3rd time lucky?! My citalopram diary

[Sparkle1984]

Yes, I'm back here yet again! On Thursday I started citalopram for the third time in as many years, after facing a serious increase in my anxiety levels in recent weeks. The first time round, I was on it for about 6 months in the second half of 2012/early 2013. I thought I had recovered, but unfortunately I relapsed just a month after coming off the tablets, so I ended up back on them in May 2013. That time, I stayed on them quite a bit longer - I didn't come off them completely until September last year. I had become used to using my wellbeing techniques and I thought I would be OK from then on, but in spring this year I noticed I was becoming more pessimistic about things, and that I was worrying more often and catastrophising about things that wouldn't usually bother me so much. I started to feel like things were getting on top of me again (although, looking back, I think I've taken on too many responsibilities in recent months, and not given myself enough time to relax).

About a couple of weeks ago, my anxiety levels got much worse and I started having trouble sleeping, I had negative thoughts and worries on my mind pretty much constantly and I began to feel constantly on alert, as if I couldn't switch off. I started to lose enjoyment and enthusiasm for my usual hobbies, and I felt as if the slightest thing might make me burst into tears. On Wednesday afternoon at work, I felt very low and I wanted to cry my eyes out (thankfully I didn't as I wouldn't want to feel silly in front of my colleagues). I didn't sleep that well on Wednesday night, and then at about 3.30am on Thursday morning I woke up feeling extremely panicky and with my mind full of negative thoughts. I don't think I slept any more that night. My heart was pounding so hard I thought it would give out, and I also felt hopeless about the future. I felt completely exhausted and couldn't face going to work on Thursday morning, so I called in sick and had an emergency appointment at the doctor's. I completed the usual questionnaires and the doctor said that the anxiety and depression levels are almost equally severe (score 16 for anxiety and 17 for depression). So I'm now back on citalopram and the doctor advised me to contact the Wellbeing Service for additional therapy. He also advised me to cut down on some of my additional responsibilities outside of work.

On Thursday I went round my best friend's house for several hours. She also has anxiety & depression so she understands how it feels, and she invited me round after I texted her to say how I was feeling. I was very grateful for that, as both of my parents were working that day and I would've been at home on my own otherwise. I didn't feel like doing much once I was round my friend's house (she gave me some lunch but I didn't have much of an appetite due to the extreme anxiety) and I still felt completely awful, but I was glad to have someone to keep me company.

Day 1 (Thursday 21st May)
I took my first tablet on Thursday evening after tea (in the past, I always took my tablet in the evenings so I thought I'd stick to that routine). I began to feel a little bit better later in the evening, although my anxiety usually tends to be better in the evenings anyway. My niece came over for tea that evening, and I was able to eat most of my tea. I sat in the conservatory in the early part of the evening, and then later on we watched TV, and I didn't feel too bad at that point.

Day 2 (Friday)
I had booked Friday off as holiday several weeks ago, so I could have a 4 day weekend. I had planned with my parents to go to a local zoo that day, and I didn't feel too bad. It was one we'd never been to before as it had only opened a few years ago. Even though I did still have some negativity in the back of my mind, I think going to the zoo helped to take my mind off things a bit. I took a lot of photos too. We spent 2-3 hours there (it's not a particularly big place), and then later in the afternoon we visited some local gardens to see the bluebells, azaleas and rhoddodendrons. I enjoy going for walks in the countryside and taking photos of flowers. At this point, some of my negative thoughts started to come through more strongly - I started getting thoughts like "what will happen when my parents die, how ever will I cope?" and so on. However, I still feel like being out in the fresh air was better than sitting at home feeling bad. Once we got back home, I discussed my feelings with my step-dad (he is very understanding). Again, later in the evening my mood lifted and I felt less anxious.

