Tom Jacobs

Depression: When the drugs don’t work

In the wake of Robin Williams’ death, Tom Jacobs follows up his piece on being a comedian last week, revealing his own attempts to leash the black dog of depression.


(Tom’s piece last week – Why (do) Comedy? Do you suffer from depression?)

When I turned 30 I was diagnosed with clinical depression, ADHD and a “Tilt”.

I’d actually never heard of a “Tilt”, but it was enough of a problem for my optometrist to send me to a chiropractor to have this fixed when she noticed that I slightly “tilted” my head to look at things instead of looking straight like a normal person.

The weekly chiropractor visits were quick and painless and, over time, I stopped tilting, which changed my life in ways I can’t describe (because I don’t know what they are).

The psych appointments were a different experience.

The point is, I’ve had ADHD all my life – I just didn’t know it until recently. I knew that there was something wrong with me, in that I couldn’t focus on anything for more than a few minutes and often daydreamed, but in an effort to not be different from my mates, I never addressed the problem until I was thirty. The best analogy I’ve heard to describe ADHD is it’s as if you’re watching multiple movies on multiple televisions all at the same time and you’re doing your best to follow all of them. Your concentration is constantly shifting from screen to screen as each film is competing for your attention and soon you become agitated by the information overload.

Remember those guys at school who couldn’t sit still, so they’d start running around and breaking stuff? Usually, that was because they had ADHD, but theirs wasn’t the same as what I’ve got. Mine is classified as non-behavioural ADHD, which means I’d fly under the radar, daydreaming as I stared blankly at the teacher with my freakishly slightly tilted head, instead of running around in circles.

When you’re diagnosed at 30, you do get the feeling that it’s too late; this information would have been useful when I was at school. However, better late than never, as now I get the chance to experiment with mind altering drugs! I say mind “altering”, but when it comes to ADHD, the drugs they give you are more mind “alerting”, or at least they are supposed to be.

The first drug I was put on was Ritalin (Methylphenidate). Back in the eighties, Ritalin was the most common of the psychotropic drugs and was given to everyone who had ADHD. So, it came as no surprise that it was the first thing I was prescribed. I was to take half a tablet each day for a few days, then report back to the psychiatrist. I followed his instructions, expecting some sort of immediate result. I had hoped that my first hit of Ritalin would rid my mind of at least a few of those movies in my head. It did nothing. He upped the dosage to a full tablet. Nothing. Then three. Then six full tablets per day. It still had no effect on me whatsoever. I didn’t feel anything.

He took me off the Ritalin and put me on something called Dexamphetamine. When I researched this drug on the net, I found out that the U.S Air force had been giving Dexies to their pilots when they went on lengthy missions to keep them alert, and so I went through the routine again. Halves. Then fulls. Then threes. Then sixes. I still had no reaction, other than a feeling of annoyance when the psychiatrist told me that he’d never met anyone that had failed to experience any sort of effect from the pills, whether it be positive or negative.

“They should have at least been doing something to you,” he said.

We gave the dexamphetamine another few weeks, but, with no success he put me on something called Strattera (Atomexetine).

The psychiatrist was a bit hesitant about prescribing this Strattera stuff because the drug worked a little different from the others. Ritalin and the Dexamphetamine were fast acting drugs, but Strattera took four to five weeks before any effects could be felt. I did a quick internet search on the medication before taking it, as I had done with the other drugs. According to the internet, Straterra had a bit of a red flag over it. There had been reports of adverse side effects such as nausea, fatigue, constipation, erectile dysfunction, urinary hesitation, abnormal dreams, ejaculation disorder and dermatitis. There was also a 0.1-1% of “male genital pain” and “suicide-related events”.

With the battering your genitals take, you’d want to kill yourself.

Suicide wasn’t a risk for me as I knew I didn’t have the stomach for it. I couldn’t stand the sight of blood, I didn’t like heights and I couldn’t tie a knot, let alone a noose. I’d be the world’s worst Cub Scout and suicide case.

Thankfully I was taken off the Strattera after eight weeks when it was clear that it wasn’t doing anything to my brain and, thankfully, to my underpants.

“I could keep throwing pills at you,” my psychiatrist informed me, “but maybe we should concentrate on your depression.”

The depression I was diagnosed with is called clinical depression, meaning there is no trigger that sends you into a downward spiral. It’s more to do with my brain not producing as many feel-good-chemicals as yours. So, when someone says “just don’t be depressed,” it’s the same as telling a person with no legs “just don’t not have legs,” – you have no control over it, but like every psychosis, there are drugs for this too. The anti-depressant I was put on is called Sertraline.

Sertraline is known under the brand name Zoloft or Lustral and classed as a selective serotonin re-uptake inhibitor. With over thirty million prescribed in America, it is one of the most widely taken antidepressant medications and has been used to treat people suffering depression, social anxiety, panic attacks and post-traumatic stress disorder. As with the other meds I had been prescribed, it also had a similar list of adverse effects, again mostly comprised of giving a big “I hate you!” to people’s groins.

Again the words “arousal” and “disorder” appeared side by side on some websites. “Genital Anaesthesia” was a new one, so at least there was some variety. Self-harm reared its ugly head again as these pills had been linked to suicidal behaviour, which I found odd in a thing that was supposed to stop depression. I now realise that if I got all my medical knowledge from the internet I’d only ever be reading about the negatives, such as the fact that, according to one website, these drugs were created by the government as part of some black ops plan to enslave humanity through mind controlling pills.

So, is the Sertaline helping?

To tell you the truth, I don’t really know. I’ve been on them for over a year now, and when I think about it too much I start getting anxious, so I mostly just ignore it. I take the pill with breakfast, and then start my day. If at any point I feel happier than normal, I ignore that too. Trying to dissect happiness will just bring the experience down, so I just let it happen instead. Things could be worse. I could have been diagnosed at 40. 30 is a good number. I’m still relatively young. I’ve lived with myself for 30 years and I know the guy well. I’m really just one of millions of other people around the world who are traveling the same bumpy road as me.

We just stop to ask for directions more than you do.

At least we are traveling in the right direction and I can look straight ahead now that I’m “tilt” free.


 If you or someone you care about is dealing with depression, there is help out there – check out the government’s page on Mental Health and organisations that might be able to help.


Tom Jacobs

Tom is a writer and budding comedian who, when not writing and 'comedying', enjoys collecting old blues records and doing terrible things to his cat with a fork.

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  1. BrilliantIce said:

    My doctor put me on a mixture of medication for over 5 years to cure PTS and also depression from a break up. I was like a zombie and also really angry a lot of the time. I ended up playing doctor myself and going off all the meds cold turkey. I then started running. It was the best thing I ever did. I not only felt healthy but my mind felt clear and for the first time since my break up I was able to feel good about meeting new men. I not have a wonderful man who runs with me regularly and we are getting married in 7 months time and just had our first child together. I really don’t think that would have happened had I stayed on the medication the doctor prescribed me. Who woulda thunk that healthy eating and exercise would make so much difference

  2. thebigsmoke said:

    Good pick up, thanks for pointing that out.

  3. Clifford said:

    “Williams'”. Put the apostrophe in the right place, editor.

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