Fluoxetine/antidepressants

[Cloudd]

Hi. Need your advice/positive experiences...
Couple weeks ago I was diagnosed with severe depression and generalised anxiety disorder so started fluoxetine/Prozac for first time. It’s been 3weeks now, a did a week on 10mg and then to 20mg. I’ve seen an improvement in my mood and energy, from a 0 to a 4, but will this continue to improve over the following weeks or is this the best it’s going to get? I still feel down during the evenings, when did it start to work for you/noticeable improvements? Xx

Thanks for the update @bookcrazy.

My nausea lasted about 2 weeks when I started the medication and I lost my appetite but not everyone gets this.

@Maidenpink
i know what you mean, it does feel like you want shooting sometimes that or hibernate till it's over 🤣

my moods are always 1/2 and end of my cycle so definitely hormonal. plus my cycle varies from 21 to 35+days, starts heavy and then calms to very little.

can I ask are you on any meds, please don't say if your not comfortable. ( sorry if youve said before and i missed it)

@Maidenpink the BC risk I believe increases if you stay on HRT longer term. I’ll see if I can find some evidence for you. Yes they do use SSRIs for mood-only symptoms as the NICE guidelines state, however you are having other symptoms so imo you are an appropriate candidate for, at the very least, a trial of HRT. Honestly it does make me cross that as women we have to fight uphill battles in respect of our health. From what I’ve seen on the menopause topic here, I wonder if GPs are a bit wary of prescribing to under 45s. Do you know any family history on your mothers side about when she went through the menopause? My mother was early, like me, and my GP took this into consideration. I would have a look at the NICE guidelines I shared earlier on a post to @bookcrazy (think they may have the BC chances on them too) and reiterate to the GP about your non-mood symptoms, assuming your other bloods are normal. Don’t worry about inflammatory markers, it’s pretty routine in ruling out certain auto-immune conditions which can sometimes display similar symptoms to peri/low mood (eg lupus, arthritis).

@sugarlost I’m sending you a hug. I’m adamant that my mid 40s were plagued with the effects of peri without realising what was happening. It’s only in hindsight that I realise so many of my emotional symptoms which have simmered away at a lower level when I was younger (though they’ve had their moments), really escalated as soon as I hit peri around 44-45. I’m now 49 and been on HRT for around 18 months. I’ve said to @Maidenpink before that if it weren’t for the pandemic, work related trauma and some stuff coming up from my childhood, I believe the HRT would’ve been enough to keep me stable. Obviously that’s not been the case as you know. Try to keep prioritising yourself and if you need to reduce your hours at work in the short term or take some time off sick, then it’s probably very sensible to at least consider that.

@bookcrazy I’m sorry your DH isn’t understanding. I’m in a very similar situation to you (a read through my previous posts on here will give you some insight). Along being a parent of teens, feeling like this seems a very lonely place to be a lot of the time. There is something quite cruel about feeling so alone when you are surrounded by others particularly when they are your loved ones. I’ve started to realise that my DH just doesn’t really know what to say. I think he fears saying the wrong thing and that it’ll make matters worse. He’s never been great at emotional support, that’s not his thing, so it’s unsurprising but it hurts. I get it. Keep checking in with us here if you think that’ll help. This is a really supportive space.

@FiloFaxx good to hear you will be getting some counselling sorted. Not easy with little ones, and returning to work (how do you feel about that?) but remember you need to prioritise you as you are the key to your family’s wellbeing.

Honestly you lot I can’t wait to us all to feel better and fully functioning again. Love to all. X

@Maidenpink cross posted with you. The forgetting words or mixing up of words is a dead giveaway. At work I would worry so much that I would say the complete opposite of what I meant. It hugely affected my confidence professionally. Do you know so many women leave their careers in peri due to what their symptoms do to them. It was definitely a contributory factor in my leaving my profession.

@bookcrazy please have a word with your GP about topical, vaginal oestrogen too. I massively struggled with this and it is very, very common and one of the least discussed symptoms of peri. It’s called vaginal atrophy which is essentially a degeneration of the delicate vaginal and vulval issues due entirely to reducing oestrogen levels (aren’t we lucky 🤦🏻‍♀️). Dryness, redness, itching (sometimes very intense), an increase in UTI and/or thrush symptoms are all very common. Unfortunately I did not get on well with the topical HRT so was one of the many reasons I went on full HRT. I’ve made it my mission to educate as many women as possible about this as so many suffer unnecessarily in silence.

