Fear And Obstacles To Medication Treatment

[Kefira]

I think I'm looking for support/understanding and if anyone has any success stories or advice I would definitely take it.

My PTSD symptoms are pretty well under control at the moment, but I'm experiencing severe situational depression. It's absolutely valid. I don't want to get into details here but with the level of loss and disappointment I've had this year across most aspects of my life and heavily in interpersonal relationships and my own health I would frankly be concerned about myself if getting out of bed wasn't a struggle.

I'm considering seeking temporary treatment, but the only other times I've been on meds in the past it was pretty immediately post-trauma, so same thing with it being situational. I'm concerned that maybe since it's not purely chemical there just won't be the right medication, or that everything will get so much worse like it did when I tried meds before. I'm really sensitive to medications anyway, and I try to avoid them because I always seem to get bad side effects.

I also was a minor when I was last treated and I don't remember most of my childhood/adolescence and there's no one I can ask which medications I did try. I only know it went poorly- I can't even give a good medical history to improve chances of success.

To top it all of the mental health professionals I trust don't have psychiatrists in my area they honestly recommend. So not only am I really worried about even considering this treatment path and I have a history of not being taken seriously/not having my concerns heard by psychiatrists, I don't even have the benefit of being able to go to someone trusted by those I trust.

But something has to give- I can't keep being this depressed and functioning. And since the source is a whole bunch of situations I don't have the tools or ability to fix or even improve right now I can't see it getting any better.

 

[joeylittle]

Do you know much about Sam-E or 5-HTP?

I honestly know very little, except that they are each purported to have positive effects on mood. They are supplements, so non regulated.

Also: how are your magnesium levels, and how's your sleep? Sometimes addressing those two can be a corrective 'lift'.

The typical prescription for a low grade situational depression would be an SSRI, Prozac or Zoloft. They can be very good at addressing it.

Are you getting any therapy support right now?

 

[Kefira]

Do you know much about Sam-E or 5-HTP?

No, nothing at all. I can research. I've had a bit of success with a couple supplements for mild symptoms but this is severe enough I'm not sure what might help.

how are your magnesium levels, and how's your sleep?

My sleep is awful, but that's also pretty common, I have a lot of sleep issues. I've been using light therapy to regulate a little, and I've noticed some improvement since I started up with that again.
I don't know what my magnesium levels are and that's something I've been wondering whether it might be contributing because the whole list of symptoms is basically my life right now. I also had a pretty bad vitamin D deficiency a few months back, but then my insurance changed so I'm switching Drs and had to before I went to re-test those levels. When I see my new GP (later this week) I want her to retest the vit D levels to make sure it's not also an absorption problem and/or that we had high enough doses to raise the levels enough (they were in the teens). I also will be getting them to do some more complete thyroid checks because I've had a three weird reads in the past year but the retests later on have been okay so they've been brushed off.
Are magnesium levels something I can ask them to check as well? Would that be on a normal panel or would I have to ask? Sorry for all the questions, I'm still reasonably young and definitely in the learning about your health and being a self-advocate to medical professionals and learning you really do have to ask- it took 3 drs and me insisting something was really wrong even to find the bad vitamin D deficiency.

I believe I tried zoloft and it didn't go well. Granted, the last time I was actively medicated was 10 years ago, but we tried 4 different antidepressants and the reactions ranged the gambit from suicidal to homicidal to just lethargic and non-functioning. As much as I keep saying this can't get worse because I've been having physical grief responses causing all sorts of pain from headaches to chest pain and crying myself to sleep every night and waking up every morning wanting to kill myself I'm really terrified if I ask for help, it will get worse. Because my experience with antidepressants is that they make things worse or as bad in a different way. I also was wrongfully committed around that same time, so the thought of asking for medical help is definitely a stresser on top of the bad experiences before.

I'm definitely not making excuses. I want to find help. I just want to figure out what the right help is for my current situation and how to get that help with the least amount of potential harm to me in the process

I'm in therapy, but it's more keeping me in contact with someone than doing anything productive because along with all sorts of health issues and some other trauma stuff I've lost 95% of my support network in the past year. I also think she's a competent traumatologist when we get to processing, but she doesn't seem to get (or I'm not communicating in a way that gets through to her) the severity of depression and other symptoms that have been coming up. For example my eating disorder has been becoming a problem again, and past me bringing it up in session a couple months ago it's not been discussed at all.

 

[Justmehere]

I have had a couple of rounds of depression due to situations and ptsd.

I had a lot of success with Effexor and taking a low does for just three months and then going off.

I also found that 5-HTP and b-vitamins can help me pull out of the slump enough to be able to use other tools to manage depression.

I really struggle to find docs I trust. When I know it's time for meds for depression, I usually focus on any physical components - how it's affecting appetite, sleep, etc. Waking up early and being unable to fall back asleep are two big parts of depression for me. Irritability as well.

Low magnesium can often be remedied with over the counter supplements pretty well - and it's fairly safe to take magnesium even if not low. It's fairly cheep too - when I get down, I take suggest 500mg in the middle of the day when not taking anything else (it can affect absorption of other things) and see if it helps. Sometimes it does, sometimes not. If someone takes more than they need, it, um, can cause slightly too loose stools (sorry to be gross.) But other than that, it's pretty safe. I've been so deficent in the past that I had to have iv infusions of it. I'm not anymore and only take it 1-3 days a month. For me, it helps a lot with tension and sleep.

Because your eating disorder symptoms have flared up, it might be worthwhile twas consider a consult with a nutritionist who can help work through any nutritional issues with your doc.

