Tag Archives: antidepressants

Antidepressant withdrawal effects – my experience

Antidepressant medication is undoubtedly a life-saver for some people. My number one piece of advice where the decision to take antidepressant medication is concerned is to educate yourself, make an informed decision that’s right for you and don’t be too hard on yourself if you make some mistakes in managing this – I certainly have made a few that I want to share with you with the hope you’ll find it helpful and maybe even avoid making the same ones as me!

One of the things that I feel isn’t discussed enough is what happens when you’re ready to come off antidepressants. I hope that this post outlining my own recent experience will be helpful for you if you’re considering going on or coming off antidepressant medication yourself, or if you’re supporting a loved one with this. If you’re feeling vulnerable at the moment, please come back and read this article when you’re feeling stronger in case you find it triggering. 

If you read my story last year about burning out and how I felt about being on antidepressants, you’ll know it was a difficult one for me to write and made me feel very vulnerable, as these personal posts continue to do. The good news is I’m improving and squirm a little less when talking about it now! 🙂 I was really resistant to accepting medication and felt the stigma when I was put on Citalopram by my doctor. After coming off six months later and going through awful and unexpected withdrawal effects, I was put back on them again – this time for over two years.

Coming off antidepressant medication

It’s now a month since I took my last antidepressant and you know what? I’d say it’s bloody tough – maybe more than you’d imagine – but it’s doable. You can do it. Even when it’s scary. Even when you’re not sure you’ll manage it. Even when life’s throwing curveballs. Obviously, it’s better to do it when life’s more settled if possible, but we can’t always predict these things!

I felt much better prepared this time. I consulted my GP and followed his advice to the letter, tapering since April so I would reduce through spring and come off in summer when my Seasonal Affective Disorder (SAD) symptoms are usually at bay. Things were feeling pretty stable in my life. I was ready!

Now, I’m pretty bloody-minded, I’m afraid. Some would say stubborn! I made my decision when I was coming off the medication and I wasn’t letting anything stand in my way! So of course… cue lots of unplanned big life changes to test my mettle! 😉 I was made redundant at the end of April. I got engaged in June. Then I went self-employed and am working to build two businesses. I’ve just been on a family holiday for the first time with my fiancé’s children and parents and I’m preparing to move house… all while tapering and suffering withdrawal effects – eeek! What did I say last year about lessons learned?!

I saw my GP again around two weeks before I was due to take my last tablet. I was managing the tapering pretty well at this point. His advice was mixed. One moment, on hearing about my life changes, “well should you be coming off them, then?” A resounding ‘yes’ from me as I was excited by my progress! To then, “well since you’re only taking 5mg every other day it’s nothing… just come off now.”

Hmm. This is the problem. I had a plan, and I stuck to it. I naively believed I’d have a much easier ride this time as I’d tapered over four months. I’d read up about it in advance this time and knew where I’d gone wrong last time. I knew to expect a bumpier ride as I got down to the lower dose. But I was only on what my doctor had called ‘a mini dose’ of 10mg to start with… so I would be fine, right?

Well, not entirely – but at least I had some previous experience with this! With hindsight, I can see that it wouldn’t really matter how much you’re on to start with as you’d have tapered down over longer, reducing your dose. As it turns out, coming off 5mg doses of a short half-life antidepressant can still give some people a rough ride!

I had all the same physical stuff as the last time I stopped – nausea, dizziness/vertigo, feeling disconnected from my body, sweating, pins and needles from shoulder to fingertips, brain fog and insomnia – delightful! I didn’t have the ‘brain zaps’ some people get, though – small mercies! These are pretty much the same symptoms I experience when starting them, too.

Did I mention that being the genius I am, I’d also very helpfully timed my last tablet to be a few days before a bout of PMS kicked in? Joys! Emotionally, the numbness I’d been experiencing lately while on antidepressants gave way to a flood of emotions – literally! I felt very tearful and fearful for a couple of weeks. This can be really scary if we’re not prepared for it because it can make us feel like we’re ‘re-lapsing’ into depression or anxiety.

We need better education about antidepressant withdrawal effects

I’m a bit of a ‘seeker’, so naturally, when I was feeling really awful I researched further to find out more about what was going on. What I read made me feel a bit better, seeing that what I was experiencing was ‘normal’. But in the thick of it, I also felt angry, to be honest – with myself mostly – and with my prescribing doctors. I’m not saying I was right to be annoyed – I just was!

