Let’s talk about all the good things and the bad things that may be. Let’s talk abooooooout meds (and some sex too as per the song).
Firstly I want to make my position clear: I am pro medication. A masters degree in medicinal chemistry and 6 years working for 2 of the biggest pharmaceutical companies in the world has definitely made me Team Med. I think it’s important to point that out because if I didn’t I may give the impression of someone who is anti-medication. How can that be?
Well, I’m talking those pills that everyone and their granny seems to have an opinion on: antidepressants. I’ll confess I didn’t learn much about antidepressants in my degree and I have never worked on an antidepressant as a chemist so, in truth, I was pretty ignorant of them. But I had my faith. My faith in pharmaceuticals.
I’ve been offered antidepressants loads of times over my life. Probably because I’ve been depressed loads over my life. Makes sense. I refused each time because my own belief was, in every instance, that there was an emotional reason for my depression – such as pregnancy loss for example. My understanding was that antidepressants worked on the chemical imbalance theory of depression (which is on shaky ground I believe currently in scienceland) and I didn’t think that was what I had. Instead, I was sad because something sad had happened and actually I needed help to manage that – not pills. That’s quite an ignorant view I realise now. In my defence I never actually realised I was depressed! OK that sounds pretty stupid now but then none of the doctors told me I was. They just offered the medication and I refused. And on we went.
I know a lot of people on antidepressants. Everyone does don’t they? I didn’t judge them. I was pleased that antidepressants worked for them. My faith in pharmaceuticals was untested and as strong as ever.
My GP offered me antidepressants again in December 2015 and I finally accepted. I was such a mess. I knew that trying to work through past trauma would mean that things would only get worse and I could do with every bit of support going. I was prescribed fluoxetine and had joined my Prozac peers. I felt disgustingly cliche.
I used the t’interweb and researched fluoxetine so that I was prepared. I wasn’t best pleased about possible weight gain and positively horrified that these meds may mean never having an orgasm again. Ever. (Just so you know that was the sex bit I promised earlier!!! Disappointed? Sometimes sex can be disappointing…ok, focus, back to it) That didn’t sound like a very happy pill. Hmmm none of the folk I knew on antidepressants had mentioned that one!
Anyway, I wasn’t put off. My pharma experience had shown me that actually information about side effects could be misleading and in fact most people, most of the time wouldn’t experience any problems. I mean, have you read the info that comes with paracetamol?! That stuff is lethal!
Quite soon into taking the flux my suicidality increased. I told myself it was probably just an early side effect and would pass. In hindsight it may have been the illness progressing. Who’s to know if it was drug or disease? And does it matter anyway? I had 2 good weeks on fluoxetine. For 2 weeks it looked like it was all going work out just fine. Well, you can guess it didn’t work out just fine can’t you? I became massively dangerous to myself: one day I tried to find the knives in my friends kitchen…that’s not good.
The big huge massive shock that came to me about antidepressants is how long they take to work. You’ve gotta give ’em 6 weeks. Dems de rools kid. In those 6 weeks your suffering can, and often will, get worse. What the fuck?! So after feeling crappy enough that speaking to a doctor is worth doing (and no one wants to make that appointment so you really have to be ill to do it) you get these pills which will probably make you feel worse and then after 6 weeks you find out it was all a bloody waste of time. The reassurance will be that it’s not a waste a time. Finding out what doesn’t work is important apparently. Not to me it wasn’t. But anyway. Then there’s the dose increase on the same med – give it another 4-6 weeks. That takes us up to 3 months with no improvement and, in fact, a deterioration! Yes that was a bloody shock to me because that is utter shit. I doubt ibuprofen would be such a big seller if it might stop your headache in 6 weeks but first it was going to make it worse but then depression can be life threatening so some sacrifices are worth it to get better.
I was cut up when fluoxetine didn’t work. I felt like a failure. My GP raved about the stuff. My friends said it was wonderful. The chemist in me had believed that the medication would work. I naturally assumed it was my fault. Stupid me. I’d probably not tried hard enough or focused too hard on the negatives or something. I was genuinely gutted! Thinking about my relationship with pharmaceuticals I couldn’t decide which of us had let the other down. It’s not you, it’s me. Or maybe it is you?
