When I first became unwell it was the anxiety that sent me to see my GP. At this point I wasn’t truly psychotic or manic, but it had started to creep in (if only I knew the warning signs back then!). I hadn’t been sleeping because I was so afraid that if I slept, my husband and I would be murdered in our bed by the neighbours. On top of the paranoia I was also ‘running fast’; I wasn’t able to slow down enough to shut off. I was having anxiety attacks every night over this fear and have experienced them before so thankfully I was able to at least identify; ‘yes this is anxiety’.
I booked an appointment to see the doctor to see if I could get some help dealing with the fear. My regular doctor wasn’t available, so I took the first free appointment with a locum. In I went, my heart beating in my chest with the anxiety of having to talk to someone about what was going on. When she asked why I had come in to see her I broke down. I spilled my heart out and told her everything – that I wasn’t sleeping, couldn’t calm down and was having anxiety attacks. I probably only talked for a minute but it felt like forever. She listened and made reassuring mhmm noises as I spoke; but when I was done she came out with the least helpful statement a doctor has ever made:
“I don’t know what you want me to do about it. You’ll have to sleep sometime.”
I was shocked. Worse still, I didn’t have an answer. I didn’t know about asking for referrals to talk therapy (in this area of the UK there is a very good telephone counselling service, as well as the opportunity to take up six face-to-face sessions), and I didn’t know about anti-anxiety or sleep medications. She had knocked the wind out of my resolve to get this sorted and I had no idea how to respond.
After a moment of silence she started to talk about the link between depression and anxiety. She suggested that I was in fact depressed and it was manifesting itself as anxiety. That’s not to say it doesn’t happen; that’s just not what was happening with me. She wrote me a prescription for citalopram (which is an SSRI anti-depressant) and sent me on my way.
What a disaster that was. I felt rotten, but relieved that I could at least try these pills and maybe get a break. I didn’t know then about certain anti-depressants exacerbating mania. Pretty quickly, I found out though.
For the first few days I felt no change. A quick search online told me to be patient – 2 to 4 weeks is typical for SSRIs to take effect. My mood was still elevated and I was still terrified to sleep. Gradually, however, the mania took hold. I hadn’t been sleeping more than a few hours a night anyway, but this amount dropped away until I was catching around three or four hours every third night. I was restless, agitated; every night I fantasised about going out for a long walk just to take the edge off. I was raging angry at my husband for every tiny transgression, and I couldn’t focus on my work.
The thing that made me drop the citalopram in the end wasn’t this manic experience though. I am notorious now with my psychiatrist for getting the weird, rare side effects on every medication we’ve tried. In the case of this particular anti-depressant, it was making my food taste rotten. I couldn’t eat a thing unless it was highly flavoured or highly spiced to cover up the taste of the meat. Fatty foods were out; whenever I tried even so much as a sausage it felt as though my tongue was coated in the oil from the meat. It was disgusting, and I was hungry, so I stopped the medication.
From there on in the mania settled a little. Probably back to ‘simply’ being hypomanic rather than full-blown raging mania. It was another month or so before it came back in full and my husband got me to see a different doctor, this time armed with mood charts and trackers.
Even now I’m on a different anti-depressant we are careful of my mood. Sertraline is nowhere near in the same league as citalopram was for triggering mania, but it’s not perfect either. Unfortunately without it I get severely depressed, so it is a case of balancing the pros and cons.
So to wrap up, I suppose the moral of my story is to do your research and never be afraid to challenge your doctor if you’re not sure they are right.