Should I start on medication?

Mental health
1

Hi all

Firstly, I'm kinda glad to have found this forum, hoping to get some help and support as I'm not sure where else to get it.

So, a small bit of background first... I'm just over forty and was diagnosed with depression and anxiety a couple of months back now.

I feel like I'm going to sound very ignorant now but I think, if the diagnosis is right, I have misunderstood what depression is for most of my life... I understood depression to be feelings of sadness, despair and hopelessness that were not brought on necessarily by any actual negative thing happening, but was an illness, be it caused by a chemical imbalance or something else 'medical'.

I have had some horrible things happen the last few years. I am not going into detail, I don't think it's necessary but between loved ones being diagnosed with potentially terminal illnesses, total career failure, loss of all sources of income, death of family members and numerous other things... I've kind of been left feeling totally dead inside. I have always had a fear of death and this past couple of years it has become all-consuming, I can't go more than a couple of hours without thinking about the futility of life and the fact I am going to die and how pointless that makes everything I do.

I haven't bothered going to the doctor about this until recently because I didn't feel this was a 'condition' to be treated, it was just the way anyone would feel under similar circumstances, I guess a suitable analogy would be... if your head suddenly started hurting for no reason you'd go to the doctor to investigate and hopefully give you something to help ease the pain.... if however someone had just punched you in the head, you wouldn't bother... it's obvious and normal why your head is hurting. That's how I felt... I had mentally been punched in the head, repeatedly, for several years, so I didn't need a doctor to help, I needed to stop getting punched.

I still kind of feel like that, like NOT having my life destroyed and having no hope for the future is the thing that needs to be fixed and my mental state will recover accordingly. I suppose I have only now decided to go to the doctor because I have realised that's unlikely to happen and I no longer have any motivation or energy left to try and make it happen, I have resigned myself to the fact my life has pretty much ended with no hope of anything actually improving so I need help mentally coping with that new reality.

Anyway... what I wanted initially was therapy, I wanted to speak to someone, but my GP said I'd have to wait months to get a referral, and I should pay to do it privately... the irony of me being pretty much bankrupt and being told the only way to get help is to pay for it at an insane rate per hour was not lost on me, at least I can still laugh about that :-)

I have been referred and after a few months I have a phone assessment appointment booked for about 4 weeks from now.

In the mean time, my GP was insistent that I should be on medication and has prescribed me Sertraline.

I've read the list of side effects and I must admit I'm scared to death! It sounds like I need to be on them for weeks before I expect to see any positive effects and the negative effects seem to be immediate and in some cases pretty horrible. The withdrawal symptoms when I stop them sound even worse.

I am very tempted to not bother starting.... I guess I really want some advice on whether I have actually been correctly diagnosed and whether starting medication like this is going to be worth it?

I sort of feel like artificially masking the feelings of anger, pain, hopelessness and unhappiness isn't going to help me get my life sorted out... is it really a solution?

Anyway, my thanks in advance for everyone's help and advice....

2

It’s a good thing you went back to the dr and came here. The meds do take a little while to work. But, you will feel better. The meds and therapy will help you to cope with the depression and anxiety. If they don’t work or make you ill the dr will change them. Keep in close contact with your dr. While taking them so that you will be monitored. I’m sorry for everything that has happened to you. You deserve a quality life. We all do, but unfortunately we are all suffering from this disease. It may go away after being on the meds for a while. I too am suffering deep emotional pain and have a very hard time facing each day when I wake up. But I take the meds and I feel better. When it is too bad I come here and call my dr. I hope that I helped you. You can always come here. This is your safe place. You can talk and vent that helps a lot too.

3

Carmela, you replied to Ben so much more elequently then I could. I hope he takes your advice. 

4

Carmela's advice is excellent. Yes there will be side effects and theyvrake time to work but you will feel better. This place was invaluable to me when I started taking meds and confronting my problems. People have been through it and know and sympathise with how you feel. No judgement whatsoever. I agree though you must stay in close contact with your Dr when you start the meds. I hope this helps and you feel better soon. Take care

5

Thank you so much I really needed to hear that 

6

Hi Ben,

I found that the depression meds I was prescribed made me so tired and I hated the feeling. I should have given them longer I guess, but as they had made me feel even worse, I came off them and the experience of feeling worse oddly made me feel better. 

My boyfriend has ocd, anxiety etc. He has been on them for a few years. He came off them for a bit and it made him get worse again, so they do seem to help. I do notice that he doesn’t seem as with it emotionally but I guess that part of that could be everything going on in his head and using alcohol. 

