On the Royal College of Psychiatrists website re. anti-depressants

[deliakate]

they admit they "don't know for certain" how anti-depressants work. This scares me, and imo puts paid to the idea that they are just like replacing, for eg., missing insulin for a diabetic person.

I think they have so many scary side effects, I have googled one or two (bad move), but its really put me off going near them. Does it worry anyone else?

I have been on ads in the past, and am going back to the doctor this week to see if I can go back on them again. I am struggling to cope, and know from previous experience that they work for me. But not all tablets work for all people. Fluxotine made me so ill I dropped 3 dress sizes in 6 weeks, and was suicidal. Citalopram was fab for me, but made my friend ill.

My Mother scared me about taking ADs when I'd had my children and had a hell of a lot to deal with. "They don't know how they work. You'll get hooked. Withdrawals are horrible" etc.

Cue one half-hearted suicide attempt by me 1.5 years later because I absolutely could not go on.

I went through a few ADs before I found one that suited me, but I have no doubt that it helped turn my life around. I was on Mirtazapine for about 2.5 years and have been off it now for around 6 months. It saved my life.

In the correct circumstances anti depressants save lives. If you are trying to comit sucide or have stopped eating or have delusions then you won't be able to access councelling/ CBT

However councelling has its risks as well. There are risks in becoming emotionally dependent on a councellor. Its a phenominon known as transference.

The problem with anti depressants is that they are often misprescribed. This happens for the following reasons:

1. A lot of doctors and patients do not understand the difference between deep unhappiness and true clinical depression.
2. Many people think that being happy is the default position for a healthy human.
3. GPs think they are a quick cheap fix.
4. Sometimes patients who have taken anti depressants in the past are more likely to ask for them in the future.
5. Once people get a temporary lift they can't be arsed with learning about mental wellbeing/ CBT/ self help.

I think that doctors are getting better. It used to be that anti biotics were misprescribed. Just like anti biotics there is a time and a place for anti depressants.

Pychological theraphies in this country are a bit of myth. Self help books and websites are useful, but sometimes you need a human being. I think its hard to read intellectual books when you are depressed.

I did a short well being course run by Mind and it really helped me.

reallytired it was only AFTER my suicide attempt that I got the help I needed. That involved finding the right AD for me and a 6 week CBT course with a counsellor. Therefore, I never felt dependant on her. Just helped and understood. After those 6 weeks, I had the strategies in place to cope by myself.

Obviously the help provided differs from region to region. Plus, what works for one person will not necessarily work for another.

Does it worry me? No. Not at all. For even a second.

The alternative is being a non functional adult who can't get out of bed, wash, eat etc.

To be fair they dont know why Electric shock treatment works either , but it does .

I've been depressed since my teens but despite a couple of selfish moments and ending up in hospital, no help was ever offered and I never sought any. I thought I was past help. Also, since I was a teen it would have been easy to put it down to puberty.

It took until I was nearly 30 before actually making an appointment with a doctor about it. During that time I was up and down, about 50/50 - which made me believe that at at least some points in my life I didn't need any help.

Anyway, after being devastated by my doctor's lack of understanding (He said 'go down the pub with your mates' ....) I waited a couple more months and was urged to go back and talk to a different doctor by a friend.

This doctor listened, pulled out a questionnaire and made me tick off stuff. I felt deeply ashamed at what I admitted to but because of that I was offered counselling, but no drugs. I believe this questionnaire is scored similarly to risk assessments and perhaps that's to help the GP make a better diagnosis.

I went to counselling and was given numbers for different organisations. I went to one, fell apart because I felt the guy wasn't listening to me and refused to go back there again. I contacted another and was told I wasn't in the catchment area to use the service. I contacted another and was told that there was a 6 month waiting list just to get ON the waiting list!

I went back to the counsellor who must have run out of options because he got the doctor to prescribe 10mg of citalopram a day. I used up a month's prescription and I believe I felt even worse than before. I was very close to carrying out 'The Plan' because I felt I'd gone down every avenue available and there was no hope.

