I am going to have to give in.

[OrmIrian]

Sorry this is so long - I want to get it all down so I can get it clear in my head.

Off citalopram since last April after 3 years. It took ages to get clear of all the shitty symptoms but was doing OK. But depression is creeping back - had a meltdown last night and can't stop crying today.

Thing is I know the depression is a symptom of something else. I am utterly exhausted and without energy. Started a few years back. All of a sudden I couldn't run the distances I had been running, just was too tired. I persisted for ages thinking that if I just got on with it I'd run through it. After about 6m of this I started to let myself run less, and then less again. Then I allowed 'injuries' to be my excuse to stop something that I had loved but which know was just a painful depressing slog. I was always tired, slept all the time, looked like a deaths' head with huge bags under my eyes. No energy to do the things I used to do without a second thought. I put on tonnes of weight.

Menopause, I thought - I has been perimenopausal for a while but thought that maybe HRT would help. It did get rid of the nightsweats and hot flushes but did nothing for the energy levels. GP asked if I needed my citalopram levels changed. I wasn't depressed. I knew what that felt like and I wasn't there.

Come off citalopram? When I first started taking it I noticed how much I slowed down - which was what I needed at the time. Maybe coming off it would help.

Thyroid? TSH is normal according to uK measurements. As is everything else. GP asked if I was sure I wasn't depressed. I wasn't depressed. I knew what that felt like and I wasn't there. I was going to ask them to do further tests as in the US my levels would have registed as abnormal but TBH I can't face the hassle.

My life has shrunk to the essentials. Work, kids, housework. DH was out last wed night. The boys were rampaging round the house at 11pm because I simply couldn't summon the energy to get up and make them go to bed. My marriage is at breaking point because I have no time or energy for DH. I don't run because I can't. I don't go out because I am too tired. I am a waste of space. I wish my family had someone better. They deserve someone better.

3m down the line and guess what? I am depressed. But I am depressed because I feel like death warmed up and no-one can tell me why. I don't feel ill because I am depressed. I don't feel like I felt when I went on citalopram in the first place (I was anxious rather than depressed) but maybe it will work just as well.

So I am giving in and doing what the GPs seem to want me to do. It's just easier.

Sorry about the self-pity.

Hi Ormirian I think I remember you from another thread a while back. I remember we had a love of running in common. So sorry you're feeling so awful. I'm not sure what the answer is here, but I relate a lot to how you say you feel, tired all the time and sure that it stems from more than depression. Do you feel you have any more energy during the summer months? January especially seems to be making me very tired and flat.

I think you do need to have a long chat with your doctor. Maybe book a double appointment so you have time to talk about everything. Perhaps print off this post. If your doctor does think ADs may help with energy levels, it doesn't necessary have to be back to citalopram. There may be something better suited for you. Also check diet maybe you might have a food intolerance? Sometimes wheat and dairy can cause tiredness.

It may be aswell you need to do more gentle exercise to boost energy. It often feels like a vicious circle. Often the less you do the less you feel like doing etc.

Hope this helps x

Thanks for your reply orange.

I am worse this time of year without a doubt - as soon a NY comes round I find my mood takes a dive. But I was pretty bad beforehand.

I have tried going back to running on and off quite regularly but I can't seem to get started again properly. We got a dog back in the summer so I am walking him most days - probably averages out about 3 miles a day - but it isn't the same.

I honestlt can't face seeing the GP again. I never get to see the same one twice and while they are all well-meaning and pleasant I know they won't do anything for me. And I feel like such a hypochondriac. As far as the NHS is concerned I an part of the worried well and a waster of time . Easier just to go and ask for ADs again and be done with it.

I stood on the mway bridge last weekend while I was walking the dog and thought how easy it would be to jump off. I felt so bad at the moment I thought my family would be better off without me so I wasn't worried about them. What stopped me was my dog getting scared and hit by a car, and that thread in AIBU about train jumpers being selfish.... MN has it's uses sometimes

I am so sorry you're feeling so low OrmIrian. I can't really add much, apart from that my anxiety is always dreadful at this time of year and it grips and paralyses me during the low times. I was on that thread too and was horrified at how ignorant some people are about mental illness.

