Antidepressants

[FramptonRose]

I started taking sertraline about 6 months ago, I had awful moods, massive anxiety and just felt more and more unhappy, my moods were really dependant on my period so GP put it down to the hormone drop just before my period starts.
At first (once my body got used to it) I felt better, definitely less anxious but I have found in the past month they have almost stopped working, I have gone back to feeling rubbish again. I am really not inclined to keep increasing the dose as I put off going on them for a long time as I was concerned about becoming dependent.

I just don't want to be a horrible mum to my kids and a rubbish wife to DH.

DH is fantastic, always supports me, very hands on, we have been struggling financially since COVID as his business was really affected but we are a real team and work together to get back on our feet, I just don't want my anxiety to creep back in as it was almost crippling and exhausted me in the end.

Has anyone else found something that worked better than antidepressants, even maybe therapy or any other adjustments to their life that helped them.

How old are you?
What dose are you on?

I am 41 and on 50mg

I think antidepressants are just part of the treatment. Ideally they'd be used in conjunction with improved self care such as:

• regular and enjoyable exercise, preferably in a group (this has a better success rate than exercise alone)
• eating regularly fresh fruit and vegetables, and being mindful that you're meeting dietary requirements. Potentially you may need a supplement such as iron.
• prioritising positive social intera tons by staying away from people who criticise and complain, and spending time with people who help you feel good.
• talking therapy or another therapy such as art
• maintaining a sleep routine of same bedtime and wake up time

Those are the cornerstones of wellbeing.

I’m wondering if a bit of peri is creeping in. Do you know how old your mum was when she started?

Do you have any other symptoms other than moods and anxiety? Any hot flushes, change to period, sleep issues etc? It’s sounds like it could be peri-menopause and the list of symptoms is endless! Antidepressants are not the answer for peri-menopause but are often given out by GP’s. This could be why they are no longer working. Maybe go back to GP?

Is this your first experience with antidepressants? Sertraline is the first one most gps will prescribe. It doesn't agree with me. I take certraline, it's much more suited to me. Speak to the gp about trying something else.

Also, you can self refer for talking therapies.

Do you exercise? Eat well?

Completely agree with Harrietthefirestarter above. And get outside, you need sun on your skin to make Vit D, which is essential for mood.

And also, if you have the time watch Georgia Ede on YOutube, or read her book. It's about the physical impact of diet on the brain and how it affects mental health.
I found it helpful. Best of luck!

s

Thank you for all of the responses. I did question menopause, my mum and nan didn't go into menopause until they were in their 50s, my mum was still having periods into her mid-late 50s. I also do not have any hot flushes or trouble sleeping so GP didn't think it was.

Exercise was the game changer for me - started with daily walks, then couch to 5k, then running longer distances. The exercise in nature also helped - and there's growing evidence that both those things have a positive impact on anxiety.

It is my first experiance with anti depressants. The GP was offering them to me for a year and a half as I kept going back to them as I felt my birth control pill had to be changed.

I absolutely think anti depressants have their place for people, I just really didn't want to start a journey with them and end up having to keep increasing the dose and then having the stress of having to come off them.

This happens sometimes with antidepressants. For some people, it seems to mean that the drug is helpful, but it's just not quite a high enough dose for the effect to stick, and a dose increase will get the effect back properly. Effective doses for sertraline are between about 50mg and 200mg IIRC, so you've got room to go upwards.

Other people sometimes find this happens with several antidepressants, that they work for a little while then "poop out" (I dunno who came up with that phrase, it's gross 🤣), and that for them, none of them really help long term.

I get why you're not keen on increasing but I'm not sure dependency is the best framework to think about this under — it's not the kind of drug where it's standard for people to need to repeatedly increase the dose over and over to keep getting the same effect, like can happen with benzos or opioids. More that if you're on a dose that's not quite enough for you, you might get some effect but not all.

Being on a higher dose probably won't make you more likely to have difficulty coming off them, as far as I know (though if you are one of the unlucky people who has bad symptoms when stopping, it might take a bit longer to gradually taper off).

Talking therapies, lifestyle changes, hormonal investigations and all the things others are suggesting are also good, either instead of, or as well as, antidepressants.

But if it were me in your position, I might be reluctant to back off from the antidepressants without giving them a chance at a higher dose, when they've already shown they can help, albeit temporarily, at this dose. Sometimes it's easier to access and make good use of things like CBT, or put in place helpful lifestyle changes, when you've got a bit of help from antidepressants, for example.

On the other hand, recovery without medication can often be done, and it might be that antidepressants aren't for you. It's entirely your choice obviously.

I feel like it might be a good idea not to set aside any reasonable options at this stage, if that makes sense?