At the medication review I told them how I was feeling and they upped the dose to 20mg. My life changed. One day I did a huge spring clean and my parents who were with me at the time stared at me open mouthed but did not say a word. I said 'yes' more than 'no', I slept well, I stopped eating loads as I didn't feel a 'hole' and... well there's loads more but basically I can't understand why scientists don't seem to know how these pills work as it seems fairly obvious to me that they change something, there's some chemical reaction. I know that SSRI's are supposed to inhibit the reabsorption of serotonin and if that's what they do then I'm damn happy to be a guinea pig as they have entirely turned my life around simply by making me feel 'okay' and able to do normal things.

I bet you any money that other 'users' (sorry for the word) feel the same.

CailinDana

No more than 20mg of any AD? For many of them that isnt even the lowest adequate dose.

Actually reallytired I'm surprised at some of the content you've put forward there, particularly number 2 "Many people think that being happy is the default position for a healthy human."

I haven't heard many people on AD's talk about how happy the pills make them, just about how relieved they are that they feel willing and able, and capable (is that the same as able?) to carry out tasks that were previously a problem.

I admit, I call mine 'happy pills' but that's a jokey reference. They are actually just 'can do' pills.

Sorry cats, that should probably say the minimum dose, I was thinking of fluoxetine which starts on 20mg.

I don't see how anyone could confuse being unhappy with being depressed. Everyone feels unhappy at some stage, and very few people would consider going to their doctor because they're just sad about something. Feeling depressed has nothing to do with happiness. A depressed person doesn't just feel unhappy, they feel hopeless, have no energy, can't get interested in life any more and sometimes they feel like they can't go on living. That's a world away from feeling unhappy.

I reckon if the the not knowing how they work scares you, then you probably don't need them.

They can have unfortunate side effects, but if they side effects outweigh what life is like without them, then they are the thing for you.

(I once got a bit cross with a poster who thought citalopram wasn't worth it because it can cause hyper-pigmentation. - Better than topping yourself, IMO)

ADs are fucking brilliant.

What would be the point in only allowing GPs to prescribe the starting dose?

I know that you have said that " If 20mg doesn't work then the person should be referred to a psychiatrist, not just pumped full of more and more drugs."

Some people do need higher doses than others of some drugs. Some conditions require higher doses than others.

Would you say the same to someone with hypertension that didnt respond to the first medication at the lowest dose?

ADs are powerful drugs that often have serious side effects. I have a few friends who are GPs and they all admitted to me when I was depressed that they had very little understanding of depression and that they prescribe ADs in a hit and miss fashion - trying the one they're most familiar with first and then moving on to other less familiar ones if that doesn't work. I'm not saying people shouldn't be prescribed higher doses, I'm saying a psychiatrist should be the one prescribing, not the GP, as it is the psychiatrist who has the expertise in that area.

Yes, it does concern me. I know they work and they have worked wonders for me, but I wouldn't take them for a minute longer than necessary.

Well they don't know exactly how anasthetics work either, but I wouldn't want an op wiithout ine.

I will never ever go off my meds. Ever. They will pry them out of my cold, dead hands.

I honestly don't care how they work or why. The only thing I care about is being happy.

I'm suffering from late-onset post-natal depression. It started off with little things like DS refusing to latch, DP leaving the pooey nappies for me etc. And then it just escalated. I thought I was doing a good job of acting like the perfect mother - DS would be washed, cuddled, smartly dressed, I'd brag to all and sundry about his development. But gradually these "clouds" started taking over.

I felt like a cartoon character with a huge storm cloud directly above me. I started having nightmares and day-time "visions" of how easy it would be to just turn my back for 30 seconds while he was in the bath, or how easy it could be to fake SIDS...

I was shaky, useless, forgetful, depressed and bordering on suicidal. I'd keep thinking about how much better DS and DP would be if I weren't in their lives to fuck it all up. I even went so far as to get into the bathtub with a knife.

My partner and I started arguing more and more. Eventually I refused point-blank to take it any more and packed a bag to leave. He stopped me with my hand on the doorknob and just said "something's seriously wrong... isn't it? I've thought it for a while..."

My world came crashing around my ears. I thought that as long as I could pretend to be a good mother, no-one would notice how much I was struggling.

