This train terminates here

Until recently I was avoiding getting the help I needed. It wasn’t that I didn’t want help, or even that I didn’t think I needed help, it was just that I felt so completely beaten by everything that I didn’t know how to start thinking about where to start. To some extent, I suppose I had decided that I was beyond help – that this really was it, and there was nothing that I, or anybody else, could do to stop it. Over the course of the piece, there had been a few abortive attempts to get help but I always managed to straighten myself out just enough to be able to think I could manage my symptoms on my own; the lesson I learned during the months I was managing on my own was that I couldn’t actually manage on my own.

When you’re in the middle of an episode it’s incredibly hard to admit that you are having problems coping with yourself and that life has got too much for you. Nevertheless you need to try to focus the mind so you can reach in and grab yourself by the scruff of the neck; in the end, all you’ve done is take a wrong turning somewhere along the line and what you need to remember is (motivational quote warning):

“When you board the wrong train it’s no use running along the corridor in the opposite direction”

Eventually I found the strength to stop running and get off the train.

Step one in the right direction was booking an appointment with my GP. Over the years I have been fortunate in almost always receiving excellent care from the GPs I have been treated by (when I eventually engage) and my recent experience has been no different. Quite aside from the relief of getting in place the interventions that I knew I needed, just getting to the doctors’ surgery felt like and achievement and a baby step towards a better place. I left the surgery with a psychiatric referral and a referral for a refresher course in cognitive behavioural therapy (CBT) as well as a prescription for the anti-depressant Citalopram. Anti-depressants aren’t new to me, but are a form of treatment that I have tended to resist in all but my bleakest times. It felt like it was a big thing for me to decide that an anti-depressant was right for me at the moment. Although I had a few concerns, they were quite easily dealt with in the end:

• Anti-depressants aren’t prescribed in the short-term, so I knew that if I decided to go down that route I would have to continue taking them over a period of months and that a managed withdrawal would be necessary – on balance that didn’t seem like a significant reason not to take them
• I haven’t always had a good experience with anti depressants, on occasions becoming numb and more withdrawn and on others experiencing a significant worsening of my self-harming problems – I chatted this through with the doctor and we agreed that I would continue regular appointments with her throughout the course of treatments so that my state of mind was properly monitored. We also spoke about my strategies for managing any crisis intervention that might be required, and I felt a little better knowing I had a plan.
• I’m only too aware that medication alone is not the answer to depression – this isn’t a real concern if the other things you need are being put into place
• I was worried about short-term side effects having an impact at work – this one didn’t really fly, because my symptoms were already affecting me at work

Once I’d had the chance to talk and think things through, it seemed like a good idea. At the heart of my decision to medicate was the simple fact that I needed to get from a to b and that once I’d dragged myself through the motions I didn’t have any energy left to make that particular journey.

I’ve been taking the Citalopram for just over three weeks now and feel like it is helping to clear the fog. I did experience some early side effects (restlessness, heightened anxiety and difficulty sleeping) but these passed in a fairly quickly. I was also a little bit too ‘up’ for a couple of days, with a ridiculous number of disjointed ideas and plans flying around my head but this also seems to have passed – I wonder if I just wore myself out?!. Now I’m starting to feel a little bit more like myself at last; Citalopram hasn’t been, and isn’t likely to be, a miracle cure. Still it feels like a tiny chink of light is shining into my dark space and I feel able to think about what I can do next to support myself and manage my symptoms.

To return to my train analogy, it feels like I might be about to board the right train…… I suppose this is where the hard work starts.