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    Beginner question about antidepressants

    Dear MSWorld MS'ers, I have an appointment with my Primary Care doctor this evening because I am thinking about trying an antidepressant. Can one "try out" an antidepressant? It feels like a giant step and I'm not even sure I *need* to go on one. I have bouts of the blahs where I just feel gray, and uninspired, but not all the time. I have never had suicidal thoughts, but I know I am not enjoying life the way I used to, perhaps because I am preoccupied with thoughts of MS, tired, or just boredom, I don't know. Outwardly, I am a really positive person (put on a smile and the good mood will follow) and feel like a fraud feeling like this on the inside. I have been very open about my MS with friends and do a lot of fundraising with that smiley attitude of 'I have MS, but MS doesn't have me', yada yada. (Truly, I have very few remaining symptoms from my flare, that helped get my diagnosis 4 years ago) And yet, in private, sometimes, MS does have me, and has my former 'zest for life' taken hostage.

    When I socialize with friends every now and again, I usually have a drink or two to loosen up and be the person I used to be (sad to say, the alcohol helps, but I don't need to drink, say like an addiction). I would miss having a glass of wine or two on antidepressants, but wonder if the positive effects of the drug would outweigh that urge.

    Mostly, I feel like my blahs are affecting the way I am a mother and wife. I'm just not that great company and wish I was invisible. I mean, who wants to be around someone like this?

    I do yoga, I have even tried the seasonal affective disorder white light box. When I am busy and productive, and especially when the sun is out, I feel much better, but often days I just can't seem to get out of my own way to get there. I eat a healthy diet, gluten and dairy free. I exercise every day, like a robot. And I have everything in my life I've ever dreamed of--wonderful husband and family and living my dream of being a stay-at-home mom, which is why I feel guilty even feeling like this. I need to change something, and wondering if an antidepressant is the key.

    Are there beginner antidepressants? Lesser dosage kind? How long do you need to try them to see if they work?

    Sorry for the long story. Any thoughts you have would be most appreciated. Thanks for reading. Marleigh

    #2
    Hi Marleigh! I'm sorry for how you are feeling! I feel like your were describing me in parts of your post! After reading what you had to say, I got the impression you don't really want to be on an antidepressant but you want to be how you were before you started feeling this way.

    I started 10 mg of Lexapro because I had post partum depression after I had my daughter (4 years ago and 4 years after MS diagnosis). After crying for nearly 9 months I finally bit the bullet and talked to my gyno. I stayed on Lexapro because my life is too full and I have days were I am very moody.

    What are you going to say to let your doctor know you want an antidepressant? I would suggest talking to your doctor and seeing what he/she suggests. You might just need to see a therapist for a little while to help you refocus your thoughts. I did that while I was pregnant with my son and it was very helpful. Granted I'm currently making my neuro re-prescribe the Lexapro because I feel I still need it, but that's me.

    Let your doctor know how you've been feeling. The best bet might be to see a psychiatrist because this person would have a better idea as to whether or not you need medication. Just because you have MS doesn't mean you need an antidepressant. I didn't need one for 4 years after my diagnosis, but now I'm on one because life is hard for me right now.

    Good luck no matter how things work out for you!!

    To answer your question at the end: It depends on the antidepressant you're given. ADs need some time in your system to start working. If you start an AD you'll probably start at the lowest dose and increase if necessary. Or you could stay at the low dose like I have. :0)
    Lori
    Betaseron 2004-2009, Tysabri 2010-2011, Copaxone 2012-2013, Tecfidera 2013...

    Comment


      #3
      Most people on antidepressants can also enjoy a few drinks! . Just let your doctor know so he can prescribe the proper meds.
      When I can laugh at my experiences, I own them and they don't own me!

      Comment


        #4
        First of all, I can appreciate how you have been feeling. It is always good to identify when we are not feeling right rather than deny it. But having the "blahs" may not exactly equal depression.

        Anyone with a chronic illness or pain, has a change in how they are feeling. And yes, you can have depression as a result, but not always. Mostly the brain is missing good nutrients and minerals that keep is functioning best it can. Most docs will never tell you that, because they are not educated in nutrition. Meds alone deplete or affect neurotransmitters.

