Are antidepressants warranted in this scenario?

[Feelinglow1]

I've suffered first with primary infertility for years, then we had our wonderful DS. Tried for a second, first I was very chilled about it but as the years have gone on I've become increasingly desperate/ depressed about it. I'm immensely grateful for the one we have but I'm at the point where if anyone just announces a pregnancy I'm breaking down in tears. I tried therapy, sports, being busy, the works- I feel down and guilty and somehow less than, and I just cannot help it. Add to this I'm so anxious about my one precious child and if he gets as much as a fever I'm panicking. Im generally very anxious but this whole thing has made it so much worse. I sometimes get heart palpitations and stomach upset from the worrying. AIBU to get antidepressants for this?

Hi , thanks so much for you very kind reply. It has been really helpful. I've suffered massively with anxiety in the past and did have a low dose citalopram for this and it helped tremendously. I agree with you that it's probably not great to try for a baby if I'm already so anxious! We've been trying again since 4 years now and I'm 37 now so time really isn't on my side. I am also petrified that something could go wrong in pregnancy and I've got a prolactinoma so can't do IVF (well I could but it's too risky for my own health). It's just all round difficult!

With respect but this isn't true, ad's definitely help with anxiety

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?

@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.

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.

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.

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.

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!

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.

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

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.

Deal with it how though?

Depends on the situation as to how to deal with it. So for example when I was raped I focused my anger in helping changing the law and working with MPs to improve the justice system when it failed for me. That made my anger purposeful and made changes happen. I also worked on understanding my body and learning about trauma and that it was normal and how my body would process and re-process things. I learnt to understand when I would re-process things more (specific dates) and when I would need to give myself more time. I also learnt that people will push you to 'move on' and 'overcome' trauma and when you struggle that this in itself can cause harm so accepting the impact it will have and learning what works when you have a bad day. Learning that your body is responding normally is a game changer and that there isn't anything in your body that needs fixing.

That is all very, very different than having an anxiety disorder.

All mental health has a root in trauma. It is not abnormal sorry if you think it is.

No, it isn’t.
Sorry, but you haven’t got a clue what you’re talking about.

Yes it is. All of it does! Dr Spitzer admitted as such. Or kindly explain the medical testing that you have when you get diagnosed with being abnormal which goes against the person who created the label?

Why did so many people get this in lockdown? Odd eh their brains suddenly all went wrong at the same time? Or was it something they experienced?

No, sadly there is not “always” trauma behind this

sometimes neurotransmitters in the brain are just messed up (DS is like this high anxiety due to low serotonin)

these are the cases that therapy does very very little, meds is the way forward

If it was about neurotransmitters they would test that to diagnose surely but they do not. No tests are done as none exist. The creators of the diagnostic manual admit there is nothing biological behind these diagnosis. So are they liars?

What are your DS serotonin levels? How do they measure those in the brain? How often are they measured and what units are they measured in?

PS - the chemical imbalance theory was debunked many decades ago.

Also serotonin in the brain? Are you sure it isn't your DS gut that is the issue if it is serotonin?

Maybe it is the gut that’s the issue, maybe it’s an infection messing with immune who knows

the point is he has no childhood trauma and he lives in a very loving home

yes he has had lots of tests including DNA test that show hypo functioning neurotransmitters (not just serotonin) … when he takes specific medication he’s calmer, happier more focused than anyone

so yes it is a chemical issue 😎

@whippy1981

”Just to be clear anti depressants are as much for treating anxiety”

Dr Martin Bruner - book “Your worry makes sense”

Its acknowledged that we don’t know why anti depressants are helpful and that the previous theory that it was because serotonin was imbalanced has been debunked, but that isn’t the same as discovering that anti depressants aren’t effective - they are - we just don’t understand why.

Healing looks different for different people - you’re thrown out a trauma and used it to speak with authority about MH issues. I’m the victim of both CSA and rape and my recovery looked different. Symptoms that were previously well managed can re-emerge, recovery isn’t linear. Now I have children my previous coping mechanisms aren’t as readily available - I can’t just run a half marathon to get rid of my anxious energy - that’s just one example of a previous “treatment” I can’t do and not an exhaustive list.

Also - what if the root cause is genetic or something like ADHD. My family has a history of anxiety, that’s an element: I can’t rewire my brain to absolve that.

Im happy for you that you’ve managed your MH issues in the best way for you - but don’t assume you speak on behalf of everyone and understand their struggles too.