'If people knew the miseries one goes through and the discouragements, they would realise how much balances out the small successes…' Sylvia Plath, Letters Home, p.285.
Depression has always been sneered at. Many do not accept the fact that there are biological reasons behind a pro-longed period of sadness and sufferers are not simply 'moaners' or 'pessimists'. It may come as a surprise to know that 1 in 4 people in the UK experience some kind of mental ill-health during their lives and it is therefore paramount that people accept this and change their attitudes. Depression is more common in women than men, and it is also more common for a person to relapse, if they have already had an episode of depression in their life. People suffering from depression are usually offered some form of therapy (largely counselling) and/or medication. Doctors guard against prescribing drugs though, and are avoided if possible. What causes depression?
There may be many reasons why a person will become depressed. There are both predisposing and precipitating factors. A person may have a certain personality, lifestyle, genetic make-up, early lifetime experience or social circumstances that provoke the disorder. On the other hand, an external influence such as the loss of a job, or the end of a relationship may trigger depression. It may also be brought on as a side effect of certain drugs. What happens to the brain when somebody is depressed?
During an episode of depression, the sufferer's brain chemistry alters considerably. The levels of certain chemicals will change and consequently, the individual will feel very different. A sufferer will constantly feel down and in many cases, will be unable to function successfully on a day-to-day level. It is also a frightening time, as many do not realise their need for treatment and instead feel guilty and lazy. These are the main symptoms of depression:
* Low mood* Lack of interest
in and pleasure from usual activities and interests
* Poor attention and concentration* Disturbed appetite, usually associated with weight loss, but it can also cause an increased appetite
* Disturbed sleep, often causing waking in the early hours of the morning and, a feeling of being unrefreshed by sleep* Tiredness
* Decreased sexual energy (libido) * Feelings of worthlessness or hopelessness
* Feelings of guilt or shame* Suicidal ideas and thoughts of self harm (which is a separate issue in itself)
My Experience of DepressionFor as long as I can remember, I have had a predisposition towards feelings of hopelessness and despair. Unlike my mother, who is happy until something goes wrong, I tend to be happy when something goes right. As a child I was a real worrier and often had what I'd now term 'panic attacks' (having the advantage of a language for it all now) although back then I was simply a 'moaner' and a 'worrier'. These comments were both hurtful and unhelpful, and simply led me to become increasingly unhappy. I felt that I had the world's problems on my shoulders and could not 'lighten up' as I was told to at school. I felt frustrated and confused as to why I couldn't enjoy life like my peers.
'What came first, the music or the misery?' - Nick Hornby, High Fidelity, p.26.When I hit adolescence, things went from bad to worse. I became increasingly introverted and often experienced wild mood swings, which were of course, attributed to growing up and nothing more. When I reached fifteen however, I noticed that though my friends were also experiencing periods of emotional turbulence, I was particularly uneasy and happy to spend prolonged periods of time alone. I read books and listened to music that told me that others felt the same as I did and I convinced myself that there was nothing wrong. As it happened, things didn't improve. When my parents split up my life was at an all-time low point and I found myself visiting a clinical psychologist up to twice a week and trying explain why I had taken to cutting my arms. It was not an easy time, to say the least.
My doctor prescribed Lustral (sertraline), which I took for a while and then flushed down the toilet - adamant that I didn't need such help. So then I carried on as before, self-harming and visiting my psychologist, until I reached eighteen and was told that the therapy had to end as I was now an adult. That was hard, as my problems were still the same and I felt that I had been pushed aside. Nearly a year later, I started at Bristol University, which I hated and found my course unsuitable too. I was once again in a very bad way and nearly killed myself with drink. Insomnia had also become an issue, and I was prescribed both Prozac and some sleeping tablets. In the end however, I realised I had to leave the city itself and reluctantly took a year out before embarking on another degree the following September. I abandoned the Prozac, and took to over-dosing and crying hysterically. I was trying to keep a job down and save for a trip to Canada, but my mental health was terrible. By August I realised that I had to take some serious action because I wasn't getting anywhere. I didn't want to get out of bed in the mornings and went back to bed in the afternoon - I did all I could to escape the outside world and relieve the pain. My doctor (a different one this time, a more friendly, female GP) prescribed Cipramil (citalopram hydrobromide) and I took the small white tablets religiously, 20 mg a day. Within a fortnight I noticed that I felt 'numb' and a lot less volatile. My family commented on my improvement and though still fragile, I felt that at last, things were picking up. I hadn't noticed any nasty side effects and was generally content to stick with this medication. I was sleeping soundly and slowly I began to forget the sadness that had been such a large part of my life before, and looked forward to my new beginning at Sheffield University.
'The hardest thing, I think, is to live richly in the present, without letting it be tainted and spoiled out of fear for the future or regret for a badly managed past.' - Sylvia Plath, Letters Home, p.208.Nearly eight months down the line from then; I am still taking Cipramil on a daily basis and am leading a normal, depression-free life - although I am still prone to the 'down' periods that everyone has occasionally. The changes that the anti-depressant has made to my life are dramatic - I am now happy with where I am in my life and am hopeful for the future. It does, of course, bother me that I may have become dependant on the drug, but I am confident that my GP will taper me off them slowly and will provide the support I may need. Cipramil is definitely worth trying as it has worked well for me, although every individual is different.
Some Information about Cipramil (Citalopram hydrobromide)* The active ingredient is citalopram (as hydrobromide)
* They are available in blister packs of 28 tablets* They are manufactured by a Danish company called Lundbeck
* Reasons why you *shouldn't* take this medicine:- if you are pregnant, trying to become pregnant, or are breast-feeding
- if you are allergic to citalopram hydrobromide- if you are taking the drugs lithium or tryptopan
- if you suffer from any heart, kidney or liver problems- if you drink alcohol
- if you are already taking anti-depressants, if so, you need to wait two weeks before finishing with that particular drug and starting a course of citalopram hydrobromide- if you suffer from epilepsy
- if you are taking certain migraine treatments, known as 5-HT and agonists such as sumatriptan* The ability to drive or operate machinery may be affected
* These are some possible side effects:- nausea
- dry mouth- sweating
- drowsiness
- tremor* These side effects usually calm down after the first two weeks, otherwise consult your GP
* Finally, NEVER share your medication with anyone
11.11.2002 14:01
Thanks, I have just been put on this, so it was interesting reading your opinion.
26.02.2002 14:40
I started taking this drug today and I decided to look it up because I already feel very sick and light headed. Your op was very interesting, it good to be able to read about it from a patients point of view. Thanks
21.06.2001 14:03
very comprehensive - thanks