Sertraline - please help

[Yubaa]

I’m late 30s and suffered with anxiety all my life. It’s been pretty horrendous. Somehow I’ve managed to hold down a job and on the outside it looks like I have my life together. But I have huge bouts of anxiety which tips me into anger and sadness. I’m sick of living like this.

I have always resisted meditation, I suppose because that in itself makes me anxious. I also now have a toddler and I’m a single parent and I worry that taking sertraline could give me side affects which could in some way impact my child.

Ive tried talking therapies, cbt, etc and the worry and intrusive thoughts and anxiety remained.

ive been prescribed sertraline but I just don’t know what to do, has anyone had any experience please?

I don’t understand how it will stop my thoughts though?

It may be an oversimplification, but you can think of anxiety as being an overactivity of the brain centre that produces feelings of fear (the amygdala). So drugs that change the balance of stiluatory vs inhibitory neurotransmitters in that brain area will alter the feelings of fear.

Sertraline inhibits the reuptake of serotonin into nerve endings, so it elevates the levels of the transmitter available to bind to receptors on other nerve cells. Serotonin is a very complicated neurotransmitter because it acts on at least seven different families of receptors, some of which mediate stimulatory actions and others of which mediate inhibitory actions. Overall, the effect of sertraline is to correct disordered levels of brain-derived neurotrophic factor (BDNF), which is under the control of serotonin in a fairly complex way. The BDNF restores the normal balance of stimulatory and inhibitory nerves in brain areas including the amygdala.

Sounds like a coherent story, but there are lots of variable factors so it doesn't work for everyone. However, a patient who doesn't respond to one selective serotonin reuptake inhibitor (SSRI, eg.g sertraline) might respond to another, or to another drug that alters serotonin and dopamine levels (e.g. buspirone).

This is really dangerous advice. Also SSRIs don't increase the amount of serotonin in the brain they increase the amount of available serotonin that hasn't been bound to serotonin receptors which is a different thing entirely. Misinformation like this is how people end up stopping their antidepressants and getting serotonin syndrome from taking 5HTP thinking "more serotonin = natural antidepressant".

Dosages and prescriptions are calculated for a reason and cutting up tablets in ways they're not meant to be cut up means you can't dose effectively which reduces the effect of the medication. No qualified professional would give out advice like this over an internet forum.

OP please take your medication as prescribed by a qualified doctor who knows your history and the severity of your symptoms and if you have any issues, go back to the doctor. We're here for moral support not medical advice. x

That’s interesting. I’ve never had that cautionary approach from medics-it doesn’t sound helpful at all. I guess a happy medium is ideal!

Yes agreed. It’s not addictive in the sense you need more and more of it to have the same effect. Your body/brain can essentially get used to it, so causing withdrawal

Absolutely agreed. Tablets don’t necessarily contain even amounts of the active medication throughout so if you cut up tablets you might not be getting an even dose. If you’re worried about starting on a particular dose discuss this with your GP/prescriber. There are liquid versions available for taking smaller doses although these can be costly so in my experience some GPS aren’t keen to prescribe.

Please don’t take the support on here as medical advice-it is individual experience x

Unfortunately this may not be true for the OP-please see my previous posts on the potential for serious side effects/withdrawal issues. We don’t know about the OP’s specific circumstances, what else they have tried, any risk factors so we shouldn’t be saying things like this, however we’ll meant

It was horrible. The actual designated mental health nurse was essentially putting me off them, when they knew full well I was prescribed sertraline already by a GP (equally pessimistic) as I was really struggling. Of course their reluctance was the excuse I needed to stuff the tablets in a drawer and not take them for a good two years, as everyone managed to scare me shitless about them. Honestly some people are just very bad at their jobs and/or cannot read the room.

I was on it for a year when my anxiety was debilitating with lots of physical symptoms insomnia stomach ache alongside overwhelming negative anxiety. After a couple of weeks of weirdness - bit of nausea bit of flatness just feeling a bit weird it settled down. I'd say it made my feelings about 25% less strong and my ability to sleep about 25 % more. I did have difficulty habing orgasm while I was on it but wasn't impossible. Coming off was fine in a controlled way 2 weeks feeling funny
. Nicotine withdrawal was worse. It was a useful tool whilst I worked on root causes of my anxiety alongside counselling. My other advice is stay off the anxiety chat boards across the Internet. They always seemed to be full of people having an unsurprisingly misery fest rather than a proactive source of hope which is what I needed.

Thank you.

I've actually tried hypnotherapy, talking therapy and CBT. I've had a full course of each over the years.
I'm booked in for another stab at hypnotherapy this coming week, so I'll see what effect it has alongside medication.

OP I could have wrote this myself back in April 24. Early 30s. Suffered from anxiety my whole life. Had been prescribed multiple things to try in the past but never taken them due to worrying about side effects. Tried CBT etc which didn't work for me.
I found myself in a horrible place that was taking over my life (having a toddler, husband, house to run, full time work it was less than ideal). So I tried sertraline in a desperate state.
The first night it took me a little bit longer to fall asleep. Then no side effects at all. I've continued 50mg since then so getting onto 10 months and I feel like a totally different person. I can function at work, home and as a wife/mum. I find that the things I used to worry about, I don't worry so much about anymore. I sleep well. I'm eating well. I've gained weight. People have commented on how healthy I look.

I'm currently pregnant with DC2 and still taking it and I plan to continue until at least 3 months postpartum.
Honestly it was the best decision I made for my mental health.

