An education in medication. #WMHD15

October 10, 2015


Today is my 75th day on antidepressants. Sertraline, to be exact. I’d never heard of it until the day I had a breakdown in my doctors’ surgery’s reception, and at first I treated it like a child hating its new baby sibling. This tiny, tiny white pill was apparently going to help things, but I had no idea how and resented it for being so smug in its ability where I lacked it.

But now we are best friends. The kind of friendship where you walk into the friend's kitchen and help yourself to food, know how to work the oven, and make yourself at home taking control of the TV remote. We’re comfortable, we’re tight, and if it ever moved away, I would cling on to its ankles wailing that Skype calls would never be enough.

Today is also World Mental Health Day. So, to mark it, I've written down the things I have learnt since starting medication, in the hope that it might help others who are battling between unwelcome sibling and clingy friend.

- You will not feel better straight away. At first, you might even feel worse. Side effects can come in all shapes in sizes. They may be worse than period pains, and they might not appear at all. I always felt sick in the mornings, felt high as a kite at 2pm, and had restless legs at night. I also couldn't orgasm for a month, but the less said about that the better. Too soon, man, too soon. Regardless, antidepressants need a good few weeks, maybe even months, to survey your mind and settle in well. Sometimes they’ll fit in quickly, and sometimes they won’t at all. For the latter, you should go back to your doctor to try something else, and that is okay. There are a bunch of different antidepressants which work well for different people. But give it time.

-  Medication does not replace your own strength. As well as expecting it to work faster than it did, I couldn’t understand why I didn’t feel... Brilliant. Fine. Happy. Excited. I got frustrated that I’d finally accepted medication but it wasn’t fixing anything. Medication isn’t a fixer. Medication gives you the time and space to breathe, and it gives you a kick up the arse. It quietens down the terrible monsters in your mind and turns up the volume of your own confidence, self-worth, and motivation. Now, I wake up and I actually get out of bed. I go out for a run because I don’t clock any voices telling me not to bother and I cheer myself on the whole way instead of listening to the dark laughter about how stupid I am for even attempting to get fit. The voices are trapped in a binbag in the corner of my mind. And if I do happen to hear them, in any context, I stop. I wait. I breathe. I re-evaluate what has just happened. I think. I carry on.

-  Telling people you’re on medication gets easier. I was incredibly reluctant to tell people I was on antidepressants. Not because I felt like a failure for having to take them, but because I was terrified that they wouldn’t understand. I quickly realised that that’s not my problem. I am looking after myself and that’s all that matters. I didn’t tell a lot of best friends for weeks, and some only found out when I wrote my initial blog post about it. Thankfully, everyone was lovely. Some didn’t quite understand and some admitted they didn’t know what to say, but no one judged me. Now it’s easier to tell people, if I feel the need to. I’m taking medication to fix something broken in me, like any other illness.

-  You might have to set rules and do some taming. What has been harder than telling people I’m on antidepressants, is telling people I can’t really drink. Telling me, specifically. I like a drink. I like my 2 for 1 cocktails and cold glasses of wine. So telling people that I can no longer indulge is worse than killing a kitten. My doctor said that alcohol can have different effects on different people so to just be careful with it. At first, I was fine. I was careful with wine but carried on merrily with spirits and cocktails. Now, I’m off everything. For now. I started to feel incredibly tetchy, anxious and emotionally exhausted, and days after a night out were a write off. I felt groggy, down, and hated myself. So sometimes, although medication is awfully clever, it can run riot and you have to hold back on some things, much like stopping a toddler having too much sugar.  

-  How you know your mental health ‘dips’ to be may change. This is something that only hit me the other day. Now that I’m generally better at looking after myself and stopping any flickers of bad mental periods before they develop, anything I cannot control can have a bigger effect on me, because the change in my mood is more drastic. As an example, last weekend, my boyfriend and I had a slight ‘miscommunication mishap’, let’s say, and he snapped at me. I was feeling totally fine and happy in that moment, so his snap took me by surprise and I felt all the blood rush to my feet. I got a lump in my throat, the monsters in the binbags tore their way out when my medication's back was turned, and I immediately started to panic and had a desperate need to burst into tears. It was tough, and totally unavoidable. This wasn’t a thought to calm, or a social situation to deal with, it was an instant trigger for me, and I wasn’t prepared for it because I was feeling happy. Pre-meds, it wouldn’t have triggered anything. I would have been so ‘flatline’ in my mind anyway that I would have blamed myself and thought it was standard for him to be mad at me, and would have just been quiet and depressed for the rest of the day. This time, him snapping totally caught me off guard and I couldn't understand, so the effect was a lot more physical. It was panic rather than depression and something I wasn’t used to. Now I’m aware that my body and mind may react differently to before, and I’m prepared for it.

-  You will have bad days. You just will. Medication does not fix everything, and sometimes your antidepressants will take the day off. But the bad days won’t last (if they do, go back to your doctor - you may just need your dosage upped or medication changed) and you just have to ride it out. Don’t get angry at yourself, it’s not your fault and you haven’t done anything wrong. Sometimes you might just be a bit exhausted. Take some time to look after yourself. Don’t beat yourself up if you can’t get out of bed or can’t be bothered to shower. Do some things you enjoy; watch some trash telly (I recommend Catfish), eat a whole tube of Pringles, and hound your friends on WhatsApp to get them to send you links of cat videos on YouTube. You will be okay.

-  This is not a concrete situation. I say this for two reasons. Firstly, I’m struggling with getting hooked on the idea that antidepressants are beautiful and will solve my problems for the rest of my life. In an ideal situation, you will be on medication for six months to a year (this is what my doctor is aiming for with me), because in that time you will hopefully have worked on some coping strategies to look after your mental health without medication. Antidepressants can be addictive, and not relying on them is definitely something I know I’ll have to keep working on. At the moment, I’m terrified of the thought of ever coming off them. But I know that one day I should try. (However, it’s very much worth noting that if you cannot deal with coming off them, that is okay and nothing to be ashamed of. It just goes without saying that if you can try and work through any mental health blips without them, go for it. But of course each situation and each person is different.) Secondly, if you are struggling with the idea that you are on medication in the first place – always remember that does not have to be forever. Nothing is concrete. You are constantly a work-in-progress. We all are.

- You are the bravest person in the world. Battling with your own mental health is tough, especially in a society where stigma is still rife. Taking the steps to control your own body and mind, get better, and look after yourself when it’s the last thing your little monsters are telling you to do, is incredibly brave. You should be proud of yourself.

Now go and grab some Pringles. The next episode of Catfish starts soon.

For more information on antidepressants, see Mind's information and support page: http://www.mind.org.uk/information-support/drugs-and-treatments/antidepressants/#.VhUE1iDBzGc

For more information on World Mental Health Day 2015, search the hashtags #WorldMentalHealthDay and #WMHD on Twitter, and see: http://www.mentalhealth.org.uk/our-work/world-mental-health-day/world-mental-health-day-2015/

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