Curious about others' experiences with anti-depressants for anxiety.
February 6, 2015 2:42 PM   Subscribe

What is taking anti-depressants for anxiety like for you? What were your concerns getting on the meds, and did you find that they were warranted? Do you regret or feel grateful that you tried the meds?

I have general anxiety disorder and am considering getting on a very low dose of zoloft, an SSRI, for it. I've had anxiety my entire life, was diagnosed several years ago, and have since done a really nice job of developing cognitive behavioral techniques for dealing with it. I exercise, eat healthily, work hard on keeping a steady support system, do things that are important to me and make me happy, keep a gratitude journal, and have been going to therapy for a decade on and off. All of this is to say that, thankfully, my anxiety is under control enough to the point where I can function, and I'm quite proud of who I've become and who I'm becoming in spite of having this disorder.

Nevertheless, I still get panic attacks when going through major transitions. I'm in grad. school and get so stressed out about things that I have a tough time concentrating for extended periods of time. Simplifying my schedule is, unfortunately, not an option for the next few months. I just have to get through it. I initially went to see a psychiatrist about concentration meds, but because these sometimes worsen anxiety and because the concentration issues seem to be anxiety related, she suggested I consider anti depressants.

I am and always have been very resistant to the idea of getting on anti depressants, but this is going to be a stressful semester, and when the anxiety gets bad, it makes my life pretty hard. The pros of trying the meds have to do with improved quality of life and (hopefully) a bit more calm as I navigate a very stressful stretch of months (graduating soon and looking for work while dealing with a zillion commitments; I don't even know in what city I am going to live come graduation). My fears: developing an addiction to the meds, being on the meds for years on end, side effects like increased anxiety and depression. Also, while I really dislike my intensely anxious spells, I really like about myself that I get very excited about things when I'm not super anxious, and I worry that the meds might strip me of this part of my identity.

So, I'd like to hear from others who have struggled with similar concerns surrounding antidepressants for generalized anxiety disorder and who have tried the meds. What has been your experience? Note that I am not seeking medical advice -- I have been looking up research on the topic and have spoken to both my therapist and a psychiatrist about this. I think it would just help me to hear about how others in a similar boat have experienced the meds. Thanks!
posted by anonymous to Health & Fitness (25 answers total) 24 users marked this as a favorite
Anti depressants are not like sleeping pills or narcotics: they aren't addictive and you don't build up a resistance to them.

I take an SSRI for anxiety. The effect is very subtle. You likely won't see a change in day-to-day life, but you will notice that your panic attacks no longer periodically appear.

However, you have to let go of you anxiety as part of your personality. Like i no longer have a burst of productivity in the middle of the night when I can't sleep because I am anxious. On the other hand, I am more productive throughout the day and don't get paralyzed by anxirty until it is too late.

I went off them for a few years, and I can say that I was the same mess that I was before, so I guess if you want to go back to that, it is unlikely that that there will be any permanent change.

I will say that after being on meds for the long term and taking them consistenly that I regard a lot of my past as a lot of wasted time because I could have handled the previous years of my life so much better with the meds.
posted by bright colored sock puppet at 3:03 PM on February 6, 2015 [11 favorites]

I think I had a very similar trajectory to you, mental health-wise; I was diagnosed with depression and ADD in college, but only ever took ADD meds, never SSRI's, until two years ago. I also had developed lots of conscious coping mechanisms along CBT-lines, working out, etc., and of course those helped. However, when I finally went on the meds (Lexapro) I LOVED it (still do). I had a lot of the same fears you did, mostly about being zombie-fied, etc, and I can honestly say that none of that has happened. In a way, I feel more like myself, because I can actually hear my own thoughts without the constant clamor of garbage anxiety thoughts (and until I went on the meds, to be honest, I didn't even realize how pervasive they were).

I have definitely not lost my ability to get super excited about things, and I still experience what I think is a normal amount of worry, in response to real problems. But for once, I don't wake up in the middle of the night, every night, replaying the past ten years-worth of marginally awkward social interactions, among other things.

