Referred to psychiatry team...

[CatPower]

Hello,

I've been taking citalopram at various doses for about eight months, and whilst initially I found it a great help, for the last month or so I've fallen into feeling as awful as I did before taking the tablets.

I have a lot of factors in my life that my GP thought could be causing the low mood/worry/insomnia, but we've "fixed" the issues and if anything I feel worse.

I had an appointment with my GP today and she has said she wants to refer me to the local psych team as soon as possible. She said she would make the referral "urgent". She has also said I am to reduce my citalopram dose from 60mg to 50mg this week, or go to 40mg if I don't have side effects.

I'm nervous/scared about being referred to psych. It's like it's been confined that I am so tired, so f---ed up, so negative, so empty. Coming down from the citalopram means she wants to change my prescription but she didn't mention what medication she had in mind.

I am so confused. I feel lost, I feel empty, but most of all I feel so scared, like I'm on some kind of slippery slope.

Can anyone give me some advice, knowledge or support?

I found citalopram gave me side effects and didn't improve my mood at all. I changed to fluoxetine and it was better. Sometimes higher doses don't help also. Mental health teams can be of massive help providing you feel comfortable talking to them. I have had several mg nurses and cpns and was not comfortable with all of them. But it can get better. Do you have other support eg friends or relatives?

My fiancé is a great support, but I always feel guilty when I see him taking the strain and doing things that I would normally do. We have a five year old DS and I'm trying really hard to be "normal" for him. He doesn't need to see his mummy upset like this.

I have a close friend who takes fluoxetine and her mood has improved a lot, to the point where she says she doesn't want to ever stop them. Not sure how healthy that is, but if it works for her...

I think I'm just scared about getting into the system of MH care... I'm frightened I'll be forever labelled as unable to cope, fragile, mad. Sometimes when I'm at my lowest I do feel mad and fragile and lost. I am trying to stay focused though.

Thanks so much for replying, Ginger. (Ginger Snaps is one of my favourite films!)

Mine too! Wrt being in the mental health system etc- I'm no longer taking meds (right now at least) and though I've been mentally ill since early teens I do not feel stigmatised for it. I have been sectioned before (anorexia/self harm) and even that has had little effect on my life in recent years. It's ok to need help. I have 2 children under 5 and have at times felt as you do now, trying to "be normal". You just need to keep telling yourself that there are thousands of people out there like you and how you feel is normal. You just need to turn it into something more positive and equally as normal. Accepting yourself and your depressionis the first step. Accepting help is next. Please keep posting. There is a light at the end if the tunnel even if its very faint. The mumsnet lot can and will help you through. You're not alone xxx

Hi catpower - feel so sorry that you have taken a dip after feeling better for a few months. I am still trying to recover from my second major episode of depression which was Easter 2010 and was on a psych ward for 3 months. This was also the case with my first major episode following the death of my closest friend.

I am on an old fashioned AD (imipramine) a high dose and it seems to work for me, but I do have ups an downs, more ups than downs but when they come it is horrid. It does seem like the citalopram is not the right AD for you and for some reason (probably money) it seems to be the drug of choice these days. Did your GP say why she wanted you to reduce the dose?

I think the very best thing is what is happening, a referral to the MH team. I had a lovely CPN (Community Psychiatric Nurse) who visited me every week and more if I was really having a bad time. Just having someone who understood (well as much as anyone can who hasn't suffered this horrid illness) was reassuring for me. You may be seen by a consultant psychiatrist and they are very good at diagnosing and treating. The trouble is ADs work differently on different people and so sometimes you do have to try more than one to find the right one for you.

I'm sorry you feel you will be labelled as "unable to cope and mad - that is not a word that is used these days. I know that there is still a stigma attached to mental health issues and not to physical illness, but I think the media perpetuate this myth of people being "crazy" etc. Us sufferers really need to lead the way in helping to reduce the stigma.