@polelynn @Maidenpink @sugarlost ,all in this group 💕

ladies I can't thank you enough. it's so refreshing to be able to chat with and get advice from people that understand and are so supportive.

I absolutely agree with everything you've all said. this peri menopause and menopause thing sucks, the fight and feelings and symptoms are real, it's reassuring to know we all feel it and we're not going mad.

to have this support is invaluable.

i'll definitely be checking in with you all and i'm here if you need to vent.

awesome ladies... we've got this 💪😍

No probs @bookcrazy, I'm on 40mg Fluoxetine. Started 15 weeks ago on 20mg, raised to 40mg 8 weeks ago. I've been on Fluoxetine before and it seemed to work well.for me. When I started feeling crazy in Feb I thought I was 'just' having some sort of MH relapse but now I think there's a big hormonal element to.how I'm feeling as well. If you haven't had an AD before then I would definitely query being prescribed one now.

@polelynn thanks for that, really reassuring and useful. I don't know the ages the women in my family went through menopause, it was never spoken about. I don't understand how SSRIs are supposed to treat hormone related mood symptoms. Surely they can only take the edge off. I've been listening to Louise Newson and so many women seem to be given ADs and they don't work for a lot of them. I will look again at the BC stuff, I've read so much my head's about to explode.

I can't wait til we are better too! X

@polelynn
i've just read your post re dryness/uti's.
that was very useful info and great advice, i've read bits and pieces on it but what you said made so much sense.
i have to admit having to go back to the doc with all this makes me nervous. but i don't want to be on the wrong thing and/or miss diagnosed.

i hope things for you feel better soon, you've been so helpful, thank you x

This is morphing into a meno thread!

@polelynn I'm so sorry about what happened at your work. That just sounds awful. Bad enough on the domestic front. I had heard of women leaving jobs and shame on me I thought it seemed a bit dramatic. Now I'm learning exactly how that happens. It's dreadful, women are so unsupported. It was good to see in the Davina docu the police woman who was well supported by her work. So much change is needed!

@Maidenpink maybe we should start one

Morning all,
I fell asleep early, woke up early hours, fell back asleep but I'm tired 🙈

It's so nice to see the positive encouragement on this thread and the detailed information provided about Meno is brilliant @polelynn & @Maidenpink Thank you 🌟🌟

@polelynn sending a big hug back. I don't think I would have started my medication if it wasn't for the impact of the pandemic although I should have started it years before. Work related trauma has pushed me over the edge ( putting it lightly) in more than one job sadly...I really think more should be done to educate on the dangers bullying, unrealistic workloads can have etc.
There definitely needs to be more education about peri effects from early 40s possibly earlier. It's so important to have access to treatment options and knowledge so we know what we're dealing with! Life is challenging enough as it is...
I had a sudden itching down below but topical cream sorted it out thankfully...it was awful.

I will definitely consider my options and work life balance. I think I'm more fortunate in my current role that I can do that. It's so sad to hear women leaving their careers due to Peri but I can understand it because of the symptoms, pressure etc. Women have to deal with so much in life!

I'm going to send this and update further later as worried I'll lose it and have to get ready for work. Glad it's Friday!

You are all amazing and we will get through this 🌿🌾🌱🌷

Wishing you all a lovely day XXXX

@Maidenpink some evidence around BC for you, if/when you feel able to digest it.

I’ve linked a Cochrane review of the risks associated with long term HRT use. Cochrane Reviews analyse high quality research to reach a consensus and in medical circles are highly regarded. This review looked at post-menopausal women, with an average age of 60 who have taken continuous combined (ie oestrogen and progesterone) HRT over 1 year. Most of the studies used to reach their conclusions were randomised control trials which are considered as a gold standard in research. Unfortunately there is a lack of data around women of peri age, so all we can do is extrapolate the findings. Women’s health as a whole (an area I am trained in and up to recently worked in) has traditionally been an underfunded area in research circles.

www.cochranelibrary.com/content?templateType=full&urlTitle=/cdsr/doi/10.1002/14651858.CD004143.pub5&doi=10.1002/14651858.CD004143.pub5&type=cdsr&contentLanguage=

In terms of BC risks, looking at over 45,000 healthy post-menopausal women, HRT increased the risk “after 5.6 years' use: from 19 per 1000 to between 20 and 30 per 1000”

You are right, SSRIs do not contain oestrogen! Depleting oestrogen causes many of the issues associated with peri/menopause. Many women post birth, particularly those who breastfeed long term, have similar issues (baby brain anyone!) due to exactly the same reason. A solution is to replace that oestrogen, which for us won’t correct itself naturally, via HRT for symptom management, if a women decides that the benefits vs risks are tolerable to her. Many women choose to enter this state naturally without resorting to pharmaceuticals.