I would recommend trying it. If you don't like it, or experience side effects, you can stop.
posted by Aubergine at 3:05 PM on February 6, 2015 [3 favorites]

Hi. I do not have general anxiety disorder, but my spouse does. He found a great Cognitive Behavioral therapist to work with who helped him a lot. However, therapy alone did not stop the random panic attacks (often several a week).

He went onto a low dose of an SSRI (in his case, 10 mg Lexapro) per day and it made a huge difference. He's back to his old self. He still has occasional attacks and symptoms, but they are manageable and not on the scale that he was enduring before the medication.

Give it a try. Start with a low dose. You may have to try a few SSRIs before you find the right one for you. My husband was put on a different one at first, but it disagreed with his stomach. Change won't come overnight. Work with a medical professional you trust.
posted by cleverevans at 3:09 PM on February 6, 2015 [1 favorite]

This question really registers with me. I have been to a counselor at various times in the past for different issues. The counselor I had was the type of person who was hesitant to refer me to a psychiatrist because I was still trying to go through all of my other options at that point. I didn't want to be medicated. I was very afraid that it would change who I was.

Then I went through a particularly bad episode due to a major life change almost two years ago. It wasn't until after I started taking Celexa that I realized I had spent my entire life worrying and panicking over things that other people were able to deal with in a healthier manner. Celexa helped me manage pretty much everything on the scale ranging from major to minor issues. Initially I went on it to take care of my big issues, but it ended up totally changing my day-to-day life for the better. I can actually apply for jobs now without talking myself out of it and telling myself that it's pointless. Yay! I can also see the effect it has had on the people around me. My mom even told me that she feels like she has her daughter back now. I just regret not doing all of this sooner.
posted by blixapuff at 3:14 PM on February 6, 2015 [2 favorites]

I started taking citalopram a few months ago for anxiety mostly, and I agree the effect is pretty subtle, but definitely helpful with keeping from getting into anxious thought loops. Not completely but a definite improvement. It also toned down my background anxiety levels considerably.

I haven't had any negative side effects though, which is good, but certainly not the case for everyone. I think it took about a month and a half or 2 months to really notice a difference. I just noticed things didn't seem as bad as before, on reflection. I have no experience with zoloft, but if you dont have any improvement after a couple of months or have some unpleasant side effects you could try another one. Do give it at least 2 months though. It has not impacted my ability to feel the full range of emotions or anything like that.
posted by polywomp at 3:15 PM on February 6, 2015 [1 favorite]

Barring a fatal allergy or gas explosion while you're at the pharmacy, the absolute worst thing that will happen is that you won't like it and you'll stop. It isn't heroin, it won't ruin your life. You can stop for any reason.

The but-but-butting is a symptom. It's the catastrophization instinct that comes with anxiety, that all things new are bad and will make everything terrible for always.

My husband is on an SSRI and in all likelihood will be for the rest of his life or until medical science comes up with something better. It is how we stay married, because his miserable unhappiness when he's not on it is not sustainable at close range. There is nothing wrong with that, and you shouldn't judge people - including yourself - for doing what they need to do in order to live their best lives.
posted by Lyn Never at 3:22 PM on February 6, 2015 [11 favorites]

Slightly different situation, but I went on SSRIs, and then switched to an SNRI, for depression, and once that was under control, my psychiatrist increased the dose to treat my anxiety, which I wasn't even really aware was there -- until it went away. It was like someone just turned off the chatty talk-radio background noise that had been such an everyday part of my life that I had never noticed how much it had been distracting me.

I was on the medication for several years, then stepped down the dose because my life changed enough that the depression wasn't triggered, and then I stopped the medication completely (almost a year ago) because it no longer felt necessary at all. The time that I spent on the medication without the anxiety gave me much clearer insight into what anxiety-free truly feels like, and I'm therefore generally much more aware much earlier when my brain starts spinning into anxious-mode, which makes it much easier to talk myself down or implement behavioral techniques to stop it. It also makes me more aware of the consequences of slacking off on preventative techniques (for me, exercising regularly and avoiding caffeine) in a way that I was not before.

