What Did Depression Feel Like?
August 6, 2005 9:32 PM   Subscribe

When I Reduce The Amount of SSRI I Take, Is This How I Felt When I Was Depressed?

I have been diagnosed as mildly depressed, and I like to experiment. Although I'm more and more convinced it's futile, every once and a while I reduce the amount of SSRI I take (generic Celexa). It takes a few days, but eventually, "negative things" loom a bit larger. And larger. Is this how I was/felt before I started taking an SSRI (or worse?)? I don't remember what is was like avant-SSRI....
posted by anonymous to Science & Nature (17 answers total) 1 user marked this as a favorite
How long have you been on it? I've tried reducing the dosage of my SSRI every once in a while, only to find that after a few weeks, I really notice the difference. More negative and obssessive thoughts, mostly. I know it's not exactly like my mental state before I started -- back then, it was a lot worse -- but I get a general flavour of my dysfunctional mental processes. Don't forget that going through therapy and even life itself can have an effect on your mental state indepent of the drugs, so it may be difficult, if not impossible, to get into the exact state of mind that you once had.
posted by greatgefilte at 7:54 PM on August 6, 2005

Would you say one of your side effects is memory loss? You might want to consider that too. Can you dig up any old journals, or calendars from the time when you were diagnosed as mildly depressed, to help jog your memory of what your mindset was? Sometimes when I look at old papers, I'm really astonished to remember what my life was like, what kinds of things I was going through, only a few years before, etc.
posted by overanxious ducksqueezer at 8:51 PM on August 6, 2005

I'll be the usual voice of caution that chimes in to say you shouldn't mess with dosages without working with your doctor (hopefully a psychiatrist). The dosage effects of SSRIs may not be linear. I know for some, presumably all, there are threshold levels below which the drugs just don't work. So if by "cutting the dosage" you are dropping below this threshold, it might be equivalent to simply stopping the drug entirely. The fact that it takes several days for you to notice a negative effect from a dosage reduction is a pretty good basis for thinking there's a correlation, but of course you *know* the dosage has been reduced and might be affected by that knowledge. greatgefilte is of course right -- I don't think any of us can truly recall a previous baseline mood state exactly (exceptions, perhaps, for extreme dysphoria or euphora). You're clearly conscious enough of your mood to make that consciousness itself a factor in your mood, it sounds like. But you really should be discussing dosage regulation with your prescribing doctor. In the end, it will be your reported experience that provides the data the doctor uses, but at least there will be an objective perspective on those experiences in the mix that MeFites can't provide.
posted by realcountrymusic at 9:27 PM on August 6, 2005

Lowering your dose without slow titration can cause worse depression than you started with (temporarily), and other bad effects, so it's hard to guess.
posted by abcde at 9:33 PM on August 6, 2005

Which is to say, don't do it.
posted by abcde at 9:34 PM on August 6, 2005

Why are you trying to figure out what you felt like "avant-SSRI"? If you were at peace and blissful, there'd be no SSRI. So why go back?

If you're having physical effects, e.g., blurriness, can't come, then talk to your meds person. (I hope this isn't your internist or gynecologist.) You may not be on the right dosage, or the right meds.

Are you seeing a therapist? Most people respond best to a combo of meds and some sort of therapy to help deal with the cognitive stuff.

If you're trying to prove that "you" don't need meds -- that's existential wankery. If you had pneumonia, you wouldn't question whether "you" were the same person because you needed antibiotics.

This is all so blunt and unresponsive. I feel like I'm giving an 8th-grade presentation while wearing a pillowcase on my head.

Please email me if you like.
posted by vetiver at 10:01 PM on August 6, 2005

As someone who has done the same thing on multiple occasions without getting the say-so from my doctor, I heartily agree with abcde: don't do it. And never, ever, EVER go cold turkey. SSRI withdrawal can be a real bitch.

Going a little further--if it's working for you, why are you messing with the dosage in the first place? I say this only because I am still (after ten years off and on meds) trying to get around the very pervasive notion that because it's a mental thing, I should really be able to suck it up already and deal without medication. But would I say the same thing if I'd had, say, an organ transplant and needed to take anti-rejection drugs? Of course not.

Listen to your doctor, and if your doctor isn't a psychiatrist, consider asking for a referral to one. It makes a huge difference, especially if you are serious about wanting to decrease your dosage.

(On preview: vetiver, are you sure you aren't my evil (or good) twin?)
posted by Vervain at 10:18 PM on August 6, 2005

Whenever I quit my SSRI(Zoloft), I always felt much, much worse than I ever did pre-medication. The urge to experiment is strong(what if I magically became un-depressed and I'll never know it because I'll always think it's just the drugs doing their jobs?); but I'd be very, very careful, like everyone is saying. I wasn't suicidal at all pre-medication; when I quit cold turkey, pretty much everything I looked at turned into a possible means of killing myself. I wouldn't fuck around with that. Not. A. Good. Idea.
Also, having been diagnosed "mildly depressed," I wouldn't get too distraught over the idea of having to take medication for the rest of your life. There's nothing wrong with requiring medication, but if you're working things out and getting help, and discuss eventually discontinuing medication(when you're ready duh) with your psychiatrist, you probably won't be on it forever. Be patient.
As for a little more anecdotal advice, I can sympathize with the curiosity. I have Tourette Syndrome, and took heavy antipsychotics(haldol-the drug that they inject into flipping-out mental patients, the drug with the rare side effect of SUDDEN DEATH) for it. The severity of my tics fluctuate wildly throughout the day, are worse some days than others, and also change in larger patterns over months and years. I would always convince myself that if I stopped taking the Haldol, I'd discover that my symptoms were so mild that I'd never have to take it again.
posted by Juliet Banana at 11:19 PM on August 6, 2005

Another person chiming in - cold turkey is a very BAD idea; withdrawal sucks. (Attempted cold turkey on Elavil.)

