18 votes

Thoughts on SSRIs?

Hello everyone,

I recently got put on some SSRI for my worsening suicidal ideation and honestly I can't believe the difference it's made. It's like a version of myself that I find hard to believe existed, but can draw parallels with the version of me before I got depressed, etc.

I'm just curious how I should be viewing these changes in me: Are they really me without depression/anxiety or is it a more lurid exaggerated version of that?

Any other thoughts on SSRIs in general welcome! I'm interested in seeing Tildians' thoughts on them :)

23 comments

  1. [3]
    joplin
    Link
    I take a very small dose of SSRI to help with daily chronic headaches. They cut the number of headaches I get about in half. They've been pretty useful to me. You say: I've heard others ask that...

    I take a very small dose of SSRI to help with daily chronic headaches. They cut the number of headaches I get about in half. They've been pretty useful to me.

    You say:

    I'm just curious how I should be viewing these changes in me: Are they really me without depression/anxiety or is it a more lurid exaggerated version of that?

    I've heard others ask that question, and one response I heard that struck a chord with me was that the meds aren't changing who you are, the depression was obscuring who you are and the meds let you be you again. I don't know if that will help you, but I liked that sentiment.

    17 votes
    1. [2]
      3_3_2_LA
      (edited )
      Link Parent
      This is really interesting, I did not know they had applications beyond being used to treat depression and anxiety! Color me curious, but does it also help alleviate any anxiety you might...

      This is really interesting, I did not know they had applications beyond being used to treat depression and anxiety! Color me curious, but does it also help alleviate any anxiety you might otherwise have?
      Thank you for the last paragraph, it really does feel like that and I'm glad to hear that that perspective isn't just mine.

      4 votes
      1. joplin
        Link Parent
        It’s hard to say. I don’t generally suffer from anxiety, plus I’m taking a rather small dose, so I don’t think I’m getting those sorts of effects, but it’s possible.

        It’s hard to say. I don’t generally suffer from anxiety, plus I’m taking a rather small dose, so I don’t think I’m getting those sorts of effects, but it’s possible.

        2 votes
  2. [5]
    Comment deleted by author
    Link
    1. [2]
      etiolation
      Link Parent
      This is a fascinating perspective. Do you have studies or readings to link where I could learn more?

      On a more down note, this is why anti-depressants can increase the risk of suicide, as the depressed individual finally gains enough energy to put a plan into action.

      This is a fascinating perspective. Do you have studies or readings to link where I could learn more?

      5 votes
      1. 3_3_2_LA
        Link Parent
        Honestly, purely anecdotal but this is precisely the way I felt. Sometimes, depression would work in my favor when I'm 'too tired' to kill myself or think a plan through. But now with all of that...

        Honestly, purely anecdotal but this is precisely the way I felt. Sometimes, depression would work in my favor when I'm 'too tired' to kill myself or think a plan through. But now with all of that gone, even the slightest visage of a plan doesn't seem as farfetched as it did before.

        3 votes
    2. [2]
      3_3_2_LA
      Link Parent
      Thank you for the insight about the long-term implications. I was informed that my depression is primarily circumstantial, so I just need it to get through a rough patch. And I should've...

      Thank you for the insight about the long-term implications. I was informed that my depression is primarily circumstantial, so I just need it to get through a rough patch. And I should've mentioned, I have been seeing a therapist so that does help!
      It really is a bit unsettling to realize how long I've been struggling with depression, and nothing seemed to help much but just going on SSRIs was (luckily) enough to cause such significant positive changes in me. It almost feels like I'm cheating the whole recovery-from-depression path somehow...

      4 votes
      1. patience_limited
        Link Parent
        You're not "cheating", and there are times when it's appropriate and necessary to treat "circumstantial" depression. [YMMV, but a great deal of depression could be categorized as "circumstantial"...

        You're not "cheating", and there are times when it's appropriate and necessary to treat "circumstantial" depression. [YMMV, but a great deal of depression could be categorized as "circumstantial" - stemming from loss, poverty, unmet health needs, powerlessness, thwarted ability to meet personal, familial, and societal expectations, etc.]

        2 votes
  3. [2]
    mosburger
    Link
    I've been on multiple SSRIs and SNRIs for almost 20 years now. I'm really glad they are working well for you! My experience has been pretty mixed - none of them have addressed the...