There's something just extremely helpful about having that firsthand experience of "Oh, this is what calm feels like!" that helps one calibrate one's moods to stay close to that.

And I have been much more productive since my anxiety has been under control, because I don't spend such ridiculous amounts of energy worrying about things -- I just do what needs to be done and then get some sleep.
posted by jaguar at 3:37 PM on February 6, 2015 [6 favorites]

I take a SNRI (desvenlafaxine) - SSRIs had severe side effects (constant suicidal thoughts) which made them unworkable for me.

You're worried about potential effects of the SSRI? You can stop. I had very bad side effects, so I stopped. It was a difficult couple of weeks but there were no lasting repercussions, physically or mentally.

I too had worries about losing the hyperconnected enthusiasm for things I get sometimes, but the SNRI is not like that. My best description of its effects is to remove the spiralling thought patterns that come with anxiety and tend to paralyse. The negative self-talk and much of the paralysing fear is gone. It is not a complete solution. I have now come to see my anxiety as something akin to diabetes - I have to be careful with certain stimuli, make sure I take my medication and stay healthy, and there are some situations I will generally not be able to handle even if I'd like to.

I still get the physical manifestations of anxiety - tightness in chest, breathing, lethargy - but the SNRI prevents them from being mentally attached to anything. I can now reasonably think "Oh, my anxiety is acting up, I need to sit down for a minute/go for a walk/take a break" rather than "oh god i'm useless I can't do this I want to die". I do not think I will ever be rid of these. I was also prescribed mild sedatives, but their effects are much too strong for my tastes (I don't fancy sleeping 12 hours every day - I believe I'm unusually sensitive to depressants) and the improvement more incremental. These are reserved for emergencies such as insomnia over multiple days.

It's not an immediate process - the onset took a couple of months until I was really noticing differences - but it's worth sticking it out.
posted by solarion at 3:47 PM on February 6, 2015 [1 favorite]

Hello. I can relate to what you are saying. I am going to get kind of personal but I hope it will help you get the perspective you are looking for.

I'm 38, and I first started taking Zoloft eight years ago, after learning that what I had always called "depression" was really a consequence of generalized anxiety. I had not realized it was abnormal to worry so much about so many things. I had resisted the idea of taking antidepressants for years, determined that I could and would sort my brain out on my own. Of course it is difficult to use broken tools to fix your broken tools, and life just kept on feeling like a struggle, like I was never quite hitting my stride.

My life got much, much better after I finally started taking Zoloft. I'm still me, and I'm actually a *better* me, because I don't get in my own way all the time. I can just make decisions and act, and trust that it will probably be fine. I don't have to think through every possible outcome and come up with a solution for every possible problem before taking the first step. I don't spoil my own happiness by assuming that every good thing has some fatal flaw. I just live, and life is generally pretty good.

What is taking anti-depressants for anxiety like for you?

It's like nothing, most of the time. I'm just me, living my life, doing my things. Early on, it felt like a safety net underneath my brain. It made psychotherapy actually work, for the first time ever, since I no longer worried myself down into a horrible depressive pit whenever I started thinking about the sources of my unhappiness. But that's long past, and really, it's just... when life is good, life is still good. When life is tough, it's still tough, but instead of getting stuck in an obsessive loop and freezing up unable to act, I can make a reasonable decision and get on with it. The emotions are all still there, they just don't overwhelm and exhaust me anymore.

I haven't been taking Zoloft continuously - I've tapered off twice. Quitting cold-turkey isn't fun, because there are some annoying physical symptoms, but when I ramped down gently, a couple weeks at a time, I simply didn't notice any change. Nor did I feel any differently after I had completely stopped; I was just me, living my life as usual.

I'm back on it now because I went through a really rough patch a year ago and I haven't bothered to taper it down again yet. Bad job situation, breakup, motorcycle crash, divorce - it was a lot of stress. I was functioning, alright, but it was *hard*, and I felt empty and drained all the time. No creativity, no spark. Getting back on Zoloft didn't fix that but it felt like pouring oil on my mental gears - I still had to do all the work but it wasn't so hard to get on with it anymore. I kept on truckin' and life got better and I weathered my way through it and here I am. I'll probably taper off Zoloft again this spring, since I don't think I need it right now, but I sure am glad to have had its help during the last 14 months.

