How long have you been on anti-depressants?

[MayaBlue]

I'm sure this isn't a new subject but fresh insight would be so helpful. I've suffered from anxiety for years but have just recently come to the conclusion I may have some sort of personality disorder, probably borderline. My GP isn't interested in referring me and has told me that the simple answer is to stay on medication indefintely. It certainly seems to help but when I come off it I just crash so I obviously can't do without. I've been on and off sertraline now for about 10 years.

The one issue is obviously that I have an unsympathetic GP (to say the least) and should I continue trying to get other treatment, but the other is, is it OK to be on anti-ds just to feel normal and how long do you do it for?

[GetDownYouWillFall]

I don't think there's any problem being on ADs for a long time, but can understand your feelings of being less than impressed by your GPs attitude.

Out of interest, what makes you think you have a personality disorder, rather than depression? Do you have highs and lows as well?

I think they sometimes give anti-psychotics to BPD patients as well as mood stabilisers. This would have to be under the supervision of a specialist - ie. a psychiatrist.

It is pants that he won't refer you. Perhaps you need to gather some evidence to support your thinking re. BPD and present it to the GP, insisting you want a referral.

Otherwise how about changing GPs? Not wishing to be sexist, but maybe a female GP would be more sympathetic?

I have been on lithium, anti-psychotics and ADs. I was on them all for about 2 years but have gradually cut down and am now just on the AD. Cutting that out too as we want to try for another baby.

So, in short, I don't think you should worry about being on the AD long term, but if you feel you need specialist treatment you should insist on a referral.

[MayaBlue]

Thank you Get Down. My main symptom does seem to be ever-changing moods - up one moment, down the next - and this has been the pattern all my life. Also I'm very impulsive and find controlling my emotions a great challenge. Also avoiding relationships at the moment because my fear of abandonment and insecurity has always meant pain in the past.

Unfortunately my GP is a woman and because I'm "functioning" ie holding down a job and being a good mum, I'm not high priority in her eyes. I'll consider what to do. Meanwhile, I guess I'll just keep taking the tablets....

Glad things have worked out for you and good luck with the baby!

[GetDownYouWillFall]

Sorry about the assumption about the GP (I've always had nice female GPs and the not-so-nice ones have always been men!)

You could still look at changing GPs though. Some have much more of an interest / knowledge around mental health than others.

From what you describe it does sound a bit like BPD. Maybe you could order this only £1. May help you understand it a bit more?

Great that you are holding down a job and being a good mum! You sound like you are doing fab.

Thanks re. trying for a baby (am quite scared but also excited)

[Sarahpo]

I can only give my own personal experience but i found that AD's (as in SSRI's) made me much more up and down and i had more extreme 'highs' I also took some very irrational decisions when i was on them :-(

I took AD's on and off for ten years and i would really fight not to take them again. I am not against them though as they help to lift mood.

We have manic depression in my family and both me and my sis are prone to highs and lows and i sometimes wonder if a mood stabiliser would help? There is nothing wrong per se with taking Sertraline for ten years but if you feel that it isn't working to control the ups and downs then you do need to see a GP shame you can't be referred to the CMHT locally? I would perhaps try again with a different doc. Do you have any side effects from the Sertraline or is it otherwise ok for you?

[Keziahhopes]

Hi,
why not ask your Gp to refer you to your local mental health team, then it is up to their multi-disciplinary team to assess you and decide whether to see you, not your gp's.

However, a different diagnosis doesn't mean necessarily any other treatment, it may do - antipsychotics often given to people with personality disorders.

However, having a personality disorder diagnosis can be, in my opinion, a poisoned chalice - for insurance, work/occupational health, lack of access to mental health teams esp crisis teams as it is a personality disorder rather than "mental health" - not saying this is true of all teams/areas.

Can you think about what you are wanting with a diagnosis and seek that - is it talking help, in which case the IAPT (Goverment initiative, improving access to psychological treatments) can be accessed by your gp/any gp you see instead, is it a medication review - in which case a psychiatrist is the one to do that, above a ggp. All the best.

[MayaBlue]

Thanks for all the advice. Don't seem to have side-effects from sertraline, although it does seem to induce a real craving for alcohol after a few months which I struggle to control.

Kezia - you make a good point but I suppose I was hoping it might entitle me to some sort of psychotherapy. What kind of mood stabliser would be appropriate I wonder? I thought they were only prescribed for bi-polar etc.

At least I'm having a good weekend with my family and on an even keel again because the SSRIs have kicked in.

[kizzie]

Hi MayaBlue - i have now been on ad's for 11 years .
I cant quite believe it really - but was prescribed them for anxiety based PND and have never been able to stop them since without crashing.

I was originally on seroxat and now on low dose tricyclic (clomipramine/anafranil).
I have gone through a very difficult time this year because i came off completely in Jan again (after being well on tiny doses
through 2008 and 2009) but crashed again.

