This slightly battered, but otherwise non-descript, box has travelled with me since February this year.
It’s Sertraline, a medicine that falls under the category ‘Selective serotonin reuptake inhibitor’.
The keyword to that category is serotonin, which is a naturally-created chemical that carries signals between nerves. It’s essentially a neuro-transmitter largely present in the brain (but also blood platelets, intestines and bowels, apparently).
For generations it has been believed that inadequate natural serotonin levels can negatively impact mood. Sertraline attempts to counteract this imbalance and is often prescribed for those going through depression and related symptoms.
I am not a medical expert, but I am interested in what I put into my body… so it is natural that I am curious about the pros and cons of using a medication that attempts to replicate something that already occurs within. Apparently, the jury is still out – does depression cause a drop in serotonin, or does low serotonin trigger depression?
In my personal experience, Sertraline – prescribed after extensive consultation with my GP and used in conjunction with psychology – does as my GP described. It puts a ‘floor’ into the patterns of my mood.
Flash back to 2008 and I was steadfast that what I was feeling could be solved via non-medicated means. I saw a (different) GP and discussed a mental health plan for the first time, something I should have done in my teens with hindsight. My abiding memory of this first truly open discussion about my mental state is that, once the allotted time was up, the doctor said ‘All the best, David.’ What I thought was a sympathetic ear was suddenly an insensitive prick, in my mind.
Still, I packed my bags and lived the dream of going to Italy for the first time, immersing myself in the language (I studied every day in Siena, managed to get to a good standard, then haven’t had a lesson since) and treading the misty parkland of Monza as screaming V10s flew passed on Grand Prix weekend (perhaps the seeds for Drive Against Depression were planted right there).
There was also St John’s Wort in my bag, a natural concoction available at your local supermarket and said to assist in uplifting mood. That, and the promise of psychology when I returned home.
In terms of this early experience, the best advice I can give is to not be afraid to change practitioners. While the objective – for me, at least – of psychology was to delve deep and ask some challenging questions of myself, if there isn’t a good vibe between doctor and patient, it’s okay to ask for someone else. But I digress…
For the next few years I alternated St. John’s Wort (it always seemed to have more effect when swallowed with a cup of black tea) with sporadic exercise and even more sporadic visits to the GP, though I had found a wonderful psychologist in the city and we’d made such progress that I felt happy to ‘go it alone’.
By late-2011 I was a parent for the first time. What a life changer. Who knew love could be so completely unconditional? It was perhaps this wave of never-before-felt emotions, good and not-so-good (hello sleep deprivation) that masked the fog rebuilding inside.
Back to it. St. John’s Wort, other natural remedies, conversations with confidantes and several futile attempts to exercise consistently. But then it all came crashing down again.
Mid-2016 was a trigger point. There was nothing in particular, nothing beyond the pressures of trying to be a modern man, father, son, brother, husband, friend, work colleague. But the fog was there, and it was worse than ever. Uncontrollable tears, my body rendered inert. The internal pressure was at explosion point, and I felt completely worthless.
It took a good six months of stubbornness and discussion about how I didn’t want to take a prescription. Friends had, and some had rebuilt themselves off that backbone, but still there were others who said they just felt numb. Better to feel ups and downs than nothing, I always thought. But this time, there were only tiny blips of up, with weeks of ever-increasing down. Nothing that worked before worked now…
So we arrive back at February this year. The GP and I sat through a mental health plan (I lose count of how many I’ve done since 2008) and it was quickly determined that medication was a start point, to rebuild that rubble within. I had nothing left to argue; I was in.
We built into it slowly, and just the impact of having a supportive GP and fantastic Wifey providing me with essential oils to augment the meds set my mind on the right track. Slowly, surely, my interest in life began to return. I could read books again, and I wanted to see my friends. I well remember my brother Daniel, along with long-term mates Greg and Brendon, coming down to the peninsula to see me. They each brought a car, and I rode with each of them as we made our way out for lunch. It was that day that I really talked for the first time about what I was going through, and took the time to listen to their take on modern life… as well as what cars we should all buy next.
From that point, I have discovered the Sertraline offers me a safety net. When I feel anxious, it seems to jump in before it becomes consuming. Likewise, the vast mood swings I have been prone to having over the years (usually a small ‘up’ for a short time, followed by a big ‘down’ for a long time) had evened out, like a hand was catching me before I fell too far and giving me a massage to reduce the intensity. A mood foundation was returning, and I bought the Clio to keep the good vibes flowing.
But it’s not purely down to the medication. The ever-present other side of the coin – a known side-effect of Sertraline was that it could cut the top off your high moods – was dulling the senses when they weren’t being stimulated; by playing with the kids or flinging the little Renault around, for example. A business trip with some rare spare time would add another layer to my Drive Against Depression: exercise.
Setting up in a hotel gym in a very industrial part of Munich, I panted my way through a short stationary bike ride… and it felt so good. The next day I returned for some light weights, the day after a cross-training routine. It snowballed from there.
Back home I joined the gym at work, which was something I scoffed at six months before. Now I trade lunch time for a cardio workout and I’m eyeing off some new equipment to play ice hockey for the first time in 15 years. The bedrock I felt being re-established by the medication has been beautifully complemented by the exercise, and I haven’t felt this good in years. That’s not to say some days aren’t a struggle, but I now (mostly) have the confidence to work through it.
Once the mood foundation is fully formed, I have promised myself and my family to work towards reducing the Sertraline and seek the advice of a naturopath who we know has worked wonders with others in the same boat. At the end of the day, it’s about what works best for you… but I am proud that I made the decision to accept the Sertraline prescription; it was truly what I needed at the time.
Has there been a turning point in your journey? Or perhaps several turning points? Please feel welcome to share your story in the comments.