drugs such as Prozac and Cipramil were dispensed in England in 2009 than 18 years before.
Women are twice as likely to be prescribed antidepressants than men — around two-thirds of all NHS antidepressant drugs are prescribed to women. The scale of these increases, over a comparatively short period of time, is breathtaking. So what’s behind the rise?
The German researchers for the European study blame one factor: modern life. Professor Hans-Ulrich Wittchen, in charge of the research, says the pressure of trying to cope with having a family and pursuing a career is leaving women with a ‘tremendous burden’.
More...Kathleen thought she had the flu. In fact, it was meningitis - and it cost her both legs
Why take your backache to the doctor when you can relieve your pain at home?
But is it really so simple? Go back 40 years and British women were hardly basking in leisure. They had grown up during the Blitz, suffered severe rationing, shortages and poverty wages. They were the victims of demoralisingly blatant sex discrimination and still had to haul in the coal.
Meanwhile, modern-day men are suffering unprecedented job losses, their role as the head of the family is disappearing and their lives are also getting more hectic and harried. But men’s depression rates have not climbed nearly so high.
In fact, one of the main reasons behind this astonishing rise in antidepressant use is that women are increasingly being parked on these powerful and potentially dangerous drugs for want of anything else to help them with the emotional distress that led them to visit their doctor.
This was echoed in a poll of 2,000 women released in June by the women’s campaign group Platform 51 (formerly the Young Women’s Christian Association, YWCA).
Women are twice as likely to be prescribed antidepressants than men
One in three of the women polled had taken antidepressants during her lifetime. More than half of these were not offered any alternatives to drugs. And a quarter were left on the drugs for more than a year without having their prescriptions reviewed.
This is despite the fact that guidelines from the health watchdog NICE say that ‘talking therapies’ such as cognitive behavioural therapy (CBT) should be the first-line therapy for patients with mild depression.
Treatment for patients who have moderate to severe depression should be a combination of talking therapy and antidepressants.
‘Women and girls don’t want to take these drugs for a long time and would prefer GPs to discuss with them why they are down in the first place,’ says Platform 51’s director of policy, Rebecca Gill. ‘They can feel no one is interested in their story.’
But many GPs say they feel forced to prescribe women antidepressants because it is difficult to organise alternative support such as psychotherapy.
Dr Peter Kandela, a former correspondent for The Lancet and a GP with a special interest in depression, says: ‘Theoretically, it would be better to give many of them counselling or CBT than antidepressants.
‘I would love to do it. But you have to fill in so many forms and contact so many people.’
Dr Kandela, who has a practice in Ashford, Middlesex, adds: ‘When the appointment finally comes, it is often too late to be of help.’ He says that arranging therapy can take three months.
‘This happened recently with a distressed patient. She gave up waiting and went to another doctor, who put her on antidepressants.’
The drugs carry the potential risk of serious side-effects, ranging from anxiety and loss of appetite and libido to convulsions and mania.
For this reason, the Royal College of General Practitioners advises that antidepressants be prescribed for only limited periods, up to a few months.
However, there is another factor affecting the judgment of hard-pressed doctors: women who are having emotional problems are far easier to spot than depressed men.
‘Men might not have their symptoms recognised so easily as women,’ says Bridget O’Connell, head of information at mental health charity Mind.
‘Evidence from our survey that compares 1,000 men and 1,000 women shows women may describe classic symptoms such as feeling down, tearful or anxious.
‘Men are more likely to act out their distress through drinking too much or being hostile and withdrawn, or they may have physical symptoms such as feeling nauseous or suffering from headaches.’
On top of that, there is the oft-quoted fact that men are much less likely than women to visit a doctor about emotional issues. This has traditionally been put down to the fact that men are too scared or incapable to describe their feelings of anxiety, depression or loneliness.
But a new study of nearly 2,000 children and adolescents has found a rather different answer — many males simply can’t be bothered with such thoughts.
‘When we asked young people how talking about their problems would make them feel, boys didn’t express angst or distress about discussing problems any more than girls,’ says Amanda Rose, a psychology professor at the University of Missouri, who was in charge of the research.
‘Instead, the boys’ responses suggest they just don’t see talking about problems to be particularly useful. It would make them feel as if they were wasting time.’
Antidepressants carry the potential risk of serious side-effects, ranging from anxiety and loss of appetite and libido to convulsions and mania
That still leaves us with the question: Are women really more depressed than ever?
Professor David Healey, director of psychological medicine at Cardiff University, thinks this is unlikely. Instead, he says, the leap in prescriptions for antidepressants may be seen as a triumph for drug company sales departments.
Professor Healey, the author of Let Them Eat Prozac, has argued that antidepressants are today’s ‘mother’s little helpers’ — the new incarnation of tranquillising drugs such as Valium.
‘In the Sixties and through to the end of the Eighties, companies marketed tranquillisers and had to persuade people they were anxious,’ he says.
When Valium-type drugs fell from favour in the Eighties because of their addictiveness, drug companies developed a different class of drugs: antidepressants.
‘In order to market antidepressants you have to persuade people they are depressed,’ says Professor Healey.
‘It is a case of labelling. People are as stressed as they were. The reason they view the problem as depression is down to marketing.’
Drug companies certainly do continue to push antidepressants on to women — even if the women are not suffering from a mood disorder.
Pharmaceutical firms are always keen to find new uses for their existing drugs because they do not have to take them through another highly expensive round of trials to prove they are considered safe enough for human consumption.
Furthermore, it may well be that so many women take antidepressants that it seems normal and acceptable to be given them — for whatever use.
For example, an American study in June declared that the antidepressant drug escitalopram can ease hot flushes in healthy, non-depressed women.
The study concluded that 55 per cent of women who took the drug, which acts on the brain’s feelgood chemical serotonin, had at least 50 per cent fewer hot flushes. But since when were hot flushes a problem to be medicalised and drugged?
Antidepressants have also frequently been prescribed to women with menstrual problems. The practice has been criticised by Claudine Domoney, a consultant gynaecologist at Chelsea and Westminster Hospital in London.
‘Doctors should always explore other avenues before handing out antidepressants for premenstrual syndrome.
‘It shouldn’t be first-line treatment,’ she says. ‘Why give a young woman a drug with potentially serious side-effects when it might not be necessary?’
Meanwhile, there is a dearth of well-funded research or support for alternative forms of treatment for women suffering from emotional problems.

