Is anyone managing depression without SSRIs?

[Newjobadvice]

If so, what's working for you.

I've been on and off SSRIs for many years.
Fluoxetine turned me into a zombie
One I can't remember the name of zoned me out so far I'd forget to turn off the cooker or drive right past DCs school instead of dropping them off.
Citalopram - worked OK until it didn't.
Sertraline - most effective at managing the depression but gave me weird dreams/nightmares, "exploding head" which was horrible and violent "sleep jerks" where I'd literally jump a few inches above the bed or would leave DH with bruises where I'd kicked, kneed or elbowed him. So I'm not keen to go back on it.

I was on Sertraline for about 5 years until 2024 when I took redundancy and kept forgetting to take the Sertraline until I just decided to not renew the prescription. I was fine while I wasn't working (🤔hmm, strange that), but eventually I needed to get another job and have been in my current role about 18 months. It's a customer facing role and I'm starting to struggle with depression again. I am looking for other roles but I'm late 50s and the job market being as it is, I'm really just hanging in till I can afford to retire, maybe in 3 years or so.

I know myself well enough to know the signs of depression and I'm definitely getting that "cloud over the head" feeling but I really don't want to go back on the Sertraline or have to go through experimenting with different ones that might make things worse.

I'm trying to eat healthily, get plenty sun and exercise etc but any tips on what has helped you, please share. Thanks.

Like you I can tell the signs of the 'cloud over the head' and what I did that helped (apart from telling myself this isn't going to last, you've been here before, and the usual try to keep to the daily routine, eat healthily, exercise as much as you feel you can do and sleep) was getting a copy of CBT for Dummies. There's a chapter on depression that I found very helpful and that I go back to if I find myself slipping. It feels to me like I'm reading someone who really understands and can help.

Also just sitting mindfully for even a few minutes and telling myself 'it'll pass, you're safe.' Usually I find first thing in the morning helps, (altho it's quiet in my house, it might not be in yours).

And I do realise suggesting a book entitled for Dummies sounds daft.

I hear you Op. I’m a long term depression sufferer.
Read Chemically Imbalanced: The making and Unmaking of the Serotonin myth. It’s an eye opener and confirms what I already experienced and knew. The author is Joanna Moncrieff a consultant psychiatrist. Her book is extremely well researched with hundreds of references. There is a lot you can do to self manage eg: diet, exercise, sleep, relaxation techniques, setting small tasks and goals, managed socialising. Many good quality supplements also help . But the single main thing is to understand what is causing your distress and deep unhappiness and look at what changes you can make. I know that’s very difficult and not always immediately possible, much is about the longer term picture.
Another important issue is that if you are on SSRI and decide to withdraw, you need to taper very slowly. There is a Dr on FB who specialises in this.

What has helped me recently is a book called Feeling Great, the author is a pain in the arse and the book makes you want to vom. However it has helped me after only reading a few chapters. I have many negative thoughts, and you don't realise how actively having these negative thoughts has a direct impact on your depression. And it spirals. Now one way is to take a step back and repeat those negative thoughts as if you were saying them to a friend. Would you say the same thing to a friend? Or would you be kinder, and spin it to not be negative. I've tried to approach my internal thoughts in the same way, I try to question my thinking, and reframe stuff as though talking to a friend not yourself

I ain't out of the woods, but I can tell it has helped lift some of the dark cloud. It can be so easy to be so negative in your head, and really it does affect you deeply

No, that's helpful, thanks. I'll see if I can borrow it online. I've found the "Dummies" books really useful on all different types of subject.

I would say it’s only mild depression for me but saffron tablets have really helped. Been taking them about 6 months and I can see a difference. I was prescribed sertraline previously and it gave me awful side affects.

Thanks all. I know it's mainly the job that's getting me down and unfortunately there's not much I can do about that other than apply for other roles, flexible working isn't really an option as it's customer facing.. I've taken this week as leave just to give myself a break and have a bit of a reset. Try to get more sleep, eat more healthily and get a bit of the remaining sun, just to set myself up a bit for winter.

Is there a brand that you would recommend? Thanks.

What is it about the job that’s difficult Op ?
Customer facing as in dealing with complaints/angry/impatient/upset clients ?
Would it help to tell us here ?

I’ve only tried Holland and Barrett. Sometimes on offer 2 for the price of 1.

