Are Antidepressants Worth Taking?

Since being diagnosed with clinical depression a few years ago, I’ve been on and off (mostly on) the anti-depressant Fluoxetine.

I’ve taken varying doses between the minimum and, most recently, the maximum.

What beneficial effects did Fluoxetine have for me? What were its side-effects?

Rather than writing about how anti-depressants are supposed to work, in this post I’ll share my subjective experiences, which may be typical, or they may be anomalous.

[Nerdy science warning: Care should be taken before drawing conclusions from a sample size of one with no experimental controls in place.]

Fluoxetine seems to take the edge off the more difficult aspects of life. And by “difficult” I really mean “intensely emotional.”

I experienced less emotion while on the medication. This felt a bit like having a force field, enabling me to more easily endure uncomfortable situations (whether they occurred in the external world, or purely in my internal world of thoughts and feelings).

Fortunately my emotions weren’t numbed completely. I think that would have felt unpleasant for me, though I can understand why someone who’s been through a lot of trauma might want to numb everything and feel nothing.

Often it’s really beneficial to have a force field which prevents you feeling so much emotion. For example, in stressful work environments, it’s easier to keep your cool.

Dull

Along with dulled emotions, I believe my thinking wasn’t as sharp. It’s hard to quantify exactly how dulled my cognition seemed to be. At a rough guess, maybe 10%?

I’m finding it easier to get out of bed now I’m off the antidepressants. And the morning’s mental grogginess fades faster. I concede this is partly because I’m simply enjoying life more, so I have more willingness to engage with the morning rather than trying to hide from it.

Sometimes life is fucking brutal. Our loved ones will die one day, many of them before we die ourselves. That kind of loss can cause immense suffering and pain.

Dr Jordan Peterson rather bleakly proclaims, “Life is tragedy tainted by malevolence.” I have some sympathy with that outlook.

So it’s no wonder people turn to antidepressants to get some temporary relief from the bleakest parts of life.

Was my life ready that bad?

I wasn’t taking Fluoxetine short-term. I’ve been on it for years. So what unbearable trauma happened to me? Why was my life so bad that I didn’t want to live any more?

In short, I simply didn’t like life. I wanted to escape from it. I spent large chunks of my time wishing I wasn’t around.

At the time, my understanding was that if life’s making you depressed, then it’s perfectly natural to take anti-depressants so you can cope with it.

I liked my Fluoxetine-powered force field. I didn’t want to give it up. It didn’t miraculously make me happier, but at least it reduced the intensity of negative emotions.

And that’s the key point: I had decided I didn’t want to deal with everyday life any more. I constantly wanted to escape, through anti-depressants, through videogames and eventually by taking drugs.

And that lead me to addiction and Narcotics Anonymous.

It might seem strange, but I’m incredibly grateful I hit that low point.

Because it was there, as my life teetered on the edge of total destruction, that I learned the last little secret to curing myself of depression.


The root problem wasn’t that I was depressed. My core problem was that I couldn’t cope with everyday life.

And the solution wasn’t to mask or escape from reality (via games, drugs etc). The solution was to learn how to accept life on life’s terms.


I needed to stop running away. I needed to take responsibility for my life.

It’s thanks to Dr Jordan Peterson and to Narcotics Anonymous that I’ve made these astonishing realisations.

It’s taken me literally years to get to this point. Change is often really hard.


It’s been almost 8 weeks since I cold-turkeyed Fluoxetine. I don’t recommend that anyone else does this – it can be very risky to suddenly stop taking antidepressants, in some cases fatal.

Two months ago I couldn’t fully articulate why I wanted to stop taking my medication. But I knew it felt like the right thing to do for me personally.

It’s only now that all of this is becoming increasingly clear to me, almost 5 months clean from drugs and 2 months free from anti-depressants.

Ultimately, I needed to learn how to cope with everyday life again.

I needed to start taking responsibility for myself. And I needed to learn a better way to relate to so-called “negative” emotions.

Without Jordan Peterson and NA, I expect I’d still be on anti-depressants… possibly for the rest of my life.

So, it’s difficult for me to understate how grateful I am to both NA and Dr Peterson (via his YouTube videos).

