The decision to take antidepressants for me was a significant one in my Mental Health journey. Recognising that you have a Mental Health condition and to deal with that alone is a huge step; and for many people, reaching out and admitting that you need a bit of extra help is admirable, and necessary.
I had reached that point last year, where I was open to trying anything that would help me get through the day and not have it affect my work and personal life as much as it was.
As with any new medication, I had the view of doing as much research as I possibly could before committing to taking antidepressants, in order to feel more clued up. So I immersed myself in as much knowledge as I could find from the internet, friends who I knew had taken them, and any forums online.
I had been prescribed Sertraline by my GP, so I could be specific in my search and learn more about side affects of that particular drug. What I did find however, is that the side affects covered seemed to be very general, and what I think we all need to do is more ‘real talk’ about what can actually happen, and our own personal experiences. That way the more information and knowledge we have and the more we share it can only be a good thing for people considering taking the step towards antidepressants.
So here are a few of the things I wish I had been aware of before taking Sertraline, so if you’re a little unsure or hesitant of taking this route hopefully it might help guide you:
Be prepared to be patient.
The GP always advises that two or three weeks and the drugs should be in your system; I think it’s longer in my own personal experience, depending on dosage and what you’re prescribed. The entire naming of the drug ‘antidepressant’ makes it sound wonderful, some even refer to them as ‘happy pills’. But the reality is, if you do chemically need more Seratonin then the right dosage will only take you up to the normal amount you need, so unfortunately you’re not going to be floating through your day with a beaming smile in a state of ecstasy, hugging everyone!
When I went up to 100mg from 50mg all that happened was I felt agitated, unfocused and unable to concentrate on one thing for longer than a couple of minutes. I felt spaced out, yet hyperactive, and I knew it wasn’t quite right. I’ve since levelled out on 75mg which seems to be working nicely, but it’s all trial and error and every person is different. You just have to be prepared to be patient, let the drug do its’ work, and get regular reviews from your GP about how it is working for you.
Be prepared to lose your libido in strange ways.
The medication states side affects such as nausea, headaches, loss of libido/ interest in sex. When I read that I assumed it meant just how it sounded – ‘loss of interest’. OK, so you may not feel like doing it as frequently. However what I didn’t plan for was a numbness of ‘that’ area. People often describe feeling numb emotionally whilst taking antidepressants, I didn’t bargain for it physically as well! This can be quite a scary feeling if you’re not prepared for it; I thought it was Game Over, RIP Fanny, it’s been nice knowing you, I had images of myself sitting at my desk in mourning writing ‘Eulogy for my Lady Garden’. This didn’t last, and the numbness does go away eventually (thank goodness!) however it’s always something you may choose to discuss with a partner if you’re in a relationship, as it’s something that can affect both of you in different ways.
Be prepared to not get on well with alcohol.
One thing I wanted to know before I took antidepressants was whether I could still drink alcohol. Don’t get me wrong I’m certainly not dependent on it, but most nights I enjoy a glass of wine with a meal, and on the weekend maybe a few more of something else. I’ve always handled alcohol well, so usually it would take quite a few drinks to get me well on the way to Merry Town, well not any more! Obviously I did my research and was aware of the fact that taking alcohol (a depressant) and an antidepressant at the same time is going to cancel each other out, and shouldn’t be done if at all, but what I didn’t bargain for was the way it would react with me.
Being a moderate and social drinker I could usually have a couple of G&T’s and a couple of glasses of wine and be a little bit chatty. If I were to do the same amount now, it hits me like a ton of bricks, from out of nowhere. When I was just learning this, one particular night I went from being a chatty cheery soul, to a drunken mess throwing up in the local pub beer garden, within a relatively short time period. Thankfully I have good friends who looked after me, but if I hadn’t I would have very much put myself in danger, all because I thought I would be capable of a ‘normal amount’ for me.
Over the year I’ve been taking Sertraline I didn’t feel the affect when I had smaller measures, which is what I stick to now. I still feel like I can drink socially and I’m more aware and have control, as well as it being a cheaper night for my wallet!
Be prepared to feel more anxious whilst you’re adjusting.
When the GP tells you that you may end up feeling ‘more anxious’ and the side affects include ‘being suicidal’ it makes you think is it actually worth it? The reason I’m even considering taking antidepressants is due to feeling so anxious why on earth would I put myself through more of that? Personally for me I’d never felt suicidal and I certainly didn’t want to put myself at risk of feeling that way and begin on a downward spiral. Fortunately I only experienced more regular anxiousness within the first few weeks; and also when my dosage was higher. But you know your own body better than anyone else, and if you can stick out that awkward period of adjusting to actually give the drugs a chance to work it’s probably going to be worth it. If you continue experiencing more anxiousness, then I would say it’s not for you and to get more advice from the GP – there are so many types available, so what works for me may not work for you.
Be prepared to remember!
One aspect you do get warned of online is what happens when you suddenly don’t take the pills. I can’t stress enough that you should never go cold turkey. Whether it’s a conscious decision, or you’ve just been disorganised and ran out of tablets (this one was me), you will find out the hard way as I did. I felt fine for a week, maybe even two, which lured me into a false sense of security. This was just the time taking the drugs to get out of my system, and in the meantime I was thinking ‘I’m fine! Brilliant! I don’t even need them!’ Then suddenly it was like the whole world came crashing down. Someone spoke to me at work in the ‘wrong’ way and I was a mess, I got angry and frustrated and then finished as a heap of emotions on the floor, with everyone wondering what on earth just happened. What’s worse is that I didn’t learn the first time and did this twice. If you do want to come off your tablets, that’s fine but talk to your GP first, get advice on how to do it. If you don’t feel you can, then don’t. Maybe it’s not the time, but please don’t just stop taking them!
