The side effects I felt from anti-depressants during the first 5 days of treatment.

I’ve always been too proud to rely on medicine for longer than a couple of days. I’m reluctant to even take anything other than a Vitamin C effervescent when I have a cold. You always tell yourself that you’ll be able to take care of it, that your body will do its thing, but as I get closer to my 30th birthday, I’m more aware of the shortcomings of the human body and how injuries from my childhood can suddenly spring back up in the form of an ache or a pain that lingers for a little bit. Naturally, as someone who always felt they could just “deal with things”, the thought of going on an anti-depressant is not something I ever entertained. Friends would talk to me about their experiences, family members would hint that I should think about it, but even while I was in therapy in my early 20’s, it never crossed my mind as something I should explore. You can take care of your unhappiness on your own, Conrad. You don’t need anything or anyone else. You’re strong. This is the depression talking, and yet again my stubbornness did not allow me to seek out treatment for years on end, hoping I would eventually feel better. Skip forward to last week, where I found myself suddenly telling a family member “I don’t think I’ve been happy since 2011”. To which their apt response was “Well, isn’t it time to try something else?”

That conversation was 6 days before I managed to muster up the courage to go to a GP, and also 4 days before I crashed hard, spending 40 hours nearly paralysed and stuck in my own mind in bed. I’ve talked in other posts about the experience of going to the doctor and taking the anti-depressant for the first time, but I haven’t discussed what it has been doing to me.

I’m told most anti-depressants take anywhere from a week to two weeks to really kick in, and that I’ll simply start to feel better. I don’t know what that means, but I’ll be sure to write about it when I feel it, so I can understand it better. What I do know, is that the side effects have been fairly instant, and I wanted to document them while they are still fresh in my mind. I’m on day 5 of taking Nuzak, which I’m prescribed to take for a month, until July 18th, before discussing adjustments with my GP in a follow-up appointment. Overall it’s a 6 month commitment to take something, which I committed to upfront. I’ve also been given Stresam, which is an anti-anxiety medication, in case the anti-depressant causes heightened anxiety. “It’s got to get worse before it gets better” is all that comes to mind here.

I’d like to start by saying that the side effects have not been too debilitating too far, which I am fairly relieved about. I’m sure I’m merely scratching the surface at this stage, but these are still worth a mention as it gives a bit of an indication as to the early experiences with anti-depressants, especially for someone who has never been on anything. Everyone will have a different experience with medication and I’m not claiming these as universal. This is simply my experience so far.

The first side-effect that has been instantly obvious is a loss of appetite. I’ve started waking up and not feeling hungry at all. I have made a point to eat healthy since I started treatment, and have only managed two meals a day, a late breakfast and an early dinner. I have been put off by the thought of cereal, alcohol, chips, and anything that generally seems too processed. It’s almost like my body has gone into witness protection in a way, and I’m craving more fruit and veg, which isn’t a bad thing. This is a psychological shift too of course. If you take care of your body, your mind should slowly start to follow, or at least, that’s what I believe. I’d like to do everything possible to try and assist the medication to get me back into a decent state.

Another side effect that has been less welcome, is quite a strong headache. Similar to the one you will experience if you’re a coffee drinker and you go cold turkey (I’ve gone through this a few months ago so I know what it feels like). On day 2 I had a headache the entire day, and yesterday I only felt it when I took the Stresam capsule. I’m going to experiment a bit with it over the next few days, as perhaps the Stresam is causing the headache, both times it was rather instant. Regardless, these types of headaches are tough, and if I was at work, I’d need to take a break and have a lie down for a few minutes. Someone who hasn’t experienced them before may struggle a bit, but they also pass relatively quickly. The doctor also told me that I’m welcome to take any headache tablets if need be though the Panado’s haven’t done much to help them. I’m always rather uncomfortable with mixing three types of medications when my body isn’t used to even taking one.

