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Lucy Y

Age at interview: 23
Age at diagnosis: 18
Brief Outline: Lucy first experienced depression as a young teenager but was not prescribed antidepressant medication until she was older. She continued to feel depressed intermittently but ‘muddled through’ for a while. During her first year at university things began to feel intolerable and she sought help from the GP. She was prescribed Prozac (fluoxetine) initially but didn’t find it effective. She now takes mirtazapine, which she says works well.
Background: After graduating from university, Lucy now works as a personal assistant and lives in a shared house with friends. Ethnic background: White British

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Looking back Lucy thinks her depression first surfaced around the age of 12 but as a child she did not realise what it was. She saw the GP when she was 15 and was referred for counselling but not prescribed antidepressants. Her doctor said there were limited services for young people in the area where she lived, and tried to arrange for her to access some counselling but nothing came of that and for the next few years Lucy kept going without seeking further help, although she reflects that she had periods where she was depressed, and was sometimes self-harming and not eating properly.
When she was at university she sought help from her GP as she was finding it very difficult to cope. She was unsure whether she would be considered ‘bad enough’ to be prescribed antidepressants.
 
‘I’d been afraid that I wouldn’t be offered drugs. I was afraid that what I was going through wasn’t going to be considered bad enough for that, I had it in my head that you had to… have tried to kill yourself or something to be offered drug treatment, so it was a huge relief because I was getting to the point where I couldn’t endure it’.
 
Lucy took Prozac (fluoxetine) initially for a number of months, and although it helped alleviate her symptoms she felt it wasn’t wholly effective even when the dose was increased. Prozac left her feeling able to function better, but essentially still feeling unwell. She was referred to see a consultant psychiatrist who recommended stopping antidepressants and trying Cognitive Behavioural therapy (CBT) as an alternative strategy. She stopped taking it after several months and gradually began feeling more herself again.
 
Some while later Lucy began feeling very depressed again, and was also having trouble sleeping. She returned to see the GP and this time was prescribed mirtazapine, which if taken at night time can also help with sleep problems. Lucy found this antidepressant worked well for her and continued to take it for the next three years.
 
‘It felt like I was finally, you know, my true self… and living my own life and able to do the things that I wanted to do. For the first time since childhood I almost felt like this was how ‘normal’ was supposed to feel… You know, how to be happy, which I never quite got on Prozac.’
 
More recently a new GP suggested discontinuing mirtazapine as he felt she had taken it for too long, and so Lucy stopped taking it. In retrospect she wishes she had not taken this advice as after stopping taking it she became depressed once again. She began taking mirtazapine again a few weeks prior to the interview but found this time it was not helping to improve either her mood or her sleep patterns. A new GP has prescribed citalopram for her to try.
 
Lucy feels that GP’s and consultants each have different and individual views and attitudes towards medicines for depression, and has found variations in the levels of their interest or expertise in the area of mental health. Now that she is older she finds it easier to be able to put across her own needs and views during a consultation, but feels that it can be very difficult for young people to be able to engage effectively with health professionals about mental health issues. Looking back Lucy wishes she had been able to access help more easily when she first experienced depression as a young teenager.
 
‘If I’d started [antidepressant medication] a few years earlier when I first went to see a doctor then I’d be…. You know, I’d have had many more good years in between… it needn’t have been as protracted and difficult as it was for me. It’s not for me to say they should start handing out pills to children, but you know, if that’s going to be helpful [they] should think about it because that would have made a massive difference to my quality of life for half a decade. And that’s a huge amount of time when you are young to have lost really.’
 

Lucy Y had few expectations that an antidepressant would be...

Lucy Y had few expectations that an antidepressant would be...

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I’ve had friends who’ve tried one drug and it hasn’t worked for them and that’s put them off the whole experience. I mean for me the big things was, and yeah, there were, there were times when I thought this isn’t, you know the day my doctor prescribed mirtazapine first of all, I went back to him and just, was not expecting him to be able to suggest anything that would help I was, you know, kind of, in despair about the chances of anything working or even you know prescribing a different drug or doing it, or being able to do anything that would usefully make me feel better and then when he, he suggested something I hadn’t heard of and I thought that could be interesting and gave it a try and just, you know, within a couple of months felt incredibly good.
 
I suppose it’s quite easy to, to kind of fall in that belief that when you’re trying something and it hasn’t worked so nothing else will, they could all be pretty similar really.
 
It plays into the mentality of depression as well, the kind of hopelessness of it all.
 

Lucy Y was ‘functioning’ on fluoxetine but mirtazapine made...

Lucy Y was ‘functioning’ on fluoxetine but mirtazapine made...

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Yeah, so, so Autumn of 2009 it had been sort of building up all Summer and I was feeling terrible again so I went to see the same GP and this time he prescribed mirtazapine and I’d been having terrible trouble sleeping and so I took it in the evenings and it was just incredible, it was, had quite a strong sedative effect and that was just very, very useful a time where I couldn’t sleep and that kind of, you know, knocked me out for a few weeks and allowed me to kind of sleep off the worst of it and you know, sort of, sort of slowly getting back there but I felt after maybe taking it for three or four months just like a completely new person. It had cleared up a lot of stuff that I hadn’t even, that I thought, you know, was my personality that I hadn’t even realised was related to the depression, stuff that I just thought was an intrinsic part of how I was and when I found that stuff kind of lifting and just feeling much more optimistic than I’d ever felt before I was like wow this is, this is pretty good stuff. So I continued taking that more or less straight for three years which have been the three happiest and most productive years of my life.
 
