What image springs to mind when you think of the term ‘addict’? Some poor drunk, reeking of
Or do you picture a middle-class wife and mother with a busy full-time job and a happy home life, who doesn’t drink or smoke to excess, is often to be found tucked up in bed by 11pm, rises at 6:30am and who — to all intents and purposes — lives an ordered and fulfilling existence?
That’s me. I am that addict. The only real difference between me and the more common perception is that the drugs I take, antidepressants, are legal and available on prescription.
I’m not alone, either. There are millions of us on antidepressants — around seven million in England alone. That’s 16 per cent of the adult population — one of the highest rates in the world.
And although from the outside we may look fairly normal, although we may lead functional, useful lives, we have one inescapable characteristic we share with even the most chaotic and out-of-control addicts: we cannot stop taking the drugs, because if we do the withdrawal symptoms will cripple us.
Sarah Vine (pictured) first began taking antidepressants after her husband was appointed Secretary of State for Education. She revealed her battle to withdraw from the medication which has helped to stabilize her emotions
This week a new study, published in the Journal of Addictive Behaviours and commissioned by the All Party Parliamentary Group for Prescribed Drug Dependence, found that of these seven million, four million face the risk of serious withdrawal symptoms when they try to stop taking their medication.
These can include disorders such as nausea, insomnia, extreme irritability and chronic fatigue. Researcher Dr James Davies, of Roehampton University, said: ‘This new review reveals what many patients have known for years — that withdrawal from antidepressants often causes severe, debilitating symptoms which can last for weeks, months or longer.’
Doctors now believe that this explains in large part why so many people end up on medication indefinitely; and why the number of people reliant on medication in their day-to-day lives is steadily increasing — at an annual cost to the NHS of £250 million.
I know this only too well. Because I have tried and failed to come off. But each time I’ve had to relent: the withdrawal was too debilitating.
The fact that I find myself in this situation is a source of great shame and embarrassment to me. It is not something I am remotely proud of. It’s not something I particularly want to talk about either — no one enjoys laying bare their weaknesses and failings. But given the vast numbers of people who share my predicament, I felt it might perhaps help lift some of the stigma that surrounds this very tricky subject.
Before I started taking antidepressants, I was always one of those people who thought that pills were the easy way out.
Sure, I had experienced difficult periods in my life, during childhood and then as a young adult. The usual sort of stuff: exam pressure, work stress, emotional trauma. But each and every time I had picked myself up, dusted myself down. What doesn’t kill you makes you stronger was my guiding motto.
Even after I had my second child, my boy, and was diagnosed with post-natal depression by a very worried professor who thought I should really be in a clinic, I refused to take antidepressants.
It wasn’t just that I didn’t like the idea of being dependent on a pill to feel normal; I felt it would be more useful and more constructive in the long term to tackle the root cause of my unhappiness, rather than mask it chemically.
And it worked. Perhaps because it was my first real brush with the old black dog, I was able to return to some semblance of sanity (insofar as juggling work and two small children can ever be described as sanity!) through a combination of therapy and life changes.
Sarah’s doctor advised her to take Prozac in order to cope with mood swings, sleeplessness and an overwhelming feeling of helplessness (file image)
We moved house — back to a familiar neighbourhood and familiar friends — I took up yoga, and the unshakable feeling that I was trapped inside the boot of a speeding car heading straight for a brick wall began to recede.
I think I might have even been OK had life continued as normal. But the 2010 General Election saw David Cameron become Prime Minister. Within days my husband was appointed Secretary of State for Education, a job he believed in passionately. For him it was the culmination of years of thought and planning. For me it was the start of a rollercoaster ride that, looking back, I simply wasn’t prepared for.
No one is particularly interested in the challenges politicians and their families face, and I’m certainly not searching for sympathy. So I won’t bore you with the details — suffice to say that the vicissitudes of public life had their effect, and somewhere around the spring of 2012 I found myself back in the boot of that metaphorical car.
I was experiencing uncontrollable mood swings, irrational fears, sleeplessness and an overwhelming feeling of helplessness. I was struggling to concentrate and hopelessly forgetful. Even basic tasks such as shopping for groceries seemed somehow beyond my reach. I felt like every day was a struggle.