I thought that while my doctors had been very insistent that I should take antidepressants, they hadn’t discussed with me just how difficult it can be for some people to come off them again. But then I reflected that maybe they didn’t understand it themselves. And I hadn’t educated myself fully before going on them, either. I’d put a drug in my body for a prolonged time without completely understanding the consequences and how tough it would be to stop. I felt really stupid. Worse still, I’d never been fully convinced that I needed them, especially as the weird autumn stuff happened regardless!

In a New York Times article I read, a couple of psychiatrists admitted that they only fully appreciated how tough it was to come off the medication when they did it themselves. Maybe this is the difficulty – just as you can never fully understand how depression or anxiety feels until you’ve gone through it yourself.

So, I think that while it’s brilliant that as a society, we’re starting to discuss mental health more, I’d love to see more education for everyone about antidepressants, their side and withdrawal effects. Mind is a good starting point – I’m really grateful for their website!

So, what have I learned, that I’d like to share with you?

I gave an overview of my personal advice based on my experience at the top of this article. I’m sure you can see the mistakes and lessons sprinkled throughout, too! Everyone’s different and ultimately you need to decide in consultation with your doctor what’s right for you individually.

However, here are some pointers I would give myself if I had a time machine and could go back in time:

Make an informed choice:

  • It’s really important to educate yourself about antidepressants and their withdrawal effects. This allows you to make an informed choice about whether you want to take them or not. You’ll know what to expect when going on and coming off them, so be less worried about any side or withdrawal effects
  • Don’t be afraid to ask your doctor for some time to think about it before being prescribed antidepressant medication. Know that you ultimately have the choice and it isn’t one to be rushed unless it’s a medical emergency
  • Discuss with your GP whether you’ve tried all the alternatives – have you tried lifestyle improvements like exercise, eating a healthier diet and getting more or better quality sleep? How about talking therapy/self-help like Cognitive Behavioural Therapy (CBT)? Light therapy if it’s Winter Blues/SAD?

Prepare for coming off antidepressants:

  • Plan carefully for stopping your medication when life feels stable, you’ve got a good support system and you’re feeling strong
  • Prepare to taper for longer than your GP might first advise. You can cross-check with Mind’s helpline advisors if you’d like a second opinion, as they say this is common
  • If you’re on a drug with a short half-life (I was on Citalopram; Sertraline’s even shorter) open a discussion with your GP about switching onto an antidepressant with a longer half-life (e.g. Fluoxetine). You could also ask about a liquid medication so you can reduce your dose by tiny amounts. Again, Mind can advise you about this
  • Learn about and practice self-compassion and self-care so that you can show yourself kindness as you reduce and come off
  • If you’ve already been open with family, friends and colleagues about your depression/anxiety and medication, you could let them know your plans so they can provide support and understand what’s going on

And now?

We all love a happy ending to a story, don’t we? While it’s still early days and I’m not counting my chickens just yet, I’m feeling loads better. 🙂 I still have a touch of insomnia, but everything else seems to have settled down.

What I hadn’t prepared for was the lovely upsides; things feeling more vibrant! I feel like I’ve had a big woollen muffler taken off my senses. I’ve found that colours seem brighter, music richer-sounding and I have a keener sense of smell and taste again. And yes, this does mean I’ve been going around smelling the roses!

I’ve also started to feel more connected to my feelings and intuition again in the last few weeks. Even when I’ve been tearful and anxious I’ve felt grateful in some measure. I really missed the sense of living that comes with experiencing feelings fully. That’s a difficult one to explain, but I hope you get some sense of what I mean!

As ever, the patience and loving support of my fiancé, friends and family have been instrumental in helping me navigate this transition – so much love coming your way! <3 I’m so grateful for you as readers, too – you continue to inspire me to keep showing up and sharing my lessons with you all.

I’d love to hear your thoughts and questions below in the comments, or if you prefer to email privately you can reach me on admin@littlelightroom.com

Stigma and sitting with fear

Last month, I published and shared a post on my social media channels about using antidepressants to manage SAD and touched on the stigma I felt about them. It really seemed to resonate. So much so, that it had over 900 views. I received around 100 comments and private messages from friends, family, colleagues and even people I didn’t know. This response was completely unexpected – so humbling and overwhelming.

I felt such a wall of love and acceptance around me and over a month later I’m still feeling bowled over by it. Thank you so much if you’re reading this and you were one of the people who reached out to me. I’m not able to do justice to describing how much it meant to me.

So, what did we learn about stigma from this experience?

