Seeking accounts of antidepressant use from people who were skeptical
October 23, 2017 11:09 PM Subscribe
I'm hoping to hear about how it went for you being on antidepressants if you took them despite doubts/misgivings. The reasons are about what you'd expect.
My history with antidepressants: I tried three SSRIs in rapid succession in grad school when I was having my first really bad anxiety/panic. Paxil kept me up for three straight days unable to do anything except lie on a couch shaking my foot (it's called akathisia, it turns out); Zoloft didn't seem to do much except for sexual side effects; Serzone didn't seem to do much except mess up my ability to fall asleep for a year. One would not call it a successful experiment. I started getting less unhappy when I made some big changes, foremost among them: dropping out of my grad program.
My history with various kinds of unhappiness, condensed: I'm an anxious guy and have been to varying extents since I think right after college. People have more than once called me Eeyore, though internally I think of myself as more like to be anxious than depressed, as I understand those things as separate problems. Anxiety more often causes me problems, I would have said--I haven't been on a plane in many years because I can't, whereas I sort of depressively hate things like my job but still go and am functional.
The problem right now: this cocktail of depression and anxiety feels like it's preventing me from doing stuff and wearing on friends/significant other. I could plod on like this for the rest of my days but it's not fun and it's bad for me and possibly those around me.
I've been in therapy with mixed results but can't now, yay Kaiser. I don't find I'm able to get into meditation or exercise reliably. I asked my MD for a prescription for Wellbutrin and he wrote it and I filled it. I was going to start taking it Saturday but...I didn't. I'm probably going to do it but I'm just hesitant. It seems to me that while clinical depression is obviously real, most depression is probably life stuff rather than brain chemistry. Which doesn't matter if it works, but I'm just having trouble going through with it.
Has anyone been me and gone and and done it? Thanks. Anonymous just out of some various misgivings. Did I mention I'm anxious and have a big box of misgivings?
My history with antidepressants: I tried three SSRIs in rapid succession in grad school when I was having my first really bad anxiety/panic. Paxil kept me up for three straight days unable to do anything except lie on a couch shaking my foot (it's called akathisia, it turns out); Zoloft didn't seem to do much except for sexual side effects; Serzone didn't seem to do much except mess up my ability to fall asleep for a year. One would not call it a successful experiment. I started getting less unhappy when I made some big changes, foremost among them: dropping out of my grad program.
My history with various kinds of unhappiness, condensed: I'm an anxious guy and have been to varying extents since I think right after college. People have more than once called me Eeyore, though internally I think of myself as more like to be anxious than depressed, as I understand those things as separate problems. Anxiety more often causes me problems, I would have said--I haven't been on a plane in many years because I can't, whereas I sort of depressively hate things like my job but still go and am functional.
The problem right now: this cocktail of depression and anxiety feels like it's preventing me from doing stuff and wearing on friends/significant other. I could plod on like this for the rest of my days but it's not fun and it's bad for me and possibly those around me.
I've been in therapy with mixed results but can't now, yay Kaiser. I don't find I'm able to get into meditation or exercise reliably. I asked my MD for a prescription for Wellbutrin and he wrote it and I filled it. I was going to start taking it Saturday but...I didn't. I'm probably going to do it but I'm just hesitant. It seems to me that while clinical depression is obviously real, most depression is probably life stuff rather than brain chemistry. Which doesn't matter if it works, but I'm just having trouble going through with it.
Has anyone been me and gone and and done it? Thanks. Anonymous just out of some various misgivings. Did I mention I'm anxious and have a big box of misgivings?
This has been me.. Taking the pills is not magical - I still am working with my doctor to find something for me to take in addition to the Wellbutrin, and I went through several types of medications to find one I could tolerate. But it has made the difference between me not being able to go in to work, and my making it to the office every day.
Now, you are not wrong - a lot of it is life stuff. When I stopped going to in work, it was a terrible work place. A non-depressed person would not have enjoyed themselves there and would have taken steps to leave. But as a depressed, med-free version of myself, I found every day utterly draining and demoralizing to the extent that I felt and saw myself as worthless. And rather than being able to recognize that it was a shitty place to work, the conclusion I drew was that I was a useless waste of a human being. With that mindset, I was not able to start looking for something else, or start volunteering somewhere or begin networking in my industry. I just sank like a stone - stopped going in to work, just lay like a lump in my bed at home. The effect is the same as if I had quit (like a non-depressed version of me might have), except that leaving a job like that reinforces the terrible stories inside my head of the garbage person that I am. So even when my circumstances changed - no longer going in to the terrible job - my mood did not, because whether I was going to work or not, I was garbage.
To say in another way - for me, the depression exists outside of events in my life. If I fail at something, it is because I am terrible. If I try again and succeed, it was obviously not that difficult to begin with, I am lazy and useless for not accomplishing it to begin with, and thus, I am still terrible. So changing circumstances did not change the narrative in my brain. There was never a new leaf.
The meds allowed me to break from these narratives (somewhat), so I can recognize that a workplace was toxic and I am better off rid of it. It increases my resilience, so I can recover from a setback without going through a lengthy review of all of the ways I have failed and will continue to fail in my life. I have a new job, and I can more clearly see that some parts are good and some parts are dysfunctional, but also I can recognize that I am not responsible for fixing all of the dysfunction. I just did not have that clarity before I started taking the meds.
As I said above, I am still in the process of getting a more effective combo of meds. There are still a lot of times when I am swamped by my own negative thoughts. But I feel that since I am the constant in all life scenarios I encounter, no amount of new jobs or study programs or moves will really change anything unless I can change / overcome my depressive thoughts. That is what the meds help me with.
