Taking anti-depressants

“You need to press the reset button,” said the doctor. “I’m prescribing  Citalopram. On a low dose it acts as an anti-anxiety medication. On a high dose it is an anti-depressant. It takes about a month to start working.”

It has been over a year since I first wrote about my panic attacks and struggle with anxiety and exhaustion. There were lots of things that I did  to help myself get better and if I learned anything it is that there is not a simple, “one size fits all” solution for anyone. But something that did work, and people don’t really talk about, was using an anti depressant called Citalopram. 

At the time I saw it as a last resort. I had been offered it several times until I finally relented. I had already reduced my workload, taken up yoga, changed my diet, slept more and redistributed household responsibilities. Unfortunately I still couldn’t quite stop the panic attacks which began whenever I experienced anything mildly stressful including every day activities such as running late for school drop-off, watching the kids play sports, drinking caffeine or alcohol, making decisions,  interviewing people for articles, socialising. Despite months of trying I knew I wasn’t going to crack this nut on my own.

“How often is this happening?” said the doctor, the fourth in my regular surgery that I had seen about these issues since they had begun. “Anywhere from once a day to ten times I day,” I said, my voice wobbling, like it does when you don’t want it to.

“You need to press the reset button,” said the doctor. “I’m prescribing Citalopram. On a low dose it acts as an anti-anxiety medication. On a high dose it is an anti-depressant. It takes about a month to start working.”

“OK,” I said noting that the dose for anxiety issues is 10mg per day. It is higher for treating depression. She also gave me a referral to the charity “Healthy Minds” which offers support for panic disorders and depression.

Within a month of taking the Citalopram the panic attacks had stopped. The reset button had been pressed. It worked. It seemed to generally desensitise me to what I had perceived to be stressful situations. I was not overreacting like I used to. I also felt a bit sick and had headaches. But these passed after the first few weeks. I wondered what side effects other people had. The desensitisation aspect didn’t only apply to stress, EVERYTHING was a bit less intense. In some ways that was great. Goodbye panic. In other ways, like in the bedroom, it was really not great, but like the headaches things got back to normal after a couple of months.

The referral to the Healthy Minds service turned out to be a postcode lottery. Because of the location of my doctors surgery (Buckingham) the nearest support groups were an hour away (Aylesbury) and had a waiting list of two months. The waiting list for a therapist for one to one support was even longer and would be in the same location. So I chose the third option, an online cognitive behavioural therapy system called “Silver Cloud”. I worked through a module every week and at the end of it a trainee psychologist called me to read out the answers and provide no insight or counselling. It was rubbish. The only positive thing I took away from this was that it helped me to label my trigger for stress: “excessive responsibilities”

As time went by and I felt like my old self again I found that I was pregnant and I stopped taking the Citalopram. I did not seek medical advice, which was stupid, I just stopped taking it. This was a mistake. A black cloud hung over me and despite being delighted at the idea of another child, I was so miserable I couldn’t even laugh at Ron Swanson’s pyramid of greatness in Parks & Recreation.

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If you don’t watch Parks & Recreation then I urge you to download it.

 

When the pregnancy failed I felt even worse. “It is normal to have suicidal thoughts if you stop taking Citalopram too quickly. You need to wean yourself off it,” said my brother who is a mental health nurse. Shit. I was miserable because I was no longer pregnant and because I had inadvertently plunged myself into a chemical depression. So I started taking it again.

The following summer I had been feeling better for months and decided that it was time to wean myself off the medicine.  I hoped that I had made enough changes for the symptoms of stress to no longer exist when I came off the medicine. This is something that people should really be given more advice about. Honestly I think it just depends on the doctor that you see. Some will insist on reviews every six months to monitor your progress. Others will see you as fixed as soon as the Citalopram starts to work and keep the repeat prescription going forever. But anyone taking this sort of medicine should definitely see their doctor if they feel they want to stop. Don’t plunge yourself into a pit of misery like I did the first time around!

But less of the misery – it is Friday. Happy weekend everyone! If you have experience of these medicines then it would be great to hear about it. No-one talks about these things. Let’s compare notes. You never know, it might help someone.

Update: These are a few of the things that I did that really helped me manage anxiety and prevent panic attacks.

