Nigel Rumsey

Author: Nigel Rumsey

  • My head hurts #9: A Year of Antidepressant Withdrawal

    A man's hand holding his ankle to ease the nerve pain of antidepressant withdrawal.

    As I sit down this Thursday morning, it’s a year and four days since I stopped taking Amitriptyline. Up to that point, I’d taken varying amounts every day for the past 25 years. It’s impossible to know while you’re taking an antidepressant how well you’d feel without it. Through the good days and the bad, at every waking moment, it’s there affecting you; maybe subtly, maybe not. 

    I’ve begun to wonder how much of my personality over those years was the drug and how much was me? Was I a little Amitriptyline, half Amitriptyline, or more than half? Was I the drug or was the drug me? Would I have still been me without the Amitriptyline? It’s an unsettling thought.

    I can’t remember how many times that I’ve put pencil to paper since writing my last MHH blog post, some three and a half months ago. I don’t find writing comes naturally. One of the few good teachers at my school, Mr Palmer, did his best to encourage us, with promises that the more we read, the easier the words would flow. Well, Barry, do you mind if I call you Barry? I can honestly say that I’ve kept my side of the bargain. This year, I’ve enjoyed everything from Steig Larsson to John Steinbeck, by way of a very disturbing time with Aldous Huxley, but their extraordinary talent is yet to rub off. However, you did foster in me a love of reading, and maybe that was the point all along. It’s too easy to focus on the destination, when there’s so much pleasure to be gained from the journey. Anyway, we’ve got off the subject; this blog isn’t about writing.

    The Year Without Amitriptyline

    I expected it to be tough, but thankfully, I hadn’t realised quite how unpleasant it would be. The withdrawal has changed over the past year. At the beginning, there were a host of symptoms, so many it would be easier to count the parts of me not affected – I made a bit of a list in My Head Hurts #4.

    On reflection, it should have been obvious quite how significantly antidepressants affect brain chemistry; after all, that is what they’re designed to do. The brain is the most complicated organism we’re aware of. One article I read suggested that the human brain is beyond human understanding, which ironically is difficult to get your head around.

    In another life, I’d have found it a fascinating subject to study. It also makes me understand why researchers studying psychedelics are so tempted to try them; there’s nothing like experiencing the effect of your work from the inside.

    “What if some of these effects aren’t withdrawal from Amitriptyline, but side-effects from the Fluoxetine?’“

    A Change in Withdrawal Symptoms

    My withdrawal symptoms are now less varied. I still have mild flu symptoms and the same histamine response, but both are less severe than they were. What has changed and become far more difficult to deal with is the nerve pain. When I first started tapering Amitriptyline (and taking Fluoxetine – more of that later), in November 2024, the first symptoms were pins and needles in my feet.

    At the time, it wasn’t much more than an annoyance; the weather was cold, and I assumed it was just one of the many pleasures of getting older! It didn’t take long for the pins and needles to become numbness, and then an ache. At some point, the ache turned into pain that extended to my hands, arms and then my shoulders, where it’s settled ever since. When it’s bad, it’s really bad; my legs feel as though they’re immersed in a bath of scalding water from which there is no escape.

    The Fluoxetine Question

    All science students are taught to avoid changing two independent variables at the same time; otherwise, it’s impossible to tell which is causing the effect. Of course, a living, breathing patient is not a science experiment, so when I started tapering down the Amitriptyline, my GP prescribed a replacement dose of Fluoxetine (Prozac). It’s the accepted practice, although I’m unconvinced it benefits the patient long term.

    This has left me with a question nagging away at the back of my well-medicated brain: What if some of these effects aren’t withdrawal from Amitriptyline, but side-effects from the Fluoxetine?’ In which case, no matter how long I wait, how many vegetables I eat each, and how many walks I go on, they’re unlikely ever to fade! So, how long is too long?

    As I now understand, doctors are concerned that taking a patient off one antidepressant without a replacement ‘could’ cause a recurrence of the original symptoms. But I experienced my original symptoms over twenty years ago. It is now accepted that fewer people suffer from serious life-long anxiety or depression than once thought – some do, of course – but for most of us, these are reactions to specific life events. In hindsight, I have a fairly good idea what those events were, if anyone had had the time to investigate.

    Researcher Dr Mark Horowitz explains this really well in one of his excellent Q&A videos. This isn’t the specific video I was looking for, however, 43:30 onwards covers similar ground. I’ll update this if I find the clip I had in mind.

    So What Now?

    For the time being, I’m going to stick with the plan. The professional advice says that the brain can often take longer than a year to recalibrate to the lack of an antidepressant, especially for someone who had been on the drug as long as I had. I could address my nagging question by tapering the Fluoxetine, but my gut feeling says now isn’t the right time.

    As I’ve said before, I always feel some obligation to provide a glimmer of hope to anyone who’s on the same path. But as I look through this post, I have to admit it’s in short supply. All I can say is, hang on to the thought that it will get better, one day. 

