I feel like it’s been a while since I’ve talked much about anything related to my mental illness, but that’s mainly because there’s not been much to talk about. But finally I have an update, and it’s a good one! As of February 2nd, I’ve been back down to a dosage of 25mg of my antidepressants. Fuck yeah!
For those of you who don’t know (or have forgotten), when I first went on antidepressants in 2014 it was at at dosage of 25mg daily. Then, in August 2015, I found that dose was no longer working for me so my doctor suggested an increase to 50mg. And that’s where I stayed until February 2nd 2017, which is well over a year. That seems crazy – it honestly doesn’t feel like it’s been that long. But the calendar doesn’t lie. So there we are.
Here’s why I decided to come back down to 25mg. On the stronger dose, I felt physically shit for a long time. Don’t get me wrong – mentally, it was great. It did what it was supposed to. My mind worked properly, I was able to function like a normal human being. It’s been a very long time since I’ve felt truly inhibited by senseless anxiety (apart from the whole hypochondria thing, but Jesus, let’s not get into that now). But unfortunately, sertraline has had some unfortunate physical side effects, as it’s known to do. And for months I was miserable because of it.
Basically, sertraline and my gut aren’t friends. I already suffer with IBS, meaning my gut has been notoriously touchy since long before I went on anxiety medication, and it seems like sertraline has only exacerbated that fact. It’s been especially noticeable since I increased my dose.
On the less harmful end, there’s been some bloating and weight gain that I can’t otherwise account for. I’ve always suffered with bloating, but for the past year or so it has been some next level shit. I almost always felt like a dead bloated whale. The only reliable ways to control it were drinking peppermint tea (fine as a short-term fix) and a low-carb diet. And a low-carb diet is neither practical nor economical. Bodies need carbs. And carbs are cheap: the ideal student/poor person food. As for the weight gain, well, it hasn’t been astronomical but it was enough to make me a miserable crazy calorie-counting self-loathing psycho. My metabolism has always been high. Around the time I started taking antidepressants, it started going to shit. And that was only magnified with the increased dose. I got sick of looking at my body and feeling gross.
Then there was the fact that the higher dose made me sleep a lot more than I was used to. When I took my meds in the morning, I’d get to midafternoon and feel unable to keep my eyes open. If I was at all able to, I’d go home and go to bed and sleep for – I’m not kidding – three hours. It was impratical. Switching to taking them at night helped with not needing to have afternoon naps of epic proportions, but it meant I could now easily sleep for ten, eleven hours at night. I’m not even exaggerating. And it made it really hard to get up in the morning. I’d set a ridiculous amount of alarms and sleep through almost all of them. It made me feel lazy. It made it really hard to get anything done. However, a bit of mental discipline, regular exercise and sometimes a cheeky coffee usually made this manageable.
So. Bloating, epic sleeping and a little bit more weight I can handle. Sure they’re not great, but there are ways to soften both those edges. (Which is funny, because it’s my edges that are soft now. Ha ha. I hate my body.) There are things I could do, at least, to look after those side effects. Now here’s the kicker, and the real reason I’m now back down to 25mg: I experienced a side effect that was much more serious, much more unpleasant, and whenever it happened there wasn’t a fucking thing I could do but grit my teeth and suffer it out.
If you’ve ever experienced an acid reflux, you’ll know just how horrible they are. And if you haven’t, I hope you never do. Essentially, it’s when your stomach acid comes back up your oesophagus. As you can imagine, it’s incredibly unpleasant when this happens. Stomach acid is not supposed to come back up. When this happened to me, I experienced a burning pain in my throat, chest and even my stomach. I would get incredibly bloated and full of wind. I would do the most horrible burps: big long ones that I swear I could feel rolling like a big acidic ball all the way up my gut to my throat. Imagine burping up your stomach acid: yeah, it fucking hurts. And it’d rarely make me feel any better afterwards.
These episodes normally lasted for an hour or two, and I would be left feeling the aftereffects (bloating, burning pain when drinking or eating, painful burps, etc) for the next day or so. I tried everything: antacids, drinking milk, changing my diet and exercise habits, sleeping in different positions. Nothing helped. I couldn’t make a connection at all. Nothing I ate, drank, took or did seemed to be an obvious trigger. What the fuck was causing it, then? For the longest time I had no idea.
I’m really annoyed at myself for how long it took to make the connection between acid reflux and the time I was taking my antidepressants. Back in 2014 and for most of 2015, I would only get acid refluxes in the morning. Which was when I would take my antidepressants. Then, suddenly and seemingly for no reason, I started only getting them last thing before bed. Of course, in late 2015, I started taking my antidepressants last thing at night so they’d make me less tired during the day. But this didn’t click for me until literally last month. Even though my doctor suggested they might be connected, I was like “nah, impossible! it’s just a random thing that happens! probably just my IBS being a dickhead or something!”
Then one night in Hastings I was taking a bath and I took my antidepressants before getting in, so I wouldn’t forget to take them afterwards when I was all sleepy and clean. While I was sitting in the tub, I felt it start to happen. An acid reflux was coming on. While I sat squirming in discomfort, miserable in the bath for the first time possibly ever, my brain started ticking over. The dots were joining up. There it was: the cause for an effect I thought was causeless.
And it was so fucking obvious. Of course. Of course. I was kicking myself for not seeing it sooner. Before I started taking antidepressants, I’d never had an acid reflux in my life. Then at the end of 2014, they started happening. Infrequently at first, but after I went up to 50mg they were coming on more and more often. It’s entirely possible this makes me the stupidest person alive. Except for maybe Donald Trump, but fuck that guy. If he can get elected president of the Free World, then I can come off my antidepressants.
Figuring it out was such a relief. And honestly, there’s a part of me that’s kind of glad I didn’t twig to it sooner. Sooner than now, I don’t think I would have been ready to hear that. I think that’s why I rejected my doctor’s suggestion when she first brought it up. But in February I felt ready to come off. Really ready. So I made an appointment with my doctor. I told her my “new” “theory”. She was incredibly understanding and supportive, and wasn’t a dick at all about the fact that she’d first said it months earlier. Even though she had every right to be. She suggested I go straight back down to 25mg and see how that goes over the next few weeks.
And that’s where I’m at now.
In less than two weeks, I’ve already noticed some good changes. Most prominently, I’ve had far less bloating. My tummy generally seems to be feeling a lot better than it has in a long time, and that’s great. My mood is fine, no noticeable changes there. I’m trying my best to keep a positive mindset through all of this, and through the worry that my anxiety might come back. Every time I begin to feel stressed or defeated by something, I try to stop the train of thought by telling myself, ‘it’s okay, you can do this, you can smash it’. It’s a mindset that takes constant work and vigilance to maintain, but it’s worth working at.
Basically, this is some big news. Quite honestly, the thought of coming off my meds used to scare me shitless. And now, I’m excited. Still scared, of course, but the excitement dominates. Which is quite something to celebrate. In January – actually, a month ago almost to the day – I posted some of my goals and visions for 2017. One of them was to go back down to a 25mg dose of sertraline. Well, it’s only halfway through February and I’ve already done it.