Who knows where I’d be without their help.


[Caveat: depression is a complex disease. It has many different causes and seems to affect different people in different ways. In this post I talk only about my own experiences. I’m not a doctor or a medical professional. I am not recommending what I did for anyone else.]

Merry F'kin Christmas

Are you feeling a little grumpy as we near Christmas? Or is it just me?

To be fair, it could just be me.

It’s been 6 weeks since I stopped taking my anti-depressants cold turkey (I’m sure there’s a joke about Christmas leftovers here somewhere). And I’m definitely more irritable.

Though I’d much rather be irritable than depressed.

Actually, I’ve had consistently good moods: literally 6 solid weeks of 4/5 or 5/5 days (as measured by the excellent Pixels app by Teo Vogel).

I can’t remember the last time I had 6 weeks of solid good moods. Over the last few years, it’s been rare for me to go more than 2 or 3 weeks without a few days of depression in which I struggle to get out of bed or have enough motivation to do anything at all.

I’m definitely feeling more irritable than usual, but not so much that it has a significant impact on my happiness levels or general satisfaction with life. Phew!

Many Reasons to be Grumpy

At this time of year in particular, there are plenty of reasons to be feeling grumpy.

There’s the stress of preparing for the big day – buying and wrapping presents, tidying the house (if you’re having guests over), trying to make sure you’ve got all those extra little jobs sorted out in time.

And then there’s incompetent delivery companies… yes, I’m looking at YOU, Hermes UK. You’ve managed to lose a parcel which contained a little boy’s Christmas present, despite the fact it was sent two weeks ago.

Yes, it was insured, but that’s not the point, is it. This present can’t easily be replaced. And by now it’s certainly too late.

You had ONE job, Hermes. ONE.

Managing Emotions

So yeah, there are a 1001 things to do and even more reasons I could use to justify why I’m a bit irritable and grumpy.

But that’s not how I want to feel.

And so I remind myself of a few things which help to return me to a place of calm.

I remember that there are people sleeping on the streets this Christmas, so I should consider myself lucky that I can even afford to send presents.

I remember that although it’s difficult to totally avoid all of life’s little irritations, I can choose how I respond to them.

I can choose to stew on those annoyances, obsessively ruminating on all the reasons I’m justified in feeling angry.

Trust me, I’m an expert at making mountains out of molehills. That’s a big part of why I ended up with clinical depression.

If I continue down that path, pretty soon I’ll have backed myself into a corner, filled with rage. I’ll be a dark, angry, depressed mess, just in time for Santa.

You should have seen me one year ago. I was depressed as fuck. I refused to actually run during the Christmas Day Park Run. Instead, I walked it, stubborn as Mary’s mule.

I hastily deleted the photos taken by the official race photographer. I’m surprised my miserable face hadn’t cracked his lens!

Or…

I can choose just to Let It Go (credit: Frozen). I can choose not to let those irritations get to me.

I can acknowledge the feeling of irritation in my mind. I can notice the tension in my body. And I can just… breathe it all out.

Ahhh, peace. Now that’s how I want to feel this Christmas.

And If All Else Fails…

… just get drunk and start a violent altercation with the nearest bystander.

See you in prison!

Merry Christmas, love from Rock Bollinger x

Getting the Most from 12-Step Programs

(Photo: Nic McPhee/Flickr)

I have mixed feelings about 12-Step programs like Narcotics Anonymous, which I’ve now been attending for 4 months.

There are plenty of good things about NA. But sadly, there are also several unsettling flaws which drag it down in my estimation.

There’s zero chance that I’m the first person to have recognised NA’s problems, which indicates to me that the organisation is stuck in the past. It struggles to adapt and change, limiting its ability to learn from its mistakes.

NA is stuck in ideology and dogma, seemingly unable to evolve and improve.

The real tragedy about this is that it unnecessarily limits the organisation’s ability to help people.

I wonder how many struggling addicts have been turned off by NA’s negatives, many of which I’ve wrestled with myself. How many of those desperate people relapsed and died as a result of NA’s failings?

