Different types of medication

MIND

I changed my antidepressants. This is what happened next

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Changing medication isn’t always easy – Kate Leaver should know. But for her, she writes, it was all worth it in the end

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By Kate Leaver on

My boyfriend and I moved in together last year, just as the cold was setting in, into a north London borough that neither of us had lived in before. One of the first things I did was fill in the NHS paperwork to sign up at the local GP surgery, so I could get a referral to a psychiatrist. I live with bipolar disorder, so I knew I’d need a supplier for the little white pills – antidepressants and mood stabilisers – that make my life liveable. It would take five and a half months before I got in to see one. Waiting for that appointment, I survived by getting my dad to post over my medication from Australia. Finally, my new psychiatrist informed me, remarkably casually, that my medication was not available in this particular area of the city. They’d had cuts to their mental-health budget, he said, adding that he simply wouldn’t be able to prescribe my medication to me. “Either move house or change meds,” he said, as though such a choice were easy.

And so I had to change antidepressant medication, something I know, from experience, can be agonising. I’ve swallowed a small pill every morning and every evening for many of the past 18 years of my life. Some of them have been circular and pink, some chunky and white. My favourites were slender and turquoise. They have all, to varying degrees, served the same purpose: to give me the capacity to function as a human being. I have tried to live without antidepressants and it is not viable for me, not yet. Without them, I flail, I shrink, I hide from the world. Without them, I am a spectre of myself, unable to participate fully in my own existence. I have tried many antidepressants since being diagnosed with depression at 12, bipolar at 18. I’ve experienced a generous list of side effects, but, to this day, none powerful enough to put me off the idea of taking the damn pills with a swig of water twice a day.

A few months ago, I began the process of changing medication. I Skyped my psychiatrist back in Australia, because he’s known me for a decade and I trust him. On his advice and with the knowledge of my local GP, I weaned myself off the first one, lowering my dose incrementally for a period of four weeks. “You should never try and do this of your own accord,” warns Mark Salter of the Royal College of Psychiatrists. “Make these decisions with a loved one and under the supervision of a GP in the first instance, and then, if needed, a psychiatrist. Lower the dose slowly before the switch, use micro-doses and ask your pharmacist for advice.” I did all of this, dutifully. I’ve done it before and I know it must be done with great patience and caution. The worst thing you can do is take yourself off medication abruptly or on a whim. I braced myself for the symptoms of withdrawal. “Symptoms of discontinuation vary by drug and will be different for each individual,” says Salter. “Maybe it begins with restlessness and agitation, the feeling that your life is not real, that you’re in a dream. Maybe you will get a rapid heart rate, maybe you will have nausea. Maybe it will feel like a hangover that’s hard to describe. The whole process is like landing an aircraft in bumpy weather; it must be done cautiously.”

I’ve had a few wobbly days since, but most of the time I feel even, rational and calm. I feel, dare I say it, normal

I was cautious. I noticed the difference almost as soon as I stopped taking the meds. I was quick to tears that had no reason to fall, except that the chemicals in my brain willed them to. I was tired, I wasn’t sleeping (though I rarely do), I was unable to sit at my desk to write. Then, I had to be without any antidepressants at all for two weeks, because the old and the new would have been dangerous in my bloodstream together. That fortnight must have stretched on longer than 14 days. I became a hermit. I spent most of my days buried underneath a duvet, sleeping off the numbness as much as I could. I would weep, if I had the energy. I would shake and I would rock back and forth to trick my body into feeling like I was being cradled. I felt nauseous, but I comfort-ate just to feel something – anything – the sensation of taste on my tongue. I cried when my boyfriend left the house; I cried at the thought of leaving it myself. Bundling myself out the door to take my dog for a walk each morning took about all the courage I had.  

Then I started taking the new pills. A small dose at first and then, when we’d decided it was safe to proceed, a larger one. I waited for them to kick in. I watched reruns of Would I Lie To You, Rob Brydon’s lilting voice about the only soundtrack that I could tolerate. I latched on to my boyfriend like a pilot fish when he was home. He cooked me meals, loved me and listened to me. My dog, somehow aware that he was more needed than usual, nuzzled in and wouldn’t leave my side. Both parents called each morning for an update: how many hours had I slept, how was my heart, could I give my mood a score out of 10. I managed to put clothes on to see my therapist, who listened as I spoke in a monotone. “I’m just waiting,” I’d say. “I’m waiting for these new pills to start working. Any day now…”

And then, perhaps eight weeks after the process began, they started working. I could feel again. I could think. I could even write. I could muster joy. I could laugh. I could put one foot in front of another without feeling as though my ankles were shackled to a boulder. I even swam laps at my local pool, plotting out a potential novel as I swept my arms past my chest. I started gingerly accepting invitations out to dinner, I saw people for coffee, I went to see Mamma Mia and appreciated it for the flawless piece of musical theatre it is. I talked to people I love and beamed with the knowledge that they could stop worrying about me.

I’ve had a few wobbly days since, but most of the time I feel even, rational and calm. I feel, dare I say it, normal. I am able to feel and love and think. I am grateful, all over again, for the invention of the antidepressant – those blessed little white pills that make me capable of living my own life.

@kateileaver

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mind
State of mind
Health
Mental Health

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