Anti-depressants and Weight Gain

Screen print 'Happy Pills' by Chris James

It's a cracking post title, right? Just what you want when you're feel downtrodden already, you've finally managed to talk things through with a doctor, you've got through the period of adjusting to being on anti-depressants with their lovely side effects and to top it off...weight gain. That's just splendid. Not all of them cause weight gain, in some cases they can cause weight loss due to a decreased appetite. Frankly I'd be game to get on those ones!

I first started taking anti-depressants in September 2013. After hiding my illness for 5 years things had become so bad that I barely had the energy to keep up the facade. My mum woke me up one day and just said that she knew something wasn't right and outright asked if I thought I was depressed. I started crying and could barely stop myself. I knew it was bad and it had slowly been chipping away at the person I was until very little of that fun loving personality remained. That same day I walked into my GP's office and told them everything I'd been trying and failing to say for years. The most I'd managed to say to them before was that I'd been having panic attacks but they didn't prescribe anything or refer me to a counsellor. This time she pushed a box of tissues towards me and said "oh it can be all that bad surely" somehow in that moment I managed to fight my corner, I told her of my self harming and suicidal thoughts, of how I barely lived these days and spent the end of my summer term at uni locked away in my room. Reluctantly she prescribed me my first dose of anti-depressants. Her hesitance was due to me being a temporary patient back in Ipswich as I was then registered with a doctor up in Durham whilst I was at uni and they might have had a different opinion on how my depression should be treated. I was prescribed what is generally prescribed in the first instance providing that you aren't pregnant or experiencing a serious health condition such as heart problems or diabetes. I was initially given a small dose of Sertraline as my score on the multi choice test for depression was pretty high and rated me as having severe major depression with social anxiety.

Unfortunately medications don't work straight away, they can actually cause the depression to worsen over the initial two weeks of taking them and even after they kick in they don't always agree with you. I experienced some pretty bad side effects and the Sertraline didn't seem to be improving my mood, so it was decided that I was be put on Venlafaxine. Bad luck for me as I had a GP that whipped me off Sertraline in a week, not recommended! Usually you will be phased off anti-depressants slowly so you're body can adapt without going into withdrawal. I went straight into withdrawal, was extremely emotional and a danger to myself. If I'd had been in a better state of mind I might have been able to give that GP a well deserved telling off, but I was barely able to speak up loud enough to check into the doctors surgery let alone give the doctor a good telling off.

I've been on Venlafaxine (also known as Effexor) for about four years now. I've experienced some side effects but nothing bad enough to prompt me to change again. Even though I knew my current GP would carefully remove it from my system, I was still scared of having another horrendous experience of withdrawal and a major depressive episode without any anti-depressants in my system. That was until I realised something recently. When I was at uni I kept track of my weight. At the time I was experiencing body dysmorphia, I still do but in different ways now, I believed that I was fat when I was actually around the perfect weight for my frame (just under 9 stone). Flash forward to today and I'm 11st 6lbs. The most commonly used anti-depressants such as Prozac and Zoloft can cause weight gain of at least 10lbs! Nightmare! The cause of this weight gain isn't known for certain, it can be because of an improved mood and the ability to find pleasure in things again such as food. It has also been shown to cause a change in metabolism (making it slower) causing patients to gain weight despite maintaining normal eating habits.

Depression did cause a major change in my diet and activity levels, for the worse. However, since January I have been moving more than I had in the past couple of years, eating significantly better, upping my daily step count and really pushing with the exercise. Imagine my horror when I put a dress on a couple of months ago that was tight when a few months prior it had been loose! I know that weight loss takes time but this was devastating. I checked out the side effects of Venlafaxine and yipeee weight gain is one of them. I discovered forums full of people experiencing the same problem. Enough is enough for me, my anxiety and depression is closely linked to my body image and self confidence. If the thing that's supposed to be helping my mood is causing weight gain and destroying my confidence, it will inevitably reignite the depression. Awesome.

I decided to head to my GP to discuss coming off Venlafaxine. He was incredibly relieved. In the years since I'd been taking it, more and more tests on the drug and those taking it had revealed that it can have major effects on the cardiac system. Anti-depressants often affect more than one nervous system i.e. the brain and something else, in this case it is the heart. With his assistance I've been slowly withdrawing from Venlafaxine since April. It has to be a gradual process as my body has become so used to it's presence after relying upon it for so many years. The body and mind goes into shock as it realises this thing it has clung to for so long is suddenly being taken away from it. My dosage was adjusted every two weeks and with it came a variety of side effects which I've listed below:

• Weeks 1 + 2: alternating days of 225mg and 150 mg, high levels of anxiety, shakes, sweating
• Weeks 3 + 4: 150mg each day, dramatic mood swings, tearful, low mood, upset stomach, fatigue and insomnia 
• Weeks 5 + 6: alternating days of 150mg and 112/5mg, sensation of chickenpox on the skin feeling itchy but no visible cause, hot flushes, nausea, fatigue, sickness, insomnia 
• Weeks 7 + 8: 112.5mg each day, less nausea, appetite returned, loss of concentration, increased sensitivity to sudden noises and movements, very dry mouth
• Weeks 9 + 10: alternating days of 112.5mg and 75mg, very low moods, low self esteem, high anxiety, poor sleep pattern
• Weeks 11 until present day: 75mg every day, very low mood, crying over nothing, very sensitive, tired, headaches, anxious, low self esteem, lack of concentration, lack of enjoyment

I've been taking 75mg each day for a number of weeks now due to difficulties getting a follow up appointment with my GP. When I did get an appointment we discussed remaining at this dosage until I returned from a planned trip abroad as we agreed it could disturb my mood further. The plan is to then alternate with 75mg and 37.5mg, followed by two weeks of taking 37.5mg daily and then being free of anti-depressants for a while. At the beginning of this process if it had been suggested that I'd be taking no medication at all at some point I might have had concern. Whereas I now can see how much of an impact it was having on my body. I also have less nerves about this as the process has been undertaken in a very controlled manner. Once my body has adjusted to being drug free and free of any withdrawal affects we will then introduce a new drug and be able to see if there are any obvious side effects from it. Hopefully I'll be able to find something that helps rather than hinders the recovery process!

 

Withdrawal

A few weeks ago I was left on my on for the first time in a while. I had a feeling that this week was going to be fairly challenging, but thanks to me miscalculating how much medication I had left it became a whole lot more difficult! As I have established a fairly good understanding with my doctor on how I prefer to treat my depression they are happy for me to have a few months supply of my anti-depressants at a time. This will vary with every patient experiencing depression as it can be risky to leave longer periods in between appointments with your GP depending upon the severity of your depression at various times. When I was feeling particularly bad I had to see my GP every two weeks to check in, but now they and I don't feel as if I'm a risk to my own safety, there is a bit more flexibility with how frequently I have check up appointments.

I'm usually pretty good at keeping an eye on how much medication I have left and ensuring I can either go in for a chat or put in a request for a repeat prescription if supplies are getting low. Unfortunately sometimes life gets in the way and my already confused mind gets turned upside down with things like big events and trips away. When my mind is preoccupied with other concerns things can slip and I end up in a sticky situation! As a result of this I ended up being on about half of the dose of anti-depressants I normally take. Not good. Obviously this can happen to the best of people with any type of medical condition that requires medication. However, you should never decrease your dose of anti-depressants on your own, and you certainly shouldn't quit cold turkey. Ceasing taking medication for depression unassisted can be very similar to quitting hardcore drugs alone, not that I've ever experienced this myself but from what I have experienced I know it's incredibly unpleasant. Even being on a lower dose of medication without being slowly weaned off can cause withdrawal symptoms and side effects.

I often experience what I refer to as 'brain zaps' when I've had a particularly low period and have slept late into the day meaning that I haven't taken my medication at the time I usually would. Even this small discrepancy in when I take medication can cause withdrawal effects. Brain zaps feel like an electric current running over the brain producing a fuzzy sensation, as if you're getting a static shock over and over again inside your skull. Not pleasant. This feeling will continue for a while after taking medication and can often last for an entire day. I can be walking around or sitting still and slightly move my eyes or turn my head and be hit with a wave of fuzzy feelings running over my brain and I'll hear a high pitched noise. If anyone has seen the Hunger Games film when Katniss has been stung by a Trackerjacker and it looks like she's trying to move but gets stuck in one movement and the noise that accompanies it, that's fairly similar to what I experience. Or think of the static noise on a radio when you flick to a frequency that isn't in tune, it puts you on edge and you want to get off that station as fast as possible. I'm stuck on that station for hours.

Other withdrawal side effects can include feeling like you have the flu, nausea and generally feeling very run down and tired. Of course feeling incredibly low accompanies all of this which can be very unsettling if you had previously been doing well. Even if you know that you'll be able to get your prescription in a few days, it can be of little comfort. You still have to go through all of this and those low feelings aren't easily forgotten even if you know they've most likely been induced by a lack of medication or a lower dose than usual.

It does scare me that I've become so dependent upon anti-depressants. It's concerning to know that even though I'm taking something to help me, it can cause harm. I know that some people are against taking medication for depression and prefer to seek alternative treatment. Much like how every experience of depression is different, an individual's treatment and recovery is unique too. I'll never take anti-depressants for the sake of it or use them as a crutch. If I do feel significantly better at some point I will talk to my doctor about decreasing the dose I'm taking. For now it provides a feeling of relief. Taking medication makes me feel like it is a real illness. It's all very well saying depression is a real illness with mental and physical effects, but the dark voices of depression can easily convince a person otherwise.