Sertraline and suicidal thoughts, looking for advice.
Posted , 2 users are following.
Hi guys. I am a 19 year old second year university student. This summer holiday I developed an anxiety disorder. It got bad enough to the point where I went to see my GP and was prescribed Sertraline as well as being referred for CBT (which I am still waiting to hear back about). For the first week of Sertraline I took 25mg and then increased to 50mg for the next 3 weeks. Initially, for the first week and a half my anxiety got worse but then started to get better. My anxiety day to day varied slightly but on average, week by week it has got better.
Anyway to what's been bugging me. The first 3 weeks of treatment I was slightly more prone to self-pity and suicidal ideation when I felt anxious thoughts of the nature 'how would people I care about react if I was to die' I felt no-where near actual suicide. I have had these before starting medication, when feeling very anxious and low but I thought that they were becoming more frequent. Last thursday marked the end of my 4th week of treatment. Through that 4th week I felt generally optimistic about it. Discussing the treatment with a friend I commented on how for the first 3 weeks I had a slight increase in suicidal ideation but that had went away in the 4th week.
By the end of the 4th week I wasn't feeling back to myself again but my anxiety was reduced and I was much more sociable (didn't really have social anxiety anyway) as well as being in a better mood in general. I was optimistic that if I was to continue for another month at my current dosage (and potentially increase if need be) I would eventually overcome this. But now I have been back at university a few days I have felt these suicidal thoughts come back. Yesterday - when I was feeling very anxious, partially due to drinking strong coffee when I felt I could handle it - I had some and today just randomly after a guy who I get on well with had served me coffee I had the intrusive thought of how that guy would react if he was to hear of my suicide.
I'm posting here because I am conflicted. I don't know - and haven't done enough research to know - whether these are only temporary whilst the treatment builds in those first couple of months. If that is the case I wonder if I should stick with it and just monitor myself carefully in the mean time. I have obviously heard that there is an increase in suicidal thoughts and behaviours in some people under the age of 25. The alternative of having to taper off the treatment and start another one again from square 1 again strikes me as incredibly daunting. Especially since I am just starting year 2 of my Physics degree. I also don't know whether my anxiety is blowing this out of proportion.
Thank you for any who reply 
0 likes, 4 replies
Patient acr
Posted
Hi acr
We note from a recent post which you have made to our forum that you may be experiencing thoughts around self-harm. If we have misinterpreted your comments then we apologies for contacting you directly. But if you are having such thoughts then please note that you are not alone in this, and there are people out there that can help.
If you are having these suicidal thoughts then we strongly recommend you speak to someone who may be able to help. The Samaritans offer a safe space where you can talk openly about what you are going through. They can help you explore your options, understand your problems better, or just be there to listen.
Their contact details are on our patient information leaflet here: https://patient.info/health/dealing-with-suicidal-thoughts, which also offers lots of other advice on how you can access the help you may need.
If you are having such thoughts then please do reach out to the team at the Samaritans (or the other people detailed in our leaflet) who will understand what you're going through and will be able to help.
Kindest regards
Patient
Red_ribbon acr
Posted
Hey acr
You sound like you have a good grasp of the factors that might be exacerbating your anxiety ie going back up to uni for 2nd year; the unknown outcome of changing medication; the coffee! My advice would be to bear all this in mind and realise that any of these can have an adverse effect at the best of times, let alone when you are trying to cope with a (relatively) new form of medication. Anxiety always blows things out of proportion, so it's entirely possible that is what is happening for you. Definitely follow your instincts and if it gets unbearably worse go back to your gp but perhaps it is just a hiccup given the extra stress you may be under at the moment.
It must be really difficult to start having the intrusive thoughts again after they had seemed to get better. If you can keep reminding yourself that right now you are actually trying to cope with a lot all at once and be kind to yourself (treats, relaxing if at all possible, no oughts and shoulds)it might also take a bit of pressure off. Sorry if you already know that stuff but it is important!!
As I said already you seem to know yourself quite well which is a huge advantage and the fact that the meds started to help at the end of the 3rd week sounds positive overall.
I hope that things start to even out for you as soon as poss. If you have any lecturers that you feel you can trust bear in mind that just letting someone know that you are struggling a bit with new medication might make it easier if you start worrying about it affecting your uni work, as they will already be aware that things might be difficult for you.
Best of luck with everything.
acr Red_ribbon
Posted
Thanks for the reply man. Later in the evening after I posted this I wrote down 9 bullet points in my diary of how I've been feeling, the facts and realised the anxiety was blowing it out of proportion. Like you said man there are lots of factors. I saw no strong causal links between Sertraline and those thoughts. And the past 2 days I haven't had any thoughts of that nature (touch wood). I'm glad you gave your reply a lot of thoughts instead of just assuming the worst and telling me I should come off the medication
. Thanks a lot.
Red_ribbon acr
Posted
No problem at all, it sounds like you are managing it pretty well so far to be honest! I think it bodes well for you
don't forget to have confidence in your own convictions and trust your instincts when it comes to this because you know yourself better than anyone else.
Best wishes.