Back in November 2012 I was interviewed about my experience of taking antidepressants in the context of a research project undertaken by The Health Experiences Research Group or ‘HERG’ at Oxford University’s Department of Primary Care in collaboration with the DIPEx charity. The project looked at Experiences of antidepressants. My interview was filmed and with my consent a number of filmed interview extracts have been uploaded and appear on the Healthtalkonline.org website (http://healthtalkonline.org/content/dina). The transcript of my entire interview can be accessed here Interview for Healthtalkonline_Experiences of antidepressants
As part of the aforementioned research project, a total of 36 people were interviewed about the experience of using antidepressant medicines in their own homes all around the UK. With people’s permission, interviews were filmed and filmed interview extracts appear on the Healthtalkonline.org website (http://healthtalkonline.org/peoples-experiences/mental-health/experiences-antidepressants/topics). In their interviews, people talked about a range of issues, such as
- Being prescribed and deciding to take an antidepressant/s
- Expectations of the antidepressant medication/s
- Using different types of antidepressants
- The extent to which people were informed about the side effects of antidepressants
- Coping with the side effects of antidepressants – Symptoms of the mental health condition or side effects?
- Treatment in hospital
- Reviewing and changing antidepressant medication
- Talking therapies and antidepressants; Alternative treatments
- Using antidepressants in combination with other psychiatric medication
- Impacts of antidepressants on daily life and work
- Feelings around taking antidepressants
- Antidepressants and recovery
- Experiences with health/mental health professionals etc.
My experience of taking antidepressants has been an everlasting ‘love and hate’, acutely ambivalent affair…
Melancholy, Edvard Munch
I was prescribed antidepressant medication for the first time in the summer of 1991. My diagnosis back then was ‘anxious clinical depression’, whereas the medication prescribed was a tricyclic antidepressant, Ludiomil, as part of a ‘cocktail’ of psychiatric drugs that included Beta Blockers, anxiolytics and very potent hypnotics. That first episode of clinical depression lasted for about 6 months, I was treated as an outpatient by a private psychiatrist in Greece (I was not hospitalised) and I managed to come off my cocktail of psychiatric drugs completely within 18 months or so. My everlasting ‘love and hate’, acutely ambivalent relationship with antidepressants – and psychiatric drugs at large- had begun…
So what exactly did I ‘love’ about Ludiomil (my tricyclic antidepressant) back in 1991? I guess ‘love’ in this case signifies my hope and expectation that the drug would help alleviate the unbearable emptiness, hopelessness and despair, the utter lack of motivation and interest in life I was experiencing whilst enveloped in the black cloud of clinical depression…my hope and longing that the drug would help mitigate my acute insomnia, lift my desperately low mood and somehow end my torment and save my life…in hindsight, I am not entirely sure how instrumental my tricyclic antidepressant was back then in terms of realising my hopes and saving my life…although I do accept that it may indeed have been helpful, I know that it was intensive psychoanalysis rather than Ludiomil alone that saved my life back in 1991 and continued being a life saver for the following 12 years…
And what exactly did I hate about Ludiomil (my tricyclic antidepressant) back in 1991? I remember I used to foremost hate the sensation of dry mouth, the drowsiness and lethargy, and the feeling that my head was very heavy and inhabited by a thick cloud that made clear thinking very difficult – all side effects of tricyclic antidepressants reported in the literature. I also hated vehemently the increased weight gain that I experienced (also a side effect of some tricyclic antidepressants) and which in the longer-term precipitated a markedly negative body image.
Vincent van Gogh’s ‘Sorrowing Old Man’ (At Eternity’s Gate)
My everlasting ‘love and hate’, acutely ambivalent relationship with antidepressants – and psychiatric drugs at large-was resumed in the summer of 2008- 17 years after I was first prescribed antidepressant medication. This time my diagnosis was ‘treatment resistant psychotic depression’. The ‘treatment resistance’ referred to the fact that within a period of one and a half years (summer 2008 – autumn 2009) I had been prescribed a series of successive antidepressant medicines of all types (an SSRI, an old tricyclic etc), including Prozac, Trazadone, Mirtazapine and Venlafaxine, which however did not succeed in lifting my desperately low mood. I took the various types of antidepressant medication as part of a ‘cocktail’ of psychiatric drugs that included combinations with antipsychotics (Olanzapine; Aripiprazole; Haloperidol), tranquillisers (Lorazepam), Beta Blockers, and hypnotics. That second episode of clinical depression was very severe and enduring given that it lasted for nearly 2 years including a 3-month period of detention under the Mental Health Act in an acute inpatient ward in Manchester – a terrifying, traumatising, profoundly scarring experience.
