Contains Happiness: Always Read the Label

My medication journey.

It was a quick doctors appointment; there were no questionnaires to fill out, no big discussions about things. I didn’t even speak; I had written my feelings on a scrap of paper, and fumbled it to the doctor, as I sat and cried.

The paper, which was tear-stained and crumpled from my anxious grip, told the doctor that I wanted to die. I was just exhausted with everything going on in my life and was ready to have it all come to an end. The doctor had a glance over my paper, slid the paper-thin tissues across her desk to me, and told me that I was depressed, suicidal, and needed medication to take the edge off this episode.

It started with Fluoxetine. Just a small dose, something to ease me into my medication journey. I started that day, and so did the side effects. It was gradual, and then all at once — I stopped sleeping, and then I slept all of the time. I was tired, numb, emotionless, and generally just meh. I wasn’t magically cured, but I wasn’t worse.

I was on Fluoxetine for around a year — the dose just kept getting higher and higher. By the time I was on the highest dose available, I was flipping between periods of insomnia and periods where I slept all of the time. I had gained a significant amount of weight, and I wasn’t feeling numb anymore. The depression was creeping in around the edges of the medication, and the doctors told me it was no longer enough for me.

Then came Citalopram, and another month of adjusting to newfound side effects. I was right back in the throes of insomnia, and I was so agitated that I started grinding my teeth so badly at night that I lost a filling, and had to wear a retainer for fear of losing any more. Once I started sleeping, I had night terrors, and an old phobia of sleeping snuck back into my life. I was more afraid — and no less depressed.

Then came Sertraline. This was a short-lived fling. I gained so much weight in the first month or so of taking it that I begged to stop. It felt conflicting; it was silly to be worried about my weight when I was attempting to tackle something as big as depression and anxiety. On the other hand, it was affecting my mood greatly; I was becoming more depressed. Sertraline and I didn’t get on well for other reasons; the night terrors remained, and I was actively choosing not to sleep out of fear. Exhaustion levels were at an all-time high, and it was exacerbating my anxiety. I couldn’t keep taking them.

It was time to try Venlafaxine. They thought it would help my anxiety; I was training to be a teacher (a decision borne from a serious manic episode and a decision I was afraid to back out of) and my anxiety was fairly extreme. I have phobias of public speaking, and facing that hourly with classes full of outspoken teenagers was a real test to see just how anti-anxiety these meds could be. Unfortunately, my anxiety just increased exponentially; I was having panic attacks daily and was so wracked with nerves that I wasn’t sleeping at all. Another fun side effect was that I was sweating profusely; all night; all day. I was on medicated deodorant; and I sweated through that, too. One of my prominent memories from this time is having to bathe at school in the staff toilets, using hand wash to soap my body and drying myself with paper towels. I had been on the highest dose for a long time, and it was very clear that the only way anxiety or depression was going to escape me was through my sweat. It was time for a change.

And so, I was referred to a psychiatrist. This took a long time; I am eternally grateful for what the NHS has to offer, but the waiting times are extreme. By the time I got to the psychiatrist, I had experienced a manic episode of epic proportion and completely changed my life; I was moving away only a month after my first appointment with the psychiatrist. Because of this, I was only given one hour, and then the recommendation was to find a new GP in my new city and then rejoin the waiting list for a psychiatrist there. It wasn’t a great recommendation, but I didn’t have any option. The psychiatrist was concerned that I still had self-harming urges despite being on so much Venlafaxine; he decided to add a second medication into the mix.

Duloxetine was added solely to stop my self-harming. It had no other purpose, as far as I am aware. We gave it the obligatory four to six weeks to see if the urges were starting to reduce, and nothing had changed. It made no difference to my feelings or urges, and I was beginning to feel very tired with the entire medication experience. I knew people who had been given their first antidepressant, and that was the one that worked and they’d stuck with. I found myself jealous of people who’d found their medication match.