The last side effect I’ve experienced is what I can only describe as a bit of a dazed look on my face. I seem a bit more pale than usual, and I have moments in the day where things start to feel a little more fuzzy. Not to the point where I wouldn’t be able to drive or function on a basic level, but this might be something tricky to navigate if I’m working on a strict deadline for a client. I’m going to keep an eye on it. I’m feeling it in particular about 30 minutes after taking the tablet in the morning. As the doctor insinuated, I’ve been operating at 150% for many years, and am now down to 120%, but I need to learn to be OK with just operating at 100%, or even 80%. Type A’s will understand what that is like.

I’m sure I’ll still go through a host of experiences and feelings as I navigate this new path, and I am excited to learn more about and to approach this journey with the “one day at a time” approach. The weekend is around the corner, which is a daunting prospect, considering how last weekend turned out, but I am going to take things one day at a time, and focus on reaching out to friends and family for support, where it’s possible to do so.

Conrad was here.

Three baby steps I’ve tackled in the first week since my depression diagnosis.

While today started with a real struggle to get going, ultimately there were three very important baby steps that took place that I’d like to acknowledge and give a bit of power to.

  1. I’ve set a new rule for myself, which I’ve asked my landlord to help enforce. The curtains to the apartment must remain open – that includes all blinds – while it is light out. First thing in the morning all the way through to when the sun sets. I have gotten too casual with shutting everything and sitting in darkness for most of the evening and in the past this has happened over an entire weekend. Check.
  2. I decided that it was time for a walk today, even if just around the block. The weather has been fairly miserable – windy and rainy – so I set off in what I can only call an impulse-decision, committed to walking around the block. To my “I usually run 5-10km’s on the beach every weekend” self, this may seem like nothing, but considering where I’m at this week, this was a big victory. The wind turned my umbrella inside out, I got soaked by the rain, but hell, I actually did it. Check.
  3. I went to the beach to watch the sunset. To clarify, my landlord drove me there as I had been indoors for too long. I spent about 90 minutes watching the waves and enjoying and appreciating my surroundings, albeit from inside the car. I used to love going to the beach, and am making a mental note to do this more often, especially when someone invites me to go with them. Check, Check, Check.

Tonight I’m appreciative of these three things, and counting them as notches in my belt, as I continue on this journey of recovery.

Conrad was here.

Finding a depression support group right on my doorstep.

As soon as I got home from the doctor, having just being diagnosed with depression, a brilliant 10 days before my 30th birthday, I had three immediate thoughts as I dropped my keys on the counter.

One – schedule your follow-up doctor’s appointment now. Like, right now. If you don’t do it, you probably won’t go. So I did. 18 July, I see you.

Two – take the damn pill. Just take it. Don’t overthink it.

And Three – there has got to be a support group nearby. There has got to be more people than me suffering with this thing in my area.

A quick Google search brought me to a Facebook Group that has been operating for a couple of years, aptly titled around the broader area I live in. If I like the page, my friends on Facebook will see I have depression. Who cares, Conrad, you actually DO have depression. The group is small, so it’s probably dead and I shouldn’t apply to join. Conrad, request to join, just do it. What if they tell me it’s all made up and that I am not depressed enough? A medical doctor diagnosed you with depression. You have it. It’s real, dude.

All of these thoughts and more raced through my head, and I still ended up only just managing to get enough courage to e-mail the group admin. I started the message off with “I was diagnosed with depression yesterday”, which surprised me. I hadn’t said it out loud, but had written it at least and I was very proud about that. “I am looking to join a support group in the area, when are you meeting?”, I asked.

Nobody is going to respond to you. Yes, they will, Conrad. The group probably only allows women in. No, they don’t. Depression affects everyone. You will have to drive so far to get there. Perhaps, but how about you find that out first. You’re wasting your time. Go to hell, depression.

*PING*

Response, featuring “I’m so glad that you reached out so quickly after your diagnosis”. Their next meeting is in 3 days, and if you’ll believe it, it’s taking place less than 1km from my house. Ask for help if you’re struggling, it’s out there, I promise.

Conrad was here.

Needing a natural “pick me up” but finding a surprising obstacle.

When I was a student, I used to go for regular Vitamin B12 injections at the local pharmacy, and when a friend suggested I go for one as a “pick me up” the day before I had initially planned on going back to work, I thought it would be something good to wake up for and to get done, so I had a bit of an energy boost to face people at the office after my diagnosis.