Still, I knew that actually sometimes finding the right med could be trial and error. I hadn’t believed it but I did know it. Citalopram was the next port of call. Yeah. That didn’t work. The crazy increased and that’s when I took my overdose. NEXT!
Then the psychiatrist said mirtazapine. He’d never met me so I couldn’t discuss it with him. Instead he proclaimed “Mirtazapine!” from on high and the GP was the mug left dealing with me face-to-face. I think it irritated the GP to be honest and I’m not surprised. I was pretty bloody irritated that night when I looked up the side effects of mirtazapine. It was another what the fuck?! moment. The side effects had not been explained which was kind of concerning.
At first I just refused to take it. Well, I say refused. It’s not like anyone checked! I just didn’t take it. As far as rebellions go it was pretty crap. I felt awful. I had stopped the citalopram so was without anything. I caved and took the mirt. Rationally I thought it was better to try it and get fatter rather than splatter myself over a train track.
I fucking hated mirtazapine. It was completely sedating. I was dizzy a lot. I suffered muscle weakness and aches. One of these spells came on when I was bathing my daughter. I felt I would pass out. That’s pretty dangerous. And it got worse. By the time I was on my last dose (4 weeks in) I struggled to move. It was horrible. There had been some improvement; I no longer wanted to throw myself in front a train. However, I was still suicidal, self-harming and acting on dangerous impulses. I did not feel safe. So, just like that, another one bit the dust.
Three antidepressants and 8 months later I had to accept that my faith in pharmaceuticals has been irreparably damaged. Perhaps we’ll be amicable and consciously uncouple rather than full on fall out.
The thing that made me write this post is that I’m currently going through withdrawal. I have googled like a pro but I can’t find any straightforward information about mirtazapine withdrawal. I can find a lot of stories but none address my concerns. For a start the psychiatrist told me (through a nurse – we still hadn’t met) to just stop my 30mg daily. No taper. I was surprised given it goes against everything I’ve seen, including information on stopping antidepressants from the Royal College of Psychiatrists but hey ho. He’s the doctor and he knows my specifics…allegedly. So I can’t find any tales that match my taking 30mg mirt daily and just stopping which can make this feel like an even lonelier ride.
Cold Turkey for Tea
It has been 10 days since I took any mirtazapine, any antidepressant at all in fact. I tried working out using half-life if I should still be feeling the effects but I realised my calculation was overly simplistic. I’ve been dizzy, weak, had nightmares/hallucinations, continually shivering with chills, crying and generally being useless. I feel awful. Tonight I couldn’t get the kid’s tea on. There was nothing in because I was supposed to go to the shop but was too weak. The guilt as they mooched about hungry. I could text my husband and he brought in chips. Chips served up with a generous side of mama’s cold turkey. I hate it. I had to lie on the floor today as I struggled to stay upright so my toddler played a game phoning for help for me. Heartbreaking.
I craved advice and reassurance. Maybe I could ask the psychiatrist? No way to get in touch with him and even if I did I don’t trust him. Maybe I could ask my care coordinator? She’d then have to ask the same psychiatrist. Pretty pointless. GP? What’s it got to do with him? Oh right, nothing. In conclusion I’m experiencing all this confusion with nowhere to turn.
I did actually meet the psychiatrist earlier this week for a medication review. His conclusion was swift: antidepressants don’t work for me. They’re not designed for my situation. I don’t have a pervasive low mood.
I wish someone had figured that out 8 months ago.
So that’s it.
No medication for me. The drugs don’t work. I still get the withdrawal though and now it feels a scary, lonely place. The same demons must be dealt with and now it will be done without my chemical backup.
Except… If I continue to insist that my existence is wrong then there’s an antipsychotic the psychiatrist can/will try. It was offered more as a warning – behave yourself or else it’s the quetiapine! This struck me as a rather strange turn of events. You see I used to work for the company who made quetiapine. I’ve sat in meetings being told about the global picture regarding quetiapine sales but here I was sat in an altogether quite different meeting. I can’t help but think that in our uncoupling the pharmaceuticals took me to the cleaners. On the plus side I’m free to still have orgasms!