Fearful Expression Induced By Electricity, Guillaume Benjamin Amand Duchenne (de Boulogne)
It was only after I started taking Lithium (a mood stabiliser that is prescribed to augment the action of antidepressants in cases of unipolar depression like mine) in January 2010 that I noticed a dramatic improvement in my mood and my levels of motivation. Currently I am only taking Lithium and Venlafaxine so over the last 5 years I have managed to come off most medicines in the aforementioned cocktail of psychiatric drugs I used to be on. I am also in the process of very slowly reducing Venlafaxine with the help of my GP. I have written elsewhere about my ‘love and hate’, acutely ambivalent relationship with Lithium which was prescribed as ‘a last resort’ medication for me in light of the unsuccessful series of successive antidepressants I had been previously prescribed (‘A Journey Into Light’? Psychiatric Drug Promotion And The Marketing Of Madness by Dina Poursanidou and Lou Rawcliffe, http://www.ragged-online.com/2013/03/a-journey-light-psychiatric-drug-promotion-marketing-madness-dina-poursanidou-lou-rawcliffe/#more-5559).
So what exactly did I ‘love’ about the series of successive antidepressants I was prescribed during my second -severe and enduring- episode of clinical depression?
Similarly to what I said above in relation to Ludiomil, I guess ‘love’ in the case of the series of successive antidepressants I was prescribed during my second -severe and enduring-episode of clinical depression, refers to my hope and expectation that at least one of these drugs would eventually work to help alleviate the unbearably persistent emptiness, hopelessness and despair, the suicidal thoughts and feelings, the acutely debilitating insomnia, the utter lack of motivation and interest in life that I had experienced for nearly 2 years…my hope and longing that at least one of these drugs would eventually work to help lift my desperately low mood and somehow end my torment and save my life…but my hopes and expectations were to be disappointingly thwarted whenever I tried a new antidepressant which did not succeed in lifting my desperately low mood…until I was prescribed Lithium to augment the action of antidepressants Venlafaxine and Mirtazapine…in hindsight, I am not entirely sure how wondrous Lithium has been (in combination with the two antidepressants) in terms of realising my hopes and saving my life…although I do accept that it may indeed have been very helpful and even decisive for my getting better/’recovery’, I know that it was a combination of factors rather than Lithium alone that saved my life back in 2010 – my mother’s love and devotion, intensive psychotherapy with an NHS clinical psychologist, engagement with the arts through attending a mental health arts project (START in Manchester) and the opportunity to return to my University-based research job were among these vital life saving factors.
And what exactly did I hate/have I hated about the series of successive antidepressants I was prescribed during my second -severe and enduring- episode of clinical depression- in other words, what exactly did I hate/have I hated about Prozac, Trazadone, Mirtazapine and Venlafaxine?
Soon after I was put on Prozac back in July 2008 I started experiencing persistent suicidal feelings and thoughts and I was increasingly telling my mum that I feared I might harm myself…I remember experiencing my suicidality as something very frightening, terrifying…although my suicidality could have arguably been part of the whole matrix of feelings and thoughts associated with my severe depression and profound hopelessness, I still to this day wonder about the extent to which Prozac may have augmented my suicidal thoughts and feelings…
When I was put on Trazadone, which is an old tricyclic antidepressant, I remember hating the drowsiness and lethargy, and the feeling that my head was incredibly heavy and inhabited by a thick cloud that made clear thinking very difficult – all side effects of tricyclic antidepressants reported in the literature as mentioned above.
