Going on antidepressants after years untreated

March 18, 2024 11:56 AM

Seems like I will soon be prescribed an antidepressant. I’d like to hear stories of people who went on an antidepressant after years and years of untreated depression. Not sure what to google to find this. Would be grateful for either your personal experiences or maybe links to other sites. Thank you!
posted by iamsuper to Health & Fitness (17 answers total)

well I guess my depression started when I was about 12. I did not go on medication until age 36. I had some therapy in those years and just working on trying to have better lifestyle habits and choices, but still struggling some times.

I went on Prozac (40mg) and stayed on until now (56, slowly reducing dose to 0 over the last few years). it was on the whole a great experience for me. like, I'm a poster child. it gave me the room to learn and practice some healthier coping mechanisms and learn what that felt like. it enabled me to have a clearer perception of my own ups and downs. YMMV of course, but if you can find the right med it can be a powerful tool for helping yourself to develop more resilience.
posted by supermedusa at 12:00 PM on March 18 [1 favorite]

I'd been having depressive episodes - several quite serious - since I was a teenager. I waited until perimenopause, politics, parental loss, and pandemic led to a massive flameout burnout situation. I signed up for a service, picked up my lexapro the next morning, and just knowing I was doing Something was enough to improve my assessment scores. I took the medication, and over the next few months was able to start mopping up some of the messes that had occurred while I was non-functional. I won't say everything got instantly better, but there was a big leap in resilience and then a slow and steady climb - all the while, I was handling all-new bullshit with reasonable grace - plus a little side venture getting dx with ADHD also.

I did experiment with going off a couple years later, but after 6 weeks I decided I was still not producing/retaining the quantity/quality of serotonin I prefer, so I went back on. I have a life that is pleasant but has a high level of background stress, and it shows when I am lacking assistance.

I have no meaningful side effects - I was very anxious about insomnia and got meds to help if it was a problem, but honestly at this point I take it at bedtime and sleep fine (and also sleep through the little wave of sluggishness I was getting mid-morning if I took it first thing).

My partner's story is much the same, though he started much longer ago and is content to stay on permanently. It is not a cure, and he has some other stuff that contributes to a more severe situation than mine, but it maintains a functional baseline where he can manage the rest with all the other tools.
posted by Lyn Never at 12:09 PM on March 18 [3 favorites]

Just a minor anecdote. A good friend started antidepressants a couple years ago and several did not agree with him, but he and his doctor kept trying different things and when the right one hit, it hit big time for his specific patterns and needs. Night and day for him and for those of us who knew him through this whole process. The different meds feel very different to different people and it can be tedious to ramp them up one after the other, but for him it was absolutely worthwhile to do so to find the right one. But it requires some patience for sure. Hope this works for you!
posted by BlackLeotardFront at 12:10 PM on March 18 [2 favorites]

I went through four different antidepressant meds, none of them effective. (Well, side-effects, sure, but nothing helpful.) Reactions to meds vary considerably by individual. I suggest keeping your initial expectations low and if the first set of meds don't work out, be honest with your doctor about it so the doc can prescribe something else.
posted by SPrintF at 12:24 PM on March 18 [5 favorites]

Depression set in around 12 years old. After failed therapy (I didn't have anything to really talk about?) I finally started looking into meds around 28/29. Got started on lexapro for a short time which had really negative side-effects (suicidal ideation), switched to Wellbutrin which was amazing. I just felt...normal. Jammed on that for like 5 years maybe until I decided that the side effects (shakiness, memory issues) maybe outweighed the treatment and I wanted to see what it would be like without the meds. And lo and behold, I'm like, fine now 5-6 years after going off? That being said, I keep a lil bit of klonopin around in case my anxiety flares up but that's maybe a couple times a year max and is a different issue (which I didn't recognize until the depression cobwebs were cleared, and probably never would have figured it out if weren't for the depression meds untangling the two in my brain).

Being on the meds for that period of time allowed the depression to be at bay enough to actually develop the life skills and coping skills that I hadn't been able to up to that point in my life, so that when I went off, I had a really solid foundation to recognize my triggers and find support elsewhere when I need it. I went back on for a little while at the beginning of covid but decided it wasn't really necessary after a few months.