Day 3 (Saturday)

Today wasn't quite as good as yesterday, but overall it was better than Thursday. My sleep was rather intermittent in the morning and I didn't feel like getting up until about 10.30am. I didn't really feel motivated to do very much during the day, and I also felt anxious and low. I felt rather jittery and shaky. In the evening, I went round my sister's house for a Thai red curry - although I enjoyed this I still felt rather anxious. One thing that did cheer me up a bit when I was round my sister's is that she asked me what my dream holiday would be, and I said that one day I'd like to go to Iceland to see the Northern Lights. Both my sister and my brother-in-law agreed that they'd like to do this one day, and that I could go with them. When we checked the prices though, we discovered it's rather expensive, so I'm not sure when this will happen, if at all. Later in the evening, I went back home and watched the Eurovision Song Contest with my step-dad. I didn't feel quite as relaxed as I did on Thursday and Friday evening though.

As I'm still feeling rather weird, I'm glad that I have 2 more days before I go back to work (Monday is a bank holiday), although I'll see how I feel on Tuesday morning.

[Sparkle1984]

Day 4

Today has been a tough day as I'm starting to feel the side effects kick in more. I've felt drowsy pretty much all day, even though my sleep wasn't too bad, and I've also lost my appetite. When I got up this morning, I didn't feel like having much for breakfast and it took me longer than usual to eat it. For lunch I had a Sunday carvery at a local restaurant with my parents and my grandmother, but I only managed to eat about half of it. This is unusual for me, as a turkey roast dinner is one of my favourite meals and I usually eat it all, but I lost my appetite the previous times I've been on these meds. Hopefully my appetite will come back again in the next few days.

I've also felt slightly nauseous and right now my left thigh feels tensed up. I had a nap earlier this evening due to the drowsiness, but I didn't feel like I was sleeping properly - it felt weird like I was half asleep most of the time. I don't feel quite as drowsy now though.

I still keep getting anxious thoughts like "What if I don't get better this time?" and "What if I always get these episodes every few months/years for the rest of my life?" I have to keep reminding myself that I've been through many of these episodes in the past, and that I've always recovered eventually, even though things seemed hopeless at the time. Then there's my usual existential thoughts about life, death & dying, mortality and this time round I've also been getting negative thoughts and worries about what life will be like when I'm older, like "Will this country/world become dystopian?", "What will happen if I'm unwell when I'm older? Will there be anyone to look after me?", "What will happen to the economy in this country - will inequality continue to increase?" and "What will quality of life be like for ordinary (ie non-wealthy) people in the future?" As you can see, these are all thoughts about things that are out of my control. That's one of the worst things about my anxiety - I feel a compulsion to worry about things that I can't control, and it's very difficult to stop it as the thoughts are always in the back of my mind. It's like a constant negative vibe in the back of my mind and I can't relax or enjoy things as usual. I was getting all these thoughts before I started on the tablets, and I'm aware it may take a while for these negative intrusive thoughts to die down.

I haven't felt motivated to do much at all in recent days, so I've been trying to take things easy.

Tomorrow is a bank holiday Monday, so I'm due to go back to work on Tuesday. If I don't feel well enough by Tuesday morning, I'll need to ask for a doctor's certificate as I will have been off work for nearly a week (if you are ill during weekends and holidays, my workplace counts that as part of the 7 days as well).

[swgrl09]

Hi Sparkle, sorry you haven't been well recently. I have been feeling similarly, and wondering if I should go back on lexapro as it was helpful for me last time. I know how you feel, thinking what if you don't get better this time?

You are doing a great job, though, and are reminding yourself that you have gotten better before and can definitely get better again!! Give it some time. How long did you take it last time before you started to see some improvement?

Try to take care of yourself and be kind to yourself, as you are doing.

[Sparkle1984]

Thanks for the encouragement, swgrl09. The first time I was on citalopram, it only took 5 days before I began to see the first signs of improvement. The second time round, it was more gradual - it wasn't until about 4 weeks in that I started to see significant signs of improvement. Both times, it was about 3 months before I felt the full benefit.

[xvolatileheart]

Sending you good thoughts! Hope you get to feeling better soon. Your side effects sound entirely normal. I'm 7 weeks in and still struggling with the half-sleep feeling all the time. Hoping it goes away soon.

[lior]

I'm 5 months in, and I recently increased my dose, and it helps. I like the fact you are very quick to notice changes in your mood, and you are very proactive in doing something about it. These are all recent changes and you are making every effort to stay on top of things - talking with your stepdad, taking meds, keeping a log of your mood on here. This is all great, keep it up )

It took me months if depression to decide to go on citalopram again, even though I was on it before!

