Reason meds take so long and why you feel rubbish
Posted , 33 users are following.
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
16 likes, 145 replies
ian90586 katecogs
Posted
To add to that explanation I'd like to add that SSRI's work immediately, and that every time on every SSRI I've taken,and that's all of them,you immediately feel better for a certain amount of time,several days in my experience which I dubbed The Honeymoon Period,before a dramatic worsening as described. The therapeutic effect you experience immediately is how you will eventually feel after several weeks,or more likely months of treatment. This is the cruel effect of these medications unfortunately which pharma companies or doctors years ago could never admit to,or still don't,claiming it takes 6-8 weeks. Added to that is another reason to the worsening of symptoms from an increase in serotonin. Check out Dr. Tracey Marks on YouTube for that explanation,Why antidepressants make you feel worse in the beginning.
katecogs ian90586
Posted
Yes I’ve heard of the honeymoon period - not everyone gets that though and some feel rubbish right from the beginning of meds.
The meds are cruel though persistence does pay off for many, though lots of people can’t tolerate them so stop them.
And yes - it takes far longer than 6-8 weeks and don’t know why Doctors don’t inform their patients of this because that stresses people out thinking their meds aren’t working.
That’s a great video - thanks for that 😄
ian90586 katecogs
Posted
Everyone is different,and when you factor in all the variables unique to every single individual that contributes to their illness,it is understandable that when you also introduce a chemical to someone's brain and system that alters the chemical makeup by affecting the neurotransmitters,that people are going to have their own personal experience.
They can't tell you it might take many many months to work,even longer with dosage increases,because people would freak out at that as well. The greatest advance in my lifetime that I've experienced,is not in the medication,but in social awareness and platforms like this one, where you get to share other people's similar experiences on these medications,and how horrible and debilitating this illness is for so many people like yourself. Years ago I,and many others,would have to suffer in silence and shame with only a small tablet for help,thank goodness those days are gone.
katecogs ian90586
Posted
Yes true, each individual has their own unique experience with these meds, all depending on their body and makeup (not talking mascara there) lol 😄
They may try and hide the truth of how long these meds take, protecting the patient, but think it does more harm than good because the patient then goes on a quest of increasing their meds unecessarily, or stopping them, switching meds which causes long suffering.
That’s what happened to me - I was first ill in 1979 when you just didn’t talk about this sort of thing, and so my condition continued for years, and then it wasn’t until the 90’s I was put onto SSRI’s that recovery happened. That long wait was still better than suffering in the Victorian era when you’d be put into a sanitorium and locals would think nothing of it for an afternoon out and to come see the 'nutters'. Nice .......
lynda84120 katecogs
Posted
hi Katie just wanted to thank you for your input on this site. I find it really helpful. I am currently struggling and have been for over a year. I was on citalapramn for many years. however, with lots of added stressors I became unwell and was taken off it. I have tried other meds with no success. now I'm back on cit and praying it works again! dide effects are bad nausea, headaches, shakiness.
I see that you have suffered from depression too! I feel like I'll never get there just looking for some reassurance as you seem to be in a better place!
many thanks 🙂
katecogs lynda84120
Posted
Hi Lynda
Aww thanks - just hope a little info goes to helping people.
Trying different meds does need to be persevered over a very long time (6 months at least I guess), but seems like Citalopram worked well for you before so am guessing it will again.
Side effects can be brutal at times but they do ease off over time. Just keep going on it and check in with your doctor at times for progress report.
Yes I had depression the second time I started meds - it just seemed to go on for such a long time.
We all think the same when we’re in the middle of anxiety. You won’t be able to see your way forward in a positive manner because if your body is anxious / depressed then that’s all you’ll be able to see for your future (at the moment). As you recover your mindset changes and you’ll start looking outward rather than inwards at yourself all the time.
Anxiety is like a broken leg - it’ll hurt and be uncomfortable as we heal, but go about your day as normal as you can and know that you are healing, however bad you may feel. As each month passes, little by little things should get a little easier.
K x
lynda84120 katecogs
Posted
Hi Kate sorry just realised I've said the same thing in my reply! 😭
katecogs lynda84120
Posted
Hi Lynda
Haha no problem - I often do the same thing at times and repeat myself 🤣
Having a 6 month break is fine and I’m sure the meds will kick back in for you in time. Things should start getting easier for you.
xx
lynda84120 katecogs
Posted
thanks kate on day 10 still nauseous v anxious n intrusive thought one on particular!! so scared as I hot unwell whilst on them
but then my life was so stressful then and I've made lots of changes! I'm determined to keep pushing as I know ppl this has happened to and they've had a break and had success second time around. feel really flat but that's nit new one think is I have stopped crying so I guess something's happening! thanks again x
katecogs lynda84120
Posted
Hi Lynda
You’re still feeling those initial symptoms - these should diminish over time. Day 10 is quite early.