Sorry, should be just under 45,000 women.

Hope everyone has a good day. We absolutely will overcome our current difficulties, we are women after all 💪🏼. Love to you all. X

Morning,

Thanks for that @polelynn. ❤ I'm familiar with Cochrane from some thing I did several years ago, it's a great resource. I was pg and bf for a total of 5 years solid which might explain why towards the end of that my MH fell off a cliff! I didn't know about the impact that could have on oestrogen and nobody mentioned it to me as far as I can remember.

That increase in numbers for BC is interesting. I listened to a Louise Newson podcast last night where she interviewed Professor Jim Simon, an ob-gyn reproductive endocrinologist from Washington Uni. He discusses body identical hormones in depth and WHI study that got everyone freaked. Obv there are well known issues with that study. But the key thing he said was that HRT doesn't cause BC in the women who develop it but because it's a growth promoting hormone (hence why it helps our bones, skin, hair etc) in women who were already going to get BC it may make it grow quicker. But in those women treatment tends to be successful and chance of death is decreased compared with other non-HRT women (I think I've got that right!).

Don't get me started on women's health. I battled to get the care I wanted in pg and giving birth but I'm now seeing that mp is even worse!

Totally agree @sugarlost re more info and sooner! I hope you get on okay at work today and you aren't too tired after your broken sleep.

Re peri symptoms and itching ... over the past few months I've been more itchy down below, but more on the 'mound' area not further down. I actually googled it a couple of times but only half heartedly. Is itching there hormonal too do you think?

I asked my aunt about meno and she says she was about 48/49 when she started getting night sweats etc. She had terrible anxiety and paranoia she says ... didn't take anything but in retrospect prob should. I don't know about other female relatives.

Feeling really anxious today, really tired and no interest in anything other than trying to figure out how to make myself feel better! I just feel I'm getting through the day counting down to when I can go to bed.

Sorry it's such a long one. So glad to have this space to connect with you all. ❤❤❤

@Maidenpink I’m sorry you are feeling so anxious today. I think the way you are feeling about focussing on getting well to the exclusion of everything else is totally understandable. You will absolutely get there though❤️.

I suspect your Aunt’s experience is not uncommon. Things are changing for the better, albeit very slowly and yes we have a way to go wrt pregnancy and birth too. Some Trusts as a whole, and individuals within them, are much better at listening to and advocating for women than others, where they often expect/coerce women to slot into existing systems and practices, forgetting the importance of informed consent and crucially actually listening to those without whom they wouldn’t have a job! Ultimately funding and impossible work loads are often at the route of these and I strongly believe it’s not the wish of any individual practitioner, at least when they are early into their careers, to necessarily practice like this. It’s no excuse for poor practice but suspect they often find themselves constrained and restricted too by the cultures and structures. Some practitioners become hardened, some cope (just) and some totally burnout and walk away.

Yes your itching may be connected. I seem to recall mine started in this area then it spread as time went on. This won’t necessarily be the case for you though and if you do go down the HRT route, it will help if it is connected. Mine was also linked to low iron stores/anaemia which I guess they will be checking with your bloods.

You probably know you can arrange a private consultation and prescription via the Newson Clinic? I suspect the answer in your case, after your bloods, will be a chat with the GP that focuses on this area in your practice.

I’m just having a day at home today. No real plans but that’s okay. I’ve been working on my fear ladders and it feels good albeit a bit scary thinking about the steps ahead. I know though that I’ve already had some breakthroughs and these will help my confidence. My daughter is struggling atm which is hard for her, and me. From a selfish point of view I know I will have to shoulder the burden, be the understandable target of her bad moods and need to support her as I encourage her to seek help. I suspect her issues are related to anxiety and the pandemic too and can’t help but feel that this is somehow my fault too, that what she has seen in me has caused her issues too.

*Need to be the primary one to support her, given the situation with my husband and his busyness elsewhere.

Yes, it's the whole people not systems thing @polelynn. I agree with you that the people working in the systems are often operating in such difficult circumstances that they are unable to provide care the way they may prefer.

My iron will be checked this week too. Funny when you were talking about the vaginal atrophy stuff I was thinking I do t have an issue with that yet and then I remembered about the mysterious itch!