I think about the dystopia type thoughts too. I reckon it's all about how you frame it. If you see all the wonderful stuff in the world, it's easy to feel glowy. If you see all the horrible stuff in the world AND feel powerless to change it, it's easy to feel depressed about it. In my opinion there are elements of the world as it is that are dystopian already. There is a huge amount of inequality - even in the UK, compared to the rest of Europe.

There are three ways I cope with these thoughts:
1) Distract myself and focus on the thing I need to do.
2) Write down all my thoughts, and maybe it will be an interesting thought piece for when I'm more in my right mind.
3) When I'm in a good enough mood to handle thinking about it, I'll try to think up actions I can take to tackle the problems. What's one small thing I can do today to help make the big change happen in the future? Sometimes I work this out through writing.

[mark84]

Hey sparkle, you sound a lot like me with your worries, and those thoughts about wealth inequality etc are me down to a tee!
I'm on 30mg, for me it took a couple of months (and a dose inc from 20 to 30mg) to see a benefit, but I hope you get the relief you've felt before soon, just hang on in there, and let us know how you're getting on

[Sparkle1984]

Thanks for your replies and reassurance. Today (Day 5) has been another difficult day - I woke up early this morning and couldn't get back to sleep properly after that, and I had a lot of negative thoughts on my mind while I was lying in bed. Sometimes I would fall asleep but would wake up again just a few seconds later, which is very frustrating.

I've felt rather low and anxious again today and I also feel rather lethargic. I didn't go out anywhere today - I was invited round my sister's to watch a local football match on Sky TV, but I didn't feel like leaving the house. This evening I've also felt heightened anxiety, including tightness in my chest.

I didn't do very much today, but I managed to fill in the online referral form for therapy, and I also sorted out my cheque and sponsorship form for the Race For Life (Cancer Research UK fundraising race) that I took part in recently - my stepdad posted this for me. I managed to eat all my tea this evening (noodles and vegetables) so hopefully this is a sign that my appetite is starting to come back. After tea, I played Trivial Pursuit on the Nintendo Wii with my stepdad - I find this helps to take my mind off things a bit. Then after that I watched the first Britain's Got Talent semi-final, but I still felt rather anxious.

I'm glad I'm not the only one to get dystopian/existential-type thoughts. Does anyone have any ideas about how to distract yourself from those sorts of thoughts? I find they're always there in the back of my mind, even when I'm not actively thinking about them.

As things stand, I don't think I'll be well enough to go back to work in the morning.

[lior]

There are three ways I cope with these thoughts:
1) Distract myself and focus on the thing I need to do.
2) Write down all my thoughts, and maybe it will be an interesting thought piece for when I'm more in my right mind.
3) When I'm in a good enough mood to handle thinking about it, I'll try to think up actions I can take to tackle the problems. What's one small thing I can do today to help make the big change happen in the future? Sometimes I work this out through writing.

^^ That's how I cope with the dystopia thoughts...

How do I distract myself? Well, two things have helped me. Practice and citalopram. I now find myself automatically distracting myself without too much effort, whereas a few months ago it would be almost impossible. So be patient and give it time, this will pass.

In the meantime, it's good to fill up your day with activities to occupy you so that you don't have as much time to think, if you don't want to. I made a commitment to myself to go out for coffee every day and that regular time filler has helped enormously. I have found that flexing my creative muscles helps. When I'm drawing it's harder to think about dystopia. I have watched a lot of TV too. I once watched three films in one day. Also, I'm pretty much fine when I'm with other people.

On the other hand, sometimes I've just needed to embrace the thoughts I was having, and write it all down. Trying too hard to fight makes it worse. It's been useful to me to record things and try to figure out where they're coming from. I don't know if you'll feel the same. Do you write?

[mark84]

Sparkle, it sounds like you're working hard getting better, so I'm confident you'll be ok if you keep pushing with your current attitude. Filling in forms and cheques and eating your tea are easy things to snub and not make a big deal of, but think of them as achievements, it shows with out a doubt you're progressing.
The dystopia thing is a tough one, I realised a few years back that I was making it worse by hanging around on political forums and certain news sources that would draw me more in to it.