Is it the depression talking or am I worse than before treatment? Considering stopping citalopram

[felttippens]

Very brief synopsis

Had severe pnd 4 years ago, was treated with cpn, citlopram and then venlafaxine was well again

In march was feeling a lot of anxiety so went to GPs to 'nip it in bud'

At that point had a lot of morning anxiety that settled most days by afternoon

I was prescribed 10mg citlopram

Within a few days my anxiety symptoms got dramatically worse and I had a horrendous week of barely coping with panic attacks etc really felt I was going mad
Went back and forward to docs got beta blockers and doubled citlopram to 20mg
These eventually helped to bring anxiety under control but a hopeless depression has crept in - I binge eat drink too much have occasional suicidal thoughts get very low agoraphobic and antisocial - feelings of numbness towards kids no sex drive or motivation

How is this 'treatment'? It's not as intense as those first couple of weeks but still isn't a life

Any advise???

HI treading, was just wondering whether the citalopram worked at all when you took it previously? As you will no doubt know some antid's have little or no effect and it is a case of trial and error until you find one that suits you.
It may be useful to go back to the doctors and explain how these other symptoms have crept in, if venlafaxine has worked in the past then maybe it could be tried again
Let me know how you get on and take extra special care of yourself.

Thank you for your reply :)
Citlopram didn't fix me last time I moved on to venlafaxine but I categorically won't take that again I hate hate hated it an was glad when I came off I'm
I'm wondering what I would be like without any but scared I crash
I hate how it's all an experiment yet I have to still attempt life even with a half broken brain
I have to fight a battle every day just to get up x

Sorry I can't help, but I'm bumping this in the hope that someone with the necessary experience can give you some advice x

Sorry to hear you're suffering the symptoms of depression again.

You mentioned that within a few days of taking citalopram you experienced bad anxiety symptoms. But this could well have happened anyway, regardless of the Citalopram. Citalopram takes 2-4 weeks to start having a noticeable effect.

I'm sure you know this already - but alcohol won't be helping. For a depressed person it's especially unhelpful, as alcohol is a depressant, so unfortunately it could be making you feel worse.

Please do go back to your GP and tell him/her how you are feeling, so that they can try some alternatives. Maybe 10mg Citalopram just isn't enough and you need to re-try what helped you last time? Or your GP might well have other suggestions.

You don't have to keep feeling like this - the sooner you find what you need, the sooner you can start feeling better. Will you phone the GP on Monday for an appointment? Let us know how you get on.

How are you feeling today?

The increase in anxiety you felt early one was almost certainly down to the medication. It's very common with SSRI's before things improve.
My own personal experience of taking ads has been that its taken at least 8 weeks to see any improvement at all - and I definately got worse before I got better. I know they say 3-4 weeks but that wasn't the case with me.
If you started them in march though that sounds like you've given them a decent amount of time.
Def go back to drs to discuss. And try to avoid alcohol - it really isn't a good idea to mix the two and it might help reduce your symptoms a little.
Hope things start to ease really soon. There will be a way to get better but I know how frustrating it is while you're trying to get there.

I feel so grateful that you've taken the time to post.
I feel like I'm properly mad, I'm pretty stable at the moment but I'm just not the same
I have started being quite eccentric I have developed a way of coping but it makes me feel crazy that I can't just 'be'
, just silly things like obsessing about a routine I do in the morning that is like a coping mechanism for getting out of bed , the first few minutes of waking up I feel utterly dreadful and the negative thoughts swim in but I then get up , make my bed perfectly in exact same way (I was hoovering the bedroom floor before leaving it but I've eased up on that, I then go in bathroom, clean it , brush my teeth wash my face put make up on, go downstairs, make tea out washing on Etc this sounds like I'm organised, I'm not, I'm really messy really
Has to be all in order and probably sounds pretty obvious but I feel anxious while I do it and have no time for kids until its done
It's been ok in half term but my husbands been doing school run and using his holidays from work as mornings are so disfunctional for me. Things like ' what to make for teA' makes me feel so stressed until I decide what to make I have to make every step tiny so it doesn't overwhelm me, I have an ongoing list on my phone which makes hilarious reading in hindsight - check weather - get dressed - what's for tea - brush dd's hair - school run - feed dog - everything broken down
I ignore things that should be done like keeping track of bills, school admin
My memory is like a seive
I've started smoking again after stopping 10 months ago
Haven't had a drink today so that's good

