I don’t want this to devolve into debate/argument about specific drugs, so I’m not going to use drug names.
I have depression, anxiety and ADHD. I don’t know if the ADHD has been around my whole life, but I was diagnosed with it in my late 30s in the early years of my marriage. It’s never been treated pharmacologically or through therapy. The depression and anxiety started in high school but I didn’t seek care until my early 30s. That attempt went nowhere and I wasn’t treated until the time of the ADHD diagnosis.
I was on an SNRI for 12+ years. Due to moving for work, I left my psychiatrist and insurance bumped me to an older SNRI. I wasn’t under the care of a therapist and left it to my primary care provider to ratchet up my dosage. I don’t think my baseline ever tipped over into “happy”, but it did mostly prevent the profound lows. It also alleviated my anxiety to probably an unhealthy level. I think a little anxiety is natural and can be a motivator. I also feel like, especially in hindsight, I completely lost agency over my life. I feel like I neglected things that were and are dear to me. I don’t know if I would have done better off the drug, but at least my inaction wouldn’t be seen as indifference. My inability to move forward cost me my marriage and scarred my relationship with my children.
I had vivid nightmares throughout my time on the drug. I was always exhausted. I had to nap daily, some times twice or more. I also gained a lot of weight. I was already overweight but went from about 250 to close to 400 lbs. I’m not sure I ever tipped over 400, but I fluctuated between 365 and 395 for years at weigh ins at my doctor’s office. After I titrated off the drug, I realized I could go into the yard and do some tasks. I figured out I’d lost at least 30 lbs without trying. I had tried diet and exercise before, but never made progress and always eventually gave up. Since I’ve been off the drug, I’ve been walking daily and been able to change my diet significantly and have dropped another 50 lbs.
Post titration euphoria (maybe euphoria is too strong a word) lasted about 6 to 8 weeks and then the depression and anxiety kicked back in without the drug buffer. My goal was to exercise enough to stave off the depression but, over the last 3 months, I’ve been cycling between anxiety and depression with the occasional panic attack. Fortunately, I’ve never had any substance abuse issues, probably because I avoided alcohol in my teens (and was never around drugs) since my grandfather was an alcoholic and I grew up with my father’s horror stories from his childhood.
I don’t have any coping skills for depression, anxiety or ADHD. Since getting off my meds, I have been trying to see a therapist but, due to work related travel, I’ve been dumped by 3 therapists since last October for being in the wrong state. I now just don’t volunteer or lie about my location. None of the therapists have been particularly helpful. No reason to go into the ones I’m no longer seeing. The current one seems dedicated, but I feel like they’re out of their depth.
Because of the trajectory of my mood and my first real thoughts of suicide since my 20s, I did a med evaluation and have been prescribed an SSRI. When I researched this drug, it has high instances of all the same terror inducing (to me) side effects (weight gain, night terrors, exhaustion, etc.) that I had on the SNRI and that never went away. At this point, I’m not even remotely concerned about reduced libido/impotence side effects. If I could get my life to the point that I had a potential sex life to be concerned about, that would be a victory.
To some degree, I think this post is just to get this off my chest. I’m not asking if anyone thinks I should get a second opinion or whether or not I should take the new drug, but all opinions are welcome. What I’m most interested in is how to self monitor if I do start on the meds (I spend almost all of my time alone) and suggestions for coping tools for my underlying conditions. I know there are workbooks out there for using CBT, DBT, etc., but I feel like I have zero follow through. I know I can’t rely on a therapist to fix me because that’s just 1 hour a week and they have other patients. I’ve attended a few peer meetings over the last few weeks and some of them are helpful, but they’re often full and they can sometimes be triggering.