I did not develop any issues with breathing. But it's possibly important to note that I run about 40-50 miles per week and my lungs are a lot more capable than the average person's (and I wasn't exerting myself while ill). It is possible that my lungs would have to be much more seriously impaired before I would notice any problems.

I developed symptoms on Sunday 15th March, though on Thursday 12th I had diarrhoea and stomach discomfort that seemed to come out of nowhere and disappear of its own accord, and on Friday and Saturday 13th and 14th I had a slightly dry and tickly throat, but nothing much.

Progression

The progression went something like this:

Su[...]]]> I caught some kind of "respiratory infection" recently which I am pretty sure was the Coronavirus. Obviously, as the UK is not testing people unless they are hospitalised, I can't say for sure, but I developed symptoms a week before the UK started its lockdown, and it has been unlike any cold or flu I've had before.

I did not develop any issues with breathing. But it's possibly important to note that I run about 40-50 miles per week and my lungs are a lot more capable than the average person's (and I wasn't exerting myself while ill). It is possible that my lungs would have to be much more seriously impaired before I would notice any problems.

I developed symptoms on Sunday 15th March, though on Thursday 12th I had diarrhoea and stomach discomfort that seemed to come out of nowhere and disappear of its own accord, and on Friday and Saturday 13th and 14th I had a slightly dry and tickly throat, but nothing much.

Progression

The progression went something like this:

Sunday 15th (day 0): I woke up at about 5AM acutely aware that I was very unwell with general flu type symptoms. My throat hurt, my head hurt and I just felt unpleasant. My heart rate when lying in bed is usually under 50bpm, but at that point it was 70bpm. I spent most of the day in bed. By the evening I had a fever of about 38.5°.

Days 1 and 2: The fever went down and I thought I was recovering (spoiler: I wasn't!).

Days 3, 4, 5 (Wed-Fri): At some point I started feeling very tired, and the cough that was previously a minor annoyance became a pretty major annoyance. Sleep became disrupted because I'd wake myself up coughing and other times I'd be coughing so hard I thought I was going to vomit. I strained a few muscles from coughing. I spent a few afternoons sleeping.

Day 6 (Saturday): I felt a lot better and thought I was recovering...

Day 7 (Sunday): It hit me again and I spent most of the day sleeping.

Day 8-9 (Mon-Tues): Still feeling rough, still coughing, but improving.

Day 10 (Wed): Cough improving, and went for a walk for the first time since this started

Day 11, 12, 13, 14: I've started running again and I'm handling it OK, but I'm definitely not 100%. Lingering effects are that my resting heart rate is still sitting about 5bpm above where it was before this started, my running heart rate is quite a bit higher still, and my throat is still sore. But overall I'm doing a lot better.

In total I only took two days off sick, but only because I was able to work from home.

It could just have been flu, but I've never had flu affect me like this before, and it seems coincidental with the timing that the Coronavirus outbreak was starting to pick up pace. I've had colds that make my nose drip like a tap and I've had flu that has left me bed bound, but this was different. I've never had a cough like this before.

It was quite disappointing to be infected as I was being very careful about hygiene, but the week before I developed symptoms I had travelled daily on very overcrowded trains due to numerous rail cancellations (thanks West Midlands trains). ]]> https://blog.asgaard.co.uk/citalopram Fri, 13 Mar 20 20:07:29 +0000 https://blog.asgaard.co.uk/citalopram I'm going to share my experiences taking Citalopram (branded as Celexa in other countries), a class of anti-depressant known as an SSRI. Overall my experience has been very positive and I wanted to add my voice to the discussion online, which sometimes focuses disproportionately on the negatives.

Recently we've had the tragic news of Caroline Flack's death, and every so often a story comes up about workplace bullying and the catastrophic effects that come with it. People don't always behave responsibly or respectfully towards others' mental health, but mental health is always important.

Background

I was originally prescribed Citalopram in early 2019, but I didn't start taking it until August.