I got up, felt ready to go do this, hell, I even managed to shower and get dressed without too much fuss. I got to the mall, and decided to try the first of two pharmacies. I knew I needed a backup in case I ran into any kinds of problems at one. Perhaps I preempted having problems with getting the shot, but after queuing patiently, I was met with a pharmacist who informed me that I needed a script to be able to get the shot. A vitamin shot, that – as far as I know – is not something that is necessarily addictive, but more just an energy boost for people who would like to prep themselves up a bit every six months or so.

Not to be too phased, I thought I’d try my luck at pharmacy number two, but still, no luck. Besides a swelling anger boiling up in me, I immediately thought of people out there who may be struggling with a low, creeping closer to a depression, who actually took the initiative to get help in a small way (like getting the shot) and being turned away, only to spiral into further darkness. Someone may have the courage to admit they need a pick me up, and then when they get turned away like this, could be further discouraged and believe the system really is working against them. If they are not in a place yet where they are ready to see a GP, then perhaps the system is failing them. Conversely, some may then actually go to a GP, but what are the chances that the GP will mention depression and talk about mental health? A vitamin B12 shot could simply be masked as “I need a boost, my energy levels are low”.

We need better systems in place, a better structure of support, especially if were going to tackle this worldwide disease. Let’s start having conversations and find new ways of making it easier for people to get access to the help they so desperately need, before things turn really dire.

Conrad was here.

Depression makes you believe nobody cares about you – which is total BS.

Having been formally diagnosed with depression, prescribed medications and following a full blown sob fest on the phone to mom, I walked back to my apartment and remembered I had promised my landlady a cup of tea and a chat. I opened my WhatsApp and she was busy typing already, she must have heard me come in, but I quickly interrupted and messaged “Ready for tea?” to which she sent her usual emoji’s. A few minutes later, after I had swallowed my first anti-depressant and didn’t know how I was going to feel in five minutes, she arrived with a tray containing Rooibos and a rather anxious look on her face.

“I need to tell you something,” I started, having poured us both a cup. She was avoiding my gaze somewhat and I realised I just had to come out and say it, like ripping off a band aid. “I’ve been prescribed anti-depressants” I started, not sure if “I have depression” would be the best way to go. Come to think of it, I’m not even sure I said it out loud until I was sitting talking to my sister a couple of days later. Her eyes lit up for a second, and there was a change in her demeanour. The air was immediately lighter, and I wasn’t sure why. She said she was sorry to hear that, and her eyes filled with tears.

“We thought you were moving out. I talked to [insert husband name here] while you were at the appointment and found myself crying about the thought of you leaving. It has just been such a pleasure having you living here.”

Not one day prior – just a few steps away from their house – I had been contemplating taking my own life before my 30th birthday, in their apartment of all places, because my depression had genuinely made me believe that I was unloved, unwanted and that nobody cared about me. What absolute bullshit. We talked for about 30 minutes, where she shared about how difficult it was for her to get mental health assistance after her brother passed away many years ago (“the only shrink in the town was known to be someone who ran her mouth”) and I realised that this is a cross-generational problem. Better than that, I realised that I was loved and my company cherished, even just by someone I would have the odd five minute conversation with as I got back from a day at work. Your depression will try fool you, and it will not get the better of you.

Conrad was here.

Talking myself out of my depression while sitting in the doctor’s office.

I was already talking myself out of going when I got in the car, but off I went to the doctor’s office. I had opted to go for a female GP, as it felt like it may be easier to open up to a woman about my depression. Not sure why, but it is what it is.

After I had paid for my consultation upfront, I sat down in a crowded waiting room and thought I would only need to wait for a few minutes. The doctor was running very late, though nobody was keeping me updated, and I hesitated to get up, because I worried that if I got up, I would walk out and not come back. Here I had decided to be brave, to be vulnerable, and to share what I was going through with a complete stranger with the hopes that I would be able to get some help, and I had to sit for an hour, questioning the decision, looking for ways to get out of there, even considering making a scene and telling the receptionist to go fuck herself.

