Lockdown #3: The End of the Tunnel?

I haven’t written anything in a while. My mental health hasn’t been great.

I’ve definitely felt a significant shift in mood and anxiety levels over the last lockdown and I don’t think I’m alone on that front. The novelty of lockdown has finally worn out for the majority of people, who have paused their lives and had to make-do with the omnishambles of less-than-ideal backdrops for meetings, exercising with Joe Wicks instead of the usual PT at the gym and straddling a newfound role as the novice teacher-parent alongside employment. This last hurdle has seen us muck our way through the festive season without the usual cheer and the longer, colder days have been brutal on the collective wellbeing. It’s no surprise that the British public have welcomed Boris Johnson’s announcement of the roadmap, outlining the forecasted milestone relaxation measures in the months ahead. It has become a glimmer of hope that indicates we’re on the road back to “normality” with a provisional end-date in sight and this seems to have lifted the gloom for some. Restaurants and pubs are already booked and busy, with online reservations flying out as people try to look ahead and plan for a summer of relative freedom.

When the roadmap was announced, I didn’t feel cautious optimism (and neither have others, to my reassurance). I saw the flurry of memes about June 21st and felt a bit sick, to be honest. After a whole year of working at home, trying to cope with fluctuating mental health, and barely seeing family and friends, the idea of a real, normal life is almost dreamlike these days. I try to remember details of that 9-5 existence like commuting, crossing paths with strangers and talking to random people while the kettle boils in the staff kitchen. Then outside of work, actually using the weekend to see family and social occasions like eating out with friends, going to gigs and getting rounds in at the pub etc. There’s a sense of disbelief: did I really used to do those things, without a care in the world, a few years ago? When I reflect, It almost feels like I’m just watching a film of someone else’s life.

I understand this all probably sounds ultra dramatic, but you have to understand, dear reader, that I’ve effectively been out of action now for 2 years. The first year was due to stress-related burnout and agoraphobia, while the second year was more the global response to a raging, unforeseen pandemic. Yet somehow, they’ve blended together into 1 block, with the 3 months of “real life” that I experienced (sandwiched somewhere in the middle) effectively lost in the ether, those massive personal accomplishments of getting a job, graduating, commuting every day and travelling to Mexico just erased entirely. This is a significant wedge of time that I’ve spent curled up like a dead spider on a shelf, and it makes me feel all the more apprehensive about finding a daily rhythm again.

The very idea of all these micro-events are overwhelming now. I’ve had to stop thinking about the future, a.k.a anything beyond the 24-hour stretch ahead of me, because it fills me with dread. I find myself catastrophising the transition back to “normality”, worrying about whether I am even capable of living that life again without days riddled by panic attacks and blister packs of mood-stabilising pills. I try to smile when loved ones talk about all the exciting things we’ll finally be able to do this summer, but my guts are twisted inside and a voice in my head tells me that regardless of lockdown being relaxed, I won’t be able to do these things. I worry I will not be able to cope again and I will be left behind as everybody else seamlessly rejoins the rat race and busy, bustling routine. I worry that I’m too sensitive and broken to be able to masquerade as “normal”, to interact with others as naturally as I once was able to.

Realistically, I know this unhelpful thought process to be completely a product of my anxiety, which has only festered without the opportunity to directly face my fears head-on. Despite a recent blog post celebrating my antidepressants-free lifestyle, I’ve actually had to go back onto medication as I hit an extraordinary slump of fatigue, low mood and fraught nerves. As soon as I saw changes in my sleep, appetite and drinking habits, I knew I had reached a point of serious reflection: is pride worth staying medication-free or is it time to listen to my guts and take action, before I’m too far gone? Needless to say, it was the latter option. I’ve spent a lot of time over the last week evaluating what I can do to be kinder to myself as we near the end of COVID-19’s grip on our lives: I’m back to daily hypnotherapy, soundbaths, reading books and regimenting food/shower habits. I’m back to taking things a task at a time, instead of putting pressure on myself to carve out an aspirational career path, find my way onto the property ladder and generally discover my purpose in life all at the same time (and especially whilst mentally unwell during a pandemic).

Writing about my feelings puts them into perspective. Times are hard, indeed, but they’re hard for everyone and there’s no way of knowing how things are going to work out over the months to come (my Mystic Meg powers are non-existent). I am doing my best to counteract every negative “what if” with a positive counterpart and also trying to take my mental state with a pinch of salt, as so much of what I am feeling now is entirely situational and will be inevitably changed as our general circumstances change in the UK. I am also trying to imagine how I would support somebody if they told me they were feeling the way I am right now, and realising that it is totally valid to feel that sense of apprehension. It is okay to feel nervous and scared about how things will be, just as it is okay to feel excited about the prospect of liberation. There is still time to come and thoughts/feelings are fleeting, so there is solace to be taken from that ❤

Sertraline withdrawal

I found my way to prescription meds when I had my big phat breakdown of the century in 2019 (see previous posts for further detail). Antidepressants were the last-ditch resort: I was tentative about being on them and suffering intolerable side effects. I had some helpful advice from friends and family, but among them, there were very different accounts of how efficiently medication worked for them and what it was like to withdraw from the meds when there was no longer much, if any, need for taking them. There were quite a few horror stories about withdrawal: tales of constant stomach agony, ‘zapping’ sensations in the brain, sleep disturbances, depersonalisation and generally just feeling the clutches of depression strongly as soon as antidepressants were reduced/cut out, but I wasn’t super phased by this. In terms of foreseeing the inevitable withdrawal process further down the line, I didn’t really have the capacity to see beyond the end of each day, never-mind a hypothetical scenario months or potentially years down the line. So I made the executive decision based on where I was in that moment, sat in that barely-padded GP’s patient chair, and said yes to Sertraline.

