Taking Antidepressants

Archived Q&A and Reviews

Questions More advice about Antidepressants:

What made you decide to take antidepressants?

Sept 2010

I've been battling depression and anxiety for some time now. It may be in part hormonal (perimenopause), it may be in part circumstantial. But I have felt really horrible for too long, and all my usual ways of coping are falling short. I plan to go see my doctor and talk with her, but I thought I'd ask here about what factors caused those of you who take antidepressant medication to start the medication? Which one do you take and why that one? How much does it help? How long do you plan to take it? What do you know now that you wish you'd known? Thank you Would like to feel better

Good for you for seeking help. I would recommend talking to a psychiatrist to help you get on the right medication--once you feel stable, your primary care physician can deal with the followup.

Why did I start on medication? I had felt for quite a while that I was not appreciating my life (especially my kids) as much as I should, and that this was not fair to my family. I tried talk therapy and self-medicating (St. John's Wort, fish oil) before finally relenting and going to a psychiatrist. First I tried Wellbutrin, which helped the depression but not the anxiety/irritability. I then switched to Celexa, which worked much better. The symptom that I noticed before I went on the Celexa was that the surface of my brain felt irritated and sore, and things like my children's voices (!) felt like sandpaper against it. Celexa soothed my irritated brain (I picture it like those old commercials where Pepto-Bismol soothingly coated a roiling stomach with a calming layer of pink, viscous liquid) and let me enjoy the many great aspects of my life, while taking the less-great ones in stride. Before Celexa, if I had a bad day at work I'd be like, ''Oh no, my job sucks and it's all my fault and I'll never be able to find a better one because I'm incompetent!'' Now I'm like, ''My job isn't so great, but it's not my fault, and someday I'll find a better one, but in the meantime, I'm grateful for the good things about it.''

The one side effect Celexa has for me (at the small dose I'm taking) is that it definitely depresses my sex drive. I wish that were not the case, but when I tried going off it, I gradually (after a few months) got depressed and irritable again, which was worse for my husband than having me happy but not interested in frequent sex.

The advice I'd give you about antidepressants is that they don't necessarily help immediately; the side effects are worst at the beginning (e.g., Wellbutrin made me feel sort of nauseous and it was hard to sleep) but tend to fade away after a while; and you may need to try more than one drug before you find the right one for you. Don't give up! What you're doing is important. Good luck! No longer depressed and anxious

I struggled with depression before we had kids for a while, was put on medication (a mix of Wellbutrin and Celexa), which helped and made us feel we are ready to take on the responsibility of having kids. When our first was born, the depression came back, worse than ever, before I even left the hospital, and it lasted for 1 1/2 years. At that point I refused medication as I felt that with it I had been in a false state of security, and none of my problems that had caused it in the first place had been resolved. I insisted on a program that incorporated cognitive behavioral methods and would allow me to access and deal with my underlying issues. We lived on the East Coast back then and I found the most wonderful program at McLean hospital near Cambridge, MA (if you want to look it up to find something comparable here). This kind of treatment is more expensive for insurance companies and they are very reluctant to offer or even acknowledge it's existence, but in the long run it truly helps as it gets to the root of the problem rather than glazing problems over as medications do. You will need a really good therapist who will make a really strong case for you with your insurance in order to get the treatment approved. Expect some initial denying from your insurance and some back and forth, but it is totally worth the fight -- my depression has not come back (and believe me it was BAD) in the four years since we left Cambridge, and I'm a very happy person now. I don't believe in meds
I can only speak to the anxiety. Last Nov. I became overwhelmed with anxiety. No one reason why. I could not sleep, had heart palpatations, felt so uneasy in my skin. I tried over the counter remedies, and alternative ones. Nothing helped. I am not big on western meds, but finally a friend said, this has gone on for 2 months, you're a wreck, go see the doctor. I went, told the Doc my situation, they took my blood pressure and it was up to 170. Five months earlier at my physical I was 120, which is my norm.She precribed Xanax. I was reluctant, thought I would get strung out, didn't want to think I was weak, etc. I took one, and within 45 minutes felt a difference. I slept for 6 hours without waking, prior to that I never slept more than 2 hours, off and on all night for months. For the next several days I took 1/2 every day. Never felt the need for more. Over the next several months I probably took 12 total. It helped tremendously that I knew I had them in case the anxiety returned. I still don't know why I was griped with such anxiety, but it has not returned. I honestly did not feel 'altered' in any way. Again, I'm not a big advocate of meds, but when you need them, they can help, and I wish I had gone to see her sooner instead of toughening it out. My sleep cycle has returned, and my blood pressure is back to 120. Go see your Doc. been there
I have episodes of depression eversince 21. I took Prozac for several months and stopped. A few years ago after menopause I developed anxiety disorder and my doctor prescribed me Lexapro. I took it for several months and stopped. At the same time I also saw a therapist, seeked acupunture therapy and my acupuncturist prescribed me herb that really helps. I soon found out that acupunture plus herb plus cognitive behavior therapy are really effective for treating depression or anxiey. I like acupuncture and herb because it doesn't have any side effect. when taking Lexapro I felt mouth dried, hungry all the time and gained weight. After several therapies I bounced out of depression. I also try to walk and practice Yoga and eat healthy everyday. I am now drug free, going to acupuncture once a month, take herb when I am feeling not happy. However, keep in mind that you don't stop taking medication abruptly. You begin taking it every other day, then once every two days and so on. If you stop abruptly your depression or anxiety will get worse. TYM TYM
I recently went on, & then off of, antidepressants. I've heard that some people only need to be on them for a few weeks to ''re-set'' the brain chemistry & break the cycle of depression, & I think that was the case for me.

I too had been living with low-level anxiety/depression for years, but I found my usual coping mechanisms were no match for my child's recent diagnosis of a degenerative, uncurable disease. Once I realized I was *willing* to try it, I realized I should. I went to my doc & she prescribed generic zoloft, which I took for 2 weeks. After 3 days I felt better - my moods still swung, but not so low. I felt like the Z. was making me a little manic, & messing with my already-troubled sleep, so my doc switched me to trazodone, which helped me sleep, but made me logy. I found the side effects annoying - I felt spacey all the time, & I think that it threw my digestive system out of whack (mild thrush & diarrhea). I went to a psychiatrist & he suggested I try going off it. 3 days later, I found I could think more clearly & had more energy, which helped with the depression.

Since being off it, my moods still swing, & sometimes pretty low, but I find that exercise, especially, can snap me out of it. It seems that regular docs don't have a lot of experience with the subtleties of meds - mine had evidently prescribed too much of the T. My advice?: 1 - Find a psychiatrist to prescribe & manage it. I established a relationship with one, in case I need to go back on. Given my child's diagnosis, I expect I may have to someday. 2 - expect it to take some time to find the right one/dosage, & also try going off them after a month or so, with your docs' support. 3 - if you can't reach your doc about something (side effects), call a pharmacist. 4 - do a little research: The mayo clinic has a good description of the different types. Find out if any close relatives had any bad reactions to any particular type.

Depression needs to be addressed from many angles. I've found Cognitive Behavioral Therapy to be very helpful, & it turns out that EXERCISE is crucial.