Oh your description of how you are feeling could be me talking on a bad day confused, lost, empty and scared. That is exactly how I feel when the bad days come, and I understand about the fear of the slippery slope. I read on a post recently that depression was not so much about feeling sad, as an absence of any emotion at all (hence the emptiness) and it made sense to me. Of course it's scarey - it's a horrid illness but you must let the people who have an expertise in mental health help you, and not feel ashamed. Are you aware that 1 in 4 people will have a mental illness at sometime in their life and 6 people will be suffering at any one time, so remember that when you are in the school playground! I know it must be so hard when you have young children. I am fortunate as mine are grown but it has meant that I have seen much less of my grchdrn this past 18 months.

Above all, you must remember that this will pass and there will be brighter days ahead - hard to believe now, but you need to accept that you are ill and need help, just as you would if you had pneumonia.

Sending you warm wishes

Thank you so much, Nana, I've read your post three times and it's a great help.

I feel a little less panicky at the thought of being referred to a psychiatrist. I have a friend of 15 years who is in a similar position to me and she has been with her psych team for some months. She spent last reassuring me (via Twitter!), and your post was the icing on the cake.

My GP is reducing my dose of Citalopram so I come off it and she can try introducing a new AD. I've been on 60mg since Oct/Nov, but today I've taken 40mg to see how it goes this week... My GP did say to only go down to 50mg, but me being me, I'm trying a little more...

My bad days come and go, but the emptiness always stays. I had a strange day on Sunday where I started cooking/baking and didn't want to stop. Ended up with a huge chocolate mud cake in the fridge and a roast chicken with all the trimmings on the go. Then yesterday I started buying random things online... ended up with make up, some bits from Lush, books... Not like me at all, I normally don't buy anything for myself at all.

Right now I'm as empty as always. I can't decide what else to do, so I'm going to lie down.

Thank you so much for responding Nana and Ginger. If it's okay to keep posting, I will, it's nice being able to get things out of my head. xxx

catpower glad my post helped a little. I really really don't think you should be reducing your meds, you say "but me being me I am trying a little more" and I think this could be one of your difficulties, in that you are scared of being mentally ill. The thing is depression makes us feel that we should be doing sonething to make ourselves better, it is somehow our fault and we feel guilty and ashamed that we can't do that. This I'm afraid is one of the tricks depression plays on us - it's a symptom of the illness I'm afriad, and I remember last time I was admitted to a psych ward I just kept crying and repeating over and over again "I'm so ashamed" and apologising at every verse end. We don't feel like this with physical illness.

I think by reducing your meds lower than the GP recommended, is a bit like pulling a piece of plaster off your broken arm - if you see what I mean. You wouldn't dream of doing that would you.

Oh god that empty feeling is so awful isn't it - when those days come I feel like I've been tipped upside down and everything shaken out of me and I hate the lack of any emotion. I cry a lot and that sometimes helps a bit, but like you all I want to do is stay in bed or more usually get up, shower etc, have a banana and go back to bed under my blanket. My CPN used to say we "shouldn't" do this, as it is not good to isolate ourselves. However I got to the stage where the lying under my blanket gave me a bit of relief, and so I did that and stopped feeling guilty about it.

I think one of the problems with MH is that only people who have experienced it know how it feels, so no matter how good the CPN/GP is they don't really understand it.

Gingersnaps was right I think when she said you need to accept yourself and your depression. You mention a lot of things that your GP thought could be the root of your depression and you say those have now been "fixed" - I don't really understand this - how do stresses in life that you mention get "fixed" - to be honest it doesn't sound very realistic to me. Usually our stresses "wax and wane" and become more manageable over time, and you might need to re-visit these at some time in your life. However I think the main thing right now is for your GP to prescribe a different AD that might well work for you. As you probably already know with ADs it's really a matter of trial and error.

PLEASE keep posting cat as there is usually a lot of help on this thread and it has got me through many a drak day.

Not sure about your internet shopping - maybe need to keep a check on that - could be that you wanted to act spontaneously for once in your life!

NNx

cat that should read dark day!