    Take care, N.

    Further Help

    If you need to talk to someone and you’re in the UK or the Republic of Ireland, The Samaritans are there for you. If you’re outside of the UK, at a look at Befrienders Worldwide. Be kind to yourself.

    Dr Mark Horowitz’s website offers the most practical, professional advice I’ve found online. The academic papers are impenetrable to the nonprofessional. But he has useful links to newspaper articles which explain things in layman’s terms. The UK mental health charity, Mind, is also a good resource.

    Related Posts

    My Head Hurts #8: Stopping Work

    At about 5 pm on Thursday, I shut down my laptop on the day’s work for the very last time, or so I imagine. We never really know what the future has in mind. I’m calling it early retirement, although…

    more…

  • Pinsta Pinhole

    Fish Pye Pottery, St Ives, Cornwall photographed with a Pinsta pinhole camera.

    The Pinsta is a pinhole camera where you typically shoot directly onto photographic paper in the camera. These shots are taken with Harman Direct Positive paper, which, as the name suggests, gives a positive image. The paper is then directly developed in the camera.

    You could, of course, use traditional darkroom photographic paper to make a negative, then print from the paper negative. Paper negatives give a less crisp image than film or the direct positive paper. Some photographers prefer that look. The alternative is to scan the paper negative and reverse the image in Photoshop. Personally, I prefer the workflow and the look of the direct positive paper.

    It can be a little tricky to master exposing for photographic paper; it has a far narrower latitude than photographic film. If you don’t get the exposure right, either the light areas are overexposed or even blown out, or the darker areas turn to black.

    These are a few images I shot in St Ives, Cornwall, May 2025.

    St Nicholas Court, St Ives, Cornwall photographed with a Pinsta pinhole camera.
    Mount Zion Coffee (the best coffee in St Ives), St Ives, Cornwall photographed with a Pinsta pinhole camera.
    Café Portminter Beach, St Ives, Cornwall photographed with a Pinsta pinhole camera.
    Boats in the harbour, St Ives, Cornwall photographed with a Pinsta pinhole camera.

    If you’ve used the Pinsta camera or have wise words regarding using Harman Direct Positive paper, I’d love to hear from you.

  • My Head Hurts #8: Stopping Work

    Small tomato seedlings

    At about 5 pm on Thursday, I shut down my laptop on the day’s work for the very last time, or so I imagine. We never really know what the future has in mind. I’m calling it early retirement, although I’m a few years away from getting any form of pension.

    Sitting in an armchair drinking coffee at 11:30 on a Wednesday morning is a strange experience. The prospect of being able to do this would have seemed like nirvana this time last year. Although not quite the ‘ultimate state of salvation’, it does feel pretty good.

    I’ve only been ‘retired’ for four days, and I know that this carefree high isn’t going to last forever; however, I’m enjoying it while it lasts! I have been working, without a break, for the last 46 years and as time passed, living to someone else’s timetable became increasingly constraining. The freedom to work, or not, when you want, to take a holiday when you need, is so liberating. I don’t underestimate the privilege of having this opportunity; I’m aware that so many of us don’t have the choice to stop working, and I’m incredibly grateful.

    So, What Do I Do Now?

    I could fill a small book with all the ideas I’ve had, things I’ve wanted to make, and projects that I haven’t started, never mind finished. My first priority is to get well, or at least to manage my antidepressant withdrawal as best as possible. Not spending over eight hours a day sitting behind a desk will help. Other than that, I’m going to start some much-needed work in the garden by planting some vegetable seeds. Gardening should help my physical health and, if all goes well, our diet.

    I’m desperate to get back on my bike. I don’t like using the car for local journeys. Whereas I used to enjoy cycling to the supermarket and loading up my panniers, driving to the store feels like a chore. I’ve written about my box camera project, which I seem to have been planning for years! I’m eager to start, but I keep reminding myself to take it slowly.

    Plant canes at National Trust Ightham Moat.

    The Elephant Is Still in the Room

    My withdrawal symptoms have fallen into a very distinct pattern. For two or three days, I feel okay; my hands and legs are uncomfortable, but with the aid of paracetamol, I get a reasonable night’s sleep.

    This is generally followed by about a week where the effects slowly peak and then tail off. I get the same several waves of pain each day, most noticeably overnight and in the morning. Sleep goes from difficult to nonexistent, and I find myself talking to the pain, as though telling it to f*** off might make a difference. Of course, knowing I don’t need to get up for work the following morning makes a big difference.

    As of this moment, on this Wednesday morning, it’s not bad. I’ve all but drunk my coffee, and I need to go to the store, although for now my bike stays in the shed.

    Take care. N.

    For Professional Advice

    Dr Mark Horowitz’s website offers the most practical, professional advice I’ve found online. The academic papers are impenetrable to the nonprofessional. But he has useful links to newspaper articles which explain things in layman’s terms. The UK mental health charity, Mind, is also a good resource.

