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So, I have fears.
Fears about treating my now out of control depression and anxiety with medication.

I usually avoid posting topics like this about myself but I know a lot of good people here deal with the same background shit I do and can offer some insight.

Since I started studying (yet again) I knew I’d have to finally deal with my depression and anxiety and was preparing to rule out some other things before I did. For instance, I did a sleep study a couple of weeks ago and the result came back negative for apnoea, which means my constant fatigue and insomnia/waking cycles can now only be blamed on my mental illness.
I’ve had depression for well over half my life and worked out in the past couple of years that I’ve actually had pretty bad anxiety as well, which has put a limit on what I’ve been able to do with my life. Recently being stressed and tired from my new job which is a toxic and disorganised environment leading nowhere I want to go, single parenting my kids at night while trying to study a completely new area to me with steep as fuck learning curve has put me over the edge. I’m now going to fail a unit because I didn’t have the cognitive resources available to label a fucking paper cover sheet correctly and submitted the wrong essay for another subject. I have never done that before in my life and I have a long history of studying while depressed and fatigued.
This has paralysed me. I’m nearly at total shutdown but there’s still a couple of weeks of the semester left and I need to punch on. I want to do well in the other subject, I cannot salvage the one I failed.

So for the first time in my life I’m going to see my doctor and get pharmaceutical help. Hopefully I can get the counseling component as well (I know I need that but Medicare may have limitations about my eligibility).
As I’ve mentioned I’ve previously managed my symptoms up until this point, but I feel like they’re getting beyond me now and I’m losing my grip on the wheel. I don’t want my kids or my wife to suffer my shit or see my suicidal, which to be honest I have been quietly for a little while now.

My questions about meds are: will I actually sleep? Will I finally wake up feeling like a human being and not like I’m a thousand year old corpse who has witnessed the world go by while rotting?
Will I be able to think clearly? Can I overcome the brain fog and actually remember things and engage my higher order thinking areas that are currently decommissioned? Will it make studying easier or harder?

I know that these are sort of retarded questions for an adult to be asking but if you’ve been in a before and after situation similar to this, it’d be great to hear from you.
Thank you, ILF.

1) Don't be afraid.

2) Couldn't say about the sleep part, but I hope so.

3) Yes, you most likely will think clearly. I can when I'm in a fog and when I'm operating on point.

4) You actually might find yourself more focused. When I increased my dosage on an SSRI I noticed a near immediate improvement in my ability to focus and work without distraction.

5) Talk to a doctor about it. For real.

6) PM me if you'd like.

Thanks man, I really appreciate that.
As I said, I have previously operated under the illusion I could manage my symptoms/events but it would seem that lately it’s all gotten too much for me.
Sorta made me realise maybe I’ve never been operating under “ideal” conditions.
Plus I’ve been working with stroke victims and all the sleeplessness and stress makes me realise I’m a big contender for that path if I don’t start managing shit for real.
Again, thanks man. I’ll hit you on the PMs if I think of anything else to ask for sure.

As a licensened mental health professional - but not one legally qualified to have Official Opinions on meds - and a sporadic depression sufferer - I say good for you for coming to this realization. Meds can help but you should also expect some trial and error, because everyone is different and antidepressants are kind of a crapshoot. Also, I highly recommend therapy in addition to meds - there is much evidence which suggests that the combination is significantly more effective than just meds. About a third of my caseload consists of clients who are on Medicare, and there is never any trouble getting coverage for them (YMMV). Finally, if you can, I recommend seeing a psychiatrist or psychopharmacologist rather than a general practitioner, just because they know the ins and outs of meds and mental health better than most PCPs (though presumably your doctor is good enough to recognize/admit if they need to refer you out).

Also, speaking less as a professional and more as a Real Person, it's really important that you don't beat yourself up about struggling and needing help. Feeling shitty about feeling shitty inevitably leads to feeling shittier. Life is hard and people need help and that's just how it is. I say this not because it's going to magically cure you but as something to remind yourself of as you push through this last couple weeks, and beyond.

You can totally do this.

