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Thread: My citalopram diary - July 2020

  1. #1
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    Post My citalopram diary - July 2020

    In the last 3 weeks or so, my anxiety has come back at full force and it's been so overwhelming that the techniques I learnt at therapy 5 years ago are no longer having much effect. As a result, I reluctantly decided to go back on citalopram again, after being off it completely for a year.

    During the first few months of 2020, I felt like I was coping fairly well, in spite of the coronavirus pandemic and lockdown.

    It was around May that things started to get more difficult for me. I've been working from home since mid-March and at first I thought I would prefer it, but I haven't enjoyed it as much as I thought I would. The longer it's gone on, the worse I feel. However, that was more like mild depression than the anxiety I've been feeling for the last 3 weeks.

    The theme of my anxiety is a bit different from my last major episode in 2015 - I'm getting quite a lot of intrusive thoughts about mistakes I've made in the past and near-misses I've had, even from several years ago, and I catastrophise over how they could have turned out worse (even though they had no real negative effects at the time).

    Day 1 - Thursday 30th July

    I felt anxious when I went to bed last night. I feel like I didn't sleep very well - as if I was only half asleep and I kept waking up every hour or so. I woke up a long time before my alarm feeling panicky. I made the decision to call the doctor.

    I went to work as normal - I felt a bit calmer as I knew help was on the way. Doctor called about 3pm. Back on my medication, 10mg then review in 3 weeks. He also recommended the Live Life to the Full website. I took the first tablet after tea, at about 4.30pm. My 2 nieces and my eldest niece's boyfriend then came round and sat in the garden with us. My eldest niece told us more about her recent mental health experiences and recommended her therapist to me. I looked up the therapist online and she sounds very good.

    I had a good group support chat on Turn2me.ie, much better than last week. Ordered a Buddy Box from the Blurt Foundation so I have something to look forward to if the side effects get bad next week.

    I've felt in a lighter mood tonight and less anxious this evening. The intrusive thoughts seem to be more in the background and less in the forefront of my mind.

    Day 2 - Friday 31st July

    I think I slept a bit better last night. I still did my work today (I've been working from home since mid-March) as I haven't had any really serious side effects yet and still felt able to concentrate.

    In the evening, I noticed a slight increase in my anxiety and the negative thoughts have been a bit more intrusive than they were yesterday. I also noticed I had a fast heartbeat in the early part of the evening, and after I had taken my second tablet, I noticed that my thighs were a bit tensed up later in the evening.

    To try and take my mind off things, I watched a film on Amazon Prime (I chose the Horrible Histories movie as I wanted something fairly light-hearted and easy to follow). I could still feel the negative thoughts in the back of my mind, and every so often they came to the forefront of my mind, but I still enjoyed watching the film more than I thought I would.

    I'm pleased it's the weekend now so I don't have the pressure of work. I expect the side effects will start to kick in more in the coming days.
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    Re: My citalopram diary - July 2020

    Day 3

    I'm pleasantly surprised that my side effects so far aren't as bad as they were the previous times I took citalopram. All I've noticed so far is muscle tension in my thighs and occasional twitching in my toes (both of which i experienced last time around). I haven't lost my appetite yet, either. Maybe I won't get such bad side effects this time round as my body is more used to the medication?

    I slept pretty well last night. Again, the anxious thoughts seem to be more in the background and I'm finding it a bit easier to challenge them. I felt reasonably able to concentrate on the things I enjoy, such as reading a magazine and watching one of my favourite programmes.
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    Re: My citalopram diary - July 2020

    Day 4

    I noticed some heightened anxiety today. In the morning and afternoon I noticed some more intrusive thoughts - for example while I was on Facebook I saw a post about a hotel I stayed in nearly 20 years ago. I decided to click through and have a look for nostalgia's sake. There were some beautiful pictures but i kept getting intrusive thoughts that there would be no point in me going on holiday now because I'd be too anxious & depressed to enjoy it properly!

    Later in the afternoon I made a start on the Living Life to the Full course my doctor recommended me. After that, I played some of the games in the No More Panic arcade. This helped to take my mind off the negativity for a while. In the early evening I cooked one of my favourite meals - sweet chilli chicken with rice. I enjoyed it but at the start of the meal I noticed my heart had begun beating fast for no apparent reason, and I was also getting anxious thoughts about whether I will fully recover this time around. The fast heartbeat carried on for nearly a couple of hours then gradually died down. I often feel calmer later in the evening.