    Related Posts

    My Head Hurts #6: Staying Positive

    In what could be an outtake from a bad episode of Star Trek, I’m talking to my Mac, trying to find the form of words that will persuade it to add punctuation to my latest blog post. I have tried…

    more…

    My Head Hurts #4: The Side Effects

    I finally stopped taking the Amitriptyline three months ago, with my final dose of 2 mg. My symptoms haven’t changed significantly since last month; except for the bouts of pain/ache/restlessness, which are far worse.

    more…

  • Box Camera Project: Planning

    A Sketchup drawing of an Afghan style box camera.


    I came across Lucas Birk and Sean Foley’s Afghan Box Camera project a few years ago when a friend, Maurício, took an interest. As a result, he made two cameras of his own and even featured in a book about the subject. I’ve always liked the idea of making a street box camera, but I have never found the time. Maurício now lives in São Paulo, Brazil, so it’s not like I could easily pop round to have a look!

    Last year, another good friend sent me a link to Lucas Birk’s latest project, selling box camera kits. The kits look great, but I couldn’t shake off the urge to make my own camera. Since then, I haven’t been in the best of health, and so the build was postponed again.

    The one good thing about being unwell is that it has prompted my early retirement – although, being honest, it didn’t take much prompting. So, two weeks from writing this (eek), even if I only work on it a few hours a week, I won’t have a lack of time as an excuse.

    Rodenstock Ysaron 150mm f4.5 enlarger lens.
    (Not my photo, from the eBay seller)

    I want to reflect the spirit in which many of these cameras were originally built. So, I aim to build it as economically as I can and, where possible, use materials that I already have cluttering up my workshop.

    Although a lovely Fujinon large-format lens would be a delight, I’ve settled on this slightly beaten-up Rodenstock Ysaron 150mm f4.5 enlarger lens that I managed to pick up for £19 on eBay. It’s not that different from the Soviet Industar enlarger lenses that were popular with Afghan photographers.

    Plans for my Afghan-style box camera.

    I’ve spent a few weeks researching, sketching in my notebook and reacquainting myself with SketchUp. I’m ready to start building the box itself; I think I have all the wood I’ll need. My aim is to be able to shoot up to 6×4 inch paper-negatives in portrait and landscape format.

    I’ll list the materials I use as I go along; it may be useful to someone. Although I’m using most of them because I already have them on hand, not because they’re necessarily perfect for the job.

    Plans for my Afghan-style box camera.



    Apart from gathering these few bits and sorting out the wood, I haven’t done much. Hopefully, next time there’ll be some physical progress to show.

    What I’ve Spent So Far

    whatcostwhere
    Rodenstock Ysaron 150mm f4.5 enlarger lens£19.00eBay
    3mm clear Perspex (ground ‘glass’)£2.65Perspexsheet.uk
    3mm red Perspex ( red ‘safelight’ window)£3.51Perspexsheet.uk
    Hinges for the lid£4.90Local hardware shop

    If you’ve built your own box camera, I’d love to hear from you.

  • My Head Hurts #7: Seven Months and Counting

    A moody black and white film image of Berlin showing the sky crossed by cables.

    I’m not a medical professional. The following is my personal experience. Please talk to your Doctor before you change your medication or take painkillers.

    If you’ve ever avoided making a difficult phone call, you realise that the longer you wait, the harder it gets. It sounds as though I’m making excuses; it wasn’t that I didn’t want to write, if I’m honest, I haven’t known what to write.

    It may not have come across, but when I’m writing about my antidepressant withdrawal, I’ve tried to maintain a note of optimism and, in my own clumsy way, inject a little humour. However, as last year came to an end, I couldn’t summon either. My 62nd year has been one of the worst, and it seems as though there’s nothing I can do about it.

    When I took my last tiny dose of Amitriptyline on the 20th July 2025, I knew that there were going to be withdrawal effects. That at times they might be unpleasant, and they were likely to hang around a while. I wasn’t wrong. What I hadn’t expected was that almost six seven months later, they would be having such a significant impact on my life and that they would, if anything, be getting worse.

    So, I put off writing, telling myself that I’d pick it up at the end of January; today is the 14th February, so judge for yourselves how well that went.

    The New Reality

    I want to think that I’ve now come to terms with that new reality, but being honest, I haven’t really. Back in July, I remember reading that 5% of antidepressant users have withdrawal symptoms that last longer than nine months. But there are dozens of antidepressants and millions of users; we’re all different. I rationalised that although most of the remaining 95% would have been taking the drugs for less than my 25 years, some had to have been. Maybe Amitriptyline wasn’t one of the worst drugs, and I couldn’t be that unlucky, could I?

