Eventually I went back to him went back to the psychiatrist and he said, you know, I don’t feel that fluoxetine is working for you anymore maybe it’s time to put you on something else and he put me on Vensir and that was just like waving a magic wand I mean it just almost immediately I was right back on, I felt better than I had in years I was taking, you know, not an unsubstantial dose about 40 milligrams a day but I just felt brilliant, I felt fantastic and the Fluanxol is for, I’m taking that as well, which is for anxiety rather than depression although obviously the two are linked. And I started taking it and I just feel fine now and I take then every day and occasionally miss a day but that usually accident rather than design or I’ve gone to my parents’ house which is 30 miles away and I’ve forgotten to you know, bring them with me or something like that but it’s never more than a day anyway. And I just feel fine now I mean I have off days and, you know, like everybody I have good days and bad days but my experience of antidepressants and particularly Vensir is that it doesn’t make you feel happy or sad it just makes you able to cope better and that’s good.

You said that it kicked in almost immediately?

Yes.

Can you describe how different you suddenly felt then?

I just felt a lot better you know I just felt less tired a lot brighter a lot clearer thinking I started to appreciate life a lot more I started to appreciate people around me more, I started to appreciate how fortunate I am, became much more optimistic just a much happier person.

I went to the doctor and he diagnosed me with depression and said clearly I’d been suffering from depression on and off for years but hadn’t done anything about it and I was immediately prescribed fluoxetine I think which didn’t have any effect whatsoever on me just made me feel really sick and lethargic. tried that for a couple of months and then had to stop it and try something else which was when I was then given venlafaxine which worked immediately more or less so that kind of sorted me out for, I think I was on them then for probably about a year and since then, since I was about 20 for the last 14 years I’ve probably been on and off them for about five times now.

When I went back to the GP they then gave me the venlafaxine again because I kept insisting that that was the only one that had worked for me before, I wanted those again. So they gave me those again and then I was on the maximum dose of 150 milligrams for about a year that must have been about six months, nine months ago I was reduced to 75 milligrams a day just to kind of keep me in check I suppose and kind of keep me okay and been taking them ever since, still taking them now daily.

You said it worked quite well so how long did that take to start making you feel a little bit more normal?

Within a couple of weeks I stared, I could feel my mood was lifting and everything was starting to be, yes a bit more understandable and I was able to cope a bit better with things.

And how, so how would you describe the difference in how you felt taking them as, when they were working as to how you felt before that?

I could just feel that my mood was lifting even though the side effects initially from them were pretty horrific.

What were the side effects?

Oh I had a permanent headache for a couple of weeks, I felt sick, dizzy all sort of really dry mouth.

So I got in a cab to this really well known hospital, and stayed there for ten weeks and it was then that I was given the antidepressant that I’m on now still and this was 1999 venlafaxine and I was started on 300 milligrams yes.

That’s a high dose.

Yes, I was very unwell.

Yes.

300 milligrams a day yes now I just take 75. It wasn’t an overnight thing; you know that it changed because even though venlafaxine helped with the depression and I found myself feeling better in terms of that, I still had a serious alcohol dependency that I’d developed…

There was a few weeks because it didn’t start immediately, there was a few weeks yes and it just, it wasn’t like a, that’s the thing about it I think when they work properly they just, it was almost I sort of accidently noticed that I sort of started to feel almost normal, does, does that make sense?

You kind of gradually realising that each day it’s like feeling a little bit more…

Yes, yes and at the time I didn’t know whether that was because I was in hospital and, you know, it was probably a combination of things, it was probably the fact that I wasn’t drinking and I felt very safe in there.

My new GP, my new GP, had looked at my records and said well you’ve been on’ I was actually back on fluoxetine by then, you’ve been on fluoxetine for years, you’re still suffering from depression so, you know, let’s try and do something about it. and she like many GP’s, well actually she was very good because she’d, she didn’t try to pretend that she knew the answer I’ve found some GP’s have favourite drugs that they tend to prescribe but she was, this is your case, you’ve been suffering, you know, all your, most of your life, you know, this isn’t just, you know, someone having a bad patch’, so she referred me to a psychiatrist at the local hospital. And he said well obviously, you know, you’ve tried all the normal drugs why don’t we put you on venlafaxine which is it does the same as Prozac but inhibits or enhances one of the other neurotransmitters as well.

