Crumpled skies and electric junkies

If the death of Gary Speed can be said to have led to anything positive whatsoever, it’s that it has dragged depression back out into the open. Admittedly, early responses from family and friends suggest Speed was not known to be a man troubled by depression, and it may yet come to light that his apparent suicide had nothing to do with the illness at all. However, it would be entirely in keeping with my own experience, as someone who has lived with clinical depression for a decade, for his friends to have been as in the dark as he may have been.

I was inspired to write this blogpost for two reasons. Firstly, James Olley’s piece in yesterday’s Evening Standard, which highlights the problem of depression still going unnoticed in communities where it might be viewed as a weakness, and secondly, an apology I recently received from a GP – an apology made “on behalf of the medical profession” for the six-or-more years I’ve spent taking the notoriously addictive antidepressant, Paroxetine. Having spent a little over 10 years visiting more mental health specialists than I can honestly remember (certainly more than this post will detail), I continue to be amazed by how little people seem to know.

My depression first moped into view when I was 23. Living in Japan at the time, I remember walking across a car park beneath a broad blue sky and thinking something didn’t feel right with it. It was almost as if I could see that the edges were crumpled just beyond the horizon; that it was all surface polish and little else. I can see how simplistic that sounds, but I remember that while I gave it very little thought at the time, it built up. The following day the idea returned, and this time it came with a mild sense of anxiety. It came again increasingly over the next few days, all the while the anxiety building steadily. I felt a nasty sense that I was becoming trapped in a thought cycle, that I couldn’t walk across that area without feeling deeply uncomfortable.

A week or so later – September 29, 2000 – the whole thing crashed. I was hungover at a conference in Fukuoka, south Japan, listening to someone talking about their cross-cultural experience. I suddenly became aware that the speaker’s lips seemed out of sync with their words, probably a result of my pounding headache and usually something I’d not even notice, but I became transfixed and increasingly worried. Try as I might, I couldn’t make what I was seeing stop, and before I knew what was happening I was shoving chairs out of the way, desperately trying to get out of the room. Once I was in the corridor, I began to run, and I didn’t stop running for about 15 minutes (in circles, as it happens – I never made it out of the conference centre car park). Eventually I managed to calm my breathing, but the sense that I wasn’t actually there, almost that I was watching the world around me on somebody else’s television screen, didn’t leave me for about three years.

Interestingly, my exit from the room had gone unnoticed. While it felt as though the world had crashed onto its side with a calamitous thud, my friends told me afterwards that I’d very politely taken my leave without drawing attention to myself. This would be a recurring theme throughout subsequent panic attacks, and seems to be common to many who suffer from anxiety disorder and clinical depression. It goes unnoticed. It’s not that easily detected. People often suffer silently for years, unable to explain what’s going on in their head.

If you think about it, reasons for why this happens make sense. A depressed or anxious person often needs to voice their problems before they can be identified and treated, but it takes a brave person to say, “in my head, the sky has crumpled edges and your voice no longer syncs with your mouth”, because that doesn’t sound like depression to anybody. That sounds like the first step towards getting yourself committed.

This also highlights a semantic problem. I had no idea that my depression might be depression at all, because very few people get through their teenage years without, at one time or another, claiming to be “depressed”. I remember chatting with a friend of mine about five years ago, an intelligent fellow who told me, “I don’t think depression really exists. I know a doctor who doesn’t believe in it.” I can fully imagine that the second sentence might be true (I have a friend who suffers from Chronic Fatigue Syndrome, known commonly as M.E., who tells me she has seen doctors who are similarly disbelieving), but I’ve often wondered whether my buddy might have confused “I have depression” with “I’m depressed”. Very different things, obviously, though it may be where some of the stigma comes from. The response to the “depressed” teenager is usually something along the lines of “pull your socks up”, whereas the response to someone displaying signs of depression is always “go and talk to your GP, and do it quickly. You need help.”

It took me a long time to find my way to my current GP, and to tell the truth, it’ll take some time before I’m convinced I’ve found the right one. Here’s why.

