Citalopram: 20mg for 8 weeks then 30mg for 2 weeks - feel much worse!

Hi Sam

Anxiety seems to follow a typical path and recovery from it equally follows a another similar path for us all too. Yes starting or increasing meds will temporarily increase your anxiety, and with that ..... all its symptoms too.

I’ll have to message you about the book and other links because it can’t be posted on the forum or will be deleted 😦

Yes not rising up to anxiety is no easy task at all - though its the same as taking meds I guess, which is no easy task either. The book talks about acceptance which basically means first throwing ALL symptoms under one umbrella of anxiety - do not separate each one. People get het up on particular symptoms (as I did too). They don’t need separate recoveries, they only need one, and to worry / fret about any symptoms is like worrying about the symptom of a runny nose produced by a cold. Anxiety is causing them all - it is the culprit. To worry about a symptom just causes more anxiety - and the anxiety then causes more of the symptom. You get stuck in a cycle.

I know you can't stop worrying about a particular issue / or issues, but just to understand that whatever it is then its only caused by anxiety.

Acceptance is simple - but its hard to do. It means accepting the feelings / thoughts (or whatever) are there, leave it alone, do not head chat with it, let it be in your mind or body and just get on with your day. By engaging with the thoughts and feelings you just keep them alive and kicking, and they’ll produce more anxiety and the anxiety produces more of the symptoms. Breaking this cycle is key.

Acceptance also means expect to feel this way for a while yet - you cannot just step out of anxiety. But carry on accepting and it will make a huge difference.

Acceptance means do not try stopping the feelings and thoughts - just leave them alone to flow through the body. Anxiety is just adrenaline and cortisol and is looking for a way out - leaving the symptoms alone means you let them go and they will slowly run out of steam.

Acceptance also means stop trying to fix yourself. You can't - and the more you try and do this the more frustrated you get and the more anxiety sticks.

When you recover the anxiety (and all symptoms) slowly lose their insentity and frequency and the nervous system starts to desensitise and lowers back to normal.

Its a long process and we can all recover. Anxiety is not a lifelong condition.

Recovery comes from the medicine - but it also comes from this acceptance method. You can recover without medicine (which is hard), but you can do both (I did). If you don't understand anxiety or the acceptance method, then often when people come off meds they fall back into the cycle again. Acceptance is something that will always be within you and my your side whenever its needed ...... whether you're taking meds or not.

I’ll send you more details on this as there’s a lot of interesting information to read.

K 😃

Hi barb

You won’t feel any improvement after 7 weeks I’m afraid - its far too early. Recovery often takes many months - 6 months / less / more??

Increasing your meds will not make you feel any better at this stage because what you’re going through is completely normal. A bigger dose does not mean you’ll get better any quicker nor will it relieve your suffering - you will go through exactly the same whatever dose you take.

Often the case is ‘less is more’ with these meds.

Morning anxiety is normal - its when we feel it more acutely due to our cortisol rising throughout the night and its this we feel in the morning. It eases over the day.

People with anxiety try anything and everything to make the feelings go away - they google remedies, take vitamins, meditate, pray, exercise, hibernate etc etc in the hope that something will switch off what they’re feeling. The more you try and fix yourself, the more you'll struggle. All the time we do these things we still worry about how we feel - and its THIS worry that keeps us locked in the anxiety cycle.

If you had a cold / flu you wouldn’t worry excessively or try and fix it - you’d just let the cold run its course. This is what we need to do with anxiety.

The worry causes spikes of anxiety - and the anxiety causes the worry. We need to stop feeding it so it can run its course.

The meds will help bring about a calmness to your body but it will take a long time - as you begin to feel calm then so too will all other symptoms you feel too.

Worry means keep checking in to see if its there, worrying how long its been, worrying how long before it goes, worrying it’ll never go, worrying its something sinister, worrying about symptoms that come with anxiety etc etc ………. all these keep your anxiety alive.

Whatever symptom you have (physical or mental) do not separate them, but just lump everything under the label of ‘anxiety’. Its one condition - and they will all go away in due course.

Try and leave the feelings alone - they are caused by an excess of adrenaline and cortisol. Worrying about how you feel causes more adrenaline and cortisol. The meds will over time lower these and you will begin to feel calmer and the symptoms will slowly diminish.

