My treatment journey

As we start amping up towards Apricty’s new show, Open Mic., I can’t help reflecting on the journey I’ve been on with my mental health over the past 4 years or so. Part of that journey is internal, sure, and to a certain extent controlled by me and my thoughts. But part of it – the treatment part – is a lot more reliant on outside advice and input.

The path to overcoming mental illness is unique to every individual walking down it – it makes it hard to talk about without worrying that someone is going to tell you your way is wrong, or will hear your words as someone telling them that their way is wrong. But there is no wrong, just different. You do you. As long as you’re on the path you’re doing great.

My path looks a little like this:

I was initially on medication for a little while. I say a little while, about two years, and actually I still kind of am. I was prescribed citalopram when I first went to a doctor, which is an anti-depressant. An SSRI to be exact (selective serotonin re-uptake inhibitor, basically it helps control the serotonin levels in your brain). I was given a 6-month prescription for 20mg and told that I shouldn’t stay on it any longer than that because it was highly addictive and I didn’t want to add another issue on top of my existing ones. During that 6 months I moved, which meant I changed doctors. So at the end of the time I went to see my new doctor to look at starting to wean off, and they suggested that if I wanted to stay on it because I felt it was helping or didn’t feel I could cope without it or whatever, then that was fine. So I did, because it was helping. It slowed down my thoughts, and although I did still have periods of anxiety it wasn’t as bad, and it tended to have an obvious trigger like a university assignment being due or something. While I was on the citalopram I didn’t spiral down from anxiety into depression, I levelled out a bit basically.

I know some people who say they really don’t like being on anti-depressants because they find that they become a bit numb and don’t really feel anything at all. That didn’t happen to me. My creativity got a bit dulled and I lost my imagination a little bit but not in a noticeable way for anyone but me. I didn’t really have any negative side-effects other than during withdrawal. Fucking hell that was awful.

Anyway, the second doctor dropped me down to a lower dosage and I basically swapped between 20mg and 10mg every 6 months for about 2 years, until I decided that I felt okay in myself and I wanted to try and come off it. Even though I wasn’t really experiencing negative side-effects the thought of being on medication for the rest of my life scared me a little bit. And I won’t lie, I knew my parents weren’t completely comfortable with it and I felt a little pressure from that to at least see how I coped without it. So over the course of a month or so I weaned myself off it – because you’re not meant to just stop cold turkey, you’d get really bad withdrawal effects because you’re messing with your brain chemistry really suddenly. The whole time I was coming off though I felt ill. It was like having a migraine and a hangover and PMS every day. Not fun, I wouldn’t recommend it, and it almost made me wonder whether I should have just come straight off, because at least then the suffering wouldn’t have been drawn out.

I spent 6 months or so taking nothing, and generally I was OK, but one week every month I would get to the point where my anxiety was so bad I basically couldn’t function, for no obvious reason. I mean, the obvious reason was hormones, but there was nothing external that would set off an anxiety attack or a day when I couldn’t get out of bed. Once I worked out the correlation between my period and my bad weeks I went back to the doctor again, and asked if we could work out a hormonal solution, see if that helped me level out a bit.

Now, I’d had bad experiences with the pill before – it made me really depressed, mood swings all the time, and it definitely increased my suicidal thoughts. You know, all those massively common side-effects of the pill that every single woman seems to know about but no one ever really talks about like it’s a problem we should maybe fix. But there’s different types of pill, so I figured he’d be able to suggest a different one to the one I’d been on before. First thing he suggested was going back onto citalopram, which I explained I didn’t want to do. Then he suggested the implant. Which felt like a very permanent and stupid option for someone who was essentially there because hormones had a massive impact on her mental health. And while this male doctor pointed out to me that it was fine, lots of people didn’t have any adverse effects from it and if I found I didn’t get on with it they could just slice my arm open and take it out again, I politely declined that offer. It didn’t seem all that appealing. I went on a normal, full strength contraceptive pill, and was on it for 3 months before I decided I needed to come off because guess what? I was getting really depressed and having an increase in suicidal thoughts. But it did make me feel consistently a bit shitty rather than super shitty once a month, so that was a step in the right direction. It also made my boobs bigger which was a side-effect I really miss, even if they did hurt all the time. Finally, I went back and explained all of this to the doctor (who seemed a bit miffed, but I was also miffed and slightly smug that it proved his implant idea was a bad one and I had been right), and he gave me a mini-pill, which has lower levels of hormone in it. Knowing my history with the pill I genuinely don’t know why he didn’t prescribe me that to start with. But either way, it’s what I’m on now. I have been for almost a year and it’s working out pretty well. I basically feel like I did when I wasn’t taking anything, but without the shitty week every month. So, while I’m not taking anxiety medication, I do take medication for my anxiety, and barring major incidents I think I’ll stay as I am for the foreseeable future.

