I Did Everything Right But I Still Had A Mental Health Relapse
They say admitting you need help is the first step in recovery. But what if you've already recovered? What if you did everything in your power to get better, and most importantly, to stay better, but woke up nonetheless less than a year after clarifying yourself well enough to finally get off antidepressants and feel like you were that they exist? absolutely no decent reason to get up?
"It's just a relapse," my doctor told me in that calming, sympathetic tone for which I am always so grateful. But it didn't feel like "just" anything. It felt disastrous, a pathetic failure, the end of my rebuilt life as I knew it.
Of course, none of these things really were. However, managing a mental relapse was almost more difficult than the relapse itself.
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I've had a long and complicated relationship with fluoxetine - or Prozac as you may know it. As one of the most widely prescribed SSRI antidepressants in the US, I first used it in 2013 for mild to moderate symptoms of depression and anxiety. I started on a relatively low dose of 20 mg, which was enough to keep me on an even keel.
Then in 2017 I was involved in a traumatic car accident and my mind spun as wildly out of control as my car. Within hours of staring from my backboard at the hospital ceiling tiles, I was plunged from mild, well-treated depression to a much darker and more frightening place. People kept telling me how lucky I was to have survived, but after the first six hours of desperate hope that I would not die, I would spend the next six months wishing I had.
"It's just relapsing," my doctor told me in that calming tone for which I am always so grateful. But it didn't feel like "easy". It felt disastrous, a pathetic failure.
When I was discharged five days later with a "badly bruised" left wrist and two broken vertebrae, the hospital psychiatrist prescribed Diazepam (Valium) for the anxious drive home - but I was still a shaking wreck and grabbed my husband's hand as when my life depended on it while my father-in-law drove slower and more carefully than ever before in his life.
In the months that followed, I was diagnosed with post-traumatic stress disorder (PTSD). My dose of fluoxetine went up from 20 mg to 40 mg and then back to 60 mg - the maximum dose. I was prescribed more diazepam and then propranolol, a beta blocker, for anxiety and placed on a 17-week waiting list for high-intensity, trauma-focused cognitive behavioral therapy (CBT).
The physical and mental recovery has been slow, frustrating, and at times quite bleak. But antidepressants kept me alive and slowly but surely things were beginning to change. My NHS CBT therapist was amazing - just life changing brilliant - and after 13 weekly sessions with her I had gone from self-harming and self-destructive to believing recovery is possible and was proactive in making it happen.
My partner and I accelerated our plans to move out of London and find peace in a leafy and quiet suburb, closer to my support network of family and friends, where we could afford a house with a garden and where neighbors could chat. I got back to work as soon as my broken body allowed it. I started eating better and cutting back on alcohol, which quickly became an unhealthy coping strategy. I read up on post-traumatic growth and gradually got back into routine, taking on new and exciting work opportunities and challenges, volunteering once a week, and incorporating real, meaningful self-care into my daily routine.
By April 2018, I felt ready to be less dependent on antidepressants. Having previously created, researched, and written an article on the challenges of reducing SSRIs, I knew I wanted to take this very slowly to make sure I was absolutely ready at each stage of the process before moving on to the next. My doctor recommended cutting down 10 mg at a time of at least two weeks at each lower dose - so I could have gotten to zero in three to six months, but I took 14 instead.
When I finally said goodbye to Prozac, I felt unstoppable. I treated myself to a Maya Angelou tattoo entitled "And yet I get up," which symbolized the progress and closure that I had achieved.
When I finally said goodbye to Prozac in June 2019, I felt unstoppable. I made it in my freelance career, training for a half marathon, and had a solid self-care system of regular exercise, massages, and therapy. I made friends in my new area, we had a dog that would regularly take me out of the house, and I finally took small steps to rebuild my driving confidence. I even got myself a Maya Angelou tattoo, "And yet I get up," which symbolizes the progress and closure that I had achieved.
And then boom. Everything collapsed within six months. The emotional equivalent of a sucker punch in the gut took me by surprise and I was overwhelmed by an intense wave of sadness, shock, fear and despair. For a few months I barely left my bed, let alone my house. Work stalled as I struggled through what I needed to meet my existing deadlines and felt otherwise too crippled by depression and anxiety to look for something new.
I told myself it was temporary. That I would feel better after our vacation - but I didn't. That I would take two full weeks off over Christmas and New Years and feel better afterwards - but I didn't. By the end of January, when the third anniversary of the accident rolled around, I was a limp, useless mess for almost three months, knowing that something had to give. Reluctantly, I made an appointment with my doctor, who suggested giving fluoxetine at 20 mg again.
I knew rationally that these things would happen. Recovery is never linear, everyone's mental health fluctuates, and it's never a shame to take (or take back) medication when you need it. I wouldn't hesitate to call someone who would say so about myself or another, but on a deep emotional level I felt like I had failed. I did everything right, followed all advice, followed all steps, and yet I was here. I felt like I was back in first place and that all of my hard work had been in vain. I felt naive, stupid, and complacent believing I was "fixed". I was afraid that I would get stuck in a never-ending cycle of having to start over all the time just to keep it falling apart.
But after a few weeks with the good stuff, the clouds started to lift, the fog cleared and I felt like me again. I realized that I was really no worse off than I was before the relapse and that antidepressants are just drugs we take for the same reason we would take other drugs.
Recovery is never linear, everyone's mental health fluctuates, and it's never a shame to take (or take back) medication when you need it.
Stephen Buckley, director of information at Mind, a mental health charity, tells me, “Our mental health is just like our physical health - it can go from good to bad and we need to take care of it. Most people will find that they are a combination of treatments that will help them best manage a mental health problem. These include medication, talk therapy, and self-care techniques like meditation, mindfulness, and exercise. "
"It is important to understand how you are affecting your mental health problem and to notice if you feel unwell so that you can seek help from your GP if you need to. If you are prescribed medications such as antidepressants, do not be ashamed Medication may not work for everyone and generally does not cure a mental health problem. However, they can help improve your mood so that you can better access long-term support and treatment, ”he adds.
"If you decide to stop mental health medication, it must be done gradually, while your GP closely monitors you," he continues. "If your mental health is going to deteriorate in the future and you find that you need to start taking medication again, try not to consider this a step backwards or if you somehow fail. While some people have a one-off episode of depression, others will find that their symptoms return over time, so some people will find that they may need long-term psychiatric medication. "
The problem is, despite all the improvements in the mental health conversation over the past few years, I still felt so deeply embarrassed and embarrassed that I would never have a feel for my immune system if I had repeatedly battled cold and flu infections shake off.
I still found this very difficult to write and I'm not sure how far I'll share on social media, but it's important to say. We read so much about people's struggles with "overcoming mental illness," but much less is said about the fact that this is an ongoing journey, not a one-off battle to be won. Mental health relapses are severe - even devastating - but they're just a bump in the road, not a dig.
For more information on stopping mental health medication, see Mind.
If you are in a crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or the Suicide Crisis Line at 1-800-784-2433.
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