Not trying to be piffy, but I try to make light of it whenever I can.

So, due to many factors that I won’t bore you about, i’ve been carrying depression around for about 13 years now. Took medication for about 4 years then asked to come off them. Was off them for two then went back on them last year when I found myself being an argumentative sod all the time.

Now these do seem to be working to an extent (20mg Citalopram seeing as you may ask) and I probably do feel a hell of a lot better than I did. Example, about 6 years ago, at the height of it all, i was spending more than 60 quid a month on magazines as I’d developed a strain of OCD into the bargain.

Now that’s under control. I feel happier than I did, I rarely buy magazines and the OCD is well under control. What is bothering me thouhg is that my decision making skills have never really returned. I feel constantly unsure about what I want to do or who I am (because my mind is constantly telling me I need to fit in somewhere and I need to be defined as a person) And I have never went back to being the generally laid back person I used to be.

Outside of work (which is most likely a big factor due to not really liking the place I work, but at least I know to look for somehting else) I don’t really do very much other than look after my little one, take the dog for a walk and wait for my wife to come up with ideas.

I am turning 40 this year, and there is a part of me wondering if all the indecision is some sort of weird midlife crisis and I just need to MTFU and buy a convertible red sports car.

Anyway, I know a lot of people on here have posted about the spectre of the dark depression, and i’m just looking for ideas in how to combat these feelings.

Cheers, and you’re welcome to ignore and go back to your rum 😀

The drugs don’t work, they just make you worse. Got to learn to live without them; learn to feel…

Hi.

I experience depression too. Like you I take Citalopram – in my case because it helps me stay more level in mood and seems to prevent bouts of crippling anxiety with huge and rapid downturns. Unlike you I don’t have an issue making decisions either while experiencing an episode of depression or during my more stable times. In fact, I am probably more likely to make bad decisions – rather than no decisions.

Unfortunately, this probably means I have no advice to offer – but felt I should chip in to explain why, rather than just keeping silent. All I can do is to wish you all the best and hope someone else is more useful!

All the best,

Jay

Unfortunately, this probably means I have no advice to offer – but felt I should chip in to explain why, rather than just keeping silent

Not at all, if anything, it helps to know i’m not alone

The drugs don’t work, they just make you worse. Got to learn to live without them; learn to feel…

This is unhelpful.

Have you tried CBT? This

because my mind is constantly telling me I need to fit in somewhere and I need to be defined as a person

Reminds me of someone for whom I know CBT really helped. It seems to give you the skills to objectively think about what you’re thinking about, if that makes sense.

The drugs don’t work, they just make you worse. Got to learn to live without them; learn to feel…

That’s not very helpful. Everyone’s different, Three Fish. Some people find that the drugs do work, and they enable them to live a happier life than they otherwise would, or just take the edge off the worst of it, which allows them to start to fix themselves. Given the OP’s history I’m sure he’d like to come off them again at some point, but for now I don’t think throwing him in the deep-end without armbands is going to be the best way to help him to learn to swim.

redsox I think your indecision could be just another manifestation of your depression. I think that as above the drugs have most likely taken the edge off, but they haven’t fixed the underlying problem. That’s something you may need to talk about to someone well versed in this sort of thing, as IHN recommends. I’d speak to your GP about counselling, assuming you’re in the UK – the NHS does offer CBT type treatments to people, it is often very helpful although it’s often not easy and it’s not an instant fix.

Good luck, chin up, heels down, keep pedalling… 😉

Given the OP’s history I’m sure he’d like to come off them again at some point, but for now I don’t think throwing him in the deep-end without armbands is going to be the best way to help him to learn to swim.

I didn’t say that, though, did I?

All I can say from my own experience is there is light at the end of the tunnel.

I have been down and out for around 5 years now – not just depression but some pretty significant medical issues plus various family induced disasters stress and bereavement.

I have had no energy, lost interest in so many things, not been seeing friends.

The last 4 weeks have been just fantastic. I feel like I did in 2002 / 2003 – just brilliant. Combination of support from family and friends, medication and a healthy amount of time off work (funnily enough enforced through redundancy).

I think I have got more stuff done in the last 4 weeks than in the prior 200.

Re: counselling – it works for some. I would suggest looking for a good Hakomi or Internal Family Systems therapist if you can afford to go private. IFS in particular is pretty groundbreaking and incredibly effective for most.

