Starting Mirtazapine! =O for anxiety and depression

[A Nervous Nigel]

So i've just been prescribed Mirtazapine on Friday. I've never had any luck with AD's before, but since this wasn't an SSRI or an SRNI, I thought I would give it a chance. I mainly suffer with general anxiety, phases of intrsuive thoughts, and periods of depression. Right now, I believe i'm depressed, i'm sick of my anxiety, i'm so far behind with my studies that there is a good chance I won't complete my degree now. I do have extensions on all of my assignments but my attendance is probably around 25%. This is because of my social anxiety, I sometimes go in then have to leave because I become so irritated, or obsessed that others are judging me on what I say or do ect.. I sometimes get panicy and have panic attacks. So everything has been building up and I think I am depressed now.

I've also been on Pregabalin at every dose possible (I find over 300mg per day too much) So now i'm on 100mg pregabalin twice per day and 15mg mirtazapine once at night.

The first night I took the mirtazapine I had a great nights sleep, woke up the next day and felt.. well I felt ok.. no side effects, no nausia, no dizziness. I still even managed to make it in to the gym (I dont get over anxious at the gym for some reason, however I only get the feel good benefits from it for around an hour, before drifting back in to my anxious depressed state)

So i'm soon to take my third dose and I just feel.. Meh.. I have had a moment or two or irritation but I think thats from the Preagabalin.

What I would like to know is, how do you know when an antidepressant is working? Just none of mine ever have, so I dont really know what to expect, they have only ever made me feel worse.. Do you just wake up one day and things seem easier? Easier to deal with problems? Some motivation?

I'm at my ends with medication for anxiety ect. If this doesn't work then I don't know what else to try.. I've been getting referred and transferred around different parts of the NHS and still havent had any real sort of therapy... I thought I was going to be able to see a psychiatrist but all I seen was an Occupational therapist and and psychologist for initial assessments (My referal was in November).. I have still not been given an diagnosis on if I have GAD, OCD, Depression, or whatever else it could be? Why does everything take so long? :/ I'm really thinking of just asking the doctor do I have GAD at my next appointment?

I'm not sure on what my aim is with this thread other than to ask, how might one feel when an antidepressant begins to work? I'm happy the side effects have been close to Zero and actually the slight sedating effect it does have, has curved my anxiety a bit.. Maybe this alone is reason to feel optimistic about the meds? If I was to ask myself, what do I want from this medication? I would probably say:
1) My mood to level out, none of this feeling okay one minute, then feeling really anxious, then feeling meh, then feeling down depressed, and then back to normal ect. I just want to have a whole day pass where I feel steady, and no overwhelmed. I know everyone has there ups and downs but does it have to be so dramatic?
2) Settle my anxiety enough to spend a full day at university.
3) Some self-esteem and the motivation to get on with life and not stay in bed/the house all day with low mood or feeling anxious!

Am I asking too much of this?

I have been reading other threads on this forum about mirtazapine, but if the title looks negative I don't tend to read them (which means quite a lot of them haha)

Any comments ect would be appreciated! Hopefully this can be the med to get my on track to a happier life. ..

[hanshan]

Hi Nigel,

I take mirtazapine and pregabalin. It's possible to take up to 45 mg mirtazapine per day - like all these things, it's trial and error to find the best dose for you.

As for knowing if it's working, I'd say it depends on what have been the negative symptoms that have been bothering you most. They should start to fade and positive feelings that you'd completely forgotten about take their place.

As for your studies, if you think you can't finish your degree requirements in time, you need to act now. If you have been getting extensions, it was probably after talking to your lecturers / professors / tutors. Generally, however, they need to get their grades in on time, and can only delay so long.

For a proper deferral, you should get a letter from your doctor (it doesn't need to be long) explaining that your medical condition makes you unfit to complete your work on time.

This then needs to be submitted with the appropriate form to university administration. Every university will have its own procedure, but in principle no university will turn down a reasonably substantiated medical application for extra time. Hopefully, if the meds are working, you will be able to complete your study okay.

[A Nervous Nigel]

Hey Hanshan, hope you doing well.

What a difference one week makes. IT seems each morning is that little bit easier for me to handle. I've hit the gym every day this week, I have arranged to do one assignment per week for uni and a lectuurer even said if I come seee her each Monday morning see will guide me through some steps for the next assignment so IO can still hit my grades! She has been great!

I havent had any suicidal thoughts the past two days and things just seem clearer. The sedative effects dont seem to strong and I dont get knocked out like some people have described. As for appetite, I cant eat like the pig, I used to, i'm full by the end of my meal (which seems to be the opposite to other people)

I've been cleaning the house each morning and going to bed at acceptable times without any racing thoughts! I've also rang debt management hotline and they are helping me with all my money problems.

