My citalopram diary - July 2020

[Aleman200]

Thanks - I agree the increased anxiety was probably more to do with the increased dose than the exercise.

Yesterday and today (so far) have been reasonable days. I walked to the pharmacy about mid-day yesterday to pick up my 20mg prescription (I've been taking 2 of the 10mg tablets and will do so until they're used up). This also helped me to get my daily dose of exercise!

I did notice some tight-chestedness yesterday afternoon and evening, but it calmed down as the day wore on. My intrusive thoughts were more in the background - and while I was busy with other things in the evening, I even had a couple of moments where I forgot about my anxiety and my thoughts, if only for a few minutes. That's the first time I've experienced that so far during this anxiety episode, so it gives me hope I can get better. Also, in the last day or so, that all-pervasive sense of hopelessness seems to have lifted quite a bit.

When I get the intrusive thoughts about dying, I'm finding it a bit easier to challenge them. I remind myself that I'm young and physically healthy and that I probably have several decades ahead of me.

Sometimes I still get a sense of dysphoria about my age - I'm 36 but I feel like I should still be in my early 30s rather than my mid 30s. I feel like the 4 years from 2016-2019 inclusive have gone fairly quickly, but that's probably because I was mentally healthy during those years and I enjoyed them (I was stable on citalopram then from my last major anxiety episode in 2015). However, I have always had a sense of dysphoria about my age - for example when I was in my late 20s, I felt like I should still be in my early 20s, when I was in my early 20s I felt like I should still be a teenager, but when I turned 13 I often wished I was still 12, as that was the cut-off point for some of the childhood activities I used to enjoy. I can still clearly remember having my photo taken with a box of chocolates when I was 8 years old, and I remember feeling too old, like I thought I should still be 5 or 6! It's quite strange - I'm not sure if this ties in with my Asperger's/autism. Also, people have always said I look much younger than I really am (which I'm pleased about). Whenever I feel like I should be younger, I have to remind myself that I was lucky to be a child in the late 80s and 90s and see the development of technology and the internet first hand. If I had been born a decade later, I wouldn't have known what the world was like before the internet became widespread.

Today I went for a walk with my mum around the local area. We walked along some paths I'd never been down before, even though I've lived here all my life! They were shortcut woodland paths connecting different roads. For tomorrow, I've arranged with my sister to go back to the beach we went to on Tuesday last week. So I have that to look forward to.

Another thing I forgot to mention is that last night I noticed one of my teeth seems to have changed shape, as if a piece has been chipped off. Thankfully it doesn't hurt at all. I'm always very sensitive to any changes in my body like this.

I can very much relate to the age dysphoria. Despite only being 29 I'm still feeling way older than that. I'm glad to hear your intrusive thought challenging is working. I need to work on that more too. Was the tight chest from walking around or did it just come on out of nowhere?

[Sparkle1984]

I think the tight-chestedness just came out of nowhere. It is happening again right now.

It's interesting that your age dysphoria is the opposite to mine - I've only ever had it about feeling younger than my actual age.

[Aleman200]

I think the tight-chestedness just came out of nowhere. It is happening again right now.

It's interesting that your age dysphoria is the opposite to mine - I've only ever had it about feeling younger than my actual age.

I'm sure the tightness will be the sub conscious anxiety from the increase

And yeah I've always felt like my body is older than what my actual age is. It's always been a bit worrying.

[Sparkle1984]

Yesterday was a reasonable day - I went with my sister to the beach and it was a nice sunny day. Then we had fish and chips at a café and looked round one of the shops. I did have some intrusive thoughts, but overall I felt more optimistic than I did when I went to the beach last Tuesday. By the late afternoon I did start to feel rather tired - this is probably because I woke up in the middle of the night worrying about whether I would get toothache in my chipped tooth. I had a nap when I got back home yesterday evening - this is actually the first time I've been able to have a nap in the daytime, ever since this anxiety episode began. Previously, I was getting too many physical anxiety symptoms during the day to be able to have a nap. So this feels like progress. When I woke up later in the evening, I felt like my mood had dipped a bit, but I felt more alert. I ate the piece of cake I'd brought home from the cafe.

I slept well last night, but I woke up this morning with feelings of gloom and doom and lots of intrusive thoughts. I feel like the heightened anxiety from the increased dose is kicking in more now. I've felt fairly unsettled so far today. :(

[Aleman200]

I still have trouble with waking up stupendously early and being anxious for the morning so I relate to you on this one Sparkle. With the dose increase I did last time it took a few days for it to settle so just stay strong. My PM's are always open if you need to talk/vent about anything.

[Sparkle1984]

I still have trouble with waking up stupendously early and being anxious for the morning so I relate to you on this one Sparkle. With the dose increase I did last time it took a few days for it to settle so just stay strong. My PM's are always open if you need to talk/vent about anything.

Thanks. I expect it may take a few more days for the dose increase to settle down.

