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Lou

Age at interview: 39
Age at diagnosis: 22
Brief Outline: Lou was first prescribed an antidepressant when she was in her 20’s. She tried Seroxat (paroxetine) on two occasions but experienced unacceptable side effects, and few benefits. When she became depressed once more in her 30’s she was reluctant to try antidepressants again, but sertraline proved to be a far more positive experience. She has had post- natal depression recently and felt confident to take sertraline again.
Background: Lou is married and lives with her husband and young baby. She works as a manager in the public sector. Ethnic background: White/Asian

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Lou thinks she has suffered from anxiety and/or depression from a very early age. When she was in her 20’s she sought help from the GP and was prescribed Seroxat (paroxetine) but didn’t like the way it made her feel.
 
‘Everything I was feeling was amplified initially during the period when I first started talking those particular tablets until it then tailed off then it turns off, the side effects turn off to just feeling numb. And also really, really dry mouth, horrible taste in my mouth and insomnia couldn’t sleep, you know, racing thoughts, and the anxiety was significant… it couldn’t have been worse.’
 
When she stopped taking paroxetine she experienced bad withdrawal effects, and had to reduce the dose very gradually.
 
For the next few years Lou kept going without taking antidepressants, but she felt depressed. In her 30’s she reached a point in her life where she realised she needed help… ‘everything was rubbish’ so she went back to the GP, but was clear that she would not take paroxetine again. This time the GP prescribed sertraline which suited her and helped turn her life around. She said it made her feel like ‘a better version of my normal self’
 
‘I was really reluctant to take antidepressants, you know, I said about the previous experience because this was a different GP at this time and they persuaded me that things had really moved on and that they would give me an antidepressant that definitely wouldn’t make me feel more anxious because that was the thing I was so, so anxious and having so many anxiety attacks that the thought of having something that would increase the likelihood of me having an anxiety attack was absolutely unpalatable and they assured me that this particular antidepressant wouldn’t do that.’
 
Lou took sertraline for about a year, and felt it helped her to find the motivation and confidence to change aspects of her life.
 
‘I think the first step of taking the antidepressants then enabled me to be in a space where I could make all the other changes that I needed to do, you know, sort out the crap job and the crap relationship and all that sort of thing. And actually get myself some, you know, decent therapy rather than just trying to sort myself out…’
 
During her 30’s Lou re-trained and began a new career, married and settled down, and life continued for a few years without any further episodes of depression. Recently however after the birth of her daughter she experienced post- natal depression. Because of her previous positive experience with sertraline she felt able to go to the GP and ask for it again.
 
‘I think as the post natal depression had built up I had become a little bit distant and I noticed it quite quickly and because I wasn’t scared of the medication I just went straight and sorted it out I wasn’t intimidated or afraid to ask for help - I knew that it would sort it out straight away and it did and I feel great now.’
 

Lou knew from past experience that sertraline worked best...

Lou knew from past experience that sertraline worked best...

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So after that life changed dramatically I had a fantastic career, great relationships, got married and recently had a baby and that was all great but then got hit with some post natal depression which I was kind of expecting really and the great thing about it was that because I’d had such a positive experience, before it got bad at all I merrily trotted down to the GP’s and said “I’d like some sertraline please” got a prescription ...and within a few days was back to my normal self again and that was great because it meant that, you know, my daughter particularly didn’t suffer for too long. I mean I think as the post natal depression had built up I had become a little bit distant and I noticed it quite quickly and because I wasn’t scared of the medication I just ran straight and sorted it out so she didn’t have the kind of distant depressed mum for more than, more than was necessary because I wasn’t intimidated or afraid to ask for help I knew that it would sort it out straight away and it did and I feel great now.
 

Lou had the prescription for a while and wasn’t sure she...

Lou had the prescription for a while and wasn’t sure she...

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I think I just thought, you know, something’s got to change and I can’t change, I can’t even begin to take a step when I’m kind of stuck like this really depressed, really low. and so I kind of thought - ‘I know I’ll go and speak to my GP about it’ and I was really reluctant to take antidepressants, you know, I said about the previous experience because this was a different GP at this time and they persuaded me that things had really moved on patient wise and that they would give me an antidepressant that definitely wouldn’t make me feel more anxious because that was the thing I was so, so anxious and having so many anxiety attacks that the thought of having something that would increase the likelihood of me having an anxiety attack was absolutely unpalatable and they assured me that this particular antidepressant wouldn’t do that and that people didn’t have problems coming off it as well because that was the other thing it was like I didn’t want to be stuck on this for the rest of my life. And I trusted my GP was we had a long talk about it and I think he had said, was it she, no he, he had said that actually the one I was on before was known to be rubbish now and that they didn’t prescribe it anymore. So I thought okay fine, fine so I took it reluctantly and I think I had the prescription for a while and was sort of dithering about taking it and eventually I thought no, do it.
 