Intrusive thoughts are a side effect of anxiety, and because the medicine heightens anxiety initially when you first take it, then it’ll mean thoughts will be heightened too for now.
Feeling flat is also normal at the moment - when I restarted meds I experienced symptoms I hadn’t had first time round. When you have anxiety then adrenaline is surging through your body - this prepares us for fight or flight. When we start taking medicine it starts to calm the body (adrenaline), so whereas before your body felt ‘wired’ all the time, now its being calmed you’re probably going to feel flat as that adrenaline is being lowered. Your body will its normal level, but for now it will swing all over the place until it settles.
Yes little things happen first - the crying stops, sleep improves, appetite ….. and bit by bit our body starts to heal.
Expect those bumps in the road - there'll be a few yet before it all smoothes out.
K x
lynda84120 katecogs
Posted
aww Kate thankyou so much! its reassuring to hear from someone who knows! as you say my anxiety is still through the roof! I'm trying to work through it and not use any meds. still feel sick and nauseous and sleep is not great. after reading your and other posts I'm determined to keep going! it's the hardest thing I've done nut I cant give up I want my life back! thankyou again! 😘
lynda84120 katecogs
Posted
hi Kate thanks so much for your response. sorry I'm late I'm replying only just seen it! I'm right in the midst of the storm and side effects are awful! headaches, nausea, sweats etc. I got taken off cit as I became unwell again but I had a lot of stress then and taken it fir 14years. fast forward other meds to now and doc put me back on it as it worked really well for me.I pray it works for me again as I've had over a six month break from it! I like you have great faith in this medication day 4 today. Thanks so much again for all your kind words! L x
hope30709 katecogs
Posted
hi.. thank you for this post.. I am 7 weeks on 20 mg prozac and while my moods are still up and down, the biggest problems I have are constant sleepiness , fatigue and headaches ... I can barely keep my eyes open even though I'm sleeping a lot better and longer... I struggle so much to even change my side in bed, let alone get up... if I do manage to get up, my mind or body, whatever it is, continuously remind me to go back to bed in an instant, as if I will fall down ... I had chronic migraines since many years, but on prozac it has probably multiplied and constant forehead pressure 24 hrs... also my throat and jaw and left ear feels so tight and painful and I am hypersalivating all the time .. these side effects and lack of motivation to move (procrastination) are really bothering me ... 7 weeks is a lot of time .. is there any hope this will get better?
katecogs hope30709
Posted
Hi Hope
I’m wondering if the sleepiness will eventually peter out.
I know people do get headaches and especially a tight neck and jaw, and this is due to clenching your jaw with tension, which often happens with anxiety. We often don’t realise that we grind our teeth, clench our jaw or hold tension in our neck or body as we fight anxiety. Have a look and see if you are doing these things and try to release it.
I know SSRI medication can make you feel tired as they do sedate you a little, and also anxiety makes us tired too as it exhausting carrying it around all day.
It might be your body still adjusting to the meds, as they really do take a long time before you start feeling any benefit - often 3 months onwards. For me it was 6 months.
It might be worth chatting with your doctor about the extreme tiredness, though I’d also give these meds a lot longer. If they still continue to make you feel exhausted then ask your doctor about switching to another meds ie Citalopram. There’s many different SSRI’s and there will be one that suits you more. I took 3 different ones before finding one that suited me better.
K x
hope30709 katecogs
Posted
thank you Kate .. yeah after reading your experience, I am determined to stick it out to at least 6 months in hopes it might make things better by then... I took escitalopram before but can't remember it doing much for me except sedation ... yeah I had fatigue from migraines and anxiety before prozac too.. but now it has totally sedated me, and constant stiff neck, head, jaw ... although I have to say mood seems better and at night I am smiling for no reason in bed lol every single night ... and back to tired unmotivated and blah in the morning... but I had ups and downs even before prozac too so its hard to tell... whats bothering me is I seem to be wired and tired at the same time, can't keep my hands still or focus on anything like tv or surroundings, its only me and my cellphone all the time, so much so that my arms hurt but the desire to keep occupied doesn't go away!
hope30709 katecogs
Posted
I wanted to know if you experienced similar fatigue/ headaches/drowsiness.. I am napping all day too or just in bed.. wondering if its normal 2 months in on prozac? and yes depression/anxiety make me feel like my body weight a thousand bricks, so heavy , waiting and waiting to feel the burden going off the chest and feeling lighter as some ppl have reported on medicines.
