Commencing treatment with SSRI meds and psychologist

[BK13]

I don't really know if I have a question per se but I finally decided to seek treatment for depression and anxiety and I felt like sharing.  I had tried once before a couple of years ago and was fobbed off by a crappy doctor (who did prescribe me meds but his attitude and care factor didn't make me feel confident enough to take them!).

I happened to find an awesome new GP a few months ago.  I was already considering approaching him about my mental illnesses and then some fairly traumatic events happened in my life.   Including my long term partner coming clean about a lot of things he had done and then trying to take his own life.  I found him and had to call the ambulance, the police came too, it was awful.  Since then his mood has improved to the point I'm no longer acutely worried of a relapse, however I don't think it would take much to push him back there.  Every time I call and he doesn't answer the phone, I swear my heart stops until he calls back.  All these horrible thoughts of what he's done.  He's agreed to seek treatment himself but he's yet to make that phone call.  He's in his early 40's and doesn't believe things can be any different as he's felt like this his whole life.

So after all of this I decided it was finally time.  I spoke to BB first to get me through a couple of tough moments and then I saw my GP last week and have been on my medication (SSRIs) for a couple of days.  I am still waiting to get an appointment with the psych.  I am already feeling very agitated, my jaw is tense, I woke up in the middle of the night and took forever to get to sleep.  I can't stop yawning and my vision is a little blurred.   My GP prepared me well for the side effects, however it still took a LOT for me to open up that packet and stick the tablet in my mouth.  I put it off for a few days because I was too scared!  Scared of what it would mean, how it would change me, how I would feel.   I think it's definitely a good idea NOT to google too much. I started to but I was just terrifying myself even further.  I have read a number of threads on the BB page which I have found very helpful. Realistic accounts of peoples experiences.

 I don't know how I'm going to go working when I feel like this. So far it's a bit tricky to sit at my desk as I'm so agitated & anxious! So it's like a step backwards ATM considering anxiety was really affecting my work already. I haven't told my boss or colleagues about the treatment (yet). I will stick with it though!

[Vegetarian Marshmallow]

I took an SSRI for about 6 months.  One day when I felt the worst and most self-destructive I'd felt in years, I dragged myself to the doctor's office.  Doc put me on the meds and a psych.  I didn't have that apprehension you did about starting meds - personally I have a decent trust in the potential usefulness of drugs, (over-?)confidence in my ability to tolerate them, and anyway, what the hell did anything matter if the alternative was to start an internal worm farm.  I can't quantify how much the meds and psych helped consciously, but the ritual of it was quite potent in that "Well, I'm on some kind of plan here now - so there's hope and I can feel slightly better about myself because I'm trying".

Side effects didn't seem that bad to me, personally.  Actually I was interested to see what would happen, and thought it would be fun and interesting to experience some different body/mind states.  I was sleepy and lightheaded for a week or two when first starting them, but that went away after not too long.  Also on some occasions I missed my meds I got quite depressive, which sounds like a bad thing, but I think the stark contrast allowed the existence of the useful thought: "This mood is probably because you missed your meds"; reifying the idea that "This too shall pass.".  I think that might have actually helped me to notice how fickle and varying our mental states can be, and to water down the illusion of continuous consciousness which gives power to harmful thoughts because of personal identification with them.  I had reduced sexual function for the entire time I was on the meds, but I didn't have any romantic prospects so that was moot, and anyway seemed less important than being able to tolerate being alive.I decided to stop the meds a few months ago partly for the one aforementioned side-effect (which went back to normal pretty soon after cessation), but mostly for the fact that I felt noticably better than when I started taking them (so I felt like I could handle stopping), and I wanted to get back to baseline and try to take stock of myself, for which having the drugs in the mix felt like a confounding variable.

Good luck with everything.  Hopefully the drugs and psych are useful tools for you.  I'm curently getting into (secular) meditation via reading people like Dan & Sam Harris (no relation) which I find useful for defanging my own thoughts.

