a year on anti-depressants

I was diagnosed with depression just before 2017 began, at which point it had been brewing for about three months but I’d found it difficult to identify.

Aside from a consistently down mood (which felt “normal”), the biggest problems I had were poor cognition, indecisiveness, complete lack of confidence, and a feeling that everything was too difficult to manage. Indecisiveness and lack of confidence were difficult to spot because I always have them to a degree and I didn’t notice how much worse they had gotten. In addition to the depression itself eroding confidence, my awareness of my difficulties with cognition and concentration also damaged my confidence.

I’ve heard it said that depression lies. That’s very true. It affected my ability to think, which in effect made me partly blind to the very symptoms it created — like walking into a fog that makes you hallucinate the absence of fog.

(Having been through a depressive episode a couple of years earlier, I found it disconcerting that this could happen again without me really seeing it. As I started to come out of the fog, I noticed I was finding laundry easier to do again, and I then realised that I’d found it almost impossible for a while but remembered that before that it had been easy and kind of enjoyable. My new rule of thumb is that if laundry ever feels like total drudgery to me again, I’ll take it as a red flag and consider whether I need some help.)

When everything feels insurmountably difficult, seeking treatment can be incredibly challenging too. I found it difficult to ask for help, but I’d already accepted that (1) I’d probably been depressed before and (2) therapy wasn’t useful this time, so when I made the doctor’s appointment I’d also already accepted the idea of being diagnosed. Even so, in that moment when he proclaimed the diagnosis I felt vulnerable and damaged. But in the next moment I knew there was the possibility of some treatment that would help, and that felt like a little ray of light.

After a year on citalopram, my mood is very stable. About two or three times per month I’ll have an inexplicable down mood, which I find fairly easy to identify because they contrast with my regular mood and aren’t situational (i.e. they aren’t caused by negative thoughts or bad news). I find these fairly easy to accept and roll with, especially because they’re always gone by the next day.

Work continued to be a struggle this past year: it’s hard to find work satisfying or even know whether I’m in a suitable career when I’m not experiencing any enjoyment from any projects. Things have recently improved to the point where I sometimes feel a mild to moderate sense of competence and satisfaction, but it hasn’t been consistent enough to know whether it will continue. I hope it does.

And then there’s the fatigue thing. I’ve never been much of a planner and it’s been especially frustrating when I don’t know whether I’ll have the energy to do anything tomorrow, let alone next week or next month. As a result I’ve become miserly with my time. Over the past few years, I’ve gotten into the habit of not deciding what I’m going to do until I assess my capabilities and limits on the day in question; after innumerable abandoned plans, the disappointment had gotten to be too much.

Lately, however, I’ve been making plans a little further out. My cognition has improved somewhat and I’ve been chipping away at a couple of projects and getting some positive reinforcement from that. Like the work situation, it hasn’t been going on long enough that I can confidently predict how I’ll be doing in a month or two, but it has been enough of a contrast with before that I’m cautiously optimistic.

Sex is not happening. I have no libido to speak of and this is causing me some distress, in part because I don’t know what the cause is. There’s a good chance that I’ll come off the medication this spring or summer, at which point I’ll discover whether it’s a side-effect or something else. I’m hoping for side-effect: it’s a disappointing to miss out on arousal and sex, but it’s easily reversible.

Another possibility is that, even post-epiphany, I haven’t made much progress on rewriting my maladaptive sexuality script, and this echoing absence is the sound of the other shoe dropping. It’s hard to remind myself that there may be a simple chemical explanation because this utter lack of sexual interest feels gut-wrenchingly familiar, and the part of me that still feels sexually broken is saying, “See? Told you so.”

If that’s the devil on my shoulder, the angel is my tolerance for ambiguity. I don’t know when I’ll be off the meds but it won’t be too long now. (My doctor’s policy is not to take a person off anti-depressants during the winter in case seasonal affective disorder is playing a role.) I don’t know whether the meds are responsible for this but I’ll find out in the not-too-distant future.

3 thoughts on “a year on anti-depressants

  1. some newer SSRIs can decrease available testosterone levels or affect blood flow. Since you’re coming off that med soon, your doctor may think it’s not necessary to change to a different SSRI, but you may ask for a check on your hormone levels & BP when it’s convenient. Blaming yourself (“it’s all in my head”) might prolong your depression for what may be a side effect of the med. or the dose.
    I don’t know your age. If you’re approaching menopause, you may also have a lower estrogen level with symptoms of dyness.
    In any case, run this by your doctor. Take care.

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  2. I was on SSRI’s for 11 years with no sex drive at all. I was on many other medications as well, so it difficult to say for sure which one was to blame, or if they all were. Five years ago I stopped everything… after spending 2 years tapering off of the really hard core ones. My libido returned even stronger than it had been before and I’ve found other ways to deal with my depression.

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