Ojh3 hope30709
Posted
hope, i feel the same as you... completely wired, but exhausted. its a strange combination.
i am on week 6/7 of citalopram and after a few better days a couple of weeks ago, i have taken a real nose dive just when i thought things were looking up.
its very demoralizing .
katecogs, i have been on and off citalopram for around 10 years. after coming off HRT i have been plunged into crippling anxiety. im now on 30mg of citalopram... no improvement at all. im sure i saw signs of improvement before 6 weeks.... im wondering if it just dosent suit me anymore.
lorraine90511 Ojh3
Posted
how are you feeling? i have just had my dose increased to 30mg after being on 20mg for 12 years, ive felt awful all week very anxious and crying lots. blurry eyes too and dry mouth. has anyone had loss of appetite too?
katecogs hope30709
Posted
Hi Hope
Recovery takes as long as it needs to - different for every person.
Why didn’t you get put back onto Escitalopram - even Citalopram? I think they produce less symptoms than Prozac. But maybe if the tiredness doesn’t improve then talk to your doctor about swapping - but do give Prozac much longer first.
I recovered fairly similar - my evenings were better than the day until this feeling spread more into my day making most of the day quite good. Mornings are always the hardest with anxiety - it wears off during the day.
When we have anxiety our body is fuelled by adrenaline which keeps us on heightened alert - I’m guessing the meds are sedating you and this is mixed with that wired feeling too. It should slowly bring that wired feeling down.
Have you tried exercising, even just going for a daily walk. This helps burn off excess adrenaline.
I think I did feel slightly drowsy, but it was a long time ago and can’t remember. 2 months is fairly early still and its always more difficult at the beginning.
If you’re recovering from an illness, an operation etc then your body would still be tired and in need of rest. Recovering from anxiety is no different really - especially taking meds too. Try and go easy on yourself, take each day at a slower pace, and do think about getting outside into the fresh air each day for a walk. It really does help.
Ojh3 lorraine90511
Posted
hi lorraine,
ive been a mess to be honest. crying, loss of appetite, suicida lthoughts, heightened noise sensitivity etc.... its been awful. like i said, i had a few better days, then wham... ive been worse than ever.
im just trying to ride it out.
how long have you been on 30mg?
lorraine90511 Ojh3
Posted
hello im so sorry you are feeling this way, what day and dose are you on? im feeling the same as you i can barely eat anything ive cried for three days which isnt me, feel detached and spaced out too, im only on day 7 of 30mg so im hoping it will get better. im here if you want to chat daily to support eachoother xx
Ojh3 lorraine90511
Posted
thankyou lorraine,
im 5 weeks into it..... so i was hoping i would feel much better.
you are still on really early days yet. how long were you on 20 mg for?
i also have the problem of hormone withdrawl as this eppisode of extreme anxiety was brought on by having to stop hrt cold turkey.
i would love daily support..... maybe we could start a new daily support thread?
xx
lorraine90511 Ojh3
Posted
5 weeks is still early although everyday feels like a week when we are anxious. that would be great im new to this site so not sure how to start up a new thread? i tried to inbox you a private message but cant seem to find the option to send you a message. are evenings any better for you? ive been on 20mg for 12 years and its kept me fine and anxiety free, i got covid 2 months ago and my anxiety has been triggered by it xx
Ojh3 lorraine90511
Posted
im new to this site too. found it through frantic googling!
were you very ill from covid? there are lots of horrible symptoms from it.... im sorry to hear your anxiety has ramped up because of it.
sometimes evenings are a bit better, but its hit and miss. are you better towards the evening?
i find mornings unbearable.
lorraine90511 Ojh3
Posted
me too, i was literally googling about how long ill feel like this on citalopram so glad i found this site, i feel less alone here, i wasnt too poorly with the covid but had breathing difficulties which triggered anxiety, mornings are awful for me too, im a complete wreck when i wake up, do you get the spaced out detached feeling? i find that really awful 😦
lorraine90511 Ojh3
Posted
morning how are you this morning? did you sleep okay?
