New medication, work and being kind to myself

[SeekingAfrica]

Hi everyone, I'm struggling a bit. Have any of you adjusted to new medication while doing their work full time? I work from home, and while that is purposefully flexible job, I am finding it impossible not to be hard on myself. I got this job so can be flexible with how much work I do and at what point of the day I do it. I got financial help for these and next month still exactly so I have the space to get on my feet and slowly get back into the full time work situation.

But things have been getting in the way. Health things, mostly, in the previous months. I'm still changing, adjusting, trying to improve and be better. And then this week, is the first week on new medication(lexapro to effexor) and I've found myself dizzy and sleepy a lot. Everything takes me longer to do. As I said my work is reasonably flexible, but I still find it hard to be compassionate to myself for not managing as much these days while adjusting to the new medication. Everything in me wants to be full force in, like, I got medication, now I have to be better than before, not worse, not even for few days. And I start thinking I'm lazy etc(I'm trying to do CBT for those thoughts, but sometimes they feel like objective truth). And then doing work while I think of myself in that way gets even harder.

 

[bellbird]

Have any of you adjusted to new medication while doing their work full time?

Yeah - starting on effexor whilst doing fulltime study.

I got this job so can be flexible with how much work I do and at what point of the day I do it.

Great that you've got a job that is flexible.

Everything in me wants to be full force in, like, I got medication, now I have to be better than before, not worse, not even for few days. And I start thinking I'm lazy etc(I'm trying to do CBT for those thoughts, but sometimes they feel like objective truth).

If it helps, I had similar symptoms when I started effexor.
It is definitely the most difficult medication I've been on in terms of my body getting used to it.

But you're certainly not lazy.
Take this thread for example: you've noticed a cognitive distortion that you're having difficulty resolving yourself, so you've reached out to the group to try to come up with a solution so that you can work fulltime and start on a new medication.
That sounds very far from lazy to me :hug:

What is the dosage you've started on? 37.5mg or 75mg?
And has the prescribing doctor indicated what your target dosage is, and how you are going to reach that dosage? (eg. fortnightly steps of 75mg)

I know I can't say anything to make the tiredness go away.
But I can tell you, from experience, that it will go away.

And I also can -try- to challenge that cognitive distortion of yours.
You're not lazy. You are so much stronger and more resilient than you give yourself credit for.

One thing that I'm currently working on for myself is making much more achievable goals.
i.e. making goals that take my health setbacks into account, instead of trying to make goals as if I didn't have those setbacks.
Perhaps that's something you could try? :hug:

 

[SeekingAfrica]

If it helps, I had similar symptoms when I started effexor.
It is definitely the most difficult medication I've been on in terms of my body getting used to it.

What is the dosage you've started on? 37.5mg or 75mg?
And has the prescribing doctor indicated what your target dosage is, and how you are going to reach that dosage? (eg. fortnightly steps of 75mg)

And I also can -try- to challenge that cognitive distortion of yours.
You're not lazy. You are so much stronger and more resilient than you give yourself credit for.

One thing that I'm currently working on for myself is making much more achievable goals.
i.e. making goals that take my health setbacks into account, instead of trying to make goals as if I didn't have those setbacks.
Perhaps that's something you could try? :hug:

Thank you! It's been so much more trouble adjusting to this medication than to any other before. It's only the 4th day, but it feels like a long time has passed because it has been intense. I am trying to do full-time while adjusting, so far I haven't been really successful. I'm lucky my workload is lighter this week, so really anything I don't manage will affect my finances the most, and nothing else.

Did you also get jittery? I'm noticing myself getting less tired now, but VERY jittery. As if I drank a lot of coffee or I'm anxious or something. I mean trembling jittery kind of feeling, but sort of constant? I think this is the meds starting to work, but still adjusting and balancing out. Not sure how long it will take for them to balance themselves out. I did start work earlier than usual today, and had the energy to do so...on the otherhand I still need frequent breaks while working*(that I needed when I was really anxious prior to Effexor, so it's not a surprise.

The doctor put me on 75mg to begin with. She didn't mention anything about increasing, but she did schedule me to see her in 2 weeks again. I'm guessing she'll assess how I'm doing and decide if I need more or not.

I am trying to work on the cognitive distortions though, especially the lazy one, because that is deeply engrained within me. Didn't help that at my worst depression this fall I was with my parents, who think depression is laziness and didn't miss opportunities to remind me that. Over and over for about 3 months. And yes, I have trouble goal-setting too. Not just with setting goals that don't take setbacks of any kind into account, but also just thinking in terms of 'should'- like, this has to happen that month, no matter what. I will try to sit down and see if all my goals are realistic... I might make something to track how much work hours I complete weekly now with all setbacks and try to forgive myself and slowly work up to full time. Because my health trumps everything else, it's just what happens. I just have to find ways to work with it, not against it.

 

[bellbird]

It's only the 4th day, but it feels like a long time has passed because it has been intense.

Yeah, I completely understand.
Try hang in there. I know it's hard, because effexor does take time to work, and so at the moment you're just in the stage where you're dealing with all these intense side effects, with really no noticeable payoff.
If it helps, I'm really glad that I stuck out the rough patch. I'm now on 375mg (max dose), split into two doses, and though I'm by no means "healed", I am coping much better than I was before I started on the effexor.