I think for the longest time in my 20s I thought that 'fighting it' was the way to go, and now I regret missing a whole decade of joy when I could have just chosen to medicate sooner. In my early 40s now and finally hitting my stride. I really think it's worthwhile to work closely with your medical team to find something that works for you.
posted by greta simone at 12:35 PM on March 18 [2 favorites]

I've had persistent depressive disorder (f/k/a dysthymic depression) since... well, in retrospect, most if not all of my life. I had some therapy when I was in 5th/6th grade (definitely not the done thing back then) when I had a particularly low time, and had a major depressive episode in 2019 that scared the pants off me. Been taking bupropion since then. Honestly not sure if it's made a difference or not. Persistent depressive disorder can be described as having a lower emotional level resulting in lower lows and highs that aren't as high as part of the natural ebb and flow of emotion. It all seems normal. I think my emotional center is higher these days, but it's not like the clouds parted and the sun came shining in. That said, I have some friends who described going on antidepressants in just that way. I think it can really depend on the person, the type of depression and the antidepressant used.
posted by slkinsey at 1:10 PM on March 18

In a similar situation as Lyn Never (minus the ADHD), and don't really have much else to add. I'm on the generic version of Lexapro and haven't had a notable depressive episode since I've started.

The only real side effect I get is nausea, which I've since solved by taking it with lunch or dinner. Maybe once or twice a week, I'll miss a day, but it hasn't been a big deal. Insomnia is an occasional issue with me thanks to thyroid disease, but the antidepressant hasn't made any difference there one way or the other.
posted by May Kasahara at 2:43 PM on March 18

For me it is like a life jacket. Don't always need it, but when I do, treading water is so much easier with it than without. Also, am learning to swim; my dose is lower now than when I started.
posted by seanmpuckett at 3:44 PM on March 18 [1 favorite]

I was depressed for at least 15 years before I began antidepressants. Unfortunately they were not helpful to me; I tried four or five different kinds without benefit. SSRIs have a net negative effect for me (they make me care even less about anything than the depression did). I wish you better luck!
posted by metasarah at 3:56 PM on March 18 [1 favorite]

I'm probably dysthymic by birth/nature, but the last over-a-decade have been hell for me at work and I've basically been having nervous breakdowns since 2020, and I was finally forced into getting psychiatric treatment and diagnosis thanks to my hell job. I did not want to go on the roller coaster, pig-in-a-poke journey of meds, plus I have pill swallowing issues. First I went on Wellbutrin, which made me mostly uninterested in eating and almost entirely unable to sleep for two weeks, and finally my body rebelled and refused to take it any more. So that was the right-off nightmare. Then I went on Lexapro, which is chewable and has had no side effects whatsoever, thank god. I haven't cried more than about 3 times since I went on it, and not very long any of those times, and I've been handling things on a more even keel. So, I'll stay on it.
posted by jenfullmoon at 7:25 PM on March 18

Been depressed since highschool, started treatment around 40.

It really really depends on the specific medication(s) that you will be on. I had a wonderful psychiatrist who helped me create an acceptable cocktail (effects v side-effects) of drugs over a couple/ three years.

The side effects really depend on the drug (cocktail) and your own genetics. For me, sexual dysfunction was a big one. Insomnia as well. For example, lithium worked amazing but profoundly killed my libido, gave me explosive diarrhea multiple times a day, and gave me tremors. I'm currently on a fairly low dose cocktail of a SSRI, an atypical antipsychotic, and a SNRI. With gabapentin for sleep.

Psych drugs aren't weren't a silver bullet (for me), I really had to put a lot of work in myself and I'm only at a 5-6/ 10 most days (Li got me to a solid 7 consistently despite the side effects).

Good on you for seeking help!
posted by porpoise at 7:34 PM on March 18

I started having serious depressive episodes in my mid-twenties. For various reasons I didn’t end up with the right meds until I was 43.

By far the biggest issue I had to deal with was that over years of depression I had reached a point of indifference about being alive or dead. I didn’t want to die, but I wouldn’t have minded. Despite many years of mental stability it’s only now, after a lot of therapy, that I feel that life is in the balance fun and I’d be missing out by dying.

A major thread in therapy can be the dismantling of coping mechanisms that no longer serve their purpose. In my case, staying unattached to life was a way of dealing with my depression. You’ll have your own coping mechanisms built up and you may need to dismantle them to get on with your life.

As an aside, the most important thing to remember about anti-depressants is that they are exactly what they say on the tin. They won’t do anything but regulate how far down you go. Peace, joy, and contentment are still your problems to tackle.
posted by Tell Me No Lies at 11:27 PM on March 18

I went on escitalopram/Lexapro almost exactly 2 years ago, then off it (slowly) starting in about June 2023. I can't say I noticed a massive amount of difference, even after I ramped up to the highest daily dosage.