I agree with what orangeflutie said about the vicious circle. How do you feel about the possibility of going back on citalopram? I am avoiding medication for my anxiety at the moment for lots of reasons but my GP has just referred me to the Community Psychiatric Nurse to discuss 'options'. I don't know what these are yet but I'd like to speak with someone more specialised and the GP seems pleased to be shot of me.

OrmIrian I'm very lucky in that I have a doctor who doesn't mind me bothering her with my worries, but I know that there are times when she or others at the surgery are busy and then I feel guilty for taking up time. Sadly the NHS can only do so much and it usually means handing out ADs and a limited amount of CBT.

As MissBetsyTrotwood has mentioned she's being referred, could your doctor do the same? Unfortunately part of the depression is feeling you're being a nuisance and shouldn't bother anyone.

I go through phases when I think I should 'Just shut up and take the tablets', but I do often need someone to listen to me. I hope you can find a sympathetic ear.

I think I remember you from last year. You said you came off citalopram last April after being on it for three years. How did you come off it? how fast? because I know from experience that for many people, and I was one of them, if you don't do it right, that is taper off really slowly, it can come back and bite you in the bum many months down the line, don't underestimate how powerful these meds are for some of us. It could be withdrawals, and it can feel very very similar to the original depression although not the same, I have lots of information on this in my blog which you might resonate with you, my blog is in my profile if you click on my name.
The thing that made me wonder is that you said it took you ages to get rid of all the shitty symptoms which makes me think you came off too fast, because if you come off a lot lot slower you don't have to tolerate shitty symptoms. Something to think about. I do know how it feels

I know you don't want to hear this, but, I think you should consider going back on a liquid AD, that way, when you've stabilized you can consider tapering off with a 5ml syringe (or whatever you starting dose is) extremely slowly which is what I have had to do, I'm now down to 1.30ml and still going.

You have had suicidal ideation, as they call it. That is a serious symptom - of depression. It is possible to be depressed without feeling depressed as such, I know this, things seem shitty and you think they are shitty, therefore it feels like you are being a realist when actually depression is warping your perception.

I'm very lucky to have a good GP, and have also been under secondary services. I know it seems like a drag to see your GP again, but it can take time and a bit of chopping and changing to find the right med for your particular physiology. I suppose if you get nowhere with that approach you could ask to be referred for assessment by secondary services ie a psychiatrist. Like GPs these can vary a lot, unfortunately.

Are you sure they think you're a hypochondriac? You have the right to see your notes, you know.

All the best x

Thanks everyone.

strawberry - yes I came off them cold turkey and I remember all the advice you gave me and I read your blog. However at that time I was already a long way down the road to coming off so just felt I had to wait it out a bit longer. And that seemed to be true for a long while. But I guess not. What frustrates me is the feeling that the depression is a symptom, a reasonable reaction to the way my body is feeling atm. Whereas the GP always seems to think the depression is the cause of the symptoms. But I was already getting them whilst still on cit.

betsy - sounds like you have a good GP there. To be fair to mine I refused to even consider depression last time I was with her. She did say that if I changed my mind I could try some sort of therapy and she would refer me. But I still think there is more to it - but that could be the depression talking? I just don't know...

pink - I don't know they think I'm a hypochondriac, but I feel like I am. Always used to go and see the GP about once a year ot reassess my athsma meds. And then for the pill. Nowt else. I seem to be there all the time now.

Thanks so much for your responses. I was really low yesterday.

There's your answer, cold turkey is a disaster, I think you'll find if you go back on them or go back on a liquid SSRI (maybe Prozac) you will then leave your options open for tapering off slowly slowly when you're ready rather than cold turkey? I think all the confusion you are feeling is withdrawals from coming off way too fast last year, sadly I've been there done it a worn the t shirt a few times

But strawberry - the exhaustion and lack of energy started way before I came off the citalopram. That is what is frustating me so much! Because I have been depressed, and probably am depressed now, the GPs first and only response is 'oh you're depressed, take these pills, see this therapist'. And I don't think it is just depression. I think the depression is a symptom of something else. If taking ADs would make me energetic and fit-feeling like I was a few years ago I'd take them like a shot, but it won't will it?