I made a decision then that had more consequences than I had anticipated. I wanted to come off both Venlafaxine and Duloxetine and to try a different medication. I was starting my teaching job within two weeks, and I wanted to wean off the old meds and onto the new ones in that time. This was not a smart decision. The withdrawal process was extreme. I had brain zaps (where you have a feeling similar to a shock in your brain), I was nauseous, I was exhausted. I couldn’t leave my house as the brain zaps got so frequent that every minute or so, I was being shocked. It was incredibly draining, and the wrong time to be withdrawing as I was preparing to move across the country to start a new, stressful career. But, I’d made the decision and there was no going back. It was time to get onto my new meds.

I say new meds, but I was back to Fluoxetine. There was a thought process that trying them again, after so long, could have different results than the first time. I started on a tiny dose, and we increased it more quickly than we had before — I wanted to be on an appropriate dose and not still adjusting when I started the new job. I was at the end of my mania, thinking I would be absolutely fine. I hadn’t found a therapist or counsellor in my new city; despite having had therapy once a week for over two years, I thought I could make this new journey on my own. In hindsight, this was also not a very smart decision.

Fluoxetine didn’t prove to be strong enough for teaching in the end. The mania ended, and I fell into a deep depression; riddled with anxiety about failing to do well. My mental health was spiralling, and I was away from my entire support network; the psychiatrist, my long-term doctor, my therapists, my parents, my dog. After six months of starting my official teaching career, I had a mental breakdown and left school one day unable to continue. I never went back. I was signed off for three months, at the end of which I officially resigned. I had spent those three months in my bed, unable to get up and face anything. I didn’t shower, brush my teeth or hair, and I completely lost my sleep schedule. I was awake all night, and I would fall asleep sometime after my flatmate had left for work in the morning. I was a mess.

Fast forward a few months, and I had left the new city for the comfort and safety of the old one. I was back at my parents, sleeping in a single bed in the sewing room. I started seeing a new psychiatrist regularly and was officially diagnosed with Borderline Personality Disorder, along with severe depression and anxiety. As there are no medications which specifically manage BPD, we were still looking at how to control the mood elements, and the depression and anxiety. Because my moods were cycling rapidly, I was started on Quetiapine, an anti-psychotic medication. I could say that they helped my moods, but only because I was asleep nearly all of the time. I wasn’t awake enough to experience any of my moods anymore. I slept for an average of 18 hours a day, waking only to get some water or go to the bathroom, the effort of these activities caused me to fall straight back asleep.

I tried to persevere with Quetiapine, I really did. I gave it months, where I slept all day. I didn’t go out, see any friends, and struggled to interact with family. I was just so damn tired all of the time. Eventually, I brought it up at the psychiatrist, and she agreed that I wouldn’t be able to function on these meds. They weren’t for me.

Escitalopram is a beta version of Citalopram; the med had been bought by a new company, revised, and re-sold under a new name. It is more expensive to prescribe than its predecessor, hence why Citalopram is prescribed first, but it has fewer side effects. I was sceptical, but running out of options.

I agreed to try it, and I’ve never looked back. The side effects are negligible, in the grand scheme of things. I was suddenly able to sleep (if I took the meds at the right time); my moods started to level out. I had more energy than I’d had in years; I didn’t need to nap at least once a day anymore. My anxiety reduced dramatically, and the periods of mania and depression levelled out. I wasn’t riding the rollercoaster anymore.

I’ve taken Escitalopram for two years now. The doses have gone up and down as required; right now, I am on a medium dose, considering taking it lower. The only significant side effects are problems in the sexual area of my life, but they can be managed fairly easily. Other than that, I have a regular sleep pattern, I don’t suffer from night terrors, or sweat through my clothes anymore. I do still grind my teeth, and I am about to replace yet another filling.

Am I still depressed? Yes, but not as profoundly as I have been in my past. There are periods where I feel much lower than usual — but they don’t last as long as they have either. I am in regular group therapy, an amazing experience where those of us with similar diagnoses can share about our lives and discuss methods for managing situations.

There is a strong chance that I will spend my entire life on antidepressants, but I don’t think that’s such a bad thing. Having now found a medication that ‘works’, I know the difference that they can make in my life. I want my life to be levelled out; to not have to suffer debilitating depressive episodes anymore.