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Time for medication.


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My therapist has thought medication to be a good idea for a while now but my psychiatrist is very anti-medication and has been trying very hard to avoid this route but she has given in (I have not spoken to her about meds) and said she would like to trial me on some anti-depressants. During a review of my treatment with both my therapist and psychiatrist in the room yesterday, they have both noticed my reluctance to open up about anything, often offering "I don't know" as an answer to their questions and they both find it frustrating that I only talk about things they ask me about, I will not bring up issues myself. They both agree that before they can work on this, they need to address my lack of motivation, consistenly low mood and suicidal thinking, and as it's been going on for months, they think it's time for the medication. I have been given a week to think about this. I will be seeing my therapist on Friday, and will obviously discuss this with her then, before seeing my psychiatrist on Tuesday, who will, providing I agree, give me my prescription.

Due to my age and the nature of the medication, they would normally require parents to pick up the prescription but because I do not live with my parents and have told them I do not want my aunt to manage my medication, I will be allowed to collect my prescription personally but it will be handed to me during my session with my psychiatrist on a weekly basis, so that I can't try to overdose, as obviously, that is a concern.

At this point, I am worried, and I have am considering whether I want medication. I am very willing to try, I am open to anything that could help, but I am concerned about the side affects of medication, primarily, weight gain. One of my problems is restricting my eating and often purging food, and I do not want to gain weight! :-( Does anyone have any experience with this?

Another issue for me is telling my aunt. Obviously, my medication is mine and my psychiatrist is letting me manage it myself, so I suppose the option is there to not tell my aunt and just hide it, but that would cause a lot of guilt for me but at the same time, I do not want to tell her, she is not a greatly understanding person and by admitting to her I need medication, that's admitting there is a problem, amd I'm not entirely sure she will even believe me because I work so hard to keep up this happy mask at home. To me, hiding the medication seems the best idea. Does anyone have any thoughts on this?

Is medication going to be beneficial? Does it work for you?

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Hi PP, welcome back :)

I think that finding the right meds can be a nightmare. It can worsen depression, anxiety etc, if meds are not right for you. That is why you have a psychiatrist watching you. So if you start gaining weight for example, you can change your meds, with your doctor's approval of course.

Last year I was given a new med and I started to feel horrible in about a week.

Don't be afraid to try, just in the beginning pay close attention to your mental and psychical changes. Pls try not to hide your meds. Give it a try:)

Hugs!

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Those are difficult decisions. I think all I can tell you is my own experience, but also emphasizing that in my case, it was unusually positive and there are also people who are/were not so lucky...

I used to take mirtazapine: 7,5 mg for 4 days, than 15 mg / day, in the evening, for about 1,5 year, then the last 2 months again only those 7,5 mg (a slow withdrawal is always necessary). It was even funny that the med had a strong placebo effect (my doc said that maybe it was also partially already the effect of the med itself - who knows?), because since the 1st day, I felt much better, my anxieties were gone (but the med is supposed to begin to work after 1-2 weeks :D)! Not "forever" - I used to have different moods and states during therapy, but the worst states/moods were never as bad as before taking the med! So in my case, it was very efficient, even at those low doses.

Weight gain is a common problem of many, if not all, ADs, but it's not a general problem - not everybody reacts in this way to every med. There's not another option as to try and see what it makes to you, if you want to know :(. In any case, you should consult the potential changes in your appetite with the doc. I don't know how it could interfere with your eating problem. For some depressed people, this effect is good because without meds, they didn't have any (or had only a small) appetite. Maybe it might positively change your attitude towards food ;). As far as I know, the mechanism is mostly related to stimulation of appetite, so you can manage not not put on weight by not eating as much as you'd love to (but, please, not by purging!). It was possible in my case (I suppose not only in mine): I felt often hungry (and you know; "sweet-tooth"..) mainly during the first weeks, but I put on only 3 kg during about 2 months, which is not bad at all, moreover I became adapted to the bigger appetite (which later wasn't as big as in the beginning!) and didn't put on more, I was even able to lose the weight.

There was also one different side-effect of my med: I needed to sleep 8 hrs a day (normally, I can be OK with 6,5-7) and I felt very exhausted at night when I didn't go to bed the time I needed - but this also was the worst during the first month, then I adapted a bit.

In these regards, it would be better for you to start with the meds during holidays...