For now try and just leave it all alone and ride it out. Take them with you throughout your day, because they aren’t going anywhere fast at the moment. Trust in the meds - let them do their thing in their own time.

Its an uncomfortable ride and the anxiety will fluctuate as you recover - some days / weeks worse than others - but just keep going because you will slowly improve.

I’ll also message you.

Thank you for your words Katecogs, thank you, thank you! i came here with the same concerns as Barb97671 and was relieved to read your reply to her. Im having all night panic stretches that leaving shaking, crying, full of dark thoughts and two days later i feel normal. My period comes and a few days later I'm back on the bathroom floor for 3 days, no sleep and the rest. its been only a month on 10mg and so my dr just accelerated my dosage to 20 for a week and then to 30. i dont want to jump that fast. I'm scared ill just feel worse.

Feeling lost and terrified already.

knowing it takes a while helps but what to do in the meantime?

Vee

Hi veekay

When you suffer with the anxiety condition it means your nerves are sensitised - this means they’re super heightened which affects your thoughts, and gives you all manner of physical sensations too - all of which can be very frightening.

We then become concerned about how we think and feel and can think of nothing else. We try and fix ourselves which only adds to the problem.

We fail to understand this and go round in circles trying different meds, researching for an answer, visit doctor after doctor as we want it to stop right now, this minute.

When you have your period, obviously hormones are at work. Because your body is already sensitised through anxiety, your hormones are just going to makes things that little bit worse each month. If you didn't have anxiety then you'd probably get PMT anyway, so the sensitised nerves are just highlighting everything.

It will stop, but it won’t stop now. You need to give your body time for the sensitisation to slowly come back down to a normal level - this can take months. Problem is, we fail to understand this and in the meantime continue fighting it.

I’ll send you some information about all this and how to help yourself.

Its called acceptance, and it does work.

hi katecogs, thankyou so much for being on this forum, i had seen that you were highly recommended and your advice has helped so many others through this journey. So i thought id reach out.

Previously i had been on citalopram 20mg for over 10 years, it was working wonderfully up until november 22, then bam, anxiety went through the roof! panic attacks, insomnia all the nastiness that comes with it, i was totally shocked, why the hell is this happening to me? im taking citalopram, why would i suddenly have all these raging emotions? i went to my docs after a few days of recurrent panic attacks, she took me off citalopram and straight onto sertraline, it really didnt agree with me, had awful diarreah for over 2 weeks, over the next few weeks i was then put on escitalopram, didnt like it, came off, then amytriptiline, to help with stomach issues, so horrible, came off, then finally got to speak with my psychiatric doctor at my GP, we had a chat about everything thats been going on, including some traumatic events that had happened earlier that year and he asked if citalopram had worked for me before, i said yes but thought it had stopped working, he decided that the best course of action would be to go back on it as it did work so well and go from there.

i am now on 30mg citalopram as i felt the 20 wasn't cutting it after 3 weeks, (im now thinking i didnt give it enough time)

im now on week 3 of 30mg citalopram and the side effects are horrendous, my anxiety is with me all the time, i cant sleep, eat properly, its so debilitating.

my problem now is that ive completely lost faith in the citalopram, which in turn is increasing my anxiety, how do i even begin to accept anxiety if the meds that i took for so long have already let me down, i just cant get my head around any if it, i know i need to give the citalopram more time but will it really ever work again, i hope this big read makes sense to you and if you could give me any advice or hope i would be so appreciative, thankyou.

Hi Katicogs,

It's been 6 months since first starting Cit and I have to say that I'm still not feeling as good as I would have expected. In the morning I still have a bit of anxiety although not as bad as previously, but if I happen to have a nap in the afternoon ,I wake up feeling like my anxiety is so high that I have tingles in my hands and my feet, and my stomach is like there's a knot in the middle . I breath to get through it and I've been very consistent to as to keeping a good frame of mind and not thinking about the way I'm feeling. I'm wondering if they are just not the right pill for me as I still feel as though I should be further along. Worst thing is I'd have to start all over. I really hope that isn't the case.