If you want – drop me an email (in profile) let me know your location and I can let you know of a good therapist near you. Note both are variants of CBT.

It can be hard I know that and when you are at the bottom it is a horrible
dark and lonely place but it can and will get better.

Hi, I’ve had several episodes of depression for the past 25 or so years. I used to find that fluoxetine helped but I gradually developed an intolerance of it (and most other meds) to the point where there are no pharmaceutical treatments available for me. I had about 12 sessions of CBT last year, which I thought were excellent. Other things I do to help my mood include getting plenty of exercise (MTB), fresh air, sunlight (I use a light box in winter), and sleep. It’s not 100% effective but it all helps.

The drugs are a tool like any other, use the right tool for the job.
Don’t be afraid of them. I’ve had a on and off relationship with anti-d’s for a few years now. Not the end of the world, when I am ill I am better with them.
I had a series of group therpy sessions in Mindfulness last year they were really good. On the NHS, but take any help you can get, does work have any schemes?
But at the end of the day its ok mate.

The drugs don’t work, they just make you worse. Got to learn to live without them; learn to feel…

If you get the correct drug/person/time the drugs work very well. It’s just that sometimes it’s difficult to get the correct drug for a given person.

Best drug is exercise. Ride bikes, loads, often, fill your spare time with riding and make it social.

Massive benefit for depression and anxiety (form of depression anyway or vice versa).

Keeps it at bay at least so long as you keep it up, and keep busy.

The drugs on offer are offered far too quickly IMO and they have symptoms that could make things worse. At the very least take counselling, CBT etc rather than the immediate drug offer, but bucket loads of exercise is the best option.

So much so it can get a bit OCD, but that’s okay 😀

5 years for me! Was on Certilapram but now on Sertraline which works better for me.Daren’t come off it though!

[professional hat on]
+1 to asking gp about talking therapies. Our local nhs/free one you can actually refer yourself but most people seem to get referred by gp anyway as its relatively new (for round here) that you can access this sort of help so easily. Assuming you are in the uk redsox, google your nearest town and ‘iapt’ (improving access to psychological therapies) and your local mental helath provider should do something easy to access and free. Waiting lists vary massively by postcode though.
I would argue that antidepressants and talking therapies can be p good: i have encountered many people who were just too low or shut off to take in therapy, and the drugs were a way of getting them to the point where they could.

Also/in the meantime redsox i am sure this is daft advice on a cycling forum but it’s summer! -make yourself go out on the bike for an hour a couple of times a week even if you don’t want to. And since this is stw, home of great pointers on quality ales, i will take a punt on suggesting that whatever your alcohol intake is at the moment, half it so you still enjoy a bevvy but less chance of it dragging your mood and motivation down.

Best drug is exercise. Ride bikes, loads, often, fill your spare time with riding and make it social.

Couldn’t agree with this any more!

I know different things work for different people, but IMO drugs really should be a last resort. My personal experience with drugs were that they numbed me far too much, tried Fluoxetine and Citalopram on different occasions, and I hated being this numb person with no desire to do anything! I actually found I’d rather have the mega highs and lows than a total flatline…

The key to dealing with depression is finding your own coping mechanisms, everyone is different. There is no single effective cure, and many people never get cured but just learn to deal with it.

Personally, despite some huge successes in my life currently, I’ve had a few bouts of depression recently. Nothing as debilitating as several years ago where I developed CFS, and was literally no use to anyone for months on end, but enough to leave me house bound for a day or two at a time before I can work my way out of it.

For me, my best coping mechanisms have been regular exercise (preferably on a bike), and removing as many negative influences from my life as possible. Positive people breed positive thoughts and positive actions. If you feel like people in your life are holding you back because of their negativity, cut them out of your life as best as possible (or at least create some coping mechanisms meaning you’re limiting their ability to influence your mood).

Most of all though, don’t beat yourself up for anything. If you feel down one day, don’t get stressed about it, do whatever it is to indulge yourself for a day at home (be that watch TV, surf the net, eat crap food etc.) and then do something positive the next day. If you’re a goal minded person (and I was VERY goal minded), setting yourself goals that you’re not likely to achieve is about the worst thing that you can do as you’ll spend a lot of time beating yourself up. I found one of my best coping mechanisms was to literally take every day as it comes, and try to take something positive from it. Once you start seeing more positives than negatives in your life, you are effectively “turning that frown upside down” as the cliche goes. Only you will know how to do this yourself, but ultimately if you have more negative influences in your life than positive ones you will be depressed, so do whatever it takes to redress the balance!