Mental health patients complain of ‘zombification’, Mark Gould (2011)
Venlafaxine is likely to have contributed to my currently elevated cholesterol levels, as well as to the severe irregularities in my menstrual cycle, i.e. the complete absence of menstruation, I experienced for a period of 18 months during my severe and enduring episode of clinical depression. Back then I was also on antipsychotic treatment with Olanzapine and Aripiprazole in addition to Venlafaxine- irregularities in the menstrual cycle are reported in the literature as core side effects of antipsychotics as well as Venlafaxine.
Rapid and excessive weight gain during Mirtazapine treatment – What I have hated most…
The antidepressant Mirtazapine (like the antipsychotic Olanzapine that I was also on for a while) is notorious for the significant metabolic effects it has and the rapid and excessive weight gain it precipitates…in my case, the combination of Mirtazapine and Olanzapine treatment resulted in going from dress size 10 to dress size 20 in the space of only 2 years! My obesity represents a substantial and particularly worrying physical health hazard that puts me at serious risk of diabetes and heart disease, whilst it already is most likely to be responsible for my currently elevated cholesterol levels and fatty liver disease.
Most importantly, the rapid and excessive weight gain I experienced through the Mirtazapine and Olanzapine treatment has come to signify the painful loss of my former (slender, agile and active) physical self that I had worked tremendously hard to achieve…bearing in mind that I had managed to lose a very significant amount of weight (30 kilos) back in 2000-2002 and also managed to maintain this weight loss until my episode of severe and enduring clinical depression commenced in 2008…the loss of my former physical self and my ensuing obesity have given rise – in the last 3 ½ years- to profound feelings of grief as well as bitterness and anger, and a markedly negative body image… such body image has manifested itself in feelings of hatred towards my body and in practices reflecting a wish to negate/disown or neglect and harm/abuse my physical self – for example, avoiding to look at myself into mirrors, going for weeks without washing, showing no interest whatsoever in buying new clothes, overeating and inflicting bleeding wounds on my scalp through persistent scratching.
My markedly negative body image also manifests itself in deeply painful feelings of physical and sexual unattractiveness that find expression in thoughts such as ‘How can I possibly be physically/sexually attractive, likeable and loveable having gained such a huge amount of weight?!’ The knowledge that such painful feelings of physical and sexual unattractiveness are being exacerbated by media messages promoting socially/culturally constructed ideals around a certain type of female body (thin, tall and symmetric), as well as the knowledge that attractiveness is not merely a matter of dress size but something far more complex which emanates from the whole person – albeit helpful- does not take the pain away by any means…
In the last 2 years or so I have been seeing a community dietician and with her help I have managed to lose some weight…but the weight loss has been a very slow and far from linear process, which at times has been particularly disheartening…an unremitting battle…
Finally, what I particularly resent about antidepressants, is the role of Big Pharma in marketing and promoting antidepressant medicines and in manipulating and seeking to withhold vital information regarding the serious and damaging side effects of such medicines…basically the role of Big Pharma in unethically manipulating – for the purpose of sheer profit making- the hopes and expectations of huge numbers of deeply unhappy and despairing people who turn to antidepressants for the relief of their misery.
Pharma attacks ‘black boxes’ as antidepressant sales fall
THE EVANSTON ROUNDTABLE
The Epoch Times – OCTOBER 15 – 21, 2008
Pharma on ‘warpath’
Ever since 2004, the FDA (US Food and Drug Administration) mandated “black boxes” on prescription drugs that may cause serious adverse effects. Selective serotonin reuptake inhibitor (SSRI) antidepressants like Prozac and Paxil now warn of suicidal behaviour in children and teens and sales have dropped 25 per cent. Pharma has been on the warpath. In a research letter in JAMA titled ‘Suicide Trends Among Youths Aged 10 to 19 Years in the United States, 1995–2005’, Jeffrey A. Bridge, PhD of Nationwide Children’s Hospital in Columbus, Ohio, Joel B. Greenhouse, PhD, of Carnegie Mellon University in Pittsburgh, Pa., and three other authors continue pharma’s campaign against black boxes. The warnings, they say, have actually increased suicide by scaring doctors and parents away from perfectly good drugs, kind of like how the withdrawal of diet-drug Phen- Fen is causing our national obesity (http://epoch-archive.com/a1/en/uk/nnn/2008/10-Oct/15/011_Health.pdf)