AIBU to want to manage without drugs?

[ProfessorofDarkArts]

I’m currently signed off work with stress and anxiety, GP has prescribed Sertraline but I really don’t want to take it, mostly due to the side effects but also because I don’t believe the problems are in my head. I’ve had an incredibly stressful few years and I know I’ve just hit a point where it’s all got a bit too much. I want to get better by making positive changes not relying on drugs but the GP won’t support that. I’m due back at work soon and don’t feel at all ready to deal with it (a lot of the stress is work-related) but I don’t think they will sign me off for a longer period, they seem to just think drugs can fix what are actually genuine issues in my life. Am I really not helping myself by not wanting to take drugs? I know all the ‘you’d take aspirin for a headache’ stuff but I don’t think it’s the same.

You said the GP isn't supportive of you trying other things? But you say here you haven't asked your GP for anything not even being signed off so what did you mean by that?

If you are very clear in your mind that it is 'situational' - a reaction to objectively overburdening circumstances - then it makes perfect sense not to take ADs. I'm surprised the GP was pushing you towards them, unless s/he saw signs of illness that perhaps haven't come into focus for you. My understanding is that GPs are trying to move away a little from automatic AD prescription. Many surgeries now have specialist mental health nurses that you can just talk to - or who may be able to help with things like social prescribing.

If you have practical strategies in mind for nurturing yourself with self-care, exercise, relaxation and a more manageable set of work/life demands, then it may well make sense to try those first.

It is entirely possible that you would feel absolutely no benefits from ADs anyway, especially if the problem is situational.

I won't take medication for shit life syndrome either. If I didn't work, had a social life and good health and still felt wretched then I'd take pills.

I feel more me being miserable and trying to manage with exercise and early nights. I've even saved a lot of annual leave for winter so I can have more gym time and daylight over winter.

I completely understand you op as I was the same.

I am lucky enough not to suffer with my mental health in general, but i have also had a shit few years because of things happening in my life.

I had a breakdown last year from physical exhaustion and took 6 weeks off work. I also wanted to see if I could make changes for the better and manage things myself but in the end, I decided things weren’t going to get better overnight and decided to start Setraline to help me cope with things better until things feel more stable at home.

I’m only on 25mg and it’s been great. You can always keep them as a back up option. Sometimes life just kicks you and it’s ok to need some help.

Rubbish.

‘In your head’ doesn’t mean ‘not real’.

Yes it can be circumstantial, but those factors are still making it hard for you mentally.

I don’t understand why you wouldn’t take medication that is going to make it easier to cope with those circumstances.

I’ve had a very good experience with anti-depressants. Which I’m now in the process of weaning off very, very, very slowly.

However, I went on them after 40 years of depression that refused to resolve after a life shattering event.

My older self on on continuous HRT is a lot more emotionally stable than my younger self dealing with the hormonal waves of a menstrual cycle. I also now have many tools in my mental health fixing box. So once I’m off the anti depressants, I wouldn’t go back on if the depression returned due to a specific event that was naturally enough causing me profound unhappiness.

As much as they have helped me, and gave me the mental foundation up on which I could build mood enhancing habits and action, I wouldn’t want them again unless I got “stuck” for a long time again. They have worked so well for me that I’m now aware of the slightly sedating and blunting effect. Which was fab when I was drowning. But not what I want for me now.

Long way of saying don’t feel obliged to take anything you don’t want to take to make yourself an easier box ticked off for other people. It’s your body, your brain, you are the only one who has to live with any changes they create in your mind & body. It’s more than ok to chose the non box ticking route of addressing all the elements of your life that will help you ride this out to the other side.

ADs will only help if you actually have the neurochemical imbalance that they are intended to correct. They are not like taking, say, tranquillisers, which would blur your sensations of misery/anxiety/etc produced by real-life situations.

I don’t understand why you wouldn’t take medication that is going to make it easier to cope with those circumstances.

Because the medication won't help if the distress is caused by 'circumstances', rather than neurological factors. If your leg is trapped under a lorry, medicine won't make the lorry weigh less or allow your leg to heal. Painkillers would help you tolerate the disaster, but in this analogy, the painkillers would be things like diazepam, not ADs.

I think it partly depends on the point at which you’ve consulted your GP. If the situation has changed for the worse very recently and you haven’t had time to bring positive measures in v if it has been more long term and you’ve only just “succumbed” to it (for want of a better description). And even then, it depends how bad you’re feeling and what physical symptoms you have.

It may take more than one GP consultation to identify the right approach for you, in my case I was prescribed sertraline but actually needed something different for extreme symptoms of anxiety that came about quite suddenly due to a work situation.