I didn't want to hear any of this at first, but I know plenty of people who are on them. Their experience & mine is that the right meds/dose don't change your emotions, they just lessen the severity, so that you can live your life & cope. It's the only one ya got, after all... Best of luck! been there & back

I'm really sorry you're going through this and I hope you find help. I never considered myself a depressed person but experience post-partum depression after my second. My doctor kept recommending I go on them but I would never fill the prescription. After a year and a terrible visit with my parents, I went blubbering to the doctor and got on celexa. I also went into therapy at the same time. The change was amazing. It was like a fog cleared. I loved being on celexa and miss it. I took it for 8 months and then got off of it because I gained 20 pounds. That was 2 years ago and I'm still struggling to lose that weight. I'd go back on if it wasn't for that. I will say tho, that I have realized that when I do even mild exercise (like a 30-45 minute walk a day), I feel like I did when I was on celexa. It's a marked difference. I just struggle with time for this and am still fighting to change that. I think you have to go on the medication that's right for you, but celexa was great in getting me through a really bad time. I do remember having headaches and feeling kind of nauseous the first week or so but then it got better. anon
I am so sorry you are feeling crappy. It is awful! I recently started taking Zoloft. I am not someone who turns to ANY kind of ''western'' medication or medical ''interventions'' easily. I resist your garden-variety OTC stuff, like tylenol and ibuprofen, for example. I prefer to treat the root problem as opposed to try to control a symptom. Anyway... my perimenopause symptom that was truly kicking my butt was migraines. I was getting a handle on them through diet and chinese medicine, but something was still just not quite ever totally right. Granted, I have a very stressful life (in some people's opinion, though to me it's just my life). When summer vacation started, all of my children were home and it was my premenstrual week. I was sooooo mean. That was when I knew I needed something different. My family deserved a better me. I deserved a better me. My OB/GYN suggested an antidepressant. We settled on Zoloft because I am still nursing my baby. The issue is hormonal, though, and she did talk about taking The Pill and about estrogen patches, but the nursing and my very strong family history of breast cancer nixed those choices.

The most important thing I know now that I wish I had known is really how long and difficult the ''break-in'' period can be. I had read the literature, but talking with someone who had been through it would have been way helpful. Also, a little closer monitoring and more check-ins from my doc would have helped immeasurably. My dosing was totally wrong initially (though it was the ''recommended'' starting point according to my OB) and I ''crashed'' hard and heavy about 2 weeks in... scary stuff, crashing like that. Got into see a psychiatrist who treats perimenopausal women. She cut my dose by 75% (yes, you are reading that correctly). I plan to take it until my life seems to level out and I can get good sleep consistently and regular exercise. I don't know how long that will be. I was initially very uneasy about how I felt on it. Now I like it. It is really nice being ''level'' and calm without being zoned or checked out. It helps me a ton!

Feel free to contact me through the moderator if you wish. my meds are working

Have always had depression, decided to start taking antidepressants because coping with a 2.5 year old led me to yell at her. Wish I had started sooner. It is good to have therapy too but that didn't make things better for those around me. The antidepressant gave me the reserve of emotional resources to be understanding, to think and come up with creative solutions, to reduce the atmosphere of tension in the household. I will take it forever if necessary. I have experienced no downside. Glad for modern medicine
I waited way too long to take medication for anxiety and depression. It almost ruined my marriage. I had small children and was dealing with anxiety after medical trauma as well. It was difficult to get out of bed, to do the normal daily activities. I was even snapping when I did my favorite things. I cried a lot and felt like I was losing my mind. It hurt. When my GP finally convinced me to take Lexapro, my life changed. I still feel anxiety and some days are harder than others, but the change is evident. I still feel like myself and have had no side effects other than some sleepiness, so I take it before bed. Good luck. anonymous
I've dealt with depression for most of my adult life. After years of not wanting to use anti-depressants, I finally conceded that I was extremely depressed and could not ''pull'' myself out of it without help. I ended up (after trying a couple of other drugs) on Paxil, which is actually considered more of an anti-anxiety drug (or so I've been told). It worked wonders for me and I can honestly say I think it saved my life. I was on it for about 5 years, and then slowly weaned off of it at my own choice. I have struggled with depression some since then (I've been off for about 6 or 7 years) but nothing like before and I do think it ''retrained'' my brain chemistry to not get so deep into the funk. That having been said, the side-effect (which seems to be permanent) is that my memory is pretty poor now. I used to have very good ability to remember things (numbers, events, etc) but now my memory is crappy and it does make me sad. My husband will try to remind me of things we did (remember our first date, when we...?) and I seriously have no memory of these things that I'd really like to remember. So that's kind of sad. Also, the dosage the doctor wanted me on turned out to be way too high for me. (The standard recommendation for Paxil is something like 20-30mg a day, I ended up very stable at 5 mg.) So keep that in mind. People are different and respond to drugs differently, so really listen to your own body's response if you decide to go that route. Good luck, I really hope you feel better. anon
I, too, was recently struggling with moderate depression/anxiety, which some days was bad. I just started Citalopram about 3 months ago and am so glad that I did. I had been on antidepressants in the past for severe depression. I didn't have that crushing depression this time, so questioned whether I should go on them again.

Realization: don't let yourself hit bottom before you take care of your mental health and get help. Realization from my first time on anti-d's: why did I wait so long and struggle with the idea of getting help or going on Rx? I felt so much better. I was so depressed that I could not pull myself up. It was night and day; it was life- changing.

Recently, I just felt low, tired, cognitively slow. My head was constantly spinning and never at peace. I always felt I was struggling. I recognized the signs and decided not to wait until I couldn't get out of bed one day. I was also having anxiety, which was new for me.

My doctor recognized that my depression could be hormonally related, since it came back as soon as I stopped breastfeeding. She recommended Citalopram, saying her female patients with anxiety/depression have a lot of luck - especially if problems are related to PMS/hormonal changes. I've had no side-effects to speak of.

As with any anti-depressant, you definitely feel off when you start it for the first week or two (soupy-headed). But you need to see it through; it passes. Now, compared to 3 months ago, I feel like myself again. I don't feel unusually good, I just feel normal. I sing to my kids, I'm engaged and patient. The days don't feel like such a labor. I also hadn't recognized how much the anxiety was interfering. One of the first things I noticed -- my mind was quiet. It was remarkable. After about 3 weeks it became apparent that I needed the full dose for it to be affective for me, so that's where I am. (40 mg)

What I know now -- take care of your mental health as you would with any other medical issue. Antidepressants don't alter you. They just help you come back to that person you are. You may also find that the 'circumstances' you feel are contributing to your depression aren't that bad. Don't struggle, just get the help you need. And if you decide later that anti-d's aren't for you, you simply tell your doc you want to stop. Nothing lost. Good luck! Feeling well again