 

Happy Anniversary Norm

To celebrate our anniversary I have dug deep into the archives of my computer and found the speech that I did for our wedding.

That’s right folks. I made a speech. I can’t understand why in today’s modern society women remain mute at the wedding that they (and their groom) have probably organised and paid for. So I insisted on giving a speech and here it is.

Today is our wedding anniversary and like every other year we forgot to buy each other a card. Despite talking about how we “really should do something special this year” we have once again been thwarted by Christmas and generally being too busy to take some time out to appreciate each other.

So Norm this post is to tell you that I do appreciate you. I appreciate your sense of humour, your kind heart, your immense work ethic, your encyclopedic knowledge of animals and the fact that you are an amazing Dad. To celebrate our anniversary I have dug deep into the archives of my computer and found the speech that I did for our wedding.

That’s right folks. I made a speech. It may not be traditional but society has moved on and I’m suprised that more women don’t do this. Anyway here it is:

Continue reading “Happy Anniversary Norm”

The missing keys…..

Norm has lost his car keys. This is a MASSIVE problem for me. Because even when I tell him exactly where something is he still can’t find it.

“Dette where are my boots?”

“In the shoe cupboard.”

“No they aren’t”

“Yes they are”

Because they are. Admittedly there are about 100 pairs of other shoes in there too but they are there.

“Oh yeah, under the other ten pairs,” he huffs like it is my fault that we all have feet.

So in respect to the car keys I am clearly going to have to find them because there is no way that he will. I have looked in all of the usual places, then I looked under them and then I looked in the unusual places – next to the toilet, in the bins (gross), in the kids rooms, in Norm’s pockets, in the garden, in all drawers in the house. No keys.

Naturally at the time of seeking the keys I needed to go out and the clock was ticking. I had one hour. Every 15 minutes Norm would call and say helpful things like:

“Have you looked on the sideboard where I always put them?”

I’m not a moron Norm.

Then 15 minutes later:

“Have you looked under the sofa?”

Stick to building state of the art race cars Norm and leave the tricky shit to me.

The keys did not reappear in time for me to go out. “No spare?” asked a friend. This made me smile because Norm wouldn’t buy a spare key. “For £300? No chance,” he said.

I continued to pull the house apart checking all the washing baskets (we have many – too many), under all the beds, in toy boxes (just in case), on bookshelves, even in the Halloween sweet buckets but the more I looked the less convinced I was that the keys were in the house. We had established that Norm was the last person to use them and I suspected that he still had them somewhere. Somewhere like in his pocket. I could imagine him shouting down the phone at me “For the last time Dette they are not in my pocket”while the keys sat there in his pocket laughing at him because they had been there the whole time.

A couple of hours later Norm barged in waving the keys with a huge grin on his face like a kid waves a medal. “They were on the drive Dette. They must have fallen out when I was lighting the pumpkins last night. Feel how cold and wet they are”

Yes they were cold. And wet. But Norm is no fool. He clearly rolled them in the wet grass after he found them where they had been all along. In his pocket.

“They were not in my pocket Dette,” he keeps saying every 5 minutes.

The lady doth protest too much methinks.

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The mysterious keys. I plan to hide them from him tomorrow so that he can spend 3 hours searching the house…..

 

Panic attacks: what the doctor said

“When you are stressed you start to breathe using shallow breaths and this leads to hyperventilation. When you hyperventilate your blood chemistry changes significantly and that has all sorts of effects,” said the GP

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The Scream, by Edvard Munch  is understood to depict the Norwegian artist’s own panic attacks (Public domain via Wikimedia Commons)

After the trip to A&E I went to see a GP that my brother (who is a mental health nurse) told me was good at dealing with stress related issues. He diagnosed me immediately. “These were classic panic attacks, brought on by hyperventilation, brought on by stress. You can’t get over a simple virus because you are too run down. You need to make some changes.”

Excellent. Whilst there can be no doubt that I was delighted to hear that I didn’t have a heart condition, pulmonary embolisms or some kind of persistent lung infection,  the news that it was something associated with stress and mental health was hard to hear. It wasn’t medicine that I needed, it was to make some lifestyle changes.

