The drugs DO work!

'Throw us another Prozac, Jeeves. there's a good fellow'

Take that Verve, you miserable one (well, two, at a push) hit wonders!

I can scarcely believe this even as I'm typing it, but I'm writing to you from the heady and unfamiliar plains of wellbeing, happiness and contentment! The shiny blue Prozac (blessed be its name) has finally kicked in, and I FEEL BETTER THAN I HAVE DONE FOR YEARS. Honestly. I genuinely think I feel like my old self again after four long, painful years of struggle in the wilderness. It's like I've stumbled across an oasis of peace and normality in the middle of a vast, parched desert. Where the hell am I?! What is this strange place of certainty, equanimity and tranquillity?! Have I been catapulted into someone else's mind?!  

I feel resilient, I feel capable, I feel cheerful. Seriously. I'm able to count my blessings - I feel deeply, humbly grateful for all the wonderful things in my life. I'm looking forward to things to come.  I'm able to laugh at things that would have had me sobbing two months ago. I'm not questioning every single tiny decision I make. I'm cheerful in the face of adversity, and am actually counselling my boyfriend out of a post-holiday slump! I'm happy for him to go away and leave me alone in the house. I don't feel scared. I don't feel afraid. I feel calm, I feel peaceful. I'm not perpetually thinking of death and disease and destruction (the three Ds?) and I FINALLY feel up to the task of living the life I've been given. I of course have still got enough natural pessimism and anxiety to immediately think 'A-ha! This will be exactly the moment Mr. 'I Love Irony' God will choose to strike me down!' BUT I don't fear it. I don't mind it. 

At a very basic level, I feel able to breathe again - both literally and figuratively. It's been weeks since I last felt like I couldn't get enough air, and even when I did last get a twinge of that, I knew that it would pass and I scarcely noticed it.

I feel like the world is a miraculous place. I'm struck by the amazing things all around me. I'm a born-again, Woody Allen-shaped butterfly emerging from a cocoon of horror and darkness! It makes me realise what a struggle my life has been for the last four years - a desperate, daily struggle to even hit the baseline of okay-ness. Each day felt like a fight to stay alive against overwhelming odds. 

But now it's as if a miracle has occurred - honestly, I want to write to the inventor of Prozac and swear my unwavering allegiance and eternal gratitude to him or her. I lay awake in bed last night feeling blissful in my own body - feeling safe, not worrying that it would stop, or break, or that I would stop breathing, or that something terrible would happen. I just smiled to myself, in the darkness, and thanked the universe for finally throwing me a break.  

Okay, so I get you're just never, ever going to read this blog again if I keep on in this saccharine vein (my favourite miserable songwriter starting writing crap songs as soon as he got married and thus happy), but I just wanted to let you all know that THERE IS HOPE! The drugs DO work, no matter what your paranoid-of-the-entire-medical-establishment hippy parents tell you, and they are bloody MIRACULOUS.  

You know how I know I'm not absolutely 100% cured? Because somewhere in the back of my mind, there's a little voice saying 'maybe you're having a weird reaction to the Prozac - maybe it's chemically-induced euphoria! Maybe this is a psychotic, manic swing and you're going to tumble right down into a depressed slump! Maybe you're going mad!' All of which reminds me that I haven't had a personality transplant, and a tiny, freaked-out, hypochondriac inner Woody Allen lives on within me. But there's a confident, blissful, brave, peaceful lady who completely dwarfs him, and I really, really like her a lot more.  

* My boyfriend wants me to add a footnote - he thinks it's important to make it clear that it's not all the drugs; he has just reminded me that I've done a hell of a lot of hard work to get to this point, and the drugs have just allowed me an easier context to put some of that into practice. I'll accept that. Now if you'll excuse me, I've just got to add another shiny gold relic to my glorious Prozac shrine... 

I don't understand! What is this sensation of warmth flooding over me?! Is this...could this really be... is this really how non-anxious people feel ALL THE TIME????!!!!'

Ten things I know about panic attacks...

This is you, trying to navigate the modern world with an ancient monkey brain. You're afraid of lions but there are no lions any more, so you're a bit confused, gawd bless you. 