I was having issues with anxiety and depression, caused by workplace bullying, which had been ongoing for around nine months at the time I was prescribed them and probably about 15 month[...]]]> I'm going to share my experiences taking Citalopram (branded as Celexa in other countries), a class of anti-depressant known as an SSRI. Overall my experience has been very positive and I wanted to add my voice to the discussion online, which sometimes focuses disproportionately on the negatives.

Recently we've had the tragic news of Caroline Flack's death, and every so often a story comes up about workplace bullying and the catastrophic effects that come with it. People don't always behave responsibly or respectfully towards others' mental health, but mental health is always important.

Background

I was originally prescribed Citalopram in early 2019, but I didn't start taking it until August.

I was having issues with anxiety and depression, caused by workplace bullying, which had been ongoing for around nine months at the time I was prescribed them and probably about 15 months at the point I started taking them.

Unfortunately, my now ex-employer was not competent in resolving this. The HR manager was (at a generous interpretation) spectacularly incompetent and added a lot of unnecessary stress on top of everything else.

I wanted to leave the job, but my mental health was dreadful and looking for other jobs seemed intimidating. Interviews are stressful and I didn't feel like I had the mental resources to deal with additional stress. In retrospect, this was really stupid and dangerous and I came quite close to ending my life because of how unhappy I was at work. The workplace was dangerous, and I should have just quit.

I was very, very reluctant to start taking anti-depressants because the list of side effects seemed scary. I ended up back at my GP in August because I had experienced some unintentional weight loss and a gastroenterology consultant had recommended I be referred to a dietitian. My GP obliged, but she gave me quite a stern lecture saying that, yes, it's worth seeing a dietitian, but she felt it was far more likely that stress was the cause of my physical health problems, and we should be treating that primarily.

I decided to take the plunge on anti-depressants with the promise to myself that if they helped, I'd use my improved mental health to secure a better job.

Initial effects

The side effects I experienced were short lived and minimal. I was prescribed 20mg Citalopram, but the GP had recommended I start on 10mg as I was concerned about side effects. The side effects I had were: Some stomach upset and nausea for the first few days, and a slightly dry mouth. Nothing major, and the upset stomach and nausea was something I was getting regularly just from stress anyway. After a few days this settled and on day 6 I went up to 20mg. I alternated between 10mg and 20mg for a few days to ease the transition, and have stuck to 20mg ever since. Moving up to 20mg gave another day of slight nausea, but it was really nothing much.

Improvements

Improvements to my mood were gradual, but over a period of about four weeks or so, I started feeling slightly calmer and more self confident. It was a subtle effect in many ways - I still experienced stress, but I became less intimidated by the prospect of interviewing and making a big step into the unknown. Day to day work became much more manageable and I found less of my mental energy was being sapped by the silly politics I was experiencing there.

I'm glad to say that it didn't make me more tolerant of my employer or more content with what was essentially an abusive relationship. It had the opposite effect - as I became more confident in myself, I became more secure in my view that I deserved better, and more able and motivated to pursue a better employer.

One of the things I'd read about anti-depressants is that they don't fundamentally change you - they just make you feel like yourself again. This is something I strongly relate to - I started to feel like myself again.

In September I began to send out a few applications to other employers and in October I attended three interviews. The process of interviewing was still stressful and anxiety inducing, but the difference is that I knew it would be and I did it anyway. In the interview for the offer I ended up accepting, something had clicked between the interviewer and myself and the anxiety manifested as more of a nervous excitement rather than an overwhelmingly negative and uncomfortable emotion.

I ended up handing in my notice in October, having secured a much better job elsewhere. It was a win all-round; more interesting work, a more professional company, and a higher salary.

