Part 23 - The Final Push

"Dressed To Kill" - New Found Glory

About three years ago, a young lady was transferred into our department. I had met her briefly before, but didn’t really know her well. However, she was a very friendly and bubbly person. Really easy to get along with. Her name is Lauryn*. Over the course of a few months whilst getting to know her, she revealed that’d she’d had a life-long struggle with depression. I didn’t really pry too much at first, but we just shared some similar experiences.

Months later, she began to open up (although she’s a very open and to the point girl), and let spill that the major course of her difficulties with depression had been due to extensive abuse (physical, mental, and sexual) at the hands of the man that she had called Dad. He wasn’t her real Dad but had acted as though he was since her early years. Her Mother had split from him, and Lauryn resided with her for many years, but at the age of twelve she returned to live with him. Between that age, and when she was sixteen years old, he frequently (almost daily) abused her in the form of beatings and bullying, followed by sexual abuse.

Had Lauryn not disclosed this information to me, I would never have know. She projected such a level of confidence and brightness, without any fear or bitterness, that I couldn’t comprehend the strength that this young woman had. She had formed a relationship with a gentleman, (all be it, a relationship where she was very slightly dominated), and even gone on to have a child. She’s an amazing Mother, and she has every right to be seriously proud of her daughter, who is now six years old. Looking back now, I can see some of the cracks that were there, but she recently underwent further counselling, and then later hypnotherapy. She is a true inspiration to me, constantly fighting to be the wonderful person, that she doesn’t even realise that she already is.

After a couple of years knowing Lauryn, I had confided in her about my own traumas. Particularly the rape. She was very supportive and comforting, and was one of the only people in my life, that truly understood all the mixed up feelings that I had in regards to this incident. And she surprised me, by saying, that (like I had with her), she would never have known that this had happened to me, had I not confided in her. As a rape victim, you often feel like everyone around you can see the flaws in your sytsem, and that you are wearing your status for the world to see. To me, it all seems so obvious; my behaviour patterns can often link directly back to my rape. I began to realise that I hadn’t fully achieved any sort of closure on this incident. Keeping it quite for so long, I had then continued once people knew with the belief that now people knew, it could be thrown away into the deep dark recesses of my conscious mind, and that it would never hurt me if I just ignored it.

I knew, through, many impromptu counselling sessions during cigarette breaks at work, that I had to resolve this issue in my own mind, and that I would only be able to do that through returning to counselling. So off I went to my GP, who kept trying to put me back onto medication, whilst I insisted that counselling would be all the action that was necessary. The wait for counselling was excruciating, so I did end up falling back onto anti-depressants (in amitriptiline form), and ever increasing my dose. I’ve got to admit, I’m still taking them now, but hell, I sleep so well. Finally my counselling began, and they had all my notes from my previous adolescent counselling. I didn’t even need to tell them what had happened. Which was lucky, because I couldn’t. I couldn’t bring myself to say the word. I think this was for three main reasons. Number 1: I knew that in re-attending counselling, I would have to endure an emotional breakdown. One that I was worried, I wouldn’t be able to control, and would therefore drive me back to my old ways. Number 2: Once you tell someone, it becomes real. I’d spent the majority of ten years running from this, and now I was going to have to face up to it. And Number 3: You can’t ever take it back once you’ve told someone, and with a lot of people, once you have, that’s all they will see. A rape victim.

My new counsellor (lovely lady) had complimented me many a time on my high-functioning abilities to cope with my disorder. She was pleasantly surprised that I had such a good relationship with my parents, and that I’d managed to hold down a relatively "normal" life for so long. But I knew I wasn’t normal, and part of the new counselling process was about me learning to accept that, and to be able to control my illness in a healthy and productive way. But first I had to get over the big hump.

After picking up on the fact that I frequently used code words such as "what happened", she asked why I wouldn’t say the words. I told her about my fear of having an emotional lapse back to what I was, but she stressed that I would be able to bring myself back from the edge, as I had done so many times. Having found the trigger she required, she then proceeded to commence dropping the word "rape" into the conversation wherever possible, and after about twenty minutes, I broke. I roared my heart out that day, and all my emotions concerning what had happened poured forth from me. And it felt so cleansing. I was finally honest about everything, and I wasn’t scared. I was proud. Proud at what I had endured and come through, and I knew I could finally finish my journey.

The next step was to confront my family. We had all tip-toed around the subject for so long, and in order to move past it, I needed to hear certain things from them. Things like my Dad telling me that he didn’t blame me, or that my Mother wished I’d have told her when it happened. And they also needed to hear from me that I would no longer let "him" win. My life had been geared so much by the rape for ten years, that he’d become this huge figure in my life. I realised that, when it came down to it, he just wasn’t that important. I was me, because of me. My parents love me, because I’m me. My friends care for me, because I’m me. And being a rape survivor figures very little into that equation.

I am finally more secure and confident than I ever have been, and through this last push of counselling, which ended approximately one month after my discussion with my parents, I can finally accept my depression for what it is; only a small part of me, and although it will be there every day, it’s who I am that people are going to most notice. And I feel petty okay about what they’re going to find.

Part 20 - Medication

"Stuck With Me" - Green Day

The following extract is taken from http://www.enotes.com/gale-psychology-encyclopedia/ ; an on-line encyclopaedia of psychological terms and illnesses:

The two most common types of antidepressants are tricyclic antidepressants (TCAs) and selective serotonin re-uptake inhibitors (SSRIs). Examples of TCAs include nortriptyline (also known by the brand name Pamelor), imipramine (Tofranil), and desipramine (Norpramin). Examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). Clinical studies have shown that some people benefit from these medications.

