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Lucy X

Age at interview: 21
Age at diagnosis: 15
Brief Outline: Lucy experienced depression for the first time when she was 15. Although she got help and was prescribed Prozac (fluoxetine) she found it was difficult as an adolescent to be able to have a say in her treatment. When she began university she experienced another episode of depression, and this time found that the university doctors were far more open and understanding. She was prescribed citalopram which worked much better for her, and continues to take it on an ongoing basis.
Background: Lucy is a university student and works part time during the vacations as an administrator. Ethnic background: White British.

More about me...

When Lucy was 15 she found herself struggling with studying for her GCSE’s and life in general. She thought that the way she was feeling was normal for a teenager, but eventually her boyfriend persuaded her she should seek help and she saw the GP who referred her to see a psychologist from the adolescent mental health team. Initially Lucy did not tell her parents about her problems, which in hindsight she regrets because when they later discovered she had been referred to the mental health team they felt upset that she had kept things from them. They worried that being diagnosed with ‘mental health issues’ could jeapordise her future studies and career prospects. Lucy felt that the service provided by the CAHMS team [Child and Adolescent Mental Health Service] was geared towards younger teenagers, and that they did not allow her to participate fully in decisions about her treatment. As well as seeing a psychologist she was also prescribed Prozac (fluoxetine), but after the initial side effects of nausea, headaches and dizziness wore off she felt numb and detached from life, which made it difficult to stay motivated to study and socialise with friends. Although she tried to discuss the problems she was experiencing with the health professionals she was seeing, she felt they didn’t listen to her and they wanted her to continue taking fluoxetine. After a time she decided to stop taking it of her own accord, and over time she found things began to improve.
 
During the time she was studying for her A levels Lucy had some Cognitive Behavioural Therapy (CBT) which she found very helpful in enabling her to notice the signs when her mood was dropping and she learned some valuable strategies to help her to cope when she was feeling low.
Starting university coincided with a difficult family time when a close relative was critically ill and subsequently died. Being away from home for the first time and trying to cope with a bereavement was very difficult for Lucy, and although she tried to use the coping techniques she had learned through CBT, eventually she realised she needed help again and went to see the university GP, who recommended that she had counselling, and offered her antidepressants again. Lucy explained about her negative experiences with Prozac (fluoxetine) and her GP explained that there were different types of antidepressants and that the key was to find one that was right for her. She was prescribed citalopram which she continues to take on an ongoing basis, varying the dose according to her situation – for example during stressful times such as exam time she takes a higher dose, and at other times she takes a much lower dose to keep her mood stable. ‘It’s a million miles away from my experience with Prozac, I didn’t have any sickness when I first started taking them, and I had absolutely no problems. I don’t feel the numbness, I don’t really feel like I’m taking antidepressants other than my mood is much better’.
Lucy’s GP thinks her depression may be primarily caused by a chemical imbalance, but that difficult or stressful life events can ‘tip me over the edge’… He felt that counselling could help with the events, but really the day to day… It would be the antidepressants that would fix the chemical imbalance’
Lucy found it very difficult to be able to talk to friends about depression when she was younger, and that it is not something that school pupils are given much information about, which can make it very difficult for teenagers to realise that help and support is available. She thinks it’s important for people to know that there is a wide range of antidepressants and you may need to try a few before you find one that works for you. Now Lucy makes a point of being open about her depression if they ask her, and is happy share her experiences because she feels it is important to de-stigmatise mental health problems. ‘I personally have never come across anybody who I feel has treated me differently or anything because I’ve told them. And you know, if someone has ever done that I think that’s more their problem than my problem, you have to kind of get the word out there, so people know they’re not alone in what they’re feeling…’ 
 

Lucy X accepted that she needed help and talking about it...

Lucy X accepted that she needed help and talking about it...

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What a lot of people don’t understand is going to the doctors the first time and explaining is just like, I mean the first time I did it I just like, I think I just cried for ten minutes and didn’t say anything and then you know it all slowly sort of came out. And then it’s just such a like as you said... you’re at your lowest and it’s like a complete oh it’s such a big thing and especially if you’re like myself you kept it very to myself to suddenly have to be like this is what’s happening was, I mean that would be another thing for people you know health professionals to realise what a big step someone has made when they originally turn up. I mean one they’ve accepted it personally which is a huge thing and accepted they need help and now they’re coming to find it. But they also have to open up to probably someone who is a complete stranger it’s like yes it’s a huge thing to like you know to maybe have a bit more respect and understanding for how big a thing that really is for people.
 

Lucy X thinks it’s important that people talk to their doctor...

Lucy X thinks it’s important that people talk to their doctor...

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I haven’t had this situation but I’ve heard it from other people that sometimes there’s a feeling that you go to the doctors and they just say ‘here’s some antidepressants and off you go’. I mean they’re you know, anti-depressants aren’t right for everyone some people need other things that, like CBT for me was fantastic and you know, it was the combination that’s really got me where I am now and so, you know, if you feel anti-depressants aren’t the right thing not to be scared to go back and say ‘what else can I have, what else can we do?’ you know, and there’s a lot of help out there, I mean but also to be patient because these things don’t always come through that quickly.
 

