I think we are all in awe of Anji’s last post and for her bravery in sharing her experiences. Hopefully she will feel able to update us all on her situation in the future, but in the meantime are there any issues or experiences that you: our blog readers, would like to share with us, or would be interested in us covering?

So, things were going well & then halfway through last week the withdrawl symptoms kicked in. Sheesh, major waves of dizziness and nausea, despite having carefully cut down on my dose before stopping the pills.

I felt reassured that it was withdrawal symptoms, rather than some fun, new ME symptoms, due to the previous comments on here. Plus, some googling revealed hundreds of posts on message boards from people complaining about dizziness & nausea when coming off citalopram.

Ended up having a couple of days off work, as I couldn’t cope with the dizziness on top of my ME, but I’m pleased to say that everything is abating now. Back at work and minimal dizziness.

I have been waking up at about 3am every morning this week, which I suspect is another symptom of my body adjusting to coming off the pills, but I’ll re-instate my sleep hypnotherapy CD tonight and see if that helps.

Overall, I’m pleased to be off the pills after three years, despite the small hiccups.

Photo by Mr La Rue

So, after nearly three years I am currently coming off my anti-depressants. I was on 20mg a day of Citalopram and lucky that I had no noticeable side effects.

Using anti-depressants is a very personal choice and it turned out to be the right one for me. However, it wasn’t an easy to start using them as it meant finally admitting that I was depressed and that I couldn’t cope.  I went through a phase of bursting into tears several times a day, including at work and this is why I chose pills. I needed to stabilise myself so that I could start dealing with my depression and work out what other help I needed.

I been to three different counsellors alongside using the anti-depressants, the most successful counselling treatment being the cognitive behavioural therapy I received in early 2008. The general advice from GPs about coming off anti-depressants seems to be that you should only come off them once you’ve felt okay for 6 months and then to cut down to a pill every other day, then one every two days etc.

I had 3 weeks off work before Xmas with my ME/CFS and IBS which was frustrating, but didn’t put me into a bad place mentally so I decided I was ready to start cutting down the pills. I’ve been cutting them down for the last month or so and I’m currently taking one pill every three days, so another couple of weeks and I’ll stop altogether.

The hardest part of coming off the anti-depressants is trying to decide what is “normal” for me. Before my depression I would very rarely get upset or cry because I tended to push all my feelings deep down inside. Now I’m double-guessing myself and thinking “am I upset because I’m coming off the pills?” The answer seems to be no, mainly when I’ve got upset the last few months it’s been about things that most people would find upsetting, and I generally deal with them sensibly and quickly. So, I still need to work on accepting and recognising my feelings and then working through them but overall I’m very happy with my progress and that I’m doing the right thing for me.

I heard a few snippets this week on the BBC news along the lines of

Put away the tranquilisers. Sushi, chocolate and a new haircut could help beat depression, a new book suggests.

The overall impression I received from this was that it was advocating the ’buck up, go out and sort yourself out’ attitude that can be very damaging to people with mental health problems. It also implies that it is aimed at women with anxiety and depression, as I can’t see many people suggesting to men that they eat sushi, chocolate and get a haircut to deal with stress.

I decided to seek out the details about the news on the BBC website and found a short interview with Professor Jane Plant, author of Beating Stress, Anxiety and Depression, and Jane Harris, of mental health charity Rethink.

Luckily, my first impressions were wrong as they seem to be advocating that people with mild to moderate depression may find a range of diet and lifestyle changes helpful. That these options should be considered before anti-depressants are prescribed, and that more non-drug psychological treatments should be available for mental health. They also mentioned that only 6% of health research funding goes towards mental health research, even though the NHS spends approx £300 million a year on drug therapies.

Got in from work this afternoon to hear the tail end of Sunbathing in the Rain on Radio 4 (which I leave on in the mornings for the dog!).

From the BBC website:

Sunbathing in the Rain: Gwyneth Lewis’s adaptation of her book, a down-to-earth, courageous and entertaining chronicle of her own experience of a severe episode of depression, how she struggled to find ways of coping and ultimately survive.

Listen again link should work for seven days:

http://www.bbc.co.uk/radio4/arts/afternoon_play.shtml

One of the few things tht I still found some enjoyment in when off work with depression and ME/Chronic Fatigue was music. Having a good, friendly local music venue meant I still managed the odd night out to listen to folk, irish or acoustic performers in a laid-back atmosphere.

When at home I could lie back and relax to celtic, new age or relaxation type sounds on at a low level, especially on those days where I couldn’t concentrate on reading or watching TV.

The other type of music I turned to were songs that inspired me with their lyrics, either to grasp a glimmer of light at the end of the tunnel or to physically get me moving.

One of my top songs for this is I should Get Up by Teddy Thompson, who I’m guessing has suffered from depression himself:

Depression looms
I’m such a miserable fool
I stay in bed
I don’t wanna got to school
But I see the sun
is beating down
No excuses from the clouds

I should get up
I should get out
I’m sure there’s something
I can’t do without
I should get up
I should get up
I should get up

I’ve heard it said
that life will pass you by
Live underground pretty soon that’s where you lie
But I feel so warm in my room
I’m safe and sound
inside my tomb

I should get up
I should get out
I’m sure there’s something
I can’t do without
I should get up
I should get up
I should get up

The world goes on without me
I know it
I know it
No one misses
the quiet kid
And there are things
I may have missed
But living ignorance is bliss
I’m so wrapped up in myself
I got no time for
Everyone else

I should get up
I should get out
I’m sure there’s something
I can’t do without
I should get up
I should get up
I should get up
I should go out
I’m sure there’s something
I can’t do without
I should get up
I should get up
I should get up

Has any music inpired or motivated you?

