Some people may think that the side effects of antidepressants can be pretty innocuous as they are commonly prescribed, but for me, the side effects can be rough.
Earlier this year I wrote about the impacts of taking anti-psychotics and mood stabilizers, so now I’m going to write about the third type of medication I take: antidepressants. I’ve been taking antidepressants on and off for six years, since I was twenty and I’ve been on a lot of different classes of antidepressants over that time. This is because for people with bipolar disorder, finding the right antidepressant that doesn’t make your mood worse can be difficult. Still, at times I’m sure I would be quite unwell with depression if I didn’t take them.
When starting any class of antidepressant I experience incredible nausea and vomiting for weeks, which in the long run isn’t a big deal but I dread having to change antidepressants for this reason. When I was getting used to one of my current antidepressants I had to take time off work and study, and I lost quite a bit of weight due to the persistent nausea.
#2 Temperature regulation
For years I have been trying to figure out which medication my poor temperature regulation is attributed to. After some hunting around I have pinned it down to antidepressants. I take lesser used antidepressants because that’s what I can tolerate but unfortunately they cause sweating. And this is really annoying. I can start sweating out of nowhere without a trigger from external temperature (for the record I am 26 so this isn’t due to menopause). Not only is this annoying in the sense that it’s physically uncomfortable – particularly as when I cool down I get really cold – but it’s also embarrassing.
…for people with bipolar disorder, finding the right antidepressant that doesn’t make your mood worse can be difficult.
#3 The time antidepressants take to work
Antidepressants can take up to four-to-six weeks to work and when you’re suicidal you don’t have four-to-six weeks. (Further, when you’re suicidal four-to-six weeks feel like four-to-six years). In the early days antidepressants felt like a beacon of light when I was severely depressed, but I always felt defeated when after weeks of taking them I still felt depressed. I take one antidepressant for maintenance and another when I experience depression. Now, being aware of the length of time antidepressants take to work and knowing my moods and their patterns, I know when to start taking my second antidepressant before my mood becomes really low. This helps fight off severe depression.
#4 Coming off antidepressants
Ceasing antidepressants can be terrible and people should taper off them rather than immediately cease them. During one hospitalization I had to come off an antidepressant very suddenly as it induced a mixed state (discussed below) as it was dangerous. This rapid cessation of the antidepressant (which had to occur in a matter of days) made me very physically sick. I had blurred vision, I couldn’t walk straight – my parents had to hold me when I walked, I was vomiting, experienced abdominal cramps, headaches, excessive sweating and hot and cold flushes. It was horrible and I never want to experience that again.
#5 Antidepressants can induce mania and/or mixed states
For people with bipolar disorder, this is probably the most dangerous adverse effect of antidepressants. The reason I have trialed so many antidepressants is because most make me manic or put me in a mixed state. Right before I was diagnosed with bipolar I was put on an antidepressant that did nothing for my depressed mood but instead made me irritable, impulsive, agitated, gave me racing thoughts and restless energy and stopped me from sleeping. I didn’t know it at the time but I was experiencing my first mixed state and ended up hospitalized. A year later during a very severe depressive episode for which I was again hospitalized for, I was put on another antidepressant which made me manic. I started it on the Friday and on the Monday I was sitting in the psychiatrist’s office babbling about my plans to quit my job and sell my piano to travel around the world busking with my cello. And they’re just two examples. It is for this reason that I am incredibly weary about having to swap and try new antidepressants because I haven’t had a good track record with antidepressants inducing mania.
However, all things considered, like with the antipsychotics and mood stabilizers I also take, antidepressants help me function. I have been on the right combination for nearly two years and I’m happy to say that I haven’t been hospitalized for depression during that time, or even have had to take time off work. And for that reason, I continue to take them – for now, anyway.
Sally lives in Victoria, Australia. She was diagnosed with bipolar disorder two years ago when she was 22, however she has been dealing with extreme moods since she was 14. When she experienced her first episode of depression, she was too embarrassed to get help even though she knew that something was wrong. Throughout high school she battled depression after depression, each one getting worse. At university she continued to have depressive episodes and when she wasn’t depressed she was extremely happy, incredibly driven and unusually energetic. Everyone thought this was her normal mood, herself included and so the elevated times went unnoticed.
The turning point was in her final year of university when she was referred to the university counsellor. She was diagnosed with depression but after many failed treatments she saw a psychiatrist who diagnosed her with type II bipolar disorder. However that quickly turned into a diagnosis of type I bipolar disorder after a psychotic manic episode.
She is currently completing her honours degree in nursing and works as a nurse in the emergency department. She blogs for The International Bipolar Foundation and has written for several publications. She also volunteers for a mental health organization where she delivers presentations about mood disorders to high school students. Although relatively new to this world, she is passionate about mental health promotion and thoroughly enjoys writing about mental health.
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