Anti-depressants are great, until you have an Adverse Drug Reaction

I’ve suffered from anxiety most of my life. Towards the end of 2014 I started to get severe panic attacks. I was prescribed the antidepressant Citalopram and was on it for about three years. Initially it did seem to help. However, I was unaware of potential adverse effects.

In the summer of 2008, I went into mania and psychosis while on Citalopram. Psychosis is a temporary loss of touch with reality. There was a spiritual aspect to my experience. I wasn’t violent. I live in a culture that lacks empathy and understanding of such experiences, even more so in 2008.

I was never told that antidepressants could cause these symptoms, despite the evidence that is out there. There is a Yale study from 2001 which looked at Antidepressant-associated Mania and Psychosis resulting in Psychiatric admissions and found this to be the case for 8% of admissions [1]. That is 1 in 12 people. The conclusion of this study states that “the rate of admissions due to antidepressant-associated adverse behavioral effects remains significant.”. Knowing this would have helped immensely, especially with the social stigma!

I ended up admitted to a Psychiatric hospital without being involved in that decision. At a time of stress and vulnerability I expected genuine support. Instead I had the police on my doorstep and I was locked into a building for 3 weeks. Forced hospitalisation was a serious trauma and I continue to feel Post Traumatic Stress a decade later. For example, if I heard a truck reverse right now I would immediately have to go to the window to reassure myself that it’s not an ambulance coming to incarcerate me! So I’m left with hyper vigilance, on alert and with Post Traumatic Stress, despite being through counselling and therapy! It has started to ease with time but is now a necessary survival strategy. I had more insight into what was going on than people seemed to realise. The method used to force so called “help” upon me was more distressing than the symptoms I was experiencing.

I was quickly given the label “Bipolar”, which should not happen when a drug can be causing the symptoms. DSM-IV-TR “emphasizes that a diagnosis of Mania or Bipolar Disorder should not be made when the hypomania or mania first appears while the individual is taking a medication that can cause these symptoms” [2]. DSM-IV-TR (2000) ~ Diagnostic and Statistics Manual, 4th edition, text revision.

What was hospitalization like, without an Open Dialogue approach ?

It is hard to put the extreme distress I felt at the time into words but I will try. I felt dis-empowered, helpless, as if everyone had turned against me, constricted, caged, my freedom taken away, agitated, pressure of speech, my every word and action observed and judged, unsafe, distressed, no autonomy, frightened, scared, angry, violated, no one seemed to understand, no empathy, felt unfairly treated, trapped, felt like I would be there forever, could see no end, dignity taken away, disbelief, stressed, anxiety, in fight mode (seeing as flight was not an option ), heart racing, adrenaline pumping, found it hard to get some relief / respite from the deep distress and emotional pain I was in (other than sleep), traumatized, misunderstood. I couldn’t believe it was like this in the year 2008 and still is today.

An asylum is supposed to be a refuge, a sanctuary, a place of safety. The Acute Psychiatric Unit felt like the opposite. There was no awareness or understanding of what was really going on with me. I had been through a trauma and was in drug withdrawal from Citalopram, which I was asked to stop cold turkey. I was exhausted. This was not the place for me. Based on my reading over the last number of years a Soteria type crisis house would have been more suitable and healing. The Electric shock instructions on the walls of one of the offices didn’t help. Or the sign “ECT Suite” at the main entrance. Was it left there to scare and scar people ? There was no Electric shock Suite in the building.

My Occupational therapy notes said “Fear of detention based on father’s history” yet they use the most backward method to bring me to the hospital. 10 people at the house including 2 police, 2 ambulance drivers, 2 Psychiatric nurses and 4 ‘others’. A complete over-reaction to the situation. I hadn’t harmed myself or others and had no plans to do so.

“No wish to kill anyone” is in my admission notes ! As if all people in emotional distress are potential killers. The Psychiatrist that admitted me wrote “Having spoken to her she calmed down”. This was the crux of the problem. No one spoke to me properly and therapeutically. At one stage I wrote in my journal that I was wound up like a coil and that certain people wound me up again when I tried to unwind. I lost my job. I had bills to pay but the hospital was reluctant to let me out to pay them, while benefiting from my private health insurance ! It cost my private health insurer €23,000 for the State to have me put away ! The local Psychiatric unit was such a cold, uncaring, unsympathetic place to be. Surrounded by strangers. With very little empathy. Just their trolley of “potions and poisons”.