It's like there's a big fat elephant in the room that only I can see. But the GPs focus on the big pile of elephant poo that needs clearing up. But unless they get the elephant to move there's only going to be more poo tomorrow and the day after....

Sometimes ADs can open a window in depression so therapy can sort of get in and start to work. I know this is probably a really facile thing to say, but if you did go on them and you felt a bit better, then you'd know whether or not your symptoms were caused by something else? A sort of process of elimination, iykwim.

There are other ADs orm Citalopram didnt suit me either (or rather it didnt do anything)

You have had suicidal thoughts...time to get to the GP and tell them and try something else.

xxxx

Thanks.

I know, I know. I'll try to get an appointment with the same GP I saw last time. Annoying though she was at least she was sympathetic.

bed - they did suit me to start with. I was very anxious - palpitations, lack of sleep, weight loss, crying all the time. Cit was like getting into a warm bath. The symptoms stopped straight away. But the other problems started a year or so after I started them and I thought coming off them might help with that.

sorry bec - not bed!

Oh, I see now. Ignore my last post! You feel as though the GP can't see past one diagnosis and she has sent you for blood tests that came back within normal ranges. Is there something in particular you are worried it could be or just that she's missing something. Have you been as explicit as you have been on here with her? I know it sounds odd but I found that my GP started really listening to me when DH came with me to the appointment. Not because he was a man or anything (though that may have had something to do with it) but more that it was clear that it was a problem that was affecting family life and that I felt I needed support in the appointment itself. I suppose what I'm asking is what you'd like the GP to do...

I love the elephant analogy.

So they did work for a while? Well thats encouraging! bound to be something else that will.

Good luck x

DH coming might help so that I might keep a bit more of a grip on things. But he jever thought I should come off the ADs in the first place so I suspect he would just encourage me to go back on them.

I have been wondering about ME or thyroid issues. But I know fuck all about them and am just clutching at straws TBH. SIL has ME and seems to have similar problems (but much much worse). Could be thyroid underactivity apart from not feeling cold - but the meno can mask that apparently. My TSH levels came back OKish but not according to US assessment. I want them to do some more tests. But i am not a HCP, I am just a fed-up lay person who wants someone to say 'yes, I can see things aren't right, let's spend time working out what the problem is'. I don't think I should be doing all of this - it's not up to me. But all I get is a pat on the hand and some ADs.... And now I think that perhaps I DO need them but if someone would help me with the other 'issues' maybe I wouldn't have..... Does that make sense at all?

It makes absolute sense. You are worried that there is something else that is causing the depressive symptoms. And you want them to take that worry seriously instead of just treating the symptoms.

OK, I have to go out now to pick DS2 and wrangle him home in the rain, but I'll be back later. There is also a pile of washing of domestic emergency status in my bedroom that has to be seen to and a large dog to walk (also adopted to get me out and exercising and keep the darkness at bay - snap!) but I will be back!

OK sorry I understand what you are saying now about the tiredness, I wasn't getting that before. Yes it sounds like you should ask them to run a load of tests to see if anything else is going on. It's possible the citalopram just stopped working when you were taking it as well (pooped out).
I still feel that withdrawals are mixed in with this as well.

"I still feel that withdrawals are mixed in with this as well."

strawberry - I suspect that you are right.

I hope today wasn't too tough... Good luck, and I hope your elephant starts getting a little more attention!

Orm, I could have written your posts. I feel dreadful atm, with an ongoing health problem for 2 years that is still being investigated plus all the aches and pains and extreme tiredness... I know my GP will just say its depression so I've avoided discussing it.

I have to go back and see him as it's got to the point of scaring me and I think that it may well be depression now. But I also know that for the past 2 years, I have been very happy and I had many of the same symptoms then. Sorry you're having such a tough time.

you need Dr. House.