Paroxetine and then Venlafaxine, but still feeling awful

Hi all,

I am here looking for advice. First, I apologize for my English, it's not my first language. Second, I know I might be repeating stuff you have read many times, so maybe writing this is more of a way to help myself than adding valuable info to your experiences.

My first encounter with panic attacks, GAD and secondary depression was in 2014 (25 y.o. back then). Since then, I have been treated with paroxetine (Paxil in the US I guess), in 6/8-months spells at moderate dosage (10mg-20mg) with excellent results. I was on and off P, each time relapsing 4-5 months after quitting, each time going back to P and coming out of it (with no symptoms left) in 2-3 weeks.

After quitting P in November 2017, I relapsed last June. So, following my psychiatrist's advice, I went back to P as usual. After one month at 20mg I was having no relief, so we decided to move up to 30mg. After a week at 30mg, I fell into bad depression (like really bad, contemplating putting an end to it for real for the first time in my life). Doctor got scared and changed me to Venlafaxine (Effexor XR) 75mg.

In a couple of days the panic attacks had weaned, anxiety was there but manageable: chest pain got worse but mentally I felt more at ease. By the end of the 1st week I was feeling sad (like bursting into tears for no reason) but not depressed, I was thinking more clearly and thought I was on the right track.

At the end of week 2, I had a couple of bad days (high anxiety and depressive brain fog) and doctor upped me to 112.5mg (75 + 37.5). Once again, I felt better in a couple of days and by the end of week 3 I was almost normal, except for some mild anxiety in the morning and some low mood in the evening. Then I got worse again, with increased anxiety and depression coming back, although not at the same depth as when I had changed meds.

So doctor upped me to 150mg (75+75). I've been there for 6 days now and feel no change. There are times at day when I feel that the thing is manageable, especially between 10am and 5pm. But mornings and evenings are bad. Anxiety comes and goes, and while it's weaker than it had been before starting P, it still hits hard at times. But the depression, although I can get up and go to work, never goes away. My ability to do anything is really low now.

Doctor says I should stay at 150mg and see what happens. But considering the period on P and this one on V, it's almost three months now I haven't been able to life my life (well, any life to be honest).

I really want to live my life, but I also cannot accept being in this state of things. I don't have a family of my own, nor a partner at the moment. But I have many things to do, wonderful parents and brother, amazing friends who are caring for me as if they were family (like visiting every single day after work, taking me out to dinner, being patient when I cry about how my existence is meaningless with this illness). I love my job, and it makes me sad that I cannot give even 20% of what I used to, even though colleagues see me struggling and do everything they can to make it easier for me (they don't know I have mental health issues, but they see I'm not ok).

I am terribly sorry for the long post, today I'm having a bad day and the most frustrating thing is that each day I hope to wake up and realize that that's the first day of a recovery, rather than the nth day of being ill.

Thanks to anyone who reads this and also to previous posters, I found reading your experiences extremely comforting.

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