Brain damaging drugs

While some tranquilizers can offer relief to a person when used short-term, I was unnecessarily put on several strong and potentially damaging drugs long-term. Zyprexa (Olanzapine), Seroquel (Quetiapine), Lithium, Lamictal, Rivotril, sleeping pills etc 9 foolscap pages of prescriptions ! I did not want to face each day and spent a lot of time in bed due to the sedating nature of the drugs. I had a very poor Quality of Life. Doctors were oblivious to the drug’s iatrogenic effects. Iatrogenic means caused by treatment. I was heavily sedated for 3 years, until I finally woke up out of a drug induced haze and started to question things.

Turning Points

Luckily a few years into my journey and search for the truth, I was fortunate enough to make connections with other Psychiatric survivors, as well as some honest and dedicated medical professionals and Psychologists. Experienced experts who do not have conflicts of interest but who want the best possible outcomes for people in distress. People like Dr Terry Lynch, Prof Ivor Browne and clinical Psychologists in the UK ~ Lucy Johnstone, Anne Cooke and Peter Kinderman. I also studied the work of honest Psychiatrists Prof David Healy (who is also a Psychopharmacologist), Dr Peter Breggin and Dr Joanna Moncrieff.

One turning point was when I went to see Ivor Browne in February 2012. At that stage I had miraculously managed to come off all the drugs with no support and was down to 25 mg of Seroquel (a low dosage where the maximum is 800 mg). Ivor listened to my human story and gave me a new perspective. He worked in a methodical way and told me I was not “mentally ill”, which was quite liberating. Like a weight lifted off my shoulders. Born in 1929, with over 60 years experience in this field, Ivor is now in his 90th year.

My father’s experience

My very sane father unfortunately became a victim of this system in 1973. He was in and out of hospital throughout my childhood. In 1983 his symptoms seemed to disappear and did so up until his early death in 1993, age 52. As recently as 2012 I believed that Manic Depression / Bipolar was genetic as that is what I was conditioned to believe throughout my life. Then, in my first session with Prof Ivor Browne, I said that my father “also had Manic Depression” and I remember his “highs” an “lows”. Ivor dropped a bombshell that day that made me rethink the whole experience. He said “Your father was around in the era of medication as well !”. Based on my own personal experience, I realise the drugs can leave you so sedated that you don’t and won’t want to get out of bed. And can also drive a person into a high.

My father was a kind and gentle man, and deserved better than what he was put through. Up to 14 pills a days and several bouts of Electric shock. Which I now know was unnecessary. I admire how he kept going and rarely complained, unlike his daughter. His favourite saying was “It could be worse”. It also created a lot of stress from my mother and the family environment growing up. They both died young and never got to meet their 7 grandchildren.

What would have helped me through my crisis in 2008

It’s been a difficult 10 years. My healing journey was delayed by the trauma caused by a flawed biomedical approach to mental health. My career ended, which created another set of problems. The whole experience has affected some of my personal relationships and trust in others. Mainstream Psychiatry is very dis-empowering. After hospitalisation I had lost all confidence in myself.

The following would have made my distress a lot more easy to cope with ~

  • truth and honesty about the anti-depressant drug I was on and its adverse effects

  • An Open Dialogue approach, which I have written about elsewhere

  • Re-assurance that my stay in the hospital was temporary ( the survival part of my brain was convinced I would be there for a very long time, possibly forever. This left me in a very distressed and agitated state and naturally so)

  • Access to a Psychologist and to also to receive some counselling or Psychotherapy

  • Honesty about drug withdrawal and akathisia with proper advice on how to try to avoid this

  • Ethical use of the major tranquilizers at the lowest dosage possible for as short a time as possible. I probably needed them for about 2 weeks initially and to be taken off them correctly.


