I feel like this is still a little taboo to speak about today. I attest that antidepressants have made anxiety more manageable in my life. My recent meltdown while being off of them may confirm this for me. The jury will always be out to some extent. I can confirm that they’ve significantly helped me find my way back.
Let me share some history. Many months ago, I successfully weaned off Citalopram under my doctor’s supervision. I lived a regular life, free from medication and side effects, for eight months. Thinking back to when I had my meltdown, I felt I’d made a mistake. My brain may have needed this all along, I thought. Some people take antidepressants for a short time, others for life. I may just be a lifer.
It’s not that medication is the only item in my repertoire that has provided help. Its contribution has felt the most noticeable. My mix includes much more.
Personal Wellness Mix To Date
- Medication: Likely the biggest game-changer thus far for me
- Specific Vitamins and Supplements: The jury is really out on this today
- Support Groups: Hugely beneficial, and I depend on them for social engagement
- Professional Guidance
- Psychologist: Somewhat helpful, but dependant on the right fit. Talk therapy has helped me re-think my thinking
- Psychiatrist: They are challenging to find appointments with in Australia. I finally have one coming in September.
- General Practitioner: The catalyst to so much of this journey. Necessary
- Urologist for Testosterone Therapy: I have just begun two weeks ago and need longer to assess.
- Social Worker for Dialectical Behaviour Therapy: Just started last week. I need longer to assess.
- Mindfulness Practice: Very beneficial, but needs lots of practice over time
- Blogging and Journaling: Also very beneficial for me on a smaller scale
- Physical exercise: Extremely helpful and I have utilised throughout much of my life, with and without anxiety.
Back to medication. I have been on other antidepressants in my life. When I originally came down with GAD in my early 20s, I spoke to a psychiatrist who put me on Paxil and, later, Zoloft. I had success with those. Although later in life I switched to Citalopram. My GP thought I may have fewer side effects and I have stayed with it.
My doctor and I also chose to start again with Citalopram because of my positive past history with it. Albeit, it took over two months before I felt the magic. Getting on a second time took longer than the initial time I started. I was seriously fearing every day that it would not kick in my second time. Positive effects happened so quickly the first. I felt like I was losing my mind waiting for them during the second journey. I was fearing they wouldn’t work for me a second time. If I had to try others, it could take extensive time to find a fit. Luckily, I ended up turning the corner with Citalopram. It’s not all roses and there are side effects.
Managing the Side-Effects of Antidepressants
Let me attest, I entirely dislike the side-effects of Citalopram. For most of the last 15 years, I have taken 10-20mg of Citalopram.
Side-Effects I’ve Experienced
Throughout that time, I’ve felt:
- So tired in the mornings, and sometimes the rest of the day. I take medication at night instead of morning to counter-act that. It helps slightly.
- Soft stool – If that bothers you, you can take psyllium husk daily. It will firm you up.
- Sexual side effects. This one isn’t great, but you bear it.
- Weight gain. I am active, yet still, extra weight seems to want to stay with me. Unfortunately, it’s only been lots of cardio and weight training that has helped me control it.
- Constant sweating. I walk up a flight of stairs and my forehead perspires. Find air conditioning wherever possible.
None of these things are fun, but when faced with the alternative, I choose to manage them. Medications and corresponding side effects are vast and they can differ for many.
Understanding Antidepressants
Antidepressants are crucial in treating anxiety and depression. It’s important to find the right class that works for you. Always consult with your doctor to explore the best options tailored to your needs.
Different Classes of Antidepressants
There is a massive amount of information on these. Each class of antidepressants works uniquely by targeting specific neurotransmitters in the brain. Here’s an overview:
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- How They Work: SSRIs prevent the reabsorption of serotonin, a key neurotransmitter influencing mood and well-being.
- Examples: Fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro)
- Some Conditions They Treat: Major depressive disorder (MDD), Generalized anxiety disorder (GAD), Obsessive-compulsive disorder (OCD), Panic disorder, Post-traumatic stress disorder (PTSD), Social anxiety disorder
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
- How They Work: SNRIs inhibit the reuptake of both serotonin and norepinephrine, impacting alertness and stress response.
- Examples: Venlafaxine (Effexor), duloxetine (Cymbalta)
- Some Conditions They Treat: Major depressive disorder (MDD), Generalized anxiety disorder (GAD), Panic disorder, Social anxiety disorder, Chronic pain conditions, such as fibromyalgia and neuropathic pain
- Tricyclic Antidepressants (TCAs)
- How They Work: TCAs block the reuptake of serotonin and norepinephrine.
- Examples: Amitriptyline, nortriptyline
- Some Conditions They Treat: Major depressive disorder (MDD), Anxiety disorders, Chronic pain conditions, such as migraines and neuropathic pain, Insomnia (due to their sedative effects)
- Monoamine Oxidase Inhibitors (MAOIs)
- How They Work: MAOIs increase the availability of key neurotransmitters by inhibiting monoamine oxidase.
- Considerations: MAOIs have dietary restrictions and potential interactions.
- Examples: Phenelzine (Nardil), tranylcypromine (Parnate)
- Some Conditions They Treat: Major depressive disorder (MDD), especially when other treatments have failed, Atypical depression, Anxiety disorders
- Atypical Antidepressants
- Unique Mechanisms: Atypical antidepressants work through diverse mechanisms, targeting various neurotransmitters or receptors.
- Examples: Bupropion (Wellbutrin), mirtazapine (Remeron), vortioxetine (Trintellix)
- Some Conditions They Treat: Major depressive disorder (MDD), Specific types, such as seasonal affective disorder (bupropion), Anxiety disorders, Certain cases of insomnia (mirtazapine), ADHD (bupropion)
Finding the right antidepressant is a personalised journey. Understanding each class guides you to the best mental health treatment. I’ve found doing my own research and understanding them makes for the best conversations with my doctors.
Also formulate a plan with your doctor. Have a timeline for check-ins. Understand the side-effects you may be getting yourself into. Will you need to change medications if you don’t see the desired effects? Is there a specific time you’ll stop taking them? Will they contrast with any other medications you take? I wish it were more simple. I’m learning more every day.
Feel free to share any experiences or information that you think may be helpful to others..