    I've been on multiple SSRIs and SNRIs for almost 20 years now. I'm really glad they are working well for you! My experience has been pretty mixed - none of them have addressed the tiredness/exhaustion part of my depression, so there might be some other underlying cause of that. But worse, the side effects (sexual) have been very frustrating to me, and they only somewhat treat my depression (I still have awful can't-get-out-of-bed self-loathing days), seemingly by erasing most emotion altogether.

    Having said that, I'm much better off with then than without them, so I'm still taking them. I wish I could try something like Wellbutrin instead, but unfortunately I have epilepsy so that isn't an option.

    Best of luck to you! :) Sounds like they're working out for you.

    10 votes
    1. 3_3_2_LA
      Link Parent
      I'm sorry to hear that you've had a mixed experience. You've probably checked it out but do ask your doctor and get a Vitamin D test done. My skin color prevents me from gaining much Vitamin D...

      I'm sorry to hear that you've had a mixed experience. You've probably checked it out but do ask your doctor and get a Vitamin D test done. My skin color prevents me from gaining much Vitamin D through exposure to the sun and just getting my Vitamin D levels up from Severe to Normal was sufficient to offset the fatigue caused by the SSRI.

      But worse, the side effects (sexual) have been very frustrating to me, and they only somewhat treat my depression (I still have awful can't-get-out-of-bed self-loathing days), seemingly by erasing most emotion altogether.

      AFAIK The emotional blunting shouldn't be occurring but then again I'm out of my depth here. My doctor did address the sexual side effects and said there is medication to help with that especially when you're on SSRIs but I'm guessing you've tried that already.

      4 votes
  4. [3]
    skybrian
    Link
    I have no expertise or experience here, but Scott Alexander is an actual psychiatrist and this article on the website of his medical practice seems pretty balanced and thorough and mostly...

    I have no expertise or experience here, but Scott Alexander is an actual psychiatrist and this article on the website of his medical practice seems pretty balanced and thorough and mostly consistent with what other people say.

    9 votes
    1. knocklessmonster
      Link Parent
      That's super informative. I always thought SSRIs were a thing you went on, and maybe off of in a few years, not something that would be used for shorter episodes. The information about withdrawal...

      That's super informative. I always thought SSRIs were a thing you went on, and maybe off of in a few years, not something that would be used for shorter episodes. The information about withdrawal was also extremely useful.

      5 votes
    2. 3_3_2_LA
      Link Parent
      Very helpful article, thanks for sharing! It's nice to read something so in-depth and he even addresses my question in section 10 :)

      Very helpful article, thanks for sharing! It's nice to read something so in-depth and he even addresses my question in section 10 :)

      3 votes
  5. [3]
    Piusbird
    Link
    So Disclaimer Time: I have bipolar so my experience with SSRIs is not typical. For me they provoked a manic episode within two weeks of starting. That was mistaken for schizophrenia, and a whole...

    So Disclaimer Time:
    I have bipolar so my experience with SSRIs is not typical. For me they provoked a manic episode within two weeks of starting. That was mistaken for schizophrenia, and a whole six year mess ensued trying to get the right diagnosis. So from a certain point of view they worked great. 😛Just watch yourself carefully over the next few weeks because if you have bipolar it'll send you on a rocket ride to god only knows where.
    That said I want to amplify a point that others have made in this thread and that is Pills Don't Teach Skills. In other words start talk therapy, you'll need it. Even with good meds in the right dose there will be days when it won't seem to work. On those days you'll need the skills to analyze your own thoughts and deterimine what is distorted, what is entirely false, and what is really you.
    As to your question all the medicine does is correct the flawed biochemical process only you can determine what's really you

    7 votes
    1. mrbig
      (edited )
      Link Parent
      Yes, I've been there. Antidepressants/SRRIs can be troublesome for a bipolar but I'd like to stress that they're generally quite safe. With the right combination, even a bipolar can safely take...

      Yes, I've been there. Antidepressants/SRRIs can be troublesome for a bipolar but I'd like to stress that they're generally quite safe. With the right combination, even a bipolar can safely take antidepressants. I have done so many times. There are even antidepressants that don't cause mania at all.

      The actual danger here, or at least the one that originates the others, is being misdiagnosed.

      3 votes
    2. Grendel
      Link Parent
      Oh man I hear you there. I'm bipolar II. Before I was diagnosed I was put on Straterra for adhd treatment. It caused a full psychotic break. In the middle of my shift I started having horrible...