There are different tablets that you can try if the ones you’re on aren’t working. And yes they do take a few weeks. 

It’s great that you have tried to seek help. That’s a great start. 

There are charity organisations, for example Mind and Cruse(cruse is a bereavement charity. You may have to wait a couple of months again though). 

A lot of private councillors also work in the NHS, so you get a good service once you’re in the system so it’s worth bearing with it. If you could afford privately then they don’t like you on the nhs waiting list. Something about ethics we were told! 

I found that going out for walks and seeing my friends (even though I didn’t want to!) actually did make things better once I was out. 

I hope you can find happiness in your life in the near future. 

7

Ben

It does sound in several different ways yo are suffering from Depression. We just need to consider those deaths of people you have known and any other problems within your Family dynamic that would also cause you problems. and become problematic within their own right.

Your past work environment and your lack of work and finances will also be a problem for you.

I look at this as a group of five where people have to many problems on their mind and they are unable to actually approach each problem in an inclusive way. Five problems depending on situations can prove to be a problem as many of your concerns have been out of your hands and you now need to approach each problem  in its own right and attend to each in a singular fashion. You brain will be stuck and can only see your problems as one big problem causing you anxiety and depression. Your lack of work will also be a serious complication .

What I would suggest in the first instance is to talk to family who knew the deceased, a first line member is the best like a parent, Brother Sister, or any in laws etc. Talk out the loss to them to talk about their life helps you celebrate the loss both good and bad memories and that will help you sort out your problems, memories remember for example activities, both good and bad. Doing that will help you not forget, just in remembering them for what they are, you will never recover from a loss that is part of life, you need to move on and that iwhat the dead I suppose would expect you to do.

When it comes to work that is a real problem, I am retired and sixty seven now and believe me when I say everyone still expects me to help with their interests at the loss of my own hobbies.

If some problems are so difficult I would advice you discuss your problems with the Job Centre or even look for retraining in some other type of work. Even if you have to take on work that normally you would not do, to find work When in work is easier than sitting at home. Sometimes voluntary work may help. It is just to keep your hand in. In that way yuo may be able to retrain as yuo look for employment.

Any other problems or concerns, cut each problem into small pieces, deal with those small  bites of each, when stuck move onto the next problem, do not stay on the problem you are stuck on, move to the next small bits again etc smaller bites are easier to sort than looking at a problem in its entirety.

It is very important you do talk and communicate with your relatives, regards the deaths.

You need in many ways be able to keep the brain working and not dwell on yesterday keep busy and live for the day when possible or yo will become stale and employers will notice that

BOB

8

Ben take your medications

If in the UK you do not need to pay for CBT, look for mental health day centres, they can sometimes give CBT in a rationed way until you get your NHS Treatment

BOB

9

Thanks all for the replies so far, I appreciate it.

I feel I should explain my situation in a bit more detail...

The deaths I spoke of were not a close relative, I don't mean that to sound callous or like it wasn't a contributing factor to my current state of mind, a friend who was about the same age as me (not a close friend, but someone who was part of my social circle and who I cared about) died about 2 years ago very unexpectedly from a heart condition, like me, he was overweight, stressed and not very healthy. That was part of what triggered my sudden all-consuming fear of death, it became imminent and a lot more real. We also recently lost an elderly relative in the family in a horrible way through a long drawn out disease, watching them suffer was also part of the trigger.

In terms of my work/career, I feel that is the main problem, the biggest issue by a long way for me solving my situation. I've worked for myself/run my own business for most of my adult life, at least 15 years now. Until recently I have felt I was utterly useless after everything has gone wrong with my career, I am trying to work on my self esteem as I actually, when you look at it on paper, am a massively skilled person, I've done things that a tiny handful of people in the entire World have done and in my twenties I felt like I was invincible and heading for massive success.. my problem is that I am VERY highly skilled in very specialist areas that only working for myself can really utilise. There is no external company that can really employ me and use my skills, if there were there certainly isn't one within 3hrs drive of my home.

I feel totally trapped and useless where I am... I am unable to support my family despite having all these skills because there is no work nearby I can do, my wife is working full time AND studying at university, my daughter is in a school she loves, we can't move house for me to try and find what would probably be very low paid specialist work elsewhere.... I am trapped at home trying to run a small business that is taking up 60+hrs a week of my time but earning about 70% or so of the money I need to support my family.

