It’s almost 12 months since I wrote about my mental health journey for the first time.
Up until then I kept it all quiet, or at least quite from the public and certainly from my employer.
The people that loved me were different. They knew exactly what was going on as they endured everything that I threw at them – bad moods, anxiety, despair, procrastination, excuses, mad theories the whole stone-cold buffet of depression.
But beyond these wonderful people it was a different story. No one could know what was happening in my head, because if they found out I’d be found out. Who wants a Chief Strategy Officer that’s wrestling with depression and thinks they are useless?
I genuinely thought that I might be fired when I first posted the piece. That clients might complain about having me on their business. And others turn on my weakness.
It’s one of the reasons I posted the piece on World Mental Health Day as surely it would be a bad corporate look to march me out of the building on a day of mindfulness and meditation.
Even though, by then I was finally on top of things.
And I am desperately glad that I did. Over the last year I have been contacted by so many beautiful people that themselves are wrestling with the way their mind works or doesn’t. It is simply one of the greatest privileges of my life to hear people’s stories. And I have been struck by the sheer quantity of hidden pain so many are enduring, while putting on a brave face and facing the day.
You need to know that you are not alone.
A lot has happened since last October. So, I thought I would update the story – in case anything about it helps you act or seek help or recognise that the thing you are experiencing is common to so many of us.
In time maybe you will share your story too and perhaps together, we can make progress in how we think about mental health, beyond giving everyone stress balls and yoga lessons on World Mental Health Day.
Since we last met
For the last 15 months I have been taking 60mgs of Duloxetine every day.
I know that its every day without fail because if I forget, I start feeling very peculiar by about 9am. I have these ‘drops’, like physical dizzy moments that only last a second or so but they kind of floor me. I call them ‘drops’ because they are like falling down a few floors and then having the fall stopped suddenly by a line or rope.
I don’t know what would happen next because I don’t let it go any further. I take my pill and grit my teeth because SSRIs, like Duloxetine, are absorbed in the intestine and it takes two hours to get there and start working.
The results of the Duloxetine are fantastic. For me it’s a wonder drug.
One app to rule them all
I monitor my mood using an app called, unsurprisingly, mood. At a set time every day it asks me how I am feeling, and I colour code the day with one of five tones of my chosen colour. You can see a snapshot in the image I have used for this post. I use red and I understand that you are supposed to code the day dark red if it’s going badly and light red if it’s going well – I guess the idea is that if its light red you are calm and measured. Not for me. I want the day to feel bright and sharp and clear and deeply fucking red. The light colour means meh to me. A meh day in which I can’t be arsed to do anything and my brain is lost in some fucking foggy bog. I want deep red every day.
The result is that I can now tell how long great and bad spells last. The odd baddish day is fine – antidepressants don’t make the rest of the shit in your life go away, just the chemical imbalance. But I watch periods of about a week like a hawk. Because I am naturally paranoid about losing the clarity and energy I have now.
The mood app shows that I have had just three bad periods in the last year and none of them lasted longer than a week. If that’s the deal, then I can live with that.
But most of the time I’m good, rarely dark red but good. It’s clear that the amazing highs at the beginning of using Duloxetine have ebbed away and of course I miss them. But they have been replaced by what I can only describe as normality.
Most of the time I now feel normal. The normal me. The actual me. The me that simply doesn’t live in a cloud believing that his brain doesn’t work.
I really understand why at this point people using medication for mental health often stop taking their drugs. After all, what’s the point now that you feel normal? I may be ‘cured’ but I rather suspect that the sheer normality of how I feel shows that the treatment is working.
Whatever happened to the snoring?
The side effects I talked about are pretty much under control.
The rash I developed in the early months turned out to be eczema – a reaction to the drugs – and a steroid cream, so potent it has a flammability warning on the side of the pack, soon knocked it into shape.
My Duloxetine dreams continue to be insane and very amusing, if a little exhausting. I really need to record them somehow.
The snoring however, that’s a different matter. It appears that the medication relaxes my throat at night, and this causes terrible snoring. That would be bad enough but with a wife that is breast feeding, with very broken sleep, it is a real issue.