Before turning to antidepressants, I'd recommend yo get your thyroid checked since the symptoms you experience could as easily be caused by thyroid problems. amma
Hi, I'm 46 and have been taking a low dose of Zoloft (or the generic equivalent ''Setraline'') since 1994. I have been prone to melancholy and anxiety (sometimes bordering on OCD) since I was 11 or 12. I actually wish I started on this medication in college or my 20s -- it would have made life so much better! It helps a great deal and I don't plan on ever going off it. I just think I'm predisposed to despair and anxiety and need an ongoing chemical adjustment. I took 25 mg per day for a long time, but recently bumped it up to 50/day. Hope this is helpful
Do it! I started taking Zoloft toward the end of my pregnancy, about two years ago. I couldn't function at all. My OB-GYN felt that Zoloft was the safest for pregnant women and I take the lowest dose (50 mg/day). It makes a huge difference in the way I handle problems. I can be present and patient with my toddler and HAVE FUN with him. I also have energy for my other interests. I switched to Wellbutrin briefly in the hopes of improving my ability to have orgasms but it didn't work on my depression and I switched back. I plan to take it indefinitely. Good luck! -Anon.
I started taking a very low dose of Lexapro after visiting my sis, who has been taking it for years. She and I are similar in lots of ways but at this visit I could how much less irritable and more tolerant she was than I had become. I think my condition is milder than hers in general but perimenopause was making mine worse. I did have one sleepless night when I first started (so I switched to taking it in the a.m.) and initially some problems with orgasm (but got over that too and now am the same as I was before). I don't notice a big difference except that my husband doesn't annoy me constantly. Which, by itself, is worth it.
I've been on Effexor and Wellbutrin for nearly 9 years, and just recently (with doctor supervision) was weaned off of Effexor, and next step is getting off the other. My tips: 1. It is crucial that you are comfortable with your psychiatrist/therapist. A bad psychiatrist can make a HUGE difference. Different drs have different styles of dealing with patients, which can potentially make or break your treatment. Learned this the hard way. 2. Realize pills will not magically make you happy. They're like good running shoes -- just wearing them won't make me fast. You have to actively participate in healing yourself. 3. Medication can take a long time to start working. If you feel 1 kind if not working for you though, TELL YOUR DOCTOR. I had to try some different meds and doses before I found the right combo. 4. Exercise and eat well. Both have a surprisingly strong effect on mood. Feel free to contact me with questions! corinne
Everyone reacts to medication very differently, so it's extremely important to recognize that when approaching Western medication choices. You may need a much lower dose, for example, or have a side effect not even listed. This is actually very normal.

Find yourself a psychiatrist who LISTENS and talks to you, not just looking at a chart and preparing a prescription. www.theicarusproject.net is a fantastic website (and community) that has a lot of info from people who experience major depression, commenting on herbs, treatments, therapies, life-style choices that have worked and not worked; it's an invaluable resource. There is a section on the website about side effects from medications that is very helpful as well.

I can personally vouch for excercise, acupuncture, Chinese medicinal herbs, oatstraw tea (calming), DBT (dialectical behavioral therapy), cognitive thearpy and medication, when necessary. Yoga is amazing.

30 minutes of excercise and eating a LOT of greens will most certainly help, with out without the meds. Girl, not Interrupted anymore

Anti-Depressant Withdrawal

May 2010

After 12 years of taking anti-depressants, (various ones) and not finding one that really works, I have decided to quit. I kept taking them all this time because I thought they were having some affect on my depression and at one time I had panic attacks, so I thought they were keeping me from having them. After getting fed up, I finally got up the courage to see what happens without. I don't have anything against them, I think they are great for some and I know people who wouldn't be alive without them but I decided to quit. I do know that they need to be tapered off of and I did that. I don't really have access to the kind of healthcare I need to have a professional supervise this which is one reason I want to quit. I feel like I can feel again, I cry when something is sad and feel happy sometimes and at first had some nausea and headaches. This all sounds fine, probably, but it's kind of overwhelming and is starting to bug me. One more thing is I have the sex drive of a teenage boy and I'm a woman in my late 40's, I can't say I mind that. One physical symptem I have is a sort of shuddering feeling sometimes. I wonder if anyone out there has experienced this or am I just imagining things? Help
me again

Just in response to the shuddering feeling: that's very common. I've heard them called the ''brain zaps'' too. They're not quite painful, but unpleasant, right? Some anti-depressants are worse than others for the brain zaps/shudders. When I withdrew from Paxil, the feeling was so awful I had to simultaneously go on xanax while I finished tapering off the paxil. It was MUCH easier than going cold turkey or even withdrawing slowly. Good luck! former antidepressant user
I'm speaking as a longtime (10 years) grateful anti- depressant user due to diagnosed bipolar and sufferer of severe depression (but not a doctor), so that's where I'm coming from.

But I respect that you may not have chronic clinical depression and just needed them at one time and not now. (Smart of you to taper down.) Just be very vigilant about monitoring your feelings in case old symptoms of more serious depression start to come back, and don't let your dislike of meds keep you from returning to them *IF* needed.

Before I was properly diagnosed as BP I too hated the idea of meds, decided I felt fine, and tapered off. The symptoms slowly came back, and I didn't realize what was happening because it felt so familiar (and of course the deeper you get into it, the less rational persepective you have), until I was full-blown again and almost hospitalized.

I'm NOT saying this is the case with you, so I'm not trying to cause fear in order to keep you stuck on the meds. Just be aware so you can take care of yourself.

Congratulations on your new life (and sex drive!) Best wishes to you

Hi There:) The first question is how are you tapering off your meds? If you've been on them for 10 years, you really need to go very slowly, even if you've only been taking your current med for a short period of time. If you go cold turkey you can have some really serious side effects. It's important that you call your doctor and let them know what you are doing, they can help you with your taper dosage and scheduling. Sometimes you need to go even slower than what they recommend. It might be good to get some sort of supportive treatment as you taper like acupuncture or homeopathy to help mitigate the side effects. That way you can stay off your meds and not have such trouble with headaches, nausea and shuddering.

It took me three tries to get off and stay off.The first two times, I went with the Dr. recommended 2 weeks at 50% and then quit. To actually stay off, I had to taper down over 4 months, spending a full month at each dose 100%, 75%, 50%, and 25%. It depends on the half-life of the med, but it can make a huge difference in your symptoms. Go slow!! anon

saw your post - usually I don't respond, but it was just too familiar. I have gone off anti-dep a number of times and experiences those ''brain shudders.'' I too thought I was crazy, but there is a ton of descriptions of such a feeling (often called brain shivers)all over the internet. VERY UNCOMFORTABLE and quite strange...I often added small doses and tapered from there before they went away - you have to taper very slow, and even then they take weeks to go away. I wish you luck. been there

Feeling some pressure to get off the meds

May 2009

I decided to take an antidepressant--celexa--after I stopped breastfeeding my son at around nine months. I'd had pretty severe post-partum depression and just clawed my way through it until then, not wanting to risk the chemicals in my breastmilk. Celexa was a godsend--helped me get my focus back at work, make the changes I needed to make in my life, be a better, more present mother.

It is now one year later, and I'm feeling some pressure to get myself off the meds--and in fact, I recently tried weaning off. After a month and a half of DAILY headaches, dizziness, flu-like symptoms, irritability (even yelling--for the first time ever--at my baby), I'm back on my full dose (and feeling IMMEDIATELY better).