The drugs on offer are offered far too quickly IMO and they have symptoms that could make things worse. At the very least take counselling, CBT etc rather than the immediate drug offer, but bucket loads of exercise is the best option.

Again, couldn’t agree more. Drugs are the GP’s “get out of jail free card” as it means they can get you in and out quickly, and it limits their culpability should anything else happen to you. Personally, I think it’s a sh1te approach, but hey ho, what do I know… I’ve only spent MANY years with severe illnesses driven by depression myself!

Counselling and/or CBT can help, but then again, they may not. Depends how open you are as an individual to talking about things, and you may or may not get on with the counsellor assigned to you! It can be quite hit and miss. The WORST thing you can do though is expect your wife, best friend or your parents to be your counsellor, they’re too involved, and can’t be objective enough to help you out. Also, unless they’re a professional, they won’t understand the best way to help you out!

The key to dealing with depression is getting to the point where you can get out of bed in the morning (even just getting to this point was a BIG win for me!), look at yourself in the mirror, and be ok with the person staring back at you. Everything above this is a plus…

Good luck though mate, be safe in the knowledge you’re not on your own, and don’t be afraid to ask for help. Mental illnesses have suffered from a social stigma for far too long, they’re as real as any physical illness, and just as damaging if not more so long term!

And since this is stw, home of great pointers on quality ales, i will take a punt on suggesting that whatever your alcohol intake is at the moment, half it so you still enjoy a bevvy but less chance of it dragging your mood and motivation down.

Good point. I was T total for many years, once or twice a week now I enjoy 2 or 3 pints of Cider, but that’s it.

If I feel depression coming on though, I’ll lay off the booze as in general, it makes things a lot worse!

Prozac here for couple years but I hate the distant feel it gives me.

I have been battling depression for five years but losing badly at present. To be honest I am really suffering just now and feel you completely.

My childhood best friend died of an OD last weekend, he’s been a hopeless heroin addict since we were caught at 14 with a couple of joints in school and we were made a completely disproportionate example of by the police and our school and bullied in particular by two teachers for the last couple years of school. We both suffered but he did more so. Annan Academy by the way. I did ok in the end, got a degree and professional qualifications but suffered badly recently with depression. Which after years of cbt and therapy I can relate directly back to my school/small town experience.

My mate left school and got in with a bad crowd, he was a very bright lad and needed a hand round the shoulder not punishment, isolation and humiliation, which is the way our sh1te school management felt fit to deal with what was a completely inconsequential incident by generally well behaved kids.

Anyway, I think that as a society we just can’t deal with complexity (in a psychological sense) and we cause a lot of the problems within it through our mismanagement of simple teenage psychological issues.

Rant over, wine to finish. Holiday in Wales with family to enjoy.

It is good that you feel you can talk about it. As with any decision, seeking other people’s experiences can really give you lots of ideas to see what could work for you.

Do you get out on your bike? Are there cycling group rides at a fixed time near you, sometimes if you do group exercise, the fact that the activity is at a fixed time helps you not miss it and the natural good feeling you will get with exercise could really help no matter how you are coping with other parts of your life.

I am very fortunate that I don’t suffer from depression, I think that being as organised as I can at work (I am self-employed now) helps me keep things in control and stops things getting on top of me, I have also decided to keep working just by myself without any employees helps, I tried when I first took over the business to have an employee and it was very stressful and would of caused me problems. Enjoying work is a very big help, if it is possible, it would be a big help if you could get a job you are happier with, not easy I know.

Hopefully you get some good ideas from this thread.

sas78. Sorry to hear that you have lost a friend.

So, after reading other people’s contributions I think actually in a general way I can offer some relevant experience.

Used CBT and also tried integrative counselling approach. Both helped. Started the medication during the counselling and for me the combination helped. Medication to give me the space to start making real headway with the counselling. I was able to identify my triggers and take steps to deal with them.

I managed to stop the citalopram after over two years but after another bout of anxiety at the start of the year, I started again. It does help that I know my warning signs pretty well – so was able to react rapidly and re-start.

Something else that helps is that I have a plan that removes me from the rat race to a career I will enjoy more, this makes the ups and downs easier to see with at least a little more perspective. The reason is that the corporate world is a real part of my issues..,

Oh and oP you are far, far from being alone!

