The first week on Citalopram & confused by CBT

[houmousandcarrotsandwich]

Finally saw my GP about my very low tearful mood on Monday, she was very nice & started Citalopram. Initially I felt improvement, but I think that was just from actually taking action & trying to tackle depression iyswim.

The last 48 hours I feel like somethings not right. I'm not tearful, but more uneasy. Husband was very kind & booked me an appointment to get my hair done today & I flipped. Had a mini panic attack (not a full on one, I've had those!) & then horrid to him for doing it. Couldn't sleep for worrying about it (pathetic?!)

Is this side effects of starting the meds?
Have been on fluoxitine in the past & not had these feelings.

Also hv recommended the living life to the full website. Tried CBT before, but was poorly presented & tutor was unreliable (was organised by previous GP). Have been on the website but just don't get it. I work through the exercises but don't feel like I can see how it will help me. Am I being thick or missing something?!

The living life to the full website is very good, but prehaps you need to allow your medication to kick in a bit first. Often the side affects of anti depresssants can be quite nasty, you need a couple of days to allow your body to settle down.

If the medication does not settle down then ask your GP to prescribe something different.

The living life to the full website has modules to help you learn life skills like assertiveness, problem solving skills, anger management and it does help you reflect on your thinking.

If you are in a deep pit of depression then you will need medication to lift out out of the depression so that you can think again. CBT helps you to learn new ways of thinking so that you stay mentally healthy.

Its worth doing the questionaires to plot your levels of depression or anxiety. Then you can see if something is actually helping you.

Its common for there to be a transient increase in anxiety when people first start taking SSRIs. It is a sign that it has started to have an effect, but it takes a bit longer before there is an improvement in mood/axiety levels.

Have mixed feelings about CBT introduced to me by my CPN (suffered major episode of dep last Easter and in hosp for 3 months) still have not recovered - many ups and downs, nor ups than downs but I get so fed up of the fluctuations.

I findthat if I am feeling ok then CBT makes sense, but when I am having bad days, it doesn't make so much sense. I think it's a good and simple theory but a magic bullet it's not. If only there were one.......Op you aren't thick - it sounds to me like you are too low in mood at the moment to be able to concentrate on CBT. Maybe you will go back to it when your depression has lifted a bit. I wonder why your gp didn't prescribe fluoxetine if that suited you previously. Citalopram seems to the drug of choice for most gps now.

Hope things improve for you soon.

take about 2 to 3 weeks to kick in proper-in this time you can feel worse before u feel better,and can have odd and strange feelings ....ect... but ive stuck with it in the past and once u over that period have felt alot better.

I found that cbt wirked very well for me, but only once I had "stabilised" a bit. I also have tried using living life to the full and moodgym but they were nowhere near as good as the sessions o had with a person.

I would just let your body adjust to the citalopram for a few weeks at least.

Thanks everyone.
I will give it more time then try CBT again

CBT was designed to be given by a therapist, individually in a one to one relationship. Most of the best, comprehensive trials that showed this approach could work were done were using that model.

Now this format has been simplified almost to the point of uselessness and presented via websites etc. If you are mildly depressed, or just normally down there is no harm in using these.

If you are more depressed they are just not as effective as actually being treated by a trained therapist.

Ask to be referred to one, and don't be fobbed off by a web-based programme - they are not comparable.

There are terribly long waiting lists for proper CBT one to one with a trained theraphist.

Many people have had a lot of sucess treating mild or even moderate depression or anxiety with computational CBT.

Even the living to the full website says its not suitable for severe depression/ anxiety. To get the most out of living life to the full you do need a supportive health professional and if the OP is prepared to support her then great.

My guess is that health visitor is making suggestions that MIGHT help the OP in the present rather than the future.

houmous just a thought...how much are you taking? I ask as the dose I started on was too low. I had mine upped to 20mg after a couple of months. The GP said that 20-40mgs was normal dose for most people although you can go up to 60mg.

I have had 2 sessions of CBT so far and I can see the sense of it. It's just getting the rethinking part to stick

Most AD's take at least a couple of weeks to start working but if you feel you are struggling, then don't hesitate to see your GP.

Agree its worth waiting 2 -3 weeks for the meds to settle before you expect any benefit, there can be lots of side effects in the first couple of weeks so don't be surprised.

CBT done well needs hard work that you should not be asking yourself to do yet, give yourself a month or so after the meds have started working.

IMO the web site is more use when you have had one to one and is still not as good as one to one. But CBT itself done well can help some people stay well once well

Big congratulations on going to see your GP!

The first time I took Citalopram I spent the first two weeks utterly on edge. I went and talked to my GP who said to stick with it for the mean time and come back if it did not go away. After the first two weeks it did settle down and I did find my mood improving a lot.

Thanks again everyone.
I saw GP again yesterday who has now upped my dose to 20mg. This was the plan anyway, to start on 10mg for a week then up to 20mg (to reduce side effects).
She agreed increase anxiety is normal initially, I will stick with it, I have for the sake of my DS. I just want to feel more normal & not feel so hateful towards myself. I hate mental illness, it makes no sence! I have a wonderful DS, who I love & adore, it's so unfair that I feel like this.
I'm going to hold off CBT until feeling more levelled out. I understand one to one CBT would be better, but not sure how I can do that with a 14 month old?

I have just started on 10mg and my anxiety levels have increased big time!! I am due to increase to 20mg as of tomorrow. In your experience do you think I should or stick with the 10mg for another week? Really need to hear positive stories about this drug.