Whatever you wind up doing, I wish you the best of luck.
posted by that possible maker of pork sausages at 12:53 AM on October 24, 2017 [11 favorites]
Now, you are not wrong - a lot of it is life stuff. When I stopped going to in work, it was a terrible work place. A non-depressed person would not have enjoyed themselves there and would have taken steps to leave. But as a depressed, med-free version of myself, I found every day utterly draining and demoralizing to the extent that I felt and saw myself as worthless. And rather than being able to recognize that it was a shitty place to work, the conclusion I drew was that I was a useless waste of a human being. With that mindset, I was not able to start looking for something else, or start volunteering somewhere or begin networking in my industry. I just sank like a stone - stopped going in to work, just lay like a lump in my bed at home. The effect is the same as if I had quit (like a non-depressed version of me might have), except that leaving a job like that reinforces the terrible stories inside my head of the garbage person that I am. So even when my circumstances changed - no longer going in to the terrible job - my mood did not, because whether I was going to work or not, I was garbage.
To say in another way - for me, the depression exists outside of events in my life. If I fail at something, it is because I am terrible. If I try again and succeed, it was obviously not that difficult to begin with, I am lazy and useless for not accomplishing it to begin with, and thus, I am still terrible. So changing circumstances did not change the narrative in my brain. There was never a new leaf.
The meds allowed me to break from these narratives (somewhat), so I can recognize that a workplace was toxic and I am better off rid of it. It increases my resilience, so I can recover from a setback without going through a lengthy review of all of the ways I have failed and will continue to fail in my life. I have a new job, and I can more clearly see that some parts are good and some parts are dysfunctional, but also I can recognize that I am not responsible for fixing all of the dysfunction. I just did not have that clarity before I started taking the meds.
As I said above, I am still in the process of getting a more effective combo of meds. There are still a lot of times when I am swamped by my own negative thoughts. But I feel that since I am the constant in all life scenarios I encounter, no amount of new jobs or study programs or moves will really change anything unless I can change / overcome my depressive thoughts. That is what the meds help me with.
Whatever you wind up doing, I wish you the best of luck.
posted by that possible maker of pork sausages at 12:53 AM on October 24, 2017 [11 favorites]
I forgot the doubts/misgivings part! I also felt like this was a matter of will power - I should be able to deal with this on my own, my coworkers were, other adults were, the rest of America was, etc. All I was going to be doing with meds was altering my brain chemistry, and my fundamental weak nature was going to remain. Well, my brain chemistry needed altering. And as far as my nature vs. everyone else's - that kind of thinking was part of the train of depressive thoughts that constantly ran in my head, that I was uniquely terrible. And now I can see more clearly that if I do need chemical assistance to do what others do naturally, then getting that chemical assistance is a good thing.
But this internal back-and-forth about "deserving" to have this chemical intervention via meds went on for a long time inside me, and still continues - if I were a better, stronger, person, I wouldn't need to take the Wellbutrin is something that still comes up in my brain. I can just more readily dismiss these thoughts as not useful when I am taking the meds.
posted by that possible maker of pork sausages at 1:08 AM on October 24, 2017 [2 favorites]
But this internal back-and-forth about "deserving" to have this chemical intervention via meds went on for a long time inside me, and still continues - if I were a better, stronger, person, I wouldn't need to take the Wellbutrin is something that still comes up in my brain. I can just more readily dismiss these thoughts as not useful when I am taking the meds.
posted by that possible maker of pork sausages at 1:08 AM on October 24, 2017 [2 favorites]
I got referred to an actual psychiatrist for the first time when my anxiety/claustrophobia started interfering with my ability to take public transport (a big problem in London). After a *lot* of coaxing (I was very skeptical) she tapered me on to a very low dose of sertraline. I take medication, on and off, for ADHD, so I'm not necessarily opposed to medication, but my ADHD meds last such a short time in my system that it feels less scary.
The sertraline has been seriously amazing. My anxiety isn't gone, but it's not as intense and I'm able to make more headway in talk therapy. My moods are way more even, and my husband has commented that I seem more stable. I often compare my ADHD meds to glasses - they make the world more in-focus when I take them, but it's not super dramatic. The sertraline feels like wearing emotional glasses, if that makes sense.
I do think that seeing a psychiatrist rather than a GP is making a big difference. She wants me on the meds or a minimum of a year, but I'm checking in with her regularly and she tapered me on to the drug very slowly, which I think minimized any side effects. If you can see a psychiatrist for the prescription, I'd recommend it.
posted by nerdfish at 2:40 AM on October 24, 2017 [2 favorites]
The sertraline has been seriously amazing. My anxiety isn't gone, but it's not as intense and I'm able to make more headway in talk therapy. My moods are way more even, and my husband has commented that I seem more stable. I often compare my ADHD meds to glasses - they make the world more in-focus when I take them, but it's not super dramatic. The sertraline feels like wearing emotional glasses, if that makes sense.
I do think that seeing a psychiatrist rather than a GP is making a big difference. She wants me on the meds or a minimum of a year, but I'm checking in with her regularly and she tapered me on to the drug very slowly, which I think minimized any side effects. If you can see a psychiatrist for the prescription, I'd recommend it.
posted by nerdfish at 2:40 AM on October 24, 2017 [2 favorites]
I was skeptical because I was pretty sure my depression was caused by a perfectly reasonable response to a whole heap of shit life threw at me the prior two years (and that was ongoing at the time of diagnosis). I thought antidepressants would only work if the depression was not situational, but rather the result of screwed up brain chemistry. My doctor told me no, that doesn't seem to be the case.
Anyway, I'm really glad I took them. It took a couple of years, with one attempted weaning off in the middle that didn't 'take' before I was able to come off them and stay non-depressed. And of course they didn't fix the life stuff, but they made me more resilient about it. And to be honest, the life stuff could only get fixed when I could do things like find a new job, which I was too depressed to contemplate. The antidepressants broke that loop so I could get stuff done to improve my situation.
(Also, I think that a long period of bad stuff happening did mess with my brain chemicals, so although there was a situational cause there, after a couple of years of it, I wasn't responding emotionally to it in the same way a non-depressed person would.)
I was lucky that the first meds I tried worked for me. It took about three or four weeks to take effect, but one morning I woke up and it was like someone had turned on the light switch after I'd been sitting in the dark for a long time. But not everyone is so lucky, so I think you should be prepared to try a few different options, and a few different dosages, over a long period of time before you decide if they are working for you or not.
posted by lollusc at 4:51 AM on October 24, 2017 [2 favorites]
Anyway, I'm really glad I took them. It took a couple of years, with one attempted weaning off in the middle that didn't 'take' before I was able to come off them and stay non-depressed. And of course they didn't fix the life stuff, but they made me more resilient about it. And to be honest, the life stuff could only get fixed when I could do things like find a new job, which I was too depressed to contemplate. The antidepressants broke that loop so I could get stuff done to improve my situation.