Has anyone found something (other than half pills for a month, quarter pills for a month--doctor's suggestion) that makes the weaning process tolerable with this particular drug? I mean herbs, acupuncture, etc. I really was shocked by how awful I felt--and am now feeling I'd rather stay drugged than go through that again! Another Antidepressant Addict

Hi there, I read your post about staying on anti-depressants and empathized. I had bad PPD after my first child, and was helped enormously by medication. When I found out I was pregnant with my second I quit cold turkey which, as you discovered, is not recommended. In the end I stayed on AD's through that pregnancy, breastfeeding, a third pregnancy, breastfeeding and now raising three small kids. All on ADs. For a while I tried to come off or cut down now and then, feeling some kind of nameless guilt or blame or something, and each time would pretty quickly turn into an angry harridan with a face like a stone. My husband can walk in the door, take one look at me, and know that I've missed my meds. I'm on a low dose, 10mg of Wellbutrin daily, and I feel fine. It bugs the hell out of me that people nag women to come off ADs, as if being medicated was somehow irresponsible, or 'unrealistic' (someone once said to me that life was depressing, that was the reality, and that it was cheating to be medicated. I told them to fuck off, and suggest you do the same if you hear messages of that ilk). If you were diabetic no one would suggest that it was natural to be off insulin, and being depressed is a state where you are suffering from a similar chemical deficiency. I'm a sober alcoholic, and used to drink to medicate myself: After 15 years of sobriety, medicated and unmedicated, I can assure you that there is nothing 'natural' about being depressed. My shrink at the time of my first PPD put it well: She said that we aren't sure how negatively medication might affect our babies, but we know for absolute certain that a depressed mother can be horribly destructive and damaging for fetuses, babies, small children and onward and upward. I am a better parent, spouse, friend and daughter when I am not depressed. Do yourself a favor and relax about it, and try not to pay attention to the vocal few who enjoy criticizing others for seeking happiness over imaginary purity.
Your question concerns me. Antidepressants are powerful medications and should not be self-administered or self-managed. Any anti-depressants should be administered under your doctor's or psychiatrist's care, not your own personal assessment or that of the Berkeley Parents community. Even a doctor providing advice on BPN is doing so irresponsibly since they have not examined you and do not know your personal medical history. When I read words like ''I put myself on celexa'', that is a big red flag. All drugs have some side effects and impact people differently. Furthermore, your doctor will be able to monitor your reactions and progress and manage dosage accordingly. They can also determine if celexa is the optimal drug for your condition and if it makes sense to taper. Without truly understanding all this and how they might interact with other drugs you are taking, you are treading on dangerous ground. Please see your doctor. Anon
I was on antidepressants for years, finally decided to get off due to side effects. I lowered the dosage with the supervision of a psychiatrist, and very slowly got off them, but still had horrendous withdrawl (headaches, brain zaps, irritablity). when the stuff was finally out of my system I couldn't handle anything-my fuse was so short, and I took everything personally. I realized I had to go back on to another one. I am on a different SSRI, and I feel like myself again. I think doctors underreport the effects of going off antidepressants, and who knows how they alter us-but I've accepted the fact that I just need to be on them, to be a good mother and enjoy my life. anon
PLEASE see a doctor about reducing your meds. There are several newer anti-depressants that require a very specific weaning process. I am not a doctor, but have been on different anti-depressants since 1991. My sister self-weaned from Paxil and it was a nightmare. She had to go back on so she could properly wean. Please talk to a psychiatrist, not your regular doctor- you really need a specialist here, IMHO. anon
Hi, I just wanted to say that I don't think there's anything wrong or ''inferior'' about staying on an antidepressant. The biochemistry of many people is such that they are ''wired'' to feel a certain level of sadness, anxiety, etc. and an antidepressant acts as a chemical adjustment to this. I've been taking a low level of Zoloft since 1994 -- I feel it lifts me to a higher contentment ''set point'' than I naturally reside at. Back in 1998 I felt like it was weak to be on an antidepressant and that I should be able to be fine without it and so went off, but soon was back on after sliding back into inordinate sadness and anxiety. ... my thoughts

Should I keep trying different drugs?

June 2007

I have been struggling with depression for many years. I am very sensitive to psychoactive drugs, and tried many antidepressants as well as lithium many years ago. The side effects of the antidepressants were brutal, so that I was only able to tolerate them for a few days. Lithium had no effect on my mood, but horrible side effects. In those days, apparently, higher doses were initiated when starting a drug. In any case, I gave up on psychiatry a long time ago and had great success with quitting drinking (also many years ago now) starting a very vigorous exercise program, stabilizing my life, getting an advanced degree etc.

Now, with a 2 year old son I am mildly depressed and have bad pms. I have very little support, and am pretty isolated: no family, no insurance, no money (waiting for my husband to finish grad school) etc etc. I saw a psychiatrist recently because I didn't want my depression (just sort of blah--not major) to affect my son. Well, she put me on a TINY (one-fortieth--yes, one-fortieth--the typical active dose) of a mood stabilizer because of my history with antidepressants and I was too sick to get out of bed, with physical symptoms like the flu. It took a week of being sick and a week to recover.

My question is: should I keep trying different drugs? Is this roller coaster worth it? Should I instead focus on all the life changes that helped me so much in the past? (this last is my husband's advice)

The doctor confirms that I have a very rare, unusually sensitive system, so this isn't a case of dealing with the usual side effects at the usual doses. I want to do what is best for my son and my husband and myself, but I just don't know what that is. It is unlikely that there are many folks out there with this experience, but any insight is appreciated.

I also have this hypersensitivity to antidepressants and mood stabilizers. Eventually, through trial and error we found the appropriate dose of the right medication and my life was greatly improved. However, I continue to struggle with low-grade depression but not major depression. I would say keep it up and if your psych dr doesn't seem to understand, keep looking for one who does. Anon
If anyone in your family (blood relative) has successfully used antidepressants you might want to try the same kind. Also if you tried antidepressants many years ago there are some newer ones out there that work very quickly and exit your body pretty quickly also so that if you do have terrible symptoms and can't stand it then at least when you stop the side effects won't continue for long. Lexapro, Effexor, Wellbutrin. Seems like you can try one and then give your body a break for a month without trying another one right away. Can't you do BOTH-- methods that worked for you in the past and also be slowly trying antidepressants at the same time? good luck
Hello, I would recommend that you do all of the lifestyle things that are possible for you and include time for yourself with both exercise and rest. I realized about a year ago that I had depression/very emotional pms. I decided to see a psychologist about once per month (all I can afford, but she's incredible - - Dr. Geraldine Alpert in San Rafael). She suggested that I might benefit from an antidepressant. I considered it and my doctor offered to write a prescription for me, but I decided instead to go to an herbalist and it has helped. My psychologist is not advocating for the medications anymore, so I think she's seen the improvement as well. For me, the biggest help is private exercise time (yoga) away from my family; it's not always possible to find the time, but the difference in how I feel is as striking as night vs. day. Good luck to you! Anon
I wonder if the mood stabilizer you're talking about is Lamictal- I take it for my mood disorder & it's been a godsend, but as I was building up on it I felt flu-ish for a few days at every dosage increase. My doctor was pretty conservative & I'd proved sensitive to meds in standard dosages in previous trials, so I began Lamictal at only 6.25mg (the standard beginning dose then was 25- 50mg, I think now it's 12.5- 25mg), & increased VERY slowly. I had an intuitive sense that it was going to be a good medication for me, so I managed to hang in through the days of feeling sick, & I turned out to be right.

I've been through many, many medication trials & I know that it's a huge drag & can be very scary. Side effects really frightened me at the start, but over time I began to take them in stride. With some drugs I tried I felt so awful that just I had to say, ''Nope, can't do it'', & with others I was able to give them a chance, even if I felt pretty weird for awhile at the start.

I hear what you're saying about being unusually sensitive & I'm not meaning to diminish that, only to say that you're not alone. One advantage for me, the flip side of being med-sensitive, has been that I've gotten benefits from some medications at sub-clinical doses, so low that I had a hard time convincing my doctors they were doing anything at all!