A journalist’s conclusions

I enjoyed the following article, which contains many salient points about Narcotics Anonymous (click the link just below)

WHAT I’VE FINALLY CONCLUDED ABOUT 12-STEP PROGRAMS AFTER 25 YEARS WRITING ABOUT DRUGS AND ADDICTION


I don’t want to sound overly negative about NA, so here’s my attempt at a balanced representation of NA’s pros and cons:

What I like about NA

  1. It’s free (other than a small donation each meeting).
  2. I love the social support I receive from other addicts. There are some really lovely, kind, caring people at my local NA meeting. After 4 months of attending meetings, some of them are starting to feel like friends.
  3. For people who diligently follow a 12 Step program, it seems likely that their lives will improve in many different and sometimes unexpected ways.
  4. One vitally important NA catchphrase is, “Take what you like, leave the rest.” You’re not forced to think or believe in a certain way. There is some room for individual differences of opinion.
  5. There’s a lot of overlap between the 12 Steps and some ancient philosophies such as Stoicism and Buddhism. These philosophies are excellent paths to self-mastery and self-improvement. I’m a big fan of both, and for me, much of NA’s ideology fits quite neatly with my existing beliefs and understanding.

What I don’t like about NA

  1. Some members seems to insist that there is only one correct way to recover from addiction (the official NA way), leaving little room for nuance, individual differences or the complexity of life. I strongly resist such a puritanical and ideological approach. Blind faith in dogma is simply stupid – we should always be willing to question what we’re told.
  2. NA’s insistence on the existence of a “Higher Power” is redundant for the treatment of addiction. NA seems wilfully blind to the fact there are plenty of secular, effective, evidence-based drug treatment programs.
  3. NA lumps all attendees together and treats us as if we’re all the same: sick addicts who are fundamentally broken. Personally, I don’t find this approach helpful. NA literature is full of unhelpful narratives about the lives of addicts – I can’t relate to much of it and I have to force myself to ignore it. The organisation could avoid this problem if it was more inclusive and better recognised the large variations in the experiences of different people.
  4. In its very first step (Step 1), NA insists I admit I am powerless over my addiction. That’s a huge turn-off for me. I’m absolutely NOT powerless. (See the article I mentioned earlier for more on this.)
  5. NA insists that anonymity is essential and non-negotiable. But some people (like me) find it helpful to be open and honest about my drug problems. I believe that silence and stigma around mental illness and addiction just makes things worse.
    (NOTE: I don’t recklessly over-disclose, I’m careful about who I share with. And for this blog I keep my true identity hidden behind a pseudonym.)

How I reconcile all these problems

For me, it all comes back to that idea I mentioned earlier:

“Take what’s useful for you, ignore the rest”

And there are plenty of things I find beneficial about Narcotics Anonymous.

It would be churlish of me to throw the baby out with the bath water – to stop attending simply because there are certain aspects I don’t like.

Perhaps NA is simply a microcosm of society… everyone is different and if we want society to function well, we must be tolerant of each other’s differences…

… that’s unless you want to live in a totalitarian state like Communist China.

Misery Is Optional

Some days, the Just For Today email from Narcotics Anonymous really hits the nail on the head for me. Today is one of those days.

“I don’t have to be miserable unless I really want to be.  Today, I will trade in my misery for the benefits of recovery.”

– Extract from Just For Today email.

There’s a lot of crossover between the ideas of NA and those in other philosophical traditions such as Buddhism and Stoicism. And this is a great example.

Look, I get it: it’s human nature to tell ourselves we are justified in our misery…

Perhaps a political party we despise has just been elected (as will happen for a large proportion of the UK electorate in the next few days). Perhaps our boss at work is treating us unfairly. Maybe we’re suffering from some kind of mental or physical illness.

But I like to remind myself of Victor Frankl and his 1946 book, Man’s Search for Meaning. Viktor survived the Nazi concentration camps. If anyone had good justification for feeling miserable, it would be him.

And yet – he took control of the way he reacted to his horrific circumstances. He didn’t let them get the better of him.

Can We Help Being Depressed?

I’d like to think I know what I’m talking about when it comes to depression and suicide. I’ve been depressed on and off for most of my adult life and been close to suicide several times.

