If being mentally ill and living in South Africa was a joke, it would have to be classified as dark humour.
Hello… Thank you in advance for taking the time to read my story.
I (26F) am honestly just trying to wrap my head around what I have endured in the last few months. This post contains some brief medical history and a more in-depth exploration of the last 105 days of living through hell.
I have no idea where to even begin.
Technically, I have always struggled with my mental health.
Shout-out to the combo of crappy genetics and one severely traumatic childhood for that.
Please note: I am not going to delve too deep into the various diagnoses that have professionally been bestowed upon me … I have been in therapy for most of my life and what started out as MDD and ADHD when I was 12 or so, turned into ADHD, BPD, C-PTSD, OCD, and BiPolar II by 18 years old. This is not the entire list, but the most likely and prominent diagnoses.
Nevertheless… after an entire lifetime worth of therapists, counsellors, psychologists, psychiatrists, various psychiatric hospitals, and one long-term institutionalization stint … I was stable. I entered long term treatment in 2022 and until the end of 2025, I was doing so well (I think it is important to note all these previous psychiatric hospitals and the long term institutionalisation was all done through private hospitals and institutions).
I went from having to take an anti-depressant (I have been on various ones, but settled on Effexor/Venlorfaxine), mood stabilizers (always epitec), anti-psychotics (the best one was Arizofy but really did go through quite a few), and concentration medication (used to be on Concerta, now on Mefedinel) everyday as well as anti-anxiety (started with Stressam and Urbanol ... eventually Alzam, Ativan, and Etomine) and sleeping medication (Adco-Zolpidem) when necessary … to slowly and safely reducing that entire list to simply:
- Effexor (Venlorfaxine)(SNRI) 150mg: every morning
- Mefedinel (ADHD treatment) 36mg: every morning
- Alzam (Benzodiazepine) 1mg: only when necessary and it was not needed often
On this little combo … I was not only stable, I was happy.
On the 25th of December 2025:
I was 100% myself: stable and sane.
I was clean from self-harm … for over 4 years and 4 months.
My OCD was rough, but nothing out of the norm.
I had no suicidal thoughts or ideation.
No thoughts of harming myself.
I was happy and healthy.
On the 26th of December 2025:
I went to my normal pharmacy to pick up my Mefedinel prescription. However, they were out of stock. The pharmacist said she will give me Contramyl 36mg instead, and despite my hesitation she reassured me that the ingredients are exactly the same.
I left with the Contramyl 36mg, fully believing that there is no difference between Mefedinel and Contramyl.
Over the next few days, I proceeded to rapidly lose my mind.
I used all the skills I know, I tried my absolute best to not fall hopelessly into a deep, dark hole.
I actively gaslit myself into believing that it was not the meds, the pharmacist had successfully reassured me the meds would not do this …
I later learnt that Mefedinel is a schedule 6 medication, and if the pharmacist had followed the correct legalities and proper procedures regarding schedule 6 medication: she would have referred me straight back to my doctor. Due to the fact that Mefedinel is schedule 6: she was legally not allowed to just give me the next best option.
I would later learn that even though the ingredients are technically the exact same in Mefedinel and in Contramyl … the release mechanism is completely different. Mefedinel uses the OROS release mechanism and the Contramyl uses MUPS release mechanism.
I later learnt this could have caused a disruption in how my body absorbed all my psychiatric medication, which includes my life-line Effexor (Venlorfaxine) anti-depressant.
However, before learning all this, on the 03rd of January 2026:
I could not take it anymore.
I wrote the letters: some pathetic attempt at an explanation of how I was fine a few days ago but now, nothing is fine.
I ran myself a bath, I put on a song worth dying to on repeat, I indulged in some self-harm for old times sake, and then proceeded to drink a mixture of: anything that contained codeine, muscle relaxants, benzos, and some sleeping tablets. Altogether: roughly 50 pills.
Then, I wrapped, tied, and secured a rope around my neck.
Life faded to black and that is the last thing I remember …
I woke up over 40 hours later, in my bed, confused, dizzy, my neck hurt, and I was disorientated.
I was taken to the hospital.
Thus, on the 5th of January:
I was admitted into the emergency room.
The hospital that I was taken to is a government hospital based in the province I live in.
South Africa’s government hospitals are infamous for the diabolical conditions that patients have to endure there, but there were no other options, and I had only ever heard the horror stories… but experiencing it first-hand was traumatic to say the least ...