    Another thing I've noticed in the last few days (although I also had this during my last major anxiety episode 5 years ago - it was actually worse then) is that if I'm laughing at a joke or something, immediately after I laugh I start to remember my anxiety, almost as if I'm feeling guilty for laughing.
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    Re: My citalopram diary - July 2020

    Quote Originally Posted by Sparkle1984 View Post
    Maybe I won't get such bad side effects this time round as my body is more used to the medication?
    Unfortunately, it doesn't work like that and can go the other way. This is one of those times when it pays to just be grateful for small mercies and not look too closely at horses' dental work.

    Another thing I've noticed in the last few days (although I also had this during my last major anxiety episode 5 years ago - it was actually worse then) is that if I'm laughing at a joke or something, immediately after I laugh I start to remember my anxiety, almost as if I'm feeling guilty for laughing.
    The thing I'm mostly getting from your posts is you're over analysing everything. This rarely helps, ime. Just the opposite. Better to just accept things are going to be out of the norm for a while and to shrug them off as much as you can. They are unlikely to be of any significance.
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    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

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    Re: My citalopram diary - July 2020

    Quote Originally Posted by panic_down_under View Post
    Unfortunately, it doesn't work like that and can go the other way. This is one of those times when it pays to just be grateful for small mercies and not look too closely at horses' dental work.



    The thing I'm mostly getting from your posts is you're over analysing everything. This rarely helps, ime. Just the opposite. Better to just accept things are going to be out of the norm for a while and to shrug them off as much as you can. They are unlikely to be of any significance.
    Thanks for your comments. I know I was probably being over-optimistic when I said that maybe the side effects won't be as bad this time as I've been on the tablets several times before. Last time I started citalopram 5 years ago, the side effects were quite a bit more severe than the first time around. It's also true that I have a tendency to over-analyse things.

    Day 5

    The day started off well - I got quite a good night's sleep and first thing in the morning, I felt almost like my normal self. However, in the afternoon and evening, I felt the heightened anxiety start up again, with my usual physical symptoms. I also thought back to a couple of my previous anxiety episodes 7 and 8 years ago - back then, I was just a few months away from turning 30, and I was terrified about that, as a common theme of my anxiety is existential themes such as getting older, death and dying. However, when I actually turned 30, it wasn't that bad after all - it was as if the anticipation was worse than the actual event. If anything, I actually feel healthier in my 30s than I did in my 20s, as I eat more healthily and exercise more than I did back then. Anyway, I had some intrusive thoughts along the lines of "if I was anxious about turning 30 all those years ago, what if I also get the same sort of anxiety about turning 40?" It is still 3 and a half years until I turn 40, though. I guess I'm finding it scary because 40 is pretty much middle age and your life is likely to be half over! I'm trying to challenge these thoughts by telling myself that my health is more important than a number - I guess it's better to be a fit and active 40 year old, than a very unhealthy/unfit 25 year old?
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    Re: My citalopram diary - July 2020

    Quote Originally Posted by Sparkle1984 View Post
    what if I also get the same sort of anxiety about turning 40?" It is still 3 and a half years until I turn 40, though. I guess I'm finding it scary because 40 is pretty much middle age and your life is likely to be half over!
    Wait until you get to 70 and have already gone several rounds with the reaper. I've done much more useful things with my life and enjoyed it far more since I turned 40 than I had before.

    I think you're focussed on the wrong thing. Yes, you will die one day. It is as much a part of life as breathing. You can't change it so what is the point of worrying about it. If anything that will just hasten the day as stress is by far humanity's most dangerous affliction for it often sets in train the diseases which take us out.

    Life is all about the journey, not the destination and this is true irrespective of what you believe the destination is. The way I see it there are only two types of people, those busy living and those busy dying, already half dead as they trudge through their existence. You can either half live in the shadow of death, or out in the sunlight fully embracing life. Instead of brooding about the end wring every nanosecond of joy you can out of being alive while you have the chance. The rest will take care of itself.

    Everyone dies, but not everyone truly lives. Don't be one of the half alive/half dead people!

    My motto: Really live, do good, be happy, die loved and with few regrets. If I manage that I won't have much to complain about at the end.

    "Life should not be a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside in a cloud of smoke, thoroughly used up, totally worn out, and loudly proclaiming "Wow! What a ride!"

    Hunter S. Thompson

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    Re: My citalopram diary - July 2020

    Thanks - rationally I know you are correct and there is no point in worrying about something that's inevitable and probably won't happen for many years anyway. It's just that in the early weeks of starting medication, the anxious thoughts are so strong that it's often difficult for me to counteract them, even though deep down I realise they are irrational.