I also see a counsellor once a week. I’ve been seeing her for again almost a year, although it really doesn’t feel like that long and I don’t feel like I’d be ready to stop seeing her any time soon. Though maybe that’s a failing on my part and a sign that’s I’m not very good at therapy and not putting enough into it. I like her a lot.

Not including initial assessment sessions I’ve seen 4 different counsellors now. The first one was only for a few weeks and it was through my church at the time, and while it was a totally safe and confidential space, I felt a bit weird about the fact she knew some of the people I was talking about, and for that reason couldn’t quite relax into it. Then there was a guy at uni who might have done more damage than good. Everyone says it, but finding a therapist is a process and there will some people you gel with and some you don’t and that’s fine. This guy I just did not gel with. He also told me he didn’t think I had anxiety, he thought I probably didn’t have anything wrong with me, was just going through a rough time or maybe I was suffering mild PTSD from my (quite recent at that point) shitty break up. And while yes that break up was responsible for a lot of the way I was feeling at the time, it wasn’t all of it. I also feel like I spent the sessions I had with this guy trying to get it right and say the right things, like I had to prove to him that I actually had something wrong with me, but also couldn’t quite relax enough to be honest and vulnerable with him. I do see the irony in that.

Next I started going to a counselling service recommended to me by my doctor – it’s here in Bath, it’s called Focus Counselling and they’re not sponsoring this post or anything but they’re really, really great. Their thing is person centred therapy (rather than cognitive behavioural therapy which is mostly what the NHS offers and I don’t know why but scares me a bit). I saw a woman there for about 3 months, and she was wonderful and lovely, and at the end of those three months I did feel like I was starting a new chapter and it was the right time to leave. I’d dealt with the stuff I went in to deal with, which was totally a product of that period of my life rather than the deeper, long term stuff that I was quite happily suppressing, and was really happy with my decision to move on. Then about this time last year I had an “oh shit, it’s not normal to not like yourself, maybe I have some crap I need to deal with” revelation, and decided that for that reason and many others it would probably be beneficial for me to start talking to someone again. So I got back in touch with Focus, and they matched me up with a different woman, but who again is lovely and wonderful.

I feel so safe with her and even the weeks when I feel like I’m being bad at therapy and wasting her time and putting off dealing with the stuff I’m there to deal with she is incredibly kind and patient, and there is an element of it just being really helpful to sit and talk to someone with no agenda, who will just listen and support you for an hour every week, whatever is on your mind.

The first few months – and even now a little – when people asked me how it was going and if I was enjoying it I didn’t really know how to describe it. The best analogy I have found is that it’s a like when you have a cramp and you have to stretch it out or rub it to make it go away, which really hurts and isn’t exactly pleasant, but you know it will make things better and so there’s a weird kind of pleasure in that.

I know this is quite an American idea and something that as Brits we slightly mock them for and feel uncomfortable about, but I think that maybe everyone should be in therapy. There’s not really a downside to it, other than feeling uncomfortable and self-conscious, but those are things that we shouldn’t have to feel when sitting down and talking about what happens in our heads. Sometimes it’s really, really, almost impossibly hard, but it’s always helpful to talk to someone. And therapists are detached from the other things in your life in a way that no one else can possibly be, which brings a real safety with it. So, yeah. I’d really recommend it. Even if you don’t struggle with your mental health and none of the other stuff here has resonated with you at all, you would still get something out of talking to a counsellor or therapist.

(And no, I don’t really know the difference. I know there is one, but I’m not sure what it is. Maybe you should go to one and find out.)

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