What were your concerns getting on the meds, and did you find that they were warranted?

I was worried that my personality would change. I worried that I would lose my emotional highs along with the lows. I worried that I would stop being creative. I worried that I would become dependent on a drug that caused some kind of undesirable side effects, and that I would end up feeling like I had just made my problems worse.

I don't think it was foolish to have these concerns, but it really hasn't been like that at all. Most of the worries now look, in retrospect, like part of the pattern of anxiety itself. It's the kind of thing I used to wonder about practically every decision. Really, it's not a big deal at all. You try it, and if your experience is like mine, you'll start to feel better and life will get easier almost immediately, and you'll wonder why you waited so long. Or maybe you won't be so fortunate, and nothing will seem to happen, and after a month or two of taking pills for no apparent reason, you'll stop. No big deal. Or maybe it will make you feel crappy, in which case, just stop right away! It's not like you become permanently dependent on these things.

Well, okay, so why have I spent most of the last eight years taking this drug? Doesn't that make me dependent on it? No! I could totally go back to the way I was and live the way I used to, plus some years of experience and some healthier thought patterns. I'd still be better off for the experience. But I keep taking it because it feels good. It makes my life suck less. I could choose to have my life suck more, but why would I do that? Sure, if I were stuck on a desert island and couldn't get any Zoloft, well, then I wouldn't take any Zoloft - but there is no way in which I would be worse off, in that situation, than if I'd never started taking it. I'd just be lacking the help it gives me.

Do you regret or feel grateful that you tried the meds?

Grateful, fuck yeah. It let me hit the throttle and actually start LIVING. My only regret is that I didn't start sooner. I could have saved myself and everyone around me a whole lot of stress.
posted by Mars Saxman at 3:53 PM on February 6, 2015 [13 favorites]

I am on a 20mg dose of citalopram (Celexa.) I only wish I had done this sooner.

I had dealt with my anxiety in the past by trying to eliminate anything I thought would provoke anxiety. So in college I'd do my papers early so I wouldn't miss deadlines. I became a massive control freak about things so that I knew as much as I could about a thing to anticipate any way it might go tits up. I had a very Internal Locus of Control.

I was convinced that every thing was in my realm to control and if something went wrong, I must have screwed up somewhere. I was also VERY stressed out at work when things weren't happening the way I thought they should, or if something was unfair, or if I was working really, really hard and not getting recognized.

I was a freaking, stressed out mess.

Then I started getting fearful of freeway over and underpasses (I lived in California during the Loma Preita earthquake, it wasn't that far off base,) tunnels, bridges, mountainous roads. Bugs, snakes, my house having Chinese dry wall. Obsessing about little things that I intellectually knew were little things but my stupid brain can't let go of.

It got worse as I got older. I started having panic attacks in the very early morning hours when I started teaching. I'd wake up feeling sick, and there would be a stupid song twirling around in my brain and I couldn't get it out of my head.

Awful, awful stuff.

Then I started on Prozac, and it was so freaking awesome! But then I developed an allergy so we switched to citalopram.

I will admit that I'm not as sharp as I used to be and the writer's block is kind of a bitch. But I would not give up the lack of horrifying stress that was feeling and that clouded my life.

Try it, see how you feel.

Join us...join us....
posted by Ruthless Bunny at 4:27 PM on February 6, 2015 [8 favorites]

My spouse is on Lexapro for GAD and his experience has been very similar to Aubergine's.
Seriously, my brain does not do this to me and if it started I would medicate in a heartbeat. I posted about my husbands exp not too long ago on a thread written by someone who'd just had a baby and had asked a similar question. Good luck!
posted by jrobin276 at 4:42 PM on February 6, 2015

I won't bother writing a long description as everyone above has already expressed it much better.

