Depression

Last week (4th October) I had an appointment with my psychiatrist, the first chance I’d had to see her since I got very ill at the beginning of September. I told her about how much I’ve been struggling – the constant intrusive fear, feelings of terror, and frequent periods of crying. I keep feeling that I can’t cope and I’m finding it very difficult to keep pushing on each day. I haven’t felt this bad for this long in at least a decade.

We discussed the fact that since I came off sertraline at the end of June I haven’t been on a high dose of an antidepressant. I did get up to 200mg of clomipramine but only stayed on that dose for a week as it was causing light headedness and I didn’t think it would be safe to drive for long periods of time.

It turns out that taking away a high dose of antidepressants seems to have resulted in my brain getting depressed. Although it sounds kind of obvious when you think about it, I (and presumably my psychiatrist) hadn’t anticipated that this might happen – to the extent that I’ve had depression in the past it’s generally been in response to trying to cope with OCD, rather than as a condition in its own right. (I was coping with severe OCD whilst I was on sertraline, but I wasn’t depressed).

The psychiatrist told me that 2 months is a typical length of time to relapse with depression after stopping antidepressants. She also told me that the fact I’ve been feeling worse earlier in the day than in the evening could be a symptom of depression know as diurnal mood variation.

Right now I’m fed up and desperate for this to stop. But when I spoke to the psychiatrist I did feel hopeful – she seemed fairly sure that the horrible time I’ve been having has its roots in brain chemistry. That suggests we can put it right by improving the brain chemistry.

Risk something new or go back to coping?

You have to build up antidepressants slowly, and it takes time for them to work. So I’ve had to choose whether to go for a new SSRI which might help my OCD, or whether to go straight back to sertraline, which wasn’t helping my OCD but which I now know seemed to be keeping me “ok” in terms of not feeling “wrong” in my head all the time/having depression.

Someone recommended fluvoxamine, an SSRI I haven’t tried before – they had found it very helpful for their OCD. So I’ve decided to go for fluvoxamine. It’ll take about a month to build it up to a high dose, and I’ll have to wait another month or so after that to see if it helps my OCD. If it doesn’t then I will have to come off fluvoxamine and build up sertraline again. I don’t want to live like this for another 2+ months. But I feel like I should keep fighting and try the fluvoxamine in the hope that it could help with my OCD. If I went straight back to sertraline I could be fairly confident it’d reduce this new form of persistent suffering, but I’d be in the same place OCD wise.

I’ve just taken my 4th dose of 100mg fluvoxamine. I can go up to 150mg in a couple of days. So far I haven’t noticed any change mental health wise, though I’ve been having a lot of trouble with insomnia. Insomnia is quite common for me but this has been particularly bad – the past couple of days I’ve spent about 4 hours trying to get to sleep. I know serotonin (which SSRIs work on) is connected to sleep, so I’m hoping that the extra insomnia is a sign of something happening serotonin wise, even if it’s not a good thing yet.

Writing this blog helps me feel a bit more like me, so I’ll probably be updating more regularly over the next few weeks as I try to carry myself through each day. Thank you for reading!