(Also, I think that a long period of bad stuff happening did mess with my brain chemicals, so although there was a situational cause there, after a couple of years of it, I wasn't responding emotionally to it in the same way a non-depressed person would.)
I was lucky that the first meds I tried worked for me. It took about three or four weeks to take effect, but one morning I woke up and it was like someone had turned on the light switch after I'd been sitting in the dark for a long time. But not everyone is so lucky, so I think you should be prepared to try a few different options, and a few different dosages, over a long period of time before you decide if they are working for you or not.
posted by lollusc at 4:51 AM on October 24, 2017 [2 favorites]
I took a couple of SSRIs when I was suicidal. They forced my patterns of thinking into weird and dangerous shapes, so I stopped taking them very quickly, and distrusted medication for several years, retreating fairly heavily to handle it.
Later on I was prescribed an SNRI (desvenlafaxine, for reference), and after a couple of months the depression background noise just...left. If I stop taking it now for a few days, I can feel it coming back on. There is no question it has made my life much better.
I aim to address one specific misgiving - do not let past bad medication experiences deter you from trying again with something different. As a process, it does -suck- to go through one after another; but I'd give my left arm to have had the right medication during those years.
posted by solarion at 5:07 AM on October 24, 2017 [4 favorites]
Later on I was prescribed an SNRI (desvenlafaxine, for reference), and after a couple of months the depression background noise just...left. If I stop taking it now for a few days, I can feel it coming back on. There is no question it has made my life much better.
I aim to address one specific misgiving - do not let past bad medication experiences deter you from trying again with something different. As a process, it does -suck- to go through one after another; but I'd give my left arm to have had the right medication during those years.
posted by solarion at 5:07 AM on October 24, 2017 [4 favorites]
I have taken five different antidepressants and none of them have improved my life.
That said, it doesn't hurt to try. Well, ramping up and withdrawal if necessary might be unpleasant, but the potential benefits are worth the risk of temporary unpleasantness.
posted by metasarah at 5:34 AM on October 24, 2017
That said, it doesn't hurt to try. Well, ramping up and withdrawal if necessary might be unpleasant, but the potential benefits are worth the risk of temporary unpleasantness.
posted by metasarah at 5:34 AM on October 24, 2017
I felt the same way about taking drugs for a long time even though it had been brought up to me several times by doctors and therapists. I felt that it made me weak to need them or that they were a crutch. I felt like I shouldn't need medication to deal with life. Maybe my chemistry was wrong, but what did people do up until 100-ish years ago? Why were so many other people getting along just fine without them? What if there were side effects worse than the benefits? What if I was a completely different person on the drugs? The irony is that I was self-medicating with several things and I was out of control in that regard.
I tried a few things that mostly made me sick or did nothing. Eventually I started taking Buspirone which is mostly for anxiety but is sometimes used for depression as well along with other things. It changed my life fairly quickly. It wasn't a massive immediate change, but it allowed me to start to think clearly for long enough to get into treatment and get off my self-prescribed drugs. Now I am on nothing and I do pretty well but if I am having issues and a doctor suggests anxiety or depression meds I will consider them with a much more open mind. They can work and if they don't they can be stopped. I'm sorry this isn't about depression meds specifically but the rest of your question sounded quite a bit like my questions at the time.
posted by Clinging to the Wreckage at 6:04 AM on October 24, 2017
I tried a few things that mostly made me sick or did nothing. Eventually I started taking Buspirone which is mostly for anxiety but is sometimes used for depression as well along with other things. It changed my life fairly quickly. It wasn't a massive immediate change, but it allowed me to start to think clearly for long enough to get into treatment and get off my self-prescribed drugs. Now I am on nothing and I do pretty well but if I am having issues and a doctor suggests anxiety or depression meds I will consider them with a much more open mind. They can work and if they don't they can be stopped. I'm sorry this isn't about depression meds specifically but the rest of your question sounded quite a bit like my questions at the time.
posted by Clinging to the Wreckage at 6:04 AM on October 24, 2017
This was me.
Around that time I was involved in a friend’s emotionally draining divorce which basically helped me reach a decision.
I can basically say I was never really skeptical, but I just could not reach an agreement with myself on how to approach taking them till that time. This was because I knew from the literature available that one might work and another may not. I didn’t feel I had time to bumble through many types to get one that worked. Like the possibility Acheman presents I eventually committed myself to treatment for life before I committed.
I was lucky and even if the early side effects took time to work through I had an effective treatment from my first drug (lexapro). In the year since I started I changed jobs and even moved overseas to start a new chapter in life. That would have been unheard of from my former self.
The number one thing is that I was no longer spending time thinking constantly about killing myself here and there.
I would never ever go back to that. Never never never!
I did do therapy alongside lexapro for a short time.
The place I moved to does not have great talk therapy for depression at all, so I feel the monsters I put to bed are never really dead, but tucked away as an old memory. I regret that I have never really addressed why I felt the way I did for so long and as the drug’s effect came along in my initial therapy I couldn’t even think about them and my therapy was almost always aimless.
Overall, I highly recommend you give it a chance again. I wish I did take my first step earlier.
posted by Bodrik at 6:29 AM on October 24, 2017 [1 favorite]
Around that time I was involved in a friend’s emotionally draining divorce which basically helped me reach a decision.
I can basically say I was never really skeptical, but I just could not reach an agreement with myself on how to approach taking them till that time. This was because I knew from the literature available that one might work and another may not. I didn’t feel I had time to bumble through many types to get one that worked. Like the possibility Acheman presents I eventually committed myself to treatment for life before I committed.
I was lucky and even if the early side effects took time to work through I had an effective treatment from my first drug (lexapro). In the year since I started I changed jobs and even moved overseas to start a new chapter in life. That would have been unheard of from my former self.
