Flinging Away The Crutch

I recently made a big decision: to stop taking antidepressants. I have been on medication for most of the past 14 years — continuously for the past 11 — and they have helped me a lot. They have been a vital tool in helping me change from someone so controlled by her anxiety and depression that she rarely left the house to someone who actually has a life. I just don’t feel that I need to take them anymore.

Deciding to take or not to take antidepressants is a a personal choice.

I have read a lot of people’s opinions on antidepressants, ranging from those who think they are evil and that the side effects are worse than the illness they treat, to those who advocate taking as large a dose as possible for as long as possible. In my experience, neither of these extremes are true or helpful. Antidepressants don’t work for everyone and even when they do, it can take a lot of experimentation to find the correct type and dosage for you.

I decided to take antidepressants in the first place because my doctor thought they would help me and I was desperate to grasp at anything which might make my life more bearable. Too many people judge others’ decisions to start or continue taking antidepressants; whereas nobody judges people for relying on medication to treat physical illness, even when that illness could theoretically be controlled through other means, a lot of people feel the need to voice their (often misinformed) opinions on antidepressants. Perhaps it would have been “better” for me to have used other methods of managing my mental health, but these simply weren’t available to me when I was at my lowest points. Medication was available and I’m very grateful.

I should stress that I am in regular contact with my doctor and reduced my antidepressant dosage according to his advice before stopping completely. This was important to prevent withdrawal symptoms, but it also enabled me to gauge whether my symptoms worsened as the dose decreased. They did not, so I decided that coming off medication was the right choice for me.

One of the key reasons that I am able to cope nowadays is because antidepressants helped me access and implement other ways of managing my mental health. When my mental illness was at its worst, I simply couldn’t do things like taking regular exercise and using CBT techniques to challenge my negative beliefs. Antidepressants were the crutch which allowed me to take steps forward.

It’s scary, but I have contingency plans — including going back on antidepressants if needed.

I will never be anti-medication, as much as I advocate using other therapies and activities to manage mental health, and I will take antidepressants again if required. I know that I have to monitor my mental health so that I can observe and address any changes — I still have mental health problems and they will never magically disappear. I hope to manage my mental health well enough that I can be considered “recovered” in the future, but I’m taking things one step at a time.

I know that my progress won’t be linear. Everyone has good days and bad days in terms of mood and mental health, regardless of whether they have ever been mentally ill, and recovery from physical illnesses and injuries os rarely straightforward. I think it’s important for me to keep this in mind. While I’m confident in my decision, the uncertainty still terrifies me. I don’t know what will happen — whether there will be a dramatic deterioration or improvement in my mental health or, as I suspect is more likely, whether things will change gradually.

So being congratulated for coming off medication is tricky.

For one thing, I don’t know whether I will have to take antidepressants again in the future. I feel unable to claim this as an unmitigated success because I have no idea if the change is permanent. I’m happy to be able to try life without medication, but it feels like being congratulated for starting to learn to drive — it’s a step in the right direction, but I don’t know whether it will turn out well.

The thornier issue is that congratulations imply that you have achieved something through hard work and while I have worked hard to control my mental illness, I was struggling a lot more when I was on antidepressants. I worked hard even when there were no positive results. It comes back to the idea of being judged for taking medication: congratulating me now implies that I was doing something wrong because I needed to take antidepressants. That makes me uncomfortable because it’s not true — needing medication doesn’t mean you are weak or a failure. Regardless of how you choose to treat mental illness, battling it takes courage and strength every day.

More than anything, I’m curious about the future — and a bit excited!

I have no idea whether I have suffered side effects from my medication for a start, though I have my suspicions. I don’t know precisely how much my antidepressants helped me, or in which situations, so I don’t know how (or if) anything will change. I never felt that the medication blotted out my personality — though my mental illness did — but I have no idea whether it affected certain behaviours or personality traits. I can’t wait to find out what life without antidepressants is like.

Having said that, coming off medication is just one of the changes I have made this year and my curiosity and excitement about the future owe more to these other changes. I may be taking tentative steps now I have flung my crutch away, but hopefully I will be skipping ahead someday soon.

 

 

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In Praise of Routine

I used to be adverse to the idea of routine. I’m a writer, an artist! Aren’t we supposed to eschew conventions and live life on impulse, travelling wherever the mood takes us? Well, following the muse might work well for some people, but it’s not the most productive way to organise your life and work. Routine, on the other hand, gives you a structure within which you are free to do the work and leisure activities you want.

Rebelling against routine is pointless, because the opposite of routine is not freedom: it is chaos, emptiness or a toxic combination of the two.

it took me a long time to learn this, even as chaos increased my anxiety and emptiness exacerbated my depression. It is only by creating a routine from the activities which help me to manage my mental illness that I have begun to feel free again. A smaller proportion of my time is wasted with having to cope with my symptoms. Planning more aspects of my life has enabled me to seize more opportunities. It hasn’t been a complete transformation, but I feel very different to how I felt in the last few months of 2915, when I was consumed with depression.

