It’s over ten years since I was diagnosed with depression and anxiety and I’m not cured. But I am better.
A coping strategy, a support network and, perhaps most importantly, a rigorously adhered to routine of daily anti-depressants keeps the lows from sinking impossibly deep. And yet every single doctor I’ve had, except my current one, has pushed me to come off the medication that makes this whole thing manageable.
As a student, away from home and dealing with my healthcare solo for the first time, the mere suggestion of coping without medication left me panic-stricken. It was my first appointment at my new surgery to organise my repeat prescription but within minutes of sitting down I was having a discussion about being medication-free within six months.
I stalled, whispered something about planning to do it soon and noticeably failed to commit to a reduction of any sorts. But that appointment set the tone for almost every discussion I’d ever have about taking anti-depressants as a young adult.
So insistent was each doctor about bringing my ‘reliance’ on Citalopram to an end that I began to approach any appointment from a place of fear. I was terrified that they would strip me of the thing that I knew was keeping depression from completely dragging me under.
Despite my angst, I accepted that coming off medication was just what you did and that not being ready to do it must have meant that I was failing.
The notion that you are failing to recover is a huge weight to carry, particularly when you already feel that you’ve failed at existing.
Thankfully, that feeling of failure no longer hovers over me. With time, support and a particularly insightful comment from a therapist I saw for a short spell, I’ve come to accept that I don’t have to fight against depression and anxiety. Sure, it still feels like a fight at times but I now know that building a wall between me and it isn’t helpful. I can’t bulldoze over it, pretending it’s an outside force. Instead I have to ease into it and give myself the space to cope, rest and recover.
With the relief of embracing a new viewpoint came a willingness to accept my medication too. Just like some take tablets to control high blood pressure or ease the symptoms of arthritis, I take them to keep me on an even plain.
With a refreshed perspective, I wanted to find out why doctors advocate coming off tablets. Dr Kenny Livingstone, GP and founder of ZoomDoc app told me: “Sometimes, certain medicines are no longer required. Whatever the reason for starting mental health medication, the ultimate aim is that with counselling, cognitive behavioural therapy and support the patient will be able to gradually come off their medication. This might take months to wean down or years but ultimately that is the goal for both patients and doctors. Although, in some cases, depending on the patients' symptoms and condition, it might be safest to remain on the medication for life.”
Dr Kenny’s comments point to coming off medication as a signifier that a patient has other coping mechanisms in place; that they are truly able to function without medication rather than, as I felt in the past, being left out to sea without a raft.
And if you’re not ready to take that step? You don’t have to. It’s comforting to know that doctors don’t see being medication-free as the only option.
As with many facets of dealing with mental health, it’s very much a case of trial and error. Previously, my doctors took an aggressive approach that didn’t suit me. Now I have a doctor who lets me take the lead and trusts that I can make the right decisions for myself.
So, yes, coming off medication can be a goal. But it isn’t the only goal and in fact, allowing yourself to accept the positive impact that medication has can be an achievement in itself.