I was reading an article (1) at work the other day about Bibliotherapy – Book Prescription Schemes: A strategy for delivering psychological treatments.

Has anyone heard of this? I hadn’t. It’s aimed at helping adults with mild to moderate mental health problems, such as depression and anxiety. GPs prescribe appropriate books from a standard list, and the patient can then get the books from the local library using their “prescription”.

I certainly would have found it very useful to have some books recommended to me when I was first diagnosed, as I tend to go into research mode whenever  come across a new challenge. As it was I (and I presume my GP) knew nothing about this and so I just picked books up haphazardly.

Apparently there are over 100 of these bibliotherapy schemes in the UK, after a successful pilot scheme in Cardiff. More info on the scheme.

This is only recommended for mild to moderate cases, as I assume those suffering from severe mental health problems aren’t likely to have the motivation/energy to use self-help resources.

So, have any books/videos/websites/resources been really helpful to you?

One of the books I found most helpful and gave me some self-insight before attending CBT was The Worry Cure: Stop Worrying and Start Living by Robert L. Leahy, as it explains some of the most common negative thought patterns.

(1) Bibliotherapy by Professor Neil Frude, Panlibus Magazine, Issue 9, Summer 2008.

One of the things I’ve struggled with over the last few years is how my mental health has affected my career and vice versa. A large part of my identity has always been entwined with what I do and how well I do it, and it all started to unravel when I found myself deeply unhappy at work.

Obviously, the first thing I thought about was changing my job, but I wanted to stay in academic librarianship and there were very few positions available at the pay rate I was receiving. I did get interviews for all suitable vacancies in the vicinity, but didn’t get any of the jobs. This happened over the course of several months and I was gradually having more time off due to stress related illnesses such as IBS and asthma. Things spiralled downwards until I was routinely bursting into tears at home (though I did my best to hid tears and distress at work…), and feeling out of control. Ending in being off sick for several months.

Since I was a teenager I’ve always wanted to live by some “feminist ideals”- I wanted to go to Uni, get a well paid job, support myself financially, get my own place etc. I didn’t want to get married or be dependant on a man (though I always envisioned having a male partner). I managed all that, so it came as a shock when I realised I had depression. I shouldn’t be depressed! I was living by my ideals and hadn’t had any major upsets in my life.

However, through counselling and therapy I’ve realised I wasn’t just living my ideals, I was trying to be ideal… I put a lot of energy and care into trying to be very good at everything, and didn’t like to ask for help.

It all came back to that common cause of distorted thinking: Perfectionism.

Having to re-evaluate my life due to my ill health (mental & physical) has made me come to the somewhat painful realisation that I am not what I do. Therefore, my job can be just a job and I can be good at it without it being the major focus of my life. It doesn’t matter if the house is a mess, or what wage I’m earning (as long as we have enough to live on) or whether I’m the perfect friend. I can be me, with all my imperfections and the people who matter will still love me.

Now I just have to figure out how to be just me!

Shatterbox’s post about welfare services & meetings inspired me to write a bit about the numerous types of meetings I’ve had about my health in the last few years.

I’ve had to have meetings with GPs, Counsellors, CBT Therapists, Occupational Health Services, Line Managers, Section Managers, and Personnel Services. The anticipation of such meetings can make you feel a bit like this:

 Here are some of the ways I prepare myself for these meetings:

• Take in Written Notes

This may sound like overkill, but during the worst patches of my depression I would be in tears within seconds of trying to talk about my health, and the written notes allowed me to get my points across even when I was too distressed to speak. They also mean I don’t forget any important points or issues, and can steer discussions back to the areas I want to talk about. My current therapist actually found it pretty useful as it meant she had my case history in my words to refer to.

• Take Someone With You

I found it very helpful to have my boyfriend with me when I went to see my GP about anti-depressants, as I was still coming to terms with being diagnosed with depression, and it meant my boyfriend understood the situation as well. I have found it even more important to have support in my meetings at work with managers, personnel and occupational health. At one point I was having meetings with three senior managers and a rep from personnel at the same time! Four to one in a meeting does NOT help when you’re already feeling very vulnerable. I got my trade union involved and have a union case worker who attends meetings with me, which has been tremendously useful. Just knowing someone else is there with my interests in mind makes it easier to cope. If you’re not in a union then you could ask about taking a colleague with you to meetings instead.

• Talk It Over Beforehand

I also found it good to talk over the issues that were likely to come up beforehand with someone sympathetic. One of my counsellors helped me prepare for meetings about returning to work after a three month absence by discussing what might be a sensible return to work schedule and if there were any duties that would need to be monitored etc. At other times I’ve talked to family, friends and colleagues, depending on who would know the most about the particular situation. It helps me work out what I want to say and what I might want to put in writing.

• Avoid Worst Case Scenario Thinking

This one is very hard to do, especially if you’ve already had a bad experience with the people you’re meeting, and it’s only now that I’m in CBT that I’m beginning to get the hang of it myself. I have a tendency to dwell on whether I’ll get upset, whether they’ll listen to me, whether I’m failing to meet certain standards or expectations… all classic anxious/depressive thought patterns. When I catch myself thinking like this I have to challenge those thoughts – have all my meetings gone badly? No. Have I always got upset? No. Have I usually managed to get my points across due to my preparations? Yes.

Some appointments go well and some don’t, but they’re hoops I need to jump through so I might as well prepare for them.

As an introduction to some of my own experiences with mental health problems in the past I thought I’d share with you some autobiographical writing that I did in early 2006, when I ended up being off work for 3 months with depression.In the future I would like to share some of my experiences with occupational health services, counselling, cognitive behavioural therapy and chronic fatigue syndrome. I hope you find something in this post and others that you can relate to.—