It's mostly just the feeling of being "on" all the time. I'm literally the first person people see when they come in the door. I'm a total introvert and find that very hard but I'd been looking for a job for over 6 months and had many interviews but it was the first one I was offered so I took it even though I was secretly horrified to learn it was 100% front facing rather than just a part of the job which was the impression I got from the advert.

Yes I can understand why that’s distressing for you. Doesn’t help that your employer wasn’t transparent either. I imagine you dread going in each day …is it full time ?

Hi, No it's part-time Mon-Fri but by the time I get home in Mid-afternoon I'm "peopled out" and just want to sit quietly for a bit but DH is retired so as soon as I come in he follows me around speaking to me and I have to bite my tongue.

I have tried saying that I just need a while by myself but he takes offence and thinks I don't want to speak to him while he's obviously been itching to tell me the minutiae of his day.

Sounds like there are issues on two fronts for you then. When really you should feel supported in both places ie: have a job that is satisfying and be able to switch off safely at home. Has DH structured his retirement or just waiting until you get home ? PS: that would do my head in too 😫

He retired last year and more recently has started going to a few classes/activities which is good but it does mean he's bursting to tell me all about it when all I want to do is stare into space for 20 minutes. I probably need to build some "decompress" time into my commute home. Sit in the park for a bit or something.

Is it actual saffron? Funnily enough in Iran they say that if it’s in your food, it makes you happy but too much makes you laugh like a loon. I’m a great believer in ‘old wives tales!

Well that’s good that DH is doing his own thing 👍.
Does he know how you feel , can you find a way to tell him to give you some space ? Are you actively looking for work that meets your own needs better?

He knows I'm much more introverted than he is but I don't think he really understands it. For example, I'll come in and go upstairs to get changed and within 2 minutes he needs to go to the bathroom because he's either been pottering around or sitting down for a couple of hours and hadn't got round to going but as soon as I come in he realises he needs to go, then he'll come into the bedroom to chat. I know it sounds ridiculous to say I find it intrusive but I do.

Yes, I stumbled on metabolic psychiatry. Basically it is managing mental health through diet. But the dietary advice is not the standard NHS balanced diet, so you really need to get your head around it. A good place to start is this talk:
Georgia Ede MD - What is nutritional and metabolic psychiatry #PHC2023

This lecture explains the science and is aimed at a general audience, Georgia Ede is a practicing psychiatrist so she knows what she is talking about. Best wishes and if you try it, I hope it works for you.

Not at all ridiculous OP, it’s how you feel. We are allowed to have our own needs and prioritise them. Sadly he is not empathic to yours.
I would echo above poster about metabolism and MH. Mood disorder is known to originate in the gut. So dietary changes will bring better health. And yes it’s not the standard allopathic advice. Many resources online, books, functional practitioners etc. Do consider the book I recommended too… I think you can download it as an audiobook

Creatine supplements took my DH from suicide ideation to not depressed.

Getting blood vit D to 200nmol/L, ferritin to 100+ and transferrin saturation to 20%+ and supplementing topical B12 have helped me more than anything else.

We use the Nutrient Teams Protocol for vit D & cofactors, the Iron Protocol for Iron Deficiency With or Without Anemia group on FB for iron, and the B12oils RnB protocol for B12. Helped my depressed teen a lot too.

It is really good that you are trying but the best thing is that you are trying to quit medication. For this avoidance alone would not be very effective so rather than that you should try some therapy as well.

I also came off SSRI after 18 months on them for PTSD. I find daily running helpful. CBT helpful. Chamomile for anxiety. No or very low alcohol. Routine. Pilates outdoors with other people. Getting good sleep and good sleep hygiene. Getting enough Omega 3 and Zinc.

I've no objection to medication in itself. If I could find medication that managed the depression with minimal side effects I'd take it in a heartbeat but so far I thankfully haven't reached the tipping point where I feel I can't cope without AD's.

I think of it like a pair of scales, at the moment they're tipped about 55% coping and 45% not coping. If the balance shifts the other way I'll see the GP rather than continue the descent into depression because I'd rather live with some side effects than descend further into the darkness.

Anyway, thanks for all your input. I went to H&B yesterday and bought their Saffron Complex and some creatine powder. I've also had a look into the metabolic psychiatry mentioned by PPs and it seems to be based around a ketogenic diet so this morning I've had mushrooms, frozen asparagus, tomato and an egg all fried in butter for breakfast and had already made a pot of Cullen Skink with double cream for lunch so that's a start.

I'll look into the other resources that posters have mentioned. I'll see how I get on and maybe report back in a few weeks if it might help other people.