My GP Prescribed an Antidepressant Today

Miscellaneous and Personal Stuff I Must Share
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[Notice: Just so I don’t get the inevitable post that contains it, I’m going to mention the US NATIONAL SUICIDE PREVENTION LIFELINE[SIZE=“4”]: 1-800-273-TALK (8255). Apparently if you call there you will magically never have the desire to commit suicide ever again.[/SIZE]]

It’s called venlafaxine. Apparently it will take 3 to 4 weeks to take effect and it could worsen my symptoms in the meantime, not that that really bothers or worries me though.

What does bother me is taking medication for my problems doesn’t really feel right and it makes me a little uncomfortable and uneasy. It feels somehow wrong and ‘unnatural’ and I should just either accept my issues and their ultimate consequences or learn to deal with them without medication (and do I really need medication for them? I don’t think so). It feels kinda like I’m capitulating on my own autonomy, that I’m weak or even perverted* (*I guess this might be a little like what Christian ‘Scientists’ feel when they reject medicine over faith based ‘healing’, or when evangelicals fight against IVF, but don’t get me wrong I’m an atheist, it was just an analogy).

Now I get that there are sometimes good reasons to take medication, like for schizophrenia, bipolar disorder and major depressive disorder, but I don’t have any of those. I don’t have a “chemical imbalance” in my head either (that whole concept seems suspect or at the very least problematic, some interesting articles here, here and here), my problems are much more fundamental and a part of my personality and temperament. If taking medication will ‘trick’ me into believing I don’t actually have any problems at all, is that really a good thing? You might say that taking medication will allow me to work on bettering myself. Can this really be true when I have nothing I want to do and basically very little to live for? Will my purpose in life and will to live suddenly materialise out of thin air when the medicine starts to take effect? I don’t really see if there is a point in even trying to go through with taking them or if I can really commit to it, which I fear that I can’t.

But if someone has experience with this or other SNRIs (or perhaps other types of antidepressants), what was it like when you started taking them, specifically for depression/anxiety/suicidal ideation? Did it change how you felt about yourself, did it make you feel inauthentic or fake?

Could taking an antidepressant sometimes simply be a harmful crutch?

Was it pointless or a mistake to post this? I find it really hard to submit. Cleary I should just shut up and take my medicine like the doctor’s pathetic little bitch that I am. Yes you are. :stuck_out_tongue: I could have said no to them, after all.

P.S. I am also currently talking to a therapist. The second session is next week. I find it a little hard to bring myself to go there again, since what is the point if I don’t have the desire, motivation, discipline or will to change? It’s short-term therapy as well, so it wouldn’t be a huge loss.

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When I started one, I had many of the same feelings and thoughts you did. There was no magical overnight change. It was very subtle and gradual. Ultimately I just felt more energetic and positive. It wasn’t fake, just the better version of me, more often. They aren’t for everyone, but it certainly helped me.

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Coming from a family with many issues, addiction and mental illness among them, I had a very healthy hate on for such drugs. In the 60’s they just drugged people somewhat willy nilly. Both my parents were addicted to them in the end. So I wasn’t having any of that!

So I forced my way forward through life and my issues, reading everything I could and occasionally going to a therapist. But as soon as they reached for their script pad - I was out the door! So I white knuckled my way through largely. I made my way, but with lots of fits and starts. Being seasonally affected saw me careening from hibernating to depression, struggling every year. I did it, I got through, made a happy life and healthy relationships. But it was often messy and chaotic, perhaps with undue intensity.

Mid fifties I landed in hospital and struggled to quit smoking. I was put on Wellbutrin, a mild anti depressant, starting in Sept. I was astounded at how I experienced the following winter, it was so subtle but still amazing. No careening, no depression. I was still exactly who I am, I still tended to hibernate and mope on grey days, but there was an unavoidable difference in intensity. I told my Dr, we talked, and now I take it daily.

I don’t feel any different at all. I can finish the crossword, and outwit my hubby, and seem as creative as ever, possibly more so. To be honest, I look back and wonder how much easier some of the trials I faced, might have been eased, had I been on it then. I feel a little foolish for having waited so long, to be truthful.

If you were diabetic you wouldn’t judge yourself weak for needing insulin. The judgement you feel is fully your own. Deny it. 100%.

It’s the twenty first century, you have access to state of the art researched drugs and care, and would be foolish to not use them, in my opinion. They are just tools.

Wishing you Good Luck!

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Indirect experience from observing my 17-year-old son, who was on Effexor for awhile. He had many of the same issues you express… “it’s not a chemical imbalance in my brain”, “it’ll make me someone I’m not”, “I have nothing to live for”… No, it isn’t a magical pill that takes you to your happy place. It takes a month or two to build up to a therapeutic level.

