“I will swallow, if it will help my sea level go down
but I’ll come back to haunt you if I drown.”
Like many depressed people the world over, I take anti-depressant pills to help me function. I have come to realise that these little capsules are essential to stem the flow of melancholy that will envelope me if I stop taking them. I wish I didn’t have to take them; I wish my life wasn’t beholden to the compounds in those packets. Sometimes I feel trapped by them, powerless to live my life without them. This distrust is not unusual amongst those who take ADs; the idea that we are incapable of existing without them can put us into a state of petulant denial. But I know from experience that if I stop taking them, I allow more to enter my head than the brain-zaps caused by their withdrawal.
Those in the know are aware that there are many different types of anti-depressants, which can be taken in many different combinations. There is a good article here explaining the different types and how they work. Unfortunately there are no hard and fast rules for which ones work best for which people. Everybody’s brain chemistry seems to be as complex as their personalities and it can take numerous guesses before you get the tailor-made fit that works for you.
I am now on my sixth combination! I currently take 50mg of Sertraline – an SSRI – and I have 2mg of diazepam for anxiety as needed to stave off panic attacks. These pills are generally a godsend to those with depression. Especially those whose depression is purely chemical rather than caused by external factors. But if they are such a godsend, why are they so unpopular? Two words: side effects. It seems we can’t be cured of our debilitating sadness without swapping it for a plethora of irritating symptoms. And so here is a list of ones that I have encountered so far:
- The Rollercoaster first night (Citalopram). Well, I was warned that the first night was a wild ride and I wasn’t disappointed! My heart was jumping about like a manic bunny and I was hallucinating bright flashing geometric patterns. And if I lay back fully on my bed, my chest felt so heavy that I felt I was struggling to breathe (suppressed breathing). I had to be propped up with three pillows so I didn’t have a panic attack because I thought I was going to die.
- The Shakes (Citalopram). It’s quite a common side effect this one, and I did struggle with them at the start of taking citalopram. It was mainly in my hands and just make my writing a little spidery, but then it scaled back considerably to just a jittery feeling rather than a physical shake. I can’t imagine what it must be like to experience that constantly.
- Nightsweats (Sertraline). This is actually my main bugbear with Sertraline and thankfully it’s not every night for me, on average probably once a week, but there’s no better way to make me feel totally disgusting than waking up and having to peel the sheets off my legs and change my pyjamas and pillow case in the middle of the night.
- Icky digestive issues (Citalopram, Dosulepin, Diazepam). Some ADs can cause constipation, some can cause diarrhoea, some can cause both, but most will affect your digestive tract in some way. Citalopram caused me both. Two days one, then two days the other. For ten months.
- Suicidal / Self Harm (SH) thoughts (Sertraline). Sertraline is notorious for worsening suicidal thoughts in teenagers and so is prescribed more cautiously because of this. Seeing as I had experienced them before I was medicated – I have a history of self-harm – that wasn’t an issue, but I have noticed an increase in the frequency of ‘unbidden’ SH thoughts. Ie, sitting on the bus quite happily and the little voice inside pops up and says “Hey, you could cut yourself when you get home!” Totally unexpected and leaves me wondering where the hell that came from. On the plus side, I am able to stay SH free for months or years even at a time.
- Vivid dreams (Sertraline). For a bit of balance, not all side effects are bad ones, this one I quite enjoy! I’ve always had quite clear dreams with fairly linear plots, but with the addition of Sertaline the experience has become quite cinematic. I have even begun to have lucid dreams, which can be really fun. And, if I had a good dream the night before I can sometimes drop myself back into it if I play it through my head as I am going to sleep. I couldn’t do that before Sertraline.
- Weight changes (all). Again, this is really common. With Citalopram I slowly gained weight. Not simultaneously enough to equate with the pills, but they probably contributed to an increased appetite. When I switched to Sertraline I lost 6lbs in the first week – which I loved. Recently my GP suggested I try Dosulepin as it was not an AD associated with weight gain; I put on 10lbs in 10 weeks. So I stopped it [AMA, I have to note and not recommended ordinarily] and went back to my old prescription and lost 4.5lbs in 4 days. As my perception of my worth is so enmeshed with my weight, these gains are really frightening to me and seem horribly out of my control, therefore adding to my anxiety.
- Sleep disturbances (all). On some days my brain will not shut off and let me sleep. That was a sertraline effect as I had never struggled to sleep before. It’s quite frustrating as I know the lack of sleep makes for a foggier following day. Conversely, Dosulepin makes people drowsy and therefore it’s recommended you take it an hour before bed. But Oh My God waking up was like emerging from underwater every morning; I constantly felt like I was being dragged back under.
- Nausea (sertraline). Another common one, thankfully not a frequent one for me, more of an irritation than anything else. If I take it on an empty stomach or without enough liquid too wash it down properly, then I get hyper-salivation, which leads to nausea, which always leads on to an appointment with the toilet bowl. The stupid thing is I know how to avoid it and yet it still catches me off guard sometimes, but that would be my own fault for not following my own rules!
- Others include, but are not restricted to cotton mouth (check), reduced or increased sex drive (check, there’ll be a whole post dedicated to this one later), teeth grinding (citalopram, check), yawning (citalopram, check), numbness, abnormal taste, low/high blood pressure (check), speech disorder… the list is huge and makes the leaflet inside the pill packets an eye-opening read.
So why, then, given all the side effects and possible health problems do people like me still take them? It’s actually very simple: because the alternative is so much worse than the inconveniences. I remember all to well the gaping maw ready to swallow me whole. I remember the hopelessness, the listlessness, the apathetic monotony and I don’t want to go back. I remember the weight of pain that these pills have relieved. And for me at least, that is enough to keep me swallowing.
Talk to me:
What do you guys think? If you take ADs what do you think of them? What side effects do you have to deal with? If you refuse to take them, what’s the reasoning behind your decision? Let me know 🙂