Immediately after my initial fight-or-flight experience, back at the conference centre, I called a friend who helped me part of the way home. She was clearly worried, but had no reason to think I might be a danger to myself. Thankfully, I never have been (unless you count the years I spent trying to drown out the confusion with very cheap Japanese lager), but I do remember cowering back into the corner of my apartment, convinced that something had altered permanently. It had, of course – the illness has had an effect on my everyday life ever since, mostly for the good – but at the time, I couldn’t see how that could be a positive thing in any way. I remember thinking that I had to stop thinking, that that was the only way to calm my incessantly galloping heart. But how do you stop thinking, beyond stopping all together? I was petrified.

The first doctor I met told me I was suffering from exhaustion. He hooked me up to a drip for three hours, then sent me home. The next day, I had another panic attack. So I went to another doctor who promptly put me on a heavy dose of something-or-other (the name escapes me) that slowed me so thoroughly that I don’t have any decent memory of that particular fortnight. I do remember having panic attacks but feeling too exhausted to go anywhere. Panic attacks whilst virtually immobile aren’t much fun either, so I stopped taking the pills and didn’t visit that doctor again either.

For three years, I suffered incessant panic attacks and what I assume now must’ve been minor delusions (I remember lying in bed with a hangover and being so convinced that I was still on the train, lolling about embarrassingly, that I felt I ought to be apologising – to nobody). Back in the UK, I went to a local GP who said he didn’t believe in tackling panic attacks with pills, so he sent me to a counselor who was so obsessed with picturing calm brooks and palm trees that I pretty much left her to it. It seemed to do her immense good to natter her way through forests and around foothills, and who was I to stop her? After my sixth session, she pronounced me cured and said she didn’t need to see me anymore. I was glad she seemed to be feeling better. I had a panic attack as soon as I stepped out of the door.

At the age of 25, my girlfriend discovered she was pregnant. I was delighted by the news, hoping it’d give me something to devote my thoughts to other than my ever-circling confusion. As part of her pre-natal care, it was suggested that we both have a checkup at the local clinic. We were living in Muswell Hill at the time, North London, and the GP made history (in my own troubled world) for being the first person to put a name on my illness that made any sense to me. I hadn’t told anyone about the crumpled sky or the bizarre bed/train incident until that point, always having stayed away from detailing symptoms that I felt might impact on how tightly my straitjacket would be fastened, but with fatherhood looming I thought it best to get it all out in the open.

I’d barely finished my crumpled sky monologue before she said the words “clinical depression”. She tapped a prescription into the computer while explaining briskly that I was too far gone to know whether the depression was causing the anxiety disorder or vice versa, but that the drugs promised by this bit of paper would have it sorted in a matter of weeks. 20mg of Seroxat per day and it’d be like the last three years had never happened. I’ve never looked forward to taking medicine so eagerly.

I’ve often wondered if putting a name to it was all I really needed. Like so many other people who suffer from the illness, the confirmation that you’re not mad, and perhaps a little explanation of the science behind why your brain feels so ridiculous goes a long way towards capping the fear. For me though, the Seroxat, the trade name of a locally available product made with the notoriously addictive Paroxetine, seemed to put a little bonnet on it and see it cheerily out the door. For a year or two, I lived as happily as I ever had – probably more so, what with my gorgeous son, my newly-wed wife and my morning happy dose. I even managed to wean myself off them, ever-so slowly, fraction by fraction, until I appeared capable to live without their support at all.

It should be noted that my weaning was not taken under advisement. I made that decision all by myself, foolishly I now realise, and just stopped showing up at the doctors. By this point, aged 28, we’d moved back to Japan, and the doctor – who spoke very little English and seemed to find my monthly visits uncomfortable enough that hastily filling my prescription was all she ever got round to doing – seemed sufficiently unconcerned to never contact me and find out what on earth I thought I was doing.

Three months later, I crashed again, right in the middle of a wedding ceremony (I used to be a fake priest, but that’s another story entirely). Stood in front of 200 paying guests, with 10 minutes left on the clock, I gripped as tightly to the altar as possible, in the hope that my finger muscles could overpower the ever-growing fight-or-flight syndrome threatening to overpower my racing brain. As usual, I made it to the end, and – as usual – nobody watching had a clue that anything was up. But the damage was done. For three more years I continued to do that ridiculous job, and not a single ceremony passed without a sense of unavoidable doom. In truth, I think I survived those three years without suffering a major attack again, but the fear of it happening was miserable. It permeated into the rest of my life and I dealt with it by drinking a considerable amount.

