Unprescribed antidepressants

Some nice things happened last week that cheered me up.

Normally I get quite cross about newspaper articles stating that antidepressants are being overprescribed, or that most forms of depression can be cured by a brisk walk, eating sprouting broccoli and taking nothing stronger than a deep breath.

They may well have a point about trends, and some of the advice is jolly useful for some people. Whatever works for you, is my motto. But if you’re suffering from moderate to severe depression, do you have any idea how unbelievably crap it feels to read that sort of thing? Basically, it makes you feel like you’re lazy, and you brought this on yourself. And that you’re choosing to continue feeling miserable, when you could just opt to pull yourself together, if only you were made of sterner stuff. And really good at yoga.

It’s incredibly damaging. Depression’s siamese twin is shame, and making people feel ashamed about how they feel only makes it worse. People with serious mental illnesses need serious medical treatment. The reason antidepressants are prescribed is not just because they get you out of the GP’s surgery within your 7-minute slot, but because a lot of the time THEY WORK. Does anyone really have anything against feeling better?

It’s not dissimilar from the annoyance I feel when people wax on about the importance of natural childbirth, how it doesn’t hurt if you breathe properly*, and then utter that blood-boiling phrase: “Women have been doing it for thousands of years”.

Well, yes, but they’ve also been dying in childbirth for thousands of years. And so have lots of their babies. The after-effects when things go wrong are devastating – heard of fistula? The idea that all these women in mud huts much prefer the way it’s been done in their village for centuries is absolute bullshit, and one of the most breathtakingly patronising things anyone who lives in Fulham or California could possibly say.

I actually know a bit about this because I used to work in Africa, with women in very poor or war-ravaged countries, who had nothing. And I can tell you that not one – literally, not a single one – would say “No thanks, I’ll stick with boiled banana leaf and and sing my special magic birthing song really loudly”. They are desperate for proper, medical help. So desperate that they will go days without food or sell their bodies so that they and their children can see a proper doctor.

I’ve got slightly (thousands of miles, even) off the subject, because as it happens I’m not depressed at the moment, or taking antidepressants. Though I probably wouldn’t be quite so melodramatic about the baby in my tummy having the audacity to be a boy if my mental health was 100%.

So I’m not really talking about alternatives to antidepressants for properly depressed souls, just the unexpected things that happen when you’re a bit below par. They don’t fix anything, but make you think – ‘Well, perhaps I’ll give the Shakespeare soliloquies a rest, whizz through a few chores pretty badly but at least they’ll be ticked off, then it’ll be rioja o’clocka in front of Strictly It Takes Two’.

Watching Logie dance in front of the telly is insanely heart-warming. His standard moves are fast running on the spot (until you fall over), turning round and round (until you fall over) and the arm movements from the Thriller dance. I taught him those, in front of the Halloween Strictly special, before I put my back out. He looks a little bit like a 1950s schoolgirl doing ‘moving to music’ exercises, and it also makes it quite hard for him to see out of more than one eye at a time, but it’s a great party trick.

The nice things that happened to me were 1) a muffin basket 2) friends 3) getting an e-mail from my hero.

I crossly hobbled to answer the door on Thursday, in time to discover a man getting back in his van and a basket of baked goods on the mat. Now maybe this has happened to you, or at least in your office, but this has never happened to me. NEVER. I thought it was a mistake, or a dream. They turned out to be from some people that I have only recently met, and just started hanging out with in a worky capacity. They barely know me! Which doesn’t mean they are nicer than people who do know me, but perhaps that my woe-is-me-ing works better on fresh meat. It was the kindest thing that anyone has done for me since my husband proposed – and I basically guilt-tripped him into that, so this was a genuine surprise.

Friends. I had three batches come to visit while I was ice-packing my back on the sofa last week, and several more messages of support. It’s extraordinary how okay they make everything feel. Not necessarily better, but as if life might just conceivably go on. They are like me (though mostly thinner with careers), they sympathise, they don’t have any answers, but they help. “Yeah,” they say, “I’d probably feel exactly the same too. Have a malteser.” And I perk up.

Esther Walker. This blog is basically a poor man’s version of hers – Recipe Rifle. If I were you, I’d unsubscribe from mine and sign up to hers. She’s funnier, and food makes much tastier reading than conjunctivitis and mood disorders. Last week I eventually got up the courage to e-mail her, and she e-mailed me straight back, which made my day. I won’t say any more, as sycophancy is so unattractive (and rare for me) but it gave me a real boost.

*I can’t help noticing a theme in this post about breathing. Clearly I’ve been doing it all wrong, and it is the key to everything working out just tickety-tonk in life. Can you do it with a blocked-up nose? I did once try an 8-week course in mindfulness meditation, which focuses a lot on breath. I mainly fell asleep, or spent the sessions climbing my internal walls, silently screaming to get away from the noise of other people breathing. But it is one of the trendiest, non-pharmaceutical mood-lifters recommended by doctors for depression at the moment, so like I say – whatever works for you.