Women are twice as likely to be prescribed antidepressants than men

Research by five mental health charities found depressed patients were having to wait for six to 18 months for an appointment with an NHS counsellor, with many being forced to go private.
Other alternatives which show promise in small-scale trials include acupuncture and light therapy.
A study of 27 depressed mothers-to-be in the Journal of Clinical Psychiatry in April found that after five weeks of full- spectrum light therapy, of the type given to people with seasonal affective disorder, 13 of the women had at least a 50 per cent improvement in their symptoms and 11 were no longer depressed.
Clearly, we do need alternative forms of support and treatment for women who experience emotional problems.
It may be true that life is more hurried, but it is also true that women have always experienced mood problems as part of the natural highs and lows of life.
In the past, they would have been supported by large, close families. Nowadays, they may need to turn to their family doctors for help.
But the answer, surely, cannot be to prescribe ever more mind-numbing antidepressant pills.

Monday, 12 September 2011

Syndicating to Facebook

I’ve been wrestling with myself for ages about whether to syndicate this blog to facebook. It’s been out there on the internet for years, and now it’s linked up to various other sites, and I’ve loved how it’s helped some people and I’ve made new friends through it, and yet it’s somehow been a bit anonymous. But facebook.....that’s really close to home and I’ve really agonised about it. One or two friends and most of my family have seen my blog and know my “ishoos” already. Most haven’t.

I think there is a silent epidemic of people “stuck” on SSRI medication, unable to stop taking them and suffering side effects. There is still so much stigma around depression/anxiety, it’s easier to go to the doctor and pop pills than seek any other therapies or help. If we break down the stigma of depression & anxiety hopefully, in the long run people will seek other ways to help themselves and SSRI’s will be the LAST resort and not the FIRST resort, So this is my little contribution to breaking down the stigma and “coming out”.

Prozac Withdrawal Timeline

The Evidence, However, Is Clear - The Seroxat Scandal - Bob Fiddaman

I’ve been following Seroxat Sufferers - Stand Up and Be Counted For a little while and I cottoned onto the fact that the author, Bob had written the book "The Evidence, However, Is Clear" so I sent off for it and read it in one day, that’s pretty fast for me nowadays.

Bob was prescribed Seroxat (an SSRI in the same family as Prozac/Lustral) for depression due to work related problems, what followed was a journey that took him through a tapering process of, what he believes to be, a highly addictive antidepressant. Following almost two years of withdrawal, Fiddaman’s new battle with the manufacturer of the drug (GlaxoSmithKline) and the UK Medicines Regulator (MHRA) took him on a more frustrating journey than he could ever have imagined. (This bit is from the blurb on the back of the book). I understand from Bob’s website/blog/book that he is an activist and winner of two Human Rights Awards and lives in a council flat in Birmingham.