When I’m feeling really low, it feels like a kick in the teeth to be told that I should just decide to be happier. It feels ludicrous and absolutely impossible to even try. And I want to punch anyone who suggests it, no matter how well-meaning they may be.

But whilst in the depths of depression, I gradually came to accept an incredibly profound concept:

“Whilst I am not to blame for my depression, there are certain things I can do which can make things better for myself.”

Bollinger, R. 2019

Interestingly, Narcotics Anonymous says something similar about addiction.

Now, as I’ve alluded to above, if you’re currently depressed, often the last thing we want to hear is that we have a responsibility to try to get better. It’s much easier to throw our hands up in the air and say, “Hey, I have an illness. I can’t help it. There’s nothing I can do about it.”

That freedom from responsibility seems appealing, comforting almost – it allows us to take a break from caring. But it’s a silk-lined trap.

“When we recognise that there are ways we can help ourselves, and we’re not condemned to suffer indefinitely, that’s incredibly liberating.”

Bollinger, R. 2019

No Quick Fix

Now, I’m really not saying that a depressed or addicted person can just click their fingers and magically decide to be happy. It’s not that simple.

As any behavioural psychologist worth their salt will tell you: behaviour change is hard. And that’s because we have to build up healthy habits, which takes practice and time.

It takes incremental effort, every day, as we attempt to make our lives just a little better. Just one tiny step forward every day will result in us eventually finishing a marathon.

Actually, it’s even better than that: if you improve 1% every day, by the end of 1 year, you’ll be 37.7 times better than when you started. (I blogged about this idea here).

(Note: not 37.7% better, 37.7 times. That’s 3,770%!)

Your Turn

So, over to you…

What small things are you willing to do, today, which might help you feel less miserable, more fulfilled, happier with your lot in life?


Up or Down?

Today feels like another of those pivotal moments… depending on how I handle things in the next few hours, my life could take a turn for the worse…

…Or maybe I’ll be able to use my arsenal of mental health tools’n’techniques to dodge the knockout punch which life is aiming my way.

If today was happening just a year or two ago, I’d say there would be a good chance I’d be heading into another depressive episode.

Fortunately, I have an ever-increasing belief that I (probably) have the inner strength to handle this. I hope I’m right.


So, What’s Going On?

Let’s start with the facts: Physically I don’t feel great: tired & achey. Mentally I’m not so hot either… brain fog, lingering sadness.

My old friend’s suicide is affecting me a little… but to be fair I haven’t seen her in ten years, so I’m less distressed than if she’d been my closest friend and we’d been better at keeping in touch.

12 Steps

I’ve been pulling away from Narcotics Anonymous. I’m coming up against barriers inside my own mind which are making it hard for me to feel close to people within the fellowship. I’m losing the sense of community I felt previously. I’m also intentionally avoiding my sponsor because much of what he tells me I find unhelpful. I haven’t attended a meeting in at least a week – I’m questioning its value for me personally.

On the plus side, I don’t see myself quitting Narcotics Anonymous completely. I still can very much see the value in doing the “stepwork” from the NA Step Working Guide book. It forces you to carefully consider your relationship to the 12 Steps. It helps you become a better person. And yet I’ve been procrastinating getting stuck into it for weeks. I’m at the start of Step 2, but I keep finding way more interesting things to do around the house… mostly DIY, which at least has felt productive. Yeah, I suck at routines and discipline.

As I’ve mentioned several times on this blog, there are lots of things I dislike about the 12 Steps. However, overall, I still feel it’s beneficial for me. So I’m going to keep going.

Anti-depressant Withdrawal

It’s a little over 3 weeks since I cold-turkeyed from Fluoxetine. This is precisely the timeframe where I might expect to feel the withdrawal effects on my moods and emotions.

I’m certainly feeling emotions more strongly now. The other day, I nearly cried while listening to some emotive music – that’s not happened to me for years.

Physical Effects

Recently, I’ve been really struggling to establish a good routine with diet, exercise and sleep. Again!

I know those 3 factors are very important for my mental health. When I consume too much sugar, don’t get enough exercise and keep staying up into the early hours of the morning, it’s an almost guaranteed recipe for worsening mental health.

Bad Dream

Last night I had a bad dream which repeated many elements of another disturbing dream I had recently.