And that worked, I did see again quite a significant lift in mood after that but that one completely suppressed my libido, my sex drive, I had no interest – which was fine because I was single at the time. but and that, whether it was the drug whether it wasn’t but I had quite a period then of being, you know, pretty stable in terms of mood but then a few years later I met my current wife and having no sex drive isn’t a very good approach to a new marriage. So I had to go back to back to citalopram which is what I’m on now, another SSRI.

And did you notice any, any effects from that different from the citalopram?

Yes venlafaxine was, that’s the one drug over the years that I have, I have, I can say I can sort of feel something different. It seemed to, you know, within the six week period it did seem to produce a lifting in, I did feel better. And I did seem to sustain that feeling better while I was on it so that’s, you know, it was, it was sort of I’d like to still be on venlafaxine from the point of view of its therapeutic effects.

Yeah, so, so Autumn of 2009 it had been sort of building up all Summer and I was feeling terrible again so I went to see the same GP and this time he prescribed mirtazapine and I’d been having terrible trouble sleeping and so I took it in the evenings and it was just incredible, it was, had quite a strong sedative effect and that was just very, very useful a time where I couldn’t sleep and that kind of, you know, knocked me out for a few weeks and allowed me to kind of sleep off the worst of it and you know, sort of, sort of slowly getting back there but I felt after maybe taking it for three or four months just like a completely new person. It had cleared up a lot of stuff that I hadn’t even, that I thought, you know, was my personality that I hadn’t even realised was related to the depression, stuff that I just thought was an intrinsic part of how I was and when I found that stuff kind of lifting and just feeling much more optimistic than I’d ever felt before I was like wow this is, this is pretty good stuff. So I continued taking that more or less straight for three years which have been the three happiest and most productive years of my life.

When you started taking that one did you get any different effects?

I felt like a zombie for the first few weeks, I felt like almost stoned, it was the sort of cognitive effects were really powerful, I remember thinking it’s great that I can sleep for twelve hours but, you know, if this stuff doesn’t clear up then I’m not going to be able to function long term on this.

So when you were waking up after your long sleep you were still feeling groggy?

Yeah, for about three or four hours, yeah which, which again was useful it was a kind of cushion from all the horrible feelings which, you know, it sort of gave me a couple of weeks to sort of sleep off the worst of it and. But yeah luckily after, I kind of acclimatised to the levels or whatever it, the cognitive stuff got a lot better. I had a bit of, sort of strange short term memory stuff going on as well, the first maybe month that I took it but all that cleared up really quickly.

And so you said that you felt really good on that one.

Yes, yeah.

And how different was the feeling from fluoxetine then?

Yeah it felt like, it felt like I was finally, you know, my true self and living my own life and able to do the things that I wanted to do, you know, for, for the first time in years since I, since childhood almost I felt like this was how normal was supposed to feel and this was, you know, how to be happy, it was yeah, which I never quite got on fluoxetine, I kind of felt, you know.

Functioning?

Yes functioning but not really good whereas on the mirtazapine I felt incredibly high achieving.

So she put me on fluoxetine which I still take now.

So I was prescribed 20 milligrams when I started them last year and I stayed on that for about two months and then she upped it to 40 milligrams and that seemed to work for quite a while until about May time this year when again I started to get very depressed again, so she’s now increased that to 60 milligrams and also added on mirtazapine. One of the side effects of fluoxetine, which I was never told that I read about on the patient leaflet is, insomnia. And as she increased the dose of the fluoxetine the insomnia got worse which is why she had to add the mirtazapine because the mirtazapine is a sedative. So that helps me sleep, so I’m taking an antidepressant to deal with the effects of an antidepressant which I don’t really like doing but you kind of get to the point where you have to trust them and trust that they know what they’re doing. So that’s what I currently take alongside something else, quetiapine, which again is an antipsychotic which she uses to minimise my impulsive behaviour in terms of self-harm and to keep me calm, and that’s kind of where we are now.