I'm on a treadmill and I can't get off.... I have to keep working more hours than exist in the working day just to keep our heads above water but I need time to stop, work out what my skills are, what I actually want to be doing, what I could be doing, maybe get extra training.... but these things take time and money and I have neither so I stay and the treadmill just runs faster and faster.... the ONLY way out is for us to suddenly get a windfall of a chunk of money... but there's no way that's happening any time soon.

I have not had a single day... a single hour where I have not been worried about our imminent bankruptcy and being thrown out on the streets in at least three years now... it has been utterly constant... we have just had financial disaster after financial disaster... I have always considered myself an entrepreneur and I am a massively creative person too... I have launched three companies and about 8 new commercial projects in the last 6 years and every one has failed horribly, been forced into liquidation due to the mistakes of an incompetent accountant or made a tiny fraction of the income everyone in that industry thought it would.

I guess I've got to the point where... having just picked myself up again and tried the next thing every time I got knocked down year after year for the past 15 years... I have finally just decided to stay down. I have no ideas left, I've spent SO long thinking the next project, the next idea is the one that is going to work and we'll finally have the life we deserve, that I have kinda now just had this moment of realisation that this success is never coming, I can't risk taking any more chances, I can't risk trying any more of my ideas or launching anything new.... I just have to accept I made the wrong choices 10 - 15 years ago and those can't be reversed or remedied now, I am destined to never have any commercial success and have to just accept that and find a way to just survive financially with no joy, or happiness, or hope in my life until I die... that seems to be what destiny has in store for me.

5 years ago if I heard anyone else talking like that I'd have kicked them up the ass and told them to stop being SO damn melodramatic and just get on with trying something, but I just feel SO beaten down now that I have no interest, no motivation in anything... life just seems like one massive unfair piece of cr*p and if life won't play fair with me, I don't want to play any more.

That sounds like I feel suicidal, I don't, never have, the idea of suicide has never made any sense to me and I still feel that any life is better than no life.... but I just don't know how to live with a life that is so awful and having no hope at all of it getting better.

Right now I should be working, I have 30+ customers shouting at me to do stuff for them they've paid for... but I have no motivation, I just don't know how to get out of this hole so why should I bother starting to climb?

I also have no friends nearby... we moved away from where I grew up about 8 years ago and I have no time or money for any hobbies or leisure and I know no one at all here so I have no friends to talk to, no one to go for a drink with... just me, here, alone and thinking about death. I used to have hobbies that were the focus of my life, that I cared about more than anything.... but again, to be involved in them means giving up a load of time and having a load of money for equipment that I don't have and don't see me having any time soon... I even used to have creative hobbies I could do at home that didn't cost much, but those too take a load of time and I can't spare any time to do those so I have no enjoyment or personal time to work on those.

Anyway, sorry, that turned into another massive rant.... I guess I've been looking for somewhere to talk about all this and haven't found it yet.... it's nice to be able to just let it out.

I've had mixed advice on the meds.... yes, my Dr prescribed them after I filled in a 1-side questionnaire about my emotional state... I must admit, I don't trust my Dr and that's partly why I am seriously questioning the prescription.

I am not sure if I want to go through weeks of side effects (especially given how mad my life is and how I have no time spare to deal with anything like tiredness or sickness) just to see if they help in any way... I honestly can't see how they can help... I honestly feel like I SHOULD feel like this, my life is cr*p and making myself feel artificially happy isn't going to help motivate me to fix it.

I guess that's part of the anxiety... I analyse everything in infinite detail all the time.... I can see the disaster scenario from every decision before I make it so it's safer to avoid that situation or not make that decision... especially given my luck the last few years, everything that could possibly go wrong, even things that had a 90% chance of success, have gone wrong... so better not to take the risk of anything else going wrong and making things even worse or harder to get out of than they already are.

Also, the side effects say you need to not drive for 3 days when you start taking the medicine due to drowsiness... which is great but I have to get up at 6:00am to drive my wife to work every day or she'll lose her job and we lose our house... so there is NO point in the next few years where I can stop driving for 3 days.

This cathartic exercise has not worked :-) I now feel worse having explained the situation :-)

10

Just to add... I bit the bullet (probably a good metaphor) and took the first tablet today... gonna at least give it a try...

11

Well done. Stay in touch as you may find you feel good and in a week or 2 you will feel worse. Good luck and take care

12

Thanks.... that's my worry, pretty much everyone has said that it takes at least 3 - 4 weeks to get any positive benefits and it may well make me feel worse fir the first few weeks... I am not sure I can deal with feeling even worse at this point, I am too busy to feel ill or to have my mental state deteriorate further... but I'm gonna see.