An attractive young woman ran out of one of my events yesterday, after having what turned out to be a panic attack. She is, as so many panic sufferers are,  a highly intelligent, capable, and likeable person, and we chatted about the panic demons for a bit whilst she calmed down. She's not yet read an awful lot about this stuff, so I got to thinking about what I would like to have read when I first started getting to grips with it. Results below...   

Ten Things I Know About Panic Attacks 

1. Brilliant people have them. Oh yes. Some of the most beautiful, talented, courageous, hilarious, intelligent people who have ever stalked this earth have had panic. You're not weird, I promise. (Well, you may be a bit odd of course, but that's got nowt to do with the panic I'm afraid).

2.  They're not your fault! You've got to stop blaming yourself, and I'll give you three good reasons why...

      a) You're part-man/part-monkey (interestingly, or not, that is also the name of this not very good  Bruce Springsteen song). You're negotiating a modern landscape with an ancient ape-ish brain that is hard-wired to respond to the fight-or-flight mechanism. We are the descendants of some pretty alert and anxious chimps - the ones who heard a rustle in the bushes and thought 'it could be a lion, but then again, what are the chances, maybe it's just a stiff breeze?' all got eaten. We got the neurotic genes - tough break.

       b) Something in your past might have made this more likely. You may have had an unstable childhood, or been the victim of some trauma, or had a hypochondriac Dad. It's no-one else's fault either, but remember that outside forces have moulded you and made you the person you are today.

      c) You may just have a rubbish brain. Some people don't produce enough thyroid hormone (moi, for example), and some people don't retain enough serotonin. That's it. You didn't make it happen did you? Take it up with God when you next bump into him.

You've got to be easy on yourself. It's shit enough going through all this crap without the meta level of self-flagellation on top.

3. They go. And come back. And go again. If there's one thing I've learned I've from my boyfriend, it's how a wiggly line on a graph goes. His wise counsel is that a general upward trend on a graph is rarely straight - there are ups and downs and ups again. Whilst the downs may be lower than yesterday's ups, they're still higher than the downs a year ago - BUT - that's really hard to see from your perspective, seeing as how you're trapped in the graph.  

4. CBT really helps. My free NHS CBT course was hands-down the best thing I ever did for my panic attacks. 

5. You're not going to die. Or go mad. I PROMISE. Your heart races much faster than this when you're running (and that's considered good for you), and your breathing will not stop (your body won't allow that to happen), and will return to normal in a little while. I PROMISE. No-one has ever died of a panic attack, and no-one ever will.

6. Wishing them away makes them worse. Both in the instant they're coming, and just generally. The most suffering I ever experience is when I get furious and rail against them like a trussed up tiger, and my thrashing and rejecting ends up just tightening the knots around me. Some people get wonky noses, some people get IBS, some people get cancer, some people get panic attacks. You might have them for life, or they may go at some point. But you have to accept them for now, or you'll increase your misery exponentially. 

7. They're not all bad. All of this hardship has actually brought me a lot closer to both of my parents, and I've learned (well, am still learning) to be okay with being vulnerable. Which I've been told makes me even more likeable! Keep in mind that you're picking up some pretty good life skills here in the crucible, so you are in no way wasting your time or effort.  

8. They're funny. Learn to see the funny side of anxiety and panic (and there IS a funny side). Learn to laugh at fear rather than cowering from it, and by doing so - puncture its menace and remove its power.

9. You can cope. A large part of anxiety is fear of not being able to cope, to deal, to handle. But you have coped your whole life - all the way up until this very minute. Why would you stop now? You have the strength to cope with this, and anything else life throws your way. 

10. All of the above are really difficult to put into practise. And that's okay. As my exceptionally wise and beautiful friend told me - this is a process, it's not a solution. You may forget half this stuff, and not be able to put the other half into practise, but you're trying, and you're learning stuff all the time. Just accept that you're taking baby steps - this is not a race. 


Hey, new girl - you're doing just fine! Everything's going to be okay. It really is. 

x 

You gotta roll with the punches of outrageous fortune (as I believe Shakespeare once said...)