[PurpleShade]

I could have almost written this post except that my husband doesn't have mental health concerns but we do have relationships issues which came to a head (alongside other life crisis concerns) that led me to decide to go on anti-depressants.  I feel a little trepidation too as after 20 years of finding alternative ways to manage my depression, I hit a wall where I just couldn't deal and had become suicidal (again). Hopefully the choice for meds and psych is a good choice, I figure its got to be better than how I was feeling 10 days ago.

Living with depression is an ongoing management and sometimes we try something else because the thing before stops being effective.

Hope it works for you (fingers crossed here too)

beyondblue's clinically-trained moderators often work offline (invisible to you) on issues relating to suicide or self-harm. At the same time, general supportive comments from the community are encouraged. If you have concerns around suicide or self-harm, please phone our support service on 1300 22 4636.

[geoff]

dear BK, everyone has different side-effects when they start taking AD's, and you're right, if you check on the net to see what are the side-effects then this may psychologically put you off from taking them, but you might not get any, and if you do they might not be as bad as suggested on the net.

Normally they settle down and you begin your life with taking this antidepressant (AD), and being tired can be one of the first effects that you feel, but you finally adjust to this.

There is medication which your doctor can give you for your anxiety and agitation, but you could wait and see how it all settles down.

It's good that you have raised SSRI medication because there have been a couple of other people who have raised queries with regards to them, however you seem to be having a great deal of concern for your partner at the moment, so you need to cover yourself, and by saying this, by taking AD. L Geoff. x

[BK13]

Thanks for your replies!  I realised later yesterday (after I went over my post 1000 times in my head) that I actually DID have a question!  I wanted to know how other people had managed their symptoms, as in how to support your body best with the change to life taking ADs.  My doctor warned me against anythign St Johns Wort, but is there anything else I might try that won't affect the medication uptake?  I used lavender oil to help me get to (and stay) asleep, going to sleep was actually easy last night I was so exhausted I was asleep by 830, but I spent about 3 hours awake during the night.

I have been trying to get regular exercise and eating as sensibly as I can.  Although yesterday I ate 3 chocolate bars, not because I was hungry but because my jaw was so tense I needed to do something!  Maybe this is how the weight gain side effect happens 🙂

I have also taken up yoga once a week. 

Is there anything anyone found esp helpful for managing this initial period?

I will wait and see how the agitation goes, hopefully it will settle in a few days otherwise I will go back to my GP.  He was very upfront that it will probably get worse before it gets better.  And right now I very much feel like I want to be at home curled into a little ball.   I don't think trying to work through this period is a great idea but the timing couldn't be worse. 

What about you guys, did you work while you started/changed ADs?  Or did you have to take time off work?  Or were you already unable to work due to depression/anxiety?

 I know no one thing suits everyone but I'm interested to hear other people's experiences.  It's reassuring to know you are not alone!

BK

[BK13]

Well fate has served me well for once.  I am really finding the side effects tough, and it's really affecting my work.  I was going to ask my boss for a couple of weeks off (telling them only a minimum of information about my condition) - and it turned out I didn't have to!

The task I am working on has been put on hold for a few weeks - so I just asked for 2 weeks off in a general sense.  So I have achieved what I wanted - time off (ME TIME) for me to adjust to the medication, without having to explain anything was even wrong.  I can't trust that word wouldn't get out regarding my condition, so this is a relief for me.

I stressed to my partner this is not anything to do with looking after him, this is not to babysit or check up on him.  This is 100% about me now.  One positive of our crisis point, is that we are communicating a lot better.  I made it clear this has to be a new beginning with no more secrets.  I probably have downplayed a little how hard I am finding the medication side effects, as it's probable he will also go on medication once he seeks help for his condition.  I don't want to put him off but by the same token I need to prepare him a little for what is ahead.  He is of no illusion it's not going to be a rocky road - and not just with meds.  There is over 40 years of crap he needs to purge from his mind with a psych, there really is a lot he will need to talk about.  It will be hard but I am sure he will feel a great weight he has carried all these years lifted from his shoulders.

I am really looking forward to the next two weeks.  Some time apart and some time together, just doing things we enjoy.