When you started taking that one did you get any different effects?
 
I felt like a zombie for the first few weeks, I felt like almost stoned, it was the sort of cognitive effects were really powerful, I remember thinking it’s great that I can sleep for twelve hours but, you know, if this stuff doesn’t clear up then I’m not going to be able to function long term on this.
 
So when you were waking up after your long sleep you were still feeling groggy?
 
Yeah, for about three or four hours, yeah which, which again was useful it was a kind of cushion from all the horrible feelings which, you know, it sort of gave me a couple of weeks to sort of sleep off the worst of it and. But yeah luckily after, I kind of acclimatised to the levels or whatever it, the cognitive stuff got a lot better. I had a bit of, sort of strange short term memory stuff going on as well, the first maybe month that I took it but all that cleared up really quickly.
 
And so you said that you felt really good on that one.
 
Yes, yeah.
 
And how different was the feeling from fluoxetine then?
 
Yeah it felt like, it felt like I was finally, you know, my true self and living my own life and able to do the things that I wanted to do, you know, for, for the first time in years since I, since childhood almost I felt like this was how normal was supposed to feel and this was, you know, how to be happy, it was yeah, which I never quite got on fluoxetine, I kind of felt, you know.
 
Functioning?
 
Yes functioning but not really good whereas on the mirtazapine I felt incredibly high achieving.
 

Lucy Y takes her antidepressant at night as it helps her to sleep

Lucy Y takes her antidepressant at night as it helps her to sleep

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It was very helpful to me in terms of sleeping the whole time I took it, not as powerful an effect as in the first couple of weeks but you know, I went from maybe having two or three nights a week when I couldn’t sleep very well to having I think only four nights when I couldn’t sleep in those three years on mirtazapine, so the only thing that it did do, it was very much, it did sort of feel like I was drugging myself to sleep a bit.
 
Did you pass out, not pass out but did you just fall into a very deep sleep?
 
Yeah about half an hour after taking it so, but it meant that I didn't really feel properly tired so, you know, I’d look at the clock and think oh it’s 10 ‘o’ clock, I’m not tired but if I want to go to sleep, at half ten I’d better take the pill now, job done. So I used to take it every night because if I didn’t I wouldn’t have slept.
 

Lucy Y goes to see her GP when her repeat prescription has...

Lucy Y goes to see her GP when her repeat prescription has...

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He was very good about repeat prescriptions and things, he’d give me, you know, between three and six months’ supply and say just come back to me when you need a repeat and we’ll check that everything’s okay and that worked quite well. I mean during that time I did move cities twice, I moved from where I lived in University back to where my parents live and again when, when I ran out of repeat prescriptions I found a GP there, who was also very helpful, and yep continued reviewing that with me. 
 

Lucy Y thinks ‘crowd sourcing’ websites are useful. She...

Lucy Y thinks ‘crowd sourcing’ websites are useful. She...

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So when you start on the new one did you do some looking up to find out more about that one?
 
Yeah, yeah I have done for everything I’ve taken. Just so, the leaflets you get with them are useful but also there’s some, a couple of websites where they do some crowd sourcing on side-effects and get, you know, people’s own experiences of them. And I’m, I’m quite wary about anecdotal evidence generally but there’s a couple of sort of pretty good aggregators which say here are all the side-effects I’ll tell you about, here are some things that people have had happen to them that might be related to.
 
Yeah so they, somebody will start a site or a forum or something and say look I’m looking for people’s experiences of X and, you know, presumably as much as you’ve had that kind of response with this, there are lots of people who have got opinions about this stuff and want to.
 
Yes
 
And, and the whole point is that, you know, so you know, so say someone’s prescribed something and they got this weird side effect that wasn’t really on the labels and the doctor said yes it could have been that but they have no way of telling. They give that information to the person who’s aggregating it all and that gets put on the list of things, so if you know, if find yourself taking that drug and this weird thing has happened to you and oh somebody else had that.
 

Lucy Y has learned a lot about depression and how other...

Lucy Y has learned a lot about depression and how other...

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I’m interested in other people’s experiences but only if they meet a certain bar of articulacy which is very unfair to a lot of people who’ve got intricate experience that they’re sharing in the best way that they can but I, you know, I tend more to sort of read books about people’s experiences than to go on the internet.
 
And so have you also read kind of books?
 
Yeah I’ve read quite a lot of stuff around this, I’ve read, you know, the sort of sad girl classics, the girl interrupted, bell jar and that type of stuff and also a couple of the sort of older men with depression, there’s Darkness Visible, a William Styron book, there’s a couple of others there. And I don’t know if you know the Noonday Demon but that’s incredibly, it’s huge, it’s a thousand page turner and its half experience and half kind of social and historical cultural interpretations of depression.
 