It all spilled out. Every bad thought, every suicidal notion, all of my nightmares, my day-time visions, my struggle to just get out of bed every day. I just kept saying "What's the point in living?".

My doctor put me on AD's and I went back a week later. She barely recognized me. I was fresh, smiling, wearing clean clothes that weren't just a baggy t-shirt and tracksuit bottoms, and I felt wonderful. It was like the first rays of sun started poking through the cloud above my head.

Because of the side-effects of my medication I keep forgetting to eat because I don't feel hungry anymore. I can't achieve orgasm. I have an intermittent tremor in my hands that sometimes makes it difficult to do the bottles or even to turn taps on.

But none of that matters. I don't give a shit that I have to ask for help occasionally or that I can't climax. Anything was better than what I was experiencing for 5 months. It was the closest thing to Hell I think I'm ever going to experience.

I'm more active now than I've been in a year. I go to the gym, take DS out for walks, play with his trainset with him. I've joined a Mother and Toddler group that I've felt very accepted into. I'm finding myself buying toys for DS "just because", or giving him a cuddle because he smiles at me in a certain way. Those moments were previously so few that I can't even remember them. It's stopped feeling quite so much of an uphill struggle.

I'm going to need extra support in the future such as counselling for when I come off the tablets, but for now I'm enjoying being able to smile because I want to, not because I feel like I should smile so others don't realize something's wrong.

Sorry........ that wasn't meant to be quite so long.

I think GPs should be able to prescribe whatever dose of anti depressants they see fit. In some rare circumstances I think they should even be able to prescribe mild anti pychotics. Sometimes a patient will cooperate with their GP because they have a rapport.

The problem many GPs have is mading an assessment in five minutes flat. There really needs to be more time and prehaps some GPs could do specialist courses in pycharity. Some GPs are fanastic with mental health but others are completely rubbish. I would like every GP surgery to have their own pychatric nurse who could assess if various approaches are working.

"I think GPs should be able to prescribe whatever dose of anti depressants they see fit. In some rare circumstances I think they should even be able to prescribe mild anti pychotics. Sometimes a patient will cooperate with their GP because they have a rapport."

My point is that its better that its better for a GP to prescribe medication than a patient get to the point of making a suicide attempt or being sectioned under the mental health act.

Reallytired - I think it is a huge generalisation to say that 'once people get a temporary lift they can't be arsed with learning about mental wellbeing/ CBT/ self help'. For many people, the 'temporary lift' given to them by antidepressants may be what enables them to get counselling or CBT or to take self help measures.

And I know a number of people with depression, who, like myself, want to come off the tablets at some point. As I have told people, including the therapy group I'm in - I hate measuring out my life one citalopram tablet at a time. Ultimately, I am hoping that the therapy will enable me to come off the tablets. I recognise that this may not happen - for some people it is a chronic illness that can require life-long medication - but if that happens, I will not be happy or blase about it, I can assure you - and I haven't met anyone with depression who does think 'if the tablets make me happy, that will do - sod finding a longer term solution' - as point 5 in your post suggests.

I know that, if it weren't for the tablets, I wouldn't be able to get myself out of the house either to access the therapy group, or to do the other things in my life (choir, knitting group, felting classes) that help boost my mood and keep me included in society. I think I can also think more clearly - I know when my beliefs are wrong (no-one likes me, I am a waste of space, I am a failure as a wife, mother, housewife, friend, I am ugly etc etc) even though I still struggle to counteract those beliefs when they occur - they are the dark core of my being that act like a huge weight, holding me back, preventing me from doing what I want or need to do. But the tablets lessen the hold that the dark core has over my life - I can get out to choir or knitting group, and I can do things round the house. And I can assess the therapy I am getting, and even consider finding some CBT, to see if that would help me. Without the tablets, I would just crawl into a metaphorical corner and pull it in after me, wrapping myself in the darkness and hiding there.

stealthpenguin
Your story really touched a nerve with me, and I am sure with other lurkers too. You write so eloquently. At the risk of sounding trite, thank you for sharing- it is so important to talk about these experiences so others can be reassured and helped. I am glad you are feeling better now.