Taboos, tinsel and tablets

It’s a few weeks since I put pen to paper and wrote my blog; weeks that straddled the Christmas and new year holidays and the mince pies and the tinsel (two of my least favourite festive traditions!).The last time I blogged, I was emerging from a dark and difficult few days - the longest episode I have experienced - of painful and at times crippling depression and anxiety. I emerged into the light, helped by having my hand held by my extraordinary wife, with my mojo back fairly quickly, but I made a decision. This cannot go on. I need to being in reinforcements. I need further help. I decided to make a trip to my GP and ask for a referral to see a psychiatrist. Having been around the NHS and healthcare for many years, I already knew what he would say; no problem, but you’ll have to wait to see someone. I had guessed he would say around 12 months; instead he said 18-24 months. As anyone who has been ill - whether it’s with a sore throat, the flu or a serious mental health condition, you know that you don’t really want to wait 18 minutes, let alone 18 months. When Dr J and I left our high stress but high reward world of London-based corporate life, we missed very little. In fact, hardly anything at all. But we did miss the access we got from our jobs to the fast track lane of healthcare through private medial insurance in the moments when you just can’t wait. Old habits died hard so we invested in private medicine ourselves, taking out cover for all three of us. We have thankfully had very little call on it but was delighted to be sitting in front of the psychiatrist of my choice last week, less than 10 days from the original GP appointment, for my shrink consultation debut. There is another blog for another time about the vacuousness of the promise made by this government to provide parity of esteem between physical and mental health - they may have parity in principle but not certainly not parity of funding.As I have written before, I’ve had three periods of psychotherapy over the last fifteen years of so - all of which brought me huge benefits - but I had not yet taken the step of seeking the help of a psychiatrist. Why this time? I felt I had uncovered many, many answers about my life, how my brain works and how and why I react the way I do - often shaped by my life and experiences, especially in my early life - but I still had questions. I wanted a fuller picture. I wanted to hear more. We are each different and tackle challenges we encounter in our style and in our own way. For me, getting an understanding of what is happening to me is the key. I like to be able to put a name on something; to call it; to look it in the eye. My goals were to reach a point where I had a more formal, clear diagnosis of what was happening to me and to make any changes I could to address them. I’m no doctor - although as I was fond of saying when I worked at the General Medical Council, I did help regulate them for years - but I knew two things. I had depression and I had anxiety; they often appeared to arrive together and they were not welcome when they did. But I didn’t really understand the relationship between the two. I had assumed (I now know wrongly) that it was my anxiety - my desire for safety and security and feelings of deep discomfort when they feel threatened - that prompted the black hole of depression to open up and me to occasion fall inside. Not so. I do have those anxious tendencies and I do many of the things I do to maintain a level of control and comfort over my surroundings, my routines (including my obsession with timeliness) and my life; to feel safe and secure. But my brushes with anxiety were not causing my depression. I was most likely born with depression. I’ve probably had it all my life and it is a stand alone problem, although of course it doesn’t help the anxiety when it decides to pop along too. This news and clarity is a mixed blessing. In the course of discussing this with my psychiatrist, I now have a much better sense of what I’m dealing and know that all the good stuff I’ve been doing to work on my wellbeing is valuable. It’s helpful. It won’t be lost. But - and here’s the kicker - the depression isn’t going anywhere. Becoming less anxious and more mindful as well as reducing or eliminating stimulants and triggers for anxiety - albeit a great thing to do - won’t send my depression packing. I’m stuck with it and it with me. So that took me into the inevitable conversation I have rehearsed in my head but avoided having for some time. The conversation about medication.Like many of us I hear the words “anti-depressants” and slightly shudder. I don’t need them. I don’t want them. I’m not that sick. I don’t want to get addicted. I don’t want them to change my personality. I want to still be me. I had my questions - my reservations and excuses - ready. I knew that some of them were illogical or irrational and certainly flew in the face of how I feel about taking my hay fever medicine or antibiotics if they are ever prescribed. But I had them all the same.  Once again that day I was glad I was sitting across the desk from a consultant who had been doing this for nearly 35 years and had seen it all before. He was able to provide me with the reassurances I needed and the evidence and objectivity that science and scientists bring to the table. He was able to help me work through a notion that I have wrestled with for some time; the idea that submitting to medication means that I cannot handle this myself. That somehow reaching for the pills meant that I had failed. I know that is wrong-headed but it was in my head. It was how I felt. I also feared being judged for taking anti-depressants and fell into the trap of seeing them as a taboo not to talk about; not to admit to; not to accept. So here I am. Taking my daily dose of Citalopram. Continuing to follow my good habits of exercise, sleep, rest, reading, music, caffeine-free tea and the like. Taking each day at a time. It’s far too early to say whether this new tool in my wellbeing toolkit will work but I can say with confidence that I am still me; still working hard at being the best version of me I can be and now accepting that sometimes it takes the help of some science too.I’ve also accepted something else. It is has made me realise that of all the reasons for avoiding medication the taboo of taking them is the daftest reason of all. As with tinsel at Christmas, there is no place for taboos in life.