Another thing I did learn recently is that taking them at night is better than the morning. I always just used to take them first thing as I would get up at the same time, and knew I’d remember before I left the house. But they can make you a little groggy sometimes, and since taking them before bed I definitely wake up with more of a spring in my step. It’s a small thing they don’t tend to mention but it makes a big difference, especially if you’re not a morning person in the first place (me again!)
Be prepared to use other coping methods alongside.
There isn’t an ‘instant happy pill fix’. I know it sounds obvious, but I made the mistake of thinking this at the beginning. They are an antidepressant; not a magic bean. They won’t change your personality either. They are there to help you cope, and I can safely say that there have been days where I made it to work purely because of them. But I’ve come to know over the past year that that won’t always be the case. There will still be times when you feel anxious, you will worry, have panic attacks, and times where you feel you just can’t get out of bed and do life that day. That’s when you know that bit extra has to come from you.
There are providers out there, more than ever now, who are here to help and they are flexible. So whether you want to just study some techniques at home on your computer, or go to a group and talk, you have the options. You just need to know what’s best for you and what is available in your local area.
Cognitive Behavioural Therapy (CBT) is something I’m trying out, and is becoming increasingly more popular in dealing with anxiety and depression. Antidepressants can help, but they still can’t change your thought processes, which is where CBT fits in nicely, as long as you keep an open mind and stick at it. I tend to think of the antidepressants and CBT working alongside each other is comparable to a healthy relationship. If they were people, you wouldn’t expect one to do 100% of the work while the other just does nothing, they have to work together and bounce off each other.
Be prepared to ‘put a label on it’ and educate yourself.
By that I don’t mean stereotype, but by putting a label on something in a positive way. By saying ‘Yes, I have anxiety and panic attacks’ for me means I have faced up to an issue. It’s not me accepting, or admitting defeat, it’s quite the opposite. It’s about saying I’ve done my research, I know the symptoms, I can be empathetic to others that go through it, and I’m trying to break the stigma. It’s about talking to others, sharing stories of what did/didn’t work.
One thing I used to feel guilty for was booking a GP appointment for my anxiety and reviews for my antidepressants. I would get it into my head that it wasn’t important; there were people waiting to see the GP for much more serious worries and issues. But just because it’s an invisible illness does not diminish it’s importance in any way. Mental health affects physical health as well, so we need to be taking care of our minds and our bodies as everything is linked.
Personally I don’t just feel we should be experts on our own mental health issues, we should be experts on as much as possible. Don’t have Depression? Bi-Polar? Schizophrenia? Panic attacks? Find out about them, expand your knowledge. You never know when you might need it.
Be prepared to embrace the madness.
There’s going to be times where you have no idea what your moods and emotions are doing to you, and you can feel a bit all over the place. You never know when you’re going to have a good day, or a really bad day. The best thing to do is not focus on when your next bad day is going to be. Embrace the present (don’t we all wish we could do this more?) Roll with it, as difficult as that can be sometimes. Having a bad day is not the antidepressants not working, it’s not you failing, it just happens. It’s about accepting and knowing that you will come out if it, just as you have before, every single time!
From the CBT, my favourite thing to say to myself at the moment whenever I start to feel the anxiousness rising within is: ‘Is it real, or is it anxiety?’ This way I feel like I’m taking back the power, and I can recognise the signs and try to banish them before they even begin.
Be prepared to keep a journal and make time to write things down.
Long gone may be the days of youth where you kept a secret diary with a padlock on it, writing down which boys you fancied and what you considered your deepest darkest secrets! No, in this case keeping a journal is very much a part of the self help process. Use it to look back on, see patterns, and generally help your understanding of yourself. As a ‘creative type’, I know it helps when I get things down in writing. Even if you don’t particularly see yourself as a ‘writer’ I would challenge you to it, you may find some real hidden talent you never knew existed, as well as finding some revelations about yourself along the way.
OK that’s all very well but what the hell do I write, you ask? Your first thing to write may be to take your tablet (let’s start easy), then I like to write a quote that inspires me – something positive to start your day (you can get daily apps for this, it’s so simple). Ponder on it for five minutes, starting your day out with a smile and positive thoughts is the best way to begin. Then going on using it to record your moods – if you’re feeling anxious, where was it? Did something happen to trigger it? How do you feel physically/ emotionally? What thoughts are you experiencing? This is always helpful to look back on with a clear head and try and ascertain what happened.
As well as for the self help respect, keeping a journal daily is useful to show your GP on review of your medication, to see how you are dealing with it and whether they feel it’s working for you. It also helps make things clearer laid out on paper, relying on your own brain and memory isn’t even necessary.
Be prepared to talk to your support network, openly and honestly.
It’s important to know on our mental health journey that we are not alone. I’m fortunate that so many of my closest friends have had/still do experience different mental health issues and have an empathetic understanding. Talk to them first and foremost. It’s always best to know you’re talking to someone who has been through similar and knows what you’re feeling. Share stories of medication, side affects and self help. Talk to those who may not fully understand; the more we share the more educated we become, and the closer we get to breaking the ‘mental health stigma’.
In conclusion, I am glad I decided to take medication to help. It’s been a year of learning, adjusting and battling, but I’ve learned that everyone is different, that I can’t solely rely on tablets I have to help myself too, and that I’m still going to have bad days, and that’s OK. I’ve learned to accept that the way I am is OK, and that trying to better myself and increase my knowledge in any way I can is the key to understanding.
Your experiences may be very different to mine, but one thing we do have in common is being a (Mental Health) Warrior, battling every day and coming back stronger and stronger.