        So ask yourself, do you have trouble getting or staying asleep? Sleep too much? Eat more, or less than your usual pattern? Cannot find enjoyment, have a "flat" affect? Cry easily vs more sensitive? Or cannot cry? Losing the ability to ENJOY parts of your life, poor coping, are all things you can improve on. And yes, may need meds to deal with it.

        You can always (usually) start with 10mg of an antidepressant. That way your body/brain starts to get used to it before any side effects. It usually takes a few weeks to find any noticeable changes, but some notice it in a few days. Like a nervous "edge" is removed.

        So get a good evaluation by a psychiatrist. Primary/Neuro's can RX antidepressant, but not sure they will do a complete evaluation. In other words, its just easier to RX.

        I no longer take antidepressants. I would rather use the supplements that curb the nervousness and take the edge off. I got mine from Melaleuca online and another place, but cannot remember. It works RIGHT AWAY, never interfered with meds either. Helped me sleep.

        Dont forget that some meds can add to depressive symptoms, mostly because we lack minerals and nutrients that brain needs to be optimal.

        Good luck and let us know how you are doing.
        I will be thinking of you!

        Warmly, Jan
        I believe in miracles~!
        2004 Benign MS 2008 NOT MS
        Finally DX: RR MS 02.24.10

        Comment


          #5
          Marleigh,

          Clinical Depression is not feeling "blah" or "sad", it is a complex issue, especially with MS. Find a website or pamphlet (at your Docs) that discusses Clinical Depression, so you can understand it better.

          It is OK to "test" antidepressants. Your prescribing doctor should inform you that it takes a few weeks to feel anything. Most all AD's (AntiDepressants) must build up to a "therapeutic level" in the body, and that is why it takes a few weeks.
          Live simply. Love generously. Care deeply. Speak kindly.

          Comment


            #6
            Marleigh--
            Generally, a doc will prescribe an SSRI for you as an antidepressant. Lexapro,w hich someone mentioned, is an SSRI. It takes about 6 weeks to feel the benefit from these meds, although my son takes an SSRI, and he responds within a week. (Our doc says that isn't possible, but I KNOW it to be true for my son).
            I once tried an antidepressant, and I only took it for about 2 weeks. It made me feel a bit edgy and hyper, and I quit, probably too soon, although I decided I didn't need it.
            So to answer your question, "trying" it is a bit complicated when you have to wait weeks to evaluate its usefulness for you. But there is no real harm done, if you want to check it out. If you don't feel marked improvement after 6 weeks, I would stop. JMHO....

            Comment


              #7
              From what you have written I would definitely speak with your physician and seek their assessment. You could also try therapy first which is another strategy for coping skills especially if you are uncertain if you are truly depressed. I happen to prefer a psychiatrist or Psych NP for prescribing these medications but really a PCP is ok for uncomplicated cases also.

              I happen to be of the mind set that there is no reason to be unhappy if something can be adjusted. It doesn't mean it is forever and in the case of SSRIs although they don't help everyone the side effect profile is usually fairly manageable, imo.

              Best of luck!
              He is your friend, your partner, your defender, your dog. You are his life, his love, his leader. He will be yours, faithful and true to the last beat of his heart. You owe it to him to be worthy of such devotion.
              Anonymous

              Comment


                #8
                maybe not an anti-depressant at this time

                I also am glad to be at home taking care of family & not at work. But it's important not to forget why I'm not at work. Truth is just getting through the day, planning & preparing meals takes all I've got.

                Are you sure you're not underestimating the difficulties you face?

                I've found forms of cognitive therapy extremely helpful, & it's documented that they can be as effective as meds.

                Taking care of home and family is extremely difficult with MS. Check out this form, especially the section about irrational beliefs:

                http://www.rebtnetwork.org/library/shf.html

                Are you sure you're not expecting too much of yourself? I can't recall if your post mentioned your children, how many & what ages. It's hard enuf without MS!

                Take care,
                Linda

                Comment


                  #9
                  Hi,

                  it's not a light decision, but it's not really all that heavy. Yes, you can "try" one. And thinking you need one is a good reason. You seem pretty adept at measuring your own moods. And no need to spout that you have MS but it doesn't have you stuff. I'm not sure who made that up, but the only thing that can be said about it, is that it sucks.