Life is hard and often sucks. We put a lot of pressure on ourselves to be better and increase our knowledge or income. The results just suck. I don't talk about these things much but I've struggled with a lot of stuff for 25 years. Finally came to the conclusion that suicide is bullshit because it would really fuck up my kids. It isn't fair to them. Suicide is selfish and there are at least a few close people that would have their lives completely fucked without you. Just something to think about. Good on you for seeking help, it is brave to acknowledge your issues and try a new alternative.

As a man who is bipolar (which equal manic depression and more), I have had many struggles in life and have been on some form of psych drug since I was around 12 years old.

I will offer what I know about the human body and mind as I've studied it at great length to understand not only my personal situation but the situations of others.

In order to determine which route you need to go with depression, you must first evaluate your situation. Most people immediately run to drugs as a quick fix, but a lot of times all they do is mask what is really going on.

How is your diet? Do you exercise? Do you have any form of spirituality and if not, have you ever spoken with anyone about it? Have you had your hormones checked? Do you drink alcohol or do drugs?

There's a hundred other questions I could ask but these are extremely important.

The diet part is crucial to mental health. Most of the production of serotonin in your body is produced in the gut. So, in order to properly produce this "happiness", you have to have a well balanced diet. If you don't, well, it's natural that you won't feel well. This one area that many people neglect and push aside in favor of meds. I urge you to investigate it though. Look into nutritional psychology, it could change your life.

Exercise. The other key component. Exercise not only produces key chemical reactions in the brain and body but it also eliminates negative toxins or rather helps to rid your body of them. Without exercise of some sort, your body is not getting what it needs.

Spirituality is huge and also a key component. If I did not believe in something, then life would be meaningless to me. I'd exist just to exist. Now, I'm not saying you need to be a Christian if you aren't, I'm saying you need a connection to something on a spiritual level. It takes some of the burdens off of you as a human. You can connect with something on a different level. Even if it's just meditating and doing mindfulness techniques.

Hormones could be everything and nothing. For me, I was fine for a long long time. Then one day, I could barely move. I got progressively worse with anxiety, depression, anger, fatigue...etc. All this while eating right, exercising and taking meds. I decided to investigate my hormones and had a full panel done. I mean everything I could think of. Prolactin, Testosterone, estradial, thyroid function, blood levels, PSA levels, adrenal functions, kidneys, liver...just everything I could get. I had like 10 vials of blood drawn my first visit and many more after that. They discovered that my Testosterone levels were in the dumps. It took months and months to get my levels right, but they did and now I'm fine. It's not a miracle fix but it sure help a fuck ton. Not saying you have low T but you could have something else going on.

Alcohol and drugs almost destroyed me personally. I had to stop drinking and using hard drugs. While I was using or drinking, my mind was shut down. Depending on how much you drink or drug, it can literally change the physiology of your brain and how it levels cortisol and other hormones. I can show you scientific research on the negative effects of alcohol if that's an issue with you. It's extremely enlightening.


Lastly, psych drugs. Before you jump onto something, I would look at some of these others factors. Then I would try to talk to someone. Not a counselor (no offense to those who do it) but I license psychologist. Someone with a vast understanding of the mind and body. I have seen mine off and on for 9 years. That man saved my life. He is still helping me to this day. They can diagnose disorders and do not do so just from one visit (looking at you psychiatrists).

If I can be any help, let me know. I've had to attack depression and anxiety from every angle available and I still struggle.

I've been in that bad place many times. I've put loaded guns in my mouth, cuts myself, suffocated myself, put a razor to my arteries...etc. I know the pain. I know the feeling of wanting what's perceived to be an easy out. Luckily for me, I stopped each time and I hope I never go that way. I'm working toward being mentally sound and being a better human being for myself first, and then my family and friends.

Hit me up if you want to talk.

Jesus Was a Robot wrote:
Lastly, psych drugs. Before you jump onto something, I would look at some of these others factors. Then I would try to talk to someone. Not a counselor (no offense to those who do it) but I license psychologist. Someone with a vast understanding of the mind and body...They can diagnose disorders and do not do so just from one visit (looking at you psychiatrists).

I want to wholeheartedly back up everything you said, but also to clarify that licensed counselors often have just as vast an understanding as those with a PhD. Much of the training that takes place at the doctoral level is about research, assessment, supervision, or teaching, and generally has very little to do with increasing clinical skills. Licensed counselors are also able to diagnose most disorders.

