Please help - do I need to go back on antidepressant

[violator]

Or is this just the way things are when you stop taking them and the discontinuation lasts a long time?

I was on 10mgs escitalopram for 2.5 years. I took six months to wean down in increments and stopped completely at the end of January. By then I was taking a crumb of a pill in the mornings.

I felt fine for two weeks, and then had some nasty physical side effects, which my pharmacist reassured me were normal and would pass.
And they did.

But then I developed a crushing, overwhelming depression just before my period was due. It would lift as soon as my period arrived, but it was shockingly bad and the depths of it really scared me.
I had always had some kind of PMS but it went off the scale after my son was born.

I think the antidepressant masked a lot of it because it was really only when I came off escitalopram completely that the premenstrual mood hit the floor and I wanted to climb under the covers and stay there for a week. I think it's PMDD.

The minipill doesn't agree with me at all, my doc won't give me the combined pill because I'm over 35 and still smoking a cig a few times a day (I'd been off cigs for 8 years before PND sent me crazy and back smoking)

I'm just after another week of hell, my period arrived but this time I'm not bouncing back like I have done before. I'm just so tired of this rollercoaster. I put a lot of work into getting well when I had PND.

I did a lot of counselling, CBT and a course in mindfulness and worked really hard on myself.

Life was good, I felt well and strong which is why I thought it was time to come off the antidepressant.

Has anyone re-instated an antidepressant after 4 months off it? How was it?

I'm just so tired of feeling like this. I'm so disappointed, I really thought I'd weathered the antidepressant withdrawal storm. I don't think I'm depressed but just feel so flat and 'meh' about life, until then I get 7-10 days of utter premenstrual hell every month.

My GP is useless.

[rabbitrisen]

I dont know the answer, but could you see another GP in your practice?

[SilverStars]

Hi are there other hormonal methods of contraception ( coil???) that could help? If it is hormonal maybe treating that is a route, that may help. Maybe see a useful practise nurse if you can to discuss rather than a gp if useless.

You say you have done a lot of counselling and work on yourself - do any of those techniques you learnt help now? If not it may be a medical matter which talking treatments have less effect on and need a medical treatment? ( disclaimer am not a gp!) it is good you have realised it is cyclical, so hopefully some appropriate medication can help, or age appropriate hormonal contraception etc.

[violator]

Thanks for the replies.
I've asked to be referred to a gynae. I want my thyroid checked and hormones, I truly believe there's something hormonally out of whack.
The coil is just progesterone, and I'm terrified it'd make things worse.
Hopefully a gynae might be able to help. Seems this cyclical depression isn't uncommon in women 35+ and is often diagnosed as bipolar when it's down to hormonal fluctuations.

[everythinginthegardensisrosie]

I'm going through similar.

Had PND after the birth of my son and was on Sertraline for over two years. Very gradually weaned off of it over 6 months. I was then ad free from Jan until a few weeks ago. Had lots of therapy and worked really hard on myself too.

I'm now back on ads as had terrible PMT and obsessive thoughts again - very disappointing.

I started the ads 2 weeks ago and last week I felt terrible but after this second week I'm starting to feel myself again.

The minipill doesn't agree with me either - in fact every contraceptive pill I've tried makes me slightly crazy.

[everythinginthegardensisrosie]

....what I also meant to say is that I was very disappointed to be back on them at first as it seemed like a giant step back, but now they've 'kicked in' I feel better about it all.

[ColouringInQueen]

Hi OP. Sorry to hear you're feeling worse. From what I've read (am no expert) pmdd usually doesn't respond to hormonal contraception (and it can become worse) SSRIs are the first line treatment at a low dose.

I've been on fluoxetine for just over a year and one bonus has been no awful 8-10 day PMS. I've spoken to my GP about reducing but said I'm in no rush to come off completely as it has made me realise how bad my PMS was. Luckily she was fine with that.

Sounds like a good plan to get thyroid etc checked out, but is there another GP you can speak to about this? Try not to feel too disappointed, PMDD is a real problem and if you need a low dose SSRI to sort it, then go for it. All the best.

[Dirtypaws]

Feck me! Sounds like me too! Have been off them for 2 or so months. First month was fine, second month PMT from hell, sort of settled down abut then PMT again. Although it seems to be vicious PMT (which I used to get before kids and ad's) and then meh and slightly irritable/down for rest of time. I haven't been so good to myself I'm afraid. Although Ive finally decided to go down counselling route. I too am upset that I'm back on them, the first month was brill and I felt great.

[Dirtypaws]

Colouring queen -what about HRT? Do you know anything about that? I've often thought my PMT was PMDD. It's hell. I wonder now I'm entering the menopause whether HRT can help or would that be a hit like the pill I.e. hormone treatments.

[ColouringInQueen]

Hi dirtypaws no I don't know about HRT - good question. I have read that anxiety often increases with the menopause, and for some women shifting hormones leading up to the menopause can make PMS worse/better... But if you think you might be heading to the menopause, prob worth getting your bloods done to check hormone levels? Peri-menopause seems to start for some women in early 40s, though rare.

[superstarheartbreaker]

Why not get the non hormonal copper coil instead...it's fab. I don't know why so mAny take the hormonal stuff tbh... I think it does send me crazy.

[violator]

I'm sorry to see I'm not alone!

I came across Prof John Studd's website and he has done a lot of research into this. He's had success giving women HRT, oestrogen patches with progesterone pills or a Mirena.
He also says PMDD is very common in women who had PND previously, so I guess the hormonal link is the big factor. So I'll ask the gynae about that when I see him.

I had an awful time starting different SSRIs. In fact it was so bad I had to be hospitalised for a while. The thought of starting up on them again is terrifying.
If I can be helped with HRT I'll gladly take it ahead of SSRIs.
I'm 38 but both my mum and sister started menopause at 39 and 40 so I'm sure this is all linked.