Help considering going on meds?

[sannoji]

hiya. i went to the GP forever ago and they diagnosed me with moderate depression, and the GP did offer that i could get on meds for it if i wanted. i turned it down at the time, i'm not the greatest fan of psychiatry and haven't heard many good things about the side effects of the meds. i don't believe i was told the exact med but would definitely be an SSRI, probably sertaline or prozac (though i believe the second is a brand name…)

saying this because up until now i've been kind of ticking by just trying to take care of myself, but i recently had several pretty severe panic attacks which i'd never had similar intensity of before and trauma memories have been bothering me more than usual. talk therapy didn't help me and i tried CBT, which i didn't like at all on principle and also didn't help me personally. i've also thought about EMDR but to be frank i'm busy with a pretty intense degree and don't know if i could deal with the initial destabilisation.

so i was wondering if anyone has experience with SSRIs, especially the two i mentioned? i've been looking up stuff online about it but the reports have been really varied. just want to do my own research before getting into something like that. i'm also slightly nervous about asking for medication as i have said i'm stable to my HRT providers, who are thankfully separated from the GP for the moment. i don't anticipate it would be a terrible problem, just something i have to consider.

 

[swankysoup]

I used psych meds years ago, but now i'm off of them. I luckily didn't experience major problems from them, but i'm hesitant to get back on them since they have ruined some people's health. Also there seems to be very little scientific evidence that they even help.

 

[alltoomuch2]

hiya. i went to the GP forever ago and they diagnosed me with moderate depression, and the GP did offer that i could get on meds for it if i wanted. i turned it down at the time, i'm not the greatest fan of psychiatry and haven't heard many good things about the side effects of the meds. i don't believe i was told the exact med but would definitely be an SSRI, probably sertaline or prozac (though i believe the second is a brand name…)

saying this because up until now i've been kind of ticking by just trying to take care of myself, but i recently had several pretty severe panic attacks which i'd never had similar intensity of before and trauma memories have been bothering me more than usual. talk therapy didn't help me and i tried CBT, which i didn't like at all on principle and also didn't help me personally. i've also thought about EMDR but to be frank i'm busy with a pretty intense degree and don't know if i could deal with the initial destabilisation.

so i was wondering if anyone has experience with SSRIs, especially the two i mentioned? i've been looking up stuff online about it but the reports have been really varied. just want to do my own research before getting into something like that. i'm also slightly nervous about asking for medication as i have said i'm stable to my HRT providers, who are thankfully separated from the GP for the moment. i don't anticipate it would be a terrible problem, just something i have to consider.

They can be extremely helpful for some people but no one knows til they try. They might help you to get through your degree so you can have therapy later but by not having therapy now you run there risk of your depression and panic attacks getting worse until you can't do your degree at all. If you are willing to try meds bear in mind they can take about 8 weeks to work so sooner the better to get started. I've tried sertraline and fluoxetine but I'm not sure if they helped.
I was wondering why you dismissed CBT "on principle". At worst it can do no harm. At best it could help. Maybe you already know but there are different types of CBT for different problems. There are also lots of other psychotherapies which could be useful.

 

[Praestat_Mori]

If your degree and all that what comes with it at college/university is the stress factor that makes you depressive and/or causes the anxiety attacks the meds may not help that much. You should at least know (or your GP has to find out) why you are depressed.

It's trial and error and know the risks when you take SSRIs.

 

[sannoji]

I was wondering why you dismissed CBT "on principle". At worst it can do no harm. At best it could help. Maybe you already know but there are different types of CBT for different problems. There are also lots of other psychotherapies which could be useful.

i have tried it, yeah, it always felt kinda gaslighty to me though it can be helpful to other people. could be that what i got wasn't particularly trauma focused so i felt like only my problems at that exact moment were solved and it didn't help me much past the day i'd actually gone to therapy because the root causes weren't addressed at all. i got ahold of some dbt worksheets a while back and i think they helped me with stabilisation somewhat but yeah my track record with cbt hasn't been that great and since the only way i could access it right now would be out of my own money i'm hesitant to go back.

 

[alltoomuch2]

i have tried it, yeah, it always felt kinda gaslighty to me though it can be helpful to other people. could be that what i got wasn't particularly trauma focused so i felt like only my problems at that exact moment were solved and it didn't help me much past the day i'd actually gone to therapy because the root causes weren't addressed at all. i got ahold of some dbt worksheets a while back and i think they helped me with stabilisation somewhat but yeah my track record with cbt hasn't been that great and since the only way i could access it right now would be out of my own money i'm hesitant to go back.

That's fair. Tbh CBT didn't help me much. DBT was better. Now I'm having some different trauma based therapy aimed at people whose personality has fragmented, so very different. I've stopped sertraline (gradually tapered) and am not noticing much difference but I was calmer at 150mg per day, but kind of numb. When I got to 100mg I was no longer numb and the tapering and stopping from there hasn't made me feel any different. I didn't stop the meds because I had a problem with them. I stopped because I wanted to stop them while I was in the care of mental health services, not after I'd been discharged and no longer had support.

 

[broken_stoic]

hiya. i went to the GP forever ago and they diagnosed me with moderate depression, and the GP did offer that i could get on meds for it if i wanted. i turned it down at the time, i'm not the greatest fan of psychiatry and haven't heard many good things about the side effects of the meds. i don't believe i was told the exact med but would definitely be an SSRI, probably sertaline or prozac (though i believe the second is a brand name…)

saying this because up until now i've been kind of ticking by just trying to take care of myself, but i recently had several pretty severe panic attacks which i'd never had similar intensity of before and trauma memories have been bothering me more than usual. talk therapy didn't help me and i tried CBT, which i didn't like at all on principle and also didn't help me personally. i've also thought about EMDR but to be frank i'm busy with a pretty intense degree and don't know if i could deal with the initial destabilisation.

so i was wondering if anyone has experience with SSRIs, especially the two i mentioned? i've been looking up stuff online about it but the reports have been really varied. just want to do my own research before getting into something like that. i'm also slightly nervous about asking for medication as i have said i'm stable to my HRT providers, who are thankfully separated from the GP for the moment. i don't anticipate it would be a terrible problem, just something i have to consider.

