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John

Age at interview: 84
Age at diagnosis: 37
Brief Outline: John first experienced depression when he was in his late thirties. He had been feeling overwhelmed about his job and persistently on edge. He couldn’t understand what was wrong with him. Eventually he made an appointment with his GP who prescribed Valium (diazepam). He took this for some years, but eventually became concerned about relying on it and decided to stop taking it. He attended a support group to help him, and after that only took diazepam occasionally. He was offered psychotherapy but found it unhelpful. In the last 5 years his current GP prescribed fluoxetine, which he takes daily.
Background: John is a retired civil servant. He is married and has one daughter, and several grandchildren. Ethnic background: White British

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John first experienced depression in his late thirties when was persistently feeling on edge and anxious. He did not understand what was wrong with him. He kept feeling that things weren’t right. Eventually he decided to go and see his doctor who prescribed him Valium (diazepam). He found that after 3 weeks he began to feel the benefits; his mood lifted and ‘everything felt alright.’ and took it for several years. He explained that in those days the term depression wasn’t used, but it was referred to more generally as ‘anxiety’. It was common for doctors to prescribe Valium (diazepam), although nowadays it is known to be addictive and is only prescribed for very short periods of a time, usually in a crisis.
 
‘I didn’t know what was wrong with me. And as I say the doctor said to me initially oh its anxiety, you know, you want a tablet just to calm you down. And my doctor in those days he was a doctor that shelled out tablets, you know, like Smarties and of course you keep popping them don’t you.’
 
John became aware that he had become reliant on Valium and decided to cut down and eventually stop. He found it difficult when reducing the dose and experienced palpitations and his mood dipped. He said he felt that there was something missing when he stopped taking them. However, he persevered and remained off them for some time.
 
He has spoken to other people in group therapies and has been referred to psychiatrists on a number of occasions. He explained that when he was not taking antidepressants he went to see a psychiatrist but had not it helpful. He had felt ashamed of his depression as he felt that it is sometimes perceived as a sign of weakness but feels that the stigma towards depression is reducing. His wife has been very supportive.
 
When he experienced a further episode of depression he asked for more Valium to manage his symptoms but his new doctor was reluctant to prescribe it. At the time John was not offered any alternative treatment. He explained that his depression was often a response to unhappiness at work and he felt a lot better after his retirement. However in recent times his symptoms returned, his doctor prescribed fluoxetine. On fluoxetine he said that after 3 weeks the ‘black cloud’ that had been hanging over him started to lift and that his life began to feel more manageable. After some time taking fluoxetine he noticed that his mood lowered but increasing the dose on the advice of his GP has been effective. As he has become older John has begun to experience a number of other health problems that can sometimes get him down, but the current dose of fluoxetine helps keep his mood steady. 
 

When John started taking fluoxetine he felt he the benefits...

When John started taking fluoxetine he felt he the benefits...

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I was taking something else, I don’t know what it was but it didn’t seem to do anything. I mentioned it to him one day and he says there’s a new one out, they called it something.
 
Prozac?
 
Prozac.
 
Yes.
 
That’s right, wow. He says try that, well…
 
Oh right, tell me about how that made you feel.
 
Lovely.
 
Did it?
 
Yes. It felt normal.
 
Ah right.
 
It took about three weeks to get into the system but after that it was a pleasure to take.
 
Really? So how different does it make you feel?
 
All your problems can be managed, I wouldn’t say they go away because they don’t, not when you’re 85 they don't go away but, you know, you look back and you think well it’s not so bad, but it is at the time.
 
Does it feel like it gives you a bit of perspective on things?
 
Yes, yes. The first thing that it did was lift the black cloud and I felt that go I was sitting there one day, my wife was there and we were talking, I said ‘whoops’, she said now what, I said ‘the black clouds going, I could feel it lift, travelled up from my feet through me up’.
 
Really?
 
Crazy isn’t it?
 
Well no it sounds quite a powerful feeling.
 
Yes it was good yes.
 

In the past John said doctors gave out Valium readily....

In the past John said doctors gave out Valium readily....

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In the early days, it must have been in the 50’s or 60’s, I can’t remember….but I know I had this feeling of edginess, of anxiety, things weren’t right, I couldn’t work fast enough. Anyway, eventually I went to the doctor and he prescribed some tablets called Valium, and I took those, but it wasn’t until about the third week that I began to feel any benefits.
 
I don’t know how I felt in the first instance of taking them but it wasn’t awfully good as I remember but then like all tablets they kicked in, you know, and everything was alright. It took away this black cloud that was with me all the time and I think it made it better for, for my wife as well because I remember one day we sat down and I was moaning about something as usual and she said’ oh stop it’, she said ‘you’re not the only one here with problems’ and zunk I changed, I remember that. But I took them for about a long while, I had a mixture a right thingy of tablets I had Concordin (protryptline), Valium something else and something else, you know, it’s one of those...
 
Where they for other things that were?
 
No they called it, what did they call it in those days? They called it ‘anxiety’.
 
Right.
 
It was ages before they called it depression.
 
I didn’t know it was anxiety I knew something was happening, I’d forever got this black cloud with me and I thought this is odd. Anyway it got, it got pretty bad so I went to see the doctor.
 
How did the doctor respond in those days?
 
Oh, let’s see what tablets we’ve got’.
 
Yes and how did you feel about having tablets to help you with that problem?
 
I didn’t mind, didn’t mind at all. But they work because I felt a lot better after taking them.
 
And did you just take then regularly every day?
 
Yes I think I took 30 milligrams every day and somebody said to me once ‘you’re becoming a junkie you know, you want to watch it’. And eventually I cut down from 30 to 20 and 20 to 10 and then I cut the 10 down and it was only when I got down to five milligrams that ‘pow’ I realised I was losing this backup.
 
What did you start feeling unwell again?
 
Yes.
 
Really.
 
I went back.
 
Was it the doctor that helped you to step it down or did you decide to do that yourself?
 
No I decided to do it.
 
Were you concerned about it?
 
I was going to a meeting it was called Tranqs I think something like Tranqs and - coming off tranquilisers and I went there and I slowly but surely got down to one and then none and it was great but it was hard work.
 
And when you say hard work what does that mean?
 
Oh.
 
You got the shakes?
 
Yes everything’s alive in a, it’s like having a thundercloud carrying it about with you and even noises are sharp vision was sharp.
 
Was this during the time when you were stepping it down?
 
Yes.
 
So it was kind of like a withdrawal?
 
That’s right yes.
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