"Cry havoc, and let slip the dogs of withdrawal."

I've been on Effexor XR/venelafaxine for a long time now. Truth be told, I can't remember when I was first prescribed it, although I do recollect the long-winded, careful titration process. I began at only 37.5mg daily, so it took several months to get up to my current daily dosage of 225mg.

I was warned at the time that this was a seeeerious narcotic, that it needed to be taken at precisely the same time each day and in the correct dosage. Peculiarly, in order to avoid peaks of the drug in the bloodstream, in the accompanying instructions it also said to skip a dose if I was so much as a few hours late with it any day. I say peculiar because instinct tells me it would be worse to have less than prescribed in the bloodstream rather than more.

Then again I'm not a pharmacologist, or whatever kind of 'ist' it is that designs drugs.

So, for the last however-many-months it is, I'd say for 85% of the time I've dutifully taken my meds each day, probably within a three to four-hour window each 24 hours, at breakfast - one of the other caveats is that the drug must be taken with food, else it causes nausea and an upset stomach. The other 15% I've been slightly early, slightly late, or late enough to require skipping a dose until the next day.

Indeed, the first time I took it, I experienced an almost instantaneous hot flush, curiously in the face and - of all places - elbows, shoulders, and armpits. I wasn't hot, but my skin turned crimson and for ten minutes or so I felt sunburned. At the time my (now) ex-wife insisted I was having no reaction and that the flushing was either from a shower I'd had, or psychosomatic. However, when I returned to the pages of and pages of notes that accompanied my first prescription, sure enough, hot flushes were one of the many potential side effects. Besides, I've had other hot flushes since then, so I know it's a side effect. Ironically one time it happened in Shoppers Drug Mart while I was waiting to collect my prescription. Over a period of about 15 seconds I went consistently crimson from head to feet. It felt like I was on fire, and the guy in the lab-coat behind the counter looked at me agog. That was fun to deal with.

At the time I was relieved to know that whatever Effexor was doing, it was doing something. I couldn't gauge its effect, couldn't measure the difference, couldn't tell what impact it was having on me and my moods. In addition, having had a period during my 20s when I experimented with recreational drugs in the UK, Effexor was pretty damn disappointing by comparison. I was expecting a discernible effect within half an hour of my first dose. A sense of clarity, of purpose, of euphoria, of calm, at least of relief. But, I simply couldn't tell the difference. Apparently benzodioxolmethylpropanamine and dimethylamino-methoxyphenyl-ethylcyclohexanol are designed with different results in mind, no pun intended. In fact, the only time since then that I've been able to tell the difference was when I missed a dose: tension in the jawbone muscles; very mild although utterly uncontrollable convulsions, particularly in the shoulders and arms; yawning; and something that felt like pins and needles all over my body...but amplified.

Now let's fast forward a year or two to last week.

I took 225mg on the morning of Wednesday 29th April. I'd been a little up-and-down earlier in the week, though by early afternoon that day I was feeling pretty good. I'd scoffed my meds, lifted a few weights, completed a cursory bike ride afterwards in order to help burn off a few fat cells agitated by said weights, and was making skirt steak with caramelised onions and a bean mash (like mashed potato but with cannelloni beans or similar instead). One of the simplest rules for a higher protein and less calorific eating regime is to eat like a king at breakfast, a prince at lunch, and a pauper at suppertime.

It was then that I got the phone call from a friend regarding dinner plans that week. I was curious why she'd phoned.

"Hey - I'm seeing you and Terri tomorrow evening for dinner anyway aren't I?" I cheerfully mused as I stirred fresh rosemary and lemon juice into the beans.

"What do you mean tomorrow?" replied Tammy. "We're getting together tonight."

"Tonight?" I said, puzzled. "But I thought we were going over to Terri's on Thursday?"

There was a pause on the other end of the phone, before: "Today is Thursday Glyn."

This is the trouble with being out of work for so long. Every day is the same. There are no weekends or weekdays anymore. Time is smudged like spilt cigarette ash on a white tablecloth to the extent that I find myself having to sneak a glance at my computer screen every now and then to remind myself where in the week I am. And no, it isn't bliss. It isn't fun. It's no fucking holiday. I can't enjoy it at all when I know I need to be working. It's more like a millstone, a perpetual reminder that every moment I'm here, my debt is increasing.

The point is that I had to scramble out the door because I'd already missed my counselling appointment at 1.30pm that day, and was on the way to missing my group therapy appointment at 5.30pm. Especially so when you consider it's an hour's journey to group from where I now 'live'. I also had to pack in everything I'd wanted to take 24 hours doing in preparation for dinner at Terri's into an hour. Hence, I arrived 20 minutes late for group therapy, and then we all know what happened.