    In the cold light of January, I read the summary of a paper detailing the reality of how many sufferers experience side effects for multiple years; that many are far worse than I have experienced (so far). Missing both Amitriptyline and sunlight, my mind started to wonder whether this could last longer than my mythical nine months, and whether it could get significantly worse.

    The Symptoms

    In the abstract, it’s interesting how the symptoms have changed. The first few weeks of withdrawal were dominated by headaches. Amitriptyline takes about seven days to leave the system. So in those first few days, the headaches were the actual withdrawal of a drug my brain had become used to over the previous 25 years. Then a range of symptoms kicked in (I wrote about them in MHH #4). They affected every part of my body, from balance and tinnitus to itchy skin and insomnia. There’s a very comprehensive checklist on the Mind website, and I’ve ticked off most of them.

    The constant, since I started cutting down the Amitriptyline over a year ago, is the numb pain in my extremities, mainly my legs. At first, it was similar to pins and needles, annoying but easy enough to ignore. This transitioned through restless legs and has now developed into a dull, constant pain. It affects my whole body, from my toes to a patch on the top of my head. It never recedes completely. At times, if I’m distracted, it’s easy to ignore, and then there are the times when it is everything. Nothing quietens its presence.

    There are the large waves and the smaller waves within them. The best way I can explain it is like an electric current running through my body. The large waves last a few days; the smaller waves, a couple of hours.

    The Solution

    This is probably a good time to remind you that I’m not a Doctor. These are my conclusions from my personal experience. Discuss your symptoms with your doctor.

    I should have realised sooner that any substance that affects our perception is, to a larger or smaller degree, changing the chemistry of our brain. That could be coffee, antidepressants, painkillers and thousands of other things. This is the same chemistry that our brains are desperately trying to rebalance. It doesn’t seem a stretch to think that painkillers, even to a small degree, could slow that rebalancing. If you have a medically diagnosed imbalance, that’s one thing, but if we’re self-medicating to ease symptoms, are we hindering that rebalancing? Of course, the effect could be negligible, or a price worth paying. I’d love to have the medical knowledge to research it further.

    Painkillers

    So, the options are limited. I find the headaches the hardest to cope with. On average, I get two bad headaches a week. As I understand it, Paracetamol is one of the safest commonly available over-the-counter painkillers. Unfortunately, it doesn’t have much impact on my headaches, so for those, I take Ibuprofen, which does help, but taken long-term can damage the kidneys, so I don’t like taking it frequently.

    The pain is generally worse in the mornings and evenings, so I take two 500mg paracetamol tablets before I go to bed. Generally, they help me to get to sleep. Then I take two more if the pain is bad when I wake up in the night (as long as four hours have passed). I don’t take painkillers during the day, unless in the most exceptional circumstances.

    I mentioned in MHH #5 that I’d taken Co-codamol (which contains codeine and can be addictive). My pharmacist had said it was okay to take one tablet each night. That didn’t chime with what was clearly written on the box. When I next saw a GP, I mentioned it, and she was emphatic that it is far from okay and went so far as to insist that I don’t take it.

    The Effects

    Antidepressant withdrawal syndrome has had a huge impact on my life. If I weren’t able to work from home, I would have had to stop working some months ago. As it is, there are many days I have been less than productive, but I’m fortunate that I can catch up when I feel better.

    However, I have decided to retire early. I have a demanding job, and I know that I’m not turning in my best work; there’s only so long you can make excuses. I’m not old enough to get a state pension, but my wife is working, and I’m not a huge spender. So as long as I’m careful, my savings should last.

    I didn’t have a busy social life, which was not great, but it was okay. But now it’s virtually nonexistent and that’s far from okay. A couple of lovely close friends have kept in touch, and I’ve promised myself I will treat them both when I can. Apart from that, life is very quiet.

    I have so many plans. There is so much I want to do. When I hit 60, I realised that there is far more I want to do than I have time for; so these days spent sitting on the sofa looking out of the window seem like time wasted.

    If you’re entering antidepressent withdrawal and looking for reassurance, then I feel I should apologise. Today, you’ve come to the wrong place. I don’t have a life-threatening illness, and yet this withdrawal has all but stolen my life. At the moment, it’s difficult not to feel just a little cheated.

    Previous post: My Head Hurts #6: Staying Positive

    Next post: My Head Hurts #8: Stopping Work

    For Professional Advice

    Dr Mark Horowitz’s website offers the most practical, professional advice I’ve found online. The academic papers are impenetrable to the non-professional. But he has useful links to newspaper articles which explain things in layman’s terms. The UK mental health charity, Mind, is also a good resource.

    Related Posts

    My Head Hurts #3: Antidepressant Withdrawal Pain

    Have you thought about why some people, often young women, are driven to cut themselves? Taking a blade and deliberately cutting into your own flesh seems so counter to everything we think of as normal. I find it difficult to…

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    My Head Hurts: Reducing Antidepressants

    I’m trying not to look at the clock. It’s still dark; early June in the UK, so maybe 3-4 am? The next thing that comes into my mind are the drugs. In the last six months, I’ve probably spent more…

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  • My Head Hurts #6: Staying Positive

    A graphic, inspired by Lester Beall, illustrating positivity in the face of pain

    I’m not a medical professional. The following is my personal experience. Please talk to your Doctor before you change your medication or take painkillers.