Continue reading “Panic attacks: what the doctor said”

Trying not to die on the way to football

I am sharing my experience because a lot of people suffer from physical manifestations of stress and anxiety and until it happened to me I didn’t think it was real. Now I know better.

I had been slightly breathless all morning but I didn’t have time to dwell on it. The mild respiratory virus that had been bothering me for a few weeks was refusing to shift but there wasn’t much I could do about that. Life sped on. I needed to file an article that I’d finished the night before; my 7yr old son needed to be ready for his football tournament which was starting at 9am (where were his socks – arrrggghhh); my 3yr old daughter needed getting ready for nursery (“I not going to nursery today,” she yelled) and I had planned to throw some food in the slow cooker before we left (it wasn’t going to happen).

But by the time we were on our way to the football, 20 minutes later than planned and struggling to find the ground, the breathlessness demanded my attention.  Every inhalation felt inadequate. There just wasn’t enough air getting into my lungs. My chest was tight and sore in a burning, itchy kind of way. I put my head back and inhaled harder. Only when my lungs were fully inflated did it feel OK. I did it again and again. But the dizziness and disorientation were getting worse. There were pains in my chest, high up near my left breast.  I opened the car window and the cold air flooded in. It felt better, a bit. “Mum it’s cold,” shouted a voice from the back. I ignored it.

I was so dizzy that I thought I was going to faint. I gripped my car seat and looked straight ahead hoping that I wouldn’t pass out. We were running late as it was. My son did not need to see his Mum fainting. My husband stoically kept driving. I don’t know what he was thinking.

A few minutes later we arrived at our destination. I couldn’t get out of the car because I couldn’t stand up on my own. I was too weak and I was shaking too much. “What the fuck was happening?” Surely a virus couldn’t cause a heart attack? Was I going to die? I didn’t know what to do. I used the car door to pull myself up. My husband took my arm and helped me out. My son ran ahead oblivious, excited about his match – I was glad that he hadn’t really noticed. We walked over to the pitch slowly and I leaned on my husband like I’d lost a leg. “Phone the doctor,” he said.

The duty GP at the surgery told me to go to the nearest A&E. “I had a chest X ray last week because of a respiratory virus and it was clear.” I said not wanting to waste anyone’s time. “Things can change in a week,” said the GP.  “It is not worth taking any risks.”

Luckily the grandparents had come to watch the football too, so we were able to get me to hospital without ruining the day for my son. By the time we walked into A&E it was all starting again. As I struggled to breathe, the dark patches in front of my eyes got bigger and I had to cling to the wall to stay upright. I was helped into a wheelchair and I wasn’t even embarrassed about it. I knew I couldn’t stand up. Then the shaking started. The only time I had ever had the shakes was when my body reacted badly to all the drugs I’d had when I was having my first baby. But it was happening again.

A nurse took me into the triage room and started to monitor me and ask questions. They did an ECG. My heart was galloping and I had an arrhythmia “But that can be normal,” she said gently.

They would take blood and monitor me for a couple of hours they said. I was put on a bed. I felt bad that I got a bed when there were some very frail and poorly people in that waiting area. “I am healthy. I am only 38. It was my birthday last week. I go running.” I said more to myself than anyone else. And to be honest I hadn’t run for weeks now.

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Norm being his usual sympathetic self

Next to me a lady was crying as she sat in her wheelchair. Blood from her hand was slowly dripping onto the floor. The man next to me was vomiting sporadically into a bag, you could hear that his stomach was empty from the empty wretching sounds. A drip was attached to replenish him. The girl opposite looked like she had been beaten up, her face was swollen and she was crying. Two police officers sat with her, two more were by the doors. In the corner a man sat coughing, hacking up flem into a cup every ten minutes or so. The woman next to him yelled “for God’s sake” every time he did it and sat with her back turned to him in disgust. An elderly man nearby was yellow and quiet, he told the doctor that he had the runs. They told him that his kidneys were struggling, he was very poorly and he needed to be admitted.

There is no such thing as privacy in A&E.

“Hello Sweetie,” said a gentle voice, so kindly it brings a lump to my throat to remember it. “I’m going to put this cannula in so that we can take some blood,” she said. Her name was Maria and despite the full waiting room, the police, the hacking, the bleeding, the crying and the relentless pressure that she was undoubtedly under, Maria still cared enough to make eye contact with me and be kind.

