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How do you know if an antidepressant is working?


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I was on Citalopram (generic for celexa) for a few months. I went to see the pdoc for concerns mostly about anxiety since grad school has been stupidly stressful (from the age of 11-23 I never once missed a period--now they're sporadic at best). He put me on the citalopram in February, but by April I was busy with the anxiety again when finals season approached. I was vomiting everywhere and not sleeping and having mild panic attacks and just in general not having fun.

I decided I didn't like that doc so I switched to another. He put me on Mirtazapine (generic for Remeron). He felt it would combat some of the emptiness I'm feeling, as well as the anxiety. At first I felt like I was in a complete stoned daze. It's been a month now and I can wake up and feel normally alert, but my sleep shchedule is all out of wack. I used to sleep from around 12pm to about 8am, but now I'm staying up until 2, 3, 4, 5am and sleeping until noon or so. I hate this crap.

But I don't really feel any different. I'm not in school or work so I don't have much of an external reason to get anxious. I still, on occasion, feel anxiety, but it's pretty short lived if I can talk myself out of it (the other day the boy I like saw a hickey on my neck and joked about it but I thought 'oh no now he thinks i'm a slut and will never talk to me again' and I was worked up for a while but I calmed back down). For the most part I just kinda sit like a lump in my apartment until I mosey to a cafe or bar.

But yesterday I got all sad and mopey all afternoon. I was crying a little bit, which I don't usually do. I don't usually feel sadness, per se. The whole concept of what depression is even supposed to be is lost on me.

So anyway, I had a good cry, then I just all of a sudden was done with it and I got all giddy and excited and energetic and I wandered all over town all night. It's a small town. I felt good. I saw some friends along the way.

That kind of thing seems to happen with me. I'll shift from one mood to the other, so I never really feel like I'm categorically depressed. I don't even know what that's supposed to mean.

So if I don't know what depression is, how am I supposed to know if I'm not depressed anymore? Other than the side effects, how the hell am I supposed to know if this drug is working? I was told at first that it's possible I just won't respond to anything because my problems have been untreated for so long.

I just don't even know what it is I am supposed to be looking for.

PS I'm taking 15mg of mirtazapine at night. I still stay up for hours and hours after taking it (despite its sedative effect)

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So you've been on the new med for about a month. Good. Realistically, we should allow 3-4 months for an honest trial of a medication to see if it is working. Figure it takes about a month for you to taper off the old med, titrate up on the new med and for you body to get over the initial shock and worst side effects. Then its going to take about another month for the med to take hold in your brain and start the growth of new neurons. Give it a month for the new neurons to grow, and then wait for the new nueurons to have effect on your moods & emotions. You are at about 4 months.

How do you know if it is working? Well, you know what your worst was like before this med. If you are starting to have periods of lighter emotion and pleasure, you are better able to function socially and personally. Sounds like that is happening.

Is every day going to be flowers and sunshine? No. And no med can guarantee you won't have low periods in the future. But they will be a lot better and be shorter than if you were'nt taking the meds.

Take it one day at a time. Enjoy the improvements as they come.

a.m.

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So you've been on the new med for about a month. Good. Realistically, we should allow 3-4 months for an honest trial of a medication to see if it is working. Figure it takes about a month for you to taper off the old med, titrate up on the new med and for you body to get over the initial shock and worst side effects. Then its going to take about another month for the med to take hold in your brain and start the growth of new neurons. Give it a month for the new neurons to grow, and then wait for the new nueurons to have effect on your moods & emotions. You are at about 4 months.

How do you know if it is working? Well, you know what your worst was like before this med. If you are starting to have periods of lighter emotion and pleasure, you are better able to function socially and personally. Sounds like that is happening.

Is every day going to be flowers and sunshine? No. And no med can guarantee you won't have low periods in the future. But they will be a lot better and be shorter than if you were'nt taking the meds.

Take it one day at a time. Enjoy the improvements as they come.

a.m.

neurons are supposed to grow??

the things you learn on t3h int3rwebz.

Thank you for the explanation.

I remember the worst i've ever been. Once was when I was 16. I got mad at my boyfriend for hanging out with his friend so I cut myself and swallowed a bunch of advil or something stupid. I threw them up later though. Then there was the time maybe a year and a half ago when my boyfriend hung out with his friend all night, and even though I was out with my friends, I got mad and screamed and lost my breath and i just flipped out. But without the self-injury. I've grown past that, thank god.

But those are more like incidents rather than moods.

My teenage years seem like a distant past, and once I went to college and moved out and started that chapter, I really can only think of being depressed in the immediate time after I was assaulted by frat boys. I didn't know where to turn, I was always looking over my shoulder, the people who were supposed to help were hurting rather than helping, I was new to college, I got an inflamed stomach lining of all things, it was bad. But understandable. I had my little cry about it, now I'm just mad.

So then, if depression is more than just being sad, what is that? I get sad. Everyone gets sad. Normal, mentally healthy people get down in the dumps and cry sometimes. I just feel like if I can't see the emotion, through crying, hitting, affection, whatever, I don't really know what it is. If I'm not crying, then I'm not sad. Without the activity of crying, honestly, I don't consider myself to be sad, unless of course for social reasons I am holding them back. Aimless, sure. Tired, lonely, lethargic, boring, sure. But those feelings don't *do* anything (unless you consider sleep an activity). How am I supposed to know how I feel if I'm not doing anything to show myself what I'm feeling?