The last couple of days have been reasonable - even though Tuesday started off bad, I felt better as the day progressed. In the evening I went out for a meal with my mum and one of her friends. It was a restaurant I'd never been to before, but the food was nice.

Yesterday morning and this morning, I didn't feel quite so anxious when I woke up. Yesterday evening I went round my eldest sister's house and we had a games night with my 2 nieces. It was good fun, and we also had a Chinese takeaway. I had chicken in black bean sauce, which was tasty. I did have a few intrusive thoughts but they weren't as bad as they were a week or 2 ago. I discussed my anxiety with my sister and she also told me that she is also currently on medication for depression - escitalopram. She has often suffered from depression in the past but this is the first time she'd got help for it. Things got bad back in January when her cat died of cancer and she was working very long hours in a management job she didn't enjoy. Thankfully since then, she has changed her role and now has more free time in the evenings. My sister admitted she also sometimes gets anxious thoughts about what happens after death, but that's not the main focus of her illness. It's sad as I didn't realise my sister was suffering so badly, but also in a way it reassures me that I'm not alone, and my nieces have also suffered from anxiety and depression related illnesses in recent months. It could well be that it runs in our family, but it seems to affect the younger generations of the family more than the older ones.

[Sparkle1984]

I haven't updated this diary for a few days because the last 2 or 3 days or so have been pretty much the same as earlier in the week - I still get intrusive thoughts during the day, and the anxiety doesn't die down until the evening. My mood has also been rather flat, although thankfully I don't have the feeling of complete hopelessness that I had a couple of weeks ago. I'm only just over a week into the dose increase, so I know it may be a while until it kicks in fully.

Anyway, I've decided I'll go back to work on Tuesday (after the bank holiday weekend) - although I'm nowhere near 100%, I feel like the worst is probably behind me, I feel well enough to be able to concentrate on my work and I think it will be good for me to get back to my usual routine, even though I will still have to work from home.

[Sparkle1984]

My first day back at work went well - my manager seemed understanding about my anxiety. He asked what I thought had triggered it, so I mentioned how I've had anxiety and depression episodes on and off for many years, although I don't think the stress of the coronavirus pandemic has helped. He agreed with me that getting back to my usual routine should be helpful for me. He also said that I have several days of holiday to book for the end of the year, and suggested having a few Fridays off, and that he used to do this when he was feeling down. So I've booked off a couple of Fridays at the end of September - I'm hoping to go to the zoo with my mum and step dad on one of these days.

As for today, I managed to complete the work I had planned to do. I didn't feel too anxious while I was working, but I noticed in the evening my intrusive thoughts began to come through more strongly, presumably because I'm not so busy. Yesterday evening I completed a thought challenge worksheet and I felt a bit calmer and more optimistic after that, so I will have another read through it.

For the last couple of nights, it's taken me quite a while to get to sleep, even though I haven't felt scared at night for a while. I also woke up about an hour before my alarm went off this morning, but I haven't really felt tired today.

[Jebdog]

Positive signs Sparkle. I can relate to a lot of what you’ve said over the course of your diary that’s for sure.

Hope your second day back went well and you continue to feel better.

[Sparkle1984]

Positive signs Sparkle. I can relate to a lot of what you’ve said over the course of your diary that’s for sure.

Hope your second day back went well and you continue to feel better.

Thanks. Unfortunately today started off badly as I had a couple of nightmares last night, so I woke up this morning feeling anxious and unsettled. Thankfully this negative feeling began to wear off once I got settled into my work and I put some of my favourite music on in the background. The main nightmare I had was that I was walking down some steps, and at the end you are shown a 3D computer generated image of how you will look in 40 or 50 years time. (Kind of like FaceApp, except that it shows your whole body and not just your face). I looked frail and weak and this really freaked me out. There was also an older man in the nightmare, and I was also scared when I saw the aged version of him. Then I dreamt that I bumped into a group of colleagues from my previous company, and I was shocked that some of them were looking wrinklier and greyer than when I last saw them a few years ago! This all ties into my existential intrusive thoughts about getting older and dying.

This evening after work I had my second therapy session and I found it really useful. The techniques she uses are a bit different to the therapist I had 5 years ago - this one uses a combination of CBT and EFT (emotional freedom technique - which involves tapping on certain points on your body. It's been described as acupuncture without the needles). After doing the tapping, I did feel heavier like my body wanted to relax, which was a good thing. The therapist also suggested I set aside a specific worry period each evening, rather than ruminating on negative thoughts throughout the day. I will try it and see how it goes.

Another positive things is that my eldest niece came round to visit. Amongst other things, we discussed my therapy session. My niece was very understanding, especially as she has also recently suffered with anxiety and has been having therapy. I mentioned my fears for the future and she reassured me that I would always have a room in her house if I ever needed it. I am autistic so one of my major fears is that I'll be on my own and lonely when I'm older. So I found this very reassuring.