All of which is to say, I encourage you to do the genetic testing to see which antidepressant is most likely to work for your specific biological needs. Trial-and-error with this stuff is no fun, and you don't have to put yourself through it now.
posted by yellowcandy at 7:13 AM on March 19

Going on Sertraline and having it take the edge off was the thing that made me realize I had suffered from depression most of my life. It definitely helped me, but I eventually stopped taking it because it caused me to be drenched in sweat at the slightest bit of exertion on a 65 degree day.
posted by oneirodynia at 9:22 PM on March 19

Ended Prozac in my early teens, went back on meds when I was about 30 years old, after checking myself into an ER with terrible depression.

Since then, depression has come and gone, but it's been somewhat more manageable with meds. In my case, however, antidepressants have not been nearly enough.

There were other concerns besides the depression, that were not completely addressed until I survived an abusive relationship through the pandemic. These issues led to the hardest couple years of my adult life by far, and unearthed deeper issues of codependency, abandonment trauma and parentification, dating back to years of adversity and family conflict in my childhood. My point is that depression might not be the only therapeutic concern for you, too.

All competent mental health professionals will tell you that psychiatric intervention works better in combination with clinical therapy. Meds are a scaffolding around your emotional stability. You keep this in place while you do work with talk therapy, preferably on a weekly basis, to stabilize what's beneath the scaffolding (your psyche and moods).

The idea that depression results from serotonin or other neurochemical imbalances is thoroughly discredited by now. My view of mental health has come 180 degrees toward holistic principles. The body's physical health is paramount. There's no meaningful boundary between the body and the mind, as I see it. Since the demise of my last "relationship," I began eating much healthier, going to the gym several days a week, taking vitamin D and 1,000mg EPA daily, sublingual B-9 and B-12 (the MTFHR gene might be a thing for us!), getting outside and getting much more natural light, and working very hard to be less socially isolated. (Social isolation has been a huge obstacle to my healing, and it's a tough problem in the US especially.)

Anyhow, because of these holistic practices, I went from the worst depression of my life to the best shape and best mental health of my adult life. Even doing everything possible to recover, I still have frequent mild depressive symptoms. I'm currently halfway through a series of 36 TMS sessions, and I've recently gotten both IM and sublingual ketamine treatments. With any luck, the TMS will finally resolve my dysthymia and stabilize me for a while. It seems to be working.

It has been A JOURNEY, hoo boy. And the only way to resolve the pain is to face it head on and wrestle with it--also a painful thing, but of a higher meaning, because instead of running from your pain you run toward it.

If you want to heal, do three things a day that help you do it. Write them down. I'd encourage you to go to weekly talk therapy and stay with it for as long as you can. I hope that insurance will cover that for you, of course. Make healing your number one priority, commit to it and set specific goals with your therapist. Ask them if they have structured materials that might help, and if they might have some milestones and a timeframe for your therapy. And remember that a therapist only points you in the right direction (ideally). You have to march yourself down the path. Do not hesitate to fire a therapist based on mere gut feeling or vibes. Read self help books, go on the university of YouTube and learn all you can about yourself. Journaling and guided shadow meditations (also on YouTube) were also very helpful for me.

I commend you on your choice to get medication, though. I'm a huge fan of both psychiatry and therapy, and it takes courage to do these kinds of work on yourself. So many people spend their entire lives running from their pain. I wish you all the best of luck and health in your own healing journey.

Couple other notes:

- You might need to try a series of different meds before you find your Goldilocks dose/pill(s). For me, I tried several SSRIs (and one or two things in combination) before giving up on them (hated the sexual side FX) and going with an atypical antidepressant (Wellbutrin).
- You need to be forthcoming with your shrink about your feelings about meds and treatment. That is, you need to manage them like you have to manage all your doctors, which is an unfortunate fact of the health care system that's rarely mentioned.
posted by tovarisch at 1:35 PM on March 20

Whatever you are scared of losing or sacrificing is highly unlikely to happen.
posted by softlord at 11:51 AM on March 28

The idea that depression results from serotonin or other neurochemical imbalances is thoroughly discredited by now.

Basically every national health system in the world disagrees with this assessment, as does the World Health Organization.

For the U.S, the American Medical Association, the American Psychiatric Association, and American National Institute of Health are all right behind SSRIs as an adjunct to treating depression.
posted by Tell Me No Lies at 9:16 PM on March 28