Anti-depressants gave me back my life...

I knew I was losing my mindEleanor Bailey has suffered from crippling bouts of depression for most of her adult life. Last year she discovered anti-depressants and it turned her life around. Why, she wonders now, did it take her so long?
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I don't remember much about the dark period last year which led to my taking anti-depressants for the first time. Apparently I talked far too quickly, or too slowly, and I believed that everything was hopeless - that my life was about to collapse. Nothing rational was consoling.

I don't remember much about the dark period last year which led to my taking anti-depressants for the first time. Apparently I talked far too quickly, or too slowly, and I believed that everything was hopeless - that my life was about to collapse. Nothing rational was consoling.

My brain did not work properly. I forgot conversations minutes after having them. My mother found cheques with my name only partly signed - I had lost interest after the first syllable. She remembers asking why I had not emptied a mouldy thermos of soup, to be told "I couldn't face it".

I was walking like an 80-year old woman. I stopped going to work. I flooded the flat, and the place downstairs, with absolutely no recollection of turning the bath on - and then I almost did it again.

I lost both the car and door keys, all in one morning, after which responsibility for such things was taken out of my hands.

Throughout my adult life there have been periods when I have, scientifically speaking, lost it. Periods from a few days to a few weeks, where normal functioning seems to stop. I cry all the time, I sit on the sofa and stare into space. I eat only tinned rice pudding. I have videotape with Beaches and Steel Magnolias on back to back, so that it can just keep running, when I haven't the strength to choose another.

It's hard to explain, even to myself. Sometimes there is an obvious trigger for these little "turns", sometimes not. Last year it was just the sorry modern tale of too much work and too much stress: a family death, a full-time job with freelancing on top, a legal action and a partner over-stressed himself because of a loathsome job. I was also writing a novel which, perhaps ironically, explored the question of what is "normal" mental health and the effects of mental illness on four generations of women. It just all got too much.

Being a woolly liberal type, at first I tried relaxation strategies. But I found them, as ever, ineffective. Deep-breathing meditation was too depressing; hypnotherapy too much effort.

But what finally made me snap was insomnia. I spent all night panicking, with flashes of adrenaline whenever sleep came close. Not sleeping at night left me unable to do anything during the day. And I mean anything. I couldn't eat, wash or even speak much. That's when I finally felt mad enough in my own mind to go to the doctor. He prescribed anti-depressants and said that at the very least they would let me sleep. They did. After a couple of weeks I began to feel a bit better. It was very simple. Now all I wonder is why I waited until I had lost a stone and a half and looked like a skeleton. Why were anti-depressants the last resort?

It's unnecessary middle-class fear, says Dr Bruce Charlton, lecturer in Psychology at Newcastle University and author of a new book called Psychiatry and the Human Condition. "No amount of proof of the effectiveness of anti-depressants, or ECT, seems able to remove the suspicion of these treatments (especially among the more educated part of the population, who persistently favour psychological treatments of depression, even when these are wholly lacking any specific evidential base)."

It is amazing how we will happily sup herbal potions and tell all our problems to strangers, thinking that these are no-risk options. Counsellors are much less rigorously tested than drugs. One counsellor I saw seemed stuck with the Top 10 therapy clichés, which she probably read on the back of a cereal packet. Whatever I told her, she blamed my parents. My objections only fuelled her belief that she was right.

By going to a counsellor you are facing up to your demons. But this is far from useful if your demons haven't slept well lately. Talking it through might help when you are on the mend, but if you can't step into the shower in the morning, you are unlikely to be in a fit condition to share your problems with a group.

There is a great fear of being abnormal. And drug remedies are seen as abnormal. Yet depression is a very normal problem. According to the World Health Organisation, depression will be the second biggest cause of lost workdays worldwide by 2020. One in four of us will be diagnosed with depression at some point in our lives. In 1997, 16.8 million prescriptions were written for anti-depressive pills in the UK.

Taking anti-depressants sounds so serious. I know I've been up and down over the years, but depressive? Surely not. In any case, the term "depression" does not mean much, according to Dr Charlton.