  

Prozac nation (is not my favourite nation)...

'YES! Yes I am!'

 

Greetings from a small, Viv-shaped Prozac nation!

My six months without antidepressants have been fairly hellish, so I finally surrendered and went to see my almost-hot psychiatrist who recommended a trial of Prozac. Cue much grinding of teeth and general nervousness. 'Me? On Prozac? Sounds so 'Girl Interrupted'! Why can't my brain do it itself goddamnit?! Why can't I just RELAXXX??!!' etc etc. Although pills aren't for everyone, there's no doubt that medication has provided a lifeline for millions of people around the world (myself included), and sometimes you've got to come to terms with needing a little help. See this article for a really clear-headed and inspiring take on an often maligned and misjudged thing.

I've been taking them for a week now, and...guess what?! They've made everything much, much worse! You've got to laugh - it is quite funny. Apparently they can do that (i.e. make you feel like you want to jump out of your skin for the first couple of weeks) before they make you better. If they make you better. 

I'm so bloody anxious, I could gnaw off my arm. I've been teetering on panic a number of times a day, and just feel jittery and speedy. I had two days of really bad nausea, which has now improved to simply not fancying eating anything apart from beige food. With cheese on top.

I'm persevering, because apparently I could exit the tunnel into bright daylight any day now. Please hurry up that day!

I have to remember that:

1. This will pass.

2. Sometimes the darkest night is just before the dawn.

3. Whatever happens, I can and will cope.

4. This will pass (again).

It's been a long old time in the tunnel, and I really just want to feel a bit better soon.

Whilst I'm waiting, I am consuming approximate 1kg of Rich Tea biscuits daily, laughing at the brilliant Twenty-Twelve spoof documentary, having loads of hugs, trudging into work in the snow, and crying into my decaf tea.

See? There are always bits of sunshine, even when things are shitty. 

'It'll wash your blues away! Or make you feel so anxious you feel like you can't breathe! Yay!'

Brain - serotonin = WET CHAOS...

Just like this poor woman, my brain has fallen victim to moving and sentimental images, like fully-clothed sunbathing on LiLos, and Italian wedding dresses. 

My brain and I have had a falling out. There's been a slapped wrist (brains have wrists) and an official warning over negligence of basic duties. It's not being fed serotonin every morning with its cornflakes and has gone all mushy and sentimental and weird.

In the last two days I have cried in the following ways:

• When I flicked over to the X-Factor (eating dinner, urgently needed moving images) and listened to a mildly talented boy whose parents had split up (they couldn't even scrape together any real tragedy for the pre-singing story) sing a probably mediocre song, but in my addled state I just heard music, so was moved. I mean, multiple tears, not just A single, individual tear.

• Watching some terrible documentary about athletes and how-hard-they-trained-for-the-Olympics-and-how-happy-they-were-that-all-their-hard-work-had-paid-off-and-how-it-was-all-worth-it-and-how-they-were-really-pleased-to-represent-the-country-and-how-grateful-they-were-to-their-coaches-who-had-been-through-it-with-them-from-the-very-beginning-and-most-of-all-to-their-families-who-always-believed-in-them cue Coldplay.

• Watching the last 3 minutes (literally) of Masterchef Australia where the winner was crowned. I want to clarify that I had not watched ANY of the series, so this was a record tear release from a standing start.

• When someone's pastry tore on the Great British Bake-off.

• At several slow-motion sporting montages calculatedly created to cause maximum heartstring damage by the BBC

But here's the clincher:

• I CRIED WATCHING AN 80s RE-RUN OF THE CRYSTAL MAZE. When a girl managed to get a crystal. That's all. When she took it back to the team they all cheered and I felt my eyes moisten.

And I said -  'ENOUGH!!!! The Crystal Maze??? Really, has it come to this? You are genuinely moved by a 20 year old re-run on Challenger? What is happening up there in the control room Mr Brain? Are you pulling the wrong levers or something? Are you drunk? Are you asleep at the wheel? Do you need a defibrillator? What do you want from me?!'