The only problem was that this time I didn’t have the excuse of a new baby. This time I couldn’t just disappear from view, take time out, press the reset button. Not now that the whole world was watching (well, probably not — but it felt like that) and the stakes were so high.
I had to carry on functioning, to maintain some semblance of normality, not least for the sake of my children, but also for my own sense of self.
I couldn’t let anyone — not my employer, not my family, not the trolls on social media nor my husband’s enemies, who would have been delighted to exploit any weakness — see a chink in the armour.
So when the doctor suggested Prozac, I thought — why not? Just to take the edge off until things settle down a bit. What harm can it do?
I still remember that extraordinary feeling as, after a few days, the medication began to kick in. My main worry had been that it would somehow affect my ability to think, to write, to work. That it would cloud my mind and knock the edges off.
Sarah recalls antidepressants allowing her to regain control of her daily life when she first began taking them (file image)
But the opposite happened. As the worry and panic that had flooded my brain for months and turned everything soft and soggy now began to recede, I felt myself becoming sharper.
The everyday tasks which, in my anxiety, I had found almost impossible to tackle — dealing with bills, organising the children’s timetables, taking the car for its MoT — suddenly seemed as they were: simple and straightforward. My memory improved. I rediscovered my enthusiasm for going out. I was able to sleep again, instead of sitting up late into the night fretting.
Most importantly, I no longer felt that if I failed to wake up the next morning, perhaps it wouldn’t be such a bad thing for everyone concerned.
In short, the drugs worked. They stabilised my emotions sufficiently to allow me to regain control of my day-to-day life.
I remember phoning a friend in Scotland, elated. ‘I’m never coming off this stuff!’ I said. She, wisely, said nothing. In reality, like most people who take antidepressants, I had no intention of staying on them for ever.
Just until things had gone back to normal, I told myself. Except, life being what it is, things didn’t return to normal. If anything, they got more complicated.
I sometimes wonder whether being on antidepressants has, to a certain extent, influenced the course of my life. Whether, without that chemical crutch, I would have done things differently. Whether the emotional anaesthesia that I have been under for these past few years has led me to take on challenges that, without the drugs, I would not have felt equipped to tackle.
Sarah (pictured) says over time she developed a tolerance to the drugs. She was given Duloxetine after she began to experience shooting pains and crushing fatigue
I guess I’ll never know. But I do know this, from experience. In its natural state, the mind tells us when it finds itself under strain. We become sad, unhappy, fearful — all normal, healthy reactions to adversity. Physical pain acts as a warning sign from the body that something is wrong or broken, and emotional pain has the same function.
But if you are taking antidepressants, that process is disrupted. You are, to a greater or lesser extent, numb to your own feelings. And just as if you mask physical pain with pills you can end up pushing your body beyond its ability, potentially making the problem worse, numb the emotional pain and you end up doing the same to your soul.
The pills may help you to cope on the surface; but the underlying problem never goes away. Indeed, it may even get worse.
I certainly believe that this is what happened to me. On the outside, foolishly blind to the deepest of wounds. Inside, well, not so much.
And just as any addict over time develops a tolerance to the drugs, requiring ever higher doses just to feel normal, I reached a point when the inevitable happened: the drugs stopped working.
It was a bit like waking up in the middle of an operation: now my pain was physical as well as mental — I was unable to move in the mornings, was experiencing shooting muscle pains, terrible headaches — and an overwhelming sense of crushing fatigue.
This time they put me on something called Duloxetine — used in the treatment of major depressive disorder, generalised anxiety disorder, neuropathic pain, chronic musculoskeletal pain and fibromyalgia. Bingo. As I sank into my new chemical bath, all my aches and pains melted away. Once again, I was able to face the world.
Duloxetine (pictured) has withdrawal symptoms including dizziness, headaches, nausea, diarrhoea, paresthesia, irritability, insomnia and suicidal thoughts according to a 2005 study
Without it, I doubt whether I would have been able to cope with the stress of the EU referendum (in which my husband campaigned to leave) or the subsequent fallout of the Brexit vote (both political and personal) or the 2017 general election — or, for that matter, moving house.
But cope I did, and so it was that earlier this year I decided the time had finally come to kick my dependence.