The number one thing is that I was no longer spending time thinking constantly about killing myself here and there.
I would never ever go back to that. Never never never!
I did do therapy alongside lexapro for a short time.
The place I moved to does not have great talk therapy for depression at all, so I feel the monsters I put to bed are never really dead, but tucked away as an old memory. I regret that I have never really addressed why I felt the way I did for so long and as the drug’s effect came along in my initial therapy I couldn’t even think about them and my therapy was almost always aimless.
Overall, I highly recommend you give it a chance again. I wish I did take my first step earlier.
posted by Bodrik at 6:29 AM on October 24, 2017 [1 favorite]
This happened to me! I think you can go back through my comments on askme and find me talking about it more in depth, but basically a life-changing moment happened to me right here on Metafilter: Jessamyn said something along the lines of, "If you're anxious, of course you're going to be anxious about starting anti-anxiety medication; it's a symptom of the disease. You aren't going to be able to think your way through your concerns; you just have to trust your doctors and take a leap of faith." I did, and it was fantastic.
I also agree with everyone who's saying that there isn't really a way to disentangle brain chemistry from life stuff - bad life stuff will pound your brain into a mess, screwing up its chemistry, and bad brain chemistry will make it impossible to deal with things in a way that makes life stuff worse. Meds can interrupt this cycle.
I still remember the morning I woke up with this feeling of lightness in my chest, and I realized I was looking forward to the day in a way that I hadn't since I was ten years old. I fought really hard to live my life for 30 years while my brain was working against me, but it was a burden I didn't need to carry. I know that meds don't work for everyone, but I think you owe it to yourself to give it a shot.
posted by pretentious illiterate at 6:51 AM on October 24, 2017 [8 favorites]
I also agree with everyone who's saying that there isn't really a way to disentangle brain chemistry from life stuff - bad life stuff will pound your brain into a mess, screwing up its chemistry, and bad brain chemistry will make it impossible to deal with things in a way that makes life stuff worse. Meds can interrupt this cycle.
I still remember the morning I woke up with this feeling of lightness in my chest, and I realized I was looking forward to the day in a way that I hadn't since I was ten years old. I fought really hard to live my life for 30 years while my brain was working against me, but it was a burden I didn't need to carry. I know that meds don't work for everyone, but I think you owe it to yourself to give it a shot.
posted by pretentious illiterate at 6:51 AM on October 24, 2017 [8 favorites]
I was heavily medicated as a teenager and really hated it. I stopped taking antidepressants as soon as I left my parent's house. I've been through bouts of depression and dealt with anxiety since then, but always refused medication. I recently had a rough, complicated pregnancy and found myself more withdrawn and miserable than I had been in years. My doctor strongly suggested I consider taking antidepressants as I was at high risk for postpartum depression. I begrudgingly agreed to try a low dose of Zoloft and about a month later started feeling much better. Like way better. I managed to avoid postpartum depression and now everything just feels like less of a weight on my shoulders. I'm kicking myself thinking about how many years I wasted feeling so terrible, avoiding social interactions, hiding in bed, etc.
Good luck!
posted by galvanized unicorn at 7:18 AM on October 24, 2017 [1 favorite]
Good luck!
posted by galvanized unicorn at 7:18 AM on October 24, 2017 [1 favorite]
It's not unreasonable to be concerned about side effects. But Wellbutrin has a somewhat different mechanism than the other drugs you've tried (it's an NDRI). Therefore, you might find it more tolerable.
"Life stuff" causes sadness. But most "life stuff" doesn't actually rise to the level of gravity that should cause crippling sadness or terror or despair. That's the brain doing its haywire processing of those events. I wouldn't say antidepressants have entirely relieved my symptoms, but I tried going off mine a couple of years ago and boy howdy, I almost immediately began to appreciate the relief they did provide.
posted by praemunire at 8:40 AM on October 24, 2017
"Life stuff" causes sadness. But most "life stuff" doesn't actually rise to the level of gravity that should cause crippling sadness or terror or despair. That's the brain doing its haywire processing of those events. I wouldn't say antidepressants have entirely relieved my symptoms, but I tried going off mine a couple of years ago and boy howdy, I almost immediately began to appreciate the relief they did provide.
posted by praemunire at 8:40 AM on October 24, 2017
If you are fortunate enough to have an involved partner, my advice as a veteran of this particular war is to let your partner read the enclosed side effects leaflet and monitor you for those.
posted by DarlingBri at 9:19 AM on October 24, 2017
posted by DarlingBri at 9:19 AM on October 24, 2017
I was so worried that on anti-depressants I wouldn't be myself, that I would be changed into a different person. Instead it made me feel more like myself, since I wasn't filled with rage and self-hatred. (The particular drug was Sertraline.) It was a breath of fresh air.
posted by wnissen at 9:29 AM on October 24, 2017 [1 favorite]
posted by wnissen at 9:29 AM on October 24, 2017 [1 favorite]
I'm on Wellbutrin and it's been an absolute lifesaver. I described it to my shrink as "it raises the floor". I can still get sad and depressed, but I don't sink into the depths like I did before. I can just bounce right back. I've noticed absolutely zero side effects. As praemunire notes, it works differently than most other antidepressants, which is why my psych - who knew I was averse to medication - suggested we try it first.
posted by Rock Steady at 10:09 AM on October 24, 2017
posted by Rock Steady at 10:09 AM on October 24, 2017
Yes, I've been there. After several bad experiences with a SSRIs and SNRIs I gave up for a while, thinking that pills just didn't work well with me. Wellbutrin is not always great for anxious patients -- it made my anxiety go through the roof. Zoloft made me feel like I was trapped in a dream, etc etc etc.
A very kind and patient therapist helped me work through this and prescribed me Selegiline (an MAOI) that worked wonders but gave me insomnia, and then switched me to Lamotrigine (a mood stabilizer). It's usually prescribed to people with bi-polar disorder, but it works in a totally different way from SSRIs / SNRIs and really helps with both anxiety and depression. It's like a heavy weight has been lifted from my life, and it doesn't 'stop working' after a while, as SSRIs can. I am not bi-polar in the slightest, so don't let the different common usage stop you.
