What followed over that weekend was one of the most terrible and frightening few days of my life. It started with dizziness and I became unstable on my feet. On the second day the symptoms got worse; I became increasingly agitated and short of breath. My heartbeat soared and I sweated profusely. I couldn't concentrate, I couldn't relax but I was exhausted. My skin began to prickle, I had trouble walking and picking things up. I eventually found myself in a state of perpetual panic and disorientation, uncontrollably sobbing. As Sunday meandered towards Monday I became violent, punching the walls and kicking a kitchen cabinet door of its hinges. I tried to sleep to get a respite from the symptoms but I could not. I screamed a lot.

On Tuesday morning I walked to the pharmacist filled with paranoia and anxiety. I could barely hold myself together as I asked the receptionist for my pills and counted out the money. I couldn't get back home fast enough. The dosage was one pill a day. I took three.

I make an appointment with the doctor. I tell him what happened. He says that people can suffer such symptoms if they suddenly stop taking the medication. I tell him that my depression has gradually returned. He says that my body has probably built up a resistance to the medication and that it is no longer having any real beneficial effect. If I want to come off them I should try gradually reducing the dose over a month. He asks if I think that talking to somebody may help. I say yes. He says that the local psychiatric nurse comes in once a week and that he will ask her to call me. There is, however, a three week backlog to see her.

Four months later I go back to the doctor. I had been trying to reduce my dose but had only been able to get down to one pill every other day. Surely it should not be this hard? Could I be addicted to these fucking things? The doctor replies that he has not read anything to the effect that Paroxetine is addictive and that I should just continue to try and reduce the dose. He then asks if I have seen the local psychiatric nurse. I never got a call from her. The doctor asks if I want him to ask her again to contact me. I say don't bother, I'll go to a private therapist and can he recommend anyone. He says that he doesn't know anyone locally. I momentarily think that he means that he can't think of a name off the top of his head but has a list filed away somewhere that he can refer to. But he didn't. He had no list of local therapists he could refer to. He didn't really know how I could go about finding one.

So I went to find a therapist on my own. I searched the web and found an online directory of registered and accredited therapists. I found one who was based just up the road from my office building. Every Wednesday after work I would stroll up to her house and talk for an hour. It began to help and after a few weeks I was starting to feel better and a little more in control of my moods, although I did slightly resent the fact that I had to pay somebody to talk to me for an hour. But I could not really afford to keep seeing her. After three months she had to go into hospital for an operation. She would not be seeing patients for about six weeks. I asked her to contact me when she was well enough to start working again. about eight weeks later she sent me an e-mail. I didn't respond. I needed to save the money.

I was struggling. I was becoming increasingly unmotivated and apathetic. I never went out any more and had given up trying to make myself go to places where I might make some new friends. I hadn't written anything for about a year and had made no attempt to get anything published. I spent my evenings in my room watching movies on video or just shit TV. It had been months since I had been able to bring myself to read a book. I was becoming... dormant. I had been trying to wean myself off the Paroxetine for nine or ten months and had only managed to reduce the dose to a pill every two days. I wondered how a drug that can have such severe side effects and could take so fucking long to be kicked could be put on the market and deemed safe. The World Health Organisation did a survey of the most difficult commercially available drugs to get off from and Paroxetine came first. The pharmaceutical company that produces the drug has documents in their archives that even during the development of Paroxetine they knew that it could have dramatic side effects on users. They had even observed that giving this drug to somebody that has no history of depression could instil in that person feelings of paranoia, anxiety and, in some cases, suicidal thoughts.

By about November 2002 I was feeling desperate. I was in a rut. My job bored me to tears, my social life was non-existent (I just could not be bothered), I wasn't writing and could not muster the inclination or the energy to even attempt to think of ways to improve my life. And then one day at work, I snapped. I was staring at a spreadsheet full of part codes and prices and I began to cry. I just sat there and quietly wept, desperately hoping that nobody would walk up to me and notice. I slipped away to the toilet and sat with my head in my hands for half an hour. I then returned to my desk and wrote an e-mail to my sister: "Can I come and live with you? Like, now?" We settled on February 2003. I handed my notice in on the first working day of December.

I was to spend Christmas with my sister (the year before, I had vowed never to "celebrate" Christmas with my family ever again... or even to celebrate Christmas at all). When I arrived at her house and unpacked, I realised that I had forgotten to take my pills with me. By that time, I could just about manage to go three days without one. I would not be able to take one for a week. But then I thought, fuck it, after a year of trying to get of these things I still could only manage to go for three days before I felt that dizziness that signified the onset of the withdrawal symptoms; perhaps it was time to go cold turkey, just stop the pills altogether and ride out the withdrawal. So I told my sister that I had forgotten my pills and that I might be a bit out of it by the end of the week. She understood; she knew how long I had been trying to kick the things. I'll look after you, she said.

I was fine until the day before Christmas Eve. Fortunately, my sister and her boyfriend, with whom she had bought the house, were well stocked with wine, beer, vodka and dope. I spent most of the week consistently tipsy, if not smashed. It made me laugh that in order to distract myself from the withdrawal symptoms of my government approved and entirely legal medication, I was smoking pot! And whenever I began to feel giddy or my skin began to prickle, I just had another glass of wine. The worst of the withdrawal hit me the week after Christmas but it was not as intense as that long weekend in August 2001 when I first realised how much the drugs were fucking up my head. I was in slight discomfort but I could at least function. I was still struggling a bit when I went to Paris to meet some friends in January and was occasionally subdued and distant, despite the fine company.

And then I discovered something most interesting. I wasn't imagining things, I wasn't cracking up and I wasn't some moaning hypochondriac: I had been suffering from SSRI Discontinuation Syndrome.

"Some SSRI medications have a very short half-life. This means they produce no metabolites that help the medication stay in the body for an extended period. They go in, last a few hours, and come out again.

"SSRI's are split into two categories: long acting and short acting. For example, Prozac is a longer-acting SSRI. Paxil, Effexor, Zoloft and Luvox are short-acting. The shorter acting SSRIs, when discontinued or when the dosage is lowered, produce an "anticholinergic rebound," which is an interruption in production of the key neurotransmitter acetylcholine. (Acetylcholine is the neurotransmitter used more when a person is under greater stress.) These symptoms will last anywhere from one to seven weeks."

It's a pity that I had to stumble across this information by accident while surfing on the net; it would have been preferable if my fucking doctor had told me this a year ago when I first aired my concerns.

Well, I've been clean now for about five weeks. The "discontinuation symptoms" appear to have subsided. But now, as my brain's production of serotonin is dropping off because I am no longer on medication, the depression has been creeping back. I am now unemployed and about to move home. I don't know who to ask for advice. I am two months shy of 28 years old and I am no closer to knowing what the hell I should be doing. I'm trying to stay on top of my moods but it is a struggle. Should I find another doctor and try another form of medication? Do I want to risk that path again? Can I seriously hope to be able to get my shambles of a life together without that kind of aid? I don't trust my ability to control my state of mind on my own but I don't trust the drugs either. Will moving to my sister's home really help? Will just being around her be enough for me to get off my unmotivated arse and get on with things? What if I crack up again: How could she cope with me? Am I really doing the right thing here?

Who cares, right? There are people in the world with much, much bigger problems than me. For fuck's sake, just get over yourself and deal with it, Steve.

The problem when your brain doesn't quite work as it should, when the chemistry is not quite right, it just brings you down for no reason and, likewise, can send you back up again. You can either just put your trust in a drug to keep you level or put your trust in yourself to rise above it. Pah! Not gonna' let some poxy neurotransmitters get the better of me!

Easier said then done, though.

>> Part 2