The life changes you've managed to make are fantastic & go a long way to helping depression & you definitely should keep them up. You're the only one who can say if your low-grade depression affects your life enough to make it worthwhile to continue to pursue medical options, you're the only one who knows how it feels to be you, but since you're asking the question, I'd say yes, it's worth it. You don't know without trying if any of the dozens of medications available can help you. Low-grade depression can be just horrible even though it may not be dramatic- it's kind of like living in a gray world.

I need to take a combinations of several meds to keep me feeling okay, it's taken years to work out that combination, & they require tweaking from time to time. I sure didn't go through all that for entertainment, & I know people who've given up on meds and decided to live with depression. Whatever you do, be sure to have a COMPLETE physical examination including thyroid tests & evaluation by an up-to-date endocrinologist. As has been discussed here recently, thyroid disorders can be subtle, & can cause depression & other mood disorders. And maybe look for a psychiatrist who has a lot of experience with med-sensitive patients- you could try calling either UCSF or Stanford where they have excellent psychiatric teaching hospitals (& out patient clinics) with sliding scale fees. anon

Growing up I was often depressed, and once took Wellbritin which worked fine, but couldn't take it more than 6 months at a time. When I was perimenopausal 5 years ago, I was moodier than usual and on a recommendation I started taking flax seed oil (cold pressed 1000 mg) and evening primrose (500 mg) capsules daily. I was skeptical that it would work (simply because my doctor did not suggest it) but I had nothing to lose. To my surprise it worked amazingly well. Today, although I am no longer perimenopausal, I still take flax seed oil, but increased them to 2000 mg a day. (I stopped the evening primrose - I did not think it was needed). To date, even though I am going through an especially challenging time personally and professionally, the depressions did not return. I suggest you give it a try. It takes several weeks to feel the effect. An alternative is to increase Omega-3 foods in your diet. If you do some googling you will find more info on omega-3 and depression. anon
I'm so sorry to hear that you are struggling. I, too, am incredibly sensitive to any medications, so I can truly understand your predicament. Have you tried acupuncture or Chinese herbs yet? I recently finished my degree to become an acupuncturist and in the school clinic where I put in hundreds and hundreds of hours, I successfully treated many cases of depression in women with both acupuncture and herbal formulas. Sometimes the results were slow and subtle, but often they were quick and remarkable. Everybody I saw in my case load with symptoms of depression was able to either completely get off their meds or substantially lower their doses. It might be worth a try. As a student clinic (fully supervised by very experienced acupuncturists, of course) patients pay from $24 - $30 for a treatment, so it's great for those who don't have insurance. If you decide to go, do commit for at least 6 sessions so you can give it a fair try. I hope you find relief soon. Here's the contact info: Acupuncture and Integrative Medicine College on Shattuck at Blake 666-8234. wishing you well
Since February 2002, two companies have been measuring urine neurotransmitter (endogenous chemicals that communicate information between neurons) spillage to identify reference ranges for a healthy population. Using this data (and the CDC's reference ranges for laboratory blood and urine tests were amassed this way too), recommendations can be offered for people whose urine levels are outside the reference ranges. The suggested interventions are using the building blocks for neurotransmitters, amino acids. Recovery Systems in Mill Valley (see Julia Ross's two books and her websites) uses questionnaires to identify these imbalances and corrects them with similar interventions. Because you mention hormonal imbalances such as PMS, test panels that include hormones (using salivary samples to capture the free or active hormone levels) may be useful. It may be worth a try since you are sensitive to pharamaceuticals.

The two companies are Neuroscience, Inc and Sanesco. I have experience in my nutrition practice using these assessments. I cannot say they are 100% effective due to biochemical individuality, but enough clients have been significantly helped that I felt it might be an avenue for you. I have seen improvement with insomnia, anxiety, sugar cravings, ADD, and Tourette's thus far. Nori

I'd try St. John's wort as a high dose gel capsule(New Chapter, St. John's Sc 27). It is highly concentrated plant extract with the whole natural spectrum of plant medicine, mostly hyperforins that ''modulate'' serotonine. It's fairly expensive ( $24 for one month, but I take it only during half of my cycle, around the time when I'm ovulating and the following two weeks, which saves money). I've tried Prozac and thought it was too strong, St. John's feels just right! anon
I also am extremely sensitive to medications. I started on a very low dose of and SSRI to treat OCD and anxiety. I had horrible side effects and did not believe that I could possibly be helped by this medication. Both my therapist and my psychiatrist urged me to keep going. Finally the side effects faded and I saw an amazing change in my anxiety levels. Each time we have increased the dosage slightly I experience side effects. Each time the side effects are a little less intense and clear up more quickly. If you can stick it out for 2-3 weeks you might get past the bad part and experience some relief. Better
Granted, I don't have your particular sensitivety issue. But, I spent about 2 years trying different drugs and doses before getting it right, and my life has never been the same. Or put a better way - I am living now rather than existing and just 'doing'. Yes, I knew joy before, but not the simple appreciation for being alive. Only my experience

I'm taking antidepressants--what to tell teen daughter?

Feb 2007

Thank you to those who suggested that I see my dr. trying antidepressants for depression. I should have done this a long time ago! Now, my teen daughter, with whom I'm fairly close, found the bottle of Lexapro and asked what they were. Since depression runs in both sides of the family, it would be good for her to be aware of it, but is she too young to know right now? Any advice from those who have been there? -Anonymous

Hi -- in this day and age, I do not think that a teen is too young to talk with you about any types of drugs, including prescription drugs. If your family runs a history of depression, your daughter finding the bottle of Lexapro affords you a great opportunity to have a gentle conversation about depression and its symptoms. Much as you might hate to realize it, perhaps your daughter has experienced some of these symptoms and they scared or confused her. This is a great opportunity to talk, not only about the Lexapro, but the fact that sometimes drugs are helpful when our bodies need a little help healing. I do not think that a teenager is too young to hear this! Good luck -- falcon
Hi, I really think it's a very good thing to tell your daughter about. First of all, she probably has been aware of your moods and would find relief in you getting treatment. Secondly, as someone who was diagnosed with depression at age 13, I strongly believe knowledge is power. And if your daughter may be susceptible to it, there are three things that are really important for her to know. First, it's nothing to be ashamed of. Unintentionally, by hiding your condition, you may send the message that it's something to be ashamed of. It's okay for your daughter to know that it's hard to deal with, but that you are not a lesser person for having it. Secondly, if she does start to have signs of depression, then it's good for her to know what it is and that she has someone to turn to that has first-hand knowledge and loves her unconditionally. When I first started feeling the depression, I felt like I was going crazy. Fortunately, I had a very supportive mom. Lastly, by her understanding what's going on with you, it may give her a sense of empowerment to help you. Without knowing what's really going on, when you are having ''episodes'', she may feel completely helpless. While she can't cure you and shouldn't feel like she needs to, you may be able to give her suggestions on what might give you a little comfort. Helping you feel a little better may make her feel a lot better. I really feel for you and wish you the best. Cathy

Do the drugs for depression really help? First steps?