      Oh man I hear you there. I'm bipolar II. Before I was diagnosed I was put on Straterra for adhd treatment. It caused a full psychotic break. In the middle of my shift I started having horrible voices in my head telling me terrifying things. I believed I was powerless to resist what they were telling me to do, like they could control my body. Thankfully I got through my shift and passed out at home (I worked 4 to midnight) and I was better the next morning.

      You'd think me telling my doctors about this would have clued them in to my bipolar (it should have) but it took about 7 years of going through various doctors and treatments before I was properly diagnosed with bipolar last year. Thankfully I'm starting to stabilize on my meds and counseling is helping tremendously.

      3 votes
  6. Icarus
    Link
    I think SSRIs are an extremely useful tool in mental health recovery that puts people in better positions to work on lifestyle choices and behaviors that can lead to long-term recovery and...

    I think SSRIs are an extremely useful tool in mental health recovery that puts people in better positions to work on lifestyle choices and behaviors that can lead to long-term recovery and maintenance.

    Combining SSRIs with other proven methods of mental health recovery is a winning combination with the ultimate goal being slowly reducing the need for medication long term (if possible). SSRIs are not always useful (my partner takes an SNRI) but finding one that fits you and then finding the right dosage can be extremely helpful. I think having the patience to maintain usage and document moods daily is helpful to finding what works right for you.

    Are they really me without depression/anxiety or is it a more lurid exaggerated version of that?

    There is an idea within Buddhism that perceptions in this world are never inherently true. The way one person experiences something will not apply the same to another person. The way that we respond individually to experiences is a culmination of genetics, our past, our current mood, history, etc. I tend to use that way of thinking to sometimes distance myself from emotions/feelings so I can keep an open mind and also to understand why my reaction to something is the way it is. That distancing often helps me from letting anger or other harsh emotions dictate my actions.

    6 votes
  7. knocklessmonster
    Link
    I've never been on them. I think perhaps I ought to be, but have never made the jump, despite all the research I've done that showed the benefits way outnumber the few rare, minor risks. My...

    I've never been on them. I think perhaps I ought to be, but have never made the jump, despite all the research I've done that showed the benefits way outnumber the few rare, minor risks.

    My understanding is SSRIs correct for a flawed biochemical process. If you bought a leaky bucket and patched it, is it the bucket as it should be, or is it a tape-enhanced bucket? I'm of the idea that the patched bucket is the bucket functioning as it should. Which is more you, the broken bucket, or the working one?

    Or as a psych professor I had put it: Mental illness is illness. You aren't your cold, it's a temporary, treatable condition that can go away (generally).

    The general goal in psychiatry isn't to reprogram you with chemicals, but to fix those issues that have psychochemical causes in concert with those that are psychological in root, which is why, for example, it is recommended to do talk therapy when starting SSRI treatment.

    6 votes
  8. kuch
    (edited )
    Link
    Hey, fellow enjoyer of SSRIs. I started them about a year ago, and am now in the process of weaning off. I'm completely with you, in your praise. Someone already posted Scott Siskind'd blog, which...

    Hey, fellow enjoyer of SSRIs. I started them about a year ago, and am now in the process of weaning off. I'm completely with you, in your praise. Someone already posted Scott Siskind'd blog, which I have found to be a very useful resource on SSRI's specifically. I'm still in the process of finding a good therapist and building my meditation habits because I believe that those are key to my long term health. That being said, I was trying those things without the escitalopram, and life was nowhere near what it is now. Somedays the flowers just pop, and music hits different, and I can just sit and read a book for fun. Couldn't do that for years prior to medication.

    I experienced most side effects in the first few weeks - everytime I was upping my dosage. It was awful, I had brain fog, upturned sleep cycle, increased sense of smell & nausea, anxiety, generally feeling hot, even one instance of a brain zap. Thankfully, none of these lasted, and I was fine once I'd settled on a dosage.

    I've also experienced mild anorgasmia, but, since I'm not anxious all the while, the actual sex is more fun. So I can't really see this as a negative? On the other hand, I've experienced a consistent increase in appetite which I suppose is healthy. But I just find it annoying af because I've had to triple the amount I cook (and clean).

    I regret not taking the leap earlier, I waited for about 7-8 years before speaking to a psychiatrist. My life would have been very different if I'd had access to SSRIs and therapy when I first started to fall sick.