    In what could be an outtake from a bad episode of Star Trek, I’m talking to my Mac, trying to find the form of words that will persuade it to add punctuation to my latest blog post. I have tried dictation in the past, but whatever magic Apple has worked in the interim, it’s far more accurate.

    I established that I need to say ‘period’ instead of ‘full stop’, and I can cope with that. However, if my USA friends have a secret word for ‘paragraph’, I haven’t found it. (Update: apparently, the key is to say ‘new’ paragraph)

    You don’t have to be good at it to enjoy it!

    The ongoing side effects of antidepressant withdrawal forced me to look for alternative ways to amuse myself. A new discovery is how much I enjoy writing, particularly in this blog. I continue to be dreadful at it; that’s a given. I rewrite each one several times. But my lifelong tussle with the written word is something I came to terms with a long time ago.

    Almost no one, other than a few lovely friends, reads it, but that doesn’t diminish the pleasure of the writing. Photography is too personal; if the results of a shoot are disappointing, I can’t shake it off. I have carried them with me for years. I appreciate that it shouldn’t be like that, but that’s how it is. Writing is akin to a hobby. One that I don’t mind not being good at. I enjoy the process; maybe I’ll do better tomorrow, maybe I won’t, and that’s OK.

    I’m far too easily distracted to concentrate for any length of time on a laptop. So, inspired by the author Mark Boyle (The Way Home), I picked up a pencil and a pad; the simplicity of it is refreshing. No logging in, no apps, no syncing, no staring at another screen, and no distractions. With pencil and paper, I can write anywhere.

    I’ve gotten slightly off track. I’ll talk about the joy of writing some other time. So why dictation? Well, I have developed a pain in my right hand. The difficulty when going through something like antidepressant withdrawal is that its all-encompassing nature results in your blaming it for every ache and pain. However, in this instance, I am beginning to think this is more likely a simple case of RSI (repetitive strain injury). Good in a way, but the only treatment for RSI is rest. Writing has become a sanctuary, and this seems an unnecessarily cruel blow.

    The world is still out there. It is waiting. We will return to it. Remember that!

    I have tried writing with my left hand, which was a short-lived experiment. So, here I am in a room alone, talking to my laptop. Speaking my thoughts out loud before they are fully formed isn’t comfortable, and I already doubt that dictation is going to last. But the inability to write is one of the most frustrating aspects of my current ill health, and I’d love to find a solution.

    The challenge, as always, is to stay positive. It is now over four months since I stopped taking Amitriptyline; over a year since I started tapering. The discomfort and the poor sleep. The repetitive daily routine of work, cook, TV, and bed seems as though it may last forever. Every so often, I have to stop and remind myself that this will come to an end. That this is temporary. You will spend time with friends; you will be able to walk with carefree abandon; you will ride the bike that taunts you whenever you go to the shed. The world is still out there. It is waiting. We will return to it. Remember that!

    For Professional Advice

    Dr Mark Horowitz’s website offers the most practical, professional advice I’ve found online. The academic papers are impenetrable to the non-professional. But he has useful links to newspaper articles which explain things in layman’s terms. The UK mental health charity, Mind, is also a good resource.

    Related Posts

  • My Head Hurts #5: A Night of Antidepressant Withdrawal

    A graphic, inspired by Lester Beall, illustrating a night of antidepressant withdrawal.


    I’m not a medical professional. The following is my personal experience. Please talk to your Doctor before you change your medication or take painkillers.

    It’s Sunday morning. I can’t see the clock, but I can tell it’s late.* I try not to move a muscle. It’s the sort of game you play when you’re six, not sixty. I took some ibuprofen at about 7:30 this morning, and it’s beginning to wear off. I can feel the numbness coming on, but nothing really hurts yet. My six-year-old logic is that if I lie perfectly still, then maybe I won’t feel the pain. Not so long ago, I would have been appalled to be in bed at this time, but a lot has changed since then.

    I write and rewrite this blog in my head. Writing doesn’t come naturally to me, so on the rare occasions it flows, I need to get it on paper before it disappears. It’s beginning to slip away. How did this paragraph start? I need a pencil and some paper, but I don’t want to move.

    “I’m not fighting anything… I’m not part of the resistance, more a disgruntled conscientious objector”.

    I’m going to have to move soon. At one time, weekends were for fitting in the things I wanted to do, free from the commitments of someone else’s timetable. I couldn’t lie in bed; I had stuff to do. Now life is far simpler; weekday or weekend, it’s much the same. Get through the day as painlessly as possible, still be here tomorrow. Don’t let the antidepressant withdrawal win; that’s my job for today. Some people describe fighting pain. I’m not fighting anything; it’s happening, I’m putting up with it and trying to stay positive. Less part of the resistance; more a disgruntled conscientious objector.