Lucy X had taken Prozac (fluoxetine) before and wasn’t keen...

Lucy X had taken Prozac (fluoxetine) before and wasn’t keen...

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Did the doctor give you some information about it?
 
Yes she gave me some information but I also did personally did like some of my own.
 
And how did you go about doing that?
 
It was like Google searched it. I mean there is lots of stuff, I mean it’s a bit like, like hit and miss you know there’s lots of stuff online about people talking about anti-depressants and some of its a bit like, you know, I mean as most people I don’t go on the internet and trust everything that I read you know... the NHS website has the information and that’s where I got a lot of it from. But also there were bits where people were talking about their own personal experiences and when I researched Prozac there seemed to be a lot of people who had the same feelings as me. And there was the citalopram, there were people who had sickness and stuff but there was no, there didn’t seem to be so much of this feeling that it was something terrible and awful.
 
Was that what you were most interested to find out when you, when you were thinking about taking the citalopram, about how other people reacted to it?
 
Yes before, for like for me with the citalopram if I’d had the two weeks sickness or just the beginning period of sickness again like I would have, I would have been fine with that. The main thing for me was I didn’t want the numbness and that, the sort of like you feel like it kind of creeps up on you and then it’s there and then it takes a bit of time to go I just so didn’t want that and so it wasn’t, it was important to me to sort of hear what other people felt like.
 
And see how you could function on a daily basis?
 
Yes and there just didn’t seem to be that same like consensus that it was a problem so. you know there are always going to be people who react badly to something and, you know, that’s part of it but yes it seemed, people seemed to be much more positive about it.
 

Lucy had side effects with Prozac (fluoxetine) but not with...

Lucy had side effects with Prozac (fluoxetine) but not with...

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It was Prozac that I was taking at that point.
 
My experience of that wasn’t generally very good in the first two weeks I was very ill, I was like - lots of sickness and like headaches just feeling very dizzy and I really, I struggled to even get into school because I was feeling so terrible. And then once that settled down even after that I, I never really got on with it I felt really like distant from my emotions and like everything was a bit numbed and I really hated it. And I would sort of go and like protest that I wanted to not take them anymore and they’d obviously say that I could do, I could do what I wanted to do but they advised I kept doing it, kept taking them. And I think I kept that up for about half a year when I just decided that I couldn’t, I just couldn’t do it anymore so I stopped taking them.
 
And then when I went to university in my first year just as I came to university one of my close relatives was critically ill and then passed away just after the first term. And it was so difficult because I was away from home, none of my family or any people and just trying to cope and for me it took a very long time just to sort of accept that I would need help again because I felt I’d worked really hard to get through it the first time and to say you know, I was desperately trying to use all my CBT techniques to try to keep on board with everything and then it got to the point where I just thought oh you know this is more than I can deal with.
 
So I went back to the doctors and there I, so they suggested that I had counselling and anti-depressants again and I explained to them my feelings about taking Prozac and like I didn’t really want to take them again and I was speaking to my doctor and she explained that Prozac... with anti-depressants there’s lots out there and it’s about finding the right one for you and maybe that was the wrong one and that she was surprised that I sort of hadn’t been offered to change. And that’s when she prescribed me citalopram. And then I currently am still taking citalopram and it’s a completely, a million miles away from my experience with Prozac, I didn’t have any sickness when I first started taking them and I had absolutely no problems. I don’t feel the numbness, I don’t really feel like I’m taking anti-depressants other than my mood is much better.
 

Lucy X alters her dose according to how she’s feeling...

Lucy X alters her dose according to how she’s feeling...

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When you sometimes change the dose is that, do you always have a consultation to talk about that?
 
Yes I mean it’s, it’s kind of very much left up to me to make that decision now I always stick in the range between 10 and 30 and I will, I will always have a consultation, I mean sometimes it’s just over the phone because my GP knows me very well now and she sort of knows that because I’ve been taking it, I’ve been taking it since my first year so that’s just over two years now, that I’m quite aware of how these things affect me. She’s very happy for me to just, to let me take you know my sort of call with what I want to do.
 
Do you get a different prescription when you need a different dose or do you just take more tablets - how does that work?
 
It kind of depends because they only come in tens and twenties so if I take thirty I have to take two and then I take ten so, but normally because I get prescribed like them sort of intermittently on a different... normally I have enough to kind of be able to do it myself without having to be prescribed more. I mean so if they just cut the twenties but yes no so normally it’s not really a problem it’s normally just like, I’m more, I’m more – will phone her just to kind of have them just because like I do want to it feel like it’s a joint decision not just like I’m just going off an doing what I want on my own. I’d always want to her say that she felt that was okay but then I’m almost always certain that she will so when I was young I had a lot of sort of anxiety about sort of saying what I wanted to do just because it had been ignored. But very much now I can say ‘oh well this is what I’m thinking then.’
 