 Essentially, if I understand correctly, after much research, TCA anti-depressants work by increasing the brain’s production of serotonin, whereas SSRI anti-depressants work by inhibiting the brain’s natural ability to breakdown serotonin.

I can only speak from my own experience, and know that what medication may work for one depression patient, may not work for another. But below is a list of medications that I have been prescribed during my time with depression, and a little bit about each one, and the experiences that I’ve had with it.

1. Prozac (Fluoxetine) - SSRI - The first anti-depressant I was prescribed, when I was first diagnosed. The adaption period for this drug is quite long; it can be anything up to a month before the drug is freely working in you system, and in the meantime the symptoms of the depression can slightly increase, along with extreme restlessness and anxiety. I found this drug pretty useless overall, as it didn’t seem to stabilise my mood at all, but it is however, the main anti-depressant prescribed due to it’s extremely low risk of addiction.

2. Citalopram - SSRI- The effects of this drug usually kicks in within a week, and there is relatively low risk of addiction. However, I found myself feeling slightly numb to depression whilst using this medication. It seems to take away the brain’s ability to register positive emotions as well as bad ones that may be symptoms of depression.

3. Diazepam - Anti-Anxiety drug - Most people will only be taking this drug for a matter of weeks. It’s highly addictive, and when I was taking this, I can’t really remember a lot. I had no lucidity with this drug, and it caused me extreme disorientation, and general "grogginess".

4. The New One - Amitriptiline - TCA - The only anti-depressant drug that I have ever had to take at night. It’s the only TCA anti-depressant that I have used, and helps to diminish insomnia in depression sufferers. It usually takes about a fortnight to kick in, with a small period of increased "happiness" (sometimes a bit annoying levels of it), before settling into stable mood levels. It has a higher risk of addiction than most other drugs of it’s kind, so withdrawal needs to be medically guided. It also has some rather unusual side effects, such as dry-mouth, weight gain (along this may be due to the drug relieving the low appetite symptom of depression), and, my favourite, heat flushes when most active (when the user is most under stress). This little add-on means I run about 5 degrees hotter than most people, and my ears go burning hot and bright red whenever I’m put under pressure. They’re doing it now! On a more serious note, to the person that invented/discovered this medication: Cheers.

Part 19 - Final Attempt

"Hurt" - Johnny Cash

During one weekend whilst my parents were away, and had therefore let me stay at home for the weekend, I had a friend from school come round for company. We’d known each other for many years and had remaining close through-out my turbulent youth. I had drunk quite a lot that night, and, in the early hours of the morning, after many tears had been shed, I asked him to go home, as I "needed some time to myself". I think he knew what was going to happen, and what I planned to do, but left the house anyway.

By the time the paramedics had arrived, I had smashed up some furniture in my parents living room, including a massive mirror they had on the wall (one that has now been replaced at my own cost), cut the majority of my hair off in a rage, and gashed my wrist pretty bad. It didn’t need stitches, and would hold together relatively well with some "celery strips" (very thin, strip like bandages, meant for hold together skin in the same way as stitching), and a decent bandage. This had been my last stand. I was just too tired to keep trying anymore.

My friend cleaned me up somewhat, and then took me home to his house, so I could grab a couple of hours sleep. We came back later on in the day, once I had sobered up, and hidden my brand-new hair cut up a rather stylish baseball cap, to clean up the mess that had been made. I think in my drunken stupor that night, I’d managed to smear blood on almost every available surface at my parents house. I know that I never would have got through that night without my friend’s call for an ambulance. Sadly, we are no longer in touch at this point, which is something I deeply regret.

After the house was tidy to a partially high standard, I waited for the arrival home of my parents. It was crunch time. I had to beg for forgiveness, and ask, again, to come home. I needed stability in my life, and would only get that from them. They had emotionally washed their hands of me many months before, but I needed to be frank and open, and let them help me. But I would have to work incredibly hard to get their trust back. I can never thank my parents enough for everything they had done for me, after all I had put them through, and had it not been for them conceding to give me one last chance, I’m not sure I’d even be here to tell my story.

As with the last time I had returned home, there were stringent rules to stick to:
1. Absolutely no drugs. I had all but given drugs up by this time, but I think they just wanted to stress the point, that this would not be tolerated under any circumstances.
2. Significant decrease in alcohol consumption. I would only be allowed to drink at weekends, at appropriate situations, and was to not even drink, let alone get hammered, during the week.
3. Get a job. Education was just too easy for me to abuse, and to stop attending, so I was to move into the world of full time employment. And should I loose a job through some fault of my own, I’d be out on my ear.
4. Go back on medication. At least until a time that my parents could trust that I no longer needed it.
5. NO CUTTING.

As with before, it was slightly difficult to stick to some of these rules, but I pretty much just kept focusing on the fact that I needed somewhere to live, and that kept me on the right track. The medication, of course helped, probably the most out of all the above.

I’ve mentioned before how my sleep was a major issue for me through-out any time of emotional upheaval, so when I went back to my doctors and asked for medication again, rather than re-prescribing the pills that I had tried before, I was put on something new. I’ve been on four different anti-depressants/anti-anxiety drugs in my life, but there are hundreds more different types available; all with different effects.