When Lou took Seroxat (paroxetine) she said she felt ‘numb’...

When Lou took Seroxat (paroxetine) she said she felt ‘numb’...

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They started me on some Seroxat which I found gave me terrible side effects, I felt a lot worse and really quite mad after I started taking it. I persevered with it and it was okay up to a point, I felt very controlled, you know, like my emotions were you know if someone said oh you’ve won the lottery I’d go ‘oh right’, you know, and if someone said, you know, someone you cared about died, I’d go ‘oh dear’, you know there was no kind of... I didn’t feel I was able to experience a full array of emotions but I felt numb but not depressed anymore.
 
Everything I was feeling was amplified initially during the period when I first started talking those particular tablets until it then tailed off then it turns off, the side effects turn off to just feeling numb. And also really, really dry mouth, horrible taste in my mouth and insomnia couldn’t sleep, you know, racing thoughts and the anxiety was significantly worse.
 
I was much better after coming off them for a number of years until things got very bad, I was, everything in my life was rubbish really my relationships were awful my health was bad because I was probably drinking too much and partying too hard and I hated my job but I didn’t know what to do about it so everything was a bit rubbish. So I went to the GP and explained and said point blank ‘I’m not going to go on Seroxat again but can you help me?’ and I was prescribed sertraline, Lustral as it was then and immediately felt better, I didn’t have, a few side effects there was kind of a slightly clenchy mouth and clenchy jaw if anything I felt slightly euphoric for a couple of days and given that I was fearful that I would feel worse before I felt better that was kind of quite pleasant really and I felt like my normal self a better version of my normal self immediately.
 

Lou said Seroxat (paroxetine) left her feeling worse...

Lou said Seroxat (paroxetine) left her feeling worse...

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Seroxat?
 
Yes.
 
What were the side effects that you were feeling? Because you said that it made you feel quite numb and not there.
 
Well that was once the side effects had gone I felt more anxious by, you know, really anxious, really also, you know, initially the doctors said to keep taking it, you know the side effects will all work their way out in about six weeks and that was true.
 
So had you been warned initially to expect possibly some side effects?
 
Possibly some side effects but I mean I’d gone from feeling sort of depressed to kind of really, you know, having taken them I went from feeling, you know, depressed and anxious, anxiety was the biggest problem to feeling I wouldn’t say suicidal but getting there really not coping at all self-harming .
 
Can I ask what sort of thing you were doing?
 
Cutting my arms.
 
So had you ever done that before?
 
I don’t know because it was quite a long time ago, I don’t think so I certainly, it just everything I was feeling was amplified initially during the period when I first started talking those particular tablets until it then tailed off then it turns off, the side effects turn off to just feeling numb. And also really, really dry mouth, horrible taste in my mouth and insomnia couldn’t sleep, you know, racing thoughts. The anxiety was significantly worse.
 
And when you were going through that did you go back and speak to the GP about it, do you remember?
 
No I don’t think I did actually, you know, I remember I didn’t because I think I knew ‘oh they’re side effects and it will sort itself out.’
 

Lou has a reminder on her phone so she won’t forget to take her...

Lou has a reminder on her phone so she won’t forget to take her...

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Have you always been quite good at always remembering to take your tablets or, how do you remember?
 
Well previously like clockwork... but since I’ve had a baby it’s not as good, I‘ve got a reminder on my phone but I, the first packet of tablets, because now they’re all generics, you know, like not branded, the first time I took it was branded and it all had nice days of the week of packaging... This time I got some there was no days of the week and I was all over the place, sometimes I was taking two, sometimes I wasn’t taking any but at least now whichever chemist I got my last batch from it’s in days of the week and that really helped. because my alarm goes off, a reminder on my phone every day to take my tablet and I thought yes must do that but then, you know, something happens.
 
So if you had a time when you’ve forgotten or you haven’t taken one for a day, what would you do would you take one when you remember or would you wait until the next day?
 
I would probably take one when I remembered because I know I’m a, on a very low dose but then I guess if I remembered in the middle of the night I would wait until the next day. But I know on a couple of days I’ve missed them and I haven’t felt particularly unwell.
 
Right I was going, because I was going to ask if you’ve ever noticed a difference if you’ve missed?
 
No I think in maybe the first couple of weeks I noticed if I hadn’t taken one but not now.
 
