The next guest post comes from Ness, who lives in North West England. Her blog is called “The Girl With The Five Lads”. Her post is a great one for people just starting antidepressant treatment or for those who know people who are on them. Ness goes through all those things you want to know but just don’t end up asking. I really wish it was around when I first went on them!
What to Expect When Starting Antidepressants
By Ness, The Girl With The Five Lads
A reader asked me recently about antidepressants and my views on them. This person had just commenced a course of treatment and was feeling worse after two weeks. It really saddens me that people are not given adequate support and advice regarding how you feel during this period. You do not instantly feel better, the period after talking to your doctor is when you need so much tender loving care and support but sadly some are not told this. I realised that maybe more people needed to read this so I wrote out my advice.
This is a blog about the things that should be said when you first start antidepressants yet never are. There are far too many people in the world that find themselves knees deep in depression or anxiety. One of the hardest steps is to accept that you are not feeling right and then opening up to the doctor and asking for help. Massive well done, unless you have been there you never fully appreciate how much strength it takes to book an appointment with your doctor and openly discuss how you are feeling, this is the first step and you have done that.
People should be given so much support at this time, every aspect of care should be explained and the person should be given it all in written format also so that they can take it home and digest it time and time again. So that they can let their wife or husband read it also to offer support. These people need support also. They need to know what is happening to their loved one and how to help them as much as possible.
Some doctors are super and some are rubbish, this is with every illness not just illness in your mind. So if you got an unsympathetic one that simply handed out the medication with no empathy at all, it is more a reflection of their lack of education do not take it personally.
You may find that family, friends, work may think “Oh they have been to the doctors now and got tablets so they are fine” It doesn’t work this way at all, holding the box of tablets in your hand for the first time does not instantly make you cured.
When you are on antidepressants you will find that everyone tells you their negative stories about being on them, they suddenly become Mental Health experts and start to tell you all about how bad antidepressants are. They are not. They are a medication that has helped so many people to reclaim happiness within their life again. If everyone had the guts to hold their hand up to being on antidepressants then you would soon realise how many functioning happy people there are in society just like you.
YOU ARE NOT ALONE!
If you find yourself in this situation, unable to climb out of the darkness then this is for you.
Depression, anxiety is a cruel illness that can happen at any time within your life, you did not ask for it, it is an illness, it arrives when it likes and all you need to focus on at the moment is the word ILLNESS.
Mental illness is as much being ill as if you had half of your leg torn off and was in a hospital bed. It is not a sign of weakness, should not carry any guilt, stigmas or feelings of worthlessness. Would you feel this way if you had a bad case of the flu?
The best advice I could offer anyone with depression that has just started medication would accept you are unwell and allow yourself the time to heal. This is not going to be a fast process so accept you are in it for a long haul. During this time you must put all key decisions to the back of your mind.
When will I be well enough for work? When will the cloud lift? Will I ever be normal again? all these questions have no place within the first few months. You simply MUST focus on recovery and rest.
If you had the flu would you get up each day, get dressed and function as normal? Would your energy levels be the same? Would your appetite be huge? Would sleep be sporadic? We never push ourselves to unrealistic expectations with “REAL” illness but depression and anxiety we are expected to jump out of bed, brush ourselves down and get on with life.
For the first few weeks set yourself mini goals and targets such as I am going to have a bath and getting some sleep. You are ill remember and you are allowing your body time to heal.
When starting medication you will feel as rough as a dog for the first few weeks, this is normal and you just have to allow your body to adjust to the new balance of the medication, give it time.
Accept that the onset of the medication having a positive effect can take weeks, months. They do not work within 20 minutes like paracetamol. They make your sleep pattern all over the place so grab naps throughout the day when you can, they make you feel lethargic so rest, nauseous is a bitch at the early stages so get some meal replacement shakes to boost nutrition.
The first few months think of yourself as a poorly sick caterpillar in a cocoon, resting ready to emerge. It is so important that you keep on telling yourself that this will pass and you will have happier days again. Hold that thought in your mind and never allow it to slip as it is during this time your mind plays tricks on you and makes you feel like you should be instantly better so you must be a failure.
The mind is so powerful at times it is like having a nasty bully at our side always. Have you ever heard of Mindfulness?
Mindfulness is a technique for becoming more aware of the present moment. It can help us enjoy the world around us more, and understand ourselves better. Some of the ways you could practice mindfulness are through meditation, tai chi or yoga. Some people find this helps them manage anxiety and stress. If nothing else meditation, tai chi or yoga will teach you to practice effective breathing techniques to help calm your mind.
A few drops of lavender oil in a handkerchief inhaled is very calming when feeling anxious.
Bach Rescue Remedy is also a super calming effect, the pastels are great. They are little pastles that you suck, chew when feeling anxious. Dr. Edward Bach discovered the Original Bach Flower Remedies which is a system of 38 Flower Remedies that corrects emotional imbalances where negative emotions are replaced with positive.
A simple aromatherapy inhalation or sucking on a Bach paste may be enough to then focus your mind on effective breathing to calm you.
Communication at this stage is so important. Loved one feel left out and want to help, they want to talk but talking drains you so write little notes to each other. Use any method to express yourself and make sure they know that when you are quiet you are just healing and need that quietness.
You may, however, find that you want to talk over and over, that is fine.
Accept that tasks, hobbies will be hindered so trying to relax by reading may become a massive stress as you can no longer function on the words, it is ok, this is just because you are unwell. Read small passages and take notes about it so you do not forget the story plot.
Don’t be afraid to ask your doctor for further support during this time, that is what they are there for. But also don’t feel the only care is through a single tablet as it is not, you need to help it work effectively also but not challenging yourself to the limit during this time. Simple things like not drinking massive amounts of caffeine as this will increase agitation. Also, avoid alcohol as this is a massive depressant.
I understand you are feeling nauseous but are you getting enough protein?
The protein contains amino acids, which make up the chemicals your brain needs to regulate your thoughts and feelings. It also helps control your blood sugar levels. Try simple bland meals and have some protein-rich meal replacement shakes.
Starting a low-fat diet at this time is a NO-NO Your brain needs fatty oils (such as omega-3 and -6) to keep it working well. So rather than avoiding all fats, it’s important to eat the right ones.
You need to concentrate only on you and getting better so start becoming your own best friend. Learn to say No and don’t feel bad for putting yourself first during this healing phase.
Medication is just one part of the jigsaw to becoming well again, you have to allow them to work and then you will be in a better-equipped place to look at other aspects of your life. Depression and anxiety can only be treated effectively if it is done holistically, medication is only one ingredient. But at the moment in the first few months when you feel like a steam train is running through your mind it is not the time to think about it. Just concentrate on relaxation, rest, adequate hydration and getting nutrients and protein in your body.
Just breathe and allow yourself to heal, accept depression is an illness and treat it that way.
Go back to your doctor as many times as needed, that is what they are there for. Make an appointment with the surgery nurse to discuss medication further, ask to be referred to the dietitian to discuss nutrition. Ask at the surgery if there are any support groups in your area, it is good to talk to others in the same situation. Never feel you are alone, there are millions of people just like you and there are so many pathways of care that are there to support and help you.
Love and gentle hugs