Living With Antidepressants

Living with antidepressants is something I deal with as I seek to better my mental health. I wrote about my struggle with depression here and mental health issues in the business world being taboo. I expected that someone somewhere would use my disclosure against me at some stage. This hasn’t happened. What has happened is that many people have reached out to me publicly and privately to say it was a helpful blog post. Whether from getting the subject on the table, or it giving a mental health sufferer some notion they aren’t in some way damaged goods in the business world.

I’ve used my own disclosure to support other people in our business who may be encountering problems. This has been important especially given the COVID pandemic, which has caused untold stress and anxiety for people. We have monthly company-wide wellness sessions; we have set up other resources such as a call line and access to mental health professionals. Thankfully this kind of facility is being made available in many companies.

In this blog, I will touch on my use of antidepressant medication in recent years. If it’s becoming more acceptable to talk about mental health issues, then the use of medication deserves to be in the open too. I take a selective serotonin reuptake inhibitor (‘SSRI’), in my case, the prescription being for Sertraline. See below an excerpt from the website of Mind, the leading mental health charity.

Antidepressants work by boosting the activity of particular brain chemicals, or making the activity last longer. This includes noradrenaline and serotonin, which are thought to be involved in regulating your mood. Noradrenaline and serotonin are neurotransmitters. This means that they are chemicals which pass messages between nerve cells in your brain, and between nerves and other organs in the rest of your body. By causing a change to your brain chemistry, antidepressants may lift your mood. But antidepressants don’t work for everyone. And there is no scientific evidence that depression is caused by a chemical imbalance which is corrected by antidepressants.

https://www.mind.org.uk/information-support/drugs-and-treatments/antidepressants/about-antidepressants/

Depression isn’t a trivial issue. It’s not a case of simply ‘feeling down’. It can seep into every corner of your being, every corner of your life. As well as being challenging to live with, it is proven to increase the risk of early death through events such as sudden cardiac arrest.

Depression is on the rise in every age group and every socio-economic group, and in every region of the world. It is the predominant mental illness worldwide, followed by anxiety, schizophrenia and bipolar disorder. In the UK, it is the number one cause of illness in the workplace. Yet, as mentioned in the opening paragraph, it’s still relatively off-limits as a workplace discussion topic.

Antidepressant prescribing has increased substantially in recent years, and 7.3 million adults now receive a prescription for antidepressants each year. For many, it becomes a long term medication — one in eight of all UK adults. Now ask yourself if you are aware of a colleague taking antidepressants? Probably not would be an educated guess, yet the numbers say that one or more people are taking medication in your workplace. A lot of people are living with antidepressants.

It is the right of all of us to privacy; it’s not a given we should declare what medication we take. I suspect that this is one of those areas where it’s still a delicate discussion. I have no issue saying I have a family history of heart disease, and my cholesterol is slightly high, so I take a statin. But to tell you I take an antidepressant? — that’s a different disclosure. Even typing this sentence makes me noticeably more anxious than typing the sentence on statins.

Living with antidepressants; dark iPhone self portrait of me leaving a therapy session.

My journey towards living with antidepressants was a long one. I had a two year period in psychotherapeutic therapy, and overall it helped me. It was a painful road, as it dredges up everything from one’s past. In my case, even though I approached the process with great openness, I was stunned by the power of some of the unconscious memories. Not good memories. I continued for two years and ceased when I felt I was in a better place. I’ve used a substandard photo in this blog. It’s a blurry and dark winter’s evening shot. Standing outside the therapist’s door after a session reminds me that some of those sessions were tough.

Two years later, I was struggling with depression again and went through a second round of therapy, and again it lasted two years. During this period, I went through a major life change too. In the end, the process wore me down. There are only so many times you can revisit your past life and pore over events in microscopic detail. I get it. Your early life can fuck you up.

If you’re a lifelong depressive, you find coping mechanisms. I’ve managed to have a rewarding and enjoyable career. This despite rolling waves of depression over the years. I’ve only once felt my depression affected my behaviour in business, resulting in me going to therapy for the first time. I wasn’t acting as effectively as I could have been and was getting frustrated, and my closest colleagues were getting the blowback of that. I confided in them, and they were nothing but empathetic and supportive, and any apology I made for being … an arsehole … was brushed aside. Eternal thanks to those people for sending me on a long and productive journey.

Perversely in my darkest days of depression, I found myself turning into a highly supportive coach to my team. A health professional I know suggested that I was manifesting my need for help in helping others. I thought about that a lot, and on balance, I can see the argument. I was sleeping very little, highly anxious, and yet showing up at the office and being a patient coach. ‘Patient’ doesn’t get applied to me very often.