I had the same worries about becoming emotionally sedated, etc., but after going on zoloft for GAD, one day I was joking around with my wife and I realized I had just had my first good honest belly laugh in over 5 years.

Nthing the notion that the SSRI has removed the ugly GAD noise and let me feel like me. And I really really really wish I had talked to a psychiatrist years ago and gotten this treated earlier instead of agonizing endlessly about whether or not I should.
posted by duoshao at 5:02 PM on February 6, 2015 [2 favorites]

I was a medical transcriptionist in a hospital for a number of years and I noticed that every other person who was admitted was on an antidepressant or a psych med of some kind. I thought it was pretty disturbing that pharmaceuticals were being used by so many people as a coping mechanism.

Then my world crashed into a thousand pieces and, even though I'd had some tough stuff before and thought I could handle whatever came along - well, I couldn't handle this without help. They put me on Wellbutrin at first and it was mind-boggling how clear-headed I felt - and there was no fear, no cold and clammy stuff, no hiding or trying to escape trouble, no misconstruing everything said to me as criticism, no overwhelming negativity. But I didn't feel euphoric, either, which put my other fears about antidepressants to rest - I had no interest in swinging from chandeliers after all.

I had a bad reaction to Wellbutrin after a couple of weeks; I have a history of petit-mal seizures with a couple of grand-mal ones, and I started having a hard run of the petit-mal ones (now called absence seizures, I think). So they took me off the Wellbutrin and put me on Celexa, which didn't have any effect on me at all. Then Zoloft - nothing. Then I gave up and went a couple more years with nothing, during which time I fell back into the same patterns of fear and worry and sadness and hopelessness I'd felt for years. Then, again, things got considerably worse and I remembered how much the Wellbutrin had done for me so I asked to start an antidepressant again.

I was put on Lexapro and it's been a godsend for me. I can still get upset if there's a reason to, I can still cry or feel very sad if there's a reason to, I can get angry, too - but what I don't do is stack up all the terrible things that have been said to me or done to me and keep a running list of misdemeanors and felonies in my brain to rehash every time something new pops up. Each little misery is its own little misery now - which means life is a thousand times easier to manage. It isn't that I've forgotten anything - not at all - but before I felt like I was in a hole and every time I stuck my head up out of the hole there were monsters of fear and worry and loneliness and financial disaster and anger and rejection and all that stuff just waiting to attack me, so I'd retreat back into the hole. Now the monsters are just little things and I can step over them.

I hope you go ahead and try the SSRI or whatever they prescribe for you. As others have said, they're not something you get stuck on - you can taper away from them anytime, but they've sure made a difference for me and I'm sure they will for you, too.
posted by aryma at 5:27 PM on February 6, 2015 [2 favorites]

It got worse as I got older.

Oh, right, I forgot about this... See, I have a lot of willpower and am enormously stubborn, so I have been able to make it through a lot of stressful situations. My teen years were about single mindedly getting my out-of-control emotions under control.

Yada yada yada. It doesn't last forever, and the challenges I faced in life started to exceed my ability to beat back the anxiety that was being thrown at me as I got older. It's kind of easier when you're young and have fewer balls to juggle. Now I wonder what all that energy I had could have been used for other than battling anxiety and stress if I had been taking medication.
posted by bright colored sock puppet at 5:42 PM on February 6, 2015 [3 favorites]

My experience was quite a bit different. I went through some difficult times during the late 1990s. My main problem was depression, but I also had fair amount of anxiety. I tried a number of different drugs, both alone and in combination with each other. My therapists and I spent probably four years trying different drugs. None of them worked, either for the depression or for the anxiety. And Wellbutrin made my anxiety much worse. A number of drugs also made me very tired, to the point where I had trouble making it to the end of the day at work. Worst of all, one of the drugs (I think it was Paxil) caused me to gain a great deal of weight. I've been off all the medications since about 2001, but I lost only part of the weight that I gained.

