Don't know what to do

[prettydaisies]

I have suffered with depression and anxiety on and off for a while now. I take mirtazipine either 30mg or 45mg depending on how I am.
Just now I feel myself going down. I self harmed at the weekend for the 1st time for a good six months and whilst I'm not suicidal I do have dark thoughts.
Is it worth going back to the doctor's? I work full time and would have to get an emergency appt so no idea who I would see and what they could do. Also it's hard to leave work during the day. I know there are some reasons for feeling like this and I am hoping it will pass, but what if it doesn't.
If anyone has any advice or questions that would make me think more clearly, I would be grateful.

[noclevername]

Definitely worth going to a doctors.

Probably not a good idea to vary the dose - antidepressants are not addictive but if the dose is abruptly reduced you can get so called 'discontinuation symptoms' - these can include unsettled mood, possibly symptoms similar to the original illness. Discontinuation symptoms generally go away on their own in a few weeks but can be avoided by reducing the rise more gradually when the time comes to stop the antidepressant.

Your doctor would want to know if you were thinking if coming off the drug. After one episode if depression it's recommended to stay on the dose that got you well fir 6 months to protect against relapse. After several episodes it may be advised to stay on them for a few years.

You probably know this but mirtazapine at 45mg has additional benefits that 30mg does not (I won't bother explaining as it's all on internet if you are interested !) So basically if 45mg suited you in the past then reducing the dose may not be helping you.

The benefits of antidepressants take weeks to fully work so changing the dose say every few days is unlikely to be if benefit for reasons explained.

Sorry to hear you are feeling so bad. I can't give direct advice, but in your shoes I would make a Doctor's appointment and meanwhile take the medication exactly as prescribed.

Post way too long- hope you feel better soon.

[prettydaisies]

It's ok I dont chop and change. Used to take 45 and now take 30.