Being on antidepressant medication

Sunday, September 09, 2018

TW: anxiety, depression, self-harm

For a lot of you who know me in real life, and who follow me on social media, you would likely know that I have been on antidepressants for the past few years. Four years in fact. About halfway through last year I decided it was time me to try life without them, and in April this year (with the help of my doctor) I started to ease myself off them, and at the end of August I was completely clean.

Something I have discovered is that talking about mental health issues is still very hush-hush, and often the conversations I have, I have with people privately. It definitely took me a while to be comfortable talking about my issues (and often having a whee cry at the same time), and each time I talk about being on medication, or having mental health issues - online or in person - people commend me for being so open about it, and often come to me about my experiences and their experiences. But I want to let everyone else know that it is okay to talk about it, and it is okay to admit you need help and to go get it. Because that's what I did.

So today, I thought I'd open up the conversation and talk about my experience with anti-depressants, and answer some questions that I often get asked. Not that I'm saying that I am any kind of expert, absolutely not. If you're considering going on (or off) medication to help with mental health problems (or any kind of problems) certainly talk to your doctor, nurse or even just a pharmacist to get some medical advice. I'm however here to share my experience and open the floor for people to talk about their experiences and we can just compare notes!


How did I know I needed medication?
I didn't know. I had always thought that antidepressants and other similar medications were for "crazy" people, people who had no control. But that's simply not true. When I was really struggling, mentally, and went to the doctors for help I had no idea what was happening to me, I knew how anxiety felt like but this felt different. I knew something was "wrong" with me, but I was so lost and confused that I didn't have a clue about anything and just wanted what was happening to me to stop.

I believe it was a lot of aspects in my life that just sort of all piled up on top of each other and I just didn't know how to cope. Things like being at university, living with a group of people who I had only really just met, and starting my first serious relationship. Lots of big changes all at once. I had struggled with anxiety for many years, since my first few years of high school, but it just kind of hit an all-time high - I was coming home every afternoon from class to cry in my room until I fell asleep at night, I was withdrawing myself from my friends, I wasn't trying hard with my university work, I had started self-harming, I wasn't eating when I was hungry...

I knew I was struggling and I knew I needed help, luckily I had noticed I was beginning to go in a downwards spiral and I knew I needed to get "help" (whatever that meant) otherwise it would get even worse.

What did I have to do to get referred to a doctor?
I was studying at the time and I knew that my university doctors had mental health services so I just scrolled through the website until I found out what was offered at the doctors there, which meant filling out a form. I found the form to be amazing, as I was struggling a lot with expressing my emotions and thoughts (apart from crying in my room for hours each day) and this asked all sorts of questions which I hadn't even asked myself; why I wanted to seek help, what I wanted to achieve, how my mental health struggles were effecting my studies/relationships/general health and so on. When the doctors contacted me a couple of days after submitting the form I got an appointment really quickly, and it all kind of snow-balled afterwards. 

What were the initial appointment like?
The appointment itself was really similar to what the form was asking, except it went more in-depth with the questions that the doctor asked me. I then filled out another form which "measured" my emotions right there and then (this was then used as a baseline to compare in a few months time and again and again.) The doctor then referred me to one of the in-house counselors who was to diagnose me, I saw him a few days later. That appointment was quite awkward at first, the counselor was pretty blunt and he was sometimes a bit brash, but that really helped me at this stage as he kind of just forced me to talk and open up. I feel like if I had someone who was a bit more softer I wouldn't have be so open and I probably would have not gotten the diagnosis that I needed. After the appointment with the counselor he then referred me back to the doctor and then she and I talked about my options, including medication, which was the decision we ended up agreeing on was what was best for me.

What was it like going on the medication?
After that last appointment with the doctor, she gave me a prescription for some antidepressants (Citalopram) and I held onto it for about a week before I actually took it to the pharmacy, and then held onto the box of pills for another few days before actually starting to take them. I guess I was scared, it felt like I was "giving in" to the depression, but really it was the total opposite. I was told to take one 20mg pill per day, but I had to ease myself onto them by starting with a quarter then a few weeks later go up to a half and so on until I reached a whole pill.

I don't remember a lot of how it was like going onto the medication as it was a long time ago. However, I do remember not having a lot of drastic side-effects and I was lucky enough to not have much of a difficult time adjusting to this new chemical in my body. I was also lucky enough to have found the "right" medication for me the first time around.

Side note: I did move up to taking two pills per day in about a year's time as I was beginning to develop chronic fatigue and we had thought that the Citalopram was a cause. I didn't find any change to the fatigue going up to two pills but we just never reduced it back down to one as I felt like this dosage felt "right" for me.