Coming off the drugs

Any changes to the drugs a person is on needs to be made slowly under the supervision of an expert. I am now off most of the drugs nearly seven years. In the first two years I was prone to relapse as my body readjusted to being off prescribed psychoactive drugs. I no longer go into mania / psychosis, which is a major step in my recovery journey. I use WRAP (Wellness Recovery Action Plan) and benefit from self-awareness, rest, yoga, meditation, exercise, nutrition, mindfulness, journaling and talk therapy. Support from others is vital.

When it comes to the initial anxiety I experienced I know it’s down to proper breathing, o2/Co2 levels in the blood, understanding the cause of panic, talk therapy and healthy lifestyle choices. I know I won’t find the answer in a bottle of pills as I’ve been down that road, for six years in total. The drugs have damaged me but I try to focus on the concept of neuroplasticity.

Access to my records under Freedom of Information

After receiving my hospital records I found it hard to trust anyone. I don’t really recommend requesting your notes unless you have good support around you, as it can be a traumatic experience reading them. The one thing that struck me about stuff that was written about me is the many factual errors. After 3 weeks locked away my escape route was via a transfer to a Private hospital in Dublin for another week. While I had a lot more freedom there e.g. Could go in the garden or even to Heuston train station to buy the paper, their notes more or less painted me as an academic failure even though I have numerous qualifications up to Masters Level. It shows how facts can be twisted in a person’s notes and misrepresent the person. I look forward to burning these fictional notes some day soon, as part of the healing process.

Conclusion

Being in the system and the consequences of that, including the stigma, discrimination and lack of understanding of others and the effects of the drugs, was the most traumatic part of the whole experience. In our society the general public have been indoctrinated into the biomedical model, affecting how those who have experienced mental health difficulties are perceived. Social stigma can be a trigger for the person and can seriously impact and slow down the recovery process.

What I went through since August 2008 (health issues, brain damage from the drugs which hits me in subtle ways, tardive dysphoria [3], insomnia, loss of career, disconnection from family, ongoing Post Traumatic Stress) is actually a catastrophic grief / bereavement. I sometimes need to pause and reflect on that aspect of the experience. To process the grief and accept the pain. For quite a while I have been stuck in a phase of anger. Some of it justified but on the downside the anger can keep me stuck. It’s taken a decade to process and integrate the experience.

While some may feel they had a positive Psychiatric experience, I remember my experience and the suffering of other Psychiatric survivors in the context of a system that has the potential to be very destructive to a person’s emotional well being. I also remember those that died. Any attempt to actively change such a system is met with resistance. I admire myself for hanging in there, and not becoming a statistic. The unbearable feelings do pass, if you can learn to sit with them or reach out for help. My rebellious nature helped me through.

I have seen the system from the inside out and it gave me a very different perspective. I can think about forgiveness if I know that others aren’t been potentially hurt or killed. But I find it difficult to forgive the current system knowing that the delusion continues and that prescription rates are going up year on year, including potential risks to the unborn.

{
Note Do not stop or change prescribed psychoactive drugs without consulting your prescriber, due to the dangers of withdrawal. Any changes need to take place under the supervision of an expert. What I write about is my own experience and is not medical advice. We all have our own unique journey. Samaritans are there to listen to people in distress ~ 116 123}

References
[1] Antidepressant-associated Mania and Psychosis resulting in Psychiatric admissions, Yale study (2001) www.ncbi.nlm.nih.gov/pubmed/11235925

[2]Suicidality, violence and mania caused by SSRIs: A review and analysis ~
http://breggin.com/wp-content/uploads/2005/01/31-49.pdf

[3] Tardive Dysphoria: Anti-depressants can turn mild/moderate Depression into a chronic condition ~
http://www.psychologytoday.com/blog/mad-in-america/201106/now-antidepressant-induced-chronic-depression-has-name-tardive-dysphoria

Other links that may be useful

* Psychopharmacologist & Psychiatrist Prof David Healy “Time to abandon evidence based medicine?” At 6 minutes he discusses the hiding of negative data from anti-depressant clinical trials ~
http://www.youtube.com/watch?v=A3YB59EKMKw

* Promoting awareness of the potential dangers of anti-depressants ~
http://antidepaware.co.uk/

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