Medication?

I have just over a week to decide whether or not I will choose to trial an SSRI. I am still very much undecided. As if the decision wasn’t already tough enough to make, there are some complicating factors which make it even harder.

As pharmacy students, we are taught that when we are out practicing in the real world, we should take the time to counsel patients on the medication they are taking. I assume this too would apply to doctors. A good psychiatrist should take the time to explain to the patient the medication that they want to prescribe. I was given the most minimal amount of information by Dr T. Perhaps she assumes I already know about SSRIs, due to my previous psychiatrist wanting to prescribe them to me, and the fact that I am a pharmacy student? She asks what I already know about them from studying pharmacy. I tell her we have not learnt much about SSRIs in first year. She then asks why I chose to take the pills that I took, when I took the overdose a couple of months ago. I say that I knew they would knock me out. To this she replies, ‘Well you obviously knew enough about them.’ There are no further attempts to explain SSRIs to me. I do not expect her to go to the levels that my previous psychiatrist did, in informing me that SSRI stands for Selective Serotonin Re-uptake Inhibitor. That, I know. What I do expect is to be clearly told why she wants to prescribe medication, what does she aim to achieve in prescribing medication and what are the possible adverse affects.

I have my appointment with her five days before my first exam. These end of semester exams determine whether we pass the unit or not, and more importantly for me, whether I’ll be terminated from my course, as it is my second time repeating this unit. The cynical part of me is thinking that if she does prescribe me medication, it’s part of a plot to get me terminated from pharmacy. There is the risk of falling ill from the side effects and I’m hardly going to be able to study if I am feeling ill, I’m having a hard enough time trying to study now. When I saw my previous psychiatrist in Year 12, he wanted to prescribe me an SSRI. It was a couple of weeks before my final exams, he didn’t realise this. Upon finding out, he told me he would see me again after my exams, to talk more about going on medication. Dr T has already expressed her extreme disapproval of stealing pills from my workplace and her lack of confidence in my ability to become a pharmacist. I’d be very suspicious indeed, if she suggests it’s a good idea to start on medication five days before my exams…

Considering she’s told me she thinks I’m simply unhappy because of school and Uni related issues, it’s left me doubting whether going on medication is really necessary for me. And I told her this. I said, ‘I’m not sure whether I really need to go on medication.’ She gave me some answer I can’t remember, that left me wondering whether she’s aiming to encourage or discourage me from taking an SSRI. I suppose I should be grateful she’s not pushing medication on me, like I felt my previous psychiatrist was. Some guidance would still be nice though. I am absolutely confused by this woman, no other mental health professional has baffled me as much as she does. She is the one that’s suggested I try out an SSRI. Yet, my interpretation of what she said is that she thinks I am using mental illness as an excuse and I don’t have depression after all, I’ve just employed some unhealthy coping skills in dealing with the everyday woes of life. Thus, if I go back to her willing to try the antidepressants, I will feel like I am looking for a quick fix, so I can blame all my failings on mental illness. She did however, ask me whether I’m hesitant about going on medication because it would mean admitting to myself that something is wrong, which again is a contradiction.

She tells me she doesn’t want to prescribe me medication if I’m just going to not take them or even worse, overdose on them. Huh. If I wanted to overdose on something, I would not choose an SSRI…

After that initial consultation, I’ve decided that I don’t like her very much. I very almost cried during the appointment. I succumbed to tears after the appointment. All weekend I have felt awful as a result of this appointment. And even putting that aside, I expect basic mannerisms to be adhered to, something as simple as a ‘How are you?’ at the beginning of the session and a ‘Thank you’ at the end of the session. I’ve been accustomed to getting that from every other mental health professional I’ve seen, and I didn’t get even that from her. Hmph. If I do decide to go on medication, it’ll mean I’d have to continue seeing her to monitor how I am going with the medication, for my prescriptions etc. The thought of going in to see her more than I have to absolutely terrifies me. The anxiety it brings may be more than it’s worth. Like I have the money to spend on multiple appointments with her anyway.

If I put aside all the above mentioned factors, well, I still don’t know.

I am afraid of side effects. Superficial as I feel saying this, I fear the potential side effect of weight gain. I am reluctant to consult Dr T about this particular issue though, after she condemned being an anorexic pharmacist and dealt with my eating issues in what I thought was an insensitive manner.

I am apprehensive about going on long-term medication, that once I start taking an SSRI, I will be in it for the long haul. I’m not sure how I feel about the idea of being reliant on a pill taken everyday to make me feel okay.

I am doubting the necessity of going on a psychotropic medication, especially after talking to Dr T, I feel like I don’t even have a real mental illness.