    Sticking with this tired metaphor, it’s been nearly four months since Amitriptyline ceded control of my brain to Fluoxetine. My neurons, the citizens of my grey matter, are far from happy. I started counting in days and then weeks, the way you do with a baby. ‘Ah, how cute. How old? Four months, lovely!’ Or not so lovely in this case. I can’t consider the idea that this battle may still be waging after a year.

    Too Many Painkillers!

    The painkiller is wearing off. My head hurts. I’ve committed myself not to take painkillers during the day. I have a fear of taking too many, and I need them to help me sleep.

    If I need to, as I did last night, I take ibuprofen before I go to bed. That allows me to sleep sometime between midnight and 3 am. When I wake, I usually spend the first few minutes, as I am now, trying to pretend it’s not happening; it always is.

    When I need to, I take two Co-Codamol, but be careful, they’re not for everyday use. However, last night was one of those times. I go to the bathroom, stare out of the window for a while, and have a stretch. I discovered that the muscle numbness and pain I’ve been trying to describe for the past few months is called akathisia. It’s the devil and my constant companion.

    The Co-Codamol takes about 45 minutes to start having an effect. I’d like to read, but I can’t concentrate. I’ve tried listening to a podcast, but using earbuds with a headache makes it feel as though the sound is being injected into my brain. At some point, I nod off.

    I woke about 6.30 am and dozed for a while. Took another ibuprofen, had breakfast, made my wife a cup of tea, and read the news. They’re reporting that ‘a number’ of people have been stabbed on a train in Cambridgeshire. And apparently, JD Vance believes his Muslim wife should convert to Christianity. Welcome to the world in 2025.

    I go back to bed and sleep for a while. So here I am, having less success at pretending it’s not happening.

    Take care out there. N.

    Co-Codamol can be addictive and could cause withdrawal symptoms. I’m very uncomfortable taking them and do so only, maybe, once a week. Please don’t do what I do; talk to your Doctor.

    Previous post: My Head Hurts #4: The Side Effects
    Next post: My Head Hurts #6: Staying Positive

    (* For the record, it was 10.24 am.)

    Professional Advice

    Dr Mark Horowitz’s website offers the most practical, professional advice I’ve found online. The academic papers are impenetrable to the non-professional. But he has useful links to newspaper articles which explain things in layman’s terms. The UK mental health charity, Mind, is also a good resource.

    Related Posts

  • A Tribute to Lester Beall

    updated: 9 December 2025

    A graphic, inspired by Lester Beall, symbolising the side effects of antidepressant withdrawal.
    I created this graphic for My Head Hurts 2, where I talk about the side effects during the early stages of antidepressant withdrawal.

    American graphic designer Lester Beall inspired many of the designs I’ve created for the site. In the 1930s through to his death in 1969 he produced a striking range of images. The most notable were created for the Rural Electrification Administration (REA), which was created in the 1930s as part of US President Roosevelt’s New Deal.

    Beall’s work is not well represented online; the best selection I’ve found is part of the Merrill C. Berman Collection.

    A graphic insipred by the work of Lester Beall featuring the scales of justice.

    The graphic for a post about My Values, which underpin what I do here.

    A graphic designed to symbolise the discomfort and unease of antidepressant withdrawal.

    A graphic designed to symbolise the discomfort and unease of antidepressant withdrawal, which is the subject of My Head Hurts #3: Antidepressant Withdrawal Pain. There are also discussions about self-harm.

    A graphic, inspired by Lester Beall, illustrating the side effects of antidepressant withdrawal.

    The fourth post in the series, My Head Hurts #4, focuses on the side effects I experience. This graphic aims to illustrate some of those side effects.

    A graphic representing a big tech corporation, inspired by Lester beall.

    In the post Moving Away From Big Tech, I discuss the apps and services I was using at the start of 2025 and how I’m transitioning to free or lower-cost services while moving away from intrusive big tech.

    An image inspired by Lester Beall based on a library near my home.

    The image for Recently Read, is based on the smallest local library near my house. I’m always concerned that it’s not going to survive local government cuts, but against the odds, it’s still open.

    A graphic, inspired by Lester Beall, illustrating a night of antidepressant withdrawal.

    In My Head Hurts #5: A Night of Antidepressant Withdrawal, I write about my experience during one night of antidepressant withdrawal syndrome and how it impacts the following day.

    A graphic, inspired by Lester Beall, illustrating positivity in the face of pain

    As the blog develops, the graphics are becoming more complicated to produce. The design for My Head Hurts #6: Staying Positive is inspired by Lester Beall’s work titled No 3 Photo-Engraving, created in 1938.