Like so much of mental health self-management, creating a routine which helps you is a personal challenge. However, you can seek out what works for other people and experiement with them for yourself. Here are the cornerstones of my daily routine:

Using my SAD lamp. While I’m not as depressed as I was when I started using it, I notice a drop in my mood if I forget to use it for a few days. I use it when I get up, for an hour or two.

Regular meals. I have been experimenting with a type of intermittent fasting, where you have a “feeding window” and don’t eat at other times of the day. My window is from 12pm to 8pm, since I don’t feel very hungry first thing and tend to overeat in the evening. So far, it’s working well — all of my digestive symptoms have improved, especially my gastritis, which got really bad at the end of last year.

Bedtime. I get insomnia, so I can’t control when I fall asleep — but I can control when I go to bed. It is far more effective than trying to force myself to get up at a certain time (though that often happens naturally as a result of fixing my bedtime); if I can’t sleep, I just read for as long as it takes to drift off.

Walking the dogs. This applies mostly to weekdays, when my dad and I take the dogs out when he gets home from work. It refreshes me and gives to space to think, instead of stressing and reacting to everything which happens throughout the day.

That’s it! I hardly live a regimented life, do I? Some flexibility is built in, which is important for me: my insomnia means I don’t always get up at the same time every day, so it would be a struggle to keep to set times for everything. My routine is also easy to adapt when I’m doing things which I don’t do every day, or every week, like keeping appointments and socialising.

Just as restrictions can force artists to innovate and come up with creative solutions, having a basic routine can free your mind to focus on the important things in your life.

The Myth of Independence

Everyone wants to be independent, right? We want to have the freedom to do what we want without relying on other people. We want to live according to our own goals and values. We tend to think that depending on other people will get in the way of living our lives as we wish. That’s all bullshit: nobody is truly independent.

I struggled with having to rely on my parents. I have had mental health problems throughout my adult life, so I’ve depended on them for practical and financial support for thirteen years. I had to leave three jobs because of mental illness; despite providing doctor’s notes explaining my absences, my employers seemed to regard the absences with suspicion and instead of supporting me, put me under more pressure so I ended up resigning. I have paid my parents “rent” to cover some of the grocery and utilities I use since I left college at eighteen, but my finances have been irregular for long periods so my parents have lent me a lot of money. I would not be able to live alone because the benefits I receive barely cover the living expenses I have now, which are minimal.

I also rely on my parents to pick up my antidepressant prescription. I could probably do this myself nowadays, but in the past I have been too scared to leave the house – let alone go into a pharmacy and talk to strangers. My mum also makes sure I eat a proper dinner most of the time, which sounds trivial but makes a big difference when I’m too depressed to cook for myself. My parents accompany me to appointments when needed and make phone calls on my behalf when I’m too anxious to do it myself.

As you can tell, my life is far from independent. I rely on state benefits and my parents just to survive. I rely on the NHS to provide me with treatment for my mental illness – treatment which has helped me to become a little more independent. I have learnt not to feel guilty about being a burden; at least, most of the time – it’s one of my major insecurities during periods of depression and/or anxiety. I have also observed something interesting: I have never met a wholly independent person.

All UK residents are entitled to NHS treatment which is free at the point of service. We rely on our employers to pay us on time and follow workplace laws which protect us. We depend on the police force to prevent crime and convict criminals. We expect supermarkets to sell us good quality food. Even if we consider ourselves to be someone who will never claim benefits (hey, I used to be one of you!), the welfare state still provides a safety net. Whether you like it or not, you are not self-sufficient.

On a personal level, most of us depend on family and/or friends for many things. Moreover, many of us like helping others and enjoy being asked to help out a friend or relative (within reason, of course!) – yet we balk at the idea of asking for help ourselves. I also find it fascinating how some forms of dependence are accepted, while others are criticised by many people. Apparently, living with my parents at 31 is shameful, but if I had kids and relied on them for free childcare nobody would bat an eyelid. Going to an appointment with your mother is viewed as a bit weird, whereas going with a partner is completely normal.

Being so dependent has opened my eyes to the hypocrisy surrounding the idea of “independence”. The major difference between those who think they are independent and the rest of us, is that we are aware of how we depend on others. A lot of people are simply unaware of their own privilege, like the middle class white male who gets a good job because he was recommended by a friend of a friend but is convinced he was the best candidate. Independence is an illusion. Once we give up this illusion, society will be more empathetic and compassionate towards those who need support – in particular, elderly people, people with disabilities and people with mental health problems. When we accept that nobody is wholly independent, we empower everybody to set and achieve their own goals in life, without worrying about how others may judge them.

After all, nobody is going to tell Stephen Hawking “yeah, you might be one of the most successful physicists of our time, but your achievements don’t count because you depend on other people to fulfil your basic physical needs” – so why do so many people think it’s acceptable to ignore some people’s achievements simply because we can’t be as independent as others?