How Long Should You take an SSRI?

Or this guy, Randy, whom I will be dating, I think (a very nice guy, clearly). The job is a little boring at times but, he says, the job security is such that he has to commit a criminal act to be fired by the company. A very secure company, not a start-up. Published a good technical book 10 years ago that still sells. Polyamorous by conviction and has great friendship relationships with all ex romantic partners, so no drama or crisis that most other people experience on a daily basis. Has a hobby and regularly invites members of his hobby club to his apartment for meetings, so, socialization. Goes out, so, more socialization. Does not happen to have a lot of sex life right now, but at least something and on a regular basis, so, check mark. Good income, another check mark. Loves what he is doing with computers. Watches a lot of movies, so, has some interests outside work and hobbies. So what is the problem? Nothing situational. But, reports depression for which he has finally found an effective medication after trying several bad ones. He does not have exogenous problems - it is just an endogenous illness.

from the posts... the husband didn't seem all that great. DIdn't she complain about him quite a few times?

I have to trust you on the other two.

actually.... that sure would effect person's psyche, especially when she interacts with them, is really into it. There is something like secondary trauma.
(of course solution is NOT to drop what the person is doing... but rather be aware and learn to protect themselves...
i speak from experience, spending days reading on real life bad stuff can mess up person's mind... that's why so few actually get involved).

and as for randy... how long did you know him? Maybe **** will come up. I know with most people who defended "broken brain, chemical imbalance" often do indeed have traumas little or big ones in their life.

tnlibrarian complained that H was saying that if she does not harass and abuse him and have rages against him, then she is not bp and needs to suck it up. That does not portray him as a