Tried therapy? Could help.

Also, if you find yourself numbed, you can ask your doc to change your antidepressant. I was on Zoloft and felt like you could have told me my best friend had died, and I wouldn't have cried.

Now I'm on Paxil (more for anxiety than depression) and Effexor and they work great for me. Sometimes it's all about finding the one (or combination) that works for you.
posted by IndigoRain at 12:56 AM on August 7, 2005

Plenty of what I would say has already been covered here. Antidepressants aren't cut out for experimentation in the same way that other meds can seem to be. Talk to your prescriber if you want to change things, that's what they are there for. A ten minute conversation could save you from some serious unpleasantness.

To answer your other question, though? Yes and no. I've had to shift dosage on a couple of SSRIs because they sometimes make me drowsy. I know I'm below threshold when I have almost deliberately cruel nightmares, and when I'm touchy about personal space issues. The former is a newer development, but the latter absolutely hearkens back to pre-SSRI me.

And what the Vs both said, 100%.
posted by gnomeloaf at 9:21 AM on August 7, 2005

I took Seroxat (Paxil in the US) for a year or so, and the withdrawal took 3 months, supervised by my doctor. I was told that under no circumstances should I try to come off it or reduce the dosage myself.

For me the feeling of depression was in a way an absence of feeling - an inability to experience normal human emotions, including a total absence of joy. A kind of numbness and not-caring that permeated every area of my life - work, home, hygiene, even not caring about my cats (I still fed them but had no interest in them other than that - they went 'unstroked' for months.)

Talk to your doctor, is my advice.
posted by essexjan at 10:23 AM on August 7, 2005

I'm on Effexor and Wellbutrin (Celexa didn't work for me). If I miss two doses (taken mornings only) in a row, by mid-day of the second missed dosed I can feel myself coming unglued. While it's different than before drugs, it's still very unpleasant (I believe it's a combo of depression coming back and the side affects of withdrawal). In either case, it's nothing to mess around with without your doctor(s) supervision.

While I'm unhappy at the thought of (possibly) having to take anti-depressants forever, it's much better than going back to sizing up bridge abutments and playing with the kitchen knives.

And, for what it's worth, the doc has said that the longer someone is depressed and not on drugs, the longer it will take to get to a point where going off drugs is an option.
posted by deborah at 10:57 AM on August 7, 2005

I'm going to go against the grain here: I think you should experiment. Carefully.

If you had mild depression, then IMO it was very likely situational more than chemical, in that situational circumstance can effect brain chemical changes, and when the situation changes, the brain chemical balance will change.

This is why talk therapies can effect a cure for depression: by changing the way you deal with stressors, the way you view yourself, and the way you do things, you change the balance of brain chemicals. The change in brain chemicals and the change in behaviour go hand-in-hand to eliminate depression.

It is possible, then, that the pills helped eliminate the brain chemical disorder part, which in turn has helped solve the attitudinal/behavioural disorder, which in turn will eliminate the brain chemical disorder without use of pills.

Me, I believe I suffer major chemical-based depression. I've tried going off meds, and inevitably end up in that black pit of obsessive suicidal despair. Not a happy place. I don't think any amount of therapy would ever result in a non-medical cure: things are just too whack in my head.

But I still adjust my meds to suit my needs. In the deepest,d arkest depths of winter, I find I need a higher dose than during summer. I do this while remaining very aware of my inner thoughts: I am very vigilant against falling back into the pit. I also don't adjust dosage more than once every several months, because I believe it takes that long for things to truly settle out.

Currently I'm trying to find out if I can use less medication, so that I have higher energy levels and a greater range of emotion. I find my meds don't do anything to make me feel happy: they just keep me from wanting to cry and kill myself, and make me far more sociable, useful, and hopeful.
posted by five fresh fish at 11:18 AM on August 7, 2005

My doctors also indicated that having come completely off meds twice, and completely fallen back into the pit, that it was a sign I'd not be able to come off meds.

I've since very rationally decided that I sure as hell would rather be on meds forever, than dead.
posted by five fresh fish at 11:20 AM on August 7, 2005

Bear in mind that, because of serotonin's unique neurochemistry, it can take 3 to 4 weeks for the anti-depressant effect of a dosage increase to be felt. If your experimental cycles aren't respecting this fact, you are just whacking your neurochemistry up to no good end.

Bear in mind also that there's good data showing that when people come off SSRIs and become depressed again, the resulting depression is often treatment-refractory. I've heard no good explanation why this should be, just unsubstantiated hypotheses, but it's true anyway.

With these two facts in mind, then, I think that your experiments are unsafe and likely to cause trouble over the long run.
posted by ikkyu2 at 12:16 PM on August 7, 2005

Actually, studies have shown that exercise can be a good way fight depression. If you want get 'off' the meds then maybe you could talk to your doctor about stepping down the treatment correctly and then trying to replace it with exercise. But um, yeah, probably don't want to just go messing with your dosage like that.
posted by delmoi at 8:38 AM on August 8, 2005

After 5-6 years on low-to-mid Zoloft daily dose, I decided to slowly ween myself off during a 5-day vacation to Puerto Rico. Vacation was great. Withdrawl symptoms came on my return, including disequilibrium and other weirdness that lasted a week or so. Feel great now -- occasionally something will make me have depression-like heavy feeling in my head, but it only lasts a few days then goes away. Excercise, healthful diet, positive human communication, and lots of active interests all help. I also pop Omega-3s -- supposedly good for the heart and the brain.
posted by timnyc at 9:45 AM on August 8, 2005

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