In this post I share my personal experience of taking antidepressants to try and break the stigma surrounding the use of medication, and to show how they can help manage your anxiety and be a first step on the road to recovery.
I know this is a sensitive topic for many people, and I want to share my experience in case it helps someone who is going through a similar situation.
Seeking help for anxiety symptoms
I’ve been a worrier for as long as I can remember and had periods where I have had depressive symptoms. When I found myself struggling with anxiety and intrusive thoughts in my 30s, I decided to visit my doctor to explain how I was feeling.
I had tried to cope with it by avoiding certain situations, or by self-medicating with alcohol or other substances. But none of that worked, and my anxiety only got worse over time.
My doctor decided to start me off on a low dose of Citalopram (20mg), which is one of the most commonly prescribed antidepressants. Also known as selective serotonin reuptake inhibitors (SSRIs).
What is a SSRI?
SSRIs are a class of drugs that are typically used as antidepressant medications to treat anxiety disorders, such as panic attacks, generalised anxiety, disorder, obsessive compulsive disorder. They can also treat symptoms of depression. They work by increasing the levels of serotonin, a neurotransmitter involved in mood regulation, in the brain.
How SSRIs work
SSRIs block the reabsorption of serotonin by certain nerve cells in the brain, leading to increased levels of serotonin available for transmission between neurons. This helps regulate mood and alleviate symptoms of anxiety by enhancing serotonin activity in key brain regions. They have been shown to significantly reduce symptoms of anxiety, including worry, fear and nervousness.
Common SSRIs used for anxiety
There are a number of different types of SSRIs out there, the following are the most common and widely prescribed:
- Sertraline (Zoloft): Sertraline is commonly prescribed for various anxiety disorders, including generalised anxiety disorder, social anxiety disorder, panic disorder and PTSD. It is well-tolerated with fewer side effects and has been shown to be effective in reducing anxiety symptoms.
- Fluoxetine (Prozac): Fluoxetine is another widely used SSRI that is effective in treating anxiety disorders. It is also approved for the treatment of obsessive compulsive disorder.
- Paroxetine (Paxil): Paroxetine is approved for the treatment of various anxiety disorders, including generalised anxiety disorder, social anxiety disorder, panic disorder and PTSD. It is known for its anxiety-reducing effects and can be particularly helpful for individuals with clinical depression and suicidal thoughts.
- Escitalopram (Lexapro): Escitalopram is a commonly prescribed SSRI that is effective in treating both anxiety and depression. It is well-tolerated and has a favorable side effect profile.
- Citalopram (Celexa): Citalopram is primarily used to treat major depressive disorder (although tricyclic antidepressants are still used in some cases of severe depression where other treatments have been ineffective). It is also prescribed off-label to treat certain anxiety disorders, such as generalised anxiety disorder, panic disorder, social anxiety disorder, and obsessive-compulsive disorder.
I was informed that it could take up to 6 weeks for me to start noticing the full effect and to see a significant improvement.
The way I felt at the beginning was completely unexpected. I wasn’t warned of any possible side effects at the initial appointment with the doctor. I couldn’t stop yawning and would clench my jaw continuously, and I’ve never felt more tired in my life! These initial side effects stopped after a week or so, but I have experienced other side effects since then.
Common side effects for SSRIs
There are many side effects associated with SSRIs (the medication guide states what seems to be a never-ending list of potential ones!). The main ones are nausea, dry mouth, loss of appetite {I definitely haven’t noticed this!), drowsiness, sweating, blurred vision, decreased interest in sex and yawning. These side effects are usually mild but tend to improve over time.
Something that I have only recently become aware of is Serotonin Syndrome. Although rare, SSRIs can potentially cause serotonin syndrome . This is a serious and potentially life-threatening condition characterised by dangerously high serotonin levels in the brain. Symptoms may include agitation, confusion, rapid heartbeat, high blood pressure, fever, sweating, and muscle rigidity.
Some people report weight gain as a side effect of SSRIs. While not everyone who takes SSRIs will experience weight gain, it is a known adverse effect that can occur in some individuals. Some may affect appetite regulation or may cause fluid retention or bloating, which can temporarily increase body weight. This is not something that I have personally experienced.
Many people talk about fatigue, the feeling of being constantly tired, especially at the beginning. With a feeling that they need to nap a lot. This is something that I am familiar with, feeling drowsy an hour or two after taking my daily dose.
One evening I discussed how tired I was with a friend who also took Citalopram. She revealed to me that she took her dose in the evening, rather than first thing in the morning. This had never even crossed my mind. I followed suit and I still do this to this day.
