Posts Tagged ‘SSRIs’

First Day

Well, I took the plunge and took my first tablet of sertraline (50mg) today.
Of course, I’m nervous about the side effects, especially as I’m going to be alone for 6 days from Saturday. But I knew I had to start today rather than waiting 10 days for people to get back – I would have definitely talked myself out of taking them at all in those 10 days; I have in the past.

Anyway, I have clonazepam to take care of any paradoxical anxiety (anxiety as a temporary side effect of drugs that are meant to lessen anxiety).
I’ll try to post here every day to say how I’m getting on.


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To SSRI or not to SSRI?

I’m thinking of going on SSRIs again.

Actually, scratch that. I’ve decided to take SSRIs again. I have a doctor’s appointment on Monday.
The last month or so I’ve come to realise that my life is limited a lot because of my body’s anxious reactions. Well, I already knew that, obviously. But lately I’ve been feeling it more; where previously I might not have wanted to socialise and get involved in stuff I now find myself trying and failing miserably because I’m shaking with anxiety.

My hyperventilation has got worse, or if not worse more pervasive. I’m making a game with a friend and I can’t sit through our meetings (informally, at a pub) without silently starting to freak out and hyperventilate without realising or being able to stop it, which makes me really dizzy. So, I try to correct the dizziness with food except, wait! My OCD gives me a fear of choking so I eat incredibly s..l…o..w…l..y… and try to fight off the urge to cough wildly every time food gets to near to the back of my throat and I feel like this time I wont be able to get it down ( this gets way worse in company and it’s flared up recently from an old panic from school. Thanks, OCD!). So, finally I get so dizzy that I feel like I’m going to faint, and after excusing myself a few times to go to the toilet and calm myself down enough to last another 10 minutes, I can’t take the feeling that I could collapse at any second anymore and I make my excuses and leave. Really attractive, right?

The night that happened, I had horrible panic attacks in waves on the train home, one every few minutes or so, the worst anxiety I’ve felt for quite some time.

Last night, I saw a group of very old and very dear friends. We watched Edward Scissorhands. The perfect time, my body cheerfully informed me, for a health freak out combined with derealisation and panic attack. I started to feel that my right hand wasn’t quite right – it seemed numb and foreign. Then I flipped out thinking I was having a stroke, and left the movie to do a series of obsessive tests involving matching arm heights and reciting the date/ prime minister/ president in the hallway. I made it through the rest of the movie, but everything was strange and frightening, I realised I was having a panic attack with some unreality likely to be derealisation which I get sometimes and which goes hand in hand with anxiety. When the lights went on, my friends’ faces seemed somehow sinister, which I have to admit was very scary, especially as my major fear for years has been going mad. Okay, so I knew enough to be fairly sure that I was still having a panic attack, but it was really unsettling.

What makes me sad is that, even surrounded by friends I’ve known for ages and one of whom has OCD herself, even in a very familiar place to me, A) I had this pretty bad anxiety at all, and B) I didn’t feel able at any point to tell my BEST FRIENDS about my panic attack.
I’ve always been that way – I used to envy people who hyperventilated publicly at school and got the brown bag/ lots of fuss treatment. I used to suffer in my own mind, convinced that I was going to die at any second, yet never considering that I could speak up and ask for help.
To segue momentarily into a different rant: This is why we need better mental health education at school, people!

So, that’s been my anxiety experience over the last couple of weeks. And with university work becoming more pressured, I know it’s going to get worse.
But I don’t want to be so held back by my wild nervous system. I don’t want to avoid situations because I know I’ll hyperventilate and it’s not worth the discomfort and fear. I want to socialise more normally, and hopefully eradicate some of the fear I’ve been accustomed to towing around with me, and all the conditions and limits that go with that much fear.
Should I be considering starting SSRIs so close to academic crunch time?  Am I being short sighted considering the many possible side effects I could experience?
Should I be taking SSRIs at all, given that when I tried prozac 4 years ago I had a really bad reaction and had to stop taking it after the worst night of anxiety of my entire life?

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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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