Looking for some encouragement please

Treatment and medication
1

Hi,

I could do with a pep talk today. I’ve been on Sertraline for GAD for 27 days now; 1st 2 weeks 50mgs (and 10 of paroxetine, tapering off) and then 2 weeks tomorrow 100mgs.

I am finding that my morning anxiety levels are horrendous; I wake up and within about 5 minutes my heart is pounding and I feel wracked with fear. I have noticed in the last few days that this reduces a little bit in the afternoon and evening but all in all it is still pretty bad.

I really just need a bit of encouragement, what with it being a Monday, and once again being in the house alone. I am so desperate to feel well again, as I have had a horrendous 7 months since Escitalopram stopped working back in October, and feel like my life has been put on hold.

Thank you for your support x

2

Hi Samantha,

27 days (4 weeks) might feel like forever but it is a short space of time in terms of reaction to Sertraline. Think positively that you got better before on medication (Escitalopram)and you will get better again. I know that it can feel so desperate when all you want to do is feel like yourself again. The more distracting activities you can do, the better, whilst waiting for medication to kick in. Try absorbing yourself in a good book and exercise and music are also great escapes from anxiety.

Most of all, i understand that you are not alone and there are so many people on this forum that are going through or have recovered from what you are experiencing. I was on Sertraline for 16 years and then it stopped working last September so i completely empathise with you. There is light at the end of this tunnel and you will get better, it just takes time. One of the best pieces of advice that i've been given on this forum is not to look forward for signs of improvement / recovery but to look backward. I keep a spreadsheet with daily tracker of how i'm feeling. When i look backwards now i realise how much better i am than i was last September. Sometimes it doesn't feel like you are making progress when indeed you are.

Sending you hope, encouragement and wishing you better soon.....

3

hi hun honestly i fully believe weeks 4-6 are the worst weeks on this medication im currently on week 5 tommorow and since i got to week 4 i got worse i feel like the medication must hit its absolute peak during these weeks (im no professional) just seems to have been a lot of people have said the exact same thing weeks 4-6 being worst, so please be encouraged its not you getting worse itl be the med side effects and we will get through it very soon we are atleast half way there! try and do some excersise in your home jog on the spot i played a bit of duran duran this morning and did some star jumps lol anything at all to get through it, im the same i feel by 3pm it seems to settle slightly! good luck hun you can do this xx

4

hi jon sorry to jump on im heading onto week 5 tommorow 2 weeks of 50mg nearly 3 weeks of 100mg do you think thats still early days? im trying to reassure myself its still early but when you read online 4-6 weeks to feel better it panics me more as im not as of yet! would you say 8-12 weeks is more realistic? thank you

5

Hi Jon

Thank you so much for taking the time out to reply to me, and for giving me some much needed encouragement. I have just got back from a 3 mile jog, so I am putting your advice into practice!

I find that I am stuck in my head all the time, as my physical anxiety makes it impossible to distract, but I know I still need to try and occupy myself as much as possible.

I had 15 great years; 9 on Seroxat and then, when that stopped working, 6 on Escitalopram. I am just scared that a 3rd SSRI wont work, and I might have become resistant to them, as before this I tried Paroxetine again but it didnt work.

I will take heart that I am still in the early stages with Escitalopram, and try to keep positive.

I so desperately want to feel well again, for my families sake as much as mine. I will be turning 50 in June, and had hoped it to be a cause for celebration.....here's hoping that it still will be!

I hope you continue to feel better and better, please keep in touch

x

6

Hey Chelsea

I was going to message you this morning to see how you were doing!

I have just managed to go for a 3 mile jog along the canal near where I live, which has helped a bit. OMG, my anxiety was so horrendous this morning.....I almost felt like I was going to explode. I hate it because I cant think about anything else and feel trapped in my thoughts. Its so exhausting and I look at other people and just wish I could feel normal

But you are right.....enough of this self pity! We are still relatively early on, and plenty of posts on here indicate that it could be a while before we see any significant improvement. We just habe to hang in there, and get each other through it!

Do you have a supportive partner? My husband struggles with it, and doesnt really talk to me about it, but he shows his support in other ways, such as encouraging me to eat, go for walks etc. Its his birthday on Wednesday and he has the day off, but feeling like I do I cant see that I will feel able to do anything much.

I'm loving that you played Duran Duran this morning......thats more my era than yours! ;)

Hang in there girl, we will get through this! xxx

7

*Sertraline

8

Samantha and Chelsea, as the mother of a 25 year old who went through taking Sert for depression last year, I can tell you it is true that it is still early days. I cared for my daughter for over 8 weeks and kept a calendar of how long she had been on the meds, every day hoping it was bringing her closer to relief. She started at 50 mg and was slowly increased to 150 by about the 8 or 9 week mark. She also sees a therapist which has been a huge help.

