How Do I Antidepressant? Tracking success/side effects of medication
May 3, 2015 9:37 AM   Subscribe

I'm working with a psychiatrist to try antidepressants for anxiety in combination with my ongoing work with a therapist. He's started me on a low dose of Cymbalta and says I may need to try a variety of antidepressants before I find out what works. If you take medications for mood/anxiety, how do you track their effects on you to figure out if something is working or not?

I have anxiety and my sense of my mental well-being changes a lot depending on what I'm currently anxious about. (For example, if I'm walking in nature and feeling beatific, I might feel like LIFE IS AMAZING AND WONDERFUL, and feel like anxiety is not a problem. But then an hour later and I get a terse email from my boss I'm like ALERT ALERT DISASTER PANIIIIIIIC WE'RE ALL GONNA DIIIIIE.) I'm very moody and emotional and tend to lose perspective very easily about things that happen outside of my control.

If you have anxiety, how do you track your intangible feelings to see if medication is actually working? I understand that it will be pretty simple to track side effects like headaches, sex drive, etc. But moods and panic are fleeting. Is there a way to log my moods so that when I see the psychiatrist next I can tell him how I've been feeling? Or, do you track tangible effects only, like sleep quality, tightness in your back, tingly hands, instances of lost temper?

Bonus points for strategies that involve apps, alarms, etc. so that I'm not just relying on my own willpower.

Thanks in advance!! Trying not to be too anxious about anxiety medication... :/

Throwaway email: mefiallaboutperspective@gmail.com
posted by anonymous to Health & Fitness (10 answers total) 20 users marked this as a favorite
 
What worked for me was to have a journal/log where I would write down where I was having and anxious or depressive episode. Nothing extensive, just a log entry like: "4/25: got really upset about X today"

The sign that the medication was working was not that I had some sudden change in perspective that everything about life was wonderful, but rather that I no longer was writing those sort of entries in my daily log.
posted by bright colored sock puppet at 9:51 AM on May 3, 2015 [1 favorite]


Mood journals or similar apps help. I use two free apps, Pacifica and Optimism, that are great for tracking mood stuff. They don't specifically ask about side effects but both have places for notes.
posted by mermaidcafe at 9:53 AM on May 3, 2015


I had similar experiences as bright colored sock puppet. I was already logging incidents (for my CBT therapist) and after a few weeks of drugs noted that I was making many fewer entries per day.
posted by holyrood at 10:21 AM on May 3, 2015


One of my high school students was trying meds and used her favorite tv show as an anxiety marker; "Didn't need to watch Arrested Development today or watched it and laughed or watched it and didn't laugh or couldn't focus enough to watch it at all."
posted by kinetic at 10:25 AM on May 3, 2015 [2 favorites]


A friend of mine went on an SSRI as his marriage was dissolving. A month or two later he noticed that as the ADX started working, the elaborate color-coded spreadsheet of sarcastic comments and dire predictions vis-a-vis his marriage first stopped being color coded, then dropped of in entries, until it turned into a dry, dispassionate series of notes about the logistics of separating.
posted by chesty_a_arthur at 11:50 AM on May 3, 2015


Yep, I agree with the above posters. When I first started logging my moods I was confused because how was I supposed to know how the meds were working with every little mood swing? But it comes down to this... everyone has their ups and downs day to day, the idea is to note how often they happen and how these mood shifts affect our lives overall.

With me, I knew the medicine was working for my bipolar when I felt as though I didn't need medicine for my bipolar because damn, wasn't I feeling "normal" now? I still take my meds of course, but that's when I knew I hit the sweet spot and didn't need to be on the med-go-round anymore. And, like the previous posters, I didn't feel the need to log my moods anymore.
posted by patheral at 12:19 PM on May 3, 2015 [1 favorite]


I have anxiety and my sense of my mental well-being changes a lot depending on what I'm currently anxious about. (For example, if I'm walking in nature and feeling beatific, I might feel like LIFE IS AMAZING AND WONDERFUL, and feel like anxiety is not a problem. But then an hour later and I get a terse email from my boss I'm like ALERT ALERT DISASTER PANIIIIIIIC WE'RE ALL GONNA DIIIIIE.) I'm very moody and emotional and tend to lose perspective very easily about things that happen outside of my control.