The first thing that became clear to me and hopefully to everyone else, is that the world doesn’t come crashing down around you if you share your experience of depression, anxiety, SAD, burnout, adrenal fatigue, mental/nervous breakdown… or any other common type of mental ill health.

I hope that if you saw the Facebook post you took strength and inspiration from the wonderful people who commented. You should be able to click on the comments icon after the post to read them:

I had a huge ‘vulnerability hangover’ after sharing this post and I wanted to delete it. How glad am I that I sat with that uncertainty and fear now though?! 🙂 If I hadn’t, we wouldn’t have seen the level of support that people can show when we allow ourselves to be known.

Is stigma a misunderstood term?

Interestingly, some of the conversations highlighted people’s different understandings of what stigma is. It made me wonder whether we have different interpretations of how much of a problem stigma is because of these discrepancies.

In its dictionary definition, it sounds very severe: “A mark of disgrace associated with a particular circumstance, quality, or person.” (Oxford Dictionary)

For me, it isn’t just about an obvious ‘mark’ that would indicate something about a person, that you could perceive from the outside. And it might not always feel like full-blown ‘disgrace’; it can also be disapproval or contempt. I believe that is still stigma.

Anything that incites shame around a condition, circumstance, character or behaviour, I would call stigmatising.

I’m really interested in hearing in the comments what you consider stigma to mean, if you feel able to share?

Don’t judge a person until you’ve walked a mile in their shoes…

This commonly-quoted Indian-American proverb of unknown origin is as wise and relevant today as it has ever been. When we look at what is happening in the world, we see so much suffering that stems from judging others.

Most mental health stigma seems to come from lack of knowledge. It’s okay for us not to know what we don’t know! But the distinction is that it’s not okay to negatively judge and criticise what we don’t know – that’s what makes it stigma.

Often, we can hold opinions about something that are not our own. We can soak up the general feeling and opinions about a topic like a sponge. Children in particular are primed to learn from others in this way. We can teach them well or poorly.

If you hear enough people criticising antidepressant users, for example, you can shame someone for taking them, without knowing anything about them.

The majority of people we know would consider themselves to be non-judgemental, I’m sure. If they say something out of lack of understanding we forgive them, when they respond in an open way as we have a conversation with them about the topic.

The need for empathy

Sadly, as is so often the case in life, our memories are coloured disproportionately by the minority. Those individuals and experiences that leave you feeling raw and vulnerable. Our primitive brain makes us protect ourselves from further harm by magnifying and making us feel fear.

I have an example to share with you from my own personal experience from a few years back. Talking about my experience of SAD one day to my team, my colleague interrupted me and said, “don’t be ridiculous; you can’t get depression because of the weather!” At first, I thought maybe what sounded like contempt was meant to be a joke. Her first language wasn’t English, so I understood that sometimes this can happen.

However, as the conversation progressed it quickly became obvious that the contempt and attempt to shame me was deliberate. She couldn’t empathise and refused to listen to my explanation, believing she was right and she knew more about depression than I did. The real kicker was that some time later she started to complain that she felt that the weather was making her tired and getting her down, while asking for my advice about a dawn simulator. Had she been able to empathise earlier she might have been able to recognise and head off her symptoms before they started to affect her.

Little Light Room - less stigma more love

Opening up…

The memory of this experience and others like it is what bubbled up in me as I was sharing my post last month. The irrational thoughts of ‘what if people think I’m weak or just being self-indulgent?’ and ‘will this damage my professional profile – what will my colleagues and clients think of me?’ were very loud and insistent!

So why did I not only publish the post, but share it publicly on my social media channels? Well, I feel passionately about the topic of improving mental health and our need to overcome stigma as a major barrier to this. But I felt like a fraud because I was still hiding the extent of my experience myself. I genuinely want to help people understand and feel understood, but fear was holding me back.

The reality is that most people are able to empathise, if we are brave enough to face down our fear of being judged and share. Only by more people being more open will we be able to overcome stigma. This isn’t easy for any of us and we must do it only when it’s right for us.

The reward has been that I felt more love and acceptance than I could ever have imagined when I shared. I hope one day we’ll talk as openly about our mental health as we do about having a common cold.

How can I manage SAD symptoms? Part Three – medication and talking therapies

This is part three of ‘How can I manage SAD symptoms?’, where we take a look at medication and talking therapies.