    Day 6 has been quite tough. So far, I've still been "going" to work. I've put "going" in inverted commas because I'm still working from home due to the coronavirus pandemic (it's currently company policy). When I got up at 7am this morning to get ready to start work at 8am, I felt really drowsy, and this drowsiness lingered until lunchtime. Even then, it didn't go away completely. I've also still been getting heightened anxiety, and in the last hour or so, I've felt a headache coming on. I plan to have an early night tonight, and see how I feel in the morning. If I feel bad or worse than I did today, I can call my doctor to be signed off from work - he actually did offer to do that when I started the tablets last week, but I wanted to wait to see how I feel.

    I have been trying to keep myself occupied by doing my usual hobbies in the evenings, for example watching my favourite TV programmes. Also this evening I ordered a couple more Claire Weekes books about anxiety - I read the original book during my last major anxiety episode 5 years ago and found it helpful, so I thought I would buy some of the follow-on books.
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    Re: My citalopram diary - July 2020

    Day 7 - Today started off reasonably calm, but my anxiety got a bit worse in the afternoon. During my lunch break I was scrolling through Twitter and I saw a tweet from a woman whose husband died suddenly of a heart attack - he was only in his late 30s and they have a young child. I think this triggered some negative thoughts.

    In the evening after work and dinner, in order to get out of the house I decided to go for a walk around the block with my mum and step dad. It was the area where my grandmother lives rather than our own neighbourhood, as we wanted a change of scenery. I did get some intrusive thoughts during the walk - Mum mentioned that one of my grandmother's friend's husband who lives in the neighbourhood had died and that she is now living on her own, so I think that also triggered my anxiety.
    Last edited by Sparkle1984; 06-08-20 at 21:43.

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    Re: My citalopram diary - July 2020

    Day 8 - I managed to get a lot done during my working hours today and feel a sense of accomplishment. Again, my anxiety got worse in the late afternoon/early evening after having my dinner. I suspect this is because my mind has more time to ruminate on intrusive thoughts once I've finished work for the day?

    I only get these intrusive morbid/existential thoughts a lot when I'm going through an anxiety/depression episode. When I'm mentally well, I rarely get those kinds of thoughts and when I do, I find it much easier to dismiss them.

    Today, during my period of heightened anxiety in the early evening, I had intrusive thoughts like "What if I don't fully recover this time around? The last time I had a major anxiety episode was 5 years ago, and I was a bit younger then". When scrolling through Facebook this evening I came across a post where residents of a nursing home were giving words of wisdom to the younger generations. The residents were nearly all in their late 80s or even 90s. Rationally, I know it's a really nice idea but I kept getting intrusive thoughts thinking how sad it is for these people that they are so old and are probably going to die soon, and many of them are probably already in poor health or in pain. It seems kind of weird writing that, because the rational side of me can see that they all looked happy and at peace - they have probably had happy, long lives and they are at peace with the next phase.

    Earlier this evening I also felt physical sensations such as muscle tension in my thighs and nausea in my stomach.

    As for the positive aspects of today, the BuddyBox I ordered a week ago arrived, so I will be able to use the contents to help me relax over the weekend. The Claire Weekes books I ordered also arrived today. About an hour ago, I had an Epsom salt bath while listening to a Calm "loving kindness" meditation and that helped calm me down a bit.
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    Re: My citalopram diary - July 2020

    Quote Originally Posted by Sparkle1984 View Post
    I was scrolling through Twitter and I saw a tweet from a woman whose husband died suddenly of a heart attack - he was only in his late 30s
    The good news is SSRIs reduce heart attack and ischaemic (blocking) stroke risk a little (but slightly increase it for the much less common haemorrhagic stroke). Blood platelets are normally chock full of serotonin which is released into wounds to constrict the blood vessel and help block the breech. The platelets have the same serotonin transporter proteins as are found in neurons to scavenge serotonin from the bloodstream. Serotoninergic ADs inhibit platelet transporters as efficiently as they do in the brain which reduces the amount of serotonin in the platelets causing a reduction in blood coagulation. While this is usually a positive effect caution is needed when taking blood 'thinners' such as aspirin and other NSAID painkillers. Occasionally use for a day or two is probably okay, but if a painkiller is needed for a longer period then paracetamol, aka acetaminophen, is the better option.

    Earlier this evening I also felt physical sensations such as muscle tension in my thighs and nausea in my stomach.
    The most serotonergic organ of the body isn't the brain, it is only a minor maker and user, but the gut which produces about 50 times more serotonin so may be more effected by ADs hence the nausea (and sometimes diarrhoea, or constipation). Ginger and/or vitamin B6 supplements may ease the nausea.
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    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

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