One of the things that gave me hope was reading posts here of people who said they got well at around the 12 week mark. I witnessed my daughter having some good days at around the 6 week mark, but there were setbacks and bad days and it was very gradual. She moved back to her apartment at about the 8 week mark and about 2 weeks later I will never forget getting a call from her sounding happy and upbeat and telling my husband and me that she was working again. She has been amazing ever since.

I now know that the meds work slowly but they do work! Please hang on to that hope! And I agree about "looking backwards" and maybe keeping a diary because sometimes the improvements are subtle. You may even want to ask close friends and loved ones if they see improvements. Our daughter had trouble seeing them but we knew that compared to the beginning when she could not even watch a tv show or read a magazine, seeing her start to be able to do this and do things like cooking - were all big changes and improvements and signs that the Sert was kicking in.

Please keep us posted on your progresses and remember everyone here cares - ask any questions you have.

9

Hi Sandi

You sound like an amazing Mum and I'm sure that your love and support also helped your daughter no end

I too am lucky to have a wonderful supportive mother, who just desperately wants to see me well again. Anxiety has had a big impact on my life in many ways; when I 1st got it at 25 I lost my job and spent 10 years switching from 1 SNRI to another with no success. I was then finally put on an SSRI (Paroxetine) which worked for me for the next 9 years, during which time I went back to work and restarted my career. After Paroxetine stopped working I had a further 6 good years on Escitalopram until that too stopped working in October.

I clearly respobd well to SSRI'S which is obviously reallt positive, I think I just cant believe I will be lucky enough to find success with yet another SSRI.

That said, Sertraline does feel different, so maybe I will be proved wrong. I also have to say that my anxiety has reduced considerably since this morning which also makes me dare to believe that it may work.

Its wonderful that people such as yourself continue to provide support and encouragement to those of us who are just starting out with Sertraline.

Thank you so much for being there. I hope your daughter stays healthy and happy and wish your family every happiness going forward.

xxx

10

Hi Chelsea, yes. The people who write these medical journals and advice leaflets have obviously never experienced anxiety or depression. It also sets unrealistic expectations as people think that they should be feeling significantly better by 6 weeks and often end up stopping the medication too early and/or swapping to a different medication which means you start the whole recovery process over again. In my experience and many others, it often takes up to 12 weeks and even longer. We all metabolise drugs differently but the 4-6 weeks quoted is way too short to be used as a general view. Fingers crossed and much luck and hope to you. Having a buddy really helps on these forums especially someone at the same stage of recovery so you can compare notes and support eachother. Some of the people on these forums are total angels....to me anyway ;)

11

Sandi, inspirational and so helpful to hear for those on recovery. It is sometimes so hard for our partners to empathise when they are so close to the storm and have to hold down jobs, look after kids. It sometimes seems like the person going through anxiety is the most selfish person in the world but they wish it wasn't so......this is where mum's like you can save lives.....it's amazing. My mum is the same as you.....100% supportive and always there for me. I'm a little embarrassed to tell you that i'm 46 years old but have been on the phone to my mum in tears on the way home trying to sort myself out and hide it from my wife and kids. Mums rule XxX

12

Don't be embarrassed Jon....I will be 50 this year and I have packed myself off to my Mums on several occasions during my latest 'episode', just to cry on her shoulder and be looked after.

As a Mum myself I just want to be well enough to be able to do the same for my children, should they ever need it. God willing, they wont.

xxx

13

Yes, NEVER feel guilty or embarrassed to seek help from a mom, a friend, your spouse...these people love you and want to help. I can honestly say we had ANGELS in our corner during my daughter's journey out of depression. And hers was as serious as it gets. Like, me lying in bed at night shaking all over and praying constantly that she would survive this kind of serious. 24-hour watch kind of serious. Her college roommate, friend from high school, current roommate (also a college friend), our pastor, our friends, my own mom, my sister, sister-in-law and 2 nieces who had dealt with their own devastating depressions years ago...they supported us and our daughter and pulled us all away from the brink. Their encouragement and shoulders to cry on were the most important thing in our lives. My daughter is pretty private, but I need support - and I also knew she was unable to advocate for herself so I did it, including constantly texting her friends who were worried and were glad I reached out to them. As I told my daughter - this is an illness no different from any physical illness and there's NO SHAME. People understand. My daughter's boss, when I was finally able to convince my daughter to be honest with her, was 100% supportive. You really find out how many people you know have either experienced depression/anxiety/GAD, etc. themselves or have had a loved one who has. They get it. And they are there for you - just like we are here on this forum! I will always be grateful for the people on this forum who gave me hope. You will recover. You will! xoxoxo