    Field Notes

    Some time ago, I created a series of (uncommissioned) designs for Field Notes Brand notebooks. One series of three books was based on Beall’s designs. Sadly, Field Notes didn’t take up my offer, but I enjoyed making them. One day, I’m going to print a set for myself.

    This design is part of a series that uses photographs taken at various rodeos in Georgia, USA.

    This cover is based on Beall’s design, ‘Smiling Boy and Girl’, Rural Electrification Administration, U.S. Department of Agriculture, 1930.

  • Documentary Photography Self-Study Blog #3

    Tank Man and The Photo League

    A stack of documentary photography text books

    This is the third blog post in a series about self-studying Photojournalism and Documentary Photography.

    I’m adding these three posts from my old blog, they add context to my current method of studying, and they may prove helpful for others self-studying. This is the third (and final retrospective) post of the three. My process of studying changed as I figured out what works best for me. This post brings me almost up-to-date.

    It’s been two years since I started self-studying documentary photography and photojournalism, and this is only my third blog post. Not a stunning start. For nine months, I worked on the Professional Photography Course at the London Institute of Photography—maybe more of that later—so there is some mitigation. However, I am more than a little disappointed with my progress.

    The Method

    If you’ve read the earlier posts, you may remember that I’d decided to work as closely as possible to the London College of Communication BA in Photojournalism and Documentary Photography syllabus. It felt like an artificial framework almost immediately, without a tutor to guide me. I spent almost as much time deciding which sections of the textbooks best related to each unit of the course as actually studying.

    At some point last year, I gave up. I copied all the notes about Jennifer Good and Paul Lowe’s Understanding Photojournalism into a new document and started afresh. This time, working through the book from beginning to end, as simple as that.

    It was refreshing to have such a simple guide to follow. This probably says more about me than which approach might suit you. I’ve realised I like a clearly defined path to follow. I had to remind myself more than once that I’m doing this for enjoyment. There’s no exam at the end of it. In fact, it’s unlikely that anyone else will ever read my nearly eighty pages of notes. So, why not do it in a way that suits me?

    I mentioned in an earlier post that I was writing my notes in Evernote. I’m now using Google Docs for several reasons, one of which is that Docs automatically creates an outline based on the hierarchy of headings used. This made it very easy to reference earlier notes as I was writing.

    Was it worth it?

    Yes, it was definitely worth it. I now know far more about the history of documentary photography and individual photojournalists than I did. It’s also given a greater clarity and context to the knowledge that I did have.

    Tank Man by Stuart Franklin.
    Photograph by Stuart Franklin/Magnum

    At several points along the way, I headed down huge rabbit holes. One such was an investigation into the story of Tank Man. I became fascinated by the stories of the five photographers who shot the same scene from slightly different viewpoints and, of course, the Tank Man himself. In fact, I started writing a long blog post about it and what I’d found. That was until I found Patrick Witty’s definitive post on his blog, Field of View.

    I’ve since become a subscriber to Field of View. Whether you opt for the free or paid versions, I’d highly recommend it. Witty, a former photo editor at The New York Times and International Picture Editor at TIME, amongst other roles, has a level of knowledge and experience few others can match. As with the Tank Man article, he’s often interviewed some of the photographers involved firsthand.

    Studying has prompted me to put down my page-turner thrillers and read the biographies of Lynsey Addario (excellent); Marie Colvin by the inspirational Lyndsey Hilsum (also excellent), Ben Bradlee (good, although far from impartial); Clarissa Ward (a page-turner itself), and Diane Arbus (there is SO much to say!).

    What’s Next?

    My studying days are not over. I have Michelle Bogre’s ‘Documentary Photography Reconsidered: History, Theory, and Practice’, which I’ve barely opened. I will work through that in the same way. After that, my current plan is to turn my focus to a photographer or an important event and study that more independently. High on that list is The Photo League – see below. I now better understand how to study in a way that suits me.

    One thing I’ve learnt this month year

    Boy on the Roof, Pitt Street, New York, 1938 by Walter Rosenblum
    Boy on the Roof, Pitt Street, New York, 1938 by Walter Rosenblum.

    I’m embarrassed to say I knew nothing of the Photo League. Founded in 1936 by Sol Libsohn and Sid Grossman, the Photo League was a cooperative of photographers based in New York who shared an ethos around a range of social causes. The league championed socially conscious photography.

    Some of the most renowned American photographers of the time were either members or supporters of the Photo League. This included Lisette Model, Margaret Bourke-White, W. Eugene Smith, Helen Levitt, and FSA photographer Arthur Rothstein. The list includes the next generation of photographers, including Richard Avedon and Robert Frank.

    In 1947, during the post-war McCarthyist communist paranoia, the Photo League was prescribed an anti-American communist organisation, and it folded in 1951.

    There’s a short history of the Photo League on the Morris Engel archive. It mentions a documentary, Ordinary Miracles: The Photo League’s New York, but I haven’t found a copy in the UK. It’s available on Amazon Prime in the US.