"Currently, to have depression you must conform to four out of eight indicators (such as persistent low mood, loss or gain in appetite, sleeplessness etc). If you conform to three you are not depressed. It's too arbitrary, too cut and dried."

It is dissatisfaction with accepted diagnoses and treatments of psychiatric conditions that provoked Dr Charlton to write his new book. The truth, he believes, is that most people are neither depressed nor non-depressed, but somewhere on a continuum.

Some 80 per cent of depressive episodes are thought to be triggered by life stress - illness, bereavement, work stress and so on. These external triggers are on the increase because of our increasingly stressful and "unnatural" lives - we talk to strangers rather than sticking to close family groups, we don't get enough quality sleep, and we live in claustrophobic, noisy urban environments (depression rates are higher in cities).

Anti-depressants buffer the extremes of low and lethargic feelings. They enable us to function normally in a permanently abnormal world. Dr Charlton challenges the very term anti-depressant, since the drugs have many other effects: they can calm anxiety, provide pain relief, and some can even help impotence.

As well as being inaccurate, the term anti-depressant labels the people taking them. If they were seen instead as a non-addictive method of pain or stress relief, they would be less alarming. Conversely, if a bottle of Chardonnay - one of the most popular self-prescribed drugs - were to be re-labelled "anti-anxiety" and recommended for the socially phobic, we might think twice about offering it to guests.

The impact of severe mental illness on patients and families should never be trivialised, but there is still far more of a grey area than we think. Some people with major disorders continue to lead relatively normal lives. "The argument is that most people are fine, and only a minority suffer from these problems," says Dr Charlton, "but most of us have some of the symptoms of psychiatric illness frequently."

Current medical thinking is that depressed people have different hormone and neurotransmitter levels from "ordinary" people. Yet according to Dr Charlton there is no proven cut off between one group and the other. A non-depressed person could have the hormone levels of a depressed person, and vice versa.

A recent article in the US Journal of Psychiatry looked at the effects of SSRIs (Prozac) on "normal" controls (people with no current psychiatric disorder, no past problems and no family history of psychiatric problems). Theoretically, the drugs should have had no effect on the "normals" other than the side-effects. It didn't work out that way. Instead, the "normal" people became more sociable and less prone to down moods - just like the "depressed" people. So is it normal to be depressed, or are depressed people normal? That may be the evidence, but it's hard to convince a society, still suspicious that depressives are either "mad" or feeble.

Part of the problem of depression is that you feel guilty and believe you are a malingerer. You won't go to the doctor because it would be wasting his time. This, of course, creates a vicious circle.

Once I "came out", I realised that people I knew thought depression was a weakness, too. Not because they looked down on me, but because they had never before admitted that they were also on anti-depressants. Only then could they acknowledge their own "failure" to cope.

"Is there anyone we know who isn't on anti-depressants?" asked my husband at one point.

"I thought it would change my personality," said one friend, "but my mum persuaded me to take them by pointing out that crying constantly didn't really constitute a fully functional personality.

"After a few weeks I just stopped crying. My external circumstances were exactly the same, but I simply didn't feel as badly about them. And because I felt better and less tired, I also had the energy and self-belief to start changing things."

The general public have a fear that they are "happy" pills that will leave them doped up and unable to feel. In fact, says Charlton, "they have the opposite effect. When they work they enable you to concentrate more, to be more sociable."

I am not surprised, looking back, that writing a novel sent me over to the darker side. The process is, after all, a bit like forcing oneself to go to a bad therapist. You stir up your subconscious, bring out your dark side for everyone to laugh at - and never bother to put it all back properly afterwards. Your job is to sit at home and brood. One of the best things you can do when depressed is to take care of the little things - change the bedsheets, plant a window box, empty mouldy Thermos flasks. Sadly, however, none of these things impresses the book publisher.

'Idioglossia' by Eleanor Bailey, published by Doubleday, £16.99; 'Psychiatry and the Human Condition' by Bruce Charlton MD, published by Radcliffe Medical Press

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