It makes sense for me to see the GP with the menopause interest at my surgery before shelling out for private. But I'll be keeping the Newson clinic at the back of my mind if I feel I'm not connecting with the GP.

I'm sorry about the difficulty with your daughter. I really do empathise as my 14yo is suffering from anxiety and like your daughter, I do feel the pandemic has had a big impact. But like you also I feel bad that I'm struggling myself and have 'passed' this stuff onto them. All that said, you're dealing with this stuff in a sensible way which is a terrific example. I was anxious too at my 14yo's age but didn't even have the language to describe how I felt and didn't have relationships with family that I could have got support in. I think if she's communicating with you about it that's positive. But hard on you too to hold the space for her when you're trying to do your own work. Been such a hard year in so many ways, we're only at the start of seeing the impact of it. How did you get on with your ladder?

I've made it through today but I've felt pretty mad. Racing thoughts, rising anxiety. Was able to function but seriously, where's my medal? Simultaneously exhausted and racing thoughts. How does that even work, it's like going fast and slow at the same time.

@sugarlost, @bookcrazy, @filofaxx ... how are you getting on?

Hope everyone is okay. Xxx

@Maidenpink hi, I'm sorry I didn't reply yesterday, was my dad-in-laws 91st birthday and by the time i'd taken them out in the day and for tea i was knackered.

yesterday was what i class as on 'ok' day (not good but not bad). for a long time now my days are classed as 'ok' or 'shit'. good days are rare 🤣😢. i had painful trapped wind and drank so much peppermint tea i must smell lovely 🤣

i've decided not to take the Fluoxetine and to go back to my gp in a week or so. but i'm going to say i tried it and didn't like the side effects and ask for hrt. i hate lying but don't like the idea of saying i don't think that was the correct thing to be prescribed... does that sound daft.

how are you today ? ❤️

@polelynn
im sorry to hear your daughter is struggling, as a mum it's heartbreaking to see and you feel useless. my daughter had counselling 2 yrs ago, wouldn't go to school, had anxiety and panic attacks, would txt me begging for help... all due to bullying. she's fab now as we changed schools, and she's much happier with only the odd melt down.
sending hugs to you and your daughter 🤗

Hi @bookcrazy I like your day classifications. For a while it was shit, shit, shit for me, now I have more ok. I did have about 5 good days the second week of my cycle a couple of weeks back. By good I mean I felt almost normal. It's all relative, isn't it?

I do understand why you might prefer to lie to the GP to avoid seeming like you're disagreeing with them ... but ... you can use the NICE guidelines to back up your concern, citing the other hormonal symptoms you've had too. Do you have any history of MH issues? If not, then I would definitely be saying about hormonal treatment. I know it's hard to advocate when you're already anxious and the power dynamic is so uneven. Not sure if you're a podcast consumer but I would really recommend listening to Louise Newson's 'Newson Health' series, super informative and helpful on up to date menopause treatment.

I'm much the same today. I went out for a sea dip this morning with a couple of women I've gotten to know through sea swimming. Started crying when they asked how I was which is slightly embarrassing. I just can't seem to keep a lid on my emotions. They were super kind and we talked about our various challenges. Glad I went but it doesn't fix everything. Try as I might to befriend my anxiety I'm so sick of feeling mad and all the crazy thoughts that go along with it. I know it's anxiety but sometimes I just feel I'm losing the plot!

Hope everyone else is doing okay. Xxx

Thank you both for your support re my daughter.

(Trigger warning re ED)
I suspect she has an eating disorder. I’ve no idea where it has come from but I suspect with the pandemic and having gone through everything she has during year 11, its taken its toll and I wonder if her disordered eating is linked to a need to control. She definitely struggles with anxiety too but the focus of that has been school and all the assessments she’s had to do up to provide ‘evidence’ instead of sitting their GCSEs. Our GP is ruling out anything medical first via blood tests but I’m pretty certain it is predominantly a mental health issue. She looks like she has lost such a lot of weight in a short amount of time (she’s always been slight) which was confirmed by her agreeing to go on the scales yesterday prior to our chat with the GP. I was so upset to have my suspicions confirmed but tried not to let it show. I go from feeling numb to guilty to overwhelmed about it all and in one sense it is certainly distracting me from my difficulties. It is really hard to know what to say to her as I really don’t want her to loose anymore weight, however I seem to be getting it wrong a lot of the time and it’s a worry to me that I may make matters worse 😔.

@bookcrazy I would definitely quote the NICE guidelines to your GP and ask them to explain their rationale in prescribing fluoxetine when you have x, y & z symptoms of peri-menopause. Keep us posted.