I'm putting this out there not out of defensiveness or to pick a fight, but for clarification, because depending on one's location, it might be easier to find a licensed counselor who isn't a PhD (or a PsyD, which is the more clinically oriented doctoral degree) and/or who is affordable. As a client and as a professional, I've worked, studied, and consulted with licensed clinical social workers, licensed mental health counselors, PhDs, PsyDs, and the occasional psychiatrist, and I wouldn't rule out (or in) any of those based solely on their certification - I've known brilliant and awful examples of all those things. It all (studies show this) comes down to the right match.

Everything else =

Going to kind of stream of conscious this, so sorry for the disjointedness. Jwar is absolutely right on lifestyle changes that can DRAMATICALLY change your state of mind and often times help. I went through changing many of those things in my life in order to work with my anxiety and depression, and they provided plenty of tangible benefits. But those don't rule out the idea of medication. Sometimes that is exactly what you need to make those lifestyle changes possible in the first place

I decided one day that enough was enough, and went to seek help for my out of control Anxiety and Depression. I have, as far as my memories serve me, always suffered from this and it has not only become a normal part of my life, but my entire personhood seemed to be built around that. I had a few severe and serious episodes in college, but never had the will to go through with trying to seek help. So at 27, I had a friend book me a doctors appointment and told them about how I had been feeling, about how many parts of my life I felt like I had just missed out on because of this wall around me, about how many times I didn't see an end to this so I had resigned myself to the (seeming) fact that either it would never end, or that I would have to be the one to end it through unfortunate means.

I had never really thought that medication would be an answer for me. There's a really great movement going on with destigmatizing depression in the US, but it definitely has a way to go. I had heard of the "zombies" taking prozac because their upper class lives are too boring, and never wanted to lose myself by just numbing my thoughts out of existence. When I was prescribed antidepressants, I had a hard time deciding whether or not to even go through with it, but realized that things weren't going to get better if I didn't try new things. I'd been doing cognative behavioral therapy for a while, meditating regularly for over a decade, and found plenty of different coping mechanisms, but this was one I was really afraid of.

To make a long story a little less long, I started taking Fluoxetine (Prozac among others) and it didn't immediately help. It took a little while to figure out how much I needed, and it didn't fix things all at once. It was like different lights in a room coming on at different stages, which was more weird than beneficial. I felt like a new person, good and bad. But after taking the time to really figure out how much I needed to take (with my doctor) and letting it take its time to change 27 years of brain wiring, I came out of that period feeling like I had a new life to take advantage of. One of my friends at the time said "It's not like you're a new person, it's like you're more you than you've ever been" and I feel like that's accurate. This came with side effects, my sleeping was messed up for a long time, there were certain, inevitable, sexual side effects that happen with medication like that (nothing serious, and for me it worked itself out), and I had to watch my drinking, especially early on. But I can legitimately look at my life as the periods before and after I started taking medication, which was not at all a future I saw for myself.

Medication for anxiety and depression are not miracles, they work differently for each person and takes a while to really figure out what, if anything, provides the best benefit. What it is, though, is a medication. Mental illness is an illness, often debilitating, and medication is a legitimate treatment for illness no matter the root. It can come with side effects, and it's important to be cognizant and communicative of how it is effecting you. That being said, I wish I had the opportunity to go back in time and try taking a serious approach to dealing with my mental health, but at the same time, I'm happy that at some point, I did, no matter when in life it was. Sometimes you need to change your lifestyle in order to truly get over a mental hump. Sometimes you can't do that and you have an ingrained enough issue that medications the only real solution. And sometimes the anxiety and depression itself is the thing blocking you from treating it, at which point the medication is often a great option for letting yourself get in the midset of fixing many of the external and internal issues that are making an impact, just to go off medication(responsibly, with a doctor) once you feel you have a handle on things. There is no better advice that anyone could give than to go talk to a doctor and therapist that you trust. If you don't trust them, see too. They're expensive, it sucks, I know this advice is tone deaf to the millions without the financial or geographical means to make that happen, but if you have the opportunity, I would recommend it. There are plenty of low cost/free options for seeking help that are just as helpful, and plenty that are not. I'm not in a position to make recommendations other than to do your research.