A sleep study may also be worthwhile. Most sleep med docs are dual trained in psychiatry and understand how mental health can affect sleep.

I hope you find some good solid relief soon!

 

[Kefira]

5-HTP and b-vitamins

Yes, B, D and natural calming supplements as needed for anxiety or sleep (Valerian root/passionflower teas do better for me than melatonin) seem to help some. I'm a vegetarian so I just sort of figure if I'm super tired my B levels are probably low or won't be hurt from a boost.

it's fairly safe to take magnesium even if not low.

I put in an order on a vitamin shop and had added some to my cart (this was a few days ago, like I said I've been wondering about the magnesium) just to see if it would help. My friend sells supplements and mentioned it was one she wouldn't worry about short term even if I didn't need it. I think I'll ask the Dr to check it too though because I don't know if they would run that normally, and even then I know things can be missed. I'm certain that I was severely vitamin D deficient for as long as a year with Drs just not catching it or it being borderline and them not caring to treat until it got so low it was a serious issue.

it might be worthwhile twas consider a consult with a nutritionist

I think I will ask my new this week Dr for a referral and see if insurance will help. I got some nutrition counseling at my school's rec center, but it was more a general eat healthy and here, we can give you some recipes instead of being very targeted or helpful. They also didn't seem to know how to help me much being a vegetarian OR with being eating disordered. So maybe I can find someone who can be of some real help through the new Dr if this goes well. Because obviously if sleeping and eating are both suffering everything else is as well.

A sleep study may also be worthwhile. Most sleep med docs are dual trained in psychiatry and understand how mental health can affect sleep.

I think I may look into this at some point. I had one shortly after my initial trauma (so a decade ago) and they said I had chronic fatigue and seasonal depression (grew up in the northern midwest), which seems to be one of those diagnosis that CAN be real, but is also used for "we don't know what on earth is wrong with you".

 

[lil_fighter]

This is all great advice. I took a SSRI for depression when I couldn't function and saw no way out of the rut I was in. That was when I was first diagnosed with PTSD and mild depression and was due to the trauma. The meds worked so well and got me back on track, living in the real world again and being able to achieve my goals. I honestly couldn't have done it without the meds. It was Citalopram that I took. I came off of them gradually when my life was stable and I then took 5-HTP. It was very hard to say whether the 5-HTP worked at all. I also have a vit D deficiency so have been taking quite high levels of vit D prescribed by the doctor for the past year.

In the past few months I have had situational depression. All the things that were stable in my life were turned upside down and I have hit an all time low. It almost feels worse when you have climbed to the top of the mountain and have then fallen back down. Finding the energy to get back up is so hard. Today I'm going to see my doctor and ask to go back on a low dose of Citalopram because it is at the point where getting out of bed is a struggle. It is so unfortunate that this is all down to circumstances and isn't chemical, similar to your situation. I feel though that I'm sinking and I need something to keep me afloat. Recent events were out of my control and have really affected me.

I was very lucky that the first medication I tried worked for me and I totally understand your fears because I had a lot of fears about going on them first time around. I can honestly say though that when they do work for you, it is life changing. This is why I am going to take them again because that boost and zest for life they gave me before reassures me. I am at a stage where I will either totally give up on life and stay in bed, lock the world out and cry or sleep. Or I can take the chance to be better again. There is no shame in taking meds. A few months ago if someone told me I would be going back on them, I would think I've failed or gone backwards but the reality is, I can move forwards and I know from experience works for me. I was 22 when I took my first Citalopram and it helped me live my life. I am now 28 and I don't want to give up (even if I feel like it) so I know what I can do to make this better.

Maybe see your doctor and discuss the options. You could try 5-HTP but if you are at the stage where everything is a struggle, consider SSRIs. The vit D could also help. Many people have a lot of success with meds, it's worth a try. It's great that you have been seeing your therapist too. Good luck and try not to worry. Don't let past experiences put you off, this is a new chapter and maybe new meds can help you :) If you feel that you are sinking, this could help keep you afloat :) Speak to your doctor and hopefully they can find the best options for you.

 

[Kefira]

There is no Shame in taking meds.

Yeah. I've been looking at this a lot. I think some of it is the stigma. I mean, I have a hard time taking my inhaler around really supportive people who I know would never judge me.

I think more of it though is that I really honestly can't afford this to get worse. As is my grad studies are going smoothly, there's so little else going right that they have to be. If I have a reaction like I did the last time I tried medications, I will likely end up failing out. So I get that I'm barely hanging onto functional, but I don't know what will happen if the meds tip me into totally non functional instead of stabilizing me because right now school and my career promise is what does manage to get me out of bed most mornings.

I think testing for everything else and then insisting on a lower than normal dose to start because no one ever listens to the fact that I'm really sensitive to meds might be the best middle ground here.

 

[lil_fighter]

It's really good that you know what you need and that you are thinking carefully about this, especially as your studies are going so well. It's great that your studies are giving you motivation and your future career is keeping you going.
Absolutely, getting tested for any deficiencies etc and then possibly going on a low dose sounds like a good move. The doctor you see makes all the difference too, if he or she is sensitive to your needs and actually listens properly it won't feel as daunting. If you see a doctor and don't agree with their opinion, get a second opinion. This is your mind and body we are talking about so go with what you are comfortable with. Good luck :)

 

[Kefira]

if he or she is sensitive to your needs and actually listens properly it won't feel as daunting.

I'm discovering this is astoundingly hard to find. I finally found a good gyno who admitted that his first thought was wrong, verbally, in front of me, when presented with evidence that it was in fact incorrect. I had never experienced that and about broke down crying it was so validating.