Part one covered bright light therapy, which is delivered via a SAD light and is highly recommended for treating Seasonal Affective Disorder (SAD) and Winter Blues. Part two covered dawn simulators and investing in light therapy. In the fourth part I’ll cover some lifestyle factors and share a couple of ideas with you about things you can try to jolly yourself along!

I consider myself to be very fortunate that I’m one of the 85% of people for whom light therapy is effective. But that’s not to say that I don’t use other things to help me manage my symptoms. Or that there’s no hope for you, if you find that light therapy doesn’t help you.

This is the part where I’m going to ask you to bear with me! I’m not a doctor or a therapist. So I’ll point you in the direction of good quality medical information. Please do consult your doctor or a qualified professional about any symptoms you experience.

Medication

I’m aware that some people are very uncomfortable with the idea of taking antidepressant medications. Sadly the stigma that people feel about mental health prevents many from seeking the help they need. I count myself here; I had to really challenge myself to accept taking medication – read the real story.

If you have been to see your doctor about symptoms affecting your mental health, then I’d like to say a huge well done to you! It takes a lot of courage to take this first step.

Small, round, white pills coming out of a bottleWhile the ‘first line’ recommendation for SAD and Winter Blues treatment is bright light therapy, your doctor may want you to try an antidepressant medication in addition to, or instead of light therapy. 

Mind’s page on antidepressants is very thorough and accessible and of course, your doctor can also answer any questions you might have too. 

For additional personal perspectives on managing SAD with antidepressants, I would recommend chatting with people on the Lumie Forum. I’ve found that people are very open and honest about their experiences. They’re generally happy to answer questions and share tips too. There is also the facility on the site to send and receive private messages. You can also become a member of the Seasonal Affective Disorder Association (SADA), who offer peer support services by telephone and email.

Some people find that a herbal remedy called St John’s Wort can help with feelings of mild depression and anxiety. Other products in a similar category are 5-HTP, which is a pre-cursor to serotonin production.

Products like ‘Kalms’, ‘Stress-less’ and ‘Bach Rescue Remedy’ aim to help with feelings of stress. These are available in health stores and chemists, and you might find they help. However, a note of caution: herbal remedies can interact with other prescribed and non-prescribed medications, including the contraceptive pill. They won’t be suitable for people with certain conditions, so always check with your doctor.

Cognitive Behavioural Therapy (CBT) and other talking therapies

CBT is a commonly used treatment for depressive conditions (including SAD). It has a lot of support in the medical community because it has strong scientific evidence to demonstrate its effectiveness. Some studies have found it to be as effective in treating depression as antidepressants.

Again, I’m going to refer you to a Mind page for more detail, but for now, this is how they define it:

CBT is a form of talking therapy that combines cognitive therapy and behaviour therapy. It focuses on how you think about the things going on in your life – your thoughts, images, beliefs and attitudes (your cognitive processes) – and how this impacts on the way you behave and deal with emotional problems. It then looks at how you can change any negative patterns of thinking or behaviour that may be causing you difficulties. In turn, this can change the way you feel.

Your doctor may offer you CBT through the NHS. This may be delivered face to face, over the telephone or it may be an online course. You can also find private therapists on the It’s Good to Talk website, which is hosted by the British Association for Counselling & Psychotherapy (BACP).

Most services or therapists would have a chat with you before starting the therapy to ensure that CBT is the right approach for you. From this, they may recommend CBT or perhaps a blended CBT and person-centred counselling approach.

There are also some really good self-help resources available which you could use while you’re working with a CBT therapist, or you might want to just try giving it a go yourself. I’ve read and can recommend Overcoming Depression: A Self-help Guide to Using Cognitive Behavioural Techniques by Paul Gilbert and The Feeling Good Handbook by David D. Burns, M.D.

Two people, one with a bike, walking in a park in the sunshine - talking therapiesRemember that as with any therapy, only you can do the work, and you’ll get out what you put in. Sometimes CBT itself is enough to help you. Sometimes you might need to combine it with medication and/or light therapy.

Of course, sometimes it can also help just to talk to other people who live with this condition and understand where you’re coming from. I hope that you might take some comfort from looking around this site, perhaps adding your thoughts and questions. The Lumie Forum is great too. And don’t discount talking to your family, friends and colleagues – they could be a great source of support if you are willing to share with them how you’re feeling and why.

For some less formal coping strategies, head on over to part four – I hope you’re finding this series helpful.

Image credits:
Medication: http://www.freeimages.com/photo/softgel-capsule-1325982
Walking friends: http://www.freeimages.com/photo/friendship-1534626