14

Jon I totally agree - why do they all say 4-6 weeks? That is INCORRECT, in my experience with my daughter and MANY of the folks on here. They should say 12 weeks. Yes, you may start to see improvements at the 6 week mark, but you won't be back to your old self. It's slow and there are setbacks. Good days and bad days until the good days outnumber the bad. They also don't tell you that in the beginning...things can get a bit worse before they get better. My daughter said WHY don't they warn you about that? It could have been worse for her because she is so young. She was 25 and they say "in patients 24 or younger" it can plunge them down, and she was right on the edge of that age group. But they should warn everyone of the possibility. That's why I agree with you - I learned a lot more and got a lot more encouragement HERE than from doctors!

15

Hi,

I am recently diagnosed with OCD and I have severe anxiety and would like to offer some encouragement.

4 months ago I was maybe 10% of former self because I thought I was going insane, schizophrenic and had to seek acute mental hospital. Today, thanks to alot of courage, therapy and medication I feel more like 70% of myself and I have overcome many deep fears and conquered much of my worst anxiety.

I am on day 50 of Sert and dose is currently at 100mg and the goal is to reach 150-200. I started with 25 and increased by 25 every 2nd week. Tye first week was worst, I experienced anxiety like never before. Woke up from terrible nightmares with ice running through my veins. I noticed some improvements by week 3 after being on 50mg for some time but then around week 5-6 when I increased I got a big dip. Every time I increased doses it felt like going back to square one with intense anxiety and terrible nightmares. This usually subsides after about 1 week in my experience. A few weeks ago I could barely leave the house on weekends because of crippling anxiety and intrusive thoughts, but last week I've been feeling really good, I have been very active doing exercise, enjoying company with friends and I've been feeling even bored being at home and instead wanting to go out and just do stuff. slowly, i feel the good days outweighing the bad.

Please be patient and wait at least 12 weeks, and keep in mind that with each dose increase it takes long time for the body to adjust. So track your progress and keep a diary and record your mood, this will help to continue pushing through.

When it comes to dealing with anxiety, something that has worked wonders for me is ACT - Acceptance and commitment therapy. You have to accept your anxiety and commit to your life goals, and if those are not defined you have to start thinking about them and set up practical part time goals that you can strive towards. And by doing mindfulness will connect you with the present moment and your body, which works wonders in stopping intrusive thoughts and it cuts the never-ending spiral of anxiety and feeling like you are all in the head because you create a little bit of distance from it. So when you feel like shit, let it be there in your mind without applying importance to it, don't push it away but realize that you are capable of focusing on your life goals and things that mean something to you at the same time as you are having the anxiety. You see, Your life doesn't have to wait and be on hold until your anxiety disappear. Invite the anxiety into the present moment without letting it get to your head, and at the same time commit to life, to what you really care for.

Paradoxically, acceptance has the effect of reducing or even eliminating anxiety, because it is your resistance to the anxiety that keeps the fueling the fire. By focusing on getting away from the anxiety you get attached to it, and you essentially tell the mind that something is really wrong here and you have to give this anxiety feeling some extra importance. And so struggling to get away from anxiety will have counter-intuitive effects in the long run even though it might feel great in the short term, escaping some event that makes you feel bad. So if something makes you feel anxious, don't escape because that will reinforce the anxiety and make it worse. By staying in the uncomfortable and behave differently, focusing on our values we will teach our minds that this anxious event is not dangerous. To break free from anxiety we have to change our behavior, thought is not enough.

Best of luck to your recovery.

16

With the best will in the world, they dont have a clue. I asked my Psychiatrist if I was likely to feel more anxious in the early stages of starting Sertraline and he emphatically said no.

Fast forward to last week I was on the phone begging to be given something to provide relief; again I was met with a no.

There is no desire for knowledge like one has when they are in the depths of despair....just desparate for any shread of hope to cling onto, any nugget of information that may indicate all is not lost.

My Psychiatrist gave me instructions to increase my dose every 2 weeks by 50mgs until I reached 200, and maybe then to increase still if no response. This forum has made me realise that if I had followed his instructions I would have been on course for a hideous time that would doubtless have culminated with coming to the conclusion that Sertraline didnt work for me.

I am so grateful for the advice given on this forum that comes from people that have actually experienced the effects that this drug has on them, and how best to manage it.

👏👏👏👏

xxx

17

Hi Mibuyoku

Thank you for your great advice!