How long does it take brains to get back to normal after a number of years being chemically enhanced, I wonder...

Oh no, don't, I can feel them forming. Look at her eager face. Oh God, it's too late. What a moving display of ingenuity and problem-solving. Pass the tissues please.

An exciting journey through my medicine cabinet...

Me too!

I've got a very special treat for you guys today, so hold onto your pillboxes and lavender sachets...

 I thought I'd give you an quick run-down of the medication I take for anxiety - I'm really nosy and always want to know what other people take (and I assume you're like me), but also it's obviously also really crucial to get a sense of what works on the pharma front and what doesn't.

I think it's also important to be open and frank when discussing this kind of stuff - there should be no more stigma attached to the fact I take anti-depressants for this condition than if I was diabetic and had to have  regular insulin injections. Sadly, there is, but we can all do our bit by being OUT AND PROUD about pill popping for our condition, and not despising ourselves for having to do so.

1. Citalopram 20mg. An SSRI anti-depressant medication (Prozac is probably the most famous in this category). Mostly used for depression, but SSRIs are also very effective for anxiety and phobia related conditions.

Pros: For a lot of people these are the perfect solution - just that extra bit of serotonin is enough to tip them over into a calmer, happier place. But I've been on them for so long, I don't actually know if they work any more. I'm going to experiment with coming off them SLOWLY soon for the reasons below. Then we'll see if they were doing anything at all (eeek, the sword of anxious Damocles dangles above me )

Cons: There are tons, but all I've noticed in my case is their effect on...sexytime. People, they kill your libido. Like stone-cold DEAD. Mine is so decimated that RPatz could turn up at my house in a loincloth with a rose between his teeth, and there'd be nary a flicker in my loins. This is causing me no end of anxiety in itself, so I have to jump off the comfy serotonin cushion and see what happens. I'll obviously keep you updated on this experiment...

Amazingly, this is an actual ad from the 50s...

2. Pregabalin 100mg. A seizure and neuropathic pain medication that works on the brain's GABA receptors (weed works on the same brain bits apparently). They've only fairly recently worked out that this stuff is great for anxiety too, and it's now available on prescription for panic disorder and agoraphobia. Apparently doctors are reluctant to prescribe it because it costs a fortune, so you may have to visit a psychiatrist for a prescription first.

Pros: I found these amazingly effective and calming - much more so than SSRIs. I would highly, highly recommend these to anyone who is really suffering with generalised anxiety disorder, panic disorder or agoraphobia.

Cons: Can make you feel a bit stoned and dizzy when you first go on them, but that quickly fades. Also, I put on a bit of weight on these, but as with all of this stuff, you have to weigh* it up . Would you rather be a skinny wreck sobbing into your soft toys and pleading with your  boyfriend to not leave the house, or the calm owner of a spare tyre? (You can tell which one I plumped* for...)

*They can also make you amazingly proficient at creating hilarious fat puns.

3. Lorazepam (Ativan) 1mg PRN . A Benzodiazepine tranquiliser. Valium (Diazepam) is the most famous in this category, but does absolutely nothing for me. These are absolute lifesavers, but are only to be taken sparingly. I take one as and when I need one, but try to keep them in reserve only for very bad panic attacks, as they have huge addictive potential. BUT this doesn't mean you can't take them almost every day for a couple of weeks in a massive crisis, so don't do what I did and freak out and sob and wail each time before you take one because you're afraid of turning into an addict and losing your job/home/family and ending up hooking for cash etc etc etc.

Pros: They are God's/Big Pharma's way of giving us respite when we're going through sheer hell, so don't be afraid to use these (or be intimidated away from them by incompetent doctors) on occasion. If you're worried, seek reassurance from a professional psychiatrist (not therapist or counsellor or doctor) who can explain the pros and cons more thoroughly to you.

Cons: They're very addictive, and are not a long-term, daily solution. But in the short term, they can give you the clarity and respite to seek a more sustainable long-term solution, and can help you to take big first steps (leaving the house, getting on a plane etc) toward recovery.

Hooray for tranquillisers - they bring us peace and enable us to hang out the washing without crying!