AIBU to want to manage without drugs?

I used setraline for around one year after a very rough part of my life. The GP said I didn't need them any longer than that. It didn't make much difference after that year except negatively affecting my sex life.

DH got recently redeployed after nine months being signed off due to stress. It took ages for a solution to be found. Going back to his previous role was making him more stressed. If this redeployment doesn't work out either the clock will be ticking and he'll be given a time limit by his employer to find another suitable role or waved out the door in two year's time. Companies only seem to have so much patience...

Hi OP,

Thank you so much for starting this thread because I am in a very similar situation to you. I picked up my prescription for Sertraline at the weekend, but I haven't started yet.

I too am concerned about the side affects . Firstly because I'm a god awful sleeper and I don't want that to be made worse. And secondly, and perhaps unreasonably, I'm really worried it might have a negative impact on my hair. I know it's silly but I've just read too many posts on here / Reddit where people have described hair thinning and hair fall because of ADs. My hair isn't that great to begin with, at least I have it thankfully, I just mean it's really flat and fine and even a small reduction in quality would be noticeable and would knock my confidence.

I also am putting my rough patch down to life circumstances and being generally worried about the state of the country / world, Antisemitism (I have Jewish family members and many Jewish friends now leaving Britain), not happy in my job and pissed of with their work (woke) culture. Not a chemical imbalance. If it wasn't for my lovely toddler I think I'd just give up (not in that way, I mean I'd go and teach English abroad and drift around, which for an almost 40 year old it kind of lame).

Have you checked the NICE guidelines for the treatment recommendations? I’ve been on ADs a few times, successfully, but also used CBT to learn how to manage moods and emotions. I found most recently (it’s been years since I had an episode) that the guidelines have changed and they’re not meant to just push ADs on to you but offer other options too (such as Talking Therapies which tends to be CBT based, or other counselling) plus the behavioural stuff like being in a routine, sleep hygiene, eating, exercise.

Can you use your Employee Assistance Programme and/or self-refer to Talking therapies?

I refused ADs this time as I didn’t want to deal with the side effects and instead did counselling, plus reduced workload and getting work to deal with the things that were causing stress (counselling helped with this). Plus structured routine, concentrating on eating and sleeping plus spending time with friends/family. I’m feeling a lot better now.

Not completely discredited. Lost Connections and Stolen Focus were both well received.

seems you have spent the time off doing useful things. Have you thought of adding some therapy in? If your workplace has an employee assistance programme that will be a good place to start and you can also ask for a work stress risk assessment from HR.

Do you mean the completely discredited Johann Hari?

Scientology?

Johann Hari analyses the evidence base in his book Lost Connections.

Remember that any kind of “support thread” is going to be filled with people who are struggling - people who just take the meds and get on with things aren’t going to be the ones posting about it online.

But if the side effects are worrying you then you can always ask to try a different medication - there are loads of SSRI’s out there and each one will be different. I personally didn’t get on with sertraline but have been on paroxetine for 18 months with no issues.

Personally I would try medication - it doesn’t need to be forever but you’re clearly struggling and I don’t see the benefit in forcing yourself to struggle through when there’s help being offered to you.

I would love a link to the evidence. Otherwise I might think you have a Scientologist agenda.

So how are you going to access this time and space? If you know that is what you need, why haven't you done it already?

If you don't want to take sertraline, why not ask the GP for an alternative there certainly are other possibilities.

Quite often the refusal to take medication is a part of the illness that causes the patient to need it.

I guess the question is, if you don’t want to take the medication, what is it that you wanted from visiting the GP in the first place?

Don't take the drugs if you don't want to. Its up to you but there is nothing wrong with taking the medication designed to make you well again. If you don't want to feel well, don't take it. The pride in not taking medication will surely give you so much joy your physiological scientific illness will spontaneously clear up. My grandfather would probably have had a life worth living and wouldn't have hung himself if these naughty old pills had been available then. I have absolutely no time for this crap. Be happy, be miserable, you are the master of your own life. Just don't let it spill out into your loved ones lives and ruin theirs.