What would be the difference?
 
Clenchy jaw.
 
That would return?
 
Yes clench jaw when you’re yawning would return.
 

Lou said it’s very easy for doctors to keep doling out...

Lou said it’s very easy for doctors to keep doling out...

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I would ask people to keep revisiting that with people they’re prescribing to and really try and motivate people to have some kind of talking therapy as well because I think otherwise you are just treating the symptoms and not helping people really move on, you know so just push that message really because it is very easy to dole out medication to people who are willing to, very happily willing to take them. But you know I think people should have regular reviews and that should include you know, where they are with talking therapies. A little bit of me would say that, you know, should consider refusing to prescribe people unless they’re open to that, it’s a bit harsh but you know I do think it would be criminal just to give someone antidepressants for ten years, medicating just, you know for ten years, twenty years and then not try anything other than medication.
 

Taking an antidepressant helped Lou to be able to deal with...

Taking an antidepressant helped Lou to be able to deal with...

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I don’t feel any particular shame or any, I don’t, any kind of....in fact I that the more people talk about antidepressants as a positive thing, the better it is that people don’t end up, you know, people don’t end up not taking something they need because of the stigma.
 
And do you still, do you think the stigma is still quite a big part of the whole thing?
 
I think for some people, I think some people just have a real mental block when it comes to taking antidepressants, you know, they’ll merrily have ibuprofen if they’ve got a headache or whatever and it’s like but you know... but depression no, no, no I don’t really like taking medication, all of a sudden, you know, people are suddenly become quite pure about it even though they’re drinking like a fish!
 
Why do you think that is?
 
Why do I think that people have a stigma about it? Well I think that people think that it might change your essential self or people might think it might turn you into someone that you’re not and I think, I would say that was a valid thing to think if the only antidepressant available was Seroxat but my latter experiences say that, you know sertraline’s a bit like Berocca, it’s you on a good day.
 
It’s the good version of you.
 
Yes it’s the good version of me or the version of you that you always thought was there but was kind of being weighed down by depression.
 
Your authentic self....
 
My authentic self... I don’t feel that I’m anyone different just that I’m unburdened really.
 
And coping?
 
And coping and, you know, and then able to kind of do the other things that I need to do, you know in order to then maybe stop taking the antidepressants, you know to put the other structures in place so that I don’t need them anymore but without the crutch if you like of the antidepressants you’re never going to get to the point at which you can... not take them anymore.
 
So it sounds like they’re a stepping stone to help you through and get you to another place.
 
Yes.
 
Where you can.
 
Yes or, you know, I mean I guess like I’d say to people it’s like, it’s a bit like you know if you have really bad migraines all the time it would be like having pain relief to give you enough time to then not have this dominant headache while you try and work out what’s triggering you migraines. You know, it’s a lot harder to do something if you’re in a lot of pain; well psychological pain’s the same.
 

Lou sees taking an antidepressant as a stepping stone on the...

Lou sees taking an antidepressant as a stepping stone on the...

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I don’t feel that I’m anyone different just that I’m unburdened really.
 
And coping.
 
And coping and, you know, and then able to kind of do the other things that I need to do, you know in order to then maybe stop taking the antidepressants, you know to put the other structures in place so that I don’t need them anymore but without the crutch if you like of the antidepressants you’re never going to get to the point at which you can... not take them anymore.
 
So it sounds like they’re a stepping stone to help you through and get you to another place?
 
Yes.
 
Where you can.
 
Yes or, you know, I mean I guess like I’d say to people it’s like, it’s a bit like you know if you have really bad migraines all the time it would be like having pain relief to give you enough time to then not have this dominant headache while you try and work out what’s triggering you migraines. You know, it’s a lot harder to do something if you’re in a lot of pain; well psychological pain’s the same
 

Lou reflected ‘I don’t think the changes I made would have...

Lou reflected ‘I don’t think the changes I made would have...

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I guess I’d say ‘you’ve got to do what’s right for you’ but I would say that my experience with modern SSRI’s is, is wholly positive, you know, and that my life’s been completely enriched if you like by my decision to take antidepressants. I don’t think, I don’t think the changes I made would have been possible without that initial stepping stone of taking them. and I think I would tell people that it doesn’t change what, my experience is that it doesn’t change you at all it just makes you a better version of you. and that, you know, side effects these days are neither here nor there.... coming off them isn’t the as bumpy as it used to be at all and just ‘do it really!’
 
It’s a great first step but when you’re feeling better don’t get complacent and think ‘great that’s solved it’, it hasn’t. It’s propped you up for you to solve it yourself, if you see what I mean.
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