Mental Health Issues

This is a blog post about my mental health issues.

I am depressed and I have general anxiety problems.

I was diagnosed with depression earlier this year. I’d been suffering with symptoms for a while – feeling sad most of the time, self-loathing, insomnia. These had been affecting me for years on and off. Only recently did I have a seriously distressing depressive episode. I decided to go to the GP to tell them about it and see if they could offer any help.

I sat down with him and told him that I thought I was depressed. I explained how I’d been feeling and how it had been affecting me. Straight away, he agreed that I was depressed. He asked me to fill in a questionnaire about how I’d been feeling. I came out as being moderately to severely depressed.

The GP told me that as I was under 18, he wasn’t supposed to prescribe me anti-depressants. Instead, I was to be referred to the psychiatrist as part of the CAMHS (Child and Adolescent Mental Health Services).

I waited for a while. A referral letter didn’t come through.

I was getting quite distressed by this.

Eventually, I went to see my gastroenterologist about my Crohn’s disease. I told him about the depression. He referred me to see a clinical psychologist who worked with the gastroenterology department in the UHW. I waited for a referral.

Not too long after, the referral letter came through the door and I went to see the clinical psychologist. We talked over how I’d been feeling. We started looking over problems in the past that may have contributed. We discussed possible treatment options in a second appointment the next week.

After waiting close to one and a half months from the original GP appointment, I decided to book another appointment. I saw one of the main GPs in the surgery. I sat down and told him about how I’d been feeling. He also pulled up the results from the questionnaire that I did with the other GP. He could see that I’d been waiting for a while for the CAMHS appointment. He also told me that it wasn’t protocol to prescribe anti-depressants to under 18s, but that he would speak to his colleagues to see what could be done. About a week later, I got a call back telling me that they were willing to prescribe me citalopram, an antidepressant, and some zopiclone to help with the insomnia in the short term. I went back to the GP and picked up the prescription.

Day to day, I hadn’t really been feeling great. I was still tired from the insomnia keeping me up and still having to get up early for school. This, in turn, didn’t help with my mood.

I started on the citalopram at a dose of 20mg a day. For the first few weeks, I didn’t feel much different. However, after about a month of starting them, my mood started getting better. My sleeping pattern was also normalising. The appointments with my clinical psychologist were going well. Things were starting to look up for me.

Unfortunately, I started having problems with really bad days. I had one seemingly random period of about three days where I’d been getting quite distressed by my depression. This carried on. I saw the GP again and upped my dose to 30mg a day.

I started feeling great soon after this. Day to day I was feeling much better. This continued for a while.

However, again, my good state started collapsing down around me. I was suffering with anxiety. It started to become somewhat disabling. I was stopping being able to talk to people, feeling really anxious about going out. It was distressing and didn’t help with the depression at all. In fact, it was almost as if I was back to step one.

I finally had an appointment to see the psychiatrist. I told him about the depression, my history, schooling etc. He also very quickly picked up on my anxiety. As I sat there talking to him, he noticed the nail picking – my main anxious tic. He told me that he wanted to review me every three months and I was on my way.

I went back to the GP last week after a trip abroad to Cyprus. The trip is when my anxiety really started getting to me. If it was bad before, it was getting out of hand now. I just sat around on my iPad for the entirety of the holiday. I didn’t want to go round checking to see if there were people my age to make friends with or anything. I sat there with my iPad – my barrier.

My GP upped my citalopram dose again to 40mg a day and put me on propranolol, a beta blocker drug that . I tried it out at home to see if the background anxiety would begin to fade. It did. The random humming that only I noticed and the subconscious desire to pick my nail. They went much more quickly than they’d started.

However, disaster struck a couple of days ago. I had a suspected allergic reaction to it. Before I’d even had a chance to use it in a situation where I would benefit from it’s use! I called the GP the next day to be put on the emergency list, given that the patient information leaflet told me to see a doctor as soon as possible. Yes, my dad is a doctor, but it’s not quite the same!

I saw one of the main GPs in the surgery who told me that it was probably best I stopped the propranolol. We talked briefly about the anxiety and how it’d been affecting me. She decided to prescribe me some diazepam, a benzodiazepine, 2mg a day to start off with.

