The withdrawal method

In my experience, there are two types of doctor. One who enjoys the stimulation of a well-informed patient - someone who has done their research and arrives in the room with Google-sourced print-outs - bringing their own ideas, questions and proposed plans of action to engage in a proper discussion about the diagnosis and the treatment required. The second, rolls his eyes (this type in my experience tend to be men) and struggles to disguise his dismissal of the amateur medic’s theories and ideas, based as they often are on chat room-inspired tall tales of disaster and horror stories. They mouth of the words ‘patient voice’ but are still wedded to a paternalistic model in which the doctor knows best. 

Although I prefer the former stethoscope wearer, I have a little sympathy for the latter. 

Sadly, the bit of the internet labeled “google your symptoms” or “check out the side effects of drug X,Y or Z” is full of scare stories and bad news. I will be kind and say that it is mostly well-meant and accurate stuff - accurate in the experience of the author - but it unfortunately gets used as the single source of truth of what will happen to every patient in the same or similar situation. 

I understand the temptation - which in the best traditions of all great temptations - is virtually impossible to resist - of reaching for the iPad, phone or laptop and open the door into the paranoid patient room. I have spent many an hour in there, finding out how my mild and common symptoms are certain to lead to my imminent, painful death. I know too that in the world of mental health there are fewer more terrifying online rooms to enter than the one with the door marked “how to come off your anti-depressants”. 

This is a dark space. I can vouch for there being very few happy endings waiting your arrival and very, very many stories of how your life is about to get a lot worse if you try to do it - possibly the worse it could get. There is nothing more sobering than a depressive (which is a term I happily use for myself) hearing about others in your boat trying something you are contemplating only to take on water, listing and then drowning. This particular room - and some of my inbox and social media accounts over the last few days - is full of warning about the risks and dangers of trying to withdraw from medication. People - with every good intention - try to warn you that things could get worse and that you would be better not rocking the boat (sorry, that metaphor again). I hear the safety first, if it ain’t broke don’t fix it philosophy. I know that it is easier to do nothing - to keep calm and carry on - but I also know myself best and that the time is right for me to make a change. Why?

The last fourteen months - since I started taking my daily anti-depressant - has definitely had its upsides. The medication has helped me to enjoy a less anxious, calmer, slightly more chilled out day to day life. It has played a part in helping me feel more settled most of the time. It has been effective, to a point. But - and it is a big but - it has not reduced the frequency or the duration of my depressive episodes. I’ve had three in the last three months and if anything they are getting worse, or at the very least staying the same, when they do arrive. Treating these bouts of depression was the reason for starting on the medication and why I have stuck with it for the last 14 months despite some downsides. 

The short term and initial side effects of aggressive wind (lovely!) and some tricky dreams and headaches passed quickly and I have been left with an overall dulling of my emotions - the bad and, sadly, the good. Highs are not as high, even European Cup wins or 44 match unbeaten runs. I missed the tears when I hear You’ll Never Walk Alone or the lump in my throat when I think back to the day my darling Nan, Mary, died (16 years ago last month) or when I think about all the water that has gone under the bridge of my life since Alan Hansen lifted that shining league championship trophy and I watched with my tearey-eyed Dad from the sixteenth row of the Main Stand thirty years ago this May. A year after we all shed buckets of tears that are yet to dry. 

I now miss some of the rawness of my emotions. I miss the edges that have been ironed out. I miss it all, even some of the tougher points. I miss them because I still have my depression. It still appears, a little too often, and stays a little too long for my liking. The medication has not changed me and it has mostly helped me be a calmer version of me but it has not really done the thing it was intended to do. I never expected a magic tablet to take away all my issues but I was hoping for a little more. 

I am therefore left with three main options. Stick with my current tablets and appreciate and bank the positives that my daily dose has given me and live with the negatives. Stop taking it completely and try to go without - seeing if a more-informed, better-prepared, more-experienced me will find it easier to deal with day to day stuff and continue to face into the depression when it lands. Or I could switch to something else - a mood enhancer - possibly lithium - and try different, new medication. As is so often the case when you face three options, I have chosen to merge two and create a fourth. I am reducing my current dosage over the next two weeks and then going to see how life feels without any medication. I am going to see how I manage. I am going to work hard at all my normal wellbeing interventions and specifically going to step up my running to get more fresh air and exercise. I even went to church today - I will try anything!

I am scared. I am worried. But I am also up for it. I want to know truly how it feels and whether this period taking the medication has done something of a job and will help me go it alone. I would be lying if I said I am confident. I am not and I am ready - and partly expecting - to have to return in the short term to my current medication with a view to trying something new. Let’s see what happens. Only time will tell. 

None of this is easy. But when you live with depression, easy is not something you expect. Over the next few weeks I guess I will know more. Perhaps I will know myself better. Perhaps I will feel better. Perhaps not. Either way I will be in a better place - one with more answers, even if it’s not the ones I wanted to hear. I will taken another few steps on the road to living with my mental health challenges. I will have made some progress, even if it highlights how much further I have to go. 

Whilst I may be successful in withdrawing from medication - although the betting man in me says I will not - I will never withdraw from trying to learn more about my condition; my options; myself. I will keep entering that doctor’s room armed with all the information and understanding I can muster, because in the final analysis, it is my life - my brilliant, blessed, very tough, bumpy, beautiful life - not his. And only I know what is right for me.