I am so pleased to hear that you have come such a long way. Your story is truly inspirational and gives me so much hope for the future.

My anxiety seems to start off as purely physical; When I am well I am very confident and happy go lucky. I am not a worrier and never have been.

This makes it all the harder to understand, but it seems to me that there are many different reasons that people suffer. Not enough is known or understood about how the mind works and why people suffer with anxiety or depression. Hopefully in the future, continued research will lead to more understanding, and maybe even a cure for these terrible, debilitating disorders.

I hope you continue to feel well and enjoy your life.

xxx

18

Glad to hear that! We can do a lot more than we believe if we put our minds to it, and you can think that you are now on a journey to become stronger. 😁

have also experienced physical anxiety, it seems very common on Sertraline. My psychiatrist said that it is a good sign that I have these symptoms because it means I'm responding to the medicine. She prescribed me to take anti anxiety drugs in the meantime to cope with the side effects because it takes up to 3 months for the brain to adapt to the medicine.

I have the worst episodes in the morning just as I wake up but I activate myself and won't let the anxiety control what I do. And usually it fades away when I behave like that. I Let the physical anxiety be just physical, you know it is just the medicine doing its thing, no need to let it take over all of my attention. 😄

I also have a psychosomatic conditioning where when my stomach gets upset, I get an increased anxiety, and vice versa. What I have learned when I get increased anxiety is that I can influence the mind by giving attention to the body, such as breathing slower and deeper, scanning the body from tension and relax, relaxing my posture, observe my senses, touch, smell, sound, vision. Grounding techniques are very helpful for letting go of obsessions.

I believe mindfulness and CBT are very powerful tools that can help us recover in addition to medication. Medicine can help restore the balance and be used as a band-aid, and future medication might come with even less side effects which is very promising, but we still need to put in some work with ourselves and find new ways to think and behave if we want to achieve lasting change.

Thank you so much! I love this forum. Everyone is so nice and supportive and it gave me lots of hope when I was in the worst stages.

19

Is it possible to change your psychiatrist? A doctor who doesn't listen to patients isn't much of a support system. I could NEVER have gotten through beginning weeks of Sertraline without diazepam. Most people are prescribed something in beginning weeks. I experienced a horrendous increase in anxiety in the first two weeks, and then off-and-on anxiety/intrusive thoughts for two more weeks.
All of your symptoms are typical, but certainly not to be taken lightly. I really think another psychiatrist would be more sympathetic. God bless you.

20

Also looking for some advice.

Sertraline 200mg pooped out after 16 years of working brilliantly. with no life event triggers. I am normally a happy go lucky person (as most of us, the last person in a friends group that you predict would suffer from anxiety and depression). Initially, GP recommended through liaison with Mental Health specialist (pysch) to add Mirtazipine as it has a good track record working in combination and complementing with SSRI's (e.g. Sertraline) in kick starting them again.

Since September last year i have been on a roller coaster ride with doseage trial and error and it is completely obvious that my GP is unable to support as they just seem to agree with whatever i state based on my symptoms that i have been tracking through a spreadsheet.

I have been referred by my GP multiple times for an antidepressant medication review with a psych but i keep getting referred to the Wellbeing Team and talk based therapies. I am already undergoing online CBT calls with Wellbeing Team and using the online CBT Silvercloud service. However, despite repeated attempts from my GP to refer me to a Mental health specialist qualified to discuss medication, i am refrerred back to the same wellbeing team through their single point of access. I've now raised a complaint through PALS (Patients and Liaison Service) to intervene and arrange a session for me to meet with a qualified specialist to discuss my medication as i feel like i am going round in circles and the current system / referral process is failing me.

My latest self medication has been to gradually reduce Sertraline and maintain Mirtazipine at 30mg. I am at a point now where i am not sure whether to continue with Sertraline reduction, e.g. move down to 25mg Sertraline or reduce Mirtazipine. The evidence suggests i should reduce the serraline as i had a significant bad reaction for a number of weeks the last time i went below 30mg Mirtazipine so my gut feeling is to reduce sertraline. I have also suffered no signficantly bad reaction at all since reducing from 200mg sertraline through 150, 100, 75 and more recently 50.

I'm thinking of reducing the 50 to 25 this week and then see how i go on 30 Mirt and 25 Sert combined. I get the feeling it's still going to be a while before i get to speak to a pysch on the NHS.

All i can say is thank god i have loving family and friends to support me. God only knows what it must be like to navigate our underfunded / underresourced alone without any support. My GP told me that the triage lisaison decision making progress above is all due to underfunding for mental health support. The quick fix is drug and talk based therapies but you never seem to be able to speak to anyone with a specialist background in medication (e.g. psych)