Hi cat I felt exactly the same as you when I was first referred to the local team. (similar circumstances.)
Try if you can to think of it as your GP simply referring you on to a specialist in the same way that they might with any other illness. GPs only have a certain amount of experience with depression etc so it can be v useful to get further input.
Hope you start feel better soon x

Nana - what I meant by "...the issues have been fixed..." I am on the waiting list for an operation to fix my deformed hip (hip dysplasia). I've been on a lot of strong painkillers (including morphine and fentanyl) so my GP was convinced my low mood was because of the pain I am in. We've fiddled around with lots of painkillers at various doses and seem to have found a combination that gets rid of 90% of the pain I am in... because of this, my GP thought that less pain would improve my mood, but after three weeks on this combination of pills I feel as low as I did before I started on ADs. I've always known my depression isn't linked to my pain; I've had spells like this since I was seventeen, nearly a decade before the pain in my hip and leg started.

I slept all afternoon again, on the sofa, under "my" blanket. My DF knows that when I'm sleeping like this things aren't good, so he's taking up a lot of the strain in the house, collecting DS from school, shopping etc. I don't know what I'd do without him.

As you can see cat we are more than happy to help and if posting keeps you talking about it that can only be a good thing. I'm glad our experiences have made a difference. If you have any questions or just want to vent then ask or vent. And please don't feel guilty for taking support. I'm sure you would do the same for your fiance if the tables were turned. My dh has been of massive support as have I to him (he is bipolar) and having that person there even just for a hug or a smile when you need it is important.

Nana your post is fantastic and insightful :)

Oh cat the pain does get to you though. I have fibromyalgia and believe me it can make me sad that i can't always do the things I want to with my kids. Perhaps once your op is done you may well feel slightly better though Im sure it won't solve all your problems like your doc thinks

Hi cat - glad you have a lovely DF and were able to sleep under "your" blanket. I understand what you mean about other health problems being fixed (or more or less so). Did you mean that you have had episodes of depression since you were 17 - have I got that right? Have you any idea of the roots of your depression? It is often related to loss of some kind (not necessarily bereavement) Have any ADs suited you in the past and is this one following a similar pattern. Sorry if I have got this wrong. I don't know what I would do without my DP either. He doesn't understand depression but he is always supportive and loving when the bad times come.

Gingersnaps thank you for your kind words. I have a friend with fybromalgia, and it comes and goes but has a big effect on her life. She finds complimentary therapies work well. Is this how yours is, as I think it varies a lot between different people doesn't it.

Hi kizzy - hope you're on an even keel NNx

Yes Nana it has a huge effect on my life. Some days I can barely lift my head but l have to look after my dcs and cannot lie in bed all day. I push myself to walk the 2 miles to school everyday even when i feel like a cripple. They keep me going and I am thankful everyday that I have the chance to experience something so wonderful. It does hurt that sometimes I can't do things with them. But i am happy with my lot nonetheless. Wrt complementary therapies I have found massage to help but unfortunately I am quite rural and find it hard to get to such places. There is a lady who does physio at my house but not as often as I would like. I am lucky to have supportive pils who help me alot and dh who is amazing. If I didn't there are things I would never have got through. I see some of the threads on here and feel blessed :)

Dont be afraid if your psych team they have seen everything you have been through and much worse!. They are there to help and can usually help quite quickly. I was so relieved to get talking to my CPN and was shocked when she said that all I had been thinking and going through was 'normal' within the confines of depression I seriously thought I was going insane and inches away from being sectioned! I wasnt at all and they changed my meds and had me well again within weeks. One thing you mention is insomnia I suffered horribly with this when I was unwell and my AD is now Mirtazapine which has sedative qualities and has me sleeping like a baby-maybe worth discussing? I found Citalopram worsened my insomnia and this is not good when you already feel bad. Best of luck you will be much better soon.

Chief, you say Citalopram worsened your insomnia? I can't help but think that's happening with me, too. Hmm...

Yes I tried many ADs and did not get on well with the SSRIs-they gave me dreadful anxiety and worsened my insomnia. Mention it at your next appt they will help you find something that works for you.

I'm not able to start a new AD until I'm off Citalopram, am I?

Yes you need to come off Citalopram first discuss it with your psychiatrist I think they reduce your dose and then introduce new one-they will advise you whats best.

I'm having a much brighter, more positive day, got to school early, went home via the supermarket and had a big big spend (bedsheets, pillows, toiletries for bathroom, make up, jeans, a couple of tops... ), home and tidied up super fast. I'm starting to see a pattern when I'm feeling "up" I tend to do much more, in much more of a rush yet not really stopping. Not sure I like it.