Is therapy enough or should I consider SSRIs for depression and anxiety?

[alphasox]

I’ve started seeing a private therapist for a few issues and we agree I have severe depression and anxiety. I went for the therapy because I had bad experiences in the past with GP’s not being sympathetic and also found the drugs prescribed in past years didn’t agree with me - made me feel queasy. I wasn’t given support to come off them so had awful withdrawal side effects. So that’s all put me off the drug route.

Therapy is going ok though it’s very early days. However today the therapist has suggested I consider talking to the GP about drugs as well as the talking therapy. Obviously they said it was my choice but with some of the issues I have the therapist strongly recommended/encouraged me to do this.

Being depressed and unable to make a decision about anything in my life, I am not sure what to do now. I would appreciate hearing some experiences of both approaches.

I can’t say that talking alone would have helped me when my depression was really bad.

If you have had a bad experience with your GP in the past, is changing practice an option or even seeing a different one at your usual practice. Supportive Drs make all the difference ime.

Medication has helped me hugely, more than the 6 weeks counselling for my depression & 12 weeks of CBT offered on the NHS for my anxiety anyway.

Being on meds after my 3rd pregnancy really helped me. It was at least 9 months after the birth and I seemed to have postnatal depression. However once I started taking them I found my mind really calmed down and I realized I had actually been very anxious. I was ruminating constantly and that was relieved with meds. Can't remember how long I was on them, definitely less than a year but it was like I got a reboot so I could look after myself better. I would highly recommend exercise/yoga/walking any physical movement and having a routine for sleeping and waking. Mood disorders really respond well to routine, good diet and exercise but it can be hard to do the self-care when you are depressed. So yes, I would give meds a try. This time talk to the Dr about your side effects and make sure you ask your therapist to monitor you and check in with you while on your meds. Sleep deprivation or sleeping too much made things worse so that's why I would advise a daily routine/rhythm to help your body which helps your mind. Do you have any social support?

Thanks @Pinkshrimp and @Wishingstarr for your experiences they are reassuring and helpful.
It was a different GP in a different area before so maybe my current one will be better you are right - it’s just the past has tainted my feelings about it and made me hesitant.

All you describe around exercise, sleep, routine and healthy food is exactly what I know I need and am discussing with the therapist, but it’s the hardest bit to crack at the moment as I feel so hopeless and unmotivated.

Thanks again for your thoughts x

I hope things feel brighter for you soon

I am on day 1 of meds. Short version- I procrastinated for ages over them as in past they have made me unmotivated (sertraline), awful withdrawl (sertraline) and weight gain (mirtazapine).

I had already started healthy eating and was working my way through a backlog of tasks, slowly. But I could not shift the bad feelings. Therapy was helping but I really think exercise and social interaction are important too, which can be so hard when feeling low. So short answer is wish I had sooner. I plan to taper off very slowly. No med is without side effects but its worth trying different ones and unless its an absolute no giving it a go.

You absolutely can beat depression without meds, with being kind to yourself, boosting well-being, being aware, I just haven't yet.

alphasox it is so hard when we know what would help, but our mood disorder of whatever kind is preventing us from doing the very things we need! Try and focus on one area at a time. Getting up and doing ANYTHING can be so hard when you are suffering from depression. So if at all possible try and get up & dressed and out in some fresh air first thing. If getting in the shower is just not going to happen, don't beat yourself up. Leave some easy comfortable clothes next to the bed (including shoes) before you fall asleep. Put them on and go straight outside for a walk. It can be so hard but natural light (even gloom) really helps our brains get on a natural biorhythm. If at all possible try and leave the house by 9am. Just do that first, take a walk and then come back for a wash and breakfast. Getting moving seems to propel you to the next thing. Even if after breakfast you find yourself grinding to a halt again, it almost certainly will help to get outside.

I remember with depression going to bed in a good mood and waking depressed. That's what can be so hard, so if you can drag yourself out it can really help.

Also pay attention to anything that makes you feel better. If watching a movie, watching comedy, having a friend over etc. helps your mood make sure to add that to your routine. If someone is visiting and it's having a positive effect ask if they could commit to a regular visit (once a week, twice a month etc) its good to give yourself as much structure as possible and have something to look forward to. Make plans with them immediately and put it on your schedule/calender because that can just be something you never follow up on when you aren't doing well.

Also, if anyone offers help accept it. Have them do things you are struggling with and are depressing you. So if your house is messy have them help you tidy up. If you're not eating, ask them to make you some sandwiches to keep in the fridge. Whatever tasks that are getting you down that you are beating yourself up about, ask friends to help you take care of it, so you can't reproach yourself.

Be kind to yourself. I would love to hear how you are doing ❤

So I went to the GP and have been prescribed Citalopram. That appointment was so hard but the doc was wonderful and really listened to my concerns about side effects. Talking to the doc made me see just how much pressure I am under at the moment.

Anyway, I took my first tablet as soon as I got it this morning and now (3.5 hours later) I feel sick as a dog and really anxious. I Didn’t expect the side effects to hit so fast !
Having spoken to the doc I’m fully aware I might have these effects and feel worse for 2 weeks before they get into my system. So I will persevere. But oh my goodness I feel rough right now.

You have to give any change a fair shot, a few months rather than a few days. So unless your side effects become debilitating I would persevere.

Hope you're feeling a lot better in a few weeks x

I didn't want to go on meds either but within a week of going on them i felt the depression start to lift. Mine was so severe the gp told me the therapy would only take me so far. When id settled on the drugs, i felt like someone had steadied the ground under my feet so i actually had somewhere to stand while i have the therapy a chance to work. I did have side effects but they went away after a few weeks.

For me, medication takes the edge off my mood which allows me to effectively use therapy, routine and exercise to improve my mood.

I found the first 7-10 days of citalopram brutal for nausea and anxiety but then it improved. I promised my gp I would try to commit to taking the medication properly so I stuck with it. Prior to this I had a bad habit of abruptly stopping medication and disengaging which wasn't helping long term. I couldn't stay on citalopram as it ended up triggering mania in me but sticking with medication and fully engaging with treatment did led me to the right diagnosis and a fairly stable mental health. Focus on the long term goal to get through these difficult first few days.

Hi op, that is what I am on.

The GP told me to take 10mg a day for a week to start with then increase to 20mg, this could be an option to suggest to your GP?

I also decided to take mine at night time. I do get vivid dreams so am going to try a bit earlier e.g. 8pm.

I had mild headache the first couple of days. I did get some lower abdominal pain, a bit like period cramp. Not sure what that was but I took magnesium and a few other vitamins and that helped. I would recommend taking magnesium as apparently anti depressants leach magnesium from the body. Also calcium and vit D as I think they work synergistically together.

B vitamins and zinc are also very good for anxiety. I try not to take too many supplements but an all round one and some omega 3 is probably a safe bet.

The other side effect which is mildly bothersome is feeling a bit achey in my bones, I read this can be a side effect. I think the magnesium and calcium will help, I was just holding off as I booked a blood test at the doc to check D vitamins, B12 etc to see if there was any deficiency behind my low mood. Thats done today so will start the vitamins.

Hoping you feel better soon, take care. Keep talking as I know this really helps.