Medication is personal, very personal. I’m sharing this experience because it helps me to process by talking and writing, and because maybe someone else needs to hear that medication changes are hard, and scary, and that even though they might be challenging, they eventually pass. I’m not a mental or physical health professional, so don’t take my experience as gospel, and remember that everyone, and every prescription, is different.

{Content Warning: mental health, medication, suicidal ideation, depression}

When I first started taking antidepressants a couple of years ago, I was terrified. I had heard horror stories from friends and colleagues of the impossible task of getting the cocktail right, and that dosage was always a moving target. I had heard that people felt they’d lost their personalities, that the meds made them foggy and numb, and that doctors were just throwing darts at a wall, hoping one would stick. The whole process sounded risky and low reward, and not at all appealing, especially given my anxiety around medical officials and facilities.

I was afraid. I was also so much lower than I’d ever been. I wanted to die and I was looking for anything that might help. One trip to my GP and I had a prescription in hand. It was so ridiculously easy, given the state of crisis I was in, that I was momentarily buoyed. My doctor at the time was notoriously not a pill-pusher and I had worried for nothing (thanks anxiety!) that she wouldn’t deem me in need enough for pharmaceutical intervention. I read the pamphlet carefully, researched the side effects, and prepared myself for the dizziness and nausea, hoping it wouldn’t make my insomnia worse. I was tired and mentally/emotionally absent, I was knee deep in every trope of anxiety and depression that you’ve read about. I was a mess, but I took the pills.

No one had prepared me for the fact that many people experience a worsening of their depressive symptoms, sometimes to the point of suicidal ideation or attempts, when they first get onto antidepressants. Again, we all metaboloze and respond to medications differently, but as I learned, that drop is common, common enough that I found myself there within the first two weeks: sleep deprived, nauseous and afraid. Again. Everyone said, just hold on, it will pass, and it did. I made it.

Until last week, that was my first and only prescription for antidepressants. There were increases, they weren’t fun, but they weren’t hard or insurmountable, and the increased dose was always the right choice and I made incremental progress. Now I’m seeing a new psychiatrist in addition to my therapist and she has taken over the supervision of meds. I was due for a review anyway, but when I met her last week, I did not expect that she would change things right away, but here we are. I’m transitioning off the SSRI I was on and slowly getting onto an NDRI (there’s lots of chemistry to that but the basics are that the former focuses on serotonin and the latter, with dopamine, both of which the brain needs in balance to, well, balance).

It’s not been easy this week, and it will be another 2 weeks before the transition is complete and I understand what the NDRI is like. I’m already tired of how gross I feel, how off my mood is, and how the side effects of both the measured withdrawal and the adjustment to an entirely new drug are both uncomfortable. I’m also not sleeping well or at the right times and that’s even more of a problem than usual, but I’m learning a lot about this process and really actively trying to manage myself through this, versus just giving into it and being a victim of circumstance.

Here’s how I’ve been getting by:

Knowledge Is My Super Power
For me, if I can, the best thing for me to do when I’m overwhelmed is to acquire information. I knew that I was too rattled as I left the psychiatrist’s office, script in hand, terrified I’d be suicidal within a week, to push through and start right away. I got the new prescription on Thursday, but I waited until Monday to start the new regime. That gave me time to confirm with myself that a) I was not simply resistant to the idea of changing of meds b) I felt confident with her assessment and c) I’m looking forward to incremental improvement as a result of the change. I knew that I needed the weekend to set the pace and be operating from a place of information and strength, when I would need it most.

My Mind Is My Body and My Body Is My Mind
Because mental health is always spoken of in hushed tones, separate from physical health, I sometimes need to remind myself that I am just one organism and that how I treat my body will affect my mind and vice versa. I’m trying to get to sleep by midnight or one. I’m doing light exercise and getting sun on my face every day. I’m staying on top of eating and water and showering, because these are always the first to go when that dark spiral starts to pull. I’m making time for daily CBT exercises (cognitive behavioural therapy), journaling or meditation, whatever is motivating or appealing in the moment. And I’m taking my meds. I’m scared, but I’m taking my meds.

I’m Allowed to Feel Like Shit If I Feel Like Shit
So far it feels like I have the flu or a really bad hangover. I’m achy and tired and kind of foggy; I’m losing my words mid sentence, and my flesh and bones feel anxious, like a strong hum of electricity is pulsing through me. I’ve been consistently nauseous for 3 days and I haven’t been this fidgety since the last time I did cocaine, which was a long time ago and is a story for another day!

Moreover, if I feel shitty. I’m allowed to say that I feel shitty. I’m allowed to express that and process that. I’m allowed to use my creative spaces (including this blog) to share, ponder, worry, or whatever else is needed. This is a hard one for me because I naturally accommodate and stress about making other people comfortable and not letting anyone down with all this gosh-darn vulnerability.

Gratitude, Always.
I have so much to be grateful for. As much as this is temporarily uncomfortable and scary, I am not alone in this – I have friends and family and partners who are supportive. I have the time and flexibility to be at home as much as I need to and I live in a place where healthcare and psychiatry/therapy is free and accessible. I can’t lose sight of these blessings, especially if things get harder before they get easier, because you never know when you will need to remember the things worth living for.

Thank you for reading this more than 1200 word ramble that took me an inordinate amount of time to write because: brain fog. The exercise of articulating it helps solidify my resolve to survive this transition. With any luck I’ll come out the other side more seasoned, less scared, but still taking my meds.


9 thoughts on “How I’m Surviving a Mental Health Medication Change”

  1. Thank you for writing your coherent 1200 words. I wish you success with your new medication regime, and other therapies. Phamacogenomics and other omics will make the prescription of antidepressants much more effective, and the range of other complementary therapies and therapists are giving like somatic experience EMDR, etc are so effective when you find the right one for you. Also testing for things like MTHFR mutations and others that make one susceptible to anxiety.
    After almost ten years of being off antidepressants, I became an incomplete paraplegic due to consequences of elective surgery. When I realised my condition was permanent, I asked my wife for permission to die. I was shortly before an acute mental health service and taking antidepressants again.

  2. I get it. Meds are tough. And that bit about them actually bringing you down before they bring you up should be discussed more by docs. I didn’t know about it either, so it blindsided me. I’m good now, even though the meds I take kind of worry me from time to time. Side effects on the body must be weighed carefully. I wish the best with the change. At least we are lucky enough, as you have reminded us all, to have access to mental health care and medication. It’s a blessing, really.

    Xoxo, B

  3. I hate medication changes. I’ve never understood why we have to feel worse to get better. I hope the adjustment goes quickly for you and you start to feel “normal” again. ❤️

  4. I felt similar to you about antidepressants before trying them out. There are so many horror stories around and a lot of people, still, that are very against using them, as if it means you are officially broken from then on.

    When I came to this country and went to the gp for help I was shocked that I ws given antidepressants so easily and straight away. I had been told when receiving mental services in the past that this should only happen while being supervised by a psychiater and not been taken lightly.
    I can’t believe that you weren’t even warned about the worsening of the symptoms when going on them.

    I know how bad it is to go off and on and the transitioning. I’m glad you’re holding on and pushing through it. I hope it will be worth it and that it’ll work good for you!

    Thank you for writing about this. I think it’ll be really helpful for others to read about.

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