There are also those horror stories that you hear of people who started taking antidepressants. The ones who experience all these horrible side effects, the ones who become addicted to the meds and can’t come off them without experiencing severe withdrawals, the ones who become increasingly suicidal and commit suicide whilst on the medication.

I feel like I am choosing to take the easy way out by taking antidepressants.

That being said, I’ve tried the counselling route. I went to the counselling sessions with my school counsellor in Year 12, I had the eleven sessions of therapy that I did with my previous clinical psychologist. I’m no better than when I started. Though, that could be a lack of effort to change on my part, or a lack of skill on the professionals’ part, or both.

Maybe medication is what I require? By declining them, I could be denying myself the chance to get better.

I’ve been depressed for years, I started cutting myself since I was twelve. Isn’t that long enough to have suffered? I’ve already waited this long to try medication, maybe it’s finally time.

The majority of people who really know what I’m going through and the struggles that I’ve had in the past, think that it’s a good idea.

Medication has also helped loads of people with their mental health problems.

I haven’t yet made a decision. I have more than a week, in my mind, that’s plenty of time. However, that’s my attitude to everything, including Uni, and it’s that attitude that has landed me in so much trouble with being able to successfully plan my time and study for tests and exams. I need to come to a decision soon, a week will well and truly creep up on me and before I know it, I will be heading off to my appointment of doom.

I suspect I’m overthinking it all. It probably shouldn’t be this difficult a decision to make. Yet, going on long-term medication seems a huge deal to me. The only prescription medication I ever remember taking are antibiotics and a flu medication.

It’s interesting to note that when I flick back to my diary entries from May 2009, I am in almost the exact same position. I had come back from an appointment with my previous psychiatrist, where he was being, in his words, ‘…a bit stern with you today,’ because I had taken an overdose. He was pushing medication on me as a result, and used the OD as proof I needed medication to get better. I only didn’t end up trying the meds because my parents declined them for me. Shows how far I’ve come in a year…haha. Only difference is that this year my parents don’t get a say in the matter of medication, the decision rests solely on me. In fact, I haven’t even told them about the possibility of going on medication and I don’t plan to either. I’m not sure how easy or difficult it would be to hide the fact I’m on medication from them, if I do decide to trial an SSRI however…

The last time a psychiatrist wanted to prescribe me an SSRI, he wanted to prescribe me sertraline (Zoloft). I’m unsure which SSRI this new psychiatrist has in mind.

If anyone is willing to share their thoughts on this and/or their experiences with SSRIs, that would be much appreciated. Thanks 🙂

5 thoughts on “Medication?

  1. Right – side effects. SSRI side effects are usually pretty mild, if you get any at all. The most common ones are dry mouth, bad sleep, decreased libido etc. Nothing too major, although having said that, if you are seeing her just 5 days before your exam, then I would wait until after the exam to actually start taking them, just in case. But I have been on several SSRIs, and any side effects have been pretty manageable – the older anti depressants are much worse for side effects. They are fairly unlikely to affect your weight – it can happen, but it wouldn’t be a typical SSRI side effect really.

    Secondly – taking an SSRI does not mean you will spend the rest of your life, or even years, on medication. Lots of people take them, and then come off them at a later date. On the other hand, I do know other people who having found the drug that helps them, have chosen to stay on it once stable, because they don’t want to risk things getting worse again. But either way, it isn’t a life sentence, and to be honest even if it was, there are worse things than taking a pill daily.

    You would have to see the psychiatrist more often if you were on medication, yes, but you may find she isn’t as bad as you think when you have seen her more – sometimes we get bad first impressions of people but then realise they are actually ok. And sometimes you can really like someone when you first meet them, and then discover they are a complete idiot. But if it comes down to it then you can see a different psychiatrist if needs be.

    On balance, I would take them. I don’t see what you have to lose. You haven’t ever tried medication before, and you have felt bad for years, so why not give it a go? It is unlikely to make things worse (although if you do suddenly start feeling very suicidal then stop taking them and make an appointment to see your GP or Psychiatrist ASAP) and it could really help you. Medication isn’t a miracle cure, but it can help. Particularly things like concentration and anxiety, and some of the other more clinical type symptoms of Depression. Although I have never found an anti depressant that has had that much impact on my mood, I have realised since coming off them that they had been helping with things like that, and little things like that can make a big difference when you are feeling really bad. If I were you I would try the medication. But it is your decision.

    xxx

  2. I don’t really feel qualified to offer any concrete advice on this one, but I don’t like the sound of this Dr T, and you have every right to expect more from her than you have recieved so far, especially in terms of respect and compassion. It sounds like a stressful time to be introducing new drugs, is there anyone else you can talk to about this? Maybe your GP?