What was it like being on the medication?
As antidepressants are more often than not mood stabilisers, it essentially did just that. My low moods were just so low all the time, I needed them to be brought up, but in order to do that the medication then brought the highs down. I was just sitting around this grey zone in the middle (imagine it like a wave graph). That was something I really didn't like, but if you think about it, there isn't really much of a way around that; I was simply glad that the lows were no way near as bad as they were.

I did have a few side effects, and these were having a very low labido, having a lot of alcohol especially any amount of wine would turn me into an emotional mess (I read up on a bunch of forums and many people using Citalopram would have the same experience with wine), I did develop constant fatigue (although I am not sure if it was the medication to blame or the stresses that came with university). I did have a small handful of panic attacks whilst on the medication, but these were kind of a given with how my mind and brain were behaving.

Some common side effects that I didn't experience at all were changes in my diet or appetite (being on the medication actually motivated me to eat when I was hungry), I didn't have any feelings of nausea, nor did I have any suicidal thoughts or tendencies. 

How did people react to me being on medication?
Some people were taken aback by the idea, but once I explained to them that I was truly struggling and that taking medication like antidepressants wasn't something myself or my doctors were taking lightly, they came around and even supported me.

I told my boyfriend (who I had only really started dating at the time, and am still with him now!) from the very beginning what was happening (because if he wasn't going to accept that then, then it wasn't going to work), I told my flatmates and a few close friends (some of which struggled with the idea of me having mental health issues, and a few distanced themselves from me to the point of the friendship just fizzling out), I told my parents and brother (who were a bit shocked at the whole situation at first as I never told them I was struggling for all those years, but they accepted the whole thing and were lovely). I then warmed up to telling a few tutors/lecturers at university (who were all very understanding, they even offered me some extensions on some assignments if I felt like I needed a bit extra time). When I got the job I currently have I told my bosses and a few colleagues who were all completely supportive and check-in with me every so often.

It's quite easy to see before even telling people who will accept and understand mental health issues. If people use slurs, or mock mental disabilities or mental health issues, then it's very likely not going to go down well. However, if they are genuinely nice people and you feel comfortable talking to them about serious issues, then go ahead and tell them. If people don't end up taking it well, then maybe they're not the right kind of people to be around.

What made me decide to come off the medication?
I guess I thought that I was ready to try life without the need for mood stabilisers. I had been panic attack free for over a year, I had finished university and got myself a stable job, my relationships were strong (romantic and platonic) and I just overall felt ready. I was also a bit "over" the grey zone of moods I was experiencing (remember that wave graph I mentioned earlier?) and wanted my peak highs back - I knew this may mean that my lows could return but I felt like I was ready to tackle them as they came apparent.

I talked to my doctor about my idea of coming off the medication (as I had finished university I had to change GPs and thus my doctor) and he said that my life had to be calm and settled before I try changing anything with my medication. As it all was, we agreed it was time.

What was the process of coming off the medication?
Coming off the medication was the same process as going on it, I had to lower my dose by small increments over a long period of time. However, before I even started that I started going to therapy, as I hadn't talked to a professional about my thoughts, feelings and emotions since that initial consultation and thought it would be a good idea to do so. I went for about six months, once a fortnight, until I felt like I had addressed what I wanted to address and I had developed a game-plan to help handle my anxiety when I was reducing my medication and then being off it altogether.

I didn't really experience any side-effects coming off the medication apart from my body low-key freaking out that this boost in serotonin was going away. This didn't start happening until I had gone down to half a pill (that's 10mg) and then a quarter of a pill (5mg). I noticed my mood was flipping dramatically quite quickly, and that I wasn't handling stress like I used to. Something as simple as planning a trip to the movies with some friends not working out would feel like my world is crashing down and I would just start to cry. I knew this was expected and had told a lot of people close to me that I was going to be pretty sensitive to things, and I had a game-plan of coping mechanisms.

I've been off my medication for about two and a bit weeks now. I'm certainly taking a while to adjust to having no medication in my body. Hey, I was on it for over four years, my body was essentially reliant on it and now it doesn't have it. I'm expecting to take a good few months of whirl-wind emotions before things properly settle. When I next go to my doctor I'll bring it up if I am worried.

I'd love to know your experiences of being on medication. Have you (or do you) taken medication for mental health reasons, what was it like for you? Do you know someone who uses medication like this, what is it like looking form the outside-in? I'd love to talk to some more people about their experiences with antidepressant medication!

I'm thinking of doing an update on how things are in a few months, and document some coping mechanisms that I have found work for me, and ones that don't.

- Louise x

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