When you feel like you need to increase it for example what is it that you’re feeling that makes you want, need to do that?
 
So mainly for me it’s around the exams would be the normal one it’s just for me probably my trigger thing is just being a bit tearful and like just could be anything just like ridiculous stuff. And it’s not even, sometimes it’s not even that I feel like… sad I’m just like overly emotional and I notice it.
 
A drop in mood...
 
And then that for me that’s like oh okay that for me‘s not a good thing.
 

Lucy feels the stigma around antidepressants is unjustified...

Lucy feels the stigma around antidepressants is unjustified...

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If I ever felt like things were going downhill again I would like 100% take them again because yes I mean if you’re diabetic you’ve insulin, like if you’ve got depression you take anti-depressants if that’s the treatment that’s suitable for you I’m not saying it’s suitable for everyone but for me it is and so I’m not going to feel ashamed that I need them because like it’s just an illness like anything else.
 
And so when you’ve talked to your flat mates and your friends about it have you come across other people who are in similar situations?
 
Yes a lot of people have come to me, a lot of people have asked me questions and I’ve told them how I feel and they’re like ‘oh I sometimes feel like that’ and actually a couple of them have gone to the doctors and, I think university is like an incredibly stressful time and in some ways to be able to... I mean when I talk about my experience and people relate, I think for some that gives them the permission to go to the doctors. I think like when you’re younger you go to the doctor because you’ve got a cold or because you’ve got some kind of physical... and I think it’s very difficult to go to the doctors and be like ‘I feel sad’ because it feels like that’s the wrong reason but it’s like some people need the, you know, it’s okay to do it that’s what they’re there for.
 
So in a way it kind of, I’m using ‘inspired’ in a sort of way that by talking to other people you’ve kind of given them that open idea that it is okay?
 
Yes and also to be able to say… if you tell people, like I personally, like other than my parents I’ve personally never come across anybody who I feel has treated me differently or anything because I’ve told them. And, you know, if someone has ever done that I think that’s more of their problem than my problem and so I think yes to just kind of get the word out there and so people know that they’re not alone in what they’re feeling and not, you know, it’s not wrong it’s just what’s happening.
 
Has your parents attitude changed since you’ve been, become older about you having these problems or the medication?
 
They, I think they’d like me to not take the medication but because they want me to be better not because, you know, my medication implies there’s an illness and I think they just don’t want me to have the illness and so they sort of get that feeling about the anti-depressants and it’s like you know a bit of a backwards way round of doing it but nowhere near as much as when I was younger because I think they know now that going back on them and, I mean obviously when it was the death of our close relative they were very much involved, I mean it really shook the whole family and so you know I think they really, you know, they understood how hard it was and I don’t, you know, I think they’ve become much more accepting now. And I think what they really want is just for me not to be ill anymore.
 

Lucy X accepted that she needed help and talking about it with...

Lucy X accepted that she needed help and talking about it with...

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What a lot of people don’t understand is going to the doctor the first time and explaining is just like, I mean the first time I did it I just like, I think I just cried for ten minutes and didn’t say anything and then you know it all slowly sort of came out. And then it’s just such a like as you said... you’re at your lowest and it’s like a complete oh it’s such a big thing and especially if you’re like myself you kept it very to myself to suddenly have to be like this is what’s happening was, I mean that would be another thing for people you know health professionals to realise what a big step someone has made when they originally turn up. I mean one they’ve accepted it personally which is a huge thing and accepted they need help and now they’re coming to find it. But they also have to open up to probably someone who is a complete stranger it’s like yes it’s a huge thing to like you know to maybe have a bit more respect and understanding for how big a thing that really is for people.
 

Lucy X found the combination of antidepressants and talking...

Lucy X found the combination of antidepressants and talking...

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I haven’t had this situation but I’ve heard it from other people that sometimes there’s a feeling that you go to the doctors and they just say ‘here’s some antidepressants and off you go’. I mean they’re you know, anti-depressants aren’t right for everyone some people need other things that, like CBT for me was fantastic and you know, it was the combination that’s really got me where I am now and so, you know, if you feel anti-depressants aren’t the right thing not to be scared to go back and say ‘what else can I have, what else can we do?’ you know, and there’s a lot of help out there, I mean but also to be patient because these things don’t always come through that quickly.
 
I suppose I think sometimes people cannot understand that they take a while to kick in to start having an effect.
 
Yes.
 
It can be quite difficult through that period to keep with it.
 
Yes I mean yes I would just say definitely you need to just stick with it because I mean for me I think it took about like two or three weeks. I mean I think there’s a slight placebo effect in there because you kind of feel like you’re taking something that’s going to make you better. I definitely felt that the second time around so yes just you know, that hopefully things will change, you have to give it time and if they don’t then there’s always help there.
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