My advice: if you have family (trustworthy and reliable) around that can help/be on-call if needed, take one tablet in the morning with breakfast (taking with food, no matter what medication helps digestion and absorption) and see how you get on throughout the day. If you get side effects that render you unable to care for your toddler then just discontinue and inform your GP. It may be that you could start on 25mg and slowly build up, side effects allowing.

There is no quick fix with this. It took me around 3 months to notice a considerable change in the way I reacted to things and the difference was also noticeable to others.

Good luck OP. Even if it doesn't work out for you, at least you can say you tried

@Yubaa OP, we've just put our young teenage DD on Sertraline (under a psychiatrist) for anxiety and OCD. She's been on them about 4 months. The difference in her is incredible, it's joyous to see what she can do now that she couldn't previously

Your anxiety will have a much greater effect than antidepressants. Honestly, get a grip and do what's right for your child.

I'm two months in and it's honestly transformed my thinking. Very few side effects and all gone in two weeks

What exactly is stress - is it like going to the dentist or into an exam or job interview I feel lucky that I don't suffer from it in normal daily life but why is it so debilitating in some people and not others

Is this thread about stress? I thought it was about anxiety.

Stress has little impact on me. I excel at work in a deadline-driven, high pressure role. I perform very well in interviews. I've never worried about exams, I tend to ace them.

Anxiety presumably feels different for everyone, but for me it's a feeling like you want to rip your skin off and run for the hills. It's a creeping dread. A knot in your stomach. A panic that rises in you out of nowhere.

Why I experience it and someone else might not is, I presume, perhaps as a result of some aspects of my upbringing, and/or a chemical imbalance.

How do stress and anxiety differ

Honestly just take it don’t over think it. The first time I was prescribed it I didn’t take it because I didn’t understand how it could work, I was cared of it not working and I was obsessing about it working and having loads of side effects- I went on like that for another year. Then I got another prescription and took it from day one and I haven’t looked back.

I have been on sertraline for over a year and it’s changed my life. My anxiety peaked to the point I couldn’t leave the house without having a panic attack and had health anxiety and chest pains constantly and had to be signed off work. Since being on medication I feel like my old self before anxiety took hold all those years ago.
please try it OP, you have nothing to lose and it really can make a life changing difference.

Well typically anxiety is a future scenerio - worrying about the future, which may or may not happen.

Stress is a reactive state - a response to things that happen to you, whether you worried about them or not.

They are not the same thing.

It's not fully understood how it all works, but the theory is that Sertraline boosts the availability of serotonin and to a lesser extent dopamine in the brain. These neurotransmitters help the brain move thoughts into actions. When you have anxiety your brain can be stuck on just the thoughts. This is how boosting these neurotransmitters might help obsessive or overactive thoughts

Thanks very very much for all these posts.

to answer a few questions, the anxiety is generalised, I can quite literally latch onto anything really and obsess over it for weeks. I often wake with a racing heart either in the night or first thing in the morning and I’m not able to express why, other than a feeling that ‘something bad is going to happen.’

9/10 if the phone rings from family then I think someone is unwell or died. I get fleeting panic before answering.

I also worry that people are not telling me the truth and get very obsessive over what people have said to me.

if my manager is a bit offhand or short on the phone I will think I am getting fired and obsess over that.

in honesty I haven’t felt like I’ve actually lived life for a long time. I have this cloud of anxiety at all times.

I suppose my worry with taking medication is that I am not sure these problems with anxiety are a result of a chemical imbalance… I actually think they are a product of a bit of a dysfunctional and stressful childhood. That’s what makes me worried that medication may not help, what if there is no chemical imbalance but I am programmed to respond with anxiety due to patterns picked up as a child? In which case medication wouldn’t work would it?

Just to reassure, as I have posted already, this is exactly what I have experienced. It has helped me rationalise the things in my upbringing that led me to such anxiety and obsessive behaviours.

For example, I would completely obsess about taking the washing upstairs. The whole time it was washing, I would think, I am going to take that up after, and then I would obsess with the same thought until I had carried out the action.

Things that ridiculous would send me into a panic. I actually couldn't give a stuff about the washing now. I'm still me, I still have the same opinions, but I'm not wasting 3 hours obsessing that I must take the washing upstairs the moment it is finished.

Honestly no one knows what causes anxiety disorders/depression. Chemical imbalance is one theory but is contested. No one knows hie SSRIs work either, there are theories and I think a PP posted one above. They work really well for sone people whatever the mechanism. What I would recommend is that, whether you go down the medication route or not, you try to access therapy which is recommended for your particular situation. If there’s trauma to unpack that could involve EDMR for example. For intrusive thoughts that might not be standard CBT but instead ERP (exposure and response therapy.) If you have any means of going private to find a therapist and therapy that works for you, I would really recommend this. Obviously it would be great if this sort of help were offered on the NHS, but in my experience it’s hard to get NHS MH support. My understanding is that for people with more severe anxiety, which yours sounds like, medication rarely solves the problems. Personally I found sertraline took the edge of my profound terror just enough so I could engage with the behaviour change as part of therapy. Feel free to PM me x

@TheNewSchmoo i obsess over this too! I feel like if it goes over 15 mins I have to re wash it. How long were you taking them before you felt better? Thank you for sharing your experience

@Nocd39 thank you. I have tried so much therapy over the years and it certainty helped in moments but the old habits crept back in. I am so exhausted these days and don’t even really want to have to unpack everything all over again. I don’t know if that’s the right attitude but it’s how I feel. I know why I have developed anxiety and can look back and see it in my childhood but I just wish it could change now. It’s ruined much of my life.