I know this should be a positive and exciting time in my life. My new novel, Clean, is an Amazon best seller and I’m about to embark on a promotional world tour. And while I recognise this may sound like a ‘my diamond shoes are too tight’ scenario, I mostly feel one thing: crippling anxiety.
I know what happens when anxiety starts seeping, like damp, through the walls of every room of my mental interior. The public panic attacks. The sense of the walls closing in on public transport. The voices in my head telling me I’m trapped. So I’ve responded in the best way I can for myself and begun taking antidepressants again.
Health Secretary Matt Hancock has called antidepressants ‘unsophisticated medication’ and pledged to expand schemes to treat mental health problems with gardening and arts clubs. The announcement came amid criticism of the ‘mass prescribing’ that saw one in six adults given antidepressants last year.
For me, and no doubt many of the hundreds of thousands of others who suffer the paralysing, life-destroying effects of anxiety or depression, it felt like a slap in the face. To be told we’re a nation of ‘pill poppers’ dosing ourselves up on drugs when we could be doing a bit of weeding or colouring, is so patronising it would be laughable, if not for the fact that the way we approach mental health often means the difference between life and death.
I agree, the numbers look alarming and it’s a cause for concern that 70,000 under 18s and 2,000 primary schoolchildren were among those prescribed the drugs last year. A lack of funding means GPs have to hand over prescriptions while patients fester on waiting lists for counselling.
But too often lately, antidepressants are demonised as something shameful to be avoided. The reality is that for people like me, they’re a saviour. Despite this, I haven’t told my mum, or my new boyfriend, that I’m ‘back on the pills’. Why? I’m worried my mum will worry and my boyfriend will think I’m a Valley Of The Dolls case.
My anxiety started, as these things often do, at puberty. As a transgender woman, I went through the wrong puberty and this kick-started a generalised anxiety that saw me off school for weeks, unable to leave the house over unfounded fears I might vomit in public. Clinical anxiety is not the same thing as worry. Soon, you’re anxious about nothing and everything. I spent most of my twenties with this background radiation but, as I tiptoed towards starting my transition in 2013, my health declined.
Living in London, public transport became an issue. If the train paused in the tunnel, it felt like the walls were closing in and the voices would start: ‘You’re going to be sick, everyone will laugh at you, you can’t get off, you’re trapped, what if you need the loo?’ I’d feel like I was going to lose control. This physical response is ‘fight or flight’, an excess of adrenaline released into your body with nowhere to go.
After an excruciating moment at the Hay Festival in 2015 where I had to leg it off-stage mid panic attack, I decided enough was enough. I went to my GP who, after I described my symptoms, was amazed I’d never been prescribed antidepressants. ‘I’m not depressed,’ I said. And I never have been, mercifully. Luckily, the same medication also treats anxiety. Before I was given the medication, my GP ensured I was seeking other support (I was already seeing a therapist over my gender dysphoria).
I was prescribed Selective Serotonin Reuptake Inhibitors or ‘SSRIs’ – specifically Escitalopram and, aside from a bit of dry-mouth, I only really noticed the impact of the drugs when I was next on a broken-down train. Immediately the little voice in my head said, ‘Juno, this is where you’re going to die, you should probably freak out now.’ But my body wouldn’t play along. My stomach didn’t kick like Buckaroo, my palms didn’t go clammy, my breathing stayed regular. My brain gave it a good go, willing my body to react to this imagined catastrophe, but it simply wouldn’t rise to it. It was as if the Escitalopram was
a barrier between my body and brain. That mental wall got me through the most challenging year of my life. I came out to my family, friends and publisher, and my readers. It got me through the public ridicule and scrutiny of the first year of gender transition. But it had one unexpected side effect. It’s amazing how something as tiny as a little white tablet can prompt so many opinions from so many people.
From people who’d never taken them telling me I’d be ‘a zombie’, to people sharing their cousin’s wife’s horror story about how they made them suicidal, everyone had an opinion. More quietly, other ‘users’ confided in me. These less sensational stories detailed SSRIs getting them through divorces, post-natal depression, and anxiety like me.
A close friend of mine said with a shrug, ‘They work, why would I stop taking them?’ The only reason I can think of is that the more they’re portrayed as something to be avoided, the more people will believe ‘relying’ on them makes them ‘weak’. But there’s nothing stronger than asking for help, and accepting it, when you need it.
Don’t get me wrong: if yoga, chanting, long walks and avocados help your anxiety, that’s wonderful. They make me happier, too. I’d stopped taking the tablets, but, as I embarked on a period of life I knew was going to affect my mental health, I went back to my doctor for another prescription. If I can get through the tour, a fledgling relationship, and a spell of dizzying uncertainty at work, I imagine I’ll come off them by winter. For now I want to stop worrying and enjoy what should be an amazing time in my life. And I don’t care how I achieve that.
‘Clean’ by Juno Dawson (£7.99, Quercus Kids). Are antidepressants being unfairly demonised? Email firstname.lastname@example.org