I was in London and wanted to get home. “Home” in my dream was Hampshire, where I grew up. It’s westwards from London. But I got on the wrong train and accidentally headed North. I didn’t even realise I was on the wrong train until the train was outside London.

Once I realised, I got off at the next stop and planned how I would get back to Hampshire. It was going to take forever.

I would also need to walk through a place where I knew a lot of old acquaintances would be using drugs. It would be hard for me to resist.

This morning I’ve been trying to work out if the dream holds any significant meaning. What is it trying to tell me?

I find it alarming if my unconscious thinks that going North is/was a mistake. My wife and I moved North 9 years ago. Sure, we’ve had some difficulties, and it’s been tough for me being socially isolated (I’ve not made much effort to make new friends locally).

However, I can’t stress this enough: I have zero regrets about moving to Yorkshire. I love it here. My hometown holds a lot of painful memories for me and I have no inclination to return.

I’m 100% committed to my wife. My intention is that we’re going to be together until we die.

Moving North was very much NOT a mistake. So, what else could the dream mean?

Perhaps it simply means I’ve been heading in the wrong direction recently. Maybe I’ve been spending way too much time being obsessed with DIY when really it would be wiser to get stuck into NA meetings and stepwork.

Or perhaps the dream holds no meaning at all and I’m too eager to read something into it.

Maybe I should just “collapse the house of cards” – remove all sense of meaning and interpretation from these recent events. Maybe I need to get back to my “being mode” – experiencing life as it is, mindfully, without layering on so much meaning, which only exists inside my own head.

Taking Action

Practical steps I can start taking immediately to wrestle control of my life away from any impending depression:

  1. Remember that nothing holds any meaning unless I decide it does. That immediately reduces any emotional valency.
  2. Get busy. Do some DIY or something productive. Be mindful whilst doing this.
  3. Exercise, eat better today, get a good night’s sleep tonight.
  4. Listen to my favourite music.
  5. Be kind to myself.
  6. Reach out to my NA sponsor. I’ll chat with him at 3pm today.
  7. Get stuck in to working Step 2 this weekend.
  8. Cry if I really need to. Don’t bottle up emotion, but equally don’t wallow in it.
  9. Remind myself I’m on the right path, despite what the dream might suggest.
  10. I just felt this list should have 10 items and not 9. LOL.

The Big S

My brain keeps coming up with amusing ways to begin this post. It’s bizarre, the subject I want to talk about isn’t funny at all.

Suicide

There, I’ve said it. I’m sorry if I’ve just ruined your day.

Last week, an old friend took her own life.

She was recently married and had a young baby. But depression and other mental illnesses don’t particularly care about your life circumstances. It doesn’t matter how successful and happy you might seem on social media.

She wasn’t the first person in my social circle to do this. It’s distressing that I’ve actually lost count of the number of friends and family who have died by their own hand.

And even worse, I’m not particularly unusual. By the time most of us reach our forties (like me), we’ll know at least one person who killed themselves.

Suicide is the biggest killer of men under 45 in the UK. I’m sure the rest of the Western world has similar stats.

Just stop and think about that for a second…

Not cancer, not heart disease, not even car crashes. Suicide.

And yet many of us are still too scared or feel awkward talking about it. And that stigma contributes to the problem.

I feel strongly about this issue – before my blog’s recent redesign, this post aimed at preventing suicide was permanently featured on my home page.

Impotence

I’ve had my fair share of mental health problems: depression which brought me close to suicide several times, panic attacks and addiction in recent years.

I’m incredibly grateful for these difficult experiences. They’ve taught me useful skills, for helping both myself and others. I’m better able to empathise with people going through similar experiences.

Volunteering as a listener for a suicide prevention charity was one of the most fulfilling roles of my life.

And yet, I feel like I should be doing more. More to help others, more to reduce the number of deaths by suicide.

Suicide isn’t inevitable. Severe depression can be treated. Maybe not for 100% of people, but certainly for some, maybe even most.

There’s more I could be doing to help.

Recently I’ve been looking for a clearer purpose for my blog, a tighter focus. Again and again The Universe keeps prompting me to do something about mental health issues and specifically suicide.

I guess it’s about time I did something.