So confused about my AD

[Parapluie]

So, I have another med question. Sorry about that, I'm not new to depression, but I am very new to meds. How do I know if my med is working well enough? What did it feel like for you? Ugh. I'm feel like I'm everywhere and no where.

I have been taking Celexa (citalopram) for 3 months, and 1.5 months at my current 40mg dosage. But, I still feel pretty horrible. I have been journalling faithfully for the past 3 months as well (I was at my worst in this depressive episode in November/December), so I have a pretty good idea of how my mood has changed. I feel that it's barely changed. I feel like I have changed physically, more than mentally.

For example, I have more physical energy compared to a few months ago. I can get out of bed faster and push myself harder to keep going during the day. My appetite is still not quite what it was, but it's getting back to normal. I get more restful sleeps, mainly because Celexa has helped immensely with my GAD.

Mentally/emotionally.... blah. I basically feel blah, uncaring or a sickening, deep weight of sadness and despair on my chest, nearly every goddamn day. At least it's not 24/7 anymore. But, it's anywhere from 3-10 hours of the day that I'm staring at nothing, trying not to cry. The thing is, I finally feel capable of reacting with happiness to happy things (a joke, my pets, a movie). However, the moment that I'm alone, I'm consumed with depressive thoughts and, thoughts of SI and suicide. I intensely crave being alone, despite that I end up feeling worthless and useless. I think of suicide everyday and think of plans. A general low, blah mood is the norm.

On the other end of the spectrum, I do have good days now, when the sadness doesn't last as long and I feel more calm. As well, I can concentrate much better than before.

Where the hell does this leave me? I feel like Celexa helps somewhat..? I'm so resigned. Am I asking too much of a medication? Along with my med, I get weekly therapy and attend a CBT group. I feel like this combined, should be helping more? What am I doing wrong? I feel like this is all my fault, I'm just not trying hard enough. This is much worse than any other depressive episode that I've had (I've had at least 2 prior to this, though my boyfriend thinks I've had more).

I also have a people-pleasing problem, so when I report to my pdoc, I feel like I'm not being totally honest about my symptoms sometimes. This is my fault and I'm not going to do it at my next appointment. Plus, it's just hard to describe depression accurately without resorting to some kind of poetic monologue... or maybe that's just me.

This got a lot longer/ more rant-y than I'd anticipated. To sum it up, should I give up on Celexa?

Thanks very much for reading all that.

ETA: when I say my concentration has improved, I mean I could write this post or read the newspaper. When it comes to school... Not so much, And my grades are falling. UGH

[jt07]

Since you are getting a partial response from the Celexa, have you considered adding another med like Abilify or Remeron? I do well on my Celexa + Remeron combo. Remeron is very good if you have a low appetite and Abilify may be good. I know that Abilify increased my appetite.

Keep in mind that I'm not a doctor and am only stating what I have found helpful for myself.

[kittyloaf]

I'm guessing Celexa is the first antidepressant you've tried? It seems like it is helping somewhat but not completely. To me you either have the option of getting off Celexa and trying another anitidepressant, or your doctor could add another med to your Celexa. Like jt07 said, you could try an antipsychotic like Abilify which has been approved as an addon to an antidepressant. Or maybe your doctor will do like mine did, and add another antidepressant. There are a lot of meds out there and you have a lot of options.

What concerns me is your suicidal thoughts. If you're making plans to hurt yourself this is very serious and your pdoc and therapist may recommend hospitalization so you can be safe while getting you on the right meds.

[chimpmaster]

First of all, dont think of this as your fault. It often takes several attempts to get medication that will help significantly.

I tend to agre with Jt07 that a med like remeron in addition to your ssri might be the way to go. Go see your dr, explain that the celexa alone isnt working for you and that you would like to try something else.

If your dr prefers to replace the celexa with another med, something like Effexor might be the way to go.

[olga]

If you have trouble explaining how you feel to the doctor, print out your post and give it to him. I think you wrote very clearly about how you feel and the limitations of your present med regimen.

Taking an AD won't make you instantly feel like you could leap tall buildings in a single bound, but the right one can keep you from that dark edge and help you to care enough about yourself to exercise, eat well, and develop a good sleep pattern. Like all of us, you deserve a reasonably stable life with periods of fun and happiness. If you aren't getting that, the doctor has to work with you until you find a med combination that gives you some sense of hope and a future.

olga

[Parapluie]

Thanks so much for the responses, everyone. I saw my doc and explained that I just don't feel better. I'm sure most of you know what I mean... That dull aching sadness, punctuated with despair and general shit. We decided to try Effexor, which I started this week. So far, I'm sweaty and anxious, but hopefully that goes away. I'm still feeling hopeless, but there's a little bit in me that is saying "give it time, try to get better." So, in that spirit, I actually sat in the sun today! I usually avoid the sun. And I forced myself to eat and see a friend. Also, seeing my tdoc helped. So, it was a big day for helping myself.

Kittyloaf - (cute name) I told my pdoc and tdoc about the suicidal thoughts and we wrote up a plan. So I'm feeling a bit safer now. Thank you for your concern.