I hit the pregabalin on the head because it was making me irritable and have felt better ever since (about 5 days ago). Oh AND I went in for a FULL Day of uni yesterday! So fingers crossed for full attendance next week! My anxiety has decreased both general and social, I even started a conversation with a random woman about fruit at the supermarket earlier today!

I know, I know, it is still early days, im exactly one week in!

I have been on countless other meds and so far this has pulled me out of feeling low and miserable mood. The past two days I haven't felt miserable once! I know I can expect a bad day and im still not working, but one day at a time eh? If I was asked today based on the last 2 days have you suffered from anxiety and depression, I think I would have to say no!

The future seems to be looking bright, unlike last week when I was thinking of missing the rest of my uni year! I feel I CAN do it!

I've also got the urge to quit alcohol altogether, I'm not a daily drinker but a social binge drinker that doesn't now when to stop! Then feels like utter poop for days afterwards!

I will post again next week to let people know how things are working! If SSRI/SNRI or whatever the hell you have tried and hasnt been effective, Mirtazapine might just be the answer!


Nigel

[Chiffon]

Hi I'm also on Mertazapine and find them incredible. Virtually impossible to 'stress out' once you've taken them and they roll over to the next day and block panics.
I would recommend them 100%.
I also, haven't had the overeating thing with them, quite the opposite

[keggsy]

Can't say mirt has had that sort of dramatic effect for me, but pleased to see anyone getting good benefits from it.

[A Nervous Nigel]

Keggys, maybe part of it is the placebo effect for me? But The fact I feel clear headed while thinking and im not getting suicidal thoughts makes me think it is having some sort of effect already.

Im just trying to get the ball rolling with routine in my life. 2014 was my worst year, I achieved nothing and felt like a complete failure relying financially on parents for part of the year made me feel awful. My anxiety and depression progressively got worse. Suicidal thoughts were a regular 'normal' part of my day.

Although i'm not fully fixed I am definitely around 80%.

I am trying to change something in my life once per week. Small changes.

Start of January I changed my diet and stopped drinking as much, then a week later I joined the gym and just got myself used to it. This week I started a fitness program with my housemate and we are both going out our way to eat healthy and also I started taking the tablets last week. IT could be all of these changes coming together which has caused such a dramatic change in my mentality.


I believe we are still quite far behind in development for treating mental health. We have to keep trying different medications for weeks then if they dont work or you suffer with side effects you have to stop and start the whole process again with a new med. Its hard.. Maybe things will change in years to come?

Keggsy has mirtazapine helped you at all, and what dose are you on?


Chiffon its nice to hear your also doing well on mirtazapine, can I ask how long you have been on it for?



P.S I'm sure at some point i'll have a bad few days and come running back on here thinking nothing will ever work lol. Touch wood I wont!

[hanshan]

Hi Nigel,

I'm so glad to hear that mirtazapine seems to be working for you. It's faster acting than other ADs, and a positive response by two weeks in is a good predictor of a sustained positive response.

Best wishes for continued success with it, and for completion of your studies. It sounds like you have a wonderful lecturer who will help you personally with your assignment.

[A Nervous Nigel]

Hi hanshan,

Been upped to 30mg today following a pretty low weekend and some negative thoughts I had began to shake off, started to return.

Would you say 15mg is quite a low dose anyways? Hopefully I won't start getting side effects now I've moved up. The doctor said I should stay optimistic since I had shown such improvement up until the past 3 days. Might just need that extra 15mg to keep me steady and on track!

[SmilingAlbert]

hi Nigel,

Good to hear its been helping

Max is 45mg/day, so on 30 you're halfway house

No AD is going to kill all negative thoughts - that is not possible, so no point in expecting that. Negative thoughts are part of the human condition...

What they should remove, in time, is the ginger-ale-in-the-head feeling that is the big D

But the good thing is that mirt, if its going to work, works quickly

I remember the first time i took it it removed me from a horrendous mental situation. I took it in the morning, had a nice peaceful snooze for a few hours, and woke up feeling great - it remains one of the greatest days of my life.

Albert

[A Nervous Nigel]

Hi Albert,

Thanks for your reply! When I meant negative thoughts it was suicidal thoughts that pop in to my head, these had reduced greatly as each day passed. Shame they came back but hopefully the upped dose will stop it again.

Apart from that I have a great routine going! Lifestyle has completely changed around.

I know what you mean about the sleep its great. I know that each night I'm pretty much gaureteed a good rest and feel better for it the next morning.
The dreams are pretty cool as well!

Have you came off Mirtazapine now? If so how long did you stay on it for?