My therapist thinks I need antidepressants. Do I?

[JustForTheTasteOfItDC]

TLDR:

I've been having therapy with current therapist for about 6 months, and at our last session she asked if I had considered taking antidepressants, because she was worried about how sad I had been in our previous sessions.

I hadn't thought (or realised?) I was depressed, but life has been hard for the last year, and I don't enjoy anything any more.

Do I give them a try? I've taken them a very long time ago (in my teens and 20s) and to be perfectly honest have no idea/recollection of whether they worked or not!

LONGER VERSION:

Long term relationship ended at the end of last year. I was ok at first and then struggled to cope, got signed off work for months but had some counselling through work which really helped. Have been single since and I'm happy with that, although sometimes it does feel quite lonely.

Work is currently good, but there is a lot of uncertainty in the coming months as it's possible that the place I work might be taken over next year, which may mean I am out of a job. This is obviously rather stressful!

Since covid, my life has shrunk massively, and I barely do anything. I became slightly obsessed with covid during the pandemic and afterwards, and I have read so much about the long term consequences in terms of immune system and impact on the whole body that I felt completely stuck between part of me wanting to go back to some sort of normality, and being completely fearful of that. Things that I used to enjoy doing, like going out for coffee and journaling, I really struggle with now, and in fact I find it difficult to bring myself to do it at all. Partly that's fear of covid still, partly it's a worsening of OCD that I've had for 13 years. I am still obsessed with illness, contamination, germs, particularly sickness bugs etc. I hate going out to eat because I'm convinced that whatever I eat will give me food poisoning. If I do go out (with family etc) I go to places that I've been to before, order things that I've eaten before. I can't remember the last time I ate something in a restaurant that I actually wanted to eat. I order whatever is least likely to poison me.

Home isn't much better for eating. I eat the same things pretty much every day. Making a sandwich requires hand washing about 10 times during the process. I find it really difficult to eat anything that isn't in my current repertoire of foods, because I am scared it will make me ill.

I used to enjoy sports but find it difficult to find motivation to go, and don't really enjoy it when I'm doing it.

I just feel completely stuck. I am sure that my mood/mental health is not helped by my poor eating, but I just can't bring myself to widen my current safe foods. I'm having therapy which really started because of struggling to cope after the relationship broke down, but I think my therapist also feels stuck with me which is why I think she mentioned about the antidepressants. It's also not at all focusing on the eating/OCD, so I don't know how to change that without help, or what kind of help to get for that.

I'm sorry this is long and rambling.

Maybe antidepressants would be a good idea since I can't work out what else might help at the moment?

Would a GP refer me for that, or do you mean to access it privately?

In my opinion, a therapist has more training and inside knowledge than we do. So perhaps, if a therapist is advising it, I would give it a go. They know what they are talking about, mostly.

I know you can’t compare before anyone jumps on- nobody is qualified… anyway. A friend has OCD and anxiety and is prescribed anti depressants.
What you’ve described- no longer enjoying the things you love, isn’t that depression? It would be for me.

What you’ve described- no longer enjoying the things you love, isn’t that depression? It would be for me

Yes, I guess so. I have felt depressed before that felt so different to this - low in mood, difficult to get out of bed and do anything. I don't feel like that now.

But I do feel knackered all the time, fearful, and nothing brings any joy. Everything is just flat.

My friend has being trying to come off his antidepressant for several years. He never found it helpful (just experienced negative side effects) but was encouraged to persist with them by the doctor.

years later, every time he has tried to come off them it plunges him into a severe mental health crisis (suicidality etc). For years he has been asking multiple doctors (including a psychiatrist) to give him a proper plan which will allow him to taper off them safely and they just keep fobbing him off. I guess they don’t want the responsibility, but it means he is stuck taking a medication which doesn’t help at all.

after witnessing this saga, I would only consider starting a course of anti-depressants if I was utterly desperate and felt like all other options had been completely exhausted.