Now

It's now March 2020 - around six months since I began taking Citalopram - and I'm still taking 20mg Citalopram. My GP advised me not to try coming off it while starting a new job, which sounded reasonable, so I didn't. But things are going well and I'm feeling quite settled at my new job and I'm unsure that I still need to be taking the tablets. The GP has floated "the summer" as being the time to think about coming off them, as they want me to have been feeling better for some time before withdrawing to reduce the risk of relapse. Currently, I feel they probably are no longer necessary for me - having addressed the issues in my life that caused me problems initially - and I could withdraw sooner, but on the other hand there's no urgent reason to, so I'm happy to let the doctors make the decisions at the moment.

I feel that the anti-depressants helped me immensely in getting out of a bad situation and into a better one. I feel that they helped me to find the motivation to make changes to my life to safeguard my mental health. My only regret over them is that I didn't begin taking them back when I was originally prescribed them.

I also feel that Citalopram probably helped me settle in to my new job. Supposedly, starting a new job is stressful. In reality, it was the opposite - starting a new job was less stressful than staying in my previous one. I imagine the anti-depressants helped take the edge off that and helped me to focus more on it as being an exciting opportunity rather than a scary step into the unknown.

People outside of work have commented how much happier I seem. My mother was upset by the idea of me taking anti-depressants initially, but in her opinion I'm a different person than I was six months ago and she's very glad with the outcome.

Update: August 2020 I am now off Citalopram entirely, and have written more about the withdrawal process.

Other concerns

Some people say that SSRIs cause weight gain. I have gained weight - I've gained 4kg. But it's hard to say that this is a problem. As previously mentioned, I had significant weight loss due to stress, and now that I'm happier, it makes sense to be putting weight back on. My BMI is still at the lower end of healthy.

I'm an avid runner and I had concerns that Citalopram might affect my performance by making me sluggish or tired. It didn't. I actually set 5k, 10k and half marathon personal bests within a few months of starting to take Citalopram - I suspect it indirectly helped my performance by improving my health in general!

Summary

I was scared to start taking anti-depressants because of the potential side effects. In reality, they were minimal and short lived. But, in the end, Citalopram helped me to make important changes to my life to improve my mental health, and I can say with total certainty that it was the right decision for me.

Additional resources

• The NHS's website is always a good place to start on medical issues: Anti depressants, Citalopram
• The mental health charity Mind has a comprehensive area on anti-depressants.

Savings accounts

Regular savings accounts are easy to open and understand, but pretty dire as far returns go. It's difficult to find anything that gives a return higher than inflation. The advantage of a savings account is that cash in savings is generally easy to get hold of and has predictable value. Whilst the nature of the value of money is a complex and malleable thing, you pretty much know what £1 is worth today, what it'll be worth tomorrow and what it'll be worth next year.

Pensions

Pension[...]]]> The array of investment options available for sensible long term savings for the average person is broad and overwhelming. For people earning more money than they really know what to do with, this is a basic overview of the options and thought processes involved in deciding where to put one's money.

Savings accounts

Regular savings accounts are easy to open and understand, but pretty dire as far returns go. It's difficult to find anything that gives a return higher than inflation. The advantage of a savings account is that cash in savings is generally easy to get hold of and has predictable value. Whilst the nature of the value of money is a complex and malleable thing, you pretty much know what £1 is worth today, what it'll be worth tomorrow and what it'll be worth next year.

Pensions

Pensions are a form of retirement fund, which are subject to tax relief by the government. The rules around pensions are incredibly complex and subject to change by governments in future, but the basic idea is that you can't access the money until later life.

For basic rate taxpayers, for every pound you pay in, the government will pay 25p into your pension.

But this isn't the whole picture, because when you come to claim the pension later in life, it will be classed as income, and you will be charged tax on it. Quite what this means depends on exactly how much you're claiming and your other income, but, generally, you'll be paying less in tax than you claimed in tax relief, so it's a net positive for you (but probably not 25%).

Workplace Pensions

Most people in the UK are now required by law to be offered a workplace pension by their employer, and the employer must pay 3% of your salary into it as long as you agree to pay 5% (or, more accurately, the total value must be 8%, of which at least 3 percentage points must be paid by the employer).