@Maidenpink 🎖. Crying is okay, a necessary release sometimes and is a positive sign. Don’t feel embarrassed not being able to keep a lid on your emotions. A good friend who has been checking in on me tells me how it’s good to feel all the emotions, good and bad. I’m not convinced (!) but I’m passing on her advice to you. Maybe we can come up with a list of things which are positive about having anxiety..... surely there must be something! 😉

@sugarlost I hope you’re weekend is going okay. X

@polelynn I'm really sorry about what you're going through with your daughter. I went through a spell of making myself sick as a teenager ... it was a few years actually, on and off. A few friends have confessed it's something they did too for a time, it's so common. I hope that with your support and as things become less strange in the world she will come through it soon. You are very empathetic and understanding so she is lucky to have a mum like you caring for her.

Thank you for my medal btw. I REALLY appreciate it. 🤗

Morning all,

@Maidenpink I had to work later than expected on Friday so by the time I finished was very tired and had an early night.

Sorry to hear how you've been feeling💐. I often just want to get through the day so I can to bed and wake up . I haven't the energy to do much most days and have to push myself or make plans but I could easily do nothing due to tiredness and low mood at times. I'm hoping once I start exercising again this will help me physically and mentally.

@polelynn you're right about the treatment provided by health professionals weather their overworked or another issue. The right Health care is vital to maintain good wellbeing. I'm not sure what the answer is...of course funding is an issue but I think it always has been and I really worry for the future of health care staff and the public if the government don't take effective supportive action.

And @MaidenpinkSorry to hear your daughters are struggling too. It can be hard being a teenager and with the pandemic thrown in the mix their journey through life must feel extremely overwhelming.
I agree with @maidenpink it's a good thing your daughter is communicating with you. I never had that growing up and it would have been life changing for me.

To everyone Sometimes we think we have to be almost perfect to be a mother, friend etc but we wouldn't be human if that was the case. I think the emotional challenges we are experiencing can also help those around us going through difficult times as we tend to be more sensitive and understanding even though we may feel guilt we shouldn't. We haven't asked to be ill. We love our family and friends and are trying to be the best that we can in extremely difficult circumstances at times..be kind to yourself🧡

@bookcrazy I hope your feeling better and smelling fabulous with all that peppermint tea
I'm so pleased your daughter is doing well now☀️
I know the pain of being bullied as a child and adult and it's truly heartbreaking and isolating.

If I feel ok that's good for me and if I feel good that's amazing for me. Shit days are so relatable but the pills seem to be helping to pull me up from the hole I've fallen down for what seems most if my life sadly...

I'm going to send this and continue as scared I'll lose it.

X

@bookcrazy I was prescribed anti depressants in the past but got scared to take them so didn't then and never went back to the GP which I should have. I understand what your saying as you want to know you're given the correct medication. Your GP should really be understanding if you query this. Don't feel bad X

@Maidenpink sorry to hear about your day out when swimming💐. I'm glad they were super kind to you. In life most of us have been in that situation so can relate and support. Will you contact your GP again? It's so difficult isn't it trying to be patient on the road to recovery but feyel like we're battling through life when it seems like others are floating effortlessly through life...not that we should compare as we don't know what happens behind closed doors.

I remember times like that when I was asked how I am and would cry as I would feel so overwhelmed and for someone to ask would trigger me. I cried alot by myself in the past too. Its taken me about 6 months to feel kind of ok and still having low mood at times, intrusive thoughts and fatigue and feeling that I'm taking steps back in recovery at times.

I've mentioned previously that I feel the medication is surpressing my ability to cry as I have in the past. It feels like there is a block there emotionally I'm not sure how I feel about that long-term...

I hope you're feeling brighter today 🧡

@polelynn sorry to hear the update about your daughter. @maidenpink is right she is lucky to have a mum like you.☀️
*all of you ladies are lovely..your children are all blessed. I'm wishing them all recovery and much happiness going forward 🧡🧡🧡

My depression escalated in the pandemic and I have to watch my eating as I know that could affect me when I look at my eating patterns and lack of motivation to do anything at times...even eating. I think sadly it's easy to fall into suffering from an eating disorder. The good thing is your daughter has support and the issues have been recognised so hopefully she will be on the road to recovery soon. Please don't be hard on yourself...you don't deserve it... your trying your best and your unwell too X

I'm tired today but had a good day yesterday.

Thinking of you all🌺🌹🌷🏵️