Are antidepressants warranted in this scenario?

Deal with the root cause. Whatever is causing them trauma. Find out what is hurting them not avoid it and pretend it is the brain that is the problem when it is something external that is the problem.

So what do you recommend people with problem levels of anxiety do?

That sounds really tough. I really hope everything works out for you x

I’m almost forty and I gave up on the idea of a second about a year ago. It was hard but honestly now that I’m moving past that point, it is getting easier and easier. I’m still sad about it but I no longer have that kind of agitation, that I need to do something, to fix it - it just is what it is and that is so much easier to cope with.
Antidepressants have helped me a lot. I wasn’t sleeping and they massively helped with that which really really helped my mood. I’m not going to say they’re a solution on their own or they work perfectly but I find they really do help.

Going with one that’s worked before can be a good idea. Obviously mention to your doctor about the prolactinoma in relation to anything they prescribe.

There is no pathology at all as it isn't medical. It is a normal response to something.

What is wrong with taking a drug to dope and not deal with the root cause? Go figure! Same as with cough medicine! Makes pharmacists rich and naff all else 🤣

Oh I can argue they dope people in that doping doesn't deal with the issues nor does a placebo! Neither do a thing against the root cause. Of course it'll do something in your body but it won't treat anxiety! Like taking paracetamol won't treat anxiety but it'll do things in your body!

Stress and problem anxiety are a medical issue because they affect how the body functions and can cause or exacerbate other physical problems, plus they cause psychological distress and lower quality of life generally.

Even if a drug does work on the basis of sedation, that can lower stress / anxiety levels and help get the person to a place where they can make other positive changes and increase wellbeing - what’s wrong with that?

You can’t argue both that they “dope” people and that they are only as effective as a placebo. They either have a sedative effect or do nothing, it can’t be both.

None of that answered my question. I've read quite enough to make my own mind up - reading both sides of the coin and the evidence is quite clear it shows no noticeable result compared with a placebo as there isn't anything that the drugs can do within the body to improve what is a normal reaction.

Anxiety isn't medical so why do you need medication for something that isn't medical? There is no abnormality in the brain for the medication to target so what does it do?

The research shows they dope as there is no underlying abnormality that has been found so the drugs do not act on anything within the brain other than to dope. The chemical imbalance has been proven to be a myth.

By all means see your GP, and describe your symptoms, but they will decide whether antidepressants are appropriate. There may be other options, and you need a proper clinical opinion.

@whippy1981
https://www.cochrane.org/news/antidepressants-reduce-anxiety-long-term-impact-remains-unclear

Decent summary of the evidence base here - more long term research needed but good evidence from placebo controlled trials that antidepressants are effective in anxiety.

Please be careful not to make statements like "AD dopes and does nothing else" - there's good evidence that this is untrue but quite possible that someone who is / has been unwell could read this, and stop or not start medication that is appropriate for them ie create a potentially dangerous situation.

To OP - definitely make an appointment with your GP (or mental health practitioner if your surgery has one) and talk through your options with them. Good luck and I hope you feel better soon.

What do they do when it isn't a medical issue it is a response? Given anxiety isn't biological how does something medical fix something that isn't broken?

What tests do they medically perform to prove anxiety and what medically does the AD do to change what they have tested?

That’s interesting, thanks.

OP, talk to your GP. If you tell them you are TTC, they can recommend something suitable.
There are lots of ADs which aren’t SSRIs.
However, it’s quite restricted what you can take while ttc/ pregnant/ bf, especially if you are not already in it or have been before.
Honestly, it’s not a very good idea to ttc when you are suffering from depression and anxiety. A doctor can help you work out whether you are clinically depressed and/ or have problem anxiety.
If you can, I would recommend you focus on getting yourself to a better place emotionally and park ttc til then. I know sometimes time is not on your side but you have to consider that conceiving might not necessarily immediately fix everything and think about whether you are in the best place to be ttc if you aren’t feeling well in yourself.
I had ppd/ anxiety and had to go on meds not suitable for ttc/ pregnancy. I had been holding off going on them so I could try for number two but I was cracking up and couldn’t go on any longer.
Eventually I had to make the very difficult decision to accept that I probably wouldn’t have another child and prioritise getting myself in better shape so I could be the best mother I can be to the child I already have.
Now that I’m thinking straight, I realise there’s no way I could have coped with a second pregnancy/ baby anyway when I was feeling so low. My thinking was all over the place.
It is the last thing you want to hear at the time, but honestly once you accept it it really can start to get easier.
Then for me I noticed, as you start to move away from that point in your life, you get less focused on it. For most people, I think the pain does lessen with time.
I think hormones have a big part to play in it and it can be helpful to bear in mind how much hormones can influence how you think and feel and try to see things objectively.

googling brings lots of sites highlighting potential issue

one example here https://www.psychiatrictimes.com/view/ssris-decrease-fertility

Yes I did hear about the antipsychotics too - anything that potentially lowers dopamine might cause this

Oh I have and it all points that AD do naff all as anxiety isn't biological, thanks for the advice though!

Medical trials have shown that the placebos either create the same impact or work better. The study by Kostic was interesting. You might wanna read it.

There’s plenty of medical trials and literature on the topic - Google is your friend.

That is true - first what is the test for anxiety, what is broken in the body that needs fixing? What tests do they do and then what does the meds do in the body to change that?

That’s not true - anti depressants are effective in treating anxiety too.

AD dopes and does nothing else. Not sure how it brings it down when anxiety isn't a biological issue so meds will have no impact on it.

Where did you get that information from?

I have heard of particular anti psychotic medications like olanzapine triggering gallactorrhea (abnormal milk production) because it suppresses dopamine which in turn can lead to overproduction of prolactin, but never heard this about antidepressants? Which ones particularly?

Yes good idea, they can really help you get your head above water.

You do also need therapy alongside to deal with the grief though.

She mentions anxiety etc though and I think we underestimate how those normal responses creep into our lives and become an issue, that isn’t part of our response to the initial upset. Things manifest.

AD’s can help bring your baseline anxiety etc down and give you some space to focus on the bigger issues and carve a way forwards.

I'd say no as there isn't anything wrong with you and your emotions are normal in response to the trauma you are experiencing. There isn't an illness in your brain that needs fixing and medication will not fix the root cause of this.

YANBU. Secondary infertility is so painful and there is no escape from it. It was all consuming for me - the first and last thing I thought of every day, and I was constantly bombarded with intrusive thoughts that no amount of counselling or CBT could remove. Therapy gave me a space to vent about my feelings, but until you either conceive or decide to stop then you're just stuck in the trying and it's torture. You might find that a low dose might takes the edge off and quietens that inner voice. Just make sure you are open with your GP about the reason and ask for something that is ok for ttc and pregnancy. Also just fyi setraline is known to crush your libido, which is probably already taking a battering from the ttc so I'm afraid that is likely to get even more joyless!

Omg! useful not useless!

I'm really sorry you're having such a difficult time.

It would certainly be worth seeing your GP and medication is definitely one of the things that might help you. Obviously it's not like a taking a magic pill that makes everything all right, but it certainly might just help you feel a bit more able to manage your feelings and navigate your way through what you're experiencing. Antidepressants won't make you feel instantly better (you might even feel a bit worse for two or three weeks at first) but long term they can certainly help.

I've taken Seroxat, citalopram and sertraline and have had slightly different experiences with all of them in terms of side effects, but they've all ultimately been effective. I'm currently on Sertraline and I had some side effects for the first three weeks (mostly nausea) but after that, no side effects at all really. Everyone's experience is different but that was how it was for me.