I enjoy shopping and spending money I shouldn't
I can't talk on the phone much , I feel unable to answer to people unless I'm in the right mood
Won't answer door unless I know who it is, missed an important delivery last week Cos I was hiding behind door anxious as hell not knowing who it is
If I go to shops I have to go up and down each aisle even if I know that what I want isn't there
I dread upcoming events but usually enjoy them when I'm there
I very often just switch off in my head and find it impossible to interact properly with my kids , wish they would go away
I read a lot about suicide, even tho I don't want to die
If I have to buy something I drive myself mad compulsively researching it
I run a business from home and the pressure I feel is massive, have tendency to be workaholic to the point I neglect what I should be doing sometimes as my work really distracts me
None of this I recognise as the real me but the real me is becoming distant memory

I have constant dragging feeling of not really knowing what I should be doing, what's the point etc

Sorry that was so long x

You say you're compulsively researching things, feeling you have to go up and down the aisles in shops, obsessing about your morning routine, and having lists yet feeling anxious while you carry them out.

Is it possible you might have OCD to some extent? Either way these are unpleasant anxiety symptoms. SSRIs may be needed in a higher dose for anxiety than for depression.

My dh is a GP with special interest in psychiatry and he never prescribes Citalopram, says its a waste of time!

You might want to see someone else, try to get a change, you don't have to go for venal faxing first go - I was well treated for depression with sertraline (several episodes over several years) and a close friend with fluoxetine.

Would referral for a talking therapy - counselling or clinical psychology - be something you'd consider? (With/without medication).

As I was typing that message I did think it sounds pretty OCD

It's so odd as all of that doesn't particularly bother me I see them as coping mechanisms to deal with the huge feelings of not coping , being overwhelmed, feeling of doom and not wanting to get up

One minute I feel very detached and then I'm laughing. I laugh a lot with friends etc

I've been referred to 'psychological services' the letter came I ignored it for few days, felt unable to ring the number , then emailed them , got response to say please ring, felt unable to ring, DH rang and I have an appointment for initial meeting to see how they can help early July

I'm worried about changing meds as if it all goes wrong I feel I've used the resources around me already ie DH couldn't be off work again, friends and family presume I'm feeling a lot better now, have this feeling that everyone things I should be 'over' it now

As your app't is in early July you've still got another month to see if your medication is starting to make a difference to your mood. If it isn't working by then as you started it in March, they will probably change it again. But at least you'll have given it a chance.

It sounds very hard feeling trapped by a routine that is controlling you and preventing you having an easygoing relationship with your children. Your friends and family are worried about you, they want your meds to work too, they aren't criticising you for the meds not working yet.

But well done for even getting out of bed in the mornings, it must be very hard to do that if you aren't sleeping properly. Is there some sunshine there today?

I've had quite a good day today , in that anxiety been minimal - did lots of work though (too much) and now sitting staring at the mess, packed lunches to make, uniforms to iron , I've had a drink and my mood crashes

Citlopram is making me very fat too

Sorry embarrassed at the negativity in that post

I had 3 drinks and put rest back
I did packed lunches and uniforms
Am now in bed

More positive :)

Hi treadingwater

I am also on citalopram 10mg for anxiety.

I started meds nov 2012 and I would say the first two weeks I had heightened anxiety. And other side effects. It took 6 weeks before I felt any real difference.

I also have had therapy. Some private which was the best but £130 per hour so couldn't keep that up. She suggested using a cd mindfulness. It makes you aware of your breathing and stop your mind from over thinking everything. It's very good. It's very relaxing.

I agree that your anxiety is manifesting in OCD tendencies. Cbt therapy will be beneficial.