I’ve had bad anxiety and treatment for it… I turned down medication and managed with an anxiety management group. Which did have some effect. To be honest though, the biggest change for me was just moving out of London and reducing the number of stresses on me. Unfortunately, the biggest stress moved with me but once I had a bit of a handle on the anxiety I started to be able to see that and sort myself out. Until I could get a breather from the worst of it though, I couldn’t sort anything out – like a really messy room that is just too chaotic to start tidying, but once there’s a square of floor you can see it gets easier and easier.

I’m still aware of that feeling – the background noise of anxiety which is really hard to describe and I could only define it at all once it disappeared, a year or so after I moved out of London – and if I get any of the physical symptoms I used to have I am wary of the direction I’m going in.

But things are way better now. I can be super indecisive but now it’s about stupid little things like what flavour pasta to buy, not the big stuff 🙂

Best drug is exercise. Ride bikes, loads, often, fill your spare time with riding and make it social.

Sometimes the drugs are needed to get your arse out the door to get the exercise. Get into the habit and eventually you don’t need the drugs. BUT

This may not be the answer for everyone, there’s good advice in the thread but a return to the GP may be a good idea. Book a double appointment if necessary and get the doctor to suggest some therapies other than drugs and discuss alternatives to Citalopram from the “Big Book of Smarties Doctor Edition”

Been drug free for 5 years now after 5 years of depression. Once you can get moving mentally have a good look at what you are doing with life and make changes to that to get where you want to be. Change job, move whatever it takes. Good luck with it all and one step at a time wilt the job done.

I had a bout two years ago. No drugs just CBT and it helped. But it really made me realise that it was the setup of my life that was causing the depression. Your mental state is influenced by your environment – people, places, things. And really if you don’t tackle that it doesn’t matter what drugs you take it what CBT you do. It’s hard but worth it.

I’ve divorced, moved house, changed friendship groups, adjusted family ties and am much happier.

Change the people around you, change your work, change your location, change your bike! Maybe not all at once but at least one thing. And if that doesn’t work change something else. Even if the changes result in disaster you’ll be in control and you’ll be learning.

Good luck.

Citalopram is kicking my arse at the moment.
Been on it six weeks now and I am constantly nauseous, extremely tired , no motivation and feel stoned (not in a good way).
I was recently offered the choice of swapping meds by my GP to mirtazapine but after being told it can take up to eight weeks for the citalopram to start doing its job and the side effects to lift I chose to stay on the cit hopeing it does, as the thought of going through it all again after swapping to a different med is not appealing.

I struggle to get out of bed, and when I do make it it’s only as far as the sofa. I hate leaving the house as I hate being in public while feeling stoned.

Anyone else have similar issues when starting citalopram?

Good post by Robbo, a lot of male depression is situational/reactive, like crappy jobs, bad relationship/divorce, and drugs are only a short-term fix (if they don’t make one worse that is).

Ive has severe anxiety disorder with some depression but am fine now.

Best advice i can give is you need to learn to detach from that little voice in your head, the thinker. You cant consciously control it but you can ignore it. Dont get caught up in what its saying, otherwise they can become your beliefs and i bet most of the thoughts are ridiculous.

Plenty of books about on mindfulness, but you have to practice it.

Goodluck, i know its not a nice feeling.

Dont get into a habit/loop of trying to control your thoughts and subsequent feeling. Youll go around in circles ad i did for around five years.

Chip – I didn’t experience that at all. Go back to the doctors as citalopram may not be for you.

I have been taking citalopram for about three years, now down to 20mg. When I first started taking it I had incredible chest pains / indigestion and flatulance, Dr subsequently prescribed omneprazole and this has cured the side effects.
Getting on my bike and long walks with the dog are a great form of therapy

Best drug is exercise. Ride bikes, loads, often, fill your spare time with riding and make it social.

^+100

I’d add to that varying exercise (swimming did it for me) and volunteering with some local cause/project close to your hearta few hours or a day here and there, which is good for socialising too, not to mention expanding personal skills repertoire/confidence/identity etc.

Our little family continues to be challenged (has been for over a decade) with ill-health, disabilities, resultant unemployment and financial ruin, all of which can comtribute to anxiety and depression. Sometimes it’s hard to see above the waves and feel you’re sinking whatever – but swim, swim for your life! It feels good to keep moving, even little steps are better than stasis.