My GP my GP prescribed me mirtazapine. I think it’s a small dose 50mgs of mirtazapine. For depression but also for the sleeping problems. He said, It’s quite sedating. It can act in the same way that zopiclone can, sleeping tablets. And, you know, I hope you get some sleep, and double benefit it may help your depression. I’ve not found really that it’s done anything for my mood whatsoever It’s quite a low dose. It’s a quite a low therapeutic dose anyway. And I found that while it did sedate me, it didn’t sedate me, just at night time. When I took it, it sedated me all the time. So I would simply have to soldier my way through it and essentially you know, I’ve discontinued taking mirtazapine as I have done with all my other antidepressant medications because it did absolutely nothing for me. It, one pleasing thing though was that it didn’t affect my sexual functioning which was good. All the other medications I have taken have. It didn’t cause any weight gain. It didn’t have any kind of bad taste in my mouth at all. The only thing with mirtazapine was the sedation which was permanent. It was always there, it wasn’t that it got better through the day, as the level of drug in your system decreases, it was constant and that’s a problem because I’m in a job where I have to meet lots of people. I have to use my head. I have to talk to people. I have to write things, and I found that I would spend hours just looking at half a page of paper, and I just couldn’t. I just couldn’t function. So I discontinued taking mirtazapine and at the moment I’m taking nothing.

On the mirtazapine it kind of had an adverse effect and I became very aggressive and even at one point raised my fist to my partner at the time, my ex-partner now. I didn’t actually strike her thankfully but went back to the GP’s going there is something very wrong, I know I have a few anger issues but I’ve never done that before, that is so out of character, you know, I was shocked I did it, my partner at the time was shocked I thought oh this isn’t right. So we did a quick change over from mirtazapine to duloxetine. All the while I then started doing CBT with the mental health service but it didn’t go so well so we ended up doing art therapy as well, finished the CBT then started art therapy which went even worse, and then we started psychoanalytical therapy which didn’t go too bad. I was on the duloxetine for two years, actually stuck to this one stayed on it for two years got to the point where I was feeling a lot happier with everything and was ready to try to come off it with this with the support of the GP and we discussed it and discussed weaning off of it which wasn’t too bad, it took me a long time to wean off it, the physical side effects from withdrawal weren’t very nice.

Can you describe them?

Well my head would spin one way my stomach was spinning another it was a bit of vertigo you end up with a bit of an odd twitch because my head would spin kind of jerk out a bit just even though we were still weaning down very slowly at first even then it was still too fast and I just basically ended up curled in a heap on the sofa because I couldn’t move, to try and move would make my head spin.

Quite alarming actually

It was, it wasn’t nice it took me, as I say, it took me months to come off of it, absolutely months to come off of it because actually it was so, so slowly in the end the last little bit was the worse.

So I was quite happy because I was sleeping what they didn’t tell me, and I found out by reading the kind of, you know, patient note information leaflets that you get, was that it makes you sugar crave in a really, really big way . So I didn’t, I didn’t get on very well with that drug because I had a history, well have a history of eating problems so giving a drug that makes you sugar crave to someone who has eating issues was probably not the best idea in the world.

And can you, do you counteract that or do you, you know, just sort of fight against it or?

I try to kind of when I was first put on it I was very aware that that was, I knew having been on it in the past I knew that was going to happen. So I was kind of like right I’ll have, you know, if I want sugar I’m going to have fruit and I’ll have yoghurt and I’ll have healthy sugars and I lasted for about three weeks and then I was just like I need chocolate. I don’t, it’s a constant battle with me not just necessarily just with this drug but I used to think that I would rather be rather be dead than fat. And somehow somewhere along the way that changed and I my sanity took over as being more important and so I think you have to kind of balance.

Yes it’s that balancing the side effects against the benefits I suppose.

Yeah it is, yeah.

Think they had a complete overhaul on the medication at that point and that’s where the mirtazapine came about. I think that was the first time I’d experienced severe anxiety, which is why I think mirtazapine was particularly thought to be quite useful because I’d had a period of insomnia again the first time I’d ever experienced insomnia and severe anxiety. And mirtazapine for the first year was actually really, really good although the very, the huge negative on mirtazapine was weight gain, which was horrendous because if you’re already, if your self-esteem’s low even though your moods increasing you’re getting bigger, you know, it’s just, it’s just horrible and I went up, I must have gone up to a size 18 and I put on about four stone it was really quite, quite horrible.

Did you notice increased appetite, where you eating a lot more?

Yes a huge increase in appetite and it’s funny because they say well it’s not always just the medication, just try and eat a healthy diet and everything but it was completely different for me, I’d never been that way ever on anything and I know you can comfort eat with depression but, you know, that’s going a bit too far, you know, I have been, I have, have tended to be little bit up and down but usually it’s within a stone certainly not within sort of four, about three or four stone.

