please tell me about AD's

[goingdown]

Hello,

I've name changed.

I've been really struggling, have been seeing a pyschotherpist since feb and all good going she's dug up all my past and related it to my behaviour to life now. It all makes sense, I get it ALL (unfortunately) but its been all very painful and I find myself feeling worse. She says I should grieve my past and what I don't have now (long story), understand it and move forward, but I'm finding it very hard and feel stuck and very down. Having now had children of my own and raising them the way I have never experienced is a daily slap in the face and reminder.

Anyway, I waffle, I feel that AD's might be the next step for me, I can't seem to get out of this slump, I have all the depression symptoms. Will it help me?

I tried Ad's (ssri's) many years ago (over 10) but it affected me badly, heart palpitations, headaches, anxiousness, numbness of feelings and once even more suicidal.

I am sure AD's have progressed since then but don't know what to expect? how they work? how long do I have to take them for to take effect? what are the best kinds to take the edge off and make me happy? will they affect pregnancy/ivf treatment? (not that I am right now), can I still drink? etc etc.... any experiences and advise much welcomed please.

I have to say I'm also hesitant on going to my GP and outing my depression properly to taking medication. Last time I went I was referred to psychotherapy although he did immediately want to prescribe AD's within 3 minutes of completing the depression questionaire!

Many thanks, sorry for being so long windeed and disjointed! bit like how I feel right now!

Oh dear sorry to hear you are suffering. It doesn't sound like great therapy, if it just tells you all the stuff that is wrong and leaves you feeling worse TBH. Have you tried CBT? Focuses less on the past and more on dealing with thoughts / feelings in the present.

ADs, well you have some experience of taking them in the past.

From my limited knowledge, I have come to understand there are basically two types (this is very basic though, please bear in mind!) Activiating ADs e.g. if your symptoms are very low, apathetic, low energy, sleeping excessively etc.
and
Sedating ADs e.g. if you have "high" symptoms such as agitation, insomnia, anxiety etc etc.

Of course you can have a combination of these symptoms.

Different ADs work differently for everyone, which is why it's sometimes hard to find the one that works for you. There are literally hundreds of ADs.

The older style ones are the tricylics. These have been widely studied, often well documented, some evidence of use in pregnancy (generally thought to be low risk, but not all of them, so always say to your dr. if you think you may be pregnant).

SSRIs e.g. citalopram, sertraline, prozac etc.

MAOIs

Newer style ones.

They all normally need a minimum of 2 weeks to start working, often reaching maximum benefit at around 6 weeks.

They work by increasing amounts of neurotransmitter in your brain either by inhibiting their take up or by some other means (complicated )
e.g. serotonin

Drinking in moderation is usually ok, but not at first as you don't know how you will be effected (e.g. they can increase the effects of alcohol greatly). I only have one glass of wine as a maximum.

Try not to see it as a failure, but as the first step on the road to getting better.

My goodness thanks so much getdown for your quick and detailed reply, really do appreciate it. I haven't thought of CBT but I think there might be something in that as my therapist is anti CBT for some reason, at first I thought she was good but she seems to liken everything I feel now to my past which I can see now is not helping me feel better but the contrary... She was taken a back last week when I sat down and said I wanted to focus on the future....

Sounds like the sedating ad's are more for me as I'm classic high symptoms and unfortunately more, what names are they, little bit confused? I can then research, thanks again.

I am on ADs and having children has made me really depressed. I was depressed before I had them but having them has made me very ill. I just try and get through the best I can but I know I need the ADs.

Sorry you are feeling this bad.

FWIW psychotherapy is meant to make you feel a bit worse initially. It uncovers the stuff you have kept inside. This is why it takes a while and is important not to stop...you need to find your way back to a safe point, before you stop going. Anyway if it is private (hope it is) rather than NHS this will be indefinite which is brilliant (NHS can stop suddenly after 6 months - pointless)

I have had psychotherapy and CBT. I actually find CBT easier but the psychotherapy was helpful first. CBT doesn't hurt so much, but once you have done the hard bit as you are now, you can then move on to thinking about coping strategies, which CBT is good at.

I think stick with it and you will start to feel the benefit of it fairly soon. I;ve never taken ADs and wouldn't. I did try one time and felt like you did - only one pill! (just me being melodramatic but ykwim)

They might also interfere with the course of the therapy...you need to be open to your bad feelings with psychotherapy. I think ADs can compromise its effectiveness iyswim.

Maybe talk to your therapist first and see what he/she suggests.

Good luck x

She may appear anti CBT because it is more of a coping thing, while proper psychodynamic psychotherapy is more in depth - it can make real changes under the surface.

It really depends on how you feel about it as to what you prefer and are suited to. Psychotherapy can go on for years and years!

Getdown - sorry to disagree with you! If OP didn't feel worse at this stage I would be inclined to think the therapist wasn't getting anywhere. It's supposed to be like that.

Hi,
often therapists work with people on ADs, as people may need them to stabilise them enough if therapy after a while not worked on its own. Ultimately it is about what you want not her ... the SSRI's are often prescribed and have a lot less side effects than they did 10yrs ago. Why not go to your gp and tell them your symptoms, what you have done first of all with talking treatments and what you would like out of ADs, so they can talk about the options right for you. Perhaps citalopram, sertraline, prozac might be given? Sertraline may interest you as it is the AD prescribed that people can breastfeed on.

All teh best.

that's fine flightattendant I confess I know little about psychotherapy, just seemed to me if it was making the OP worse, it perhaps wasn't best for her, but can understand your point about needing to get to the root of things.

goingdown some of the sedating ones include mirtazapine, dosulepin and amytriptyline.

Good luck
x

thanks ladies, very interesting i was thinking the same as getdown that it wasn't working hence my inclinatin to go down the AD route as I feel really desperate, but flightattendant it makes sense what you say, i've just been so upset past few weeks and she seems so nonchalant about it all but if what you say is true that I have to feel worse before better then I feel some hope somewhat that maybe it is working.

Yes they psychotherapy is private (through insurance thankfully) so far its indefinite... I'll discuss with her this week about AD's and what she thinks although I am very very hesitant on taking anything that alters how I feel on a permanent basis unless its sedating iykwim. But I did read something in the papers yesterday about 1/10th of prozac helps pms symptoms, so maybe a small dosage might take the edge of things? I'll discuss with gp and therapist.

Thanks again, I feel slightly better already just sharing this and that I'm not alone in feeling down. pinkbasket hugs to you.