When I was initially handed the prescription for that first pill packet, I was told that, at minimum, I would be taking this medication for at least a year. This accounted for the initial period of up to six weeks, wherein Sertraline gradually builds up in your system and starts to take effect, and the progressive withdrawal, which is done incrementally.

A year from the first prescription: that should have taken me to Spring 2020, however, as the world was burning down around us and I didn’t want to inconvenience very busy NHS staff with my minor ailment of medication reviewal, I let that preliminary deadline slide. Also, with the entire routine of existence as I previously knew it in the air, only mere months after I’d started to venture out of the house and “take control” of my life, I didn’t feel it was the right time to talk about taking the stabilisers off.

I was right to follow my gut.

I think, in a way, I was acclimatised to many elements of lockdown life and this therefore softened the blow of the first few months (I still obviously had “down days” but they could have been far, far worse). I could have dropped the Sertraline, on track with the trajectory my GP had set, and probably winged it last summer. However, because I was tentative about the timing and unsure about how the COVID-19 situation would pan out, I clung on out of caution. Others were optimistic without cause, but I feel quite lucky as I’m a huge critic of the Tory government and anticipated their ineptitude, so I wasn’t as upset or surprised as others when we’d end up 1 step forward and then 50 steps behind. While others mourned their freedoms, I hadn’t grown attached to the idea of them returning in the first place and quietly continued on, reading and drinking wine.

Alas, it eventually caught up to me and another round of restrictions, which felt like a bit of a slap from the universe, and other influences such as seasonal changes, hormones being out of whack and employment stress led to peaks of tension that significantly worsened my mental state. There’s been light relief in between these periods of angst and anger, so I can definitely say that my mental health has fluctuated a lot on the wild rollercoaster ride that has been life during COVID-19. I altered my dosage to reflect how I was feeling in certain periods, so I swung from the lowest dosage of 50mg all the way up to 200mg, dependent on whether the symptoms of my depression or anxiety were moderate or severe.

Towards the end of the year, my journey with Sertraline came to an end and entirely by (accidental) cold turkey. This was not the plan. Cold turkey is not medically advised because the risks are so high for relapsing or experiencing severe withdrawal symptoms, which usually leads to people ending up back at square 1 of mental illness: turning to all the wrong people and places for solace. But you see, the thing is, I really didn’t mean to do this. I mean of course I occasionally forgot to pop one, or maybe two, but always found myself returning to the routine in spite of minor slips. Then came a point where I’d gone more than two weeks without taking it and I decided I was at an interesting crossroads. I did call my GP at this point, mainly to flag that I had achieved this feat with no major differences felt physically or mentally, but also to query whether it was worth me continuing on my rogue-ish course of abstinence. After all, I’d already come quite far without Sertraline and it was promising to see that I hadn’t completely deflated without it or suffered the cruel symptoms of letting it go. The GP was 100% supportive of me ‘weaning’. This process essentially meant that I had to slowly take smaller dosages, dropping one step and waiting for around 3 weeks before dropping another and waiting that out for a few more weeks.

It was during the second dropdown phase that I felt the slow ascension into my natural more manic state, which involves hyperactivity, struggling to sleep and taking on a multitude of tasks at the same time (juggling until I go kaput!). I also experienced heartburn, a completely new and unprecedented symptom that I literally never experience, and a slight spike in my IBS/digestive issues. These were uncomfortable experiences, but tolerable as I reiterated constantly in my head that they were literally just products of weaning and not signs of actual mental deterioration. Was this challenging? Yes. But nowhere near the same level of challenging as the condition which led to me taking Sertraline in the first place.

I worked through it. Honestly, there have been a few occasions where I’ve felt low and my instinct has been to blame the withdrawal from Sertraline, but I’ve not felt it strong enough to warrant turning back to the drug as I’ve generally managed to handle the symptoms I’m experiencing with holistic or alternate treatments. I’m lucky to be in this position and know that this is generally a sign of recovery, as I’m able to manage myself in a small capacity and look forward to testing the waters even more when the pandemic comes to an end. In the meantime, I think I will continue to take things a day at a time and try to avoid drastic decisions regarding medication as it worked for me only in tandem with talking therapy/other avenues being explored.

The world is a very weird place at the moment and I think it’s justifiable that we humans feel out-of-sync and a little tested by our current circumstances. Like countless others, navigating the new territory of a global pandemic and trying to keep mentally afloat, I have generally tried to be a little kinder to myself even when I get unfavourable blips of madness or sadness. Sometimes things work out and sometimes they don’t, so we end up in these frustrating bubbles where it’s easy to overextend or to abuse our crutches (be they in substance form or otherwise). My one significant achievement from this pandemic will be the fact I was brave enough to commit to life for the foreseeable future without antidepressants, even if that’s challenging sometimes and even if this only happened initially by accident. I’m very privileged to be in this position and I sure as heck couldn’t imagine it at all a couple of years ago, so I’m grateful today and I’m going to actively celebrate this victory as it’s no small feat.

If you’ve been feeling a little poopy lately, as if you’re missing the spring in your step, I would definitely implore you to write a list of all the things (however big or small) you’ve persisted through this pandemic and take a long, hard look at how far you’ve come. Nothing is to be taken for granted. If you beat yourself up about your shortfalls, it’s equally as important, if not more so, to celebrate all that you have done, as these feats are a testament to your stamina and positive will. I am guilty of focusing on the negatives myself and it doesn’t make for a productive or kind headspace. All I can say is: don’t lose sight of the bigger picture!