I think too many people (and doctors, for that matter) think that anxiety and depression means trying out different SSRIs/SNRIs, when really there are many other medications that can be more effective if those just don't work for you.
Bets of luck. Most people with anxiety have, well, anxiety about taking meds. You are in good company and I sympathize.
posted by ananci at 11:13 AM on October 24, 2017 [1 favorite]
A very kind and patient therapist helped me work through this and prescribed me Selegiline (an MAOI) that worked wonders but gave me insomnia, and then switched me to Lamotrigine (a mood stabilizer). It's usually prescribed to people with bi-polar disorder, but it works in a totally different way from SSRIs / SNRIs and really helps with both anxiety and depression. It's like a heavy weight has been lifted from my life, and it doesn't 'stop working' after a while, as SSRIs can. I am not bi-polar in the slightest, so don't let the different common usage stop you.
I think too many people (and doctors, for that matter) think that anxiety and depression means trying out different SSRIs/SNRIs, when really there are many other medications that can be more effective if those just don't work for you.
Bets of luck. Most people with anxiety have, well, anxiety about taking meds. You are in good company and I sympathize.
posted by ananci at 11:13 AM on October 24, 2017 [1 favorite]
It seems to me that while clinical depression is obviously real, most depression is probably life stuff rather than brain chemistry. Which doesn't matter if it works, but I'm just having trouble going through with it.
Yes and no. There are a lot of people dealing with situational depression (i.e. something in my life is making me sad in a way that feels and seems reasonable, my brain is not trying to sabotage and/or kill me) who still get stuck in ruts where their thinking isn't clear enough to strategize ways to help make themselves feel less terrible about whatever the thing is. With medication you still need to do the work on whatever it is in your life but you have slightly fewer impediments. I think of it like trying to barbecue in the rain. You can do it! But it's a pain, you're in the wrong place for it, and there's a big "why bother?" feeling. Bring an umbrella, better BBQ.
Anyhow, yeah I was afraid to take anti-anxiety meds for a long time but I was also self-medicating in order to sleep which felt... worse. And now I take it when I need to, which is not all the time but when I do take it it's because I need to and it helps all the things. Try the Wellbutrin, give yourself a week or two. Read the question again. See how you feel then. Also might want to look into finding sliding scale therapy if you felt it was helpful. ThereIsHelp has some suggestions.
posted by jessamyn at 11:31 AM on October 24, 2017 [1 favorite]
Yes and no. There are a lot of people dealing with situational depression (i.e. something in my life is making me sad in a way that feels and seems reasonable, my brain is not trying to sabotage and/or kill me) who still get stuck in ruts where their thinking isn't clear enough to strategize ways to help make themselves feel less terrible about whatever the thing is. With medication you still need to do the work on whatever it is in your life but you have slightly fewer impediments. I think of it like trying to barbecue in the rain. You can do it! But it's a pain, you're in the wrong place for it, and there's a big "why bother?" feeling. Bring an umbrella, better BBQ.
Anyhow, yeah I was afraid to take anti-anxiety meds for a long time but I was also self-medicating in order to sleep which felt... worse. And now I take it when I need to, which is not all the time but when I do take it it's because I need to and it helps all the things. Try the Wellbutrin, give yourself a week or two. Read the question again. See how you feel then. Also might want to look into finding sliding scale therapy if you felt it was helpful. ThereIsHelp has some suggestions.
posted by jessamyn at 11:31 AM on October 24, 2017 [1 favorite]
Hey there. I have been diagnosed with GAD and PTSD for many years. I have had some bouts of major depression. I did take Wellbutrin for a while back in 2012 and it helped me get out of a pretty bad slump, I think. Recently, I had the same kind of reaction to Paxil that you described and I also had negative reactions to other SSRIs (couldn't sleep, jittery, and so on). If you need to move beyond SSRIs, there are a lot of options that could be helpful. You should of course talk any plan through with a real doctor and not take any of what I'm writing here as actual advice for you to follow.
What has helped are benzos -- specifically clonazepam (although of course, benzos have seriously downsides like dependency!), prazosin (to deal with spikes in panic), and a mood stabilizer (mine is quetiapine). The mood stabilizer is relatively new for me (like within the last 8 weeks), but the results do seem to be positive. I don't have a mood disorder like bipolar, but I have immediate family members who do, so that might have something to do with its effectiveness for me. However, we're already talking about switching me off it to avoid long-term side effects related to the heart and liver. It can be discouraging to make so many changes, but then again, my life is so much more stable and enjoyable than it was when I started this journey with medication about 6 years ago.
The problem right now: this cocktail of depression and anxiety feels like it's preventing me from doing stuff and wearing on friends/significant other. I could plod on like this for the rest of my days but it's not fun and it's bad for me and possibly those around me.
That sounds awful! Sometimes I find myself kind of rationalizing that sort of suffering in my own life. Like, I go "Oh, it's just what it is. I'm just anxious and I suffer and that's fiiiine." But then my awesome therapist reminds me that it's not necessary to put up with that kind of thing. So, we keep working with specialists and I keep making adjustments to get things to a place where I feel good. I hope you can remember that you deserve that, too. It's a long road, but I heartily encourage you to not give up!
posted by pinetree at 1:43 PM on October 24, 2017
What has helped are benzos -- specifically clonazepam (although of course, benzos have seriously downsides like dependency!), prazosin (to deal with spikes in panic), and a mood stabilizer (mine is quetiapine). The mood stabilizer is relatively new for me (like within the last 8 weeks), but the results do seem to be positive. I don't have a mood disorder like bipolar, but I have immediate family members who do, so that might have something to do with its effectiveness for me. However, we're already talking about switching me off it to avoid long-term side effects related to the heart and liver. It can be discouraging to make so many changes, but then again, my life is so much more stable and enjoyable than it was when I started this journey with medication about 6 years ago.
The problem right now: this cocktail of depression and anxiety feels like it's preventing me from doing stuff and wearing on friends/significant other. I could plod on like this for the rest of my days but it's not fun and it's bad for me and possibly those around me.