After 4 hours of tests and waiting the results were normal. I was not having a heart attack, there was no fluid in my lungs. But the score for a protein related to blood clots (D Dimer) was on the high side so they decided to do a CT scan to check for pulmonary embolisms. That too was clear. There was nothing wrong with me. I wasn’t dying. I should go home. But what was going on?

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CT scanner: the drugs that show up any clots make you feel like you have wet yourself – odd

“These were classic panic attacks, brought on by hyperventilation, brought on by stress,” said the GP that I visited a few days later to try and make sense of what had happened. “You can’t get over a simple virus because you are too run down. You need to make some changes.” he said*.

*He said a lot more than that and I’ll give more information in a future post

**I am sharing my experience because a lot of people suffer from physical manifestations of stress and anxiety and until it happened to me I didn’t think it was  real. Now I know better.

 

 

Dette Vs Norm

In building my new blog I’ve been updating my old blogs. Here is the one where we nearly got divorced over swimming…….

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Someone copy this in case I ever go missing.

For some time now I have been trying to get Norm to accompany me on the boring exercise routines that pregnant women are encouraged to carry out. So far he has accompanied me on one walk around the local park where he complained of being bored half way around and sat on a bench waiting for me to finish walking. This obviously led to a massive row and me crying in the street.  Norm then started walking a lot faster to try and get away from me (note from the future: what a tool. I hated him so much that day).

When the pregnancy was first discovered 3 months ago he promised to come swimming once a week. But so far he has not been. To be fair he has been away a lot and not really had much opportunity but he was off work on Monday and therefore able to swim with me. So as soon as he was awake I said “will you come swimming?” and he unenthusiastically said “all right then”

The next few hours passed quickly with me researching an article and Norm playing on his PSP (his new PSP as he punched his old one right in the face for not working properly and broke the screen – effectively killing it) (PSP? I’d forgotten that they even existed! How far technology has come in 7 years). By about midday Norm had graduated onto the Wii and was playing tennis and boxing. That is when the warning signs began.

Norm: “Pass me a towel Dette”

I.e. look how hard I am working on this game.

Then a bit later.

Norm: “My arms are sore now. I have done loads of exercise today.”

I.e There is no need for me to go swimming.

I was ready for him. “We are not swimming for you, we are swimming for the baby. So have a rest ‘cos we are going at 3. And we are walking there.” (have a rest? This concept is hilarious now that we have two children. Come to think of it so is the idea that Norm can have mid week time off where he plays computer games all day)

Norm: “I am not walking home with wet hair. I just had a cold.” (pussy)
Me: “Fine, I will walk up and meet you there.”

By 2.45 I was ready to go. Norm was still playing on the Wii, with no signs that he might leave the house. “I am going to measure the floorboards we need in the spare room now,” he said and put down the Wii controller as I picked up my swimming bag.

I saw red. The bastard was not going to come. He was going to pretend to meet me there and then not turn up. “Fine.” I shouted. “Dont come. I don’t need you. I don’t need you now and I don’t need you when the baby is born.” And I slammed the door so hard the windows shook. (I should have poured my half drunk cup of tea over his Wii)

By the time I got to the leisure centre I had my life as a single mother all planned out. I would live in my house up north. Pay my brother and Mum to babysit and earn lots of money and never be lonely and never miss Norm. And when people asked where the father was I would say “I had to leave him, he wouldn’t come swimming with me.”

Had I overreacted? Probably. But the point was quite serious. I just wanted a bit of support. Norm would hate it if I gained 5 stone and sat on the sofa eating cake.

I had calmed down by the time I got into the water and set off. Swimming is boring but it was nice to be weightless. And then 6 lengths in a miracle happened. Norm got into the pool. Hooray. He does love me after all I thought. He didn’t look very happy to be there, but he had come and after about 10 minutes I think he was enjoying it. It was much less boring and he tried to teach me to do handstands.

After we finished swimming I was very glad I didn’t have to walk home, it was freezing. Norm had redeemed himself and I didn’t have to leave him after all. (phew, the kids quite like him and he is pretty handy when the car breaks down)