After trying all sorts of remedies, I finally got a sleep test done. This led me to a device that, with some discomfort keeps my airways open by forcing my jaw forward. But that has caused a problem called TMD in which causes my jaw to be extremely painful when I bite.
Fucking hell if it’s not one thing its another.
Oh, and there is the drinking. Early on I was told by my psychiatrist not to drink while taking duloxetine. I took her at her word, but it was a bit weird because the NHS is perfectly happy for you to drink and take the drug.
So, I started experimenting with the odd single glass of wine when I was out for dinner. Things seemed to be fine. Then in Cannes this year I allowed myself a beer and a glass of wine each night – just call me Mr Fun. Finally at the agency summer party I went on a bender and had three pints.
At this point I had not been drinking in any real way for 18 months.
And the result was horrible. Straight back into a low period. This may be a classic case of correlation not causation, but it was close enough to freak me out. I stopped immediately.
I really, really want to drink a lovely welcoming glass of Haute Medoc, or frankly the fruit of any part of Bordeaux, but I have come to the conclusion that my drinking days are over.
To be clear there is no upside to this state of affairs. I no more spring out of bed in the morning than I did after half a bottle of the gorgeous stuff the night before. There is nothing I like about not drinking, except I want to avoid ‘that’ feeling at any cost.
That’s where I am at with my medication. At 60mgs it’s here for the foreseeable future, possibly forever. Originally there was talk about coming off after a year, but I have been using Duloxetine for 18 months now and I can’t see letting go any time soon. The withdrawal is supposed to be horrendous and needs to be managed, so I’m none too keen to experience that and if I had to use this drug for the rest of my life, I would be more than happy.
I’d really like to hear from anyone that has come off after a good experience of using SNRIs. Or has been using them for an extended period of time.
The therapy confusion
And while I am taking a break from therapy, it was immeasurably helpful in going beyond the immediate and unpacking a whole cupboard of self-knowledge.
To my mind therapy is the unlock for all of us. How can we possibly be expected to navigate this world when we are chronically unaware of the way and reasons we respond to it? I wouldn’t say my life has been transformed by therapy and in many ways the insight I have into myself as a result is a bit fragmented. But it’s definitely helped.
The thing is, I can never be sure how good the therapy is that I am getting. Part of me thinks that the therapist doesn’t matter, it’s up to you to do the work and if you are prepared to do this, it will happen for you.
But there are also so many different types of therapy on offer that I don’t know which one is right for me or even what variety a therapist is offering. To me therapy is like going to a restaurant and not been allowed to see the menu and when you do, not understanding what any of the dishes are.
But overall therapy has been a good experience and I’d really like to get back to it. Knowing that I am not asking it to sort out the depression but to help me understand why I get into a bad place.
A year on I really am OK
Every day I am amazed at how good I feel.
This is not a boast, it’s the total and utter pleasure that comes from not waking and having the cloud descend on you. Not briefing yourself in the shower about how shit you are. Not being desperate to get to the end of the week so the pressure in your head lifts for a bit. And not being so hard to live with.
My newfound energy and clarity have transformed my professional value. And that this has had a massive knock-on effect on my sense of worth and mental health. I am prolific in terms of both ideas and output in a way I haven’t been in many years.
I have been able to enjoy every single moment of my youngest child’s first eight months. The very few occasions I have been ‘down’ since his birth have underscored how difficult these first months would have been if I was still lost in depression.
My older boys will be the judges of whether I have showed up differently for them or not. I truly hope so.
And though I am still a deeply flawed person to love and live with, I deal with both the ups and downs of my relationship better than I have ever done. At least I can say that my family gets the best of me and not what’s left after bluffing my way through a best forgotten day.
That’s the story so far. I will let you know if anything changes – good or bad. But if you ever need to talk about your experience or issues with mental health my email is email@example.com. I am not an expert and have no ability to advise you. Such advice as I have in my original post. But I can share what I have been through or simply listen.
I can definitely do that.