Coming off drugs – does Citalopram help?

I’ve taken Citalopram for the last year and a half.  I’m not sure if it helped or not. I did get better, but I was trying other things too, so it is difficult to know.  I definitely did notice some side-effects: stomach upset when I started the meds and interference with my sex life – which could in itself be depressing – thank goodness I have an understanding husband!

Anyhow, I’ve decided to come off the Citalopram and visited my GP who agreed.  It sounds quite simple.  I’m taking 20 mg daily. I am going to cut this down to 10 mg for a month, then 10 mg every other day for two weeks.  I am also going to keep a daily log of my mood, so that I can see what is ‘normal’ for me and if there are any changes.  That’s it.

Coming off the medication is a bit scary in case I get ill again.  I also made the mistake of looking up the spelling off Citalopram in Google and finding a lot of posts from other blogs about it being difficult to come off.

I also think it will be interesting to see if Citalopram worked or what difference it’s made to me. It is the same family of meds as Prozac (an SSRI) and they are often described as ‘happy pills’.  I didn’t notice any instant happiness, so maybe I’ll just give up and all will be well?

Here’s my first log:  I feel a bit under the weather with a cough and I’m tired because of being ‘entertainment secretary’ for my 4-year-old during our holidays! My happiness/confidence level at 80 percent.  Anxiety at 7 percent.  Mood 90 percent good.  This is using my own subjective HAM index (Happiness, Anxiety, Mood)!  If you’re giving up the meds to do let me know how you’re getting on.

‘Coasting’ to relieve anxiety and worry

Photo: Richard Styles, stock.xchng

The first time I went to see the doctor he gave me some advice about work that I have found to be helpful for other aspects of my life.  He suggested I ‘coast’ my way through work; ‘Do the minimum, take breaks, look after yourself’.  Usually there is no way I would pace myself at anything less than 110 percent.  However, I felt so lousy that I had no choice.

What I discovered was that although I thought I was taking on less at work, no one has noticed.  In fact I am now working at a similar pace to many of my peers.  I am indeed doing less, but I’m also doing more of the things that matter, and the extra tea breaks are good for me and my colleagues.

I’ve recently started to generalise the ‘coast’ mantra to other parts of my life.  For example, this morning I was discussing plans for the day with my husband.  I started to detail all the complicated recipe options I could cook for a friend that was visiting for lunch.  My husband chipped in, ‘So much for coasting!’.  So I changed my plans and coasted; we had a sandwich and all was well.

Similarly, I’ve been making more time for myself during the day.  When I’d finished lunch I tidied up, even though my friend was still here.  This might sound like a simple thing, but I have been brought up to believe that I ought to prioritise the needs of guests over my own.  Today I did look after my guest, but not at the expense of my own well-being, and am glad I did, because at the end of the day I wasn’t left with a great pile of clearing up.

This small example of my day might sound trivial, but I think it’s illustrative.  I’ve learnt from reading about worry (principally in the book Overcoming Worry by Mark Freeston and Kevin Meares) that being in a highly anxious state means that we are in a state of hyper-vigilance, which I think of as a kind of amber alert.  This means that I can always see all sorts of possibilities for extra things I can fit into the day. I often make myself ridiculously busy and then wonder why I’m tired.  Now I’m learning to do less and have made the surprise discovery that what feels like coasting to me is probably more like how most people live.

Seeing the doctor, anxiety and accepting help

Photo: SP Veres, stock.xchng

Yesterday I saw the doctor again and he gave me some advice which surprised me and I thought might be useful to others.

I’m lucky because the GP service where I live has a doctor that specialises in working with people with mental health issues.  I’ve asked to see him about once-a-month whilst I wait for cognitive-behavioural therapy (CBT) because the waiting can be difficult.  He agreed with no hesitation, which is great.

I explained that before Christmas a small situation with a friend triggered a bout of painful anxiety.  I really dislike it if someone disapproves of me and find it quite intolerable.  Once I’m anxious my thoughts quickly race into a series of other doubts and uncertainties.  Before I know where I am, I’m exhausted and uncomfortable all over again.

I think the last bout of anxiety was particularly difficult because I had been feeling better and so it was disappointing to take a step backwards again.  The doc reassured me that it’s normal to have two steps forward and one back and that I am getting better gradually.

One thing that surprised me was his question about how my husband was doing.  I said that he was (and is) a complete saint.  When I was having a bout of anxiety he really looked after me well, for example, one night when I felt awful he told me to sit down and watch telly, whilst he brought me a glass of port!   The doc suggested that it was important to let those who love us care for us in this way, because it can be difficult for them to know what to do when they see us tying ourselves in knots with worry. So accepting help can actually be good for those we love as well as ourselves.

Taking medication for anxiety

In this case, the drugs do seem to be working.  I have been taking Citralopram 20mg a day.  At first the only effect was feeling sick.  I was sceptical it would work, since the packet suggests its only for people with depression.  But to be quite honest I was so desperate to get better that I would have tried anything.  After about 6 weeks I started to notice that sometimes I could think more clearly and was a lot more calm.  I don’t feel like I’m on something or drugged or drowsy, so the effects seem to be subtle.

Just looked up the spelling of Citralopram and noticed that there may be side effects following withdrawal – another little something to worry about!

Seeing the doctor – the turning point

I am lucky to have access to a group practice that is excellent.  I had the courage to ask the receptionist if I could see and general practitioner who specialised in mental health problems; so the first person I saw was a doctor who obviously has a lot of expertise in this area.  I was impressed that he didn’t start with the usual ‘So what can I do for you?’  He just seemed to start a conversation and then I spilled all my worries in a big muddle.

He asked me to fill in some forms (scales) to find out how I rated in terms of both anxiety and depression.  The result is that I was offered medication and to go on a 6 month (6 MONTHS!!) waiting list for cognitive behavioural therapy. He recommend that I ‘bin the book’ that I was using to try to help myself and ‘coast’ with all aspects of life and work.  He said that usually when people reach the point of going to the doctor they have reached a low point and things begin from this point to turn round.  He also asked to see me again in two or three weeks.

Strangely, knowing that I only had to get through two or three weeks was quite liberating.  I no longer had to think about fighting this thing on my own, for ever, but just, with help for two weeks.  This I could do.  I returned home a bit exhausted, because I had been worried that either I’d be sectioned, or not believed and had spent ages rehearsing in my head what I would do in either case. There was a small immediate change in that I now had a shred of hope that I would get better.