13

You may not. Everyone is different. Just stay in contact with your Dr. There are many things that can help while you are adjusting to the meds

14

I started on that same medication15 years ago because of years on and off of anxiety. It really helped.  I would recommend you try it.  I didn't have any side effects.   It's worth the try. If it doesn't help after about a month you can alway stop.  Just don't quit cold turkey.   Talk to your Dr. if you want to stop and they should very gradually reduce the meds.   Very important to remember - "what you think determines how you feel"  so pay attention to what you are thinking and telling yourself. Stop negativity and tell yourself good things. Stop the worry.  Think good thoughts.  This will make you feel good.  Also look up " tapping "on the internet and try that. 

15

How is it going? You need a comprehensive approach in treatment for depression. If you combine medicines and psychotherapy, you'll feel much better soon. A few sessions of psychotherapy might work for you.Just talk to your GP or psychiatrist about it. Our life is short, enjoy every moment of it!

16

Thanks again all

To reiterate, I do have an initial phone session/assessment session booked for February which is the earliest they could do anything for me on the therapy front... it's at least a three to four month wait to get any kind of help at present and adult depression is not considered a high priority.

I started on a half tablet dose per day instead of the full 1 tablet to 'ease' myself in as I wasn't sure about the side effects and my need to drive every day given some of the stated side effects...

I am guessing it was the placebo effect but I actually felt mentally MUCH better within 24hrs and have actually felt very positive and been working on fixing various things in my life this past week since I started... I have had a bit of a setback today, woke up feeling inexplicably down and then had a financial setback which has got be very worried again.

I am upping the dose to the full tablet this week, will see how things go.

I have had some mild side effects so far, hoping they don't get worse when I up the dose.

17

Quick update...

I started on a 50% dose about 2 weeks ago now... went up to a full dose last week... about to hit the 2 week mark since I started.

So far... no significant side effects, a little nausea the first few days but nothing since, a few slightly dizzy/lightheaded spells too but again, only for the first few days. I have had a couple of days since going up to the full dose where I have got to about 9pm in the evening and just suddenly felt SO exhausted I had to go to bed and sleep immediately, and a couple of days where I've woken at about 5am in the morning with my mind racing and been unable to get back to sleep again (which is very unusual for me).

The positive side is... I seemed to feel better psychologically from day 1.... initially I thought that MUST be the placebo effect in that I felt like I was 'doing something about my problems' and therefore just felt more positive because of that but it has continued and I have only had one 'down' day (caused by a sudden and unexpected financial crisis) which I managed to get through much better than before and the CONSTANT negative feelings that were plaguing me all day every day seem to have largely gone already?

I'm hoping the positive effects continue and/or get even more pronounced as I hit the 3 week point where most people seem to claim they start getting a real benefit.

Will update again in a week or so... felt I should post with what's happened so far as the only personal experiences I could find when I was making the decision whether to start on the Sertraline were from people who were complaining of massive side effects and a very slow positive effect.... wanted to balance that out with my experience at least :-)

Thanks again all for the support so far.

18

Glad you are doing better. I still find I wake up early and feel anxious burnt dies pass. Please Do stay in touch. We all help each other through x

19

Well done Ben! How's it going now? Give yourself credit too...it's not just all about the meds. Your positive attitude is a big part of the way forward. Don't over-analyse where the positivity is coming from....placebo or not....just hold on to that good attitude & if u experience any wobbles, which is common, don't beat yourself up & think u are back at square one. It's just likely to be a pause on your journey to recovery. Keep us posted. Good luck!

20

Hi Ben, in my personal experience (had bouts of depression off and on for different reasons since I was 12, I'm now 36) over the years I have dealt with it by being a stubborn determined little sod and got through it on my own and other times with meds which was a longish, annoying, stressful journey until I finally found one that suited me. I almost gave up on trying medication ( I'd always felt strongly about relying on meds up until I'd tried all other options) thing is I'm so glad I gave yet another tablet one last chance as it turned out to be the one that helped me get better. Yes it takes a few weeks to get into your system and yes it may feel even longer until you notice a difference but the important thing is they will make a difference. Therapy is also a good idea and it's great you are open to that as I've never been great with talking about feelings and to be honest I always thought therapy was pretty pointless. Untill i tried it, and now I would recommend it to anyone. You sound like you are in a pretty realistic place concerning your mental health so my advice to you would be, if you truly feel like you can wait for your therapy appointment as you are then put off starting on meds. But if you feel you might not be able to fight it till then, discuss meds with your GP you can always request starting on the lowest dose. I wish you all the best