    I wish I could offer some more useful advice…

    Hugs

    Sarah x

  3. My advice, would be to first, find out what SSRI she wants to put you on so you can properly Google the heck out of it.

    Second, I don’t suggest starting them until after exams. Focus on exams and pass the course. Then let yourself relax enough to deal with the SSRI, p-doc, and psychologist issues.
    I know it is soo hard to do all of this and school. Try to focus on that you’re almost done and that you ARE good enough to be in and pass the program.

    As per the SSRI question – most of us can probably give clearer advice/experience help once you know what it is.

  4. I was on aropax years ago and for me, the initial few days I was dizzy and had a dry mouth. The dry mouth was what drove me nuts but that went away after a little while. I didn’t think they worked for me but my husband took zoloft and it worked really well for him, but had a side effect for him that made things difficult, but is a side effect men get. It really is different for each different person. No one is the same. If your new psychiatrist offers you meds, you could have a look here http://www.mydr.com.au/ which is a website you can look up the leaflets you can get for different meds. I hope you are feeling a bit better. The bad impression from your first visit to the psych, may just be that you were nervous and you don’t know each other very well yet. Maybe see how it goes and good luck!
    *hugs*
    Sarah

  5. Hey =]

    I’m glad to hear you’re getting help again, although I have to say this Dr T does not sound like a very nice person. But beware that if she’s prescribing meds she must think you have a problem, is it possible you’re misinterpreting some things she’s said? It doesn’t sound like there would be but it’s something to consider. It is good that you’re going to a psychologist as well, and that it’s not just going to be CBT, that approach doesn’t work for everyone and I think you have to be really determined and sure for it work which with an eating disorder most people aren’t.

    As for the SSRI’s I have always been against them myself and had a bad experience with fluoxetine [prozac] when I was 15, however I have gone back on them recently [fluoxetine again] and I’ve changed my mind. I took them as a last resort because I just couldn’t cope. The side effects initially were dizziness, nausea, lack of balance/coordination, stomach pains, anxiety, racing thoughts, lack of appetite. The side effects disappeared completely after around 4 weeks [aside from the lack of appetite] but the physical ones went between 1-2 weeks, the psychological effects started later and lasted a week or two as my mood began to change and took some time to stabilise properly. I couldn’t tell you 100% what the effect has been on my weight but I know most SSRIs can be associated with weight gain OR loss, and fluoxetine is generally considered to be fairly weight neutral. I’ve lost weight since I went on it, although I dont know whether that is due to eating habits or the medication, but given that I’ve increased my food intake in that time significantly they definitely aren’t causing gain. I think that a lot of weight gain associated with SSRIs is due to an increase of appetite or depression where weight loss has been a symptom, and you can always choose whether or not you eat.

    I do think though that you have a right to find out exactly what they’re being prescribed for. If it was for anxiety I really don’t see why she would prescribe SSRIs instead of anti-anxiety meds so I’m assuming she’s prescribing them for binge/purging or depression. Which you do have, I don’t think anyone with two brain cells to rub together would think that you are just depressed because of your school course. I think this has been going on long enough that it cannot be just down to your situation, if it was surely changing your situation from school to uni would have helped? But nothing has so far so there is evidence for a chemical imbalance. My GP asked for evidence of chemical causes for my low mood, i.e that dips in mood weren’t always associated with negative events, sleep disturbances, weight disturbances etc.

    I also wanted to comment on the pharmacy issue. I think it’s obvious from what I know about you that you’re 100% intelligent and diligent enough to do the course if you were mentally healthy and as for being an anorexic pharmacist – there are anorexics in every job, anorexia doesn’t discriminate [and I thought you were bulimic anyway?]. It’s very insensitive of your psychiatrist to say that. I wouldn’t go on medication until after your exams because there’s no telling 100% how your body will react and you don’t want to risk side effects or a bad reaction when you’re at such a critical time. However I also remember you saying in the past that you would actually like to persue psychology as a career and that the pharmacy course was more for your parents. So maybe if you do leave the course it wouldn’t be the worst thing? I know you would consider it a failure but honestly hon, if you do fail pharmacy you have done so purely because of mental ilnesses that you have not chosen, not as a reflection on your ability. And when one door closes another door opens. It would leave you in a position to apply for the course you genuinely want to do, that you have passion for, because you’re capable of that and it’s your life not your parents.

    So, to conclude. Dr T = useless, find someone else if possible. Good luck with the psychologist, that’s a good step. SSRIs can be very good, I would strongly advocate trying on but not until after your exams. You’re brilliant and nothing will make you a failure. Try and find the positives and think about what you really want in life and follow your dreams =D

    Apologies for the cheesy cliches

    Becca xxx

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