Sept 2006

I have been functional but depressed for many years; I am not in counsling but was in college and was told I would always have anxiety problems. There is a history of depression on both sides of the family, so it should be no surprise. My mother's sister takes medication for depression; my cousin is bipolar and my mother suffered from depression thoughout her life, though never got treatment. Worst of all, I have a 10 year old son, IQ in the hg range, who is clinically depressed. Have already been told by two psychologists that he will likely have anxiety thoughout his life. I feel I need to get treated so I can create a more positive, happier environment for my family, esp. my son, and break this sad cycle. For those who take meds for depression, how does one go about this? Is there a test to confirm depression for get treatment? Who to see? How to choose the right doctor? Do the drugs really help? Which ones to take and which to avoid? Is it safe? Will I be a better parent?
Signed, Anon.

In my experience, depression screws everything up.

I'd say Thing One is to contact your doctor and get a referral to a psychiatrist. A therapist can also help, though cannot prescribe drugs. I think there are many levels and types of depression, and it takes some doing with your qualifed professional to figure out what's right for you. I've had a few bouts of depression over the years, and most recently taking time off work, learning to relax better, and working with a therapist bi-weekly (talk), and psychiatrist (drugs) saw me through a tough two-year stretch. I personally was on Lexapro as an antidepressant and Trazadone (a non-sedative antidepressant) as a sleep aid and it worked for me. What's right for you might be different. I would recommend acting sooner rather than later.
Doing OK in Berkeley

You are to be commended for trying to tackle this issue. I grew up in a family affected by mental illness, which includes clinical depression. You also mention bi-polar disorder which can affect not only the person, but their families, extensively. I recommend you get the book: ''When Someone You Love Has a Mental Illness, A Handbook For Families, Friends and Caregivers'' by Berkeley family therapist Rebecca Woolis (available local bookstores or Amazon.) This will give you some important guidelines for managing both the identified person and those affected of the family and/or friends. It includes info on drugs and what to expect. In my experience, pharmaceuticals can play a critical role in recovery, and my family members' life was improved immensely with the use of drugs, which basically made her life productive again, rather than the quagmire that had become her existence. You'll need to find a good psychiatrist (MD) to manage these for you, as there are many indicators and contraindications to their use, depending on other medical conditions, age, other street or recreational drug use, alcohol, and other meds, etc. (Many people who are ill, self-medicate with street drugs and alcohol, so the entire situation must be dealt with.) Also, some drugs need several weeks to take effect, so patience and perseverance are also important. An experienced and trained professional (MD) is really essential, and a family therapist (MFCC, MFT, LCSW) would also benefit your family. Some problems are too big for the talking cure alone. Best of luck to you and your family in lessening your suffering.
Psychotropics saved our family member
I wish my daughter could answer your posting, but she's in school right now. She has been on anti-depressants for a little over a year now (she's 15). I am not a big fan of chemical meds, but I have to say this has saved her life! She is a happy person (though not ridiculously so), she can function in the world, she can get herself out of hard situations, she doesn't stay silent as long as she used to. Not EVERY piece of clothing is black! She has come out of her shell, in a way. She had the cards stacked against her genetically also. At the same time her father, who had been suffering from massive depression for years (we're not together anymore-probably because of that) decided to try them also (he has Kaiser). I saw a difference in him also, but I think he is a tougher nut to crack (no pun intended) and don't think he's had as a miraculous a change. And I hear his mother is on some kind of anti-depressants too! I think the genetics are real. When things got so bad, my daughter's therapist recommended going to a psychiatrist for meds. I looked around and found someone who treated adolescents. Call your insurnace company see what they can do to help you. They can usually give you a long list of Dr.s in your area. You also might look at the BPN for recommendations for you and your son. You cannot and should not perscribe these heavy-duty drugs yourself. You might have to try for a while to get the dosages or types right. The people on the outside will notice a change before the person themself does. A good Dr. is the way to go.

I don't take them so I can't comment from the inside, but from the outside, I saw such a change in my daughter. It's like she's back from a very dark and lonely place where I coudn't reach her very often, and is so much the stronger, smarter, and with so much more self-awareness. I don't know how long she will be on them, but for the moment she's not wanting to stop.

All the best and please get help for you and your son's sake, whether it's drugs or meditation! anon

I have suffered from depression for years, as has my sister, mother and maternal grandfather. In our case it behaves like a predisposition, making my sister and I more vulnerable to normal stresses. We have both tried medications (Prozac and Zoloft) and found them useless with unpleasant side effects. I have been able to manage my depression to the point of eliminating it using nutritional strategies, esp. the program outlined by Julia Ross. She has two books, ''The Diet Cure'' and ''The Mood Cure'', and runs a clinic near Mt. Tamalpais. Given that you are considering medicating your ten-year-old son, I most strongly recommend at least a consultation with her clinic -- I think if you read her books you will hesitate to manage your child's regimen yourself, though you might find it helpful for your own health. After an initial period when the clinic might recommend supplementing with amino acids, the ''treatment'' consists of a diet that meets US-gov't recommended levels of protein consumption, avoids sugars and refined flours, and includes sufficient fats and _lots_ of veggies and fruits. The basic theory is that much depression can be traced to insufficient levels of neurotransmitters, which can be addressed by ensuring sufficient neurotransmitter building-blocks (amino acids/protein) stabilizing blood sugar.

I found a few of the ideas in the books odd, but the framework quite solid -- the science behind it is robust. Amino-acid supplementation is controversial but a search on PubMed reveals that at the levels her clinic recommends, only beneficial effects have been found. This is how I've managed depression during my pregnancy and through breastfeeding. A.

here are some resources and interiews (audio recordings/podcast) with people who transformed their personal pain into their life purpose - I posted from my book, Listening to Depression: How Understanding Your Pain Can Heal Your Life http://psychjourney_blogs.typepad.com/listening_to_depression/ www.visionarysoul.com
Some progressive psychologists have been working with a new technology that allows for neurotransmitters to be measured via a urine sample. Because the ranges have been established for a ''normal population'', comparison of test results to those can yield some useful information. From there, rather than using pharmaceuticals, target amino acid therapy (TAAT) provides the raw materials for the deficient neurotransmitters (which are made from amino acids, protein building blocks) to help normalize mood. This approach has been used for eating disorders, autism, insomnia, depression, AD/HD, and more. The company that has done the most in this area is Neuroscience, Inc. and their web site offers supportive and accessible information. Nori Hudson
Please see a psychiatrist. They will diagnose you and decide if you would benefit from medication. I highly recommend Richard Levine at the Berkeley Therapy Institute. He doesn't do talk therapy, but he's a master at prescribing the right drug. There are so many antidepressants out there and some may not be right for you. He truly saved my life. Without him, my anxiety would completely control my life. I'm a much better mom now that I don't see life through anxiety-colored glasses. Good luck to you! I hope you get the help you need anon
Boy, did your message hit home with me. I've been in and out of therapy for depression (minor, low-level with anxiety) for the last 10 years. I resisted medication for most of those years, until last year, when I started Celexa, or citalopram, which is a selective serotonin reuptake inhibitor (SSRI).

The change was immediate! I felt almost euphoric at first, then my brain gradually calmed down and settled into a calm state. The constant, grueling self-criticism and gnarling knots of anxiety in my stomach were gone. In its place was the ability to see my life clearly and realistically. The best analogy I can think of is that it's your still in your own skin, but the ''infections'' of anxiety and depression are gone. It's made me a less anxious, more confident mom, too.