At long last, I was moved to another waiting area, and a short while and a few forced smiles to people walking past later, I was sitting in front of a young doctor who had trustworthy eyes. “I’m so so so so sorry to have kept you waiting” she started, after which she rambled something about old people taking forever during consultations. I was too anxious to care or even listen, I just wanted to get talking. I had made it this far, and I just wanted to hear some sort of feedback for how I had been feeling. I had practiced over and over how I would start the conversation. How do you start the conversation? This is a great source of anxiety in itself. “Hi doctor, I’m depressed.” – too forward. “Hi doctor, my mental health is low” – low? What does that mean? I didn’t know how to do it.

I can’t recall what I said or what she asked, but a minute later I was rambling off about the last six months of my life, talking about how I had started to isolate myself from everyone for the past few years, mentioning the breakdown of my engagement last year, discussing how it had affected my work performance, how I had always been able to “put on a show” at work, and how I had somehow managed to make it here. “Suicidal thoughts?” she asked. I paused. I mentioned that I was unable to see past June. As in, unable to see past 13 days from now, when it would be July 1st. “So no plan of action yet then?” she continued, adding what I interpreted as humour. Time and place, lady.

Now this is where I need to give her some serious props. Following this and acknowledging my depression diagnosis, she started talking to me about mental health, the stigma around it and how by 2030 it will be the leading cause of death in the world.

She called it a disease, which automatically made me feel more scared, yet more validated. I had expected to be told that it was something “you just get over” but she really stressed the severity of the situation. I am thankful to her for doing so, because had she not, I may have walked out of there feeling worse about this illness, perhaps also thinking that it wasn’t serious and that my suicidal thoughts would go away. She told me that she was going to try me on an antidepressant called Nuzak for 1 month, but that I would need to commit to 6 months as a minimum if I wanted to see any long term changes. She told me it wasn’t a magic pill, and that I would need to make some serious lifestyle changes. We talked about marijuana, which I don’t use anyway, but funny enough she didn’t mention alcohol at all – something I do consume, pretty regularly. I was a little disappointed that it wasn’t mentioned as a go-to.

Regardless, and still feeling more assured and like a weight had been lifted off my chest, I left her consulting room and went to the dispensary in the same building, handing my prescription (which also contained some anti-anxiety medication – apparently anxiety is a side effect once you start taking anti-depressants for the first time) to a nice old lady who I felt was probably going to judge me for needing to get these medications, but I couldn’t dwell. All part of the stigma, all part of the fear that you’re somehow “broken” by suffering from a physical imbalance over which you have absolutely no say or control. She came back a little while later, I paid for both medications, happy that they were more affordable than I thought they would be (in your mind you also tell yourself that they will be ridiculously expensive to deter you from going), and I was on my way.

As I got into the car, it started raining and I sat for a minute staring at the boxes. I opened them frantically and started reading through the leaflets for information on anything I could expect to feel over the next few days. The doctor has simply mentioned headaches, but had not given me an indication as to what to expect. She didn’t give me an indication as to whether the dose would be low, or if it was high. I really was going in blind, which is something that is definitely also a part of the hurdle of getting treatment. I wish there was a simple way – a checklist of sorts – to help people get the information they want. If people had more of an idea of what they were in for – regardless of the fact that I know everyone responds differently and there is no ‘one size fits all solution’ – perhaps more people would reach out and seek treatment for depression.

After digging through the leaflets, still not satisfied but keen to get going with my treatment, I decided to head home, but not before calling my mom from the driveway, sobbing, and finally acknowledging that I had been diagnosed with that dreaded, never-to-be-spoken of disease called depression.

Conrad was here.

Being diagnosed with depression – how it happened.

It had been a long time coming. I have been feeling out of sorts, disconnected and isolated for an extended period of time. I had been covering it up as a “dip” for far too long, and this past weekend it all came crashing down.