My solutions were 2.5 years of counselling which gave me a lift, then I went to the gp after a major nosedive and had citalopram. I was fortunate enough to not suffer the side effects, but it wasn’t a wonder drug for me. At the same time I self referred for some private cbt which helped again, then started going to a local support group which really helped, and through that studied mindfulness meditation which is another great tool to have. I’m now off the drugs since the start of this year and am stable, but crucially am really in tune with how I’m feeling and can avoid the spiralling self damaging judgement that used to push me down.

Chip – I didn’t experience that at all. Go back to the doctors as citalopram may not be for you.

Glad your not having the problems I am.
I originally went to my GP with health concerns that I kept worrying about that rapidly turned into anxiety and then depression.

Before the cit I was functioning well, just very worried and down even with the anxiety as it was constant and health based so was not intensified by any going out and about. But now even taking a shower feels like a massive chore.

redsox

I to have suffered with depression and anxiety for over 30 years.

Over that time I have had counselling and taken various medication.

I knew the root cause of my issues along time ago, the medication did seem to help, but the underlying problem still existed.
In my case, it was largely family based, but these are my experiences , and everyone will be different.

I made the mistake of work making me stressed aslo. I had a stressful position which never allowed me to get out of the vicious circle of pressure ( which I don’t react to well).

It was difficult as I was supporting my wife and three children and felt that I needed a high salary to provide etc….

I have since retired from work (I’m 60 now), have slowly reduced te medication (not for the first time), and now feel much better, even though I don’t have a large salary coming in each month.

It can be difficult, and everyone is different, if you want drop me an email ( in profile), but ultimately you have to come to terms with the root cause of the issues, and then take actions to reduce / remove the stress and anxiety levels –
Regards

Denis

all SSRI’s have similar side effects, being tired is one of the main ones and it affects me pretty badly. this doesn’t help that I’m up at 3am for work ha ha ha ha. What helps me is not sitting about doing nothing all day but it can be hard to motivate myself into doing things. Things are made worse by my wife suffering really badly from PND and having the same feelings. watch out for foods that contain aspartime, as phenylalanine is a mood stabliser and if you say drink a lot of diet fizzy then stop it can affect your moods. Sadly its such a complicated illness that there isn’t one particular answer to help you.

@chip – I have never been on Citalopram so cannot comment specifically about that but if after 6 weeks it is isn’t working and you are having side effects then it would seem that it is not the right AD for you. It can often take 2 or 3 attempts to find the right AD, so this is nothing unusual.

I think the NICE guidelines say after 2 or 3 interventions the GP should refer you on.

In my experience some GPs are fantastic in supporting patients with depression and others are next to useless. Make sure you are seeing the former.

I take Lamotrigine which has pretty much turned my life around. I lost 5 or more years of my life with depression and anxiety, been on pretty much every type of AD. Some worked for a while, some made things an awful lot worse.

Eventually got a Psych referal and never really looked back.

When changing ADs do you have to ween of one then build up on the replacement, or literally just stop the first and start the replacement.

Thanks,

My GP, who I regard as a top Doc, has always just switched directly from one to another, some GPs taper people off one before starting another.

There are a class of ADs called MAOIs that have very serious interactions I.e fatal with other ADs and vica versa, but they are very very old drugs that I suspect are very rarely, if ever used now, in primary care. I would be surprised to hear if they were even used by specilalists. I believe there should be a period of 14 days between say stopping an MAOI and starting an SSRI.

Just go with the advice of your GP.

Mirtazapine is one of the more sedating ADs but everyone is different. It does, however, have the effect of reducing the orgasmic threshold, so you may find your orgasms more intense.

SSRIs have the opposite effect hence delayed ejaculation, loss of sensitivity and a limp dick.

I really feel I must say this – exercise is not the answer for everybody all the time. When I experienced my breakdown I was exercising every day and maintained this. Minimum of 1 hour mix of strength, flexibility and aerobic and 2 decent length rides a week – so not slacking. It works extremely well for some people but not so much for others.

I am also a massive proponent of a multi-dimensional approach to managing depression and anxiety – diet, exercise, counselling and also other lifestyle changes. I do feel that medication has a place for some people too. I know it is often over-proscribed and perhaps over-relied on by GP’s, but still let’s not write it off completely.

Mirtazapine is one of the more sedating ADs but everyone is different. It does, however, have the effect of reducing the orgasmic threshold, so you may find your orgasms more intense.

Sounds promising!

not if you’re a porn star lol