Constantly sleeping. No motivation. Should I come off ADs?

[Unsurprisinglysurprising]

I started on citalopram around December last year. I ended up switching to escitalopram because of the side effects. One of the side effects I've always felt I had is tiredness - even after the switch.

Whilst I feel ADs have made me more balanced and less angry, stressed and emotional, I miss some of the good emotions. Things that might have given me some joy before don't seem to now.

I am self employed and have found I have no motivation at all. Whether that is down to depression or ADs I can't be sure but I suspect the medication doesn't help. I used to feel stressed as a deadline loomed. Now I don't feel stress and ignore deadlines.

When I work I get tired and sometimes end up going to bed where I can sleep for most of the day if left to it. That means I'm not working and not making money.

This isn't sustainable. GP quite useless so not really somewhere I can go with this. I was offered and am doing an online CBT course but that is equally useless.

The situation is damaging me professionally and financially and also impacting on my time with DC (lack of joy due to stifled emotions).

Any thoughts on what I should do next?

I feel very alone. No one at all knows all of this about me.

Tiredness and lack of motivation are symptoms of depression. Stopping the ADs is unlikely to be the answer, though a review might be an idea if they're not having an impact.
Any chance you could have face to face CBT rather than online? I would imagine that interacting with a computer can only enhance your sense of aloneness.... it would for me.

Don't stop the antidepressants, I agree with the PP that the sleeping is far more likely to be a sign of depression than the meds tbh!

Is there a different GP that you could try?

I agree going to bed and feeling totally unmotivated could be the depression but I also can see it might be the medication. I really want someone to help me unpick it and I don't know who can. I know the ADs are working in one sense as I can see improvements and I don't feel depressed in the way I used to. That's what makes me feel it could be a side effect.

I would love face to face therapy but this is all I've been offered so far. My work situation and other personal circumstances mean I am very isolated. I want to do something positive but I don't know what that is at the moment. I don't want a nasty withdrawal but I just wonder if it's worth giving it a go.

Is there another GP you could see or another join a different practice? Could you do a diary for a week - it might not show the lack of emotion, (though you could make notes of things you do that would have made you very happy/sad/angry and are now flat), but you could record things like sleep. If you do change (under medical supervision) it will also be a guide of what things were like before.

Op the things you are describing are symptoms of depression, including the flattened emotion. Please don't stop the antidepressants without discussion with a doctor. Can you see a different gp if you don't feel ok with the one you're seeing? You could maybe discuss them how isolated you're feeling and request referrŕal to a CBT therapist. It does sound as if some if the 'lifestyle' things you've described could be contributing to how you feel and a good therapist would help you sort that out and make changes to help.
You can see CBT therapists privately but obvs that would be at a cost.

It is the meds that are helping with the depression though - in fact, whenever I hear someone saying they think they should come off the meds it is often a sign that they are actually about to take a turn for the worst so please don't come off the meds, OP!

Can you self-refer to any services in your area, or see a different GP?

I've been on escitalopram and propanolol for four months. I'm always tired. I put it down to both meds and I'm cutting down the propanolol but I'm sticking with the AD for now.
Ask for a review but you could be feeling this way because of already switching meds. It may wear off.

You could have an underlying condition and depression is one of the symptoms to it. Have you been tested for an over or under thyroid, anemia, gyno issues such as PCOS and endometriosis? There's also conditions such as ME and fibromyalgia which haven't had a whole lot of looking into but people do seem to have these conditions and show physical symptoms of it that GP's can't ignore and have to diagnose. Also, lack of certain vitamins such as B12 can cause extreme fatigue and also depression to the rut it leaves you in

I switched very quickly because I had bad side effects from citalopram. I honestly was in a daze and completely drowsy the whole time. That's why I think it might be the medication even after switching. I'm scared of switching to something else because it means potential side effects again.

I take them in the evening to try and combat the effects. I have noticed that if I forget and instead take it as I'm going to bed, I'm even more tired the next day.