Eventually the medication got him to a point where he did have the desire, motivation, discipline and will to change. Then he was able to get something out of therapy. Therapy is useless if the patient isn’t receptive, and medication is useless without readjusting your thought processes. The combination is what is effective. He still has issues, but his apathy and listlessness dissipated to the point that progress could be made. The most significant progress was the depression lessened to the point that his psychiatrist was able to observe and recognize OCD symptoms, which are probably the root cause of his depression (OCD->perfectionism->nothing I do is good enough->I’m not good enough->I suck->major depression). He’s since been switched to a TCA-class antidepressant.

He now views the more depressed version of himself as the sick version. He does insist that most of the changes are due to himself being more mature and not the medication. He does value the therapy and does recognize he needs more improvement. Most significantly, he wants more improvement, which is a huge change from a year ago.

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Antidepressants are every bit as unnatural as surgery, radiology, bifocals, and a lot of other aspects of modern medicine. But “unnatural” is not inherently a good or bad trait; whatever benefits or flaws your particular treatment may have, the fact that it’s “unnatural” is certainly not a valid reason to eschew it.

I don’t know the first thing about the circumstances of your life, but if you are actually suffering from clinical depression, then antidepressant meds can sort of “lift the cloud” a bit so you can start to think (and feel) about things more reasonably. You may indeed take a little more interest and derive more satisfaction from various activities than you used to. Echoing others, it won’t be a huge/dramatic/sudden shift, but the flipside is that you won’t feel inauthentic/fake - nor should you, no more than a person who takes meds for hypertension or other ailments.

I really recommend that you follow through, and participate in each session as fully as you are able. An outsider’s perspective on your life can be very helpful; your mind may resist the ideas and suggestions of the therapist at first, but if you mull them over afterwards, they can help to change your state of mind.

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Did you stop using them at some point and how was the transition of using them to not using them?

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Yes, I have gone on and off Paxil a few times. Most people have to wean themselves off to avoid a variety of unpleasant side effects. I was one of the lucky ones who could just quit with minimal problems. However, after about 6 months, the reasons I took the antidepressants in the first place came back. Now I am taking a very small dose.

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Why did he switch?

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I’m glad for you to have taken this important step. You may already be doing this, but if not ask at your session next week about cognitive behavioral therapy (it’s essentially very structured habit changing that you do each day); it works great in combination w/ talk therapy and the right medicine. There are many moving parts to keeping up one’s mental health, each one contributing to the success of the others in working their best for you. Heck, nutrition is even a cog on that wheel, so keep an open mind if it’s suggested that you go to a dietary consult.
As incredibly important as it is, it seems to me a no-brainer to take good care of one’s mental health as well as physical.

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Once the OCD symptoms became apparent, the doctor decided to target that aspect, with the theory that mitigating the OCD will have the side effect of lowering the depression. Tricyclic antidepressants target obsessional thoughts and behaviors. So far, nothing has occurred to disprove the theory. As his OCD lessens, we’ll keep an eye on the depression to see if there is a corresponding decrease.

This brings up another point. If the Effexor/venaflaxine does not work, don’t assume that medication won’t help you. There are lots of different medications and classes of antidepressants. Finding the right one for you may take a bit of trial and error. Don’t give up.

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I dont know if this is what you had in mind when you wrote “stop using them” but it is VERY IMPORTANT to NOT abruptly stop taking Venlafaxine. Sudden, complete cessation can have a lot of really unpleasant effects. Here are some listed on this site:

Anxiety, confusion, or agitation
Lack of coordination or vertigo
Nausea, diarrhea, or vomiting
Sleep disorders or nightmares
Headache
Dry mouth
Fatigue
Brain zaps (electric-like shocks)

My personal experience of this happening (exactly ONCE–it was so nasty I made sure it never happened again) was after I forgot my pills when I was traveling. After 48 hours I felt nauseous, dizzy, and experienced a feeling of dread and impending doom. Some of the way I felt is indescribable, really. I can only sum it up as feeling very, very, bad both mentally and physically. I was terrified. Very close to going to an ER just to get supportive care and hopefully some Venlafaxine. I ended up having my doctor phone in an emergency prescription to a nearby pharmacy.

Once established on Venlafaxine one should only quit taking the drug under the care and advice of their doctor. Generally one needs to very slowly ween themselves off of the meds. It can take months to get down to zero. I believe sometimes another drug, such as Prozac, can be used to help take the “edge” off of the ramp down. After you are down to zero Venlafaxine, you stay on the Prozac for a short period of time and then you can safely quit the Prozac more abruptly than Venlafaxine.*

  • This is what my doctor said could happen in my case. It is different for everyone. Follow your doctor’s advice. I am not a doctor, I am not YOUR doctor.
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I just wanted to add to my previous post that Venlafaxine seems to be somewhat unique among anti-depressants (there could be others, I don’t know) in terms of the dangers in abrupt cessation. AFAIK quitting Paxil does not have the same nasty effects. Although quitting ANY anti-depressant should be done with care and perhaps tapering off, Venlafaxine is different. Quitting that takes special care and handling.