I have been on . . . alot of different psychiatric meds for various things 15+ years. I've also done a fair amount of different therapies. I'm one of the unfortunates who is extremely sensitive to medications so keep that in mind, but here is what I would suggest:

• The cause of your symptoms really matters and influences what path you should take
  • What therapy/medication differs greatly based on the cause
  • If you have any significant trauma or long-lasting symptoms you really should go to a psychologist first and get diagnosed
    • Expect to get re-diagnosed by future psychiatrists/therapists, but this will give you a starting point
• Psychiatry is a mixed bag
  • If you can afford it/your insurance will pay for it try some different psychiatrists until you find one you are comfortable with
  • A good psychiatrist will make a huge difference
  • Some signs of a good psychiatrist (in my opinion)
    • Listens carefully and answers all of your questions
    • Will work with you to find the right medication and not just push one on you
    • Will explain the side effects and work with you to find another medication if one doesn't work
  • On medication some notes
    • Don't expect the first medication to work
      • If you really only have moderate depression that is good, for Major depression SSRI's only have a 40-60% effectiveness rating (it's a bit more complicated than that, but it's not fantastic)
    • For the people that they do work for, the really do make a huge fucking difference
    • Expect SSRIs/SNRIs to take 4-6 weeks to really start working and for side effects to go away
    • You also will have to taper back off them if they don't work and that can take awhile
    • Spend some time looking up the different classes of medications
    • If SSRIs don't work, there are other options, they just tend to be the first thing everyone tries
• Therapy is complicated and there are alot of options
  • Also it's much better in some countries/areas and terrible in others
  • If you have significant trauma CBT can kind of help . . . but you may get really limited results
    • At minimum it needs to be combined with another therapy
    • It probably should be combined with medication
    • It is work
  • EMDR can be phenomenal for dealing with trauma, I can say this one has helped me more than any other therapy so far
    • You are right though, it can be destabilizing, but that depends on a few things
      • A good therapist will take time to get to know you and your limits before actually starting the therapy
      • It may take a few months to build a relationship, minimally several sessions
        • If they push you before you are comfortable bail and find a better therapist
      • Your therapist should help you create a plan and help you figure out how to notice if you are destabilizing
        • If that happens they should be available to call or have someone who is
        • They should back off a bit in future sessions and take things slower
      • If you can, definitely schedule sessions for times when you will be able to take the rest of the day off when you start actual EMDR, it can be very taxing

Hopefully some of that is helpful. TLDR - both psychiatry and therapy can be helpful with the right mental health expert and medication, but it's not a quick or simple fix. Trust me though, if you have shit that needs to get dealt with the sooner you deal with it the better.

 

[miyabi]

For more mild or moderate cases of depression, they're worth a try. They're also absolutely worth a try for idiopathic depression as opposed to things caused by life circumstances or environmental factors.

If you end up going on SSRIs, I wouldn't pay much attention to online reports of side effects. Some people say the side effects can linger. I have a lot of experience with taking prescription medication fearmongered by a lot of people as having long lasting effects, and I've never had any side effects. The nocebo effect is just as effective as the placebo effect, so be careful about going into a course of treatment expecting to get medically unfounded side effects. Be aware that a lot of side effects are listed as a precautionary measure to protect the manufacturer from legal liability.

You mention you're on HRT so you may be familiar with finasteride. It was largely superceded by dutasteride which is the gold standard in East Asian countries as a firstline therapy. If you do a bit of digging a lot of the 'persistent side effects' are associated with finasteride as a result of this pop culture phenomenon. Dutasteride, despite being a newer medication with markedly higher potency, reports lower side effects because it doesn't get tagged under the "Post Finasteride Syndrome" brush. The manufacturer Merck added suicide as a side effect to cover themselves legally, similar to the manufacturer Roche and Isotretinoin or Accutane. It's easier and cheaper to add it as a rare side effect when someone taking it ends up committing suicide than it is to fight it legally.

Ultimately just go into treatment with a positive mindset. Yeah, I know, it sounds like something a "wellness coach" would tell you, but from my experience negative thinking causing nocebo effects is a lot more common than vice versa. I've had a large amount of success with other prescription meds that 'increase suicide risk' and have other bizarre side effects with clinically significant results (measurable on labwork etc so not placebo) and I've had side effects from none of them.

I have not ever tried medication for mental illness but I have positively benefitted from meds like isotretinoin and finasteride/dutasteride, medications which were slandered in media scaremongering campaigns (similar to SSRIs) as increasing suicide risk, causing erectile dysfunction and liver damage, etc.

Regarding panic attacks, I don't have much experience with sedating drugs nor have I ever wanted to because of their addictive nature. I've recently been trialling beta blockers for an elevated heart rate. Propranolol is clinically well tolerated and is used as a firstline treatment for sporadic usage for treating public speaking anxiety. It will help with the physical effects of anxiety. I have issues with overactive adrenaline production when talking to people because my body is anticipating violence. The beta blockers seem to be helping. If you exercise, it may be worth bringing up this concern to your GP who may be open to prescribing Nebivolol instead which is better suited for long term use and should not hinder exercise capacity.

 

[yowai]

Definitely try them out, I was in this community before getting on Zoloft in 2018 and it got me out of terrible depression for 2 years, then I fucked up my brain with other stuff so it's not doing much anymore but it was worth it then