[BK13]

2 and a half weeks into taking medication now.  I no longer worry about taking the medication, it's as natural as taking the contraceptive pill.  So how do I feel?

 i don't quite know.  My jaw is still quite tense on and off but the other side effects have mostly died down.  There is less 'white noise' in my head, although there is now times when my mind is just blank and empty.  I don't know what's better to be honest!  I find it hard to motivate myself to get started doing things, once I get going I'm ok but it takes forever to get moving.  I also find conversations a lot more difficult, small talk is impossible and I always feel like I'm one sentence behind in group settings so it's hard to contribute to the conversations!  I'm still back on what was said previously Trying to catch up and don't want to blurt out anything as I know the conversation has moved on.  It's awkward.

i saw the psych for the first time today.  I like him and was able to open up to him reasonably well.  Today's session was more about getting to know each other but I feel positive about developing a relationship with him.

the bit which actually had the most impact though, was a self assessment questionnaire.  As I was answering it I was very aware of how differently I would have answered some of the questions last week or the week before.  I seem to be dealing with some situations differently/better which I wasn't aware of.  

I am hoping to get another week off work as I dnt feel ready to go back just yet.  Delaying the inevitable maybe but I want more me time.  I'm always worrying about everyone else so me time is overdue and is my priority.

bk

[PurpleShade]

HI BK,

I'm glad the side effects are settling a little and that your head has quietened.  I can relate to the empty feeling and small talk issues, I've been pondering this in the last 4 or 5 days cause I'm not used to it, its awkward.  I kind of have come to the conclusion that I was struggling with small talk before meds, the difference is I had more noise in my head and in a sense perhaps more senseless information to talk about lol whereas now I kind of only speak if I have something to contribute and there are alot of things people say that is just noise to fill the quietness so I'm not feeling I'm missing out too much.  

I think to that we become really familiar with the old pattern and the new responses are unfamiliar and its just a matter of adjusting.  I hear you on the questionnaire, it is a good measure and how you've improved, good stuff.

I was looking at some photos a little while back and some recent ones, such a difference, I had no idea how stressed I was, I think I was functioning.

I took some time off my studies and I'm job hunting so in a sense I am giving myself time to adjust to meds and I am glad I did but I am starting to feel ready to get back into life a bit more than before now.

Its good to hear your feeling better and that there is some improvement 🙂

[BK13]

Sorry PurpleShade I thought I had replied to you but apparently not.

That's very interesting your theory on the small talk!  It's probably not that far from the truth.

The funny thing is, I am very comfortable in silence, because previously it was a choice.  I had plenty to say but I didn't necessarily feel like I needed to say it just to fill the gap.

But now I literally have nothing to say, & unless it's someone I know well, silence causes me much stress. I'm racking my brains to think of something, feeling tension or awkwardness that may or may not actually be there but in my head it is.

I'm back at work as of this week after 3 weeks off, was back one day then took the next day off, I just couldn't stand the thought of going to work.  I nearly had the next day off too, I couldn't even get out of bed.  My partner was very sweet and made me a cup of tea and convinced me to sit outside in the sun and maybe I would feel better.  I eventually managed to talk myself into going into work, it took me forever to get ready but I got there in the end.  A small victory!

I am extra glad I went in the end, because my boss wanted to meet with me and told me that they wanted to move me as part of a restructure, into an area that I'm more interested in and that I'm much better at.  It's also quite busy so there will be plenty to keep me occupied.  Thank GOODNESS.  It's still not really what I want to do in life but hopefully will be tolerable at the very least.  The the anxiety that starts to hit the closer I get to my building may even ease a little!

I'm not sure if I'm looking any better yet.  I actually pay extra attention to how I look the worse I am feeling.  If I look ok, I am ok, right!  It's like a full body mask.  People think when I dress in bright colours and wear pretty jewellery and fun makeup it's because I'm cheery and happy - quite the reverse, nothing disgusts me more than looking dreary and sloppy when I am depressed so greys, browns and blacks are kept to a minimum.  I dress bright and happy in the hope that I will feel more bright and happy, or at the very least convince others that I am bright and happy.

When I'm at home the full body mask comes off and I can finally relax a little.  Trackies are heaven.  This is when I feel most 'me'.  It's a relief now that my partner knows the true extent of my illness, and I too about his.  Being open and honest about all these feelings we've been hiding...it's nice.