That sounds awful! Sometimes I find myself kind of rationalizing that sort of suffering in my own life. Like, I go "Oh, it's just what it is. I'm just anxious and I suffer and that's fiiiine." But then my awesome therapist reminds me that it's not necessary to put up with that kind of thing. So, we keep working with specialists and I keep making adjustments to get things to a place where I feel good. I hope you can remember that you deserve that, too. It's a long road, but I heartily encourage you to not give up!
posted by pinetree at 1:43 PM on October 24, 2017
Like praemunire mentioned, Wellbutrin is in a different class of drugs than the SSRIs, so don't be afraid to try it even though SSRIs have been terrible. Wellbutrin tends to have fewer & more tolerable side effects that most other antidepressants. I was on it years ago and, while it didn't make my anxiety any better, it didn't make it any worse, either; the worst side effect was a little trouble falling asleep. The effect wasn't dramatic—it just made everything feel ... brighter. Unfortunately I was allergic to it, or I'd probably still be taking it.
I'm on moclobemide right now, a reversible MAOI. It's not very popular—I don't even know if it's available in the US—but it works really well for me. I have no side effects other than waking up a couple times in the early morning (I used to sleep straight through).
It's hard to pinpoint the "change" but the results speak for themselves. Before I started taking it, I'd been depressed for a decade. Like you, I'd just been plodding on and trying to get by; I was afraid to try antidepressants. I'd just dropped out of my university term due to some pretty severe chronic illness issues. I would wake up most days and want to roll over and go back to sleep. I wasn't getting out of the house much. After a couple years on moclobemide, I'm back in classes, keep in much better touch with friends, have picked up several new hobbies and met new people, and am writing poetry again. My social anxiety disappeared almost entirely.
It's not that life got any easier—my chronic illness is worse now, actually—but somehow, I started being able to cope life's various problems. They feel merely difficult, instead of insurmountable, and I'm able to look at them objectively and come up with multi-step solutions for dealing with them. Also, I have motivation to do things again. It was a feeling I'd forgotten, having not felt it for a decade. So what you say isn't untrue—depression is caused by "life stuff"—but I'm of the opinion that it's caused by life stuff + the inability to cope, and medication can help with the brain processes behind that.
I really hope that you're able to find an antidepressant that works for you—best of luck!
posted by fire, water, earth, air at 2:00 PM on October 24, 2017 [2 favorites]
I'm on moclobemide right now, a reversible MAOI. It's not very popular—I don't even know if it's available in the US—but it works really well for me. I have no side effects other than waking up a couple times in the early morning (I used to sleep straight through).
It's hard to pinpoint the "change" but the results speak for themselves. Before I started taking it, I'd been depressed for a decade. Like you, I'd just been plodding on and trying to get by; I was afraid to try antidepressants. I'd just dropped out of my university term due to some pretty severe chronic illness issues. I would wake up most days and want to roll over and go back to sleep. I wasn't getting out of the house much. After a couple years on moclobemide, I'm back in classes, keep in much better touch with friends, have picked up several new hobbies and met new people, and am writing poetry again. My social anxiety disappeared almost entirely.
It's not that life got any easier—my chronic illness is worse now, actually—but somehow, I started being able to cope life's various problems. They feel merely difficult, instead of insurmountable, and I'm able to look at them objectively and come up with multi-step solutions for dealing with them. Also, I have motivation to do things again. It was a feeling I'd forgotten, having not felt it for a decade. So what you say isn't untrue—depression is caused by "life stuff"—but I'm of the opinion that it's caused by life stuff + the inability to cope, and medication can help with the brain processes behind that.
I really hope that you're able to find an antidepressant that works for you—best of luck!
posted by fire, water, earth, air at 2:00 PM on October 24, 2017 [2 favorites]
By the way, if you want to try treating just the anxiety for starters, there is a drug called Buspar (buspirone) that is neither a benzo nor a SSRI/etc. Some people find it very helpful. It's got a relatively modest side effects profile (though of course individual responses vary) and doesn't have the dependency problems of benzos. Combining it with an antidepressant is also a common tactic. Conveniently, it's a generic in the U.S.
Best of luck to you.
posted by praemunire at 2:14 PM on October 24, 2017
Best of luck to you.
posted by praemunire at 2:14 PM on October 24, 2017
All throughout my teens and twenties I fought myself when trying to fight depression. I thought if I was just tough enough, I'd be able to stick it out. Therapy never did shit for me, because honestly, I've lived a relatively trauma-free life (no abuse by anyone, well provided for, physically healthy, lots of friends, reasonably smart and attractive enough), so there was never anything to talk about. I finally ran out of energy and sought out meds because I thought it must just be my head. Lexapro was the first thing prescribed for me. Made me want to kill myself more than the actual depression. Went so far as being hospitalized. I was terrified to try anything else for a few years. Then decided to give it another go a couple years later and went with Wellbutrin.
It was a total lifesaver.
It's like when you're a child and get glasses for the first time and was like 'holy shit this is how everyone else sees the world?!'. Just like that. Not that I was elated all the time or anything. I just felt...normal. Like oh, I had a kinda shitty day, but I can just go slump into the couch and eat ice cream like a regular human instead of sob until I puke. After Wellbutrin calmed down the depression, a bit of anxiety emerged for which I took Klonopin only when needed. After about 5 years, I decided to go off Wellbutrin when I thought it might be affecting my short term memory and I couldn't drink two glasses of wine without getting hammered. That was a year ago and I feel good (and my memory is better and I can have a couple drinks with friends without blacking out)! Good, like, most of the time! And I will still occasionally take a 1/2 Klonopin to take the edge off if I've had a particularly shitty day. But that happens only once every couple months, max.
I have other friends who have had similar experiences. Some have gone on and off, but most have found it very effective. I recommend giving it a try. You might feel super-energetic your first few weeks on it, but it will even out if it's working effectively. Just monitor yourself closely--maybe write down your symptoms every day and see if they lessen or get worse, and then review with your doctor to see if your dose should be adjusted or if you should try something else.