How am I that out of touch with myself?? Or is it just the concept of depression that I'm not getting? I read that Ophelia book in junior high just like everybody else, but I still don't even know what I'm supposed to make of myself.

And what if all the kinda nothingness doesn't particularly cause me discomfort?

Really I think I'm just angry. I've heard the old thing about depression being rage turned inward, but my rage goes everywhere pretty equally it seems.

my therapist is on vacation this week. Please pardon my pity party.

;)

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If you want something quantifiable, there are all of these.

http://www.neurotransmitter.net/depressionscales.html

If you want to get to the true essence of it, read something like Silvia Plath's The Bell Jar or Styron's Darkness Visible. Soloman's Noonday Demon gets it on all levels, nerological, philosophical, psychological, poetic, etc.

http://astore.amazon.com/crazyboards05-20/...4146433-5242466

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If you want something quantifiable, there are all of these.

http://www.neurotransmitter.net/depressionscales.html

If you want to get to the true essence of it, read something like Silvia Plath's The Bell Jar or Styron's Darkness Visible. Soloman's Noonday Demon gets it on all levels, nerological, philosophical, psychological, poetic, etc.

http://astore.amazon.com/crazyboards05-20/...4146433-5242466

You know, I was looking for some Plath at the used bookstore today. I jumped your gun and figured she was a good source to check out if I wanted to know what depression looked like. I couldn't find any. That store is really disorganized so finding things can be difficult. But I'll check the libraries. MMMMMmmmmm card catalogue...

I have bad luck with multiple choice internet tests. On some questions I could easily pick both extreme answers, but I can only pick one and it's basically a coin toss. It's my various head doctors that tell me I'm depressed, based on what I tell them about my past and my behavior. That's why they keep putting me on anti-depressants when I tell them I'm there because all I want is to stop vomiting every time I have to write a paper, and stop thinking my neighbor is trying to kill me when I'm low on sleep.

It's also possible that these docs don't know jack. I met a wonderful bipolar boy the other day and we spent a lot of time complaining about our psychiatrists (due to our affiliations with the university, we both see the same psychiatrists, and he has seen both of my therapists in the past). He's delicious.

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Guest MaryBev

First, I have never heard that medication may combat emptiness. But who am I to say... Secondly, when I was experiencing my depression at its worst,

I was staying up very late (1, 2, 3am) when I woke I felt like I was more tired than when I went to bed, and like I was hit by a truck in my sleep. Immediatly upon starting medication, I went to sleep and was able to fall asleep at a normal hour and felt rather rested when I woke in the morning.

I have never felt like I was stoned on my current med. However, seven years ago I was going thru a difficult time/struggling with dep/went on a med/hated it/felt drunk from it. When meds aren't right, trust your gut. Switch meds.

Also if your energy level is down, this is another sign that your med is not working.

My definition of depression is not saddness. It is when my physical self can not be overcome by my willpower. I was extremely fatigued, cound not

think through simple tasks, was a slave to my impulses, difficulty eating, difficuly sleeping, and a feeling that I was in a rut that I could never climb out of.

I have been told that if you don't notice any substantial change on a med within four weeks, your on the wrong med, and to try something else.

My depression has been on going for some time and within weeks I felt significantly better on my med.

Also, if taking it at night is a problem, switch to the morning... but in my humble opinion, consider seeking counsel to explore other medication options.

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Guest MaryBev

I also wanted to add, that yes, I have heard the old advise that a med may take months to work... but upon asking for clarification from

my doctor... I was told that a medication may take a couple of months to reach it potential effectiveness, but within weeks of starting you should

be able to experience change.

Also, I wanted to add that I tried to read my way out of depression for YEARS. This did not help my depression.

I'm not saying don't read... But until I experienced a good med, I too did not totally comprehend depression.

I did not understand just how much I was ill effected by clinical depression until I experience relief from an appropriate medication.

Good luck to you. And by all means seek counsil from doctors and therapists... don't just rely on this box!

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  • 1 month later...

1. Your suicidal thoughts fade away.

2. You feel less irritable and stressed out all the time. You are finally about to relax a little.

3. Your sleep is deeper and more restful and you wake up feeling refreshed. You also may begin having bizarre vivid dreams.

4. The headaches, body aches and pains go away.

5. You have more energy and motivation to do things. You don't feel so exhausted all the time.

6. You don't worry about things as much. Trivial things that used to bother you don't bother you as much any more.

7. You feel calmer and more rational.

8. Your confidence and self-esteem increases to a normal level. No more feeling anxious in public.

9. People around you notice a positive change in you.

10. Life actually becomes a little fun.

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  • 2 years later...
Guest Aim-o-lino

I actually wonder if there isn't some sort of "man" problem going on here, based on these extreme reactions to your boyfriends' behaviors. What does your alcohol consumption look like?

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Guest, that thread is two years old. You're commenting to someone who isn't here, and you're not suggesting anything helpful to members who read your reply.

Everyone, please think twice before resurrecting old topics. If you don't have a really good reason to do it, let sleeping dogs lie.

olga

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