I finished therapy, and as happens every 18–24 months, along came my old companion depression once more. Ever so gently creeping up behind me, whispering to me at 3 am, managing to make a sunny day seem slightly faded. Turning up the wick on my anxiety, making me hyper-sensitive in some areas of my life. Giving me a feeling of physical fatigue that’s hard to describe.

I didn’t want to go around therapy again for two years, so I went to my GP and discussed my situation. He suggested a short course of Sertraline. We discussed the potential side effects. I wasn’t really concerned about the side effects, and none of them has come to pass. Perhaps a little worried about being dependent on chemical intervention. I don’t know why I was worried, perhaps a sense of giving up control of my brain to some extent. Living with antidepressants, on reflection, was a major decision for me.

I had this strong feeling that I may be crossing a line professionally that I couldn’t go back from. In the same ways as my first discussion on my mental health with colleagues filled me with tremendous foreboding, the same was happening here. I took a deep breath and talked to a senior business figure who I knew well. He was nothing other than supportive on broaching the subject and said, “a small white pill has helped me tremendously.” We build up these fantasies we are on our own, that no one else has the same challenge, yet we find the challenged all around us.

Nothing happened for two weeks and then three weeks after the first small white pill. Then gradually, life seemed a little sunnier. That’s all I can describe it as. I was enjoying things that had been a struggle. There is a huge debate as to whether these medications work or not. The benefit sidled up to me ever so slowly, and that’s my reasoning for believing they work. I wasn’t waking up every day wondering when the medication would work. I just felt happier. Of course, it could have been a natural cycle in my chemicals, but then again, the timing of my upswing was more than coincidental.

After a year or so, I spoke to my GP, and we agreed that it was probably time to taper off the Sertraline. Did I want to live with antidepressants permanently? — probably not. I did this in my usual careful way, ever so gently reducing the dosage over six weeks until it was at zero. Some people have me down as a rash and impulsive type. Those people don’t know me; by the time I’m looking rash and impulsive, the thinking has been in the works for weeks, months or sometimes years. That was my first experience with antidepressants, and it was nothing other than positive.

My second experience started in a much more dark place. I had gone through a long period of poor sleep, and rising anxiety and not much was fun. I was still working, and indeed this was the period where I went through my coaching period with my team. Afraid of going to bed at night, as I knew hours of anxiety and fantasies of a catastrophe were ahead of me. One morning I woke up, and my heart was racing. I took my blood pressure, and it was dangerously high, to the point I wasn’t aware it could be that high. A visit to my GP surgery ascertained I wasn’t at risk, but that action was needed.

A day later, I met with my long term GP, and we discussed my mental health and whether it was time to return to medication. I was concerned about the concern I was causing my wife. Mental health issues don’t affect just oneself; they affect those close to you as well. So I went back on the medication. Funnily, I had a couple of nights of excellent sleep; the act of talking with a health professional relaxed me to an extent. But the medication kept me waiting this time. In fact, I got worse for a few days, then started a prolonged improvement. It was a full six weeks before I was in decent shape. A testing time, I wondered if I was going to get there. Oddly a serious event in the external world drew my attention, and that seemed to take my focus off my own challenge.

After starting the medication for the second time, I again confided in a very senior mentor and role model. This person was nothing other than supportive; there was no drama or concern in the conversation. I was doing what needed to be done to keep myself doing what I enjoy doing.

I’m still on the medication; it’s been over 18 months now, I’m happily living with antidepressants. I haven’t suffered any full-blown depressive episodes. I have been aware three times that depression has been hanging around in the shadows of my peripheral vision. But it hasn’t broken into plain sight. I don’t want to stop taking the medication. But I’m concerned about using it as a prop. I still don’t worry about side effects, short or long term. But I worry about my concept of self. Am I myself and succeeding on my own terms? Or am I doing it in tandem with drugs? And does that really matter?

Life is currently good. Business life is good; things are going well. Would my team be concerned or not to know I was on antidepressants? My feeling is not. In my wider external stakeholder network, would people be concerned? I’m less confident there. We all have supporters and detractors in this world. And there are subjects which are simply uncomfortable for us to confront in business. I believe the subject of mental health is much higher on the agenda in society in general. But in business, while many are taking action to further the dialogue, it’s still a somewhat delicate area. I can only think that business is a modern arena for us to compete at some level, with ourselves and with others. And who likes to show weakness in a competition?

I will close by saying you’re very welcome to contact me if you want to discuss any aspect of this further. If you’re living with antidepressants and want someone to talk to, here I am. I received a lot of correspondence from people when I wrote my first blog about mental health being the last taboo in the workplace. The sheer numbers of people being prescribed antidepressants tell me that there will be quite several people in my own world dealing with depression.

Originally published at stephenmoon.com.

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