This is my story so far.

At the moment, I’m feeling good. I am tolerating the diazepam well, but it’s early days. I have an appointment to see my regular GP on the 19th of August, so not too long. Hopefully, I’ll be put up to the normal dose of diazepam. I hope that this is the treatment for me, even though it is a short term solution. I hope it will bring me out of this anxious state long enough to be able to deal with the underlying problems. That’s what I think the citalopram did. It brought me out of the depressive state to see the underlying anxiety more.

Talking about mental illness is not an easy thing to do. It’s still seen as a ‘taboo’ subject – something you wouldn’t mention in the same way you’d mention a broken arm, cancer or other physical illnesses. I hope by talking about my experiences, it will encourage others to know that help is out there. People are willing to listen and help.

The only way to break the taboo of mental illness is by talking about it more.

Published by Rhys

Computer Science graduate, from Oxford Brookes University. Originally from Cardiff.

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17 Comments

  1. I’m proud of you kid.

    I’m a sufferer of depression myself. It took years before I sought treatment and years later I still battle with it.
    I’d like to say the depression gets better but so far I’ve only gotten better at coping with it.

    You’re right, it shouldn’t be a taboo. And whilst I can be perfectly frank about everything else in my life, the depression is the hardest thing for me to admit to friends, family and the world.

    Keep up the good work and I wish you all the best in fighting your ills.

  2. Congratulations for talking about it openly, Rhys!

    I hope things get better for you, and it is always such a joy to see you at Cardiff Skeptics where you always seem so confident and cheerful. But a confident and cheerful manner is so often a very tiring facade in my experience.

    It is awful to be feeling really down and, having plucked up the courage to go to a GP, to be left waiting and waiting for the result of a referral.

    You are so right that people are often willing to listen and help. May this trend continue until there really is no more shame than admitting you have a broken arm.

  3. Thank you for sharing – as you say, the reason mental illness and health are taboo subjects is because nobody discusses them. I hope you fare better, and sympathize with you in terms of fighting through the nhs on this. It’s one of the areas, unfortunately, which I don’t feel our health service does so well. I speak from personal experience, both past and present – depression and self-injury.

    Earlier this year the hashtag #whatstigma? Was used to flag up people’s personal experiences with mental health problems and raise awareness of just how common they are. I hope it doesn’t come across as patronizing if i say that I admire your bravery for blogging about this.

  4. “The only way to break the taboo of mental illness is by talking about it more.”

    So true – you’re forcing us all to have to admire your pimply welshness again. .

    Having been through depression twice, and done endless reading on meds etc, in addition to thanks for speaking out so publicly, here’s my advice.

    1) Switch SSRI’s – there are a raft of options available, and if Citiopram is only working short-term at a given dose, try something else (basic Fluoxetine might be perfect for you) – rather than adding on additional meds to (hopefully) counter side effects.

    2) Whenever you feel like you can, get exercise!!! Just go for walks in the sunshine with your thoughts. It’ll make a big difference (if you’re not already being active)

  5. Rhys, you are amazing. I’m a big believer that we should break down the taboos surrounding depression, but I know from experience that when you’re actually feeling it, it’s hard to talk about it.

  6. I agree with other Justin – exercise! Endorphins are a good short term mood booster.
    I know one of the problems with depression and anxiety is not being able to just get up and do things, like exercise/go for a walk/whatever. But if you can, do it. You’re a very smart guy, so you probably already know this. Confirmation is helpful though!

    That being said, I think we’re all pretty proud of you for having been able to go see all of these people and put up enough of a fight (against wait times, calls not being returned, etc) to actually get treatment. Like I said, you’re smart. You’re also pretty damn brave – not everyone is willing to break a taboo. With those traits together you should be unstoppable.

    Best of luck to you!

  7. Hi Rhys,

    I’ve been a chronic sufferer of insomnia for about 30 years. I often go three nights without any sleep at all and have learned to recognise how my mind degrades as this happens. I can still do everything I always could, but it takes more concentration and things like listening to friends who are telling me awesome stuff tend to slide in favour of thinking about the esoteric crap I do for a living. I can feel it happening, but it’s very hard to counteract after a couple of days with no sleep at all.