I was 27 when I began to take the AD, so this is quite different from you... But nobody from my family except for my husband (whom I've lived with) knew about the med and the therapy and it was a good decision in my case. In your case, the decision is much more complicated, so it would probably be useful to consult it with both the therapist and the doc. I don't want to scare you, but... you would probably google it even so: ADs can be dangerous for children and even teenagers :(. You can read more about it - I think it's also in Wikipedia - but I'm going to try to explain it here a bit: The AD removes the depression, but depression also includes a kind of passivity. Which is very good in the context of therapy - you can become more prone to talk, to try harder, ... But it brings also a risk: When you are suicidal but depressed, you are, so to say, "too passive for such a hard decision about your life" - it's in some regard easier to stay alive than to "bother" to prepare and commit the suicide. So... when the AD activates you, then... It happens that people, and it's much more common among children and teenagers, when they begin to feel the effect of the AD, but not yet of the psychotherapy (which can change the thinking), commit suicide :(. But it's possible that this happens mostly in younger people because they are... well... they didn't yet develop enough rational blocks/inhibitions against suicide. So... maybe giving you the AD, your doc also expresses her believe in you - that you're strong enough to sustain the temptation, which is positive ;). In any case, I suppose you can see why it's important to be "monitored" during taking an AD. In some cases, monitoring by weekly visits of a doc or therapist can be sufficient. But I suppose that in case of teenagers, docs are (or: should be) more careful and that's why they prefer also a "monitoring" by relatives (caregivers)... I'm telling you all this because I think it could help to understand better the situation. It seems to me that this leads to the conclusion that... your decision to tell or not to tell your aunt is also (not only!) related to your personal feeling of your "survival will", to your reliance on your power to resist the temptations of suicide and SI...

Please, if you have any questions, don't hesitate to ask.

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Medication can help a great deal, but it can take awhile to find the right medication for you. (This is what people say over and over again. I can't tell you how many times I've heard it. But it's pretty much true.) You've got to watch the side effects. I've always made sure my partner is well aware any time I'm taking something new or changing dose, because there was a time when I was on one med that messed with my head enough that I was unable to even recognize how much it was messing me up. So in that sense, it's good that your therapist and psych will be watching you closely, but that may be a reason to let your aunt know--so she can do something if you are hit by any bad side effects. But obviously I don't know your aunt or your situation, so I can't say how good of an idea that may be.

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I think I am going to try the medication, it's worth a shot, right?

I have done a lot of reading about anti-depressants even before now and I am aware of how they can worsen symptoms and often, different dosages or drugs may be needed, and I am prepared for this, even if it's difficult, it might be worth it to find the right one. It is the summer holidays now and when I am due to start medication it is four weeks before I am due to enroll at college so I guess this is a good time so I can settle and adapt to a drug without it causing me trouble in college.

I am still going to worry about the weight gain, but we will have to see how it all works out, I'll adapt I suppose, though it might mean I do more damage to my eating patterns.

I can't imagine needing to sleep for 8 hours! I can get by on three or four usually and I tend to sleep for 6 hours at most. Maybe that will change.

I suppose telling my aunt is the right thing to do, so she is aware of any side effects and can keep an eye on me, so to speak. I have read about how antidepressants can cause an increase in suicidal thinking and attempts, but this doesn't scare or worry me. I can understand how it could make others worry about my safety, but I think I have the self restraint to fight it, and if I don't then, I suppose I will get what I want.

I have heard that AD's can cause people to feel numb to everything, and can cause more frequent or intense urges to SI. Obviously, these are not positive things, and maybe switching drugs would work, but has this happened to anyone?

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In my experience with ssri's, I felt numb and foggy and was s/i-ing a lot more. They turned out to not be a good choice for me. But there are many different types of anti-depressants. The one I just started yesterday is Wellbutrin, which acts on norepinephrine and dopamine instead of serotonin. Supposedly, it is more of a stimulant, and can even result in weight loss.

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Hi PP,

I agree, Benji’s idea for a limited role for your aunt as you try some medication sounds good. Given that you are not yet an adult, I can understand the twinge of guilt about not wanting to tell her. She is doing the best she can, etc., etc. So you don’t want to reject her but . . .

I understand from what you have written before that you respect your aunt and the difficulties and challenges that she has. Fortunately for you and the overall goal of your well-being, it sounds like you are doing a darn good job of caring for yourself – with, thankfully, the help of your psychiatrist and therapist.

For what it’s worth, as a teenager I had anorexia which then “improved” into bulimia. At least I survived. That’s first and foremost.

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Benji, as I understand it, in the UK they will not prescribe SSRI's to under 18's due to the risk of increased suicidal ideation that can come with SSRI's. Your experience with them does not sound pleasant and it's a shame you had to go through that. I hope the Welbutrin does some good for you!

DD, I think what I will do is inform her of the medication so she is aware, but make it clear that I can look after myself. You are right, I do have great respect for her but we have a difficult relationship.

Thank you for the compliment, but I think I might be giving the illusion that I'm good at taking care of myself :P I would not be able to cope without my therapist and psychiatrist, and my boyfriend and his mother. I feel as if I'm being like after.

It's a real shame you had to go through that awful time. I suppose Bulimia can be better than Anorexia, but you survived, and that's the important thing! I am very glad you did.

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