For me, one of the major signs that the medication+therapy was working was that, for the first time in my life, this exact sensation (the inability to imagine myself outside my current mood) subsided. I was able to think to myself, "I am upset about this email now, but I will probably be less upset about it later." Or "I am happy now, on this walk, and it's true that later it's going to be annoying to deal with that stressful email but I'll do it this afternoon and after that I'll feel better again."

This combined to dramatically shift away from my usual mindset, which was something along the lines of --

OH MY GOD MY BOSS IS ANNOYED WITH ME LIFE IS TERRIBLE THIS IS AN UNENDURABLE EMERGENCY I MUST ESCAPE NOW oh wait what a lovely walk just kidding everything is absolutely fine and good what the hell is wrong with me that I don't recognize how good I have it I feel so guilty I need to go to yoga more and meditate and exercise because it's definitely my fucked-up moods that are the problem otherwise everything is perfect OH NO ANOTHER STRESSFUL EMAIL ALL IS DARKNESS DEAR GOD PLEASE RESCUE ME FROM THE UNENDING PARADE OF SUFFERING THAT IS MY LIFE.

to something closer to:

"Overall, the past few days have been a mixture of good and bad, but taken together, there has been an undue amount of stress and unhappiness so I think it's probably time for me to change my situation."

I never did any organized mood tracking - the change was pretty clear.

I also woke up one Saturday morning and the sun was shining and I felt...different. It took me a second to realize why. And then I thought, "Oh. It's that I'm not worried about anything." And then I thought, "I haven't felt this way since I was ten years old."
posted by pretentious illiterate at 12:35 PM on May 3, 2015 [9 favorites]


I have anxiety that is usually managed by exercise and diet and sometimes with as-needed medication. I had a bout of it recently (I had been sick, I was not managing that well, I didn't exercise as much or eat as well) that was unpleasant and I wound up seeing a therapist. For me the differences were things that were really obvious, not so much about my moods but about the day to day things in my life I could or could not manage. I tend to get irritable when I get anxious.

- crossed the road without getting angry at cars or myself for not being able to cross the road
- went to supermarket and left not angry at everyone
- did not give anyone the finger as I was driving to or from work

And the other stuff that people are saying which is more like "dealt with some bullshit and was annoyed by it but 15 minutes later I was not annoyed by it AS MUCH" For me the big deal was that the anxiety rush in was similar but the dissipation was also similar which was not at all what was happening before (I'd get it and could not get rid of it for hours or days) and not what I was used to. Worrying it's never going to go away is part of managing anxiety, what is weird is when it starts to go away and you don't even notice it.
posted by jessamyn at 2:12 PM on May 3, 2015


My anxiety has presented as stomach pain the first time or obsessive repetitive worrying the second time. I could tell that the meds were working when I could think about applying for a job without stomach pain. Now, when something stressful happens, I can tell myself what solutions I have, plan it out and then stop worrying about it.
posted by stoneegg21 at 2:22 PM on May 3, 2015


Ask for feedback. My husband can help give me insight into my moods. I give his feedback to the doctor, especially when he says I am worse and need to see the doctor.

I never bothered tracking my moods. However I have changed meds plenty of times. Reasons included:
- subjective experience of persistent low mood
- the symptoms of depression: fatigue, lack of energy, poor motivation and concentration, not enjoying anything
- crying spells
- irritability
- insomnia
- cognitive errors and lapses
- night time seizures (!!!)
- pregnancy
- weight gain
- bicycle accident
The issues are fairly easy to remember at appointments.

it's not necessarily your moods that determine the success or failure of a given drug. It is also the side effect profile, drug-drug interactions, and other health conditions.

I know if the meds are working if I can carry out a full day of activities without mood disturbance and sleep all night. I do not need a journal for this. I do not think my treatment would have materially changed over the last decade by keeping one.
posted by crazycanuck at 8:22 PM on May 3, 2015


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