I spent 24 hours locked in that ER.
In those 24 hours, I witnessed, smelt, heard, and went through the unthinkable.
- The bathrooms had feces smeared on the toilets and walls.
- The smell was awful throughout the entire ER.
- The room I was put in had a smaller room in the corner of it where women received abortions, around the clock - for the entire 24 hours I was there. Putting the entire pro-choice vs. pro-life argument aside: hearing these women go through that ordeal traumatised my soul. The sounds that came out of that room can only be described as sexual distress. More than once, the women who had already started the procedure would beg for a break or for the doctor to stop and in the coldest tone of voice, I heard the doctor simply repeat, “Ma’am the procedure has started, we cannot stop now”.
- Another patient, who was completely out of it and probably experiencing some sort of drug induced psychosis … was held down by five nurses in the hallway, stripped naked, and redressed into the blue hospital clothes that indicated she is a psychiatric patient. This lady was screaming, some sort of sustained high pitch scream that I have never heard before … except maybe in a horror movie for a few seconds … But the entire ordeal of these 5 nurses holding her down and stripping her naked and redressing her, lasted much longer than a little jump scare in a horror movie. I have no idea exactly how long it lasted for but my best guess would be somewhere between 35 - 50 minutes. She urinated on the floor and the urine just stayed there (when I left the ER: the urine was still there in the hallway, uncleaned … this lady laid there: now completely sedated but her one eye was already blue and starting to swell) …
- Somewhere roughly 12 hours into this ER experience, I started to have one of the worst panic attacks I have ever had. Seeing the lady being stripped naked and held down by five nurses while screaming, the women who were herded in and out of that abortion room begging for a break in severe sexual distress, the claustrophobia of being locked behind gates and bars, the constant stench and feces smeared all over the bathrooms and urine left unattended to, and my already problematic mental state sent me into some sort of C-PTSD level flashback panic attack. Eventually, nurses started to come into the room to see what was wrong, but the moment they saw that it was me … hyperventilating in my blue hospital clothes … they would mumble or say something about “ward 3”, turn around, and just left me there. Before I left, I was told that the blue clothes indicate a psychiatric patient who is being sent to ward 3… the psychiatric ward. Nevertheless, after hours of crying, not being able to breathe, flashbacks, screaming at nurses asking for help, and just being beyond triggered … I just went sort of mute. Eventually the nurses changed shifts and when the morning nurses came to take my vitals, I screamed at them and refused to allow them to take my blood pressure / heart rate / whatever else. I demanded to talk to a mental health professional (psychologist, psychiatrist, therapist, anyone, I did not care about the title but desperately needed the help), and refused to give them any of my vitals until I received said help. I started crying again and tried to explain that for hours throughout the evening, I was having a severe panic attack, and received no help. I explained I had not slept at all, and woke up the entire room worth of women with my hysterical crying. I explained that other patients comforted me and tried to calm me down, whilst the nurses flatly ignored me and refused to treat me. So until I get some help, they do not get my vitals. The nurse returned with some different pills, and said that the pills would help with the anxiety and put me to sleep. I drank the pills, but before I could fall asleep, the doctor who admitted me into the emergency room came to review my case. I was confused. I asked for clarification on what the doctor meant by wanting to “review” my case. I quickly understood what was happening. I was about the be admitted to ward 3, but before she transferred me, she just wanted to see if I am still feeling suicidal. I said what I needed to say to get out of there. To be fair, I would have said anything to get out of there. Within the next hour, I was out of those stupid blue pajamas, given a script for Mefedinel 36mg (so that I could stop the Contramyl and go back to what I was used to) and citalopram 20mg (I was told this would help with my anxiety and panic attacks), and was promptly discharged.
On the 06th of January 2026:
I left that godforsaken hospital with a new found sense of gratitude to just be out of that place.
Amidst all of that, I was under the delusion that citalopram was supposed to be taken as necessary. I knew what the doctor told me: it would help with my anxiety and panic attacks.
So over the span of 06 January – 17 March, I drank a total of 11 citalopram every now and then. When necessary.