Just don't stop trying. After a lifetime of depression, it's pretty great to be in my 30s and out of it. I'm bummed that I didn't start treatment sooner (I grew up in a family that didn't really 'believe in mental health issues--I was just treated as if I had a behavioral problem alone, so I'm sure I absorbed some of that thinking as well).
Good luck!
posted by greta simone at 2:50 PM on October 24, 2017 [2 favorites]
It was a total lifesaver.
It's like when you're a child and get glasses for the first time and was like 'holy shit this is how everyone else sees the world?!'. Just like that. Not that I was elated all the time or anything. I just felt...normal. Like oh, I had a kinda shitty day, but I can just go slump into the couch and eat ice cream like a regular human instead of sob until I puke. After Wellbutrin calmed down the depression, a bit of anxiety emerged for which I took Klonopin only when needed. After about 5 years, I decided to go off Wellbutrin when I thought it might be affecting my short term memory and I couldn't drink two glasses of wine without getting hammered. That was a year ago and I feel good (and my memory is better and I can have a couple drinks with friends without blacking out)! Good, like, most of the time! And I will still occasionally take a 1/2 Klonopin to take the edge off if I've had a particularly shitty day. But that happens only once every couple months, max.
I have other friends who have had similar experiences. Some have gone on and off, but most have found it very effective. I recommend giving it a try. You might feel super-energetic your first few weeks on it, but it will even out if it's working effectively. Just monitor yourself closely--maybe write down your symptoms every day and see if they lessen or get worse, and then review with your doctor to see if your dose should be adjusted or if you should try something else.
Just don't stop trying. After a lifetime of depression, it's pretty great to be in my 30s and out of it. I'm bummed that I didn't start treatment sooner (I grew up in a family that didn't really 'believe in mental health issues--I was just treated as if I had a behavioral problem alone, so I'm sure I absorbed some of that thinking as well).
Good luck!
posted by greta simone at 2:50 PM on October 24, 2017 [2 favorites]
I had quite a long and horrible go with an often suicidal-level depression that started around puberty and did not entirely go away until 30ish. At the start, SSRIs were not really on the radar, and I tried a lot of tricyclics that, in retrospect, were awful; I went from a kid into swimming and tennis and sailing and so on into a logy teen with no energy for anything, and they did nothing. Then SSRIs became popular and I tried pretty much everything. The only thing I noticed anything except lousy (but undramatic) side effects from was Prozac, which just made me apathetic. Apathy beat wanting to do myself in, so I stuck with that until I was more stable.
Years passed; studies came out about antidepressants not being as effective as claimed. "No shit," I though, sadly...
Then in my early 40s my body shit the bed on processing vitamin b12. I was aware that it was highly unlikely that I was really going to die, but, in the months prior to diagnosis, I felt like I was dying; there was no other way to describe it. And I conveniently started to lose my mind, too, along with the dramatically impaired physical function. I was totally suicidal and so anxiety-riddled I was no longer able to cope with many of what what medical sorts refer to as "activities of daily living." Pay a bill? No, PANIC, because...because I don't know why. Bad anxiety.
So I went on an antidepressant -- I don't remember which -- and mostly just got terrible acne, a previously unknown-to-me side effect -- and swapped it out for another one, and still felt pretty lousy, and asked for a dosage escalation, and was told I was at the max of where it might do any good, and was put on a second one concurrently. Eventually I was no longer fixated on doing myself in.
My view on them now is that they do work when depression is a brain chemistry issue, but they are of limited use for situational depression or low-grade ditto/dysthymia. (The worst of my b12 deficiency horrors are mostly settled, but I am not out of the woods, and am staying on the antidepressants until I can tell that I am physically well recovered or at least have hit a plateau and reached "new normal.")
I think they are pretty useless for, and over-prescribed for, anxiety -- I suspect in large part thanks to the fear of addiction with benzodiazepines (and some drug company marketing) -- I have never had any help from them for anxiety. YMMV, obviously, and I know some people do feel that they have some use there. I have been on the same dose of Ativan for ages with no need to up the dosage and no issues going for days without it and find it very helpful.
I also find many doctors are quick to call any out-of-sorts state "depression" and medicate with that in mind without looking at causes. Examples: one has severe sleep problems. One is made miserable by sleep deprivation. Treatment ends up being for depression, and not wildly effective, because the real disorder is lack of sleep, not depressive brain chemistry. Or: one is having problems with anxiety. One ends up withdrawing socially, sleeping poorly, what-have-you, and seeming depressed. Dx and Rx are for...depression, not anxiety.
Buspar as mentioned might be a thing to try if you are wary of benzodiazepines and not getting any relief from anxiety from antidepressants. I found it gave me a "heavy limbs" and dizziness issue that was too much to cope with and went straight off it, but wonder if those issues might have eased if I'd stuck with it. That said, I have been on and off benzos for years, depending on life and brain circumstances, and think the risks of addiction are overblown for people not prone to addiction and who have knowledgeable doctors, and who are careful to use them as prescribed -- it is the people who are forever running out of their Rx early (some of whom are getting too low a dosage, I expect, but some of whom are abusing it) and who are not honest with their doctors, or who have doctors who do not know how to manage anxiety patients and their meds (example: on 1mg of a drug, I asked for the Rx to be prescribed in 0.5mg tablets, so that I could sometimes just take 0.5 without thinking about it, but, more importantly, so I had what seemed like a huge bottle of anti-anxiety meds, and that that alone would be reassuring. The very experienced doctor I was dealing with said "I know exactly what you mean," said I wasn't his only patient that did that, and wrote it for 2x the quantity at 0.5 without further comment. Yay! He got it! Other doctors have just given me a funny look -- those are the ones that I fear don't understand anxiety, may have a poor understanding of benzos, and may do a poor job when I want to taper off...).