I used to be the vitamin queen and I must admit I have been rubbish at keeping up with them. That is definitely something I have to get onto this year.
I have had bouts of low iron in the past.

They did do a blood test before they prescribed anti depressants which came back normal.
On the low side of notmal for folate, iron and vitamin b12.

I do try to get out as much as possible walking, I used to do a lot more ie Gym etc but when we started having issues with finances that was the first thing we stopped, I also had a car accident a year ago and have been in pain ever since and currently being passed from pillar to post to get it sorted out.

I think part of my reluctance is that feeling that I would have to keep increasing the dose and then at some point would have to come off them (I presume you can't just stay on them forever ).
I also have friends who have ended up on high doses of antidepressants and then gently came off them, they were fine for a little while then went massively downhill again, and ended up back on antidepressants and I just really fear that happening.

If I can try and reduce my anxiety and improve my moods naturally, I am all for it.

Thank you, will definitely watch this and yes my plan is to get back to my vitamins, vitamin D is so important in mood too.

I was doing couch to 5k before my accident, but I just can't do it now. I am really going to push for some more answers for my injury pain.
I think as it us so dark early and rubbish weather I also talk.myself out of doing long walks with the dogs.

I’d add vit B complex for energy. And look at D3 with K2.
Regarding antidepressants, its not a given that you need to keep increasing, or that you have to come off them. When my DH was put on them he was told that it’s for life, to never come off them.

And on the low side for folate and B12 probably means you need to take them. Lots of people get symptoms at the low end.
I was on ferrous Fumarate for low folate.

@FramptonRose have you thought about cold water swimming? Again, growing evidence of the benefits for mental health. At the place I go there are lots of people with injuries/older people who just "dip" without much actual swimming and they seem to feel a benefit. Though it might not be your thing of course!

Constant pain and increased financial pressure is definitely not a recipe for feeling totally joys-of-spring all the time, that's for sure. I'm never 100% convinced that antidepressants are the right way to go if the feelings actually make sense for the situation you're in, if you see what I mean? Tho for some people, I guess the way they feel is worse than another person might feel in the same situation, and antidepressants can help level them up… I don't know.

I didn't post because I think you should definitely take antidepressants or anything like that, but because some of what you said made me wonder whether the information you have about antidepressants is leading you to think of them in a way that's putting you off unnecessarily, and to worry about risks that aren't exactly the same in reality as how they've been presented to you. There are some risks and it's good to know them, but being concerned about risks that aren't as bad as you've been led to believe is as unhelpful as not knowing about risks that do exist.

Some people go on antidepressants, raise the dose to a level that helps, eventually come off them, and never have trouble again. Some people will feel unwell again as soon as they're not on antidepressants any more. Some people will come off them, be okay for a while, and get another episode of feeling unwell. You can't really equate them straight to antibiotics where you take them for a course then that's it, nor to meds where you'll automatically need to take them forever, it's… kind of individual. It's not a failure to stay on them, or to need to go back on every so often. But it's not automatic that increasing your dose to an effective level will mean you're dependent on them forever, either. They don't flick a switch saying "this person will for ever more need antidepressants just to be normal".

I really am not trying to persuade you to take antidepressants. Nobody should take them if they don't want to. I was just concerned, from what you said, that you haven't been given access to a realistic picture of what the potential risks and benefits are for you, to enable you to make fully informed decisions about whether to stop them, keep taking them, increase your dose, switch drugs, whatever you end up deciding.

And either way, the lifestyle changes and therapy can still be really useful.

I totally understand your reluctance to increase your dose OP but just wanted to point out that 50mg is actually a very small dose of Sertraline. Most people I have seen mention it are on 100mg, 150mg or even 200mg.
Something to bear in mind if you do find that your other coping strategies need a helping hand down the line.xx

Yes I do need to ensure I am taking these daily. I was prescribed Ferrous Fumarate last year but this time when I asked about it the GP said my numbers were not 'low enough'. I will pop into a health store this weekend and try and get something from there.

I have heard so many people say this about cold water swimming, admittedly I wouldn't say this is my thing but actually would be willing to give it a go as I am in so much pain all the time now and everyone medical I have seen seems to have given up.

I really agree that I think circumstances are causing a lot of my inclination to continue with antidepressants and I think watching people I love end up spending so much time increasing doses the struggling to come off them has put me off somewhat.
Also the GP was very quick to say they would not keep doing repeat prescriptions for them and wanted me to be reassessed each month before another perscription was issued so I suppose she put it in my mind that it would only ever be a temporary fix.

Blimey, that’s unusual for a GP to have time to do anything other than write repeat prescriptions indefinitely