                  But back to depressive feelings. It's normal after an event (such as diagnosis) but also just for having MS, even I you have light symptoms depression is a symptom just like tingling. You don't have to have a reason to feel sad. Consider your MS is mild and so are your side effects, one of which is a slightly downward leaning mood - nothing to cry about, but not your old self.


                  It used to be a big deal to get antidepressants - you had to see a psychiatrist. Now your GP can prescribe them. Discuss with your doctor, but it's like choosing a car or an outfit (i'm sure I offended someone there) - is weight an issue? Some make you put on weight. Are you a man? Some can cause erectile dysfunction. Do you have anxiety? Some are more oriented toward stress. Do you have good insurance? There are many available at Walmart for $4.00 a month.

                  In a way, we're lucky there are so many available. I've tried Paxil twice. The first time, it relieved my anxiety very nicely. The second time, it made me loopy and I had to stop. I've also tried Wellbutrin, which was a real shot in the arm (no pun intended). I think they're both good. Wellbutrin has an amazing side effect profile.

                  You can try and you can see, change or stop. Just do so with your doctor and don't overthink the decision. Good Luck. Please keep us informed.

                  Comment


                    #10
                    A topic like this is very complicated... and I will add another twist, not mentioned earlier. Do you know your vitamin D, B-12 and magnesium levels? I mention this because the reason vitamin D is calle dthe 'sunshine ' vitamin is because of how it affects the 'mood'. Can you believe it ?
                    I would agree with every other poster about the use of and need for AD's but you will be the only one to recognize its effects, positive or negative. This is a 'subjective' area.
                    I would only suggest that you combine your 'mood elevator' with a seriously healthy look at diet and exercise. If you want to feel better, maybe you want to look into increasing your body's endorphin production. Endorphins are the hormones that help the body 'feel good'. So to summarize... endorphin's= 'runner's high' and vitamin D = 'sunshine vitamin'. Good luck

                    Comment


                      #11
                      I also agree that clinical depression is a complex issue. I hope you find the right AD for you

                      Comment


                        #12
                        anti-depressants

                        Originally posted by Marleigh123 View Post
                        Dear MSWorld MS'ers, I have an appointment with my Primary Care doctor this evening because I am thinking about trying an antidepressant. Can one "try out" an antidepressant? It feels like a giant step and I'm not even sure I *need* to go on one. I have bouts of the blahs where I just feel gray, and uninspired, but not all the time. I have never had suicidal thoughts, but I know I am not enjoying life the way I used to, perhaps because I am preoccupied with thoughts of MS, tired, or just boredom, I don't know. Outwardly, I am a really positive person (put on a smile and the good mood will follow) and feel like a fraud feeling like this on the inside. I have been very open about my MS with friends and do a lot of fundraising with that smiley attitude of 'I have MS, but MS doesn't have me', yada yada. (Truly, I have very few remaining symptoms from my flare, that helped get my diagnosis 4 years ago) And yet, in private, sometimes, MS does have me, and has my former 'zest for life' taken hostage.

                        When I socialize with friends every now and again, I usually have a drink or two to loosen up and be the person I used to be (sad to say, the alcohol helps, but I don't need to drink, say like an addiction). I would miss having a glass of wine or two on antidepressants, but wonder if the positive effects of the drug would outweigh that urge.

                        Mostly, I feel like my blahs are affecting the way I am a mother and wife. I'm just not that great company and wish I was invisible. I mean, who wants to be around someone like this?

                        I do yoga, I have even tried the seasonal affective disorder white light box. When I am busy and productive, and especially when the sun is out, I feel much better, but often days I just can't seem to get out of my own way to get there. I eat a healthy diet, gluten and dairy free. I exercise every day, like a robot. And I have everything in my life I've ever dreamed of--wonderful husband and family and living my dream of being a stay-at-home mom, which is why I feel guilty even feeling like this. I need to change something, and wondering if an antidepressant is the key.

                        Are there beginner antidepressants? Lesser dosage kind? How long do you need to try them to see if they work?

                        Sorry for the long story. Any thoughts you have would be most appreciated. Thanks for reading. Marleigh
                        Hi, my neurologist prescribed Nortriptyline, a mild anti-depressant. Maybe you can use this one too. I wish I could have something stronger, but it is hard to get doctors/neurologists to listen to us.

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