Thanks for your response I advance

Hi Emma, havent been on this forum in over a year. Just to let you know I'd been ill with depression/anxiety over 20 years ago. Id fully recovered on Citalopram then 2 years ago out of nowhere I fell ill again with depression anxiety/intrusive thoughts ( they're all linked like a chain) . I cdve blamed it on a few things menopause, bad job experience, stress but tbh there was no use analysing that. What was important to me was its here and I need to find a way to recover again and not procrastinate over the rubbish that my anxiety was filling my head with.

Kate Coggs is right, it can take weeks, months, a few years even before an individual can feel well again. We are all different. One thing for sure is the medication is working, you just can't see it, it's so slow. I'm only on 10mg Citalopram and I've never changed my doze. I was on my knees begging for mercy with my anxiety, my intrusive thoughts were so terrifying I was scared to cross over my door and speak to anyone. 2yrs later I'm back at work and I can say I'm a good bit better now. I've still got some recovering to do but I've been on holiday abroad 3 times now, organised a party for my husband, been to social events etc, so recovery is there. There's even a lot of times now that I forget about it and its then that I can tell recovery is happening.

Kate is right tho, you take it everywhere with you as you can't leave it at home. Where you go, it goes too and its only then it will start to diminish. I was terrified in the beginning, I dont know how I managed it. I was so detached from myself, my family, friends, everything. I felt someone had jumped inside me and was controlling my whole being. I didn't feel suicidal but I didn't want to live like that any longer. It was excruciating to say the least.

You will gradually over the weeks/months feel tiny moments of positive feelings, the impact of it lessens and you will go further. Don't fear setbacks, we all have them, I still do, but for everytime you do, you will recover more. You need to setback for recovery to happen. Don't give up hope, the sun will shine again and if I can say that then that's a true sign of recovery happening.

Hi Barb

Sorry to hear you’re still not quite feeling as good as you’d want.

Napping during the day can affect you - and its something I still find makes me feel odd (I don’t get anxiety from it but sort of brain zaps afterwards).

Anxiety can cause tingles - its just adrenaline / cortisol running through your body, quite harmless.

Easier said than done, but maybe try not to nap during the day - I find it messes with my nighttime sleep if I do too.

When I first recovered it took about 6 months - and from there on I still kept recovering more and more probably for another further 6 months. Though I felt amazing I still had some residue symptoms that kept cropping up and I used to get flat times, but by then I knew they’d go eventually.

Other than that, it could be maybe adjusting your dose could be helpful. Even a higher dose can be too high for your body and lowering a little can be the answer. Something to talk to your doctor about anyway.

Changing medicine doesn’t mean you have to start over again. Usually a doctor will cross-taper your meds with another one so you won’t have any non medicine gap. I don’t think you’d have to come off one completely before starting another as they’re the same class of meds (SSRI’s). I’ve switched from 2 medicines before (one didn’t agree with me and one was discontinued) and I was cross-tapered over and all went well.

Also have a look again at the info I sent via message as often people can still be trying to ‘control’ their symptoms instead of accepting them (going with it). ‘Breathing to get through it’ is controlling …….

I’ve also tried to control my symptoms without realising it, and also didn’t realise I was still ‘head chatting’ to myself about my feelings and all the ‘what ifs’ again and this usually keeps you stuck in the anxiety cycle.

It might be that you just need to go with the 'acceptance' method more and give it more time. Other than that then do see your doctor to see if a dose adjustment will help or failing that then swap meds (and personally I'd give the meds much longer though) - my second time on meds took much longer than 6 months.

Thanks for your reply Katecogs.

I didn't realize doctors would do that, cross taper over. That's interesting.

So when I say I do things like breathing techniques, or count down 5,4,3,2,1 to interrupt the thought that I'm having, it is controlling? I am controlling the thought by interrupting it? Is this the case?