At another time, sertraline helped to give me space to move forwards. Each time I only took it for 3 months and that was enough.

If the situation has been building for some time, and you haven’t been able to manage it yourself, it may be time to accept medical help. However, it’s totally up to you.

If you feel you need more time off work, could you ask for a phased return or part time for a period to help? Or a redeployment as suggested by a PP?

And maybe consult a different GP if that’s possible?

People can develop depression (neurochemical imbalance) as a result of adverse life experiences. So antidepressants can absolutely help situational or reactive depression.

Reactive depression is more than 'experiencing unhappiness as a result of difficult circumstances'. Antidepressants treat the depression, not the life circumstances.

You can self refer for talking therapy on the NHS. It might help with the problems you are facing x sending big hugs x or ask your GP for a talking therapy referral instead of the anti depressants x

Op I went to the gp before and they asked did I need any help for emotional support- I had come for physical stuff but when they asked was there any stress there I told them the physical stuff was tough, work was hard, myself and dh were breaking up, my mum was in and out of hospital, I had 4 kids, 2 doing exams and my dog was trying to leave us (true story- he went through a phase of trying to break out, break away, all with his tail wagging and a smile on his face😂). I said oh no, I just have to get some of this stuff done with. I remember the look on her face- like ‘ookkkkaaay’. A few months later I asked could I have something- was on it for two months, terrified I’d get addicted but dealt with issues easier, chilled out more, with a weirdly more positive spin than I’d had in a long time, came off it no problem and will consider in the future. People say doctors overmedicate but sometimes it’s needed to get you through something easier.

Btw hilarious thing was dosage was so small she hinted it could have been a placebo as she had expected to up it but she said even the physical things had eased a bit. I honestly think stress and sleep are the biggest factors sometimes

Crikey get another job - why swing the lead on this company it’s unacceptable

Don't take the drugs if you don't want to. Its up to you but there is nothing wrong with taking the medication designed to make you well again. If you don't want to feel well, don't take it. The pride in not taking medication will surely give you so much joy your physiological scientific illness will spontaneously clear up. My grandfather would probably have had a life worth living and wouldn't have hung himself if these naughty old pills had been available then. I have absolutely no time for this crap. Be happy, be miserable, you are the master of your own life. Just don't let it spill out into your loved ones lives and ruin theirs.

I guess the question is, if you don’t want to take the medication, what is it that you wanted from visiting the GP in the first place?

So how are you going to access this time and space? If you know that is what you need, why haven't you done it already?

If you don't want to take sertraline, why not ask the GP for an alternative there certainly are other possibilities.

Quite often the refusal to take medication is a part of the illness that causes the patient to need it.

I would love a link to the evidence. Otherwise I might think you have a Scientologist agenda.

Wow I was under the impression this was a kinder area of MN than some of the others. I really dont need to be told I'm 'swinging the lead' or compared to someone's sadly unhappy grandparent.

I'm on HRT. I spoke to the GP because I thought they might look at changing the HRT dose or to find out if how I was feeling was a result of taking it or if it was menopause related.

I have no intention of claiming benefits or taking my current employer for a ride, however their lack of support for employees has in part led to this so I dont feel it's unreasonable to step back briefly while I figure out what to do next.

I've spent the time so far researching new jobs/opportunities as well as sleeping, reading, walking and trying to find ways around the other circumstances that are causing me so much stress. At this point where I've got limited time away from work I dont want to spend it dealing with unpleasant side effects or feeling worse than I already do - I've read the sertraline support thread and it sounds awful for many people.

If I still can't manage and am required to go back to work I may have to relent 🤷🏻‍♀️

Remember that any kind of “support thread” is going to be filled with people who are struggling - people who just take the meds and get on with things aren’t going to be the ones posting about it online.

But if the side effects are worrying you then you can always ask to try a different medication - there are loads of SSRI’s out there and each one will be different. I personally didn’t get on with sertraline but have been on paroxetine for 18 months with no issues.

Personally I would try medication - it doesn’t need to be forever but you’re clearly struggling and I don’t see the benefit in forcing yourself to struggle through when there’s help being offered to you.

Scientology?

Johann Hari analyses the evidence base in his book Lost Connections.

Do you mean the completely discredited Johann Hari?

seems you have spent the time off doing useful things. Have you thought of adding some therapy in? If your workplace has an employee assistance programme that will be a good place to start and you can also ask for a work stress risk assessment from HR.

I have been offered therapy through work and I’m considering it but I’m not sure how useful it would be to solve the practical issues that are causing stress. I’m definitely hoping for some kind of assessment before I go back if they are willing.