    I’ve never managed to learn any techniques to get myself to sleep, but I have learned to put myself into a kind of doze more or less whenever I need to. In this doze, I am perfectly aware of what’s going on around me, but my mind is mildly unhinged and seems to be threading in and out between thinking and dreaming. It’s what I do at night for hours and hours on end when I can’t sleep, and it helps a lot. Sometimes I actually do solve problems. More often, I solve problems that didn’t exist in the first place and are stupid. But letting my mind run amok like that is almost as good as sleeping.

  8. I’m not going to bang on about what to do to cure depression, as I don’t believe I’ve suffered genuine clinical depression, but I’ve suffered bouts of gloominess and I’d certainly go along with the other comments about exercise. Regular, early morning, strenuous. Although I’d avoid going as far as naked squat thrusts with scout leaders in the woods…

    Stop for a moment, take a step back and look at your life and what you’ve already achieved. The awards, the famous skeptics and scientists you’ve met, and what you’ve done to stop people not only drinking bleach but generally being ripped off and endangered by woo-mongering halfwits and scamsters.

    On the other hand, you live in Cardiff so on that front, I can empathise.

    I’m quite argumentative, I argue with a fair few people, and you and I have crossed swords about a couple of subjects, and although I disagreed with you, your arguments were twice as clear, lucid, rational and intelligent than most people twice your age.

    The fact that you’ve written this piece shows an immense maturity beyond most people of your years. I know this isn’t going to snap you out of any dark moments, but just remember you’ve got a helluva future in front of you.

  9. You’re absolutely right, Rhys: we need to come out of that closet (along with our LGBT and atheist friends). People have been talking about mental illness somewhat more openly since 1990 or so (when Prozac first became available), but stigma is still, as you know, widespread. Unfortunately there are lot of people out there who promote false claims (I think of them as the mental health equivalent of the “vaccines-cause-autism” crowd”). I won’t try to enumerate these: for one thing, there are so many, and for another, I’m sure you’re familiar with most of them. I keep seeing you on various social networking sites and one thing I’m pretty sure of is that you’re far too bright to trust whatever some idiot tells you on the internet. 🙂

    Regarding availability of treatment, I’m not sure if the situation is worse here (USA) or there. (Of course, although you seem to be stuck with more rules & regulations, you do at least have the virtue of universal health care while…well, I’ve no doubt you’ve heard about the level of craziness (not mental illness, just craziness!) we have to deal with, particularly in the political sphere. I’m fairly confident that if we could fix our broken, corrupt government, we could solve a lot of our problems, but that first step seems so intractable.) Does NHS/CAMHS cover talk therapy/counseling? That can be very helpful or virtually useless — I think it depends more on the therapist than the particular type of therapy — but if you have to pay for it yourself it can be prohibitively expensive for a lot of people.

    I have some idea of what you’re going through. I was first diagnosed with major depression when I was 14. I tried one antidepressant after another. I didn’t find the SSRIs (fluoxetine, sertraline, paroxetine, etc. — I think I may have tried citalopram too at some later point) or other “new-generation” drugs very effective (I remember that controlled-release venlafaxine seemed to help a little, pretty much all the rest of the newer [at the time] ADs sucked, so after adding lithium and various anticonvulsants, thyroid hormones, etc., my doctor switched me to an older tricyclic AD, desipramine. I’ve never had an allergic reaction or anything to a drug before, but this was where it got “interesting.” (BTW: are you talking about an allergic reaction like hives, or severe anaphylaxis where you can’t breathe and stuff?) After I’d been on desipramine a bit over 10 days, I had a seizure. It turned out that my serum desipramine concentration was several times the maximum safe level, even though I wasn’t taking more than the (usually) acceptable/safe amount, nor was I taking anything else that (so far as anyone knew) could cause such an interaction. It was too bad, because I was pretty sure the desipramine had been starting to work.

    Eventually I found a combination of treatments that works pretty well for me, although it’s not perfect (and is rather esoteric). I hope that things go more smoothly for you and that it doesn’t take long for you to find something that pretty much does the trick. Whatever happens, though, always remember that you’re not alone. Best of luck to you.