It wasn’t just that I felt a desire to experience life in the raw again; it was also that for the past few years I have suffered from tinnitus, a high-pitched ringing in my ears which varies according to my levels of stress and tiredness, but which began around the same time I started on the Duloxetine. I had a notion that it might improve if I came off it.
This wasn’t going to be easy. Duloxetine is renowned for its withdrawal symptoms, which are generally more severe than with other antidepressants of this type.
A 2005 study in America found that 44 per cent of users experienced withdrawal symptoms, which include dizziness, headaches, nausea, diarrhoea, paresthesia (a burning or prickling sensation, particularly in the limbs), irritability, insomnia and suicidal thoughts.
I knew from experience that in my case even forgetting a dose was liable to trigger some of these symptoms, especially the burning sensation in the limbs and the dizziness — as well as what some patients have described as ‘brain zaps’, a kind of weird buzzing behind the eyes (it’s very hard to put into words, but trust me: it’s not nice). Oh, and the irritability, which creeps up on you like a thief in the night.
Dr Jennifer Wild advises being more mindful and redirecting your behaviour in order to overcome anxiety without resorting to pills (file image)
With this in mind, I spoke to my doctor, and we agreed a programme of tapering off, gradually reducing my dose from 60 mg per day to 40, then 20, and then doing away with it altogether over a period of three months.
Has it been successful? In a word, no. No matter how careful I am, no matter how slowly I go, I still end up experiencing all of the above, plus some horrendous nightmares into the bargain.
As I write, I am still taking the stuff — albeit on a much reduced dose. I still have raging tinnitus, I still have muscle pain, I still get dizzy spells and, if I don’t get my sleep, can be extremely testy.
I don’t blame my doctors for any of this. They were simply doing their best with the tools at their disposal.
But I do think that if there were more investment in mental health services in general, more awareness of the alternatives to medication and better information about how and where to get help, fewer people would end up going down the antidepressant route.
Because however useful they may be, they are only ever a sticking plaster for the real problem.
But I am determined. Not least because, for all the adverse effects of ditching this drug, I can already feel some of the positive ones. I may no longer be — in the immortal words of Pink Floyd — ‘comfortably numb’; instead I am uncomfortably but unquestionably alive. Alive to the world around me, to the people I love — and to myself, my own feelings and emotions that for so long have been sedated.
Ways to unknot anxiety without resorting to pills
By Lauren Libbert
- Get help, even if you feel like nothing can change the way you feel. Doctors can recommend a range of treatments, some of the most effective of which don’t involve pills. ‘If you see your GP, you can seek treatment based on cognitive behavioural therapy,’ says David Baldwin, professor of psychiatry at the University of Southampton, though they may also suggest using antidepressants. ‘A “cure” is rare,’ he continues, ‘but the vast majority of people will improve with treatment.’
- Stick to small doses of social media. ‘Social media can actually help people to feel less isolated,’ says Eve Critchley, head of digital at mental health charity Mind. ‘But it’s important to be aware of how you’re feeling when you’re online and, if you are starting to feel vulnerable or anxious, come off for a while.’
- Challenge your harmful ideas about yourself — and others. ‘If you find yourself thinking, “everyone stares at me when I walk into a room”, rebut that with the truth,’ says psychotherapist Louise Tyler, who treats anxiety sufferers at her Personal Resilience clinic in Cheshire. ‘Look around — in fact, people are too busy to be interested in one person’s arrival or presence.’
- Expose your inner self. ‘With clients, I do something called gradual exposure therapy — encouraging them to expose themselves to social situations in small ways, so chatting to someone at the till or smiling at another mum in the playground,’ says Louise Tyler. ‘When they see that nothing bad happened, then the anxiety starts to lessen.’
- Be more mindful. ‘When you feel any symptom, do something to re-focus your attention away from it, even if it’s making a cup of tea or going out for a walk,’ says Dr Jennifer Wild, consultant clinical psychologist at the University of Oxford. ‘Once you redirect your behaviour, the anxiety about that symptom disappears — and often the symptom itself, too.’
Are you or a loved one struggling to give up antidepressants? Tell us your story at firstname.lastname@example.org