Sorry for the ramble. I think they have their place and are worth trying -- with the reservations that I don't think they have much to offer for challenging life circumstances, or for depression whose causes are rooted in other issues like anxiety or sleep disorders. And, once a doctor told me 'you can often pretty much tell what year a woman started on the birth control pill by what pill they take,' and I feel like there's a bit of a same-y thing going on with antidepressants; new patients sometimes seem to be prescribed the latest and greatest whatever. "Prozac was kind of helpful when I was in uni" tends to get a dim look and "there are all sorts of new ones with fewer side effects out nowadays!" Yes, but I didn't get any side...okay, you just read some great stuff about the newest one, I see... Side-effect-wise, I suggest starting out with the smallest dose and escalating slowly.
Best of luck, and, please be kind to yourself; these sorts of problems are every bit as serious, not at all a sign of "weakness" or whatever, and sometimes disabling as, physical problems can be.
posted by kmennie at 5:59 PM on October 24, 2017 [2 favorites]
Years passed; studies came out about antidepressants not being as effective as claimed. "No shit," I though, sadly...
Then in my early 40s my body shit the bed on processing vitamin b12. I was aware that it was highly unlikely that I was really going to die, but, in the months prior to diagnosis, I felt like I was dying; there was no other way to describe it. And I conveniently started to lose my mind, too, along with the dramatically impaired physical function. I was totally suicidal and so anxiety-riddled I was no longer able to cope with many of what what medical sorts refer to as "activities of daily living." Pay a bill? No, PANIC, because...because I don't know why. Bad anxiety.
So I went on an antidepressant -- I don't remember which -- and mostly just got terrible acne, a previously unknown-to-me side effect -- and swapped it out for another one, and still felt pretty lousy, and asked for a dosage escalation, and was told I was at the max of where it might do any good, and was put on a second one concurrently. Eventually I was no longer fixated on doing myself in.
My view on them now is that they do work when depression is a brain chemistry issue, but they are of limited use for situational depression or low-grade ditto/dysthymia. (The worst of my b12 deficiency horrors are mostly settled, but I am not out of the woods, and am staying on the antidepressants until I can tell that I am physically well recovered or at least have hit a plateau and reached "new normal.")
I think they are pretty useless for, and over-prescribed for, anxiety -- I suspect in large part thanks to the fear of addiction with benzodiazepines (and some drug company marketing) -- I have never had any help from them for anxiety. YMMV, obviously, and I know some people do feel that they have some use there. I have been on the same dose of Ativan for ages with no need to up the dosage and no issues going for days without it and find it very helpful.
I also find many doctors are quick to call any out-of-sorts state "depression" and medicate with that in mind without looking at causes. Examples: one has severe sleep problems. One is made miserable by sleep deprivation. Treatment ends up being for depression, and not wildly effective, because the real disorder is lack of sleep, not depressive brain chemistry. Or: one is having problems with anxiety. One ends up withdrawing socially, sleeping poorly, what-have-you, and seeming depressed. Dx and Rx are for...depression, not anxiety.
Buspar as mentioned might be a thing to try if you are wary of benzodiazepines and not getting any relief from anxiety from antidepressants. I found it gave me a "heavy limbs" and dizziness issue that was too much to cope with and went straight off it, but wonder if those issues might have eased if I'd stuck with it. That said, I have been on and off benzos for years, depending on life and brain circumstances, and think the risks of addiction are overblown for people not prone to addiction and who have knowledgeable doctors, and who are careful to use them as prescribed -- it is the people who are forever running out of their Rx early (some of whom are getting too low a dosage, I expect, but some of whom are abusing it) and who are not honest with their doctors, or who have doctors who do not know how to manage anxiety patients and their meds (example: on 1mg of a drug, I asked for the Rx to be prescribed in 0.5mg tablets, so that I could sometimes just take 0.5 without thinking about it, but, more importantly, so I had what seemed like a huge bottle of anti-anxiety meds, and that that alone would be reassuring. The very experienced doctor I was dealing with said "I know exactly what you mean," said I wasn't his only patient that did that, and wrote it for 2x the quantity at 0.5 without further comment. Yay! He got it! Other doctors have just given me a funny look -- those are the ones that I fear don't understand anxiety, may have a poor understanding of benzos, and may do a poor job when I want to taper off...).
Sorry for the ramble. I think they have their place and are worth trying -- with the reservations that I don't think they have much to offer for challenging life circumstances, or for depression whose causes are rooted in other issues like anxiety or sleep disorders. And, once a doctor told me 'you can often pretty much tell what year a woman started on the birth control pill by what pill they take,' and I feel like there's a bit of a same-y thing going on with antidepressants; new patients sometimes seem to be prescribed the latest and greatest whatever. "Prozac was kind of helpful when I was in uni" tends to get a dim look and "there are all sorts of new ones with fewer side effects out nowadays!" Yes, but I didn't get any side...okay, you just read some great stuff about the newest one, I see... Side-effect-wise, I suggest starting out with the smallest dose and escalating slowly.
Best of luck, and, please be kind to yourself; these sorts of problems are every bit as serious, not at all a sign of "weakness" or whatever, and sometimes disabling as, physical problems can be.
posted by kmennie at 5:59 PM on October 24, 2017 [2 favorites]
Just jumping back in to double down on the psychiatrist suggestion, after reading responses (rightly!) discussing how there are so many different causes of anxiety and depression. I think a major reason why I'm having a positive experience on medication now is that my psychiatrist really took her time in prescribing them - it took three appointments, and the first two appointments were more like therapy sessions as she really dug into what was going on. She also ordered bloodwork, which revealed that I'm actually quite anaemic (I had no idea) and, predictably, need to up my vitamin D dose.
TL;DR: if you can, see a psychiatrist to rule out anything physical and get a more tailored prescription.
posted by nerdfish at 10:59 PM on October 24, 2017 [1 favorite]
TL;DR: if you can, see a psychiatrist to rule out anything physical and get a more tailored prescription.
posted by nerdfish at 10:59 PM on October 24, 2017 [1 favorite]
This thread is closed to new comments.
To update briefly, I have had relapses since then, but my quality of life is so so much better than it was back in 2010. There have been a lot of factors to that but antidepressants made it possible. They aren't right for everyone but they were (and are: I've made peace, for various reasons, with the fact that these drugs may be a forever thing ) the right choice for me.
posted by Acheman at 12:01 AM on October 24, 2017 [2 favorites]