Every now and then I have a therapy session - group and/or individual - that really shakes me up. After Thursday's group last week I was literally reeling and had to sink a few beers at Terri's afterwards in order to calm myself. Then I went home and slept for a day, missing my Friday dose. By the time I next blogged, I'd been in withdrawal for over 24 hours.

This is what I've been reflecting on for the last day or so. Then I remembered that one of the other, more serious withdrawal-related side effects of straying from prescription protocol is violent mood swings. Sure enough, a few minutes of web research revealed that I was not the first to experience such effects. Moreover it was a relief to know that I could learn from other patients who, circa 2005, had attempted to come off Effexor XR 'cold turkey' and had accordingly experienced everything I'd experienced on Saturday.

It seems plausible to hypothesise, therefore, that the suicidal thoughts I had at the weekend weren't actually me per se, but a violent reaction to a dip in Effexor levels in my bloodstream. This is reassuring for two reasons. One, it means that the drug must be having some kind of beneficial effect, because not taking it causes such a noticeable, tangible reaction. This is significant also because it destroys one previous cognitive distortion I'd had about my prescription - that it might be a placebo. I now know that can't be true. Two, it means that I may not actually be as close to the edge as I felt at the weekend.

That's as far as I can get at the moment in terms of understanding and perception. Indeed, for the last seven or eight months I haven't really known who I am, I haven't known where I end and the drugs begin or vice versa. I've even feared that - were I to return to health - I might lose my sense of humour. It's very self-deprecating after all, and if my confidence were to improve then would I just stop being funny?

It feels like time to revisit my recovery plan.

Sometime in the Spring or Summer of 2008 I'd researched and written a plan that took into account everything I understood about the drugs I was taking, the disorders I was afflicted by, and the likely symptoms. It took into account time planning, priorities, nutrition, contingencies, therapy, and those things I could do in a day-to-day lifestyle that would dovetail with CBT et al, avoid triggers as I understood them, and 'automatically' improve my mental health so long as I stuck to it religiously.

Trouble is, I never really executed on it for two reasons. First, I believed the problems I was having were 'family' problems and it was therefore essential to me to have my wife fully briefed, cognisant, and supporting me in what I was trying to achieve. It was also essential to ensure that the plan could accommodate a full-time job, and would not fail the minute I started working again 'proper'.

Unfortunately, I suspect by that time my then wife had already made her mind up that she was going to divorce me. I couldn't get her buy-in. In fact, I couldn't even get her to sit down with me and go through what I'd researched and discovered. I was told this was "my" problem, not "our" problem. In addition, I was loathed to commence the plan and attempt to instigate the necessary routine without first securing a full-time 'office' job. I knew that whatever I ended up doing, the working hours for that job would have to be taken into account and if there's one thing I hate it's having to totally re-do a plan, document, or project simply because it wasn't planned with foresight in the first place.

And that's where the plan's been for almost a year now. Dormant. In stasis, waiting to be commenced with a push of a mental big-red-button that said, "OK, here we go, this is it. Do not divert from the path".

Me being well won't make it any more likely that I'll get a job. The two things are linked tenuously at best. Unfortunately, if I continue to wait for the day I do land a job that covers the rent and enables me to start paying down my debt, then I am relinquishing the power to commence my own recovery, and passing it to a bunch of faceless Torontonians who appear to have no intention whatsoever of offering me even the most rudimentary of jobs. I'm not going to rant about HRM people again but I do still feel spurned, black-balled, and discriminated against. At best, I'm suspicious and resentful. Global recession my arse.

So I'm at a bit of a loss. I have a few weeks' worth of liquid assets left before I am in a financial situation that is beyond my power to manage or control. Yet it seems futile to re-instigate the recovery plan when working full-time is so essential to preventing my my anxiety being triggered and self-worth being dissolved. It appears likely that no recovery plan, no matter how brilliant and thoroughly-researched, would have any beneficial effect while my temperament is being so earnestly undercut and proverbially blown out of the water by the fact that I'm a near-38 year old who can't fend for himself.

Equally, I know from past experience that I cannot just take the first open job I see, because if it isn't at least a little worthwhile then I will feel ashamed by it, embarrassed to be doing it, and ultimately anxious...too scared to tell anyone that that's what I'm doing. It will probably also lead to depression within a few weeks.

If you're pig-ignorant of mental illness then this will probably sound like snobbery or vanity to you, but it's run-of-the-mill to me and my lovely disorders.

Suggestions welcomed.