Reason meds take so long and why you feel rubbish

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Hi everyone, here’s something I found online which you may find intersting.  Its about why you feel so rubbish when taking these meds, why your mood is up and down, why it takes so long and the process it all goes through.

Sorry its a long post.

When starting an SSRI or increasing it's dose often makes people feel really rubbish, which can cause a great deal of stress as you begin to wonder whats happening, why is their illness getting worse, are these meds working etc.

Somone recently posted a great post explaining what these meds do in our brains, and I’d like to add further to this.  So, as already posted ….. the brain is basically a big dense bundle of nerves which carry electrical signals around our brain and body.  The nerve cells don’t touch each other, leaving a small gap between each cell, called a synapse.  So how do signals get from one nerve to another?

Neurotransmitters are chemicals released by nerve cells that tell a neighbouring nerve cell to pass the signal along.  A bit like pass the parcel.  Serotonin is one such neurotransmitter.   So when an electrical signal reaches the end of a nerve cell that deals with serotonin, that cell releases serotonin into the gap (synapse), which then crosses the gap and interacts with the nearby nerve cell and tells it to pass the signal along.

Once the serotonin has done it's job, the serotonin is then reabsorbed from the gap so that no more signals are passed until the next one comes down the nerve.  SSRIs, (Selective Serotonin Reuptake Inhibitors) interfere with this reabsorbtion process and thus it stays in the gap longer, which equates to more serotonin and more signals.

So furthering on from there ….. why do you feel so rubbish?

So, along with the releasing of serotonin, and reabsorbing it, nerve cells also have parts that detect an increase in serotonin level and tell the nerve cell to stop producing anymore serotonin until the level drops.  These are called autoreceptors, which are the reason you feel like so rubbish.

So the SSRI will increase the amount of serotonin that’s gathered in the synapses between nerve cells, but unfortunately the autoreceptors of the nerve cell pick up on this increase and tell the nerve cell to stop producing serotonin.  The result of this is that when you first start taking an SSRI your serotonin levels drop.

How do they go up again?

Eventually with continuous use of the SSRI medication, the autoreceptors become desensitised, that is to say they've continually told the nerve cell to stop producing serotonin but yet serotonin is still there.  In short they simply give up.  They stop telling the nerve cell to stop producing serotonin and your serotonin levels start to increase.

This desensitisation takes time, it doesn't happen over night and it won't even begin to happen until the SSRI levels have stabilised.  This is why you feel so rubbish, and is why your mood drops and your anxiety increases (also fuelledd by the fear of not knowing whats going on).  Your mood will be up and down as the seronotin continues to try to stablise.

So, to summarise:

SSRIs cause your serotonin levels to drop when you first start taking them.  Your serotonin levels will not rise until the autoreceptors in your brain have stopped working (become desensitised), all of which takes lots and lots of time.  Everyone is different, so for some it can be many weeks and other months.

I hope this helps some people to understand what these meds are doing and why you don't get instant results, compared to other meds that work in different ways which is the reason they can have a more immediate effects (benzos for example).

K x 

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  • Posted

    Thank you for posting this up.  Yes it really does help me understand further how this medications works and that is sooo reassuring.

    Thank you so much.  xx

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  • Posted

    Hi Kate

    Thank you for that it explains a lot, I'm nearly 4 months in and are doing great. Thanks for your help x

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  • Posted

    Thanks for posting this. It is really encouraging.

    It is great that you continue to support everyone through their citalopram mind field.

    Am I right that that you are not longer on medication?

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  • Posted

    Suddenly makes sense why everyone suffers on these meds, doesn't it.  Hope it helps xxx

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  • Posted

    This is an outstanding explanation Miss Kate. No wonder these meds take awhile to work---if at all. I'm sure this will help a

    Lot of people understand the pricess!!!

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    • Posted

      Interesting isn't it smile  Our bodies are very clever too, seeing how it handles these meds when starting them.