Ojh3 lorraine90511
Posted
morning lorraine,
ive had a pretty bad morning. very anxious and horrible dark thoughts. ive had a good cry and at the moment feel a bit better. i sleep ok... i just wake around 5am feeling jittery.
how are you this morning?
lorraine90511 Ojh3
Posted
hello, ive been the same i woke around 8am and thats when the anxiety kicks in i feel a bit down today too, have taken the dog for a walk round the block. do you find yourself anyalysing how youre feeling all the time?
Ojh3 lorraine90511
Posted
yes i do.. and its probably not helping.
i have started a daily support thread xx
lorraine90511 Ojh3
Edited
fab ill have a look for it thank you, xx
hope30709 katecogs
Posted
thank you Kate... the headaches seem to be bothering a lot, I have tried to relax my body and unclench my jaw all the time , but honestly it all works one day but the next day I always have a horrible headache, no matter what I do or eat or try to relax.. headaches bother me because they are not only painful but also cause fear, anxiety, fatigue and depression.. in fact, constant recurring headaches were my first symptom of anxiety which made me so depressed before anxiety hit full force .. so I am wondering if prozac was working, it should have improved the headaches and fatigue, and not worsen it... also my mornings are relatively okish , its around 12 pm that I start getting really heavy and headachy till around 9 pm at night ... its an alternating pattern, one day of relative less pain and another when its horrible ... 😦 also i did not want to go on escitalopram again as I thought it didn't do anything for me a year or two ago, though I cant remember how it made me feel except sedated.. so thats why I tried prozac! People on forums are telling me headaches after 2 months aren't a good sign, they should have settled by now ... now I have no idea if this side effect is going to persist or go away if I give it more time!
hope30709 Ojh3
Posted
hey , 6 weeks is probably early, that's what I am telling myself at 9 weeks... I have one day when I feel optimistic and another I have headaches and more anxiety ... the medicine is supposed to do something , and it has been proved on so many people, so we can hope for better .. although anxiety tells us otherwise .. and everytime anxiety will bring up a new thing to bother us, so group it under anxiety and say this will pass as anxiety lessens over the weeks/months... if its your second round of citalopram, I read Kate post somewhere that the second or third time around, it can take somewhat longer to kick in.. so pls hang in there.. much love xx
Ojh3 hope30709
Posted
hope,
it feels like its taking an age. i was sure i got relief well before last time i took it.
your headaches sound awful. i would definatly get an appointment with your gp. maybe you just are very sensitive to the prozac? what time of day do you take your meds?
hope30709 Ojh3
Posted
I tried taking it at different times but it doesn't make much difference, nowadays I am taking it around 12 pm noon ... and shortly before it i start getting headaches and tightness in throat, neck, shoulders and it lasts all day every other day till I sleep ... i would suggest you keep a journal or diary to track and look back on progress or setbacks.. because anxiety affects memory a lot !
Ojh3 hope30709
Posted
i wonder if its stress headaches. it sounds like you are tensing your muscles in your shoulders and neck area.. this might be the reason behind your headaches... but best to check in with your dr.
yes, i do keep a diary... it makes for grim reading so far!!
hope30709 Ojh3
Posted
yes I have always been tensing muscles in my head, neck, jaw and even all over the body like legs and arms even before anxiety and that has always caused my headaches.. I try to relax my body as much as I can but it seems like an automatic anxiety reaction
Ojh3 hope30709
Posted
yes, its a really hard thing to break the cycle of. i tense myself up too. xx
katecogs hope30709
Posted
Hi Hope
Relaxing is a bit of an art - and its not easy when you have anxiety as people do tense up as they ‘fight’ this (which is the wrong this to do).
Worry also causes headaches and if you’re worrying about the headaches then that could also be a factor?
SSRI meds do make lots of people tired, but then again fatigue and depression are also symptoms of anxiety.
Anxiety sufferers do often tense their heads without realising it so could be this too.
No headaches may not settle yet - everyone is different and we all get different persistent symptoms to the next person.
No you don’t know if the headaches will go away or if any of the meds suit us until we’ve been on them for a very long time. These meds works real slow and recovery from anxiety is slow too.
Has your doctor suggested anything for the headaches?
katecogs hope30709
Posted
Forgot to add
Do you use a laptop, tablet, phone a lot? Using a screen a lot can also have an impact on headaches.
katecogs Ojh3
Posted
Ojh3
When you took Citalopram for 10 years on and off, how long did you stay on it before coming off and then back on again? And did you feel recovered on it before?
Did you take 30mg before? Sometimes a bigger dose doesn’t suit and a slight decrease helps. How long have you been on it now?
