This week marks Mental Health Awareness Week, and I’m putting my two cents in. My own experience with mental health problems hasn’t been without its bumps in the road, and there’s a part of me that wonders if the journey could’ve been smoother if I’d known that the space you occupy as a person with mental illness is more crowded than you might think.
The fact is that 1 in 4 people in the U.K. will experience some form of mental health problem each year; put into perspective, that’s quite a lot. On average, that’s at least one per household, or six in an average school class size of twenty-four. Think about how many houses are on your street, how many streets are in your town. Think about how many classes are in your school, and how many schools are in your city. It is — for want of a better word — crazy.
Despite these high statistics, and despite the public’s drastically increased willingness to talk, talk, talk about mental health, the stigma is still here, alive and well. It’s still hard not to feel palpably other as someone with a mental illness, because mental health itself is treated as other. Attitudes to physical health are more forgiving, more simplistic in their remedies: if you’re diabetic, you need insulin; if you’re asthmatic, you need salbutamol. If you’re clinically depressed, you need… what? Fresh air? Herbal tea? God forbid you should be weak enough to take antidepressants.
I’ll always be the first to raise my hand and volunteer that I am 1 in 4. When my ~emotional abnormalities~ outgrew the Growing Pains excuse, I was finally given a diagnosis of Generalised Anxiety Disorder in January 2015, during my third year of university; I then made the decision to formally medicate my anxiety in October that same year, which by that point had become impossible to manage alone. For the last eighteen months or so, I have been taking citalopram, and as it is both the time and the place to do so, I wanted to share my experience with you all.
Disclaimer: I’ll be listing some background information on both citalopram and G.A.D. for context, but this post is about my experience with citalopram and my experience only. What works for me may not work for someone else, but I feel like my doubts about taking antidepressants could have been assuaged if I’d been able to find personal accounts such as this one in the decision-making process.
First, some background.
Generalised Anxiety Disorder is an anxiety disorder wherein a person’s long-term anxiety is stemmed from a wide range of issues rather than one thing in particular. Experience varies from person to person so it is a rather vague term, but common symptoms include restlessness, lack of concentration, heart palpitations, excessive sweating, depression, and insomnia, on top of the feeling of being constantly on edge, like something terrible is about to happen and there is nothing you can do to stop it.
Citalopram is a selective seretonin reuptake inhibitor (SSRI). SSRI-class drugs are thought to increase seretonin levels, which in turn helps to relieve symptoms and improve low moods. It is prescribed worldwide for a large number of conditions, commonly depression, anxiety, and panic disorders.
Because of the large spectrum of conditions it can treat, citalopram has an extensive list of side effects. Being the anxiously obsessive person I am, I did lots of my own research on antidepressents before talking to my GP about possible medication. When I read about all the side effects of citalopram, I struck it off the list of potential candidates, and honestly the only reason I’ve ended up taking it is because I didn’t have the energy to argue with my GP after my mum was forced to pretty much drag me to the appointment and shove me through the door.
The leaflet has a whole list of very common, common, uncommon, rare, and extremely rare side effects, and reading through them all before taking that first tablet really freaked me out. It lists:
Very common (likely to affect more than 1 in 10 people): sleepiness; increased sweating; feeling sick (nausea); headache; dry mouth (a dry mouth increases the risk of tooth decay, so be sure to clean your teeth more often than usual.
Common (likely to affect up to 1 in 10): lack of appetite; decreased sex drive; nervousness; abnormal dreams; problems with concentration; tingling, prickling, or numbness in the hands or feet; diarrhoea; constipation; pain in muscles and joints; for females, failing to reach an orgasm; loss of weight; agitation; anxiety; confusion; dizziness; tremor; ringing in the ears (tinnitus); yawning; vomiting; itching; for men, problems with ejaculation and erection; tiredness.
