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Posts Tagged ‘anti-depressants’

So, things were going well & then halfway through last week the withdrawl symptoms kicked in. Sheesh, major waves of dizziness and nausea, despite having carefully cut down on my dose before stopping the pills.

I felt reassured that it was withdrawal symptoms, rather than some fun, new ME symptoms, due to the previous comments on here. Plus, some googling revealed hundreds of posts on message boards from people complaining about dizziness & nausea when coming off citalopram.

Ended up having a couple of days off work, as I couldn’t cope with the dizziness on top of my ME, but I’m pleased to say that everything is abating now. Back at work and minimal dizziness.

I have been waking up at about 3am every morning this week, which I suspect is another symptom of my body adjusting to coming off the pills, but I’ll re-instate my sleep hypnotherapy CD tonight and see if that helps.

Overall, I’m pleased to be off the pills after three years, despite the small hiccups.

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Photo by Mr La Rue

Photo by Mr La Rue

So, after nearly three years I am currently coming off my anti-depressants. I was on 20mg a day of Citalopram and lucky that I had no noticeable side effects.

Using anti-depressants is a very personal choice and it turned out to be the right one for me. However, it wasn’t an easy to start using them as it meant finally admitting that I was depressed and that I couldn’t cope.  I went through a phase of bursting into tears several times a day, including at work and this is why I chose pills. I needed to stabilise myself so that I could start dealing with my depression and work out what other help I needed.

I been to three different counsellors alongside using the anti-depressants, the most successful counselling treatment being the cognitive behavioural therapy I received in early 2008. The general advice from GPs about coming off anti-depressants seems to be that you should only come off them once you’ve felt okay for 6 months and then to cut down to a pill every other day, then one every two days etc.

I had 3 weeks off work before Xmas with my ME/CFS and IBS which was frustrating, but didn’t put me into a bad place mentally so I decided I was ready to start cutting down the pills. I’ve been cutting them down for the last month or so and I’m currently taking one pill every three days, so another couple of weeks and I’ll stop altogether.

The hardest part of coming off the anti-depressants is trying to decide what is “normal” for me. Before my depression I would very rarely get upset or cry because I tended to push all my feelings deep down inside. Now I’m double-guessing myself and thinking “am I upset because I’m coming off the pills?” The answer seems to be no, mainly when I’ve got upset the last few months it’s been about things that most people would find upsetting, and I generally deal with them sensibly and quickly. So, I still need to work on accepting and recognising my feelings and then working through them but overall I’m very happy with my progress and that I’m doing the right thing for me.

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I heard a few snippets this week on the BBC news along the lines of

Put away the tranquilisers. Sushi, chocolate and a new haircut could help beat depression, a new book suggests.

The overall impression I received from this was that it was advocating the ‘buck up, go out and sort yourself out’ attitude that can be very damaging to people with mental health problems. It also implies that it is aimed at women with anxiety and depression, as I can’t see many people suggesting to men that they eat sushi, chocolate and get a haircut to deal with stress.

I decided to seek out the details about the news on the BBC website and found a short interview with Professor Jane Plant, author of Beating Stress, Anxiety and Depression, and Jane Harris, of mental health charity Rethink.

Luckily, my first impressions were wrong as they seem to be advocating that people with mild to moderate depression may find a range of diet and lifestyle changes helpful. That these options should be considered before anti-depressants are prescribed, and that more non-drug psychological treatments should be available for mental health. They also mentioned that only 6% of health research funding goes towards mental health research, even though the NHS spends approx £300 million a year on drug therapies.

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I’ve been on Prozac for three weeks now, so I thought I’d report back on its effects, and also offer a bit of a forum:

Comment, if you want to, sharing what medication you’re currently on, or have been on, (doesn’t have to be anti-depressants) and the effects it’s having/had on your life and mood.