What this means is both easy and hard to summarise here.

Firstly, it means that you're getting 3% of your salary as free money, so you should absolutely pay in the minimum required to get your employer's contribution. That's the easy bit.

Beyond that, it depends on your pension provider and their options, which is controlled by your employer. For example, my previous employer offered a People's Pension workplace pension. PP accounts have a 0.5% annual charge on them, which means that every year, the pension fund takes 0.5% of your fund's value as payment for managing the fund.

0.5% sounds like a small number when you consider it as an absolute percentage, but when you look at it as a proportion of the likely annual growth, things look less rosy. If you assume your pension will grow by about 5% per year from market conditions, then that 0.5% is a whopping 10 percent of your yearly growth.

Therefore I did not increase my payment into my People's Pension fund beyond the minimum, because I had a self-invested personal pension (SIPP) which was much more attractive.

Self-Invested Personal Pensions (SIPPs)

Self-invested personal pensions are like a workplace pension, except that they don't involve your employer. You just put money in, and the government adds the 25%.

The advantage of a SIPP is that you get full control over the choice of platform and fund, which means that you have more options and may be able to find a better deal than your workplace pension.

It's worth considering platform and fund fees very carefully; fees can easily wipe out a significant percentage of your potential returns on your investment. You could potentially lose out on years' worth of growth by unnecessarily incurring high fees.

ISAs

ISAs are investment accounts that protect you from having to pay interest on your savings interest. In the age of ultra low interest rates, this isn't really a concern for many people, but even cash ISAs are still worth considering, because, you never know, maybe one day interest rates will go up, or you might inherit money, and you find yourself paying tax on interest (which is usually taxed via PAYE income - which means the bottom line on your payslip goes down. Very frustrating!). It's best to start building your ISA early, because there are limits on how much you can move into an ISA per year. Currently this is a very generous £20,000 per year, but only a few years ago it was nearer to £5000. Governments can and almost certainly will change this in future.

Money inside an ISA is likely to be a long term investment, but, unlike pensions, there are no inherent restrictions on withdrawing money from an ISA (though the exact account you have may have restrictions or notice periods).

Cash ISAs

Cash ISAs are similar to cash savings accounts. In my opinion, with interest rates so low there is little reason to invest in a cash ISA over a Stocks and Shares ISA, except as a way of holding stable cash versus potentially volatile stock.

Stocks and Shares (S&S) ISAs

Stocks and Shares ISAs are an easy way into the stock market. The mechanism is similar to how SIPPs in as much as you choose a platform and fund, and the same considerations as to fees applies here too. As with pensions, investments in the stock market generally work best as long term investments. The common strategy is to feed money from income into the fund regularly (e.g. monthly) rather than waiting and depositing a larger sum infrequently.

Lifetime ISAs

The Lifetime ISA is available to people between the ages of 18 and 39, although you can continue paying into it until your 50th birthday.

Up to £4000 per year, for every pound you put in, the government will add 25p. This sounds very similar to a pension, but the money is tax free when you come to claim it. The Lifetime ISA is therefore better than a SIPP.

Lifetime ISAs can be either cash or stocks and shares.

Conclusion and priorities

This was a very superficial overview of the more obvious options available for the investor who wants to see their savings begin to work for them.

A basic strategy for saving and investment could look like this:

1. Take the 5% workplace pension (for the free 3% employer contribution)
2. Put £4000 (if possible) per year into the lifetime ISA (for an immediate £1000 return from the government) in a stocks and shares account
3. A small amount of money goes into easy-access cash savings accounts (or ISAs, if you can find an easy access account), for easy access should you need it
4. The remainder of (unspent) income goes roughly evenly between a S&S ISA and a SIPP, as this diversifies you against pension and ISA tax regulations that may potentially change against your favour in future.