Did you also get jittery? I'm noticing myself getting less tired now, but VERY jittery. As if I drank a lot of coffee or I'm anxious or something. I mean trembling jittery kind of feeling, but sort of constant?

Yes!!!!!
I did.
It drove me bonkers.
I came to the same reasoning as you; the adjusting and evening out of this sudden new supply of neurotransmitters.
But yeah, definitely one of the most annoying side effects.

I can remember how long it was like that for, and everyone's experience will be slightly different anyway, but just know that that passes too.
The thing I found most helpful for the twitching was doing slow, diaphragmatic breathing through my nose. And practicing it daily.
Either put on a meditation, only has to be like 10 min, or just some music that you like, and just focus on your breathing.
It feels really weird at first, because you're trying to lie still and your body is doing its own thing and twitching all over the place, but it did help a lot over time.

The doctor put me on 75mg to begin with. She didn't mention anything about increasing, but she did schedule me to see her in 2 weeks again. I'm guessing she'll assess how I'm doing and decide if I need more or not.

Effexor XR does have a 37.5mg capsule. That's the dosage I started on. Most people start at 75mg, but if you're finding that it just feels too much for your system (or you're typically sensitive to medications like me), then you might want to reschedule your appointment for an earlier time and ask your doc about starting out on a lower dose.

Also I should mention, though I'm on 375mg now, I did notice beneficial effects in terms of coping and anxiety, at 75mg.
I was on 75mg for about 8 months. My dose got ramped up from 75mg to 375mg during my inpatient admission.

I am trying to work on the cognitive distortions though, especially the lazy one, because that is deeply engrained within me. Didn't help that at my worst depression this fall I was with my parents, who think depression is laziness and didn't miss opportunities to remind me that. Over and over for about 3 months.

I'm sorry that your parents treated you that way. That's awful. They're wrong though; you definitely aren't lazy :hug:

but also just thinking in terms of 'should'- like, this has to happen that month, no matter what.

Yeah, I totally relate to this too.

I might make something to track how much work hours I complete weekly now with all setbacks and try to forgive myself and slowly work up to full time. Because my health trumps everything else, it's just what happens. I just have to find ways to work with it, not against it.

I love this. I think that's a great idea.

 

[SeekingAfrica]

@bellbird No medication will 'heal' you completely when it comes to mental illness, I think. In any case I am trying to stick it out, the side effects. I'm already on day 5, and from what I know the side effects that will go away shouldn't take longer than 2 weeks...so I'm close to half-way through, no sense to stop now.

Also I'm not sure if that's possible, but I had a feeling yesterday I felt some of the good effects, just for a minute or 2. There was this moment, I almost felt like my old self again. In a way in which I didn't feel even on Lexapro when I was at my best. It was a really nice feeling and gives me hope that Effexor will be good for me once I adjust. I also had this energy boost a bit yesterday, this moment where I felt like doing my makeup for example, something I usually don't care much about once anxiety fatigue hits me. In the last year I've done my make up 3-4 times at all, and usually for need, not want. But yesterday I felt like doing it (I used to love to play around with make up...but when anxiety becomes a constant in my life I simply don't have the energy for it).

About my parents...well, it is what it is. Had enough patient talks about mental health with my mom, so if she doesn't get it by now, I think there's no sense in trying anymore. We live in different countries so I just don't mention my mental health when we talk, for my own peace of mind. The problem was when I was there this winter, it was for 4 months, so all the negative words really impacted me and I moved from deeply depressed to even lower mood and getting out of bed was an issue...which only supported her lazy theory.

Anyway...I'm trying to be better, learn to be good to myself. I printed the first chapter of DBT workbook today...I am planning to print it out slowly over time(it's 300 pages...great book) so I can work on my thoughts. Today is tougher. I had a work interview and suddenly my whole world was revolving around preparing for it. Now I can't snap out of being highly trembling anxious and Effexor side effects might be making it worse. There have been a lot of nice changes that I made this week, but this interview felt important and intense and now I feel everything in me retreating and wanting to eat junk, have a nap and watch TV or find something that feels comforting. Crossed my quota for changes for the week, I suppose.

p.s. I do have a list of things that help me with mental health to track which I manage to do monthly, so this has everything from meditation to hot baths. It's hard to remember to get to meditation, but when I do, it certainly helps.

 

[bellbird]

Hey 2 steps forward 1 step back is still 1 step forward, right? :)

I also had this energy boost a bit yesterday, this moment where I felt like doing my makeup for example, something I usually don't care much about once anxiety fatigue hits me. In the last year I've done my make up 3-4 times at all, and usually for need, not want. But yesterday I felt like doing it (I used to love to play around with make up...but when anxiety becomes a constant in my life I simply don't have the energy for it).

This is so great to hear.
I'm really happy for you.
I remember I had an early "indicator" of some positive effects on Effexor and my GP said that it was a really good sign. I hope that it's the same for you :hug: :hug:

Hard days will still happen, but you're taking big steps, and you should be proud of yourself for that.