I mean and how do they, do they make you feel, how does it make you feel reading those kinds of accounts?
 
It’s interesting, some of its.
 
Does it help you to understand yourself more or does it make it?
 
Yeah, well no some of it’s very much, especially when I first started discovering these books when I was in my mid-teens, it was like how are other people, you know, not only have they had this experience but they’ve also written books, this is really inspiring. And also sometimes you think, you think oh God that person was so much worse than I am, what am I complaining about, you know, kind of the tendency to compare yourself to others is always there. And it took me a sort of a long time to properly appreciate that everyone’s experience is different and just because mine isn’t quite like that it’s still valid, that kind of sense of validation took a long time to come.
 

It can be difficult to know when to tell a new boyfriend that...

It can be difficult to know when to tell a new boyfriend that...

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So yeah, we’ve, we’ve been together since April and he knew before we started going out that I had problems with depression and I took medication for it and he’s, he’s been, he’s been really great about that stuff.
 
So was that easy or difficult to tell somebody that you barely knew to begin with then.
 
So we were friends before we started going out so I kind of got to know and trust him like that and we talked about it in that context and then got together later and it was actually, it was, so I when I’d, you know, started dating people before there was always the oh God when I am supposed to tell you moment and I, I’ve never been able, good at being that forthcoming with strangers especially so, you know, I’d think oh God well three dates, is it six dates is it when we’re going out a couple of months or you, yes because, you know, at some point you do, I feel almost, you know, it gets to a point when it’s lying by omission, if it’s still a part of your life then you sort of owe it to that person if you’re dating them to be clean about it. But also you don’t want to drop it in on the first date, by the way [inaudible speech]. I do remember with, with one guy that I’d started seeing I decided the easiest thing to do would be to just, you know, take my medication in front of him and he said is that the pill and I said it’s a pill and that was the end of the conversation.
 
Have you had any kind of bad reactions to you telling people that’s what you do?
 
Probably the worst reaction was from my parents.
 
Right.
 
Yeah, I said, mentioned it, I think when I was first prescribed fluoxetine my dad said is that really necessary.
 
Did you talk to him about it?
 
No because it was much, much easier not to really, yeah we just don’t talk about it.
 
Actually some people say that when they do tell other people that they’re taking them they can be quite surprised to hear other people say oh I do to or I know someone who is.
 
Yes, yeah. Now I haven’t, haven’t had a lot of that but what I have had is friends who I’ve, who’ve you know, if I haven’t had long conversations with them about it they’ve at least been aware that that’s my situation and then if they’ve encountered problems themselves later or if they’ve got other close friends that are having those troubles that they come to me to talk about it which I really, really like. I feel like, you know, at least it’s doing other people some good that I’ve had these bad experiences, that you know, and that I’ve had long and extensive enough experience of, you know, treatment and whatever to be able to say look here’s my advice, here’s what I think you should do.
 
I suppose it also encourages you to be able to talk a bit more as well.
 
Yeah, yeah it really does and I, I sort of quite, I really like the fact that people feel that they can talk to me about that, that they can, that they have come up to me and said look I’m feeling like this or I’ve got a friend who’s just started taking this and I know you’ve taken this so what would you, what would you recommend to her, that kind of thing.
 

Sleep problems had been one symptom of Lucy...

Sleep problems had been one symptom of Lucy...

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So autumn of 2009 it had been sort of building up all summer and I was feeling terrible again so I went to see the same GP and this time he prescribed mirtazapine and I’d been having terrible trouble sleeping and so I took it in the evenings and it was just incredible, it was, had quite a strong sedative effect and that was just very, very useful a time where I couldn’t sleep and that kind of, you know, knocked me out for a few weeks and allowed me to kind of sleep off the worst of it and you know, sort of slowly getting back there but I felt after maybe taking it for three or four months just like a completely new person. It had cleared up a lot of stuff that I hadn’t even, that I thought, you know, was my personality that I hadn’t even realised was related to the depression, stuff that I just thought was an intrinsic part of how I was and when I found that stuff kind of lifting and just feeling much more optimistic than I’d ever felt before I was like wow this is, this is pretty good stuff. So I continued taking that more or less straight for three years which have been the three happiest and most productive years of my life.
 
When you started taking that one did you get any different effects?
 
I felt like a zombie for the first I felt like almost stoned, it was the sort of cognitive effects were really powerful, I remember thinking it’s great that I can sleep for twelve hours but, you know, if this stuff doesn’t clear up then I’m not going to be able to function long term on this.
 
So when you were waking up after your long sleep you were still feeling groggy?
 
Yeah, for about three or four hours, yeah which, which again was useful it was a kind of cushion from all the horrible feelings which, you know, it sort of gave me a couple of weeks to sort of sleep off the worst of it and. But yeah luckily after, I kind of acclimatised to the levels or whatever it, the cognitive stuff got a lot better. I had a bit of, sort of strange short term memory stuff going on as well, the first maybe month that I took it but all that cleared up really quickly.
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