    Throughout my studies, I have continued updating my list of Documentary Photography: Courses, Documentaries & Talks, which may be helpful.

    Until next time. If you have any questions, comments, or suggestions, get in touch.

  • My Head Hurts #4: The Side Effects

    A graphic, inspired by Lester Beall, illustrating the side effects of antidepressant withdrawal.


    I’m not a Doctor. The following is my personal experience. Please talk to your Doctor before you change your medication.

    This is the fourth post in a series detailing my experience of antidepressant withdrawal syndrome, concentrating on the side effects. Starting in November 2024, I tapered my use of Amitriptyline over eight months. At the same time, starting to take Fluoxetine (Prozac), originally 40 mg/day, I now take 30 mg.

    I finally stopped taking the Amitriptyline three months ago, with my final dose of 2 mg. My symptoms haven’t changed significantly since MHH-3 last month, except for the bouts of pain/ache/restlessness (see below), which are far worse.

    In each post, I’ve referred to the side effects, but I haven’t really gone into any detail about how they affect me or how they’ve changed over time. Everything I’ve read indicates that we all experience side effects in different ways and to varying degrees.

    “My head hurt so profoundly that it made me incapable of doing anything other than sitting still, in a quiet room with my eyes closed”.

    The severity also seems very dependent on several factors, including:

    • How long had you been taking the medication before you started tapering.
      I took Amitriptyline for 25 years. The dose varied; at one point, it was 50 mg/day.
    • The dose when you started tapering.
      I started tapering from a dose of 25 mg/day.
    • How quickly you tapered.
      Both the size of the reduction and the time between steps. What is known as hyperbolic tapering (very slowly) seems to be the current accepted best practice. I might post about that in the future. This guide from the Royal College of Psychiatrists is helpful.

    The time you’re taking the medication seems less significant the longer you’re on it. In other words, stopping after four months should be easier than after twelve months. The difference between, say, ten years and twenty years may not be so great.

    Please remember, this is my layperson’s understanding of complicated medical data. Always discuss your medication with your Doctor.

    How Withdrawal Affects Me

    The UK mental health charity, Mind, produces a list of common withdrawal side effects which correlate closely with my personal experience. Headaches, for example, were very significant in the early stages but have become far less pronounced over time.

    • Joint pain, aches, numbness and restless legs: I’ve always struggled to describe this feeling. It’s very similar to the drained ache you get with flu; at times, it feels like an electric shock (update: since posting, I discovered this condition is known as akathisia). My lower legs and forearms are most affected, but recently it’s more of a whole body thing. For me, it’s by far the worst side effect.
    • Insomnia: Some of my inability to sleep is a result of the aches and pains, most noticeably in my legs. But there also seems to be an element of standard insomnia thrown in for good measure.
    • Tiredness: This is obvious, I suppose. But the overwhelming fatigue has the largest impact on my day-to-day activity levels.
    • Cold/flu symptoms: Cough, sore throat, and a blocked nose.
    • Itchy skin: I seem to have developed a more pronounced histamine response. I normally suffer from mild hay fever, but that was far worse this year. I get very itchy skin, although a daily antihistamine tablet mainly keeps it at bay.
    • Dizziness: Thankfully, this has largely disappeared in the last couple of months.
    • Nausea: Not too bad. It comes in waves, but subsides very quickly.
    • Headaches: Withdrawal was heralded by the most overwhelming headaches, hence the name of this series. My head hurt so profoundly that it made me incapable of doing anything other than sitting still, in a quiet room with my eyes closed. Thankfully, they’re far less frequent and much less severe.
    • Sensitivity to certain noises: This is a weird one. I’ve become very sensitive to certain noises. Imagine clanging a saucepan lid on something hard; that’s the one!

    In writing this list and trying to describe each of the symptoms, I realise that in the main they’re all connected to the nervous system, but I guess that makes perfect sense. Antidepressants change brain chemistry; my brain is now trying to readjust, after 25 years, to the absence of Amitriptyline.

    As I’ve mentioned before, my nagging concern is that maybe the side effects of withdrawal stopped some time ago, and what I’m experiencing is a reaction to the Fluoxetine. I don’t think that’s the case, but it would be good to know for sure.

    Unfortunately, I started taking Fluoxetine at the same time I cut down the Amitriptyline. Changing two independent variables concurrently is never a good idea. Then I’m not a psychological experiment, or am I?

    Take care out there.

    Previous post: My Head Hurts #3: Antidepressant Withdrawal Pain
    Next post: My Head Hurts #5: A Night of Antidepressant Withdrawal

    Professional Advice

    Dr Mark Horowitz’s website offers the most practical, professional advice I’ve found online. The academic papers are impenetrable to the non-professional. But he has useful links to newspaper articles which explain things in layman’s terms. The UK mental health charity, Mind, is also a good resource.

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