I was scared to have appointments and pre judged my nhs cbt therapist when I first met her as she was so young. It was wrong of me because she was fantastic.

Get the help you need. It's worth it. You cannot go on like this I know it's exhausting.

Big hugs xxxx

Hi

I have OCD which started in pregnancy and have had severe PND - much more severely second time around as I wasn't treated first time (didn't even realise I was unwell, thought everyone felt that shit!).

I am on the fence about medication. I think there are times it is absolutely essential and it certainly was for me at points on this journey but the real work has been through CBT and ACT (Acceptance and Commitment Therapy)/Mindfulness. I've had 25 sessions of CBT, done LOADS of self-help with ACT guided by my CBT therapist as well, 2 8 week Mindfulness courses and am doing a PND group too.

Medication is a crutch at best. There is a lot of faith these days in the idea that depression/OCD are chemical imbalances but it is rare that it is that straightforward. 50% of the adult population will at some point meet the criteria for a medical diagnosis of anxiety or depression, with very many contemplating suicide and the same sorts of symptoms that you describe. It's actually pretty normal for human beings to suffer psychological pain and for that to impact on day to day functioning. Back in the day people dealt with this by appealing to God and talking to their minister or priest or.. I dunno.. dancing at the crossroads in moonlight, but today we medicate and go to paid therapists. Evidence based practice is the new religion .

I think they're just different approaches to the same deep problem of human suffering, I just think it's a wee bit compounded these days by thinking that it is NORMAL to feel "happy" and ABNORMAL to feel "unhappy". CBT cuts through a lot of that nonsense and for me, ACT has been even better (ACT is a third wave CBT intervention with good empirical support).

I have seen this with my sister. She's been on citalopram for anxiety for about three years but with no therapy and I think she's worse rather than better if I'm honest. I think without the deep personal work on what makes you tick guided by a good therapist, medication can be worse than useless for these types of problems as it just feeds the idea it is "just illness" when actually you have to learn skills to deal with feelings and whatever in life makes these feelings intensify for you personally (which is often unique to each of us based on our past experiences etc).

Good luck. Break Free from OCD is a great book - I recommend it. Also "The Happiness Trap" by Russ Harris. It's great now because if you have a Kindle you can download these things and read them in public without advertising your thoughts to the universe!

Great post working9whie5 !!!!!

I agree completely. Medication on its own isn't going to cure you.

Agree, fab post, Working! V v interested in hearing more about the 8 week MBSR/MCBT.

And imho (and as evidenced by recent, often ignored research) ADs offer a placebo at best. This can be quite powerful if you believe in their efficacy but even then it is important to balance any benefit against side-effects.

Personally, i have no faith in ADs so no placebo benefit to derive for me. I take high quality fish oil, vit B and 5htp plus therapy, plus try to be mindful but generally fail miserably!

I definitely feel like the tablets took away the despair and intolerable stuff but have left this awful numbness interspersed with madness that I don't recognise.

I'm lying now staring in to space, feel like I've got concrete blocks on my chest, keeping thoughts at bay summoning all the coping techniques then eventually I put my two feet onto the floor and go from there

Sorry I'm not giving in depth replies individually - struggling to concentrate and remember who said what - it's so so lovely to have this support.

My gp is useless I think I'm better off waiting for my referral to come through to change anything - on my last review I said I kept thinking about suicide and couldn't connect with my kids (dd was sick one night, DH was dealing with her and i struggled to even look up let alone be hands on and cope with it) this broke my heart, I can't stress what a good mother I [used] to be - for first two kids I was nothing like this , took it all in my stride and enjoyed being a mother so much, my whole personality was totally different to this

Glad, it's helpful, OP .. And just do what you can. Baby steps.

YY salbertina is right, just do what you can and try to be kind to yourself.

Sorry you're not finding your GP very helpful. Can you make an appointment with a different GP in your practice? If you're worried about changing to a different medication, how about asking if you might test a higher dose of Citalopram? 20mg still wouldn't be a high dose.

I've been on 20mg for a few weeks now x

Keep going we are all hear for you and holding hands :)

How are you today? X