Recovery takes a long time and it isn’t always the same as before. People often feel well early on taking these meds and then slump. This is normal. There will always be setbacks throughout recovery for everyone, and restarting meds can take longer than before - could be 6-9 months, sometimes shorter or longer. Took me longer second time round.
hope30709 katecogs
Posted
yes Kate, I spend almost all my time on my phone, thats all I do ever since I fell sick.. but I cant help it.. its like OCD, I put my phone down and I have this v v strong urge to pick it up again and get myself busy in it, maybe its the anxiety ... just like if I force myself to get out of bed, my mind keeps telling me to go back to the bed and my body is tired too.. I have started coloring on an app so I am mostly busy with that, I know the phone uses so much of my energy and might give me headaches etc, but I really can't help it , its like me wanting to sleep all the time or be on the phone keeping my hands or mind busy .... other times when I am very very depressed or the headache is very severe are the only times I dont use my phone , and just lie with my eyes closed ... if only I could get up and busy myself in any other activity, physical etc, but really I cant, no matter how hard I try ! now I dont know if its the ssris or the anxiety itself ...
for headaches, I have been taking tylenol or NSAIDS, but really they hardly make a difference the aches are so severe ... they are like constant pressure around my head, neck, throat, jaw , left ear, mainly forehead all the time .. I keep straightening and moving my neck I dont know why on prozac .. its so stiff .... I have also noted I will have 2 days of severe headache which builds around 12 pm and lasts all day and night , and then one day of comparative, though not complete relief!
Ojh3 katecogs
Posted
i was probably on it for a couple of years at a time, through different bouts of anxiety.
i have been on 40mg once before. mostly though i was on 20-30mg.
this time around the anxiety has been severe. i am getting extreme anxiety in the morning. waking at 5am and going straight into high anxiety. im vomiting all morning.. and just highly wired. its unbearable.
the last few days i have started to feel better in the late afternoon. do you think that is some progress?
thankyou for replying katecogs x
katecogs hope30709
Posted
That’s what we all do when we have anxiety - and this constant battle to fix ourselves is what keeps us locked in the anxiety loop.
I’ll private message you if that’s ok.
katecogs Ojh3
Posted
Hi Ojh3
Anxiety affects the nervous system and makes your body sensitised - so yes you’ll feel wired all the time. The meds heighten this initially until they settle.
When you recover you’ll feel up and down all the time so there will be many good and bad days - the bad days don’t mean you’re not getting better but means this is normal.
So yes feeling a bit better the last few days is good and is great progress. It’ll still be up and down for a while yet but you’re moving forwards to feeling recovered.
K x
Ojh3 katecogs
Posted
thanks for the reassurance. most people i talk to think i should have seen a bigger improvement by now and say it isnt working for me... but something in me says to hold on some more.
all this started when i stopped hrt cold turkey, so im also dealing with hormonal withdrawl. that is what has caused the anxiety. x
hope30709 katecogs
Posted
thank you Kate , yes you can private message me, but i don't know how to check it .. new to this forum
katecogs Ojh3
Posted
Hi
Depends how long you’ve been on medicine as to if you should be recovered or not. It also depends who the people are - if they’ve never had anxiety then they really won’t have any idea what if feels like or how recovery works.
Recovery time is different for us all - depends on the medicine and the correct attitude towards anxiety and recovery itself too.
Ooooh yes going cold turkey from the meds causes a problem in itself - how long ago did you do that? Withdrawal doesn't last forever though and once the meds you're now taking all settle (along with withdrawal) you should feel the benefit.
Ojh3 katecogs
Posted
i took the hrt patch off the beginning of august. within a week i was hit with crippling anxiety. ... so probably 7 weeks ago. ive been on the citalopram probably all that time.... 30 mg for at least 4 of them. before i upped them i was on a maintenance dose of 5mg for around the last 8/9 months.
i have heard that hormonal withdrawl is much like drug withdrawl. your body craves the estrogen its not getting any more. i think it can take 3-6 months to even out... but was hoping the citalopram would speed this process up. x
katecogs Ojh3
Posted
Has your Doctor suggested any natural over the counter remedies to help with the HRT withdrawal?
Anxiety can start in many ways, and once it does we all fall into the same trap of fearing it and trying to control it which is the wrong thing to do.
Citalopram should really help calm the anxiety but it can take many, many months, so 7 weeks is still very early. Many people start noticing small changes around 3 months and from there it can take a few more months to feel completely anxiety free. It took me 6 months - it gets easier throughout that time.
There’s nothing quick about using Citalopram - it works really really slow, but its a good medicine.