It's making my life so difficult. I can understand why people might be concerned I'm depressed but I'm not convinced it's the depression. To be honest, I've been more depressed in the past and coped without medication than I was before going on ADs last year but I felt they would give me the clarity to sort out my personal circumstances and in truth although I don't feel as depressed I also haven't made any positive changes.

I will try to discuss with a doctor again.

@Unsurprisinglysurprising

I can only tell you that over the years I've tried Citalopram three times and every time it turned me into a zombie, constantly enervated and sleepy. Did not suit me one bit, but I struggled away thinking it was the depression getting worse. It wasn't. I'd never take it again. Haven't tried Escitalopram but since it's such a similar name I hope I never have to! Some people react differently to SSRIs that help others. Fluoxetine only ever made me feel like I had the flu; Mirtazapine knocked me out; Duloxetine made me hate myself with a vengeance. I've taken amitriptyline at a low dose for pain and that was OK, but not enough to make much of a dent in my depression. Just gone back on Sertraline, the only one that has ever given me what you described - the clarity, and some good feelings about myself and life. Within 3 days of starting it's hitting the spot at 50mg.

Explain to your GP that the two you've tried - which you've given more than a fair shot - aren't helping and you need an alternative solution. Ideally a combination of face to face therapy and a different medication to try. Chances are your original depression hasn't been resolved because the medication hasn't been working. If you came off what you're on you'd probably initially feel better coz you wouldn't be uselessly drugging yourself every day, but before long the depression would surface again because healing hasn't happened. I'm sorry you've been through the more futile aspects of your medication experience, but you must persevere

Thanks mineralmist. Escitalopram is similar chemically but is supposed to cause fewer side effects.

I will call the GP on Monday to make an appointment as I feel like my life is passing me by while I am too tired to get on with it

OP I get it, I was worse in my motivation on ADs - could not meet deadlines as well, brain fog. I also work from home. In the end I had to stop work for a few weeks to sort myself out. You need a structured get back on track plan. I don't know about your ads but I would think they are better taken first thing in morning. I enrolled at a gym and started an exercise routine and eating healthily then after a couple of weeks started to reduce ads. Reducing them was bad but I felt it was time as it had been six months and I felt better. You need to combat the isolation - work from coffee shops, schedule errands and classes. Another turning point was admitting it to a few close friends and having their motivational support. I also had a few Skype/phone CBT sessions which started once I'd already been making changes and helped reinforce it. Good luck.

Hi OP I can't say for sure what may be causing you to feel the way you are. However I can share our experience. May daughter felt the same. Went from being a bubbly, active girl to unable to get throufh a full day. She resembled a zombie. And I think the medication was the cause of this. She didn't have this issue and other side effects before going on meds. We started with fluoxetine which didn't suit and then moved to sertraline - both SSRIs like escalitopram. I think it got rid of her feeling low but the problem was that there was no motivation, extreme exhaustion etc. We tried increasing doses. We were not sure whether it was the depression causing all this or the medication . I thought it was the medication because she never felt this before the meds. But then I doubted things as thought that maybe it's get worse before it gets better. But after giving it almost a year we decided with the doctor to reduce dose and come off it. As she stated doing this, it was incredible her brain fog started lifting, her motivation returned, her ability to concentrate returned. She can now study for a whole day whereas could only manage half a day. She is now off the meds but still having some withdrawal symptoms and we are treating this holistically.

Just wanted to share our experience. The meds whilst getting rid of the depression (by numbing all emotions) created so many more issues that she was in a worse place than before. We are treating holistically now.

Whatever you do try to instil good self care habits such as nutrition,light exercise,mindfulness, - all of these will help.

Happy for you to PM me

Thanks sunburnt. As this time of year and moving into winter can often be difficult for me, I decided rather than coming off them completely I'm going to switch and see what happens. I have a prescription for sertraline. I need to reduce the escitalopram and swap over. I'll give it a try. If that doesn't work, I'll get myself off them completely.

When I have a routine I am much better. When I can, I work somewhere other than the house but the kind of work I'm doing most of the time isn't easy to do in a coffee shop. It could be done in an office where I would work well, but it's not cost effective for me to rent one at the moment.