Most frightening for me was the fact that a lot of these side effects were things I was already experiencing as symptoms of my anxiety, the very symptoms I was hoping to treat. I was genuinely terrified of making them worse. However, the leaflet also states that ‘mostly the side effects are seen more at the beginning of treatment and tend to wear off after time’, so there was still a bit of hope.
I started off taking 10mg of citalopram everyday before bed, and I experienced every one of the very common side effects during the first few weeks of treatment. The sleepiness was actually really helpful; instead of laying awake with heart palpitations unable to switch off until 5 AM each night, I was taking my tablet at 11 PM and nodding off by 12:30 for a good eight hours. The nausea was awful, there’s no getting round the fact, but it didn’t keep me from getting up and dressed and functioning as I usually did, and it passed; same goes for the sweating and headaches. The dry mouth is also definitely a thing and continues to be a thing to this day; I’m thirsty a lot of the time, but it means I’m drinking more water, so my insides are probably thanking me for it.
The common side effects didn’t crop up as much; for me it was only really loss of appetite, decreased sex drive and abnormal dreams that reared their ugly heads. It made sense, because you don’t really want to eat or have sex when you’re feeling indescribably nauseous, and I always have vivid dreams when I’m feeling particularly anxious, although some of them have been more unsettling than usual.
Fast forward about six months.
Initially I was doing very well. The side effects had, for the most part, eased off, and I was feeling better than I had done in years. I was sleeping better, eating better, exercising more, and generally feeling happier and experiencing a more rationalised level of emotions. Any anxiety I felt was just a real, normal human emotion, not an amplified caricature of my worries.
Then, it all started to wear off. Just when things had started to feel right for the first time in years, they started to feel wrong again, like someone was dangling the metaphorical carrot just out of reach. Luckily I had the sense to see my GP again, and he informed me that this was very common. I was presently taking 10mg a day, which my doctor informed me is typically used as a starter dose; some people find it’s enough, but more commonly it just lays the foundation for a more appropriate dosage. So when my GP offered to double my dosage to 20mg a day, I accepted. Since then, despite fluctuations in anxiety levels, and some extended hairy moments, I haven’t needed to adjust my dosage at all.
One thing I feel I ought to mention is the withdrawal symptoms I’ve had before. Once, a few months ago, I forgot to renew my prescription, and was left without my citalopram for nearly six days. I started feeling a bit woozy, like when you first sit up the morning after a heavy night to work out how bad the hangover is, but that soon progressed to pretty severe vertigo that came in waves every five seconds or so. I couldn’t go to work because I couldn’t stand up for more than half a minute, and I couldn’t do my driving lesson because I couldn’t see straight. I couldn’t even eat, I couldn’t lie comfortably in any position; all I could really do was curl up on the sofa with my eyes closed, trying to ignore the periodical waves of nausea. When I got a new prescription, it took just over 24 hours for the vertigo to subside. So if you are or plan on taking citalopram (or any other antidepressant, for that matter), learn from my mistakes, and please remember to renew your prescription!
I’ve been taking citalopram in some measure or another for about eighteen months now, and it has been life-changing. It feels like demisting the windows of your car, or wiping away the dust from your favourite book. I honestly feel like me again, and I haven’t been me since the age of twelve, so it’s incredible. I’m not high as a kite all the time, I still feel anxious, I still get upset, and yeah, I still experience some of my G.A.D. symptoms; but the difference between then and now is that now, all these things seem manageable to me. It’s a small change that has had huge effects on my life. That’s why it makes me sad when people say that taking “happy pills” for a mental illness is a cop-out — because it was one of the bravest decisions I had to make, and if more time was taken to challenge these stigmatic views, that choice wouldn’t have been so hard.
You should never be made to feel ashamed for giving your body what it needs; you should never be made to feel less than for doing what is right for you and you only; and you should never be made to feel embarrassed for taking what is there, practically taylor-made, to help you. You are entitled to it, and if you think medication may be a step in the right direction for you, please make that move to go and see your doctor to talk about your options. It was the best decision I ever made for myself, and it could be for you too.