And yet the positives to that were that I was sleeping and anxiety was hugely reduced, so it was a huge dilemma and I’d really struggled with, with what I was going to do about that but actually the answer came from itself in that for whatever reason it stopped working anyway, and as the lethargy, as the sleep had pretty much sorted itself out and had, so had the anxiety, it was felt that well why not go back to Prozac.

What I remember we had some discussions about it, discussions of coming off the Citalopram and gradually, because other things weren’t working or hadn’t worked I told them about an MAOI that my mother kept mentioning called tripro…

Tranylcypromine?

That’s it tranylcypromine and she’d read a lot about MAOI’s and a lot of psychiatrists say some of the benefits they have were, are far better than the new SSRI’s and for some people they, they work much better. And the only reason why they’re not used so much is as they’re seen as a bit old style, old school it’s because there are health implications to do with dietary there are certain things that you’ve got to be careful of eating. And I think there are just concerns there with, complicating things further if people aren’t able to manage the diet. But because my because I’ve known people in my extended family who had used this in the past and never had a problem with it and it seemed to have worked for them. I met the psycho pharmacologist do you call it and the psychiatrist and they pointed out all the, the dietary aspects of it.

Can you explain what those are?

Well with this particular medication it I can’t remember now what it is that it does but it upsets an imbalance of something in your body and that, that a chemical that’s creating in bodies is also created by certain foods certain soya products and yeast foods like marmite certain meats like, I think pork, sausages, it’s to do with the way the meat is left for a while or something the way that’s it’s processed that it would enhance this chemical in it. There are other non-meat products I can’t remember.

Did you have a list of things to avoid?

Yes. So they’re printed off and they gave me actually, I’d say they were extremely good in terms of the information, they gave me information, all the health information, they told me which website to go on with the medical information about the pros and cons being on the MAOI.

Very, very slowly they gradually tried, gave the dose and then increased the dosage and the immediate side effects really were quite, they were quite obvious and that was like my blood pressure dropped considerably a lot and I would faint quite a lot and it would be quite overwhelming and they said that was one of the side effects something to do with how fast the blood could get to the brain and. And so that was difficult and that was difficult because sometimes I was trying to access something, a service within the hospital to do an activity and someone would always have to be with me and I felt, you know, I found that difficult . And so apart from the, that physical time and that took about two or three weeks and they were monitoring it quite closely and they, there’s a certain period of time frame that if it didn’t improve they would stop me using it because I always did tend to have low blood pressure anyway and it was obviously causing me, you know, I was hanging onto the wall when I was walking, it was quite bad and sometimes I had no inclination it was coming so next minute I would find myself on the floor.

You couldn’t really take that outside the hospital environment then could you, quite unsafe.

No, no exactly so it needed somebody to be around or to be in a safe place sitting mostly. But after a while I continued to take it and that passed and something eventually changed for me, shifted for me.

I kind of feel that, well in terms of the health side of things it hasn’t affected my health in any way I keep, all the health side effects that we were worried about I think there are only some people who react to it and others don’t and I find that you can quite easily eat a lot of foods they say I shouldn’t eat it doesn’t have any effect.

You’ve tried them have you?

Yes I have and the pharmapsychologist from can’t remember now, said I said how will I know I said because sometimes I do have a bit of this or that and she said you’d know pretty much immediately, you’d get heart palpitations, you’d get a huge headache and sometimes I eat quite a lot of cheese you shouldn’t eat and I generally don’t, but occasionally I really want some cheese and I eat quite a lot of cheese because I love having an array of cheeses somewhere never had any problems. But I know what the sides would be if I did so the food aspect doesn’t seem to be any problem I don’t seem to have any, as far as I can see, any other side effects. I feel very much the kind of wellness and wellbeing in myself that I would feel if I weren’t on the medication and when I’m feeling a little bit stressed it’s no more than again what I would have felt or do feel sometimes in daily life if I’m not on medication.

So for want of a better word it makes you feel slightly in inverted commas your normal self?’

I feel.

Your authentic self or something?

Yes whereas before I always somehow felt that it wasn’t normal to be continually on the medication and I think now I’ve kind of made my peace with it and in fact it’s less of a difficultly than I thought it would be so I’m happy to stay on it as long as it’s not giving me any problems.