I'm a Kaiser member so that's how I got help. I went to counseling and got meds that way. I don't tell people about the medication - there's a stigma, and I'm kind of embarrassed about it, to be frank. But oh, get help if you can. There are millions of moms (and dads) on medication and you'll wonder why you waited so long.

All the best to you
Depressed No More

What medication does is alter the amount of various chemical messengers, called neurotransmitters, that are available in the brain. Typically, people with depression suffer from a lack of serotonin, dopamine, and norepinephrine in the synapses (spaces) between the nerve cells in your brain. What this lack does is cause the ''vegetative'' symptoms of depression, like difficulty sleeping, lack of pleasure in food and sex, low energy, and low motivation. Medication alone does not work as well as medication along with psychotherapy, as studies have shown. A psychiatrist, general medical doctor, or nurse practitioner can prescribe antidepressants. Psychological testing can help determine whether you have depression or not. I recommend that you be evaluated by a professional psychotherapist and psychiatrist. Many health plans cover such treatment, although on a limited basis. For ongoing treatment many people have to go outside their health plans' coverage. I am a licensed psychologist and would be happy to speak with you about this, or you can find a psychotherapist through your health insurance panel (they usually have a number on the back of the card for mental health/substance abuse). I have substantial experience treating depression and am happy to be part of a treatment team with the person prescribing the medication. As with any treatment (including medication), there are risks and benefits to psychotherapy which any responsible clinician will talk to you about before you commence treatment. I hope that you take steps to treat this, since as you noted it can make a positive difference for you and your family. Please don't hesitate to contact me at 510-258-4431 --Lisa Larsen, PsyD
I had post partum depression, and had no idea how to get it treated. I started with my internal medicine doctor who was great. I told her about all my anxiety, my unhappiness, my lack of enthusiasm for anything fun, and she recommended that we try something just for 6 months. I had done some research, and talked to other friends on anti-depressants, and I chose Wellbutrin. It's the only one I tried, but it does lessen BOTH anxiety and depression, has no sexual side effects, and doesn't cause weight gain. There were othe side effects possible (headaches, stomach upset, etc, etc) but none of them happened to me. I also found a counselor through a friend so the meds did accompany counseling, but I really think the meds were the most helpful thing I did. The key advice I received was not to feel bad about taking meds for depression - your body has a chemical imbalance, and the meds are correcting the neurotransmitters/chemicals that aren't being produced enough. It's not like being on a trendy ''Prozac'' gig, like some people joke about. It is really necessary. I noticed I make better decisions now, I don't over-react when times get tough, and I feel more confident about how I feel. I strongly recommend you talk to your family doctor about it soon.... Anon
You ask important questions, but ones with no easy answer.

Each person's experience with depression, and with treatments, is different.

For me, medication is an essential part of managing my depression--along with a healthy diet, reasonable amounts of exercise, regular sleep, social support, and therapy (particularly cognitive behavioral therapy with mindfulness components).

I would be a much worse parent--and may well not even be alive--without the meds. For me, the benefits of the medications far outweigh the down sides & side effects--but you may come to a different conclusion.

For me, treating my depression has meant being willing to try a variety of medications and medication combinations to find the best results. This I have done mostly with psychiatrists at first, and then with my primary care doctor once I have been stabilized. I have always seen a psychologist, as well, to work on the aspects of my mood that are more in my control.

When I am depressed I am robbed of my ability to take joy in my work, my friends, my family, and my dear child. To me, life is too short and too sweet to allow a disease --and I believe it is a disease--to take that time away from me.

Good luck to you
Fellow Traveller

Hi - Some people suffer from depression / mood swings due to hormonal imbalance (which affects men, women and children). Have you looked into this? You might want to check out this web page - http://www.johnleemd.com/store/hormone_bal_rewards.html Please note that I'm not at all affiliated with Dr. John Lee, but there are some really good info in his website that might prove to be 'eyeopeners.' If you wish, I'd be happy to share with you some more info on natural solutions that have helped many.

And one more very important thing...getting spiritual counsel is another great and sure way to cure depression. It's free and it's highly effective. I highly suggest that you explore this option, too. Of course, drugs could also work, but only temporarily (and in most cases, there are side effects to contend with). So anytime you can find natural and even spiritual solutions, explore them. You've got nothing to lose and everything to gain. These have worked so well for me and many people I know, and they could work for you too. Feel free to contact me - and will gladly point you to some helpful resources. Again, here's wishing you the best! Ann

I was on Zoloft for 2 years, off now for the last 2 years or so, am 54 years old and have been depressed for 40 years, though less so since my periods have stopped. Perhaps this isn't the case for you, but I know it's true for me and I suspect a ''couple'' of others folks - that we treat our bodies just as we treat the earth, like garbage dumps, creating severe (hormonal) imbalances and expect to feel good physically and emotionally. And we want to take a pill rather than doing the hard work needed to care for ourselves. Our entire ecosystem, of which our bodies/minds are part, is out of whack. For starters, please go to http://www.womentowomen.com/articles.asp for fantastic articles regarding reclaiming your physical, emotional, and mental help.
i didn't see the original posting, but for depression/anxiety, have you tried acupressure therapy? i just saw anasuya batliner in berkeley (on 6th street, www.mybodywisdom.net is her web site) and i wish i'd found out about this decades ago, the frantic sadness and anxiety went away and now that i know it can go away, i have a lot more hope about things in general. it might not work for everyone but i strongly suggest giving her healing abilities a try. drugs are just so different on different people. but it depends what your depression is like too, as i said i missed the original posting.
I have a lot of genetic loading for depression & bipolar disorder, & suffered through 20 years of depression from low-grade to clinical with briefer spells of high energy which ended in depression.

I had a life, friends, work, but was always hiding what was going on inside of me & grasping to emotionally hold on. I did years of therapy which kept me alive & gave me lots of insight. I did spiritual work, nutritional work, bodywork, & various alternative healing work, many of which gave me some slight relief.

But nothing altered my basic underlying depressive instability & I always had an intuitive sense that something was organically askew.

Finally I went to Langley-Porter Affective Disorders Clinic at UCSF for an evaluation. By then they had identified bi-polar II disorder (a BP with heavy depression & hypomania rather than full-blown mania), & that's what I've got.

It took years of working with top-knotch psychiatrists to work out a medication regime that really works for me, partly because the mood stabilizer that is my primary med wasn't on the market when I began, & partly because my own particular version of the disorder proved to be treatment resistent.

I now take a combo of meds which affect different neurotransmitter functions, I stay within a quite reasonable range of mood stability & I enjoy life. Taking care of myself in terms of diet, exercise, & sleep greatly affect my resiliancy, & those things are an ongoing challenge for me.

Most people find the correct med(s) much, much faster than I did, but I'm telling my story to encourage you to hang in there for as long as it takes, to work with the best doctor you can find, to get a thorough work-up & diagnosis to begin with, & to make yourself believe that there is a person inside you who can enjoy life.

I've never had a lot of money & my depression affected my ability to make a lot, but I went outside my insurance & paid out of pocket (instead of going to the movies, or dry-cleaners, or buying new instead of used clothes, or eating out, etc) when I needed to to get good help, both therapy & psychiatry.

I recommend going to Langley-Porter as a starting place. It's sliding scale & overseen by some of the best teaching psychiatrists in the country

Considering antidepressants, but how long doyou take them?