@AceOfCups so sorry to read about your friend, I really hope he manages to come off the medication successfully and safely.

I think you and @Luntcips are saying the same thing - don't take them unless you absolutely have to and all other avenues have been pursued. But I don't know what else I can do, or what other help to try and get?

@Luntcips my friend is on fluoxetine (Prozac)

@Luntcips sleep is ok but often disturbed by pets/outside noise. I get to sleep fine (using headspace app) by 11, get woken up usually about 4am, when ironically I feel quite awake. Then I go back to bed and sleep until my alarm goes off at 7, but I feel exhausted again at that point and keep hitting snooze until I absolutely have to get up. So I do get 8 hours, but it's not constant sleep.

Re antidepressants I've taken sertraline in my teens (I had an eating disorder and depression) and then took fluoxetine in my 20s. Can't remember either time if they had much impact.

I take citalopram, no ‘nasty’ side effects at all, and have stopped and restarted a couple of times over the years without problems.

That's good about the side effects. Do you find it's helped? Is it ok to ask what you take it for?

How qualified is your therapist? Is this IAPT?

Do you feel like it's your ocd that is taking the enjoyment out of life ? If that's the case then surely treating that would help more

I have OCD and have learned over the years that I need to take meds as whenever I phase off them, I end up suicidal - that’s just me though, we’re all different. I take clomipramine (also known as anafranil) - which is quite old fashioned but it suits me better than SSRIs - which are more commonly prescribed for OCD.

Is your therapist doing any ERP therapy with you? It’s the recommended therapy for OCD alongside CBT. It’s effective but challenging and taking meds at the same time is often recommended

My current therapist is a clinical psychologist, recommended to me by someone through my occupational health at work. I was referred by my GP to IAPT at the start of the year but I ended up having 12 sessions of counselling through work and couldn't do that at the same time as IAPT, so I declined starting with IAPT. I think I would have to re-refer myself for that if I wanted it. (I did work with my IAPT service for OCD twice before, once about 12 years ago and once about 6 years ago. There was no improvement either time).

I don't know if it's the OCD that's causing me to feel this way. I mean, the OCD has been there for 13 years and I haven't always felt as though life is so pointless and joyless, so it doesn't seem as though it's just that.

I am trying therapy because I think there must be something underneath the OCD, there must be a reason for my mental health problems that I've had all my life (anorexia, bulimia, depression, post natal anxiety, OCD). Yes, the OCD was triggered by a particular event, but it's not as if all was brilliant before that. I could work specifically on the OCD and do ERP, but I'm worried it won't address any of whatever is underlying it. But I'm completely stuck in therapy because I can't ever seem to get to whatever the really fucking painful stuff is that's playing out in all these "symptoms". I just feel stuck in a neverending loop.

I am a MH professional who specialises in OCD, certain SSRI’s can really help with OCD and intrusive thoughts/rituals. If you can I’d ask the GP for referral to local
psychiatric/secondary care services as they may be able to link you to a OCD specialist. SSRI’s (antidepressants) combined with Exposure Response Prevention therapy (a type of CBT) has the best outcomes. OP, are you neurodivergent? The reason I ask is there is sometimes a co-morbidity between OCD and ND.

Sorry OP I didn’t see your last post, sounds like you’ve already tried the OCD pathway via IAPT.

Thanks @Thischarmlessgirl. Are you allowed to say which SSRIs you are talking about?

I haven't been diagnosed as ND. My DS has ASD, and if you ask my exH he would say that I probably am as well. I suspect that's possible, but never wanted to seek a formal diagnosis. (Mainly because it would likely need to involve my mum, who to be honest is possibly the biggest cause of my MH difficulties!)

I take it for anxiety, I’ve had lots of therapy too which has been really helpful, but I feel that I have a residual physiological anxiety and the citalopram makes it very manageable. It’s been life changing.

Yes, but it was 13 years ago. I slightly lost the plot when my therapist licked the arm of the chair after I declared it the likely most contaminated place in the room!