  10. Hi, Rhys. When I read your tweets, you do not sound like a depressed person to me, but, then, it could be a masked depression. It sometimes happens. I enjoyed your post, you are a great storyteller, and I learn English when I read you.

    A social-web romance would be very good for you, besides exercise, of course, which is the most important step; there is an adolescent social web called buddy.com, you should try it.

    Having said that, I go on to tell you that anti-depressants are out of vogue, I stopped having them one month ago. I only had 20 mg a day of Prozac, you know, just to feel chemically happy, but I already stopped and feel good. I take 25 mg Atarax at night just to be sure I`m going to sleep all night long, but I do many other things, too: shower before bedtime, only pleasant reading/films once in bed, turn off TV at midnight and only read for a little while after that. Hope some of this can be useful for you. My best wishes.

  11. I also suffer from depression. I went through lots of different medications until I found that Wellbutrin worked for me. I found that SSRIs were especially bad. They made me so drowsy that I sometimes had trouble staying awake during the day.

  12. I’ve been on the Fluoxetine (40mg per day at the moment) for a few years.
    It helps, but I fear that “being depressed” will never stop. It’s the worst disability for misunderstanding.

  13. I am so glad you are able to get this starting to be worked out now rather than further down the line. I am glad they don’t automatically give pills to minors since that has been way over done in the past. I know that can be frustrating when you are one of those that needs it. I have been on and off different SSRIs since I was in 4th grade so I understand how much it can be needed. I applaud you for being so open and frank about your struggles. It is ridiculous how taboo mental health issues can be still!!

  14. You’ve an impressive intellect, and are a talented writer. I’ve enjoyed reading your posts, and have admired your wit and courage (particularly with regards to the libellous cancer-fraud-people who need a kick up the arse from a teen prodigy such as yourself).

    Depression is real, it is horrible, it is lonely and crazy, fearful and angry and sad. It can be very dangerous. For some people, it goes away, or at least becomes more manageable. Exercise helps many (you know, endorphins). Sometimes, anti-depressants help some people, too.

    Put your mental health before everything, no matter what. You’re worth it.

  15. Rhys, have you looked into cognitive behaviour therapy? Drugs are good as far as they go but CBT really helped me reduce my anxiety.

    It’s got a reasonable reputation as evidence based therapy goes as I understand it.

    I really like the idea of being able to use my brain to make the fear go away, instead of letting the fear run riot with my brain.

    Exercise is supposed to be good too .. darn it.

    Good luck with all your work. You have a lot on for a person of any age. It’s impressive.

  16. Hey there Rhys,

    I heard about you while looking up my usual skeptics articles and came across your debunking of the miracle mineral water scam.

    First up, I must say that at the age of 15, I am impressed that you were already that well versed with skepticism and science. It’s only been relatively recentally (around when I was 20 years old) that I came anywhere near that level of insightfulness and intellectual rigor when observing the world around me.

    Second of all, I want to say that I can relate to you about your experience with depression and anxiety. I didn’t have the best highschool days, and it really got me down and anxious and cynical about society, people and the world at large. In a way, it was due to my disengagement with the usual things students did my age that allowed me to become more analytical and intellectual and well acquainted with science.

    I think the main point is that my difficult days (being depressed) forced me to consider what was meaningful in my life and what mattered. It helped me mature a lot faster than my peers and I am currently writing from a place and age where I look back and am sort of glad that things happened the way they did. Not to say that depression is fun times, but it’s just another thing that happens (I suspect to most of us, though the taboo nature doesn’t allow such a reality to be known) and we need to make the most of it, even if it means just getting out of bed and providing basic sustenance for your body to keep your metabolic processes running 😛

    Anyway, I wanted to just write to say that you’ve inspired me to start my damn blog that I’ve been wanting to do about skepticism and science and all things informative. It’s great to know there are like minded kindred spirits out there, and that although we may be strangers, I feel a common connection between us that I don’t have with people I see on a regular basis.

    Remember, you’re not alone and feel free to correspond with me via email if you want to chat!

    – Edward

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