I do regret trying the drugs. I think my life would have been better if I had tried other approaches instead.
posted by akk2014 at 6:31 PM on February 6, 2015

SSRIs aren't addictive in the way that benzodiazepines are, but there can be discontinuation effects, and coming off them can be more or less uncomfortable - depends on the person and the drug. I was on Paxil, which is the worst SSRI for this issue, and coming off it sucked, fwiw, but again, it will depend and you're not being offered this in any case.

Something to be mindful of when reading about people's experiences (including mine) is that it's not always possible to determine whether or not, or to what extent, drug X had Y or Z effect, before or after. Some effects are more obviously related to the drug (e.g., discontinuation effects, weight gain (which happened to me) ). Others are less clear - effects of maturation/aging, placebo, other potential concurrent influences like therapy, changes in life situation, memory bias, and the resurgence of symptoms (or new ones) are hard to pick out.

I experienced emotional blunting and apathy while I was on it, that seems clear, and I think that it affected my ability to be creative (or perhaps my interest in creative activities, or my motivation to bother - I don't know). I still don't respond with as much intensity to art, books, films, or music as I did before. Again, I can't say for sure whether the persistence of this effect is due to the drug, or a resurgence of symptoms, or what. I know it started with the drug, and has carried on since, through long periods in which I was symptom-free. Music, especially, had always been pretty important in terms of my self-definition, so that's felt like a real loss. Maybe I just don't care about films or music as much anymore for other reasons (maybe it happens to everyone with time), hard to say.

Some clinical research suggests "apathy syndrome" is reversible; other stuff says it depends. (It's known that sexual side effects can persist past discontinuation in some, unclear why.) I'm not sure there's a clear answer to which mechanisms might be involved either way. I think a lot is still unknown about the long-term effects, for good or ill.

I don't want to freak you out, this has been my experience, on/after Paxil. Obviously, there are others who haven't experienced this with other SSRIs (or with Paxil). Many have had good experiences. It's a crapshoot. I don't think I'd be up for taking my chances again, myself, and I very often wonder how I'd feel now if I hadn't taken Paxil.
posted by cotton dress sock at 6:45 PM on February 6, 2015 [1 favorite]

After 40+ years of health anxiety my psychiatrist suggested I start taking citalopram. About 5 years before I had started having anxiety attacks fairly frequently, and was miserable because it seemed as though dying would be just be easier than dealing with the anxiety.

After my doctor suggested it, I asked him if he thought the medication could actually help me and he said, "My patients say the anxiety comes up on the porch but doesn't go through the door."

The first dose of 10 mg was too high for me; I went down to 5 mg a day and instead of waking up to a cancer day or a stroke day or a heart attack day I just wake up. Instead of going to sleep obsessed with death, I just go to sleep. Instead of having frequent anxiety attacks I've had only 2 in the two years I've been on this medicine. And they were manageable, until the ones I used to have. I could keep it together while they were going on.

No one can know how you will respond to a particular medication until you try it. It may work, it may not. But for me, the risk was worth it. My only regret is that none of my docs suggested it years ago. I suffered for years, possibly unnecessarily. I don't wish that on anyone.
posted by Bella Donna at 9:40 PM on February 6, 2015 [2 favorites]

I'm on an SNRI, which does the same thing as an SSRI and also inhibits norepinephrine (the stress hormone). It's Cymbalta, if you're curious.

For me, it handles my depression, and it makes me less tightly wound. The way I describe it is I have more of a shield up that gives me the time and space to think and react. I'm still recognizably me and my thought processes are still there, but it gives me the time and space to step back and react rather than just flailing around in a panic.

I'm very happy on it and having very few side effects.
posted by Ghostride The Whip at 10:30 PM on February 6, 2015

I've had trouble with anxiety and depression since adolescence. I started seeing a counsellor near the end of university, stopped when I graduated, and spent a few years getting things done despite recurrent anxiety. About three years ago, I was in a very stressful work situation (it was grad school, in fact) and both the anxiety and depression came roaring back, making it impossible to carry on as I had been. I started seeing a therapist and tried sertraline (generic Zoloft) for nearly a year, despite it not actually doing anything for me. Lesson learned: don't take something for a whole year if it's not doing you any good! It does take a while for SSRIs to have a therapeutic effect, but you should feel something within a few weeks or months.

