Citalopram – adverse reaction

I haven’t posted recently, on any of my blogs, because I have really not been well (mostly physically, but that has an impact on mental health too of course).

I always seem to be worse in the summer for some reason, and even though (thank God!) I’m not suffering from hayfever to anything like the extent I usually do, I really feel knocked out and completely zapped of energy, more confused and disorganised than normal and really just struggling to drag myself through each day.

I wanted to write a quick post though to mention that I had had a very bad reaction indeed to Citalopram.

I have struggled with depression, which I have really had incessantly since childhood (and I suspect it is largely due to the head injury I had aged 12 when I was knocked off my push bike in a hit and run ‘accident’ in 1983).

I liken my depression to a mild, grey cloud that never goes away. Most of the time, I just live with it. No amount of positive thinking, yoga or mindfulness takes the cloud away, but it’s manageable, I have more or less got used to it.

My GP gave me citalopram for depression and anxiety and I tried it because I thought it was worth a try.

However…

I was only on 10 mg of citalopram for about 5 days, and almost immediately, my little grey cloud went from a mild, manageable thing to a horrible big, thick, dark, heavy cloud that seemed to engulf me. I woke up feeling suicidal the first morning after I started taking it, and every day afterwards. When I stopped taking it, it took more than 10 days to come out of the thick dark cloud, and to be honest – more than 2 weeks later, I have a niggling feeling that the world would be a better if I wasn’t here. That’s not me. I don’t normally feel like that. (I do regularly feel despair, and I often feel that it’s not worth carrying on, but it’s more a feeling of laying down and waiting for death rather than actively trying to end it all. The citalopram reaction was more of the latter.)

I wasn’t imagining it. It was palpable.

Additionally, during the days that I was on citalopram, I had a greatly reduced ability to urinate. It just so happened that I needed to do a 24 hour urine sample during that week. It’s the second or third time I’ve had to do it this year, because I’m currently being tested for Cushing’s and/ or other pituitary gland disorders. Usually, I do so much I can’t fit the whole 24 hours in the pot, which takes 1200 ml. (The previous time, I only fit 18 hours in). This time, in the whole 24 hours, I managed 200 ml. I have no doubt whatsoever that citalopram was to blame.

I made a point of not reading the paper insert before I tried citalopram, not wanting to give my suggestible brain ideas! But of course afterwards I checked and both suicidal ideation and inability to urinate were listed in the potention serious side effects.

The reaction was so severe, it has made me wary of trying any other kind of pharmaceutical solution for anxiety or depression. It’s not the first time I have reacted poorly to anti-depressants, but this was by far the worst.

I’m not a person who would advise other people to not take the meds they need. Far from it. I know that meds help a lot of people, and you can only tell if they’ll work for you by trying them.

But for me (perhaps because there is Bipolar in the family, or for some other reason) I don’t seem to suit pharmaceutical meds. I think I need to start looking to food, herbs and natural solutions.

5htp has worked for me somewhat with no side effects. Not spectacular, but seems to ‘take the edge off’ without doing any harm.

St Johns Wort did not work for me, in fact it sent me completely loopy. But for others, I know this is a good natural solution that works.

People are different. I know plenty of people who swear by their anti-depressants and others who are equally opposed to them. I even know one lady who controls her Bipolar using homeopathy.

Each to their own!

What works for you?

Are there any natural solutions you recommend?

Or do anti-depressants work really well for you?

 

Therapy

This is from a group I’m part of for recovering from Complex PTSD. It’s not my own (and actually I’m waiting on permission so I may need to come back and either delete or add an attribution), but I wanted to share it because I could easily have said the same thing myself. All the calming, positivity therapies don’t seem to have much effect, and I have been doing these things for a long time – far longer than I realised I might actually have mental health issues. Back when I thought I was just a feisty redhead who needed to calm down a bit. So what is the answer? Can things change? Is it just a long road? I wish I knew.

I have a seasalt lamp.
I have a lavender pillow.
I drink milk before bed.
I try to limit my coffee to one a day.
I journal.
I try to go for a walk.
I volunteer each month.
I limit my contact with my family.
I attend my counseling.
I take my prescriptions.
I take magnesium.
I take vitamin B.
I try to eat meat free every second day.
I sit by the sea each week.
I count my blessings.
I do deep breathing.
I try to limit sugar.
I limit my screen time.
I paint.
I draw.

I do all these things to manage my cptsd.

And at the end of all of that I’m just the same.
My anxiety roars in my ears.
My depression wears me like an uncomfortable coat.
I disassociate.
I suppress my emotions.
I comfort eat.
I cry.
I don’t sleep.

It’s a complex recipe, being well and finding the right path to wellness.

Having cptsd is a complex maze of experiences,
conditioning,
inner mind talk and responses.
And some days I manage.
Other days I don’t.