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  • Posted

    I'm struggling to understand this...as I instantly felt a million times better...as in within 24 hours...yet my symptoms of anxiety/depression was all the symptoms that people experience when they first start on the meds 😳 I'm confused 😂 Doesn't take much x

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    • Posted

      Everyone's different, so all recover at different rates.  Sometimes people do feel better in the first weeks and then the symptoms hit them much later.  Again, that's the body / medicine adapting / settling down.  Some people feel symptoms and then increase their dose ..... but of course following what your body does (in my above post) I expect that will add the process and confuse the body.  Letting one dose settle seems to be better.

      Everyone also experiences different degrees of meds symptoms too - some suffer so, so bad they're forced to give up the meds whilst another person gets away quite lightly.

      When I started meds the symptoms didn't seem much different to what I was already suffering with anxiety / depression.  The meds made me feel quite nauseaus and heady, but I already had high anxiety so was used to it.  I've been on these meds twice, and the second time I had a totally different experience when starting them.  Very weird. eek

       

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    • Posted

      Hi Kate, sorry to bombard you with questions, but been having a couple of really anxious weeks.  My mind is racing all the time and feel really down on myself - very self-critical.

      I'm on week 13 now of 20 mg.  I have been up and down but this down seems to be sticking around.  Do you still think it is the right medicine for me. xx

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    • Posted

      Hi Anna - no problem at all xx

      When recovering on these meds its often a case of 3 steps forward and 2 steps back all the way.  Some of these blips can last longer than others, and often we add anxiety to it by being critical, negative, fearful etc which is only natural.  I did exactly the same.  I eventually learnt that to pass through this stage, its best to understand what's happening to your body, relax towards the feelings by letting go of tension in your body, not just when you're sitting but when you're going about your normal day.  Float along .... don't rush about, let go.  Also gentle exercise is good as it helps to burn off excess adrenaline and releases endorphins.  I've just you the link which might help you understand a bit more about all these symptoms and blips and how to pass through them.

      I recovered on 20mg and it took me 6 months (it wasn't bad all the way through).  Everyone recovers at different and 13 weeks is quite early for some.  Sometimes you'll find you're having a really long, hard blip and the next week you might feel quite well.

      Other than having this blip, have you felt any ease at all - even if its been really slight?  Have you had any feelings of being 'the old you' yet .... even if it was seconds.

      Lots of people end up chasing recovery - they find the meds haven't worked as quick as they'd like them too, and believing the dose isn't working for them they either get an increase or change meds.  Increasing causes more side effects again initially, and though everyone needs a different dose, you won't know until you've given the dose you're on a few good months.  After increasing, the person again gets heightened symptoms, they panic fearing they're worse, and so either get increased yet again (yep, more symptoms) or get a decrease ..... decreasing can cause withdrawal.  So ..... with all this to-ing and fro-ing going on they then believe the meds aren't for them so get changed to a different medicine ....... and start the process all over again.

      I'd personally give the meds / dose a lot longer.  Count recovery in months, not weeks.  

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    • Posted

      Hi Kate,  I was hardly sleeping at all before I started taking Citalopram and within 5 days of taking them I started sleeping right through the night again.  My gp said this showed they were working for me.  I've had good days and even a couple of good weeks (around week 4/5) but it's been very up and down.

      Thanks again for you advice and support.  It really helps.

      Feeling more positive now biggrin

       

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    • Posted

      Most people usually find the meds to the opposite, and gives them insomnia.  Glad you're able to sleep - it makes such a difference.

      Yes seeing you've had some good days and some good weeks too, shows the meds are working.  That's often how recovery happens - and you can even feel up and down during just 1 day.

      Just keep going - relax as much as you can when you're having a blip.  Anxiety likes tension, so taking the tension from your body helps a lot.  Strangely, even welcome the blips ..... because that's the time to practice accepting them, relaxing / letting go and just carrying on.

      You'll get there xx

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    • Posted

      'do' the opposite ...... not 'to' the opposite ???? rolleyes

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    • Posted

      Thanks for the support and advice Kate.

      Really appreciate it - you're helping so many people stay strong. xx 

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