Of course, drink and depression aren’t merry bedfellows, and the combination of the two led to a third complication: a mild but disturbing heart arrhythmia that forced me back to the embarrassed doctor more times than either of us enjoyed in the two years leading up to my thirtieth birthday. Everybody suffers the occasional arrhythmia, of course – I’m told that’s what jolts you awake occasionally when you’re on the verge of sleep. Imagine that almost constantly, and you’ll have some idea of what it does to your nerves. To say it has you worrying about your health is an understatement. Finally, inevitably, they brought the pills out again, this time a daily 20mg dose of Paxil – the trade name of a locally available product made with (you guessed it) the notoriously addictive drug Paroxetine.

This time, I didn’t stop. I took them daily for years. As a thirtieth birthday present to myself, I gave up drinking (it took a few months, but I got there in the end), which I doubt I could’ve done without my trusty pills, but I found that in the meantime, without knowing it, I’d developed a new dependency. It took only a few forgetful days without the Paxil for the chills, the dizziness and the electric shocks to set in. Yes, the electric shocks. Remove the Paroxetine for five days and nights, and it feels as though you’ve been plugged into the National Grid. The zaps leap from the tops of your limbs to your very extremities, and they don’t let up for several days. Withdrawal symptoms – nothing less – to add to your returning anxiety. It’s not a drug you want to give up in a hurry.

To bring this rambling discourse back to the present, it was only when I arrived back in the UK and went looking for my fix from the village GP that I realised what a fix I was actually in. The GP, quite possibly the first I’ve visited who has any real experience of treating clinical depression on a regular basis, listened to my tale with a sheepish, somewhat guilty look on her face. Apologising for her predecessors, she explained that Paroxetine products are no longer the reach-for antidepressant of choice. While its ability to tackle clinical depression and anxiety disorder are well recognised, she told me, the dependency Paroxetine fosters is not worth the trouble. She modestly claimed an 80% success rate transferring strung-out Paroxetine junkies to Fluoxetine (Prosac to the rest of us), which she tells me is easier to reduce should counselling be effective in combating the underlying depression. Once again, I only have the GP’s word to go on here, so forgive me if I don’t accept it without reservation. But that’s where I’m at now – spaced out as the transfer of drugs works its way through my system, but hopeful of a relief from the immediate threat of electrocution.

Of course, I’m not nearly as troubled as I might have been. I know people who suffered with the illness to a debilitating level by comparison. At the age of 34, I’m successful in what I do for a living, and I’m the proud father of two lovely, healthy kids. I dare say I’d even be capable of functioning without antidepressants – 20mg a day is not a high dose, after all – though I’d prefer not to give it a go just yet, and certainly not without supervision. On the occasions that I’ve skipped my pills for longer than is advisable, I’ve found that a combination of eating my greens and walking for a few miles a day has kept me feeling as balanced as I suspect I ever was, and I’m certainly more determined to get things done than I was in my “normal” years. All of the interviews and published articles you’ll find elsewhere on this blog I did during my “depressed” years, so it certainly hasn’t hindered my career or sense of ambition.

I don’t want to round this post off with some pithy remark. I want to point out, simply, that once I finally managed to spill the contents of my confused mind across the desk of a clued-up doctor, things happened very quickly. No, a cure wasn’t forthcoming, but help was at hand, as was a plausible explanation.

A combination of poor understanding, on the patient’s part, on the part of some GPs, and on the part of the public at large, means that the illness goes undetected, unspoken and unsupported all too often. Whether any of this was the case for poor Gary Speed may well remain a point of conjecture, but depression is a real and very powerful illness indeed, and, statistically, it will trouble someone sitting within spitting distance of where you’re reading this right now, at some point in their lives. It may even trouble you, though with a little help and perseverance, hopefully not for long.

For more information on coping with depression, see the Depression Alliance UK homepage.