Basically, I don’t think people talk about this enough! So, yes, Prozac has been… great. Unexpectedly so. The awful recurring thoughts of badness have pretty much disappeared, and when they come are much MUCH less persistent and less potent. I’ve also generally been feeling pretty ok a lot more of the time – actually contented.

So far, side effects have been minimal, although I am feeling tired in the afternoons more. At the moment that’s ok – I can either have a caffeine overload on the days I’m at work, or have a nap (yay for being a student…), but that’s not really going to be possible when I’m (hopefully) working full time in about 2 months. Apparently Prozac side effects do decrease with time as your body gets used to it, so I’m well willing to give mine the next two months to find out, but if it doesn’t get any better I know I’ll have to make some hard choices.

It’s made me think about quite a few different things, too. I had a brief email conversation with Dr Ben Goldacre (of Guardian Bad Science column fame) about SSRIs, of which Prozac is one, which have been in the news recently. Studies have shown that for people with mild to moderate depression (I would class mine as moderate, as it’s not totally debilitating, but without drugs I am depressed, anxious and suffer upsetting thoughts every day for significant amounts of time) SSRIs were about as effective as placebos.

Obviously, this was shocking news for a lot of people, and various people on here talked about it. To put a different perspective on the issue, a friend of mine who is a psychology student at Sussex University rubbished the revelations, saying they’d only looked at surveys of patients up to one month after they started taking the drug, and that it normally takes longer than that for some people to feel the benefits.

Which, of course, led me to wonder – is Prozac having a real effect on me, or is it a placebo, and I’m effecting the change on myself? I suppose it’s unknowable. Medication for depression is often likened to using a sledgehammer to crack a nut, so delicate is the brain’s internal chemistry and so primitive is our knowledge of it. Yet I do feel better, even though I’m consciously aware of the findings of that study, so I think that’s really the only important thing to consider.

The other thing I’ve been struggling with is my personal history. I’ve been on anti-depressants before, during 2003-2004, in my first few terms at university. At the time, I made lots of new friends and was feeling happy and confident in my life. I remember that time as beautiful – full of drunken nights out, laughing endlessly with new mates and being amazingly, intellectually challenged. Up until now I’ve always thought of that time as a result of the circumstances of my life, not the citalopram, then escitalopram that I was on. But I’m being forced to reconsider, now, with the clear, obvious effects Prozac has had on me. It’s patent that my cynicism was, in some ways, unfounded, and that much of my general enjoyment of that time where I felt unanxious, free, fun loving and happy was down to the drugs. I’m not discounting the experience as helping – I’m sure being at uni for the first time had a big effect on my mood. But I’m also fairly certain the drugs had a big effect too.

I’ve recently started to realise, too, that I’ve been depressed, anxious and prone to upsetting thoughts for most of my life. I remember having them, and compulsively overeating, as young as five or six. They’ve never really stopped, or gone away, but have just been influenced by different things, such as grief or love. As such, I’m starting to wonder how long I will need to be on medication. For the rest of my life, perhaps? I’m still reeling from how much Prozac has helped me in what is really a very short time, and wondering how this year, last year, all the other years of upset and sadness and anxiety would have been different if I’d just been put on it sooner. I guess it’s unknowable, too.

Conclusions from all this soul searching aren’t easy to come by, except that I’m going to be far more tolerant of side effects this time. The escitalopram and citalopram I was on before made me drowsy every afternoon, so I was napping a lot and ending up sleeping for twelve to thirteen hours every day. At the time, unsure as to whether the drugs were really having any effect, I gave them up, reasoning that I needed to be awake more of the time so I could work better on my essays and reading. I spent my second year in a haze of extreme anxiety, deep depression and self harmed a lot. I also often got work in late and didn’t read enough, which, I am sure, contributed hugely to me getting a 2:1 instead of a 1st. I don’t want something like that to happen to me again, so I’m going to stick with these a bit longer, and see how it goes. I’ll report back, anyway.

So, what are your experiences?

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