Sept 2003

I am in a very blue period in my life, and have been talking to my doctor about taking antidepressants. But I'm concerned about how long to take them, and more important, about what happens when I stop. Will there be a rebound? Will the gains melt away? What commonly happens when people start and stop taking such medications? anon.

Everyone is different, but I found antidepressants to be very helpful as a way to cope during a very blue time, and I used talk therapy during that time to build up some resiliency and skills so that when I went off the pills, I had something else to fall back on. I weaned off the pills slowly and did not have an ugly transition. I can only encourage you to get help, through the pills or otherwise, because depression is a serious and debilitating condition. not depressed now
In my experience, when I stop taking anti-depressants the depression comes back. anon
I know a number of people (family and friends) who have been depressed and have taken anti-depressants. The most important thing is to understand that anti-depressants alone will not ''cure'' you - you need to continue to talk with someone while you are taking it. Too many people take pills to feel better; and while they feel better when taking them, they do nothing or little to improve their situation. Pills aren't the answer to everything. You need to learn to understand why you feel the way you feel while you are taking anti-depressants. Good luck. anon
I have severe clinical depression and have been on meds since 1995. I needed to try 6 different types before finding the best one for me. (So don't get discouraged if you try one type and it doesn't work--that's actually pretty common). I tried going off them, but fell into another deep depression--now I realize I will be on them for the rest of my life. That being said, research has shown (and I have found) that the best treatment for depression is a combination of things, including therapy, meds, exercise, good diet, meditation, etc. Some people don't need to be on meds forever--they get through a rough spot, then go off them. Others find that just exercise alone helps them more than meds. Finally, others (like myself) learn that they can't live without meds (and other treatments as listed above). It's not an easy situation. Realize that it'll take some time to figure out what works for you. If you need a good doctor and can go there, I had great luck at Kaiser in Oakland. Best of luck. Feel free to contact me with more questions. Kerrie
I spent the better part of my mid twenties and early thirties on and off anti-depressants and was helped greatly by medications each time I took them. I had success with many and switched around to avoid certain side effects. When I first took them I was anxious to get off as soon as I felt stable and basically went against my psychiatrists recommendation and tapered off after 6 months. I wanted to be 'cured' and felt stigmatized about being on them. To make a long story short, I think I should have stayed on them for a longer time even though I was no longer feeling depressed. I relapsed relatively quickly and had to go back on medication. That's not a big deal in the scheme of things, but I did have to endure the initial side effects all over again and wait for the medication to kick in etc, not to metion the period of pain and suffering I could have avoided... As time went by and I experienced more depressions, I got more comfortable with the idea that I took medication, and I was able to be more rational about choosing the right time to stop and and when NOT to go off the meds.

So, I guess my advice is don't be in a rush to go off medication, if they are of benefit to you. anon

Before you go ''on and off'' of antidepressants, it is important to get an expert and thorough evaluation of what kind of depression you are experiencing. It is not a good idea for anyone to go on and off them many times, but for someone who has a genetically based depression it can actually make things worse by setting off what's called ''kindling''. My lay understanding of this is that the neurotransmitters (there are many, not just serotonin, and even the SSRI's affect them) get overstimulated and can become more and more reactive. Also, if your depression is genetically based and goes untreated (or improperly treated), it can get harder to treat over time.

I don't mean to scare you, but this is important info! Antidepressants, particularly the SSRI's (selective serotonin reuotake inhibitors, like Prozac, Zoloft, and Paxil) are handed out like candy these days by general practitioners and psychiatrists without thorough evaluation and diagnosis. There are many other types of antidepressants, lesser known to the general public, and several types of depression- one size does not fit all.

I have suffered from depression (which finally got diagnosed as a subtype of manic depression) for many many years. It wasn't until I got an evaluation at the Langley Porter Mood Disorders Clinic that I got a proper diagnosis and began appropriate medication therapy. I recommend that resource, and it is sliding scale.

My mood disorder is genetically based- there is a substantial history of it on both sides of my family- and I am someone who will take medication for the rest of my life. At first this scared me and I resented it. Now, I am grateful that treatment exists, and taking medication is a routine part of my day. I have educated myself about the effects on my body of the medication, am able to tell when it needs adjusting, and am reassured that the drugs are not a health risk.

If you are someone whose depression is not genetic but an effect of present life circumstances, you still need to take medication for long enough to give yourself the mental, emotional, and physical strength to change those circumstances- otherwise the depression will likely return. Many people are scared of taking meds and go off too soon. Never go off antidepressants without a knowledgeable doctor's supervision! Going off without a slow tapering can cause a rebound, but appropriate decrease will not. If your depression returns after discontinuing, it means that the cause of the depression still exists, and that requires further evaluation.

I have done much therapy over the years- it gave me insight, allowed me to grow, and kept me alive through very rough spells. But I wasn't able to fully make use of those gains until my genetic disorder was treated.

Best of luck! anon

Your post caught my attention. I was one of those people who resisted taking antidepressants for years, despite having had one therapist who strongly recommended I try them (I actually left her office upset and never went back, I am sorry to say!). After majoring in Psychology though, and learning about the real help that antidepressants can offer us when we are depressed, I decided to try them--and I am not disappointed. It took me a year to find the right ones--I was allergic to Zoloft, and Paxil was just plain BAD for me (new, unpublished research on Paxil documents unhealthful weight gain in the first year of use, along with a documented complex of lethargy and mental fogginess-- beware!!). I now take Lexapro and Wellbutrin every day, with no apparent side effects at all. Lexapro is the only SSRI out there that has no documented effects on body weight or metabolism, and the Wellbutrin is good to counteract any sexual side effects (such as delayed orgasm). This is a good combo for me--yours might be different. Keep trying--get a good Psychiatrist who knows the medications, and who is willing to work with you to find a treatment suitable for you.

All my coursework in Psych. taught me how bloody stigmatized the use of antidepressants is in our world. My take now is that if you need them, you need them, and there is no reason to be ashamed, or feel like a weak or unworthy individual. People with all sorts of other diseases use medications for treatment without shame, and so should you if you feel the need. Depression is a serious disorder that KILLS people, either by suicide, alcohol/drug use, or immunosuppression resulting in the acquisition of other opportunistic diseases. Don't let others' antiquated views of depression as being a disorder of ''character'' coerce you out of getting the help you need. As with all diseases, treatments work best when you combine them-- talk therapy and antidepressant medications together are shown to be THE MOST effective treatment for depression. However, some people still need to be on the meds for life. If you are one of them, don't beat yourself up about it. In that case, it is a chemical imbalance that you can't control.

One more word about complementary treatments...Diet is a key factor in how we feel, but there is no money for this sort of research because corporations can't profit from it. In addition to medications, I have been on a modified version of the Zone diet to control blood sugar swings, and these have DRASTICALLY improved the way I feel--no joke. I eat more calories than the recommended daily amount (1700 is just too low!), but I try to eat the carbs-protein-fat ratio that's recommended. I don't get cranky or exhausted on a daily basis like I used to. Friends (and even my ex!) have commented on how much happier I seem. As a bonus, I have lost 12 pounds since the beginning of May with this minimal effort. I am not trying to promote dieting for dieting's sake, but thought you might want to try a blood-sugar balancing diet to see if it helps you. It sure has helped me. If you want to talk more about this, please write and ask the moderator for my email address. I would be happy to be an email pal/resource for you. Good luck, and be well.
anonymous, please, for privacy