I am really so much in awe of Bob and I learned a lot from his book, about how the pharmaceutical industry has cynically marketed SSRI’s, how the MHRA is hand in glove with the manufacturers of SSRI’s (and other drugs) and not detached as it should be. How they have suppressed information that these drugs are extremely difficult to get off of, and kept the medical profession in the dark about how to get people off SSRI’s properly. I learned how the drug companies peddled the myth of a “Chemical Imbalance in the Brain” which I fell for and believed myself until the penny slowly dropped after 10 years of failure to get myself off Lustral. It’s a shocking read but I wasn’t surprised by anything I read, I’d kind of realised for myself a long while ago that someone must be making a lot money out of all these people who are hooked on and struggle to get off SSRI’s , and believe they have a chemical imbalance. There is a silent epidemic of people who have been put on SSRI’s and haven’t realised they can’t get off them, who think they are on them for life because they have “a chemical imbalance”, and of course I’m horrified that they are increasingly prescribed to children and teenagers around the world with sometimes devastating consequences.

Where I struggle is that I know many people who feel they have benefited from antidepressants as well, and feel they have improved their quality of life, I find myself avoiding discussion forums on mental health on certain web sites now for fear of upsetting people who are on SSRI’s with what I now know. I don’t want to cause additional depression and anxiety for people who are already depressed and anxious and probably wouldn’t want to listen anyway, and there is a place for SSRI’s in some situations for some people (Bob would disagree I’m sure LOL) but SSRI’s should be the LAST resort of the medical profession and not the FIRST resort.

What I really have a problem with is how lightly they are dished out with no warnings. The first time I had Post Natal Depression I soldiered on without drugs, I really struggled, because I didn’t tell anyone, the stigma and shame was crippling in itself, and it took me a good year to really come out the other side, I’m glad I did though and I’m glad I didn’t go into a second pregnancy on SSRI’s and the worry about the effect of SSRI’s on my second baby. After I gave birth the second time I thought I had got away with it, but then I felt the blackness wash over me a couple of weeks after, worse than the first time. This time I decided I wasn’t going to keep it to myself, I was going to fess up, I told Peter and my health visitor, together we went to talk to the doctor, the doctor suggested antidepressants, I was desperate to feel “normal” but my overriding concern was that I would become addicted like the people I’d vaguely heard about who got addicted to valium, and that was the first question I asked, I was reassured that no these were a new class of drug and they were not addictive, I could take them for six months to a year and then come off them..........the rest is history.

I often wonder, if my doctor had said, there is a drug that can help you feel better, but they do have side effects; they can make you feel numb, if you stop them suddenly or come off too fast they can make you feel sick, desperate, and suicidal, they can be extremely difficult to get off, and worse case scenario it could take you as long as 3-5 years to taper off them, I wonder what I would have decided then? If I hadn’t felt the stigma and shame of being depressed and had felt able to ask for support from others instead of running to the doctor as the first port of call I wonder how it would have turned out.
The Evidence, However, Is Clear

Prozac Withdrawal Timeline

Friday, 9 September 2011

I have to admit to really struggling this week

Yes I have to admit this week has been quite testing for me. We have had a really bad week, P was involved in a car collision with our neighbours, which I won't go into the details, but it turned pretty nasty with the neighbours, and there is nothing worse than falling out with neighbours. I am pretty piss poor at confrontation and it's something I tend to run a mile from, but I was really proud of myself because I was assertive and calm and I stuck to my guns with the neighbours, while P was really wound up/angry, the neighbours wife was wound up, and the neighbour was displaying a very distinct nervous twitch, I was pleased to note.

As well I can't go into details but we are awaiting a big decision that will mean a lot to our business about how we proceed with it, and the waiting is killing us.

It's my line managers last day today, I have worked with her for 20 years, she is taking redundancy/early retirement, I'm really going to miss her.

The result is that  all in all I have been feeling very flat, blah and mildly depressed this week, and it's a timely warning to me to be ever mindful and protective of my mental health and never take it for granted.

Prozac Reduction Timeline

Saturday, 3 September 2011

The reduction that didn't happen

I had set my heart on going down to 1.40ml today, but after discussion with P, we decided to hold off a bit, work issues which we hope to have resolved soon mean that he is feeling stressed to the hilt, and me having a withdrawal meltdown could be too much for him to cope with, fair comment, so I reluctantly decided to hold off for another week or fortnight.
My prozac Reduction Timeline

A Mum's Madness - Sharing the Blog Love

Thank you to Amy for mentioning me on her blog this week, I am following her blog as well.
Mum's Madness - Sharing the Blog Love
So many blogs, so little time (sigh)

My Prozac Reduction Timeline