Prolapsed disc

After last week’s self-pity-fest, I thought it might be a good idea to give myself a genuine problem to get my teeth into. So I slipped the disc in my back again.

Actually, that’s not quite accurate, but it’s a quick way of summing it up for people that conveys the seriousness of the situation. Here’s how it works.

Discs are like round baby sponges that sit between the vertebrae of your spine, and allow it to bend. Ideally, they are full of fluid. When they start to wear out, they dry out, or become desiccated. (It’s such a joy sometimes to discover a new use for a word that you thought only applied to coconut.) Just like those ramer baby sponges that go weirdly rock hard when they dry. NB ramer, not ramen like the noodles, as I previously thought. Let’s have a food theme today.

They can also start to bulge, a bit like when you ice the bottom layer of a carrot cake right to the edges, then put the top on and realise your mistake as it all squidges out the sides. Now this isn’t necessarily a problem, or a cause of pain in itself. Discs don’t hurt. But when they press on nerves they do. And then they get really malicious and start a chinese whisper with the surrounding muscles, which get all uptight and throw complete spasms.

A prolapse is when is a significant bit of the disc pops out of its usual jelly mould. So if you were to look down at a cross section, that disc would look like a round thing with a marble attached the side. Or a child’s drawing of a snowman.

This is also known as a slipped disc, and it’s what first happened about a year ago, when I got up from half an hour sitting on the floor at a 1-year-old’s birthday party, and fainted with pain. Apparently I managed to lay Logie elegantly on the floor next to me before I passed out.

Sometimes they go back in, but mine didn’t, as we discovered in May this year. The pain came back, the MRI showed that it was still out, if not slightly more so. Lifting Logie into the car (actually, on that occasion I couldn’t, and had to wait for a stranger to come near enough in the car park to rescue us) set it off again.

After both those incidents, I got some seriously brilliant painkillers (the sort that drug dealers charge extra for on The Wire) until I could have a steroid injection into both the nerve and the facet joint around the culpable disc (L4/L5, since you ask). Steroids can’t make the disc go back again, but they reduce the screaming inflammation in everything around it. And it worked like a dream.

On Thursday morning, I was giving Logie his breakfast and turned to face him slightly on my chair. Something felt wrong. I tried to stand up, and get him out of his highchair, and I couldn’t. Not ‘I couldn’t because it hurt too much that I knew I should stop’ but I physically couldn’t do that movement. So I rang our totally amazing lifesaving nextdoor neighbours, who let themselves in with their key and rescued us. Got Logie dressed, took him off for the morning, gave him lunch and put him to bed. Got me to the sofa, brought me some clothes while I waited for the emergency GP.

So nothing dramatic triggered it. The situation is so knife-edge, the distance between the prolapsed (or herniated – that’s what you call it when it’s permanently prolapsed) disc and the nerves such fractions of millimetres, that anything can set it off.

The pain is blinding, the smallest of movements seemingly impossible. Because of being pregnant, I can’t have anything stronger than paracetamol and codeine (a bit like trying to feed 34 toddlers with two fish fingers and eight peas). I can’t have a steroid injection, because it needs to be guided with a scanning machine to get it in the right place, and you can’t expose the baby to the harmful stuff that imaging machines use.

What I need is a microdiscectomy – an operation to remove the pesky bit of sticking-out disc. Obviously that’s not on the cards until after I’ve had the baby. We did talk about having it before I got pregnant, but I was wary, because the surgeon said he’d need to go in through my stomach rather than my back given that the prolapse is unusually central – ie, pushing directly backwards, rather than out to one side.

If only I could have a c-section and a a microdiscectomy at the same time, but although I keep making that as a ho ho passing joke, no one seems to think it a good idea. Clearly it’s not, but having one op, recovering from it, then wash rinse repeating a few weeks later, hence not being able to lift or care properly for my newborn baby and toddler for months, is a total ball-ache.

But let’s look on the bright side. It is getting better. Five days later I can walk fairly normally now, though from room to room only. The pain is more like 5 or 6 out of 10 than 8 or 9. The diazepam they are giving me to try and make my wretched buttock muscles relax means I’m actually getting some sleep at night. I haven’t any loss of sensation in either leg (unlike last time) or problems with my waterworks (unlike last time).

But I am miserable. It distracted me from boo-hooing about the boy baby discovery, but now that’s back with a vengeance and I can’t stop the water coming out of my eyes. I am worn down with pain. Frustrated that I can’t do anything, especially grab Logie and squeeze him a bit too hard, woodpecker kiss his podgy cheek and eat his neck, or pick him up when he put his arms up to me and implores ‘Mumma?’.

And that’s what I need to do right now, more than ever, to stop all these ungrateful feelings. To grasp solid evidence of the utter brilliance of a small human just like him. To feel the solid-gold weight of how lucky I already am. He didn’t want to come to me this morning, and just clung to Jon. I guess it’s confusing for him, my not doing the things I usually do. But he did give me a good lying-down cuddle before his lunchtime sleep. And gave the baby a lovely kiss. He is the best medicine.