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Jesus, what dosage were you on when you forgot them for your trip? I’m having serious doubts about taking them now.

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I have been on antidepressants, namely Prozac and Wellbutrin, for a little over 6 years now.

My depressive symptoms have been with me nearly all my life. Much of my adolescence is colored by the suicidal ideation I experienced most of that time. But I didn’t have a true major depressive episode until I was in college. My friends saw that I was beginning to spiral out of control, that I was sabotaging my job and my grades. They staged an intervention to try to convince me to get help and I responded by threatening to kill myself. I probably would have done it too if they hadn’t called 911. A sit down with two police officers tends to be a bit of a wake up call.

I tell you this because, even with all that, I really did not want to be on drugs. I thought I would be ok without it, that I was not in bad enough shape, that I was not sick enough to need drugs to be normal. And, you know what, in the midst of the depression, it is really hard to see yourself as you actually are. I did need drugs and therapy to get better.

When the Prozac started to kick in, I started to being able to care about things again. It was like the color came back into the world and things felt like they mattered. Eventually, we added Wellbutrin to help bolster the Prozac and to help fight some of the side effects I was having, namely not being able to fall asleep. I’m not entirely sure how it helped but I only needed the combination for about a year.

With the medicine, I feel like I’m the best version of myself. I am not the selfish, self-defeating, self-deprecating, annoying asshole that depression makes me. I can feel genuine feelings and sympathize so much better with other people.

It isn’t for everyone but don’t think you are weak for needing it.

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I take a combination of a seizure medication, an old ADHD med, an antipsychotic, and an OTC med (melatonin), to sleep every night. I also have PRNs, but I take them rarely. I have really intractable insomnia, which shows up in unusual patterns in a sleep study. I tried every possible aspect of “sleep hygiene,” as well as resetting my circadian rhythm by staying up for 24 hours; I went cold turkey on caffeine, and nothing helped. I tried a TCA, which helped, but it made me crave sugar like a housefly.

The seizure medication, ADHD med and antipsychotic I take are at subclinical doses for epilepsy, ADHD or a psychotic disorder like schizophrenia, and I take some of them at what seem like odd times of day for sleep, but combined with going to bed within an hour of the same time every night, and I sleep really well now. I take the PRNs only when something unusual happens, like flying to a different time zone, or staying up with a sick kid.

I had to get over the psychological hurdle of “sleeping is NORMAL.” I should be able to do this without drugs, to realizing that I need to be able to function, and I can’t do it without sleep. I once was awake for two nights in a row, then slept for just two hours, and went to the doctor, who insisted that I go to a shrink who did sleep studies. If I agreed, she gave me 30 days worth of Ambien (that’s how long it took to see get into see the shrink).

The medication will probably make you function better than you did without it. If it doesn’t, you can try a different medication. But this isn’t the 1960s. Drugs don’t have so many side effects that only the very ill should take them. Psychiatric drugs are very “clean” now, with few side effects. People with mild depression can take them and improve a life that was livable, albeit difficult. It may be that you were coping, but you can be better. It’s like evening the playing field, so you can be like people who don’t even have to “cope.”

I mean, cripes, it’s the 21st century. We used to order stuff by catalogue, and wait 4-6 weeks. Now we order on Amazon, and it gets here in three days, and we have drugs that are so good, they help us with even problems that wouldn’t otherwise have us in an institution.

I would say try the drug. If you don’t like the way you feel on it, you can always go off of it. If you sort of like it, but have reservations, talk it over with your doctor, and try a different drug. But don’t live in the middle ages.

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What would you say to some therapists who are sceptical or wary about pharmacological interventions over psychotherapy? There are some who think that antidepressants for most forms of depression (excluding severe or treatment resistant cases) are basically a money grab and that most people can be “cured” from depression with some kind of talk therapy.

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Anti-depressants made a huge difference for me when I felt exactly the same way you describe. Ironically, I was prescribed Cymbalta to help with nerve damage in my back. It helped with that, but I also noticed that I started to care again and to find meaning in things that had lost any importance to me.

Some of the warnings sound scary, but don’t let that scare you off. I’ve tapered off meds and it was not an issue.

It is a wonderful thing to be able to connect to family and friends again. To find beauty in the world. To laugh and smile. Even just to enjoy a movie.

Give this a try. Happy to answer any questions in the thread or via PM.

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So your doctor didn’t know you had what sounds like depressive symptoms and the fact that it helped with them was totally serendipitous?

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Yep.

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That’s kinda crazy, but I’m happy for you.

It makes me feel a little more at ease to know that it could help me (not that it totally makes that uneasiness go away, but I’ll probably manage I guess).