You've come to torture me again...
Depression is something I have had an on-off relationship with since I was thirteen. And for the past six weeks or so, the relationship is back on. In simple terms, I'm depressed again.
The timing was a bit of a shock to be honest. In August, I travelled to Northern Ireland with my parents to visit relatives. The majority of my family live there and both my parents were born there. August was the first time I had gone over in over five and a half years, and I had a wonderful time, seeing family I hadn't seen for years.
On the ferry home, I looked out of the window at the Irish landscape fading into the distance when I felt a familiar pain. Immediately I felt puzzled. Depression? Now? But I've had such a good time! The good memories were still playing in my mind, so feeling low was unexpected. I shrugged it off, thinking it was post-holiday blues or something. On dry land during the five-hour car journey home, I listened to my music with my mood yo-yoing.
The day after I got home, my mood rose to a very good place. I saw one of my support workers and enthusiastically told her about my holiday. In her words, it was the best she'd ever seen me. But this good mood wasn't to last. Over the following few days, good moods turned to episodes of low moods, and episodes of low moods soon turned into days of low moods. It wasn't long before the low moods greatly outnumbered the good moods.
About 10 days after getting home, I saw my CPN and told her about my mood. As it hadn't lasted very long at that point, she told me just to monitor it. But as the days went by, my mood became lower and lower, and by the time I saw my CPN again a fortnight later, I was really struggling. She told me she would speak to my psychiatrist and would get back to me if he suggested anything. She made an appointment with me for a fortnight later and I crossed my fingers that she would phone soon with a solution.
The first week went by with no phone call, and as the second week slipped away, I started losing hope that my psychiatrist was going to do anything. I saw my GP on the Thursday of that week and he was fantastic. He tried to phone my CPN but had missed her and as she doesn't work Fridays, he left a message for her to phone him on Monday. The appointment with him lasted 20 minutes, amazing with the current pressures on GPs, and I left the appointment feeling a bit more hopeful.
When I saw my CPN again (last Monday), I found out that she had been off sick from the day after I saw her for the rest of the week, then my psychiatrist was on holiday the week after. So that day was the first chance she'd had to speak to him. And fortunately, he decided not to wait any longer before starting to help me, and sent a fax to my GP, telling him to put me back on sertraline, the antidepressant I was on for five years. I started taking it that day and now I'm waiting and hoping for it to kick in.
I should never have been taken off sertraline. I first started taking it in October 2008, not long after I was first sectioned. After three weeks, I was up to the maximum recommended dose of 200 mg. It didn't really seem to have an effect on me, until I started to recover from the psychosis I was also suffering with. Then, my mood went from rock bottom to sky high, and after a failed attempt to jump out of a window to see if I could fly (fortunately the hospital window didn't open far enough), I realised I needed help with my mood but for the opposite reason. However, instead of lowering the sertraline, the psychiatrist (different to my current one) put me on lamotrigine, a mood stabiliser, alongside the max dose of sertraline. I still can't understand the logic behind that decision.
After a while, my mood levelled out and I came off the lamotrigine, followed by aripiprazole. The only psychotropic medication I took was sertraline, and I continued taking the max dose until late 2012. I reduced it with the hope of coming off it altogether, but after reducing to 50 mg every other day, I realised my mood was suffering. Feeling bitterly disappointed, I went back up to 50 mg everyday and found my mood stayed stable.
After a few months, I came to terms with being on a daily antidepressant and accepted that it might have been something I would have to take for a long time or possibly even forever. But I told myself the comparison that so many psych nurses had told me, some people need to take psych meds everyday just like a type 1 diabetic needs their insulin everyday. And psych meds are no less important than insulin to a diabetic.
Fast forward to January of this year. I was in hospital, voluntarily, and my psychiatrist reviewed my sertraline. He told me he was taking me off it because I was no longer depressed. Whoa, whoa, whoa. Did you not think there could be a reason behind me not being depressed? Could it have had anything to do with the antidepressant that had kept my mood stable for three years? My mood never stayed stable for that length of time before, usually it was stable for less than a year. So three years of stability could only have been possible with sertraline being beneficial to me.
I should never have been taken off sertraline. I wasn't happy about it, my parents weren't happy about it, but I had no choice. My mood was pretty low for a while after coming off it, probably due to the chemical anxiety I was suffering with, but after a while my mood did improve and I started thinking that maybe I didn't need sertraline after all. But as I watched the Irish landscape gliding past the ferry window that August afternoon, I began to realise that maybe it is something I do need after all.
I'm currently taking 50 mg and there are no plans to increase it yet. Everyone here is hoping that that will be enough to stabilise my mood again, seeing as that level kept my mood stable for over a year. If I have to take a higher dose, I'll be really annoyed with my psychiatrist for taking me off it in January. But fingers crossed, 50 mg will be enough.
And the distress that was planted in my brain, still remains…