After that I switched to venlafaxine (generic Effexor), which is an SNRI. I've found that it has a good effect on both the anxiety and the depression -- I do still get low and worry about things, but it seems to cap off those feelings at a manageable level. I very much agree with someone upthread who called it a safety net for the brain. I'm much more functional than I was without it, although of course therapy has helped as well.

Both sertraline and venlafaxine reduced my sex drive, but I haven't had any other side effects from the venlafaxine. MeMail me if you want to hear more details on that, I guess. Sertraline gave me acne (though this doesn't seem to be very common) and very mild nausea right at the start. That kind of side effect usually goes away after a week or so, so it's worth persisting if you get it.

At some point in the future I might try coming off venlafaxine, but if it turns out I have to take it long term, I'm perfectly satisfied with that. (Barring a catastrophic failure of society that means they stop manufacturing it, of course, but I have to take other medication daily so I'd already have a problem in that case. (And it's not especially likely.)) There are withdrawal effects from coming off antidepressants, but it's not an addiction, and for me at least, the sertraline withdrawal was a lot easier than I expected.

From what I've heard, repeatedly going on and off antidepressants at quite short intervals makes it more likely that they will stop working for you, so I would advise not doing that.

I haven't noticed any dulling of my creativity or ability to get interested and excited in things. To be perfectly honest, my depression and anxiety had already done a number on those by the time I started taking antidepressants, so the only way to go was up. :)

I would advise you to try the antidepressants, especially if you have a doctor you trust and can communicate with. They will most likely start you on a small dose and increase it if necessary, and you can always stop if you don't like it. If you can, let somebody who knows you well know that you're trying it: I've found it helps to have an outside opinion on whether the antidepressants are having any effect, because it can be hard to judge for yourself, especially at the beginning.
posted by daisyk at 8:29 AM on February 7, 2015

what I don't do is stack up all the terrible things that have been said to me or done to me and keep a running list of misdemeanors and felonies in my brain to rehash every time something new pops up.
Quoted for truth. I used to have crippling anxiety: I'd wake up and feel "speedy" and weird and bad. Now I don't. I personally have had a lot of luck with 50mg of Zoloft every morning; I don't have any of the negative side effects, but the anxiety cloud has now been lifted from my life.

I can still feel. I am more creative than I used to be. I am happier. I am just myself without the thing that crippled me. Like many others here have said, I only wish I'd tried it sooner.

YOU MAY NOT HAVE THE SAME EXPERIENCE. But you might try it and see what happens. I kept a journal for the first few months on the SSRI and that helped me figure out that it was really working. Now that I am about six months out it's so, so obvious that it works, but it was hard to see the change when I was still inside the change.

Take care.
posted by sockermom at 8:48 AM on February 7, 2015 [1 favorite]

I'm on an SNRI, which does the same thing as an SSRI and also inhibits norepinephrine (the stress hormone).

SNRIs actually increase available norepinephrine by inhibiting norepinephrine reuptake in the brain (the process that reabsorbs neurotransmitters that have been released), the same as they do for serotonin. Norephinephrine is one of the stress hormones, but stress hormones have a role to play in resolving stress as well. Norepinephrine also helps control alertness, focus, and motivation, which can often be negatively affected by depression and anxiety, and SNRIs seem to encourage dopamine availability as well, which seems to help with attention, learning, and reducing social phobia. Serotonin helps regulate mood, sleep, and appetite.
posted by jaguar at 9:23 AM on February 7, 2015

I just switched from wellbutrin to zoloft after realizing that the wellbutrin had completely stopped working. My only side effect from zoloft was sleepiness in the first month, and some weight loss.

The benefits have been amazing. While I was on wellbutrin or unmedicated, I needed to be so careful - careful to sleep and eat right, careful to not get myself in overwhelming situations, to exercise, to meditate - and if I dropped the ball, my mental health dropped off and I would spiral downward. It was so much pressure, all the time, and I resented it. And now that's not there. I still engage in self-care, but it's easy and I do it because I should have nice things and do nice things.

