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If Citalopram makes me feel better, why do I not want to take it?

Citalopram

I had my annual medical check-up last week. In between being hooked up to an ECG machine, being poked and prodded, and parting with a worrying number of vials of blood (I bet half of these will probably be sold on the black market in Bulgaria), I had a little chat with the doctor about anti anxiety/depression medication.

I figured we had to talk about something. And the weather is such an over-talked-about subject. And my gown had one half of the belt missing so I was pretty much naked the whole time and thought maybe ‘scientific’ talk would distract her me.

The thing that’s bothering me about SSRIs (selective serotonin reuptake inhibitors) is this – doctors prescribe them just based on somebody describing their conditions.

(SSRIs, by the way, work by blocking the reuptake (reabsorption) of serotonin in the brain, thus making more available).

How do the doctors know though that you don’t have enough serotonin mingling around in your system? They don’t usually do a blood test to check. You just tell the doc how you’re feeling and you walk home with medication.

Often that medication works. When it doesn’t, the doctor will prescribe something else that’s similar but a little bit different. It’s always a trial and error kind of a process.

I think most other long-term medications are not prescribed just based on the patients’ description of their symptoms. I think most other long-term medications are for things that are tested by either analysing one or many bodily fluids, or getting some body parts scanned in various ways.

The GP on that day said that doctors simply don’t understand psychological issues enough yet – hence the trial and error method of treating mental health conditions.

Doctors have figured out how to transplant hearts and lungs and faces, they’ve figured out how to make babies in the lab, but they don’t know for sure why people are getting panic attacks or why, without any traumatic or unsettling life event, they feel like life’s not worth living.

Of course the good thing is that with trial and error, and in combination with therapy, most of the time if you seek help for a mental health issue, you will eventually find something that works for you and makes you feel better.

The bad thing is that sometimes it takes years to find the right combination of meds and therapy for you…

And I still struggle with the lack of science in this.

I personally want ‘proof’ that there’s something wrong with me. Otherwise I’ll always be reluctant to take the medication even though it does work for me.

I keep thinking that if nobody knows or can prove with some medical test that they’re something wrong with me then maybe there isn’t? Maybe I’m just making it up? Maybe I’m just lazy? Maybe I’m just a weak human being? Maybe it’s just a big character flaw I have and I need to just become a better person?

My therapist recently congratulated me on having learned how to stop my panic thoughts before they spiral totally out of control. She said next step was to learn how to stop my brain from ever even going there. She never told me how though, and I could not figure it out…

Eventually I got tired of being afraid of everything from my kids dying to terrorist attacks to plane crashes to cancer to global warming and I started taking Citalopram again after 6 months not taking it.

And a month later my thoughts are not about one catastrophe after another.

I no longer live in constant fear and vigilance and hyper-awareness of everything that could go wrong. I’m able to spend time with my kids without looking at them and thinking Oh my God what am I going to do if they die or Oh my God what are they going to do if I die.

We just laugh and argue and talk and I’m in the moment.

So the meds work for me, they bring my thoughts back to the present and they let me live without constant fear of something bad happening BUT it still bothers me that matters of the brain do not have a clear proof-based medical diagnosis.

The little niggling voice in the back of my mind STILL says sometimes “What if I’m just a “bad/weak” person and these “happy pills” are just making me a hit “high” and mask who I really am?”

I will try to ignore that niggly voice. But it would be nice to part with some more vials of blood and get ‘proof’ that yes, there is a problem with serotonin in my body.

Without proof, a mental health condition can feel like a character flaw, instead of a true medical issue.

I know it’s not. Yet…

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