I have been using the acceptance method a bit more lately. Maybe it's like you say, I need more time in doing the acceptance mode. I am probably expecting to much.. to fast. I will Def keep going with this medication a bit longer. It's Def helping as my husband said to me just 2 nights ago, he can see a big improvement. It may be all I need . A little longer for meds to respond and more time on the acceptance method. That makes alot of sense. Im not sure if I mentioned to you that this is my 4 time on meds, but first time on Cit. Maybe this is why it is taking a bit longer for the meds to respond because I was on meds before. Hmm.. I know one thing, the meds have to be doing something because before I would have been frantic and just wanting to hide from everything and not caring about learning more about this subject, but just wanting it gone, but now I want to learn more about it instead of hiding from it. You have made this possible for me. I can't thank you enough for keeping me grounded. Barb ...(oh and no more napping🤭)

Hi Emma

Sorry you had anxiety return after so many years on medication - did you have a different brand of medicine just before this happened? Just a thought because some people react to different brands of Citalopram.

Other than that I wonder if you’d gone through a period of intense stress maybe ….

Anyhow - whatever the cause, it happened. Personally I wouldn’t have changed my medicine and would have stuck it out. However changing medicine can help, but it will take time and will cause side effects initially.

When anxiety crops up we immediately try and fix it, get rid of it, which is the worst thing to do (and I know that’s completely the normal reaction we all do). Acceptance I talk of is much more indepth than just thinking you’re accepting it, as usually people are in fact ‘putting up’ with it.

I’ll message you.

Mmmmm it is kind of controlling - its best to leave the thought in your head, don’t add on anymore thoughts about it, and just get on with whatever you were doing when it popped up. Thoughts always come and go with intensity, and if we ‘ignore’ them and don’t add any emphasis onto them, they will slowly, slowly lost their importance and eventually stop coming. Its not something to be done that gives you instant relief, because you’ll still feel alarmed about it, but over a long time the thoughts ease off and finally stop coming.

Yes acceptance again will take a long time - for some people it works within months, others much longer. There’s also no giving up on it because it doesn’t hurt to keep going with it.

Yes restarting meds can take longer (no idea why), but it did for me too. Just keep plodding away with the meds, practice acceptance and you will start turning a corner.

Recovery is so very subtle so as you say not wanting to hide is something you’ve noticed already.

How are you doing now?

thankyou for your reply, im now on week 12 of 30mg and ive had so many ups and downs, i feel a lot better than i did at the beginning but have noticed anxiety starting to creep back in again, my chest feels tight and i get so upset about it, i just want to feel normal again, trying to ride it out but its so difficult.

Hi Katie,

right now I am starting to see another difference since the spring came in and the sun is coming out. I feel more like getting outside and the anxiety is just about gone in the morning. I stopped napping in the day which has also made a huge difference. I've always had winter blues too which I believe contributed a bit as well. I would like my mood to improve a bit more but I'm guessing that will come in time . I'm very hopeful and keep plugging away at it. I am also starting to get excited for my gardening and yard work, so that is Def helping.. step by step, I'm making it.. thank goodness for this site.. acceptance is Def much harder than I anticipated, but if it's what I have to do to then so be it. I also understand why in the blog that Paul has, he says that this is where alot of people fail. I can believe it because it's Def the hardest part of the healing process.

much appreciation to you for everything you have done and said.

Hi barb

The lighter days make all the difference.

Have you ever thought about getting a lightbox for the winter months? Also taking Vitamin D3, plus of course getting outside during the winter months - all should help.

Acceptance isn’t easy - the concept is easy, but the actual practice isn’t. This is because people get disheartened when they don’t feel relief quickly when starting to accept, but it isn’t a tool for doing this - its a method that will ‘eventually’ lead you the right approach instead of how we all react to anxiety.

It is the best way to go though - it will make such a difference.

Hi Katecogs

I never thought about a light box. That's something I need to look into. I was taking Vitamin D3 to help. I did get out a but this winter, but prob not enough.

Acceptance is Def not easy. I never knew something could be so hard.

I Am Gonna Make It. I am determined .I've come this far, now I have to see it to the end.

Much respect for you. 😊

I didn’t get acceptance for years - I just didn’t understand what it meant. Whenn I finally understood, I didn’t find it easy either. Acceptance is about your response to anxiety.

You are going to make it - keep on with the medicine and acceptance - you’ll get there 😉

Absolutely. I just want to thank you again for al the encouraging words. It made this journey so much more understandable. You kept everything to where I can understand what to expect, how to deal with it and for just keeping me going when I really thought I couldn't. 🙂

Glad I was able help 💕