    That being said, I sometimes wonder at how much I've changed because of my depression and the increased self awareness and ability to relate to other people with anxiety, etc which I found hard to do prior to developing it. I'm not saying people should suffer for this sort of knowledge, but I can't help but see the upside to my illness too.

    I don't share your worries about the 'real me' reg. SSRIs. Kiskind's blog points out that we don't feel like 'different people' on caffeine, so why treat other drugs differently. I'm happy to chat with you on this issue, if you have thoughts.

    4 votes
  9. DeFaced
    Link
    I was just put on medication last monday, it's been an interesting change. I'm no longer getting irritable at little things, I'm not constantly stressed or worried, my frequent panic attacks seem...

    I was just put on medication last monday, it's been an interesting change. I'm no longer getting irritable at little things, I'm not constantly stressed or worried, my frequent panic attacks seem to be less frequent (will see on that one), but overall it's been a good experience. I was hesitant to take medication because I didn't want it to change who I was, and I didn't want to use it as a crutch to getting better, but I can safely say without a doubt it was the right choice.

    4 votes
  10. mrbig
    (edited )
    Link
    A bit hard to generalize. They've mostly been proven to work by multiple studies. Usually there will be some kind of side effect, the kind you can live with. If for some reason you cannot, you...

    A bit hard to generalize. They've mostly been proven to work by multiple studies. Usually there will be some kind of side effect, the kind you can live with. If for some reason you cannot, you just change the dosage or switch to another one (sometimes another class). Don't believe the "haters", it's usually not that bad. But make sure that you actually need them, of course. SRRIs take a long time to work so be patient. They are also not magical and won't fix your life for you, but they help a lot. The first time your antidepressant "hits" can be kinda trippy, in the long run you'll just feel normal.

    Edit: about identity, what is really you to begin with? Can you hold it in your hands? Can you weigh it with a scale?

    3 votes
  11. [2]
    TemulentTeatotaler
    Link
    I don't have much to add besides what's already been said, but one question is how long have you been on SSRIs? Typically nothing happens until you've been on them for 4-6 weeks. There are many...

    I don't have much to add besides what's already been said, but one question is how long have you been on SSRIs? Typically nothing happens until you've been on them for 4-6 weeks. There are many moving pieces (all valid) in life that can account for a changed mood/state. If you've just started with SSRIs it may be that whatever you're feeling is not what the same as the effect of being on SSRIs long term would be.

    My SIL says her medication is like "setting the dial to the right setting". Her brain is wired to be anxious at "11" and she wants it to be down at a "6-7". Sometimes finding that right dose or pill can take some time.

    Best of luck! Feel free to hit me up if you ever need someone to chat with.

    3 votes
    1. 3_3_2_LA
      Link Parent
      That lines up with what my therapist and doctor said -- 4 to 6 weeks, but I began noticing a huge improvement right around the two-week mark and it's almost like a switch was flipped. I've been...

      That lines up with what my therapist and doctor said -- 4 to 6 weeks, but I began noticing a huge improvement right around the two-week mark and it's almost like a switch was flipped. I've been diligently noting down any apparent changes each day since I started the medication and here's all the changes that I noticed right on day 13:

      Good stuff:

      • Sleep leaves me feeling refreshed
      • Lower resting heart rate (I use my Apple watch data for this)
      • Zero to very minimal anxiety
      • My depression is basically non-existent at this point
      • Very low friction to just getting day-to-day stuff done in general
      • It's hard for me to stay feeling despondent about my circumstances. It's almost like the medication pushes me right back up
      • Improved focus as I haven't zoned out at all while studying
      • No emotional extremes

      Bad stuff:

      • Insomnia is really bad now
      • My appetite is suppressed and I'm losing weight
      • I wish I had a little bit more of my anxiety back because I'm too complacent now and it's harder to work up the motivation to get out of my circumstances

      Not sure why it's so effective for me but I really hope it proves to be as efficacious for other folks too!

      6 votes
  12. Muffin
    (edited )
    Link
    I was on some Escitalopram up until recently. Yeah, it helped me out of the worst hole I was in. It also made me a shut-in who didn't get any pleasure from anything. So I just hid inside the whole...

    I was on some Escitalopram up until recently. Yeah, it helped me out of the worst hole I was in. It also made me a shut-in who didn't get any pleasure from anything. So I just hid inside the whole time just waiting for the days to run by.

    3 votes