Unfortunately this time I havent been able to stabilise again and really struggling with both anxiety and depression.

To be honest i dont like taking the medication but at the moment i would give anything to stabilise.

I am going to spend the next couple of months working really hard on cbt/relaxation but if that has no effect then will likely try another AD - although at the moment very scared that I wont find one now to work.

Anyway sorry for rambling on. the purpose was to say that i totally understand your wish not just to be left 'functioning'. I think its brilliant that you are holding down a job and having some lovely family time - but if you dont feel that your GP has really got to the root of the problem then i too would push for a referral. x

[TotalChaos]

I have been on Prozac for 6.5 years, with no plan to come off soon. Was put on them by psych in accordance with Royal College Guidelines as I had had a certain no. of relapses when off them. Obviously the lack of onward referral/your concerns round PD are a separate concern.

sorry you are still having a bad time kizzie, I remember seeing your posts a few months back, hope you feel better soon.

[AuntieMaggie]

I've been on citalopram for about 3 years (?) for anciety/pmt since I had some serious medical issues. I'd been on them before for a short period and had been off them for a couple of years.

I'm on a low dose but sometimes when something happens my GP may increase the dose for a short while. Every now and then we'll mention looking at whether I still need them but when that time comes around something seems to happen that means we agree its not the best time. But then I have to have 6 monthly scans for something that may either turn cancerous or mean I have to have a transplant later in life. Both very remote possibilities but all the same...

I try not to think about it too much but perhaps I should. I know I have to look at coming off them when I want to have a baby, but I also know that I'll have to come off the pill too which will cause its own problems.

I would try speaking to another GP and think about what you think might trigger your anxiety.

I also tried CBT but to be honest I found good old fashioned counselling with a lovely older lady much more beneficial, probably because I'm not much good at opening up to people in my real life.

I would also try not to read too much on the internet - it can be a great help sometimes but others it can make things worse.

good luck x

[strawberry17]

When you stop the antidepressants you are "crashing" because you are coming off them too fast. I have been on prozac for 10+ years and every time I tried to come off I crashed big time, I thought for years that something was inherently wrong with me and that I would always need prozac to live a stable life, but could never accept being on prozac the rest of my life because of the devestating effect prozac had on my sex life/libido. I have been weaning off liquid prozac now for two years and been very stable, no crashing at all. Does this ring any bells with you? I might be totally barking up the wrong tree here as you say you have always struggled with up and down emotions, but coming on and off antidepressants too fast definately won't help.

[strawberry17]

Doctors don't tell you that antidepressants can be extremely difficult to get off of, in fact I was told the opposite, some people have no problems getting off, but a lot do.

[sorrento56]

I have been on them this time for about 4 years but in total nearer 8-9. I will never be able to come off them and atm find they are not helping me quite as much but I think it is more to do with external pressures that no drugs can fix.

[Earlybird]

have no experience with anti-depressants, so this is an innocent question..

Is it possible/likely that coming off anti-depressant/anti-anxiety has a psychosomatic component? What I mean is - do you feel so worried that you might not be able to cope without the medication that you actually cause yourself to feel anxious/depressed?

I am generally in favor of using medication along with therapy/analysis so that a person learns coping techniques and strategies to deal with the ups and downs of life. But, I accept that some people have a chemical imbalance that prevents a peaceful mental state - no matter how much counselling they have.

[sorrento56]

I know I will never be able to manage without them and for me, it isn't psychological but physiological.

[strawberry17]

earlybird yes you have hit the nail on the head, for me and many others there is a catch 22 which put really simply means you get anxious/phobic about the coming off medication, and then the withdrawals also from coming off too fast mimic your original anxiety/depressive symptoms ten fold which is how one can end up stuck on the antidepressants, that's why weaning off really slowly is very reassuring because it buys you lots of time to get used to dealing with your own emotions slowly and gradually. It's going to take me four years minimum from start to finish to get off prozac sadly, some can do it a lot faster.

[crazyhayz]

Ive been on citalopram for quite a while and just cut my tablets in half when i wanted to slowly cut down. Its working fine so far :)

[AspieGirl]

Seroxat for 4 years. Dose seems to go up every year, so soon we'll have to look for another as I was up to 60mg in Jan. Am back to 50 now, so maybe I'll manage for a while.

Although, I would like another baby, maybe next year, which means I will have to come off the seroxat and go onto a different antiD. I'll have to swap a bunch of meds actually. Should be a lovely fun time.

Got to get thin first...least that is going well.

The problem with being on them long term is that they don't seem to work consistently, at least not on me, and so the dose has to keep going up and up. But there again, I can't function without them so it's swings and roundabouts really.

[strawberry17]

Crazyhayz - you are maybe one of the lucky ones!

[TriplePachyderm]

10 years

[angel2001]

been on them for ten yeasrs this time and was on them abut 15 years ago for a year. trial and error with them. they seem to work for 6 mths then stop