Crikey get another job - why swing the lead on this company it’s unacceptable

Op I went to the gp before and they asked did I need any help for emotional support- I had come for physical stuff but when they asked was there any stress there I told them the physical stuff was tough, work was hard, myself and dh were breaking up, my mum was in and out of hospital, I had 4 kids, 2 doing exams and my dog was trying to leave us (true story- he went through a phase of trying to break out, break away, all with his tail wagging and a smile on his face😂). I said oh no, I just have to get some of this stuff done with. I remember the look on her face- like ‘ookkkkaaay’. A few months later I asked could I have something- was on it for two months, terrified I’d get addicted but dealt with issues easier, chilled out more, with a weirdly more positive spin than I’d had in a long time, came off it no problem and will consider in the future. People say doctors overmedicate but sometimes it’s needed to get you through something easier.

Btw hilarious thing was dosage was so small she hinted it could have been a placebo as she had expected to up it but she said even the physical things had eased a bit. I honestly think stress and sleep are the biggest factors sometimes

You can self refer for talking therapy on the NHS. It might help with the problems you are facing x sending big hugs x or ask your GP for a talking therapy referral instead of the anti depressants x

Reactive depression is more than 'experiencing unhappiness as a result of difficult circumstances'. Antidepressants treat the depression, not the life circumstances.

People can develop depression (neurochemical imbalance) as a result of adverse life experiences. So antidepressants can absolutely help situational or reactive depression.

I think it partly depends on the point at which you’ve consulted your GP. If the situation has changed for the worse very recently and you haven’t had time to bring positive measures in v if it has been more long term and you’ve only just “succumbed” to it (for want of a better description). And even then, it depends how bad you’re feeling and what physical symptoms you have.

It may take more than one GP consultation to identify the right approach for you, in my case I was prescribed sertraline but actually needed something different for extreme symptoms of anxiety that came about quite suddenly due to a work situation.

At another time, sertraline helped to give me space to move forwards. Each time I only took it for 3 months and that was enough.

If the situation has been building for some time, and you haven’t been able to manage it yourself, it may be time to accept medical help. However, it’s totally up to you.

If you feel you need more time off work, could you ask for a phased return or part time for a period to help? Or a redeployment as suggested by a PP?

And maybe consult a different GP if that’s possible?

I don’t understand why you wouldn’t take medication that is going to make it easier to cope with those circumstances.

Because the medication won't help if the distress is caused by 'circumstances', rather than neurological factors. If your leg is trapped under a lorry, medicine won't make the lorry weigh less or allow your leg to heal. Painkillers would help you tolerate the disaster, but in this analogy, the painkillers would be things like diazepam, not ADs.

ADs will only help if you actually have the neurochemical imbalance that they are intended to correct. They are not like taking, say, tranquillisers, which would blur your sensations of misery/anxiety/etc produced by real-life situations.

I’ve had a very good experience with anti-depressants. Which I’m now in the process of weaning off very, very, very slowly.

However, I went on them after 40 years of depression that refused to resolve after a life shattering event.

My older self on on continuous HRT is a lot more emotionally stable than my younger self dealing with the hormonal waves of a menstrual cycle. I also now have many tools in my mental health fixing box. So once I’m off the anti depressants, I wouldn’t go back on if the depression returned due to a specific event that was naturally enough causing me profound unhappiness.

As much as they have helped me, and gave me the mental foundation up on which I could build mood enhancing habits and action, I wouldn’t want them again unless I got “stuck” for a long time again. They have worked so well for me that I’m now aware of the slightly sedating and blunting effect. Which was fab when I was drowning. But not what I want for me now.

Long way of saying don’t feel obliged to take anything you don’t want to take to make yourself an easier box ticked off for other people. It’s your body, your brain, you are the only one who has to live with any changes they create in your mind & body. It’s more than ok to chose the non box ticking route of addressing all the elements of your life that will help you ride this out to the other side.