And what’s it like, what’s it like being on lithium?

I’ve reacted fine, I haven’t… apart from a slight tremor of my hands at the beginning, which is to be expected, you know, you, you’re given a sheet which tells you what to expect, and I looked it up on the internet as well. I’m very against taking medicine for a long time, but after my experience with the depression I decided I would be prepared to take it to the… for the rest of my life if I don’t get it again, the depression again, if it stops that.

And, and also I’m not, I’m not over the top with the manic aspect but it has made me make choices I wouldn’t otherwise have made. It’s made me make choices which haven’t been good choices, and so I’ve I hope, I mean all my friends are watching out now, you know, that I’m calm and not getting hyperactive as I did before.

And I didn’t know if they would do any good or not, but I added up one day that I would, over the years, I had taken almost 20 different sorts of pills of one description or another. And had all the dry mouth and all the side-effects that were unpleasant.

So I tried, I’d try anything to get out of it so I went onto the lithium salts, and one day I was washing my hair over a sink and when I opened my eyes the sink was lined with masses of hair. So I pulled my hands through my hair and I could pull it out and over the next 2 or 3 weeks I guess it all fell out.

So I had no hair at all and I saw this psychiatrist and he said, ‘Oh, don’t worry about it, I’ll send you to a skin specialist, its come out because you’ve had a great deal of stress. So I went to see the skin specialist and by a piece of good luck he said, ‘I get depressed as well. And he said, ‘And I know what lithium salts do.

And by examining my scalp he said, ‘I can assure you it will grow again. Which it did, so that was a relief [pause]’ And to continue that story I was expected to become depressed when my wife died. The bereavement was thought.[to perhaps trigger depression].

But I didn’t really feel that ill at that time. And I saw this same psychiatrist. This was about another 10 years after the first visit to him when he had prescribed lithium. And when I walked in he said, ‘Oh, I remember you, you had an overdose of lithium!’ And I said, ‘You told me it was stress. And he said that he could have made a mistake. So all my faith in psychiatrists went zooming out the window with one man.

I think I had about 20 sessions. And I would come out of it with a splitting headache, and no memory. Couldn’t remember where I lived, and how I was going to get home. But my wife was there, and she took me home. And one day it was rather a terrifying experience because in order to have the treatment, as I said I had a general anaesthetic. And they would give curare to relax the muscles and so forth.

And so I was strapped onto a trolley, and up round my feet and waist and chest and my arms at the side. And then I was in that state, with two anaesthetists who stood by me talking about something I don’t remember what. And I swallowed my tongue and I couldn’t move or shout, so I thought ‘I’m going to die if these two don’t soon notice what’s happening.

So I moved my body as much as I could and hit the one of them with the trolley, and they were terribly apologetic and asked me if I wanted to go on with it. And I did, but ever since then I’ve had quite a lot of surgery. And I always ask the anaesthetist to be careful not to let that happen again.

So that period then I was taking quite a lot of anti-depressants drugs as well and I was off work for about 6 weeks. 6 months, I mean 6 months. When I went back to work I had no recollection of what had happened while I was away. And I knew the job well enough to go on doing it, but my memory was bad so’

While I was off, we went on holiday. And to this day I have no recollection of where we went or what happened or anything. So that was a bit frightening. And then I was determined to go back and do the job so my memory was affected by this time so I got into the habit of carrying a note book and putting everything down that I’d to do. And so to all intents and purposes, I was back to normal, or I felt I was.

I also had ECT (Electroconvulsive Therapy) while I was in hospital.

What was that like?

Horrid. I just remember being so frightened going into a room with a bed laid out and they’d get you to lie down on the bed, and give you an anaesthetic in your hand, which would basically make you go unconscious. But just that 2 minutes when you might have gone into the room and been waiting, I was just so frightened. And then they give you ECT and you wake up after a while and, again, that is quite a confusing experience. I did find that it affected my memory a fair bit.

What do you mean by that?

I remember talking to one of the women in hospital, bearing in mind I was in a mother and baby unit, and we discovered we lived quite close. And we agreed, she was leaving, so we agreed wed swap telephone numbers, and I couldn’t remember my telephone number… so to not be able to recognise my own telephone number’ And she couldn’t remember her address. And you think, well….

Had she had an ECT as well?

Shed had ECT as well, it’s laughable because you can’t remember some of the most basic things about yourself. You know, “How old am I? When, what’s my birthday?” And that’s… that’s frightening when you actually feel as though, you know, you’re completely losing your mind because you can’t remember anything. I mean you can remember things, you can remember where the kitchen is to go and make a cup of tea, it’s, it’s odd things that you can’t remember. And they come back but.

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.