I woke up on Sunday morning with that usual dread in my stomach. Is it a weekday? Do I need to go to work? Do I need to take a shower? Can I even get up to take a shower? How do I get out of work?. It’s a bit of a mental mind maze, where you talk yourself out of wanting to do anything, even before the day has even started. Thing is, usually when I get up, and get going, I get into “military mode” – I show up, I get the job done, I do it with a smile on my face, hell, I even make a couple of people laugh. I genuinely enjoy my work, and that’s what makes the depression diagnosis so difficult to understand. Surely it shouldn’t be so hard to get up to go see people you enjoy spending time with, in an environment that is supportive and understanding? It’s not that simple. Depression does incredible things to your mind, and it take a hold of you in a way that is nothing short of paralysing and utterly debilitating.

When I got up on Sunday, I had a temporary moment of relief, where I realised that all I would need to do today would be to walk the five steps over to my landlord’s house (I stay in the garden cottage on a big property) to throw my washing into the washing machine, as I do each week. Problem is, this week I was trying to talk myself out of it. I was trying to find every excuse possible not to get out of bed. And we’re not talking, oh, I’m tired, I’d like to just lay in bed and watch TV all day. Or even just going through a wobble. This eventually became a two hour battle in my head, about not wanting to get up, and throw the fucking washing in a machine. I consider myself to be an ambitious, high achieving go-getter, who works full-time, plus runs his own company on the side, but on this day, I just couldn’t talk myself up out of bed. I decided to give over, and let the day pass, so I stayed in bed, until at about 5pm, I had the strength to get up out of bed to throw the laundry in. Please don’t let my landlord be home, I thought to myself. I can’t face anyone right now, I can’t have a conversation. My landlord and her husband are incredible, kind people, who have opened their hearts and home to me since I moved to Cape Town about nine months ago, yet my mind is telling me that I wouldn’t even be able to cope with a simple “Hello, how are you?” today, as I fear they’ll see through me. Of course I ran into both of them in the five steps it took to get to the machine, and of course they could spot that something was off, but I had become very good at hiding my illness, and somehow managed to carry a short conversation and to get the job done.

Back to bed I went. My mother had sent me a message and I replied with the most generic response ever, hoping she wouldn’t see through my message. She would later tell me that she had been worried about me for a very long time. I got back in bed, and so carried on spending the rest of the day there, going into the night, falling asleep and waking up, my mind racing with a million thoughts, unable to process why I was so comfortable and happy to essentially spend what became 41 hours where I only got up to go to the bathroom and throw in the bloody laundry.

On Monday morning I got up with the usual dread, though I was also struck with the realisation that I had spent Saturday afternoon and all of Sunday in bed. Something had changed when I go up though, as I knew that the time had come for me to face the fact that things were off, and in a very big way. I had gone through weekends like this all throughout the year, scheduling social commitments for the Friday evening to make it seem like I was still managing a healthy social life, while then having the absolute relief of being able to clear my schedule for the rest of the weekend, only to lock myself away in my apartment, shut the curtains and hope that I would miraculously feel better the following day. It hasn’t worked for a very long time.

I woke up Monday and I grabbed a notebook and pen from a nearby drawer. I scribbled “Prioritise Your Mental Health” in big, bold letters. And it just flowed from me.

  1. Get GP appointment. Get anti-depressant.
  2. Contact [insert therapist name here], set up appointment.
  3. Call [line manager at work].
  4. Call mom, [best friend], [sister], [sister], [brother], [other best friend].

I didn’t quite do everything in that particular order, but before I knew it I had gotten myself off’ work for two days, set up an appointment with a GP for 12h45, plus written a letter to my mom about how I had been unable to see past my 30th birthday (June 29th) and had been living with suicidal thoughts for a while now. I managed to reach out to the rest of the list throughout the course of the day, asking that everyone give me some time to got to the doctor to get things checked out first.

On my way out to the appointment, I bumped into my landlord again, and knew that she should have been the fifth point on the list. “Can we have a cup of tea when I get back?” I asked. “I need to talk to you about something”. I knew what my diagnosis would be, and I also knew that she would be a crucial part of a new support system I would need to build as I navigate this new chapter in my life. Little did I know how interesting her reaction would be when I sat down and told her – more on that in a post to follow.

Off I went to the doctor, with the biggest fear that she was about to tell me that I was “making it all up” and that I should just get on with it.

Conrad was here.