“Maybe you’re depressed because you’re not drinking”

Yep, that’s what a colleague said to me yesterday. To be fair, it was said in jest and after I turned down an offer to go for a drink after work, but still, it’s a good opportunity for us to talk about alcohol. In fact, we need to talk about alcohol and how it affects and perhaps even accelerates the symptoms of depression.

I haven’t had a drop to drink since I started my treatment in June, and it has truly changed my life. It wasn’t that I was a heavy drinker to begin with, but it was all in the how and that I was essentially self-medicating and not really putting boundaries in place when I was feeling low. I was happy to have a glass of wine or three if I was feeling low. Wine became a part of my grocery shopping. While I can handle a hangover, I can’t handle the crippling depression that follows two days after a bender, which is usually when my mind catches up with my body and which really does send me into a spiral that is very difficult to get out of. Things balance out and to be frank, you feel worse than you did before.

Health risks aside, drinking heavily and extensively will have major effects on your body and mind in the long term, including affecting how you age, and your general levels of productivity. In the short term you may feel better by grabbing a drink when you’re stressed or anxious, but over time it becomes detrimental in many ways, all of which are detailed in a host of Youtube documentaries you can check out, but which I am only more aware of now, having been a regular party drinker in my 20’s. Thankfully I haven’t carried that habit over into my 30’s and I’d like a celebratory glass of champagne to become just that – something to enjoy for the right moment and the right reason, rather than just because or because it is the weekend.

If we’re talking about depression, we need to talk about alcohol, as the two go hand-in-hand for me. I have seen a drastic change in my mood since I stopped drinking, and generally, in conjunction with the anti-depressants of course, my mood has lifted tremendously in recent weeks. I wake up with more energy, not only to make my bed, do some chores and get to activities like walking on the beach, going grocery shopping or seeing friends for a coffee, but my attitude shift seems fairly substantial and I have a renewed capacity to be able to manage my tasks and the emotions that go along with them. It has also had quite a drastic impact on my weight: as things stand, I’m down to 87kg again, having started this journey in the 92/3kg range.

So how long am I going to be off’ alcohol? If you’ve been following the blog since the start of my journey, you’ll know that I’ve committed to six months as a minimum, for two reasons. The first, is that I don’t want to mix medication with alcohol, and I am on a six month script for my anti-depressants, which is non-negotiable. The second reason relates to it taking six months for your liver to “self repair” so to speak, especially if you have been drinking for an extensive period of time and there may be considerable damage. We’re lucky that our livers are able to repair themselves over time, though it is only possible if you catch it in the early stages, when there are symptoms of liver damage.

As I said, I drank socially all through my 20’s, so would like to allocate this time not only to improve my mental health, but to reverse some of that damage if possible, while also seeing the longer term effects and benefits to my general health and mood (if any). I’m planning on getting a checkup at the doctor’s at the end of the year and will be able to get a better sense of how my health has improved over time and hopefully this part of my journey can become another tool to help combat my depression.

Conrad was here.

What I learned from seeing a doctor again a month after being diagnosed with depression.

For one, I was a lot less anxious than going into the first consultation. Perhaps this was because I knew what to expect this time around, had met the doctor before and actually woke up feeling a whole lot better than the last time I had to get myself out of bed to admit I was depressed.

You still have these unsettling doubts though, that the doctor is going to switch up your medication, tell you you’ve been doing a bad job prioritising your recovery and leave you to get on with dealing with it. At least that’s what my depression tried to convince me it would be like. Naturally, in reality this wasn’t the case at all, and I had some valuable learnings from the experience which I wanted to share with you today.

  1. If you speak honestly about what you’ve been experiencing, a GP can help you more. I opened up about my loss of appetite and feeling like a walking zombie when I combine the anti-depressant with the anxiety medication, which we could address once I had put it on the table. It turns out that only happens to a small percentage of people, especially with the brands I am on, which I was surprised to learn. I haven’t taken an anxiety tablet for a few days and I’m coping fine, so the recommendation is to leave them and just focus on the anti-depressant for now. What this means is that I only have to take one tablet a day, which is a winner in my books. It also got me thinking: If I take an anxiety tablet systematically when feeling anxious and highly stressed, is that not the same as reaching for a beer after a long day? It’s all about the how, not necessarily the what. I don’t need more bad coping mechanisms. I’d prefer to focus my energy on positive ones, like writing, walking on the beach, reading my book or cooking a healthy meal.
  2. Loss of appetite and fluctuating energy levels are part of the first couple of weeks on Nuzak. The doctor told me to expect the loss of appetite to subside by month 3 (after 8 weeks), not any sooner. This was reassuring as I had been wondering if my system was actually rejecting the medication but this isn’t the case. I now have a framework of what to work with and what to expect, which does really help me, and I’m happy to know that this is mostly a phase that comes with the territory when you start on anti-depressants and particularly this kind of medication.
  3. You don’t have to buy all your meds in one batch. While I don’t have to see her again for a consultation until the end of the script (December), I could arrange with the dispensary that I come collect and pay for the medication each month. As I’ve never been on chronic medication, I thought you had to pay for it all upfront, which was a point of anxiety for me. Call me naive if you want, but I imagine other people wonder the same thing. Bottom line, is that you get to dictate when and how you collect your meds, which I thought was pretty cool, and reassured me that I did actually have some element of control in a process which is largely uncontrollable.
  4. This is only the beginning. She was pleased with the lifestyle changes I had made, and commented that it seemed like things were going better with me (“You smiled at me when you greeted me this time”). She did remind me that this is only the beginning though, and that the SSRI’s will “level out” (peak) at the 6 week mark only, so we’re still building the levels of serotonin in the brain. She told me to be patient, and that the lifestyle changes now might not have immediate positive benefits, but that in six months they definitely will. The alcohol abstinence, for example, does wonders not only for my mood, but for my liver, which took a hammering in my 20’s. I really, really, really don’t want to be 35 and suffering from liver disease (there are some really interesting documentaries about this on Youtube, if you want to learn more).
  5. I’ll be on medication for the rest of the year, and I’ve come to terms with that. Like I mentioned, she’d like me to see her again early in December, for us to discuss how I’ll be reducing the dosage going into January, so that ultimately I can (hopefully) be completely off’ the anti-depressant by February next year. That’s the goal for now, and it is a fluid one. Situations change, my body could respond differently to the medication a day, week or month from now, but it does seem like there is a bit more clarity about the process now and I am happy to proceed with the framework for the rest of the year. While it seems like a long time away, it really isn’t that far away, and also gives me a bit of a benchmark and a goal to work towards.

The ship is slowly starting to steady and even though I’m aware that we’re still in the early days, I’m starting to feel more of a glimmer of hope about the future again, and quite frankly, heading in a new direction that I know can only bring me better things. Let’s keep the conversation (and the momentum) going as we look towards August.

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.