The background UGH of my life is gone. I have more patience, more energy, more kindness - I don't need to rely on my emotional reserves any more. I am similar to you in that I always loved my enthusiasm when it showed up - now I'm enthusiastic about almost everything. I'm so much less self-conscious. Everything is just easier.

It really feels like my brain sort of unclenched, and I've been set free. I honestly didn't know how it felt to be not depressed; I assumed that everyone was kind of mucking around at my level of anxiety and depression, but...nope. It turns out that most other people weren't facing a daily struggle.

So, that's been my experience. Best of luck; I hope you choose what's best for you.
posted by punchtothehead at 10:37 AM on February 7, 2015 [2 favorites]

"It wasn't until after I started taking Celexa that I realized I had spent my entire life worrying and panicking over things that other people were able to deal with in a healthier manner. "

This. I wasted thousands of dollars and years in university, after panicking outside of my classroom doors, refusing to go inside, and then getting a string of Fs I felt was inevitable. There was lots more too — after some time, generalized anxiety culminated with a particularly bad string of panic attacks, which is what prompted me to seek out a doctor. It took about two months for the drug to take hold, but I haven't looked back. Everything in my life is better. I don't have unbearable fits of emotion. I'm a better husband/partner, a more stable person and can better participate in the day-to-day life that seems normal for everyone else but could often be agonizing for me.

I take 20mg of citalopram (Celexa) daily, and have for the past four years. Costs me $12/month at Costco. So that's about $150/year to not feel crazy, which is a price I'm very happy to pay. I like to think I make it back by not kicking holes in walls or throwing my cellphone into the wall every few months.

I've had no side effects, other than I've found I don't have the high-highs or low-lows. It's not that I feel flat, as you sometimes hear, but I find my ability to get really happy or really sad to be limited. I'm like a volume knob that only goes from 3 - 8, instead of 0 - 10. But that can also be an advantage, so take it as you will.

Give it a try. If it doesn't work for you, stop.
posted by lukez at 4:53 PM on February 7, 2015 [1 favorite]

I'm on Cymbalta for GAD and not depression, and have had similar experiences to many people in this thread. I only started medication because I was already doing all of the non-medication things which are supposed to relieve GAD, and my doctor proved that I was putting in so much genuine effort but only seeing mild results. He said I knew what I needed to do, but the GAD was stopping me from doing it properly. I was worried I wouldn't be myself anymore, and not keen on the expense and effort involved in taking daily medication for the rest of my life.

The result has been very satisfying. It relieves the symptoms *just* enough that I can actually successfully do the CBT techniques, and exercise and sleep the way I have been trying to for years. Finally I'm getting useful change in ways I'd almost given up on thinking were possible. I had unmanageable physical side effects on the full dose, so I'm on a reduced dose and sometimes I feel that it's not quite enough for the GAD but I prefer not to get the intrusive side-effects. Maybe that will change in future but I'm happy with it for now.

The expense and effort are nothing compared to the free time I have now that I'm not a tight ball of stress every time I have a negative experience or have to make a decision.

I had to adjust my perception of my personality, and some days I still feel a bit lost - who am I when I'm not anxious? But this is a comparatively fun problem to have compared to GAD!

The worst that can happen is that the medication disagrees with you and you get awful side effects. This is shitty, but has a practical solution: you just have to see your doctor and say "let's get me off these meds and try something else". The potential benefits are so useful that I think it's worth your while to try the medication as an experiment to see if it will work for you.
posted by harriet vane at 4:47 AM on February 8, 2015 [1 favorite]

One final thought: after I was settled in to my medication, I couldn't quite believe how much unnecessary anxiety I'd been putting up with before. My digestion problems and skin irritations and frequent random headaches all went away, just because they were the a side-effect of the constant background anxiety. It was very freeing, even when I still had crappy days. Other people don't have to deal with this shit! You don't have to either, especially when you're dealing with sources of genuine stress that anyone would find difficult.
posted by harriet vane at 4:55 AM on February 8, 2015 [1 favorite]

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