Sorry for the jumbled mess, I hope a small part of this is useful or helpful!

I wrote a lengthier response but it took me so long to write that I got signed out and it didn't post. *sigh*. So I'll just summarize: I have several very close friends who have depression and all of them were reluctant to try meds for a long time and all of them eventually did and found them really helpful. I don't know exact drug names or dosages but I've seen it work! One of them described it to me like this: when she was depressed, some gloomy thought would occur to her and then she would fixate on it and it would just choke out all other thought until she was just crushed by the weight of this thought. Sometimes they were fears about big things: nuclear war, homelessness, racism. Other times they were about small things: a stranger that was rude at the grocery store, a neighbor who was inconsiderate, feeling like she didn't deserve to have anything she had, feeling like nobody recognized her work. But however it started the result was the same: she couldn't stop thinking about it. She said that with the medication, all the same thoughts occur to her, but they no longer take over her consciousness. She's able to move on if she wants and think/do other things.

So from her experience, the drugs aren't some kind of deadening zombie-agent. Really it was the depression that was deadening her ability to think any other thoughts and the meds were able to restore that.

My only other advice, as someone "on the outside" so to speak, is: reach out to your friends and family. I'm guessing that you feel like you would be burdening them or that you don't want to put them through it. But your friends will want to help. They want to know what you're going through and want to help carry the weight if they can. Not sure if that's something you're experiencing, but with the people I know that have depression part of it is that they don't want to put it on their friends. But it's ok to.

I've had clinical depression (and a litany of symptoms peripheral) for a long time, Jwars post really hits home.


i also think meds are a quick fix that is approached in an overly lax manner by most health care professionals. I've been on probably 40+different types, sometimes up to 7 at once. Many for long periods. Seeing a doctor would be the best thing, but use your own head as well in regards to your situation. I would research your symptoms and come up with pertinent questions to ask your doc, really try to hone in on concrete answers (about things like efficacy, how long the medication has been on market, long term testing of the medication, his/her own personal view on the medication, what he's seen in other patients and his perception on how much is from the med or other stuff in that persons life, the complications of these medicines in regards to how they are judged for being successful or not, etc). I've had many a consultation with doctors where I walk out of the office and realize I just talked to this doc for an hour, and nothing he said had any real substance on what I would call the actualities of the medication or plan is, and then kicked myself for not having a more discerning attitude to cut through the fluff.
I'm sure meds help people, but I've also seen people and myself so desperate for alleviation that you begin lying to yourself that the meds are doing something positive, and they are pretty much all judged by the doc asking you if you feel they are doing something positive and there are no actual legit tests to perform.
Be extremely cautious with benzodiazepines if presented the choice to use them for anxiety.
Putting things in your life in order that could use some tune up would be advisable over diving right into meds (IE commit to regular sleep schedule no matter what, commit to regular balanced nutrition intake no matter what, doing stuff around the house that needs to be done before entertaining luxury/fun stuff, relegate use of things like TV/Internet, etc. And be on board and completing those tasks and disciplines for a while to see how your mental state is then before starting meds.

I'd suggest investigating (not starting) ketogenic diets for people with depression/anxiety and mindfulness techniques or meditation.


FWIW exercise, diet and regular meditation practices have been far more effective than any medication personally. Unfortunately they are much harder to commit to and find time for and require strict adherence to, and their benefits disappear like a fart in the wind when you lapse and slow to come back when you are on schedule again. Any benefit I saw from meds was something I invented in my own mind for finally finding a fix. Except benzodiazepines which definitely work, but then build tolerance and then you need more and more, don't get your dose, and now your anxiety is 100x worse than if you hadn't been on them, etc. (Fuck benzodiazepines)

You'll get through this Pope. It probably won't be easy, and you'll almost definitely have to go through 3-5 medication changes before everything settles in (which could be up to a year), but don't get discouraged and quit. The meds take time, and you have to stay on schedule. I'm absolutely shit when it comes to taking my mood stabilizer and I can definitely tell when I haven't taken it for a few days.