Emotional blunting
Another common side-effect is known as ‘emotional blunting’. This is when your feelings are emotionally dulled so that you feel neither up nor down. It can have both positive and negative effects. On the positive side, it may help reduce intense emotional reactions . This can be beneficial for people with anxiety or mood disorders. However, it can also lead to a sense of emotional emptiness or detachment, which some individuals find distressing.
I believe this is something I experience when I take Citalopram. I feel slightly disassociated, and I’m sure that I am more distant towards the World around me. For me, this is probably the biggest downside to taking antidepressants.
How antidepressants helped my anxiety symptoms
Over several weeks, I noticed a gradual reduction in the intensity and frequency of my anxious thoughts and physical symptoms. I felt more calm, more confident, and more optimistic.
Of course, antidepressants are not a cure-all, and they do not solve my problems. I still have anxiety sometimes, and I still have to work on myself and my issues. I would be lying if I said that I don’t worry about messing up, being criticised, or not meeting expectations. But I don’t fret so much about every little thing, and focus on doing my best.
How long should I stay on antidepressants?
Even once you have started to feel better, doctors generally advise that you to stay on antidepressants for at least 4-6 additional months. It is a good idea to stay on them for at least one year.
A dose of antidepressants should be slowly reduced, normally over several weeks, and sometimes longer. This varies depending on the type of antidepressant you’re taking, your dose and how long you’ve been taking. They may take days or weeks to leave your system and you can experience withdrawal symptoms after reducing the dose. Reducing the dose gradually is always the best option. You should never stop taking them without tapering them off.
Tapering off antidepressants
I have personal experience with stopping antidepressants abruptly and I would never advise someone to do this.
At my first visit to my doctor to inform them that I was pregnant I asked whether I should be taking Citalopram. I was instructed to stop them immediately as it could be harmful to the baby. Of course, I did as I was told, fearful that the medication would cause abnormalities or worse.
What followed was a few weeks of dizziness, severe anxiety and ‘brain zaps’ (also known as brain shivers, brain flips) which can feel like short electric zaps in the head. My hormones were all over the place and it was a tough time.
Stigma associated with antidepressants
Stigma surrounding the use of antidepressants is a complex issue with both societal and individual factors at play. It often arises from a lack of understanding of mental illness and its treatment. Some people may believe that depression or other mental health conditions are not “real” illnesses. Or that taking medication is a sign of weakness.
Others fear becoming dependent on antidepressant medication, which can contribute to stigma (it’s important to note that antidepressants are not inherently addictive).
Some people worry that disclosing the use of antidepressants may lead to discrimination at work or in other areas of their lives. I will admit that this is something that I do not ‘advertise’ or talk about, as I worry that people’s perceptions of me will change.
Which antidepressant is right for me?
The choice of medication should be made in consultation with mental health professionals, taking into consideration the individual’s specific symptoms, medical history, and potential side effects. Their effects should be monitored regularly to ensure the best possible outcome. I have regular check-ups with my doctor to check if my dosage is correct, how I am feeling, and whether I feel it’s time to start coming off them.
Taking antidepressants isn’t for everyone. For some, the side effects can be overwhelming, and they feel that they are unable to continue with the medication. If this is the case, it is always best to speak to your doctor who may be able to prescribe an alternative or lower the dose until you get used to them.
If you feel that the side effects are too much, then a lower dose may be the best option. They can be a valuable tool in the management of anxiety, but they are not a one-size-fits-all solution.
Look after your wellbeing for the best results
Alongside medication, therapy and lifestyle changes may be necessary to address the root causes of anxiety and develop coping strategies. Personally, I have to ‘check in’ with myself throughout the day:
- Have I drunk enough water?
- Am I eating the right foods?
- Have I exercised?
- Am I getting enough sleep?
Combining antidepressant medication with Cognitive Behavioural Therapy (CBT) is a powerful and often recommended approach for treating anxiety and depression. Whereas SSRIs and other antidepressants work by altering neurotransmitter levels in the brain, CBT focuses on identifying and challenging negative thought patterns and behaviors that contribute to anxiety and depression through psychological treatments and talk therapy.
I hope this post on how antidepressants can help manage your anxiety has given you some insight into how they can help if you are suffering from anxiety, and considering taking medication.
My experience has been largely positive but of course, everyone’s experience is different, and what works for me may not work for you.
The bottom line is, there is nothing wrong with taking antidepressants for anxiety, and there is nothing to be ashamed of. They are not a sign of weakness or failure, but a way of taking care of yourself and your mental health, which is something we all deserve.
I’d love to hear what you think in the comments. Thanks for reading!
