Citalopram - increase dose needed or minor setback?

[Jenny85]

Hi everyone,

I've been on 20mg Citalopram since January now, and for a while had been feeling like they were working - I didn't feel sick every morning, could look at the future with hope instead of without and was coping well with my work again. I had suffered on and off with anxiety and depression for a few years beforehand, and, in November/December last year started to feel like it was constant and life wasn't worth living.

So, the Citalopram made an enormous difference. However, for about a month now I've been feeling like I'm sliding again. Today,it really feels like it. I don't have any appetite and I feel rotten. I think it may have kicked off because I went for a first session of CBT yesterday and really hated it. I ended up in floods of tears (and I haven't cried in ages) and my head has since been full of horrible thoughts. I thinkit might have been revisiting things which I really didn't want to remember, and also doing the exercises reminded me of last summer, when I had a bit of a breakdown, and had to do similar exercises in guided self help.

And this might sound ungrateful, but I feel like the therapist was barely listening to me. It sounds awful, but I feel they often put words in your moutyh and won't listen to what you're trying to say. She was saying, so you need some time alone, and your own space, when in fact I am terrified of being alone and can't stand it. My problem is not that I need "more time alone."

Anyway, I had a short blip where I felt bad around my time of month in Fenruary, but it eased off. This has lasted longer, and I don't know if it's time to increase the dose. My doctor, who is a lovely, understanding woman whom I trust deeply, has said this might happen, but is on annual leave til Monday.

Has anyone else had experiences like this with Citalopram/CBT? Perhaps I should only have attempted the CBT when I was feeling better, I don't know.

Sorry for the ramble, and any thoughts would be much appreciated.

Jenny x

[Spongeballz]

It sounds like the CBT has kinda shook you up. I'd wait to see your doctor before upping the dose yourself, and see what she says. If she's only away till monday you don't have too long to wait, I'd just try keep yourself occupied till then.
She may also be able to advise you on what to do about the CBT, it'd definitely be worth mentioning.
Best of luck, hope this helps

[deepreason]

There are loads of things to consider: it could be that the Citalopram has just stopped working (happens a lot with atypical depression or underlying bipolar), you could be just having a bad phase (I often get them during the winter), the most likely sounds the CBT though like you mentioned. Try and hang on till Monday. Look after yourself with a bit of TLC like chocolates, films and getting loads of sleep. Should hopefully keep you going till Monday. Hope you feel better.

[sarah1984]

Hi Jenny,

Sorry to hear you feel you are relapsing. I would certainly talk to your GP about increasing the dose of citalopram because it sounds as if it has definitely helped you, maybe you just need an extra boost. Are you seeing a psychiatrist at all? If you feel comfortable with the idea, it might be worth asking your GP for a referral.

I found my first session with a therapist very gruelling and I came home in tears too. Going over traumatic events from the past is always distressing but fortunately, once you have put the therapist in the picture, you can then move on to discussing what to do to help you cope in the here and now. It is worth perservering as a combination of meds&CBT is the best way to conquer anxiety.

I was initially sent for an assessment with a trainee pyschologist to see what sort of therapy would suit me. I felt she put words into my mouth and twisted what I said to suit her interpretation of my situation. Some therapists seem to better than others at connecting with their patients. I found the guy who actually led my CBT sessions was much more sympathetic, however he did have a habit of talking over me at times!

To be perfectly honest with you, I found searching the internet for CBT techniques/using the books in my local library a lot more useful than my actual therapy sessions - especially as I had to wait 6 months to see a therapist! Might be worth you having a look to see what other CBT resources you can find to supplement your therapy sessions. Good luck x

[Jenny85]

Thank you for your replies, everyone...I thought the Citalopram was really helping, so I'm going to try and keep the faith that it will again sooner or later.

Hope everyone is well today.

j xx

[NoPoet]

Hi Jenny, it seems quite clear to me (having recently had some very painful sessions of hypnotherapy) that you're having your first blip, and this blip was provoked by your therapy.

You need to continue with therapy but maybe you should find a different therapist. The worst therapist in the world is the one who already thinks they know you. Who knows, maybe that session was a write-off but the next one might be really good.

You should be prepared for some therapy sessions being tough. You should ask your therapist to go easier on you for a while as you have only just started to recover and you are still fragile, scared and worn out.

Recovery can be almost as traumatic as being ill when it first starts. You don't trust it fully because you're so used to feeling dreadful and it's hard when you first start feeling like life does have some meaning after all. Believe me, some days you will feel like you've fallen back into the anxiety, whereas others you will almost want to cry because you feel such a wonderful sense of serenity.

You WILL have blips like this, probably quite often, and it is possible that you may need a dose increase at some point - discuss this with your doctor. That's not a backwards step, believe me, medication is just another tool at your disposal.

[Tero]

Jenny, it seems to be helping with your anxiety, if not depression, so stick to it till you see the doc.

Take care.