I've been diagnosed with being bi-polar, depression, anxiety, insomnia... I think that's it, and most of those for over half my life. But I've been on probably 2 dozen different medications (possibly more) because I'm just a miserable asshole with a high tolerance. I'm finally getting to where I need to be with the meds (sleep aids, mood stabilizer, hopefully an anti-depressant soon, anti-anxiety). One of the most important things is finding a doctor you like and trust... I had one that put me on medication that fucked with me heart, and then prescribed two more in the same class in succession. I've luckily found a practice that is a little better.

I'll echo some of the other sentiments here that a solid diet and exercise routine can work wonders. I still had my bi-polar episodes, but I wasn't near as depressed when I was in really good shape. I want to get back there... I'm paralyzed by the though of starting over. I remember the first journey; it took forever. I really dread getting back to it, and that has kept me from doing so (along with all the newfound joys of being a parent). I think part of what used to help me was having such a rigid schedule.

As far as your questions go; yes, you will sleep. It will take some tries to find one that doesn't leave you foggy. It will also help if you can drill down to the heart of the issue on why you can't sleep. Sometimes insomnia is just insomnia; sometimes it is anxiety or depression keeping you from sleeping.

Anti-depressants can be wonderful for keeping your concentration on point; so can peace of mind. I guess what I'm getting at is work with your doctor to figure out the why instead of the what. Once you get down to why, you can figure out what you need to make peace with and what needs to be medicated.

Sorry the the stream of consciousness rant...

Repoman and Calf make a good point about exercise. That really makes a difference. The less active I am, the less good I feel. When I was at my youthful peak and cycling all over the state I rarely had breakthrough depression or anxiety. Similar to Calf, I've let that slip away and it's hard getting back.

Don't expect the first med to make everything better though. If that happens, that's awesome. But some meds work for some and not for others. Work with your doctor and shrink/therapist/psych to find the best solution that makes you the best you.

It seems like combining strength training and cardio/endurance sports works much better than doing one or the other as well (in my experience). Aside from regulating hormones it gives you goals to work towards (IE lift more weight or run/bike faster or longer etc).
For getting back into working out after not doing it for a while, I find it helps a ton to just start with the thought that anything you do will help- "if I sit at the bench and do 10 presses of light weight, that will be better than nothing at all, or even if I bike 5 miles, that's better than nothing."

It's always actually starting the process that's the hardest part, doing the actual work is pretty easy/enjoyable.

A couple of things:

I've had some issues with sleep - not insomnia - but getting up often to piss. This is more because of anxiety.

I was on prozac and it did help with anxiety but had bad sexual side effects. I would also wake up in the middle of the night with heart palpitations. It helped with mental focus and helped with work. I was off that for some months.

I'm currently taking Mirtazapine - 15mg. I was on 30mg but felt it was a little too intense for me. It gave me too much energy/nervous energy.

What has been helping most with anxiety and depression is meditation and exercise.

I've also been wanting to get into martial arts - for self defense reasons - but also because I can envision how it can help with self confidence and more psychological grounding - being more in your body.

With depression and anxiety its a tricky system and cycles where your being in your head can make you avoid or not feel like doing certain things that might get you out of your head. You continue to ruminate and overthink, fear, etc. which only exacerbates being in your head.

Mirtazapine has helped quite my overactive internal chatter a bit which has helped me have more focus and presence with meditation which then helps ground me into the moment and my body and help me cultivate a more positive flow.

I'm looking at medication as a aid to help me while I work to get other methods and systems of health and wellbeing in place.

I hope any of this helps. Keep us posted and always post your thoughts or questions about anything. It takes a village......

Hi guys, thank you all for giving such detailed replies. It has been really helpful and means a lot.
I'm really tired right now and have some study to do before I go to bed, so please don't think I'm trying to be glib. I really appreciate your efforts and expertise.

I do try to watch diet and exercise. I could always do more of each but I do what I can.
I'm not expecting medication to be a magic bullet, but I've tried to do this every other way without it and I feel like its time to go down that road.
I'm hoping it will just be another thing to help me get through this period of changing my circumstances without any fuck ups.

Anyway, I'll report back with some more detail once I have some news.

Thanks to everyone that has reached out so far. It means a lot.