Here we go again

Mum was with us for 6 months while I attempted to function as her carer. For various reasons, it did not work out, and we took her home again in March and have arranged for professional carers to be on hand to look after her. My caring duties have not completely finished, but I now have a buffer of 250 miles or so between us, which really is much better for my own mental health (and hers, it would appear, although there are issues with her not taking her meds for bipolar which I can’t control from a distance and that is a frustration and a worry).

I expected that, when the stress of looking after mum was lifted, that I would get well again quite quickly but in fact the opposite has happened and I have retreated and isolated myself again with agoraphobia.

My physical health is quite bad at the moment, but issues have arisen (conversations on twitter and with my eldest child, mainly) which have make me realise that in fact my physical ill health may in fact be due to early childhood and repeated trauma.

The ACE score is a study which looks at Adverse Childhood Experiences, and uses it to predict a number of outcomes related to physical and mental health in adulthood. Out of a possible total of 10, I score 4 on the ACE quiz, and my resilience score is low (3 out of 14) when it should be high.

I am going to come back and look at this in detail, but it is such a hard subject to look at, I don’t really know where to begin. I feel as though I am having to force myself to open a Pandora’s Box of evil that I thought was long dead and buried.

In the first instance, though, I am told that the way back to health and wholeness (other than the standard pharmaceutical and CBT) is:

1) Talk about it.

2) Write about it,

3) Talk to other survivors and finally

4) physical exercise.

Due to the agoraphobia, physical exercise outdoors is not an option right now, it’s just too overwhelming, so I have brought the running machine in from the garage, and it’s set up in the bedroom, so I’m heading there next. I am annoyed with myself that I’m missing the beautiful sunshine and blue skies of spring in Cornwall, but it can’t be helped at this stage.

Also I have made an appointment to see my GP in two weeks to discuss the possibility that all my mental and physical illness is actually manifestations of Complex PTSD.

Just to clarify, the trauma that I received was not physical or sexual, but mental, emotional and spiritual in nature (church abuse amongst other things). I mention that, because for years I didn’t see it as abuse even though I knew I had been traumatised. What I hadn’t seen at all until this week was that I had unknowingly perpetrated some of the same kinds of abuse I had received on my eldest child. I can’t tell you how deeply I regret that.

Next time I will talk about the symptoms of Complex PTSD. I have given myself license to use that term although at first it felt a little bit wrong (because I associated the term with other types of abuse that are more serious and more damaging) but I think it fits, and in the absence of another term.

I don’t know who might be reading this, but if you have recovered or are recovering from mental/ emotional/ spiritual abuse and have Complex PTSD, I would be interested to hear from you. I can’t give any advice other than what helps me, and perhaps that can be another topic for another post.

Bye for now.

Sudden Changes

mh-carers-fine

I thought I would post an up-date, as it has been a while and a lot of things have changed.

It became apparent that it would have been impossible to leave my mum on her own – we had done everything we could to try to get NHS carers, but no help was forthcoming, so she agreed to come back to Cornwall with me.

The timing could not have been worse, as we were just about to move house. My brother organised a caravan for her to stay in to avoid the chaos, but as it turned out she hated it and it was just one more thing for us to deal with, so she came back to the house and lived with the chaos.

We started to move house two weeks later (and we’ve done that gradually – paying for an extra month of rent was cheaper than getting removals, but it has meant doing everything ourselves which has been pretty awful), so it has been differing levels of chaos over the last month. It won’t be over and done with until the end of this month.

So now, I am a ‘carer’. In a way it’s my worst nightmare come true, but it hasn’t been as awful as I expected because on the whole, mum has been much better – happier and healthier with us than she was at home. The doctors here have been much more responsive to dealing with mum’s physical health issues than her (apparently incompetent) doctors back home. It turned out that mum’s lithium levels were almost toxically high and so they reduced it and a lot of the symptoms (diarrhoea every day, which mum thought was IBS, amongst others) have lifted which has made a huge difference to quality of life. My only criticism is that the GP made an ‘urgent’ referral to the Psych Team, and we’ve heard nothing from them more than two weeks later.

For myself though, I thought I was fine at the beginning – my ME/ Fibro seemed to be in remission after a pregnancy earlier on in the year, but over the last few weeks I was beginning to feel signs that the Fibro was coming back. I didn’t want to believe it so I tried to ignore it, stupidly, and now I feel completely burnt out.

There are lots of things that have made everything more challenging – my  mum is a completely different character to me. Whereas I am perfectly happy to stay indoors, mum is a real ‘going-out girl’. She would like to go out every day, and wants me to organise groups and dinners and day centres. I’m finding it a challenge to find things for her, but hopefully that can be sorted in due course. But in addition, mum hates going in the car, and since we’ve moved out of town, now we’re about ten miles from everywhere. That can’t be helped unfortunately.

So I’m just having to deal with it, and get over my natural tendency to agoraphobia. I’ve been pretty brave myself as well, going out to support groups and the like. Next time I’ll post some info on some nice places we’ve been instead of doctors and mental health centres!

I found the picture above when I googled ‘mental health carers’, and felt that it was exactly how I felt as a sudden carer. Hopefully it will get better (although mum doesn’t really want to be here, she forgets very quickly how unhappy she was alone, and wants to go home every day), and I plan to make sure I plug into support groups and resources for carers.

Counting Blessings

bipolar

Hi folks.
I’m taking some time out at the moment to care for my elderly mother who, in addition to suffering from bipolar disorder, is beginning to show increasing signs of dementia.

it is a bit of a challenge to determine where the bipolar ends and dementia might begin, because my mum has always been incredibly disorganised and was never really able to cope with the housework at the best of times. Over the years, our attempts to help her – for example by trying to make her kitchen and particularly the fridge, counters and sink more sanitary, tended to be met by anger and accusations of wanting to control her life/ steal from her/ hide her things/ some other nefarious motive. It has always been hard work. In fact my brother said recently that the relatively new term ‘Bipolar Disorder’, replacing the old ‘Manic Depression’, really just not do the illness justice.

Recently, though, she seems to have had a ‘crash’ (what might once have been called a ‘breakdown’) and due to chronic insomnia, has very suddenly accelerated her memory loss and confusion, and instead of being consistently high or low for weeks or months, has started ultra rapid cycling of moods and what appears to be mixed states of mania and depression at the same time. In short, she can’t function at all. What we didn’t realise, because she hadn’t let on, was that it isn’t just the sudden memory loss and confusion – that part of the problem has been coming on for months and months. We only discovered it because with this ‘crash’ she had to admit she needed help.

Over the few days I have been here, she has run the gamut of all possible emotions. At the weekend when my husband was here, she behaved appallingly – swearing and violence – and I was very embarassed. Anger, crying, despair, laughing, singing, and obsessing about God and the devil (she has had a whole life’s worth of unhelpful religion, and is often convinced that her illness must be demonic in nature). It is exhausting to be around.

But I do also know, to a lesser extent, how exhausting it is to experience first-hand. I don’t have any kind of diagnosis, and I certainly don’t believe I have full-blown BPD, but children of parent(s) with BPD are at increased risk both genetically and in terms of the emotional environment they grow up in to experience difficulties with mental health generally and BPD in particular. There have been occasions – when I have been prescribed various prescription medicines and also some alternative medicines – when I have experienced symptoms of BPD. Fortunately, I recognised it and the symptoms disappeared as soon as I stopped the medicines.*

I obviously have a vulnerability there, so I do need to take care to look after myself and practice self-care – get a good amount of sleep, eat as healthily as possible, exercise, and exercise emotional intelligence in all my relationships! (Easier said than done, of course, for all on that list).

I was worried that being around my mum would be bad for my own mental health, and I think that would be true if I stayed here for long. But in the short-term, apart from worrying me that I must take more care, it has made me realise actually how well I am. It has always been a worry in the back of my mind that I might ‘end up’ like my mum. But I know I am not my mum, and hopefully it’s an unfounded fear that I don’t really need to worry about.

Now, though, we have the enormous task of finding a suitable and acceptable long-term solution to looking after my mum who is really very difficult to live with, now that she seems to need not only help with day-to-day washing, housework and shopping, but constant supervision and company round the clock. The best and most logical solution, since I live 200 miles away and can’t be much help on a regular basis, is for my mum to move in with or near to us in Cornwall, but she really doesn’t want to. Is it awful that a part of me feels relieved about that?

* Incidentally, the medicines that threw me for a loop were: Amlodopine, prescribed for blood pressure – not known for affecting the brain perhaps, but it obviously didn’t agree with me, and St John’s Wort – a well-known traditional remedy for depression which I took for PND, but oh boy, that made me ‘crazy’, in a word.

Additionally, Gabapentin, which I was given for pain, made me feel suicidal when I was on it regularly last year. It is known to have risks for people with BPD, but is often prescribed nevertheless because in people with BPD it has the ‘off-label’ effect of reducing anxiety. I’m not overjoyed that my mum has been given that particular medicine, but anxiety seems to be of particular concern at the moment, since it seems to be what is causing the insomnia, and the local Psych team don’t want to try any anti-depressants until the sleep is sorted out. The wheels of the NHS turn incredibly and frustratingly slowly. It’s a pretty nerve-wracking time for everyone involved.

I am looking forward to getting home to Cornwall and to my kids, but I don’t know when that will be.