I recently attended a talk called “All Kinds of Minds: Let’s talk about mental health” at a software testing conference**. My “a-ha!” moment came when Aaron admitted that he really didn’t want to present this topic, and that the only way to reduce the stigma around mental health issues was to start having these discussions. To honour Aaron’s effort, I’m sharing this experience of a time when I switched anti-depressant*** medication.
When I need to change my medication or dosage I try to wait until my next holiday from work, to avoid the side-effects from impacting my career as much as possible. It does take some fun out of the holidays, and it can be hard on friends and family. It also means that I try to make the change over 2-3 weeks rather than the recommended 4-8 weeks. Please note that I never adjust my dosage without consulting my GP.
After almost 2 years my Cymbalta (SNRI) medication was no longer effective, and my GP recommended I switch to Citalopram (SSRI), using Mirtazapine to assist with the changeover. This post is in NO WAY a recommendation for others. I recorded the notes below only to assist in conversations with my doctor. Looking back now, I realise that my notes may provide insight for others when suggesting that somebody “just take some happy pills”, or when wondering why a colleague seems a little vague for a few weeks.
After reading this you may wonder – “Is it worth it?”. Obviously I think it is, and this is what I’m willing to go through for a few weeks per year so that I can feel normal-ish for the rest of the year.
6 days on half Mirtazapine tablet with 1 Citalopram:
Chest pains with anxiety attacks, dizzy
29 Dec: Switch to 1 Mirtazapine and 1 Citalopram
Swollen feet and ankles, anxiety strong, chest pain, mood swings/rage, wind, insatiable appetite, headaches.
31 Dec: Feet & ankles mildly swollen, anxiety, feel slow and heavy like underwater, want to do nothing, irritable (not rage), no wind, no headaches, eating lots and often – need to use will power a lot more than usual.
Chest pains and anxiety during self criticism. Major one when I decided to change dosage without getting doctor’s advice. So I didn’t do it.
3 Jan: less anxiety and hunger since evening of 1 Jan, neither is an issue now. Not irritable etc.
Feet are uncomfortably swollen. Sleep of the dead, I don’t wake until I’m woken.
5 Jan: feet still swollen, left one is slightly worse. Very deep sleep. First day back at work, got more anxious as day progressed.
9 Jan: 1 Citalopram and 0.5 Mirtazapine
Base level of anxiety higher today 5/10. No depression, very swollen all over.
10 Jan: swollen, achy, anxious 5/10, had to lay on the floor for a while, not depressed, still sleeping deeply.
14 Jan: great day yesterday. Today 4-5 anxiety attacks at work. Felt like my family and I would be better off if I moved away. Cried myself to sleep, swollen feet, slept like a log.
15 Jan: down to 0.25 Mirtazapine and 1 Citalopram.
18 Jan: good, swelling basically gone. Easier to wake. 1 anxiety attack yesterday, none today. Feeling positive.