However, I started experiencing weird things… I got diarrhea, my normally already trembling hands were shaking way worse than usual, my anxiety slowly but surely got worse and worse, I usually had no issues sleeping and all of a sudden I was basically a full blown insomniac, I started the experience intense rage, I lost all control over my emotional state, I started to suffer from muscle spasms, I would be resting and laying down with my heart beating faster than if I was actively running a marathon, I started to lose comprehension of what people were trying to say to me over messages and calls (I read/heard english but it was as though they were speaking a foreign language), I had to try focus not to let my jaw clench and lockup, I started getting paranoid about somehow being drugged without my knowledge.
Thanks to all my previous suicide attempts, I know what an overdose feels like … and I could not help but feel like I was slowly but surely overdosing … but I was not taking any drugs? I was not actively attempting to overdose on any substances?
While all these symptoms continuously just got worse, the more I felt the need to take something to help calm the severe anxiety and/or rage.
Eventually the dots connected …
Every time I took one of those citalopram “chill-pills”, the symptoms worsened and eventually became completely debilitating.
I thought maybe the citalopram had some severe rebound anxiety side-effect that was really affecting me badly. So I googled it …
Turns out citalopram is not a chill-pill, it is not a benzodiazepine, and it is not supposed to be taken ‘when necessary’.
Citalopram is an anti-depressant, it is an SSRI, and it is supposed to be drank daily.
But … I am already on an anti-depressant? The Effexor (Venlorfaxine) … my life line SNRI …
So I googled what happens if you are put on two different anti-depressants and that was when I learnt about the dangers of taking an SNRI and an SSRI simultaneously …
It is simply 1 too many S’s which leads to a little something called Serotonin Syndrome.
This explained all of these bizarre physical symptoms I had been experiencing.
This also explained why I had been suffering from such severe anxiety and agitation.
It explained why I felt like I was unknowingly and unintentionally overdosing.
It explained why I felt like I was dying, because Serotonin Syndrome can escalate from mild, to moderate, to severe, to fatal very quickly … and the only symptoms I did not have were: seizures, coma, and death.
Upon this realization, I cried … I cried, and I cried, and I cried.
I cried because I was not just losing my mind for no reason.
I cried because of that doctor that put me on an SSRI when she knew I was already on an SNRI.
I cried because I listened to that stupid pharmacist who convinced me changing from Mefedinel to Contramyl would not make any difference.
I cried because from the time of being discharged from hospital on the 06th of January until the 17th of March, I had only taken 11 citalopram pills. If I had drank them as I was supposed to: daily … I would have most likely been dead before the end of January.
I cried even more when I found out how serotonin syndrome is treated: with benzodiazepines.
I cried because I knew what I needed and despite thinking I was taking what I needed, I was unintentionally overdosing on serotonin.
I cried because I desperately needed help but the only options were either the same hospital that all the above trauma occurred in or a different government hospital, which none are any better.
I cried because I knew I would rather enter into the only three symptoms left on the list that I was not experiencing (seizures, coma, and death) than have to go back to that government hospital.
I cried because I would rather die, than have to go back there.
I cried because I was so severely chemically imbalanced that all I could do was cry.
Since then, I have been taking benzodiazepines (Urbanol 5mg) prescribed by a GP who is trying to help me recover and avoid hospitalization. I have started seeing a therapist at the counseling unit for the students at the university which I attend. I have also been referred to a psychiatrist and my appointment is scheduled for the 13th of May.
It is currently only the 11th of April.
The current dilemma is that I am still taking my usual SNRI, the Effexor, that I have been taking for years and years now.
As far as I understand, after serotonin syndrome, one should immediately discontinue all serotonergic medication, which would include the Effexor.
However, withdrawals from Effexor are a known nightmare and should only be done extremely slowly, and under doctor’s strict supervision.
So do I continue overexposing my poor little serotonin fried brain with the effexor (SNRI) and attempt to balance it with benzodiazepines ?...
Do I start to taper off the effexor and face simultaneous serotonin syndrome recovery as well as effexor withdrawals?...
I have no idea what to do.
I have no idea what the future holds.
I just know for now: drink the effexor, drink the benzos, deal with the insomnia, deal with the diarrhea, deal with the crippling anxiety, deal with the intense rage, deal with it, and hope I somehow survive til the 13th of May.
Just know that if I have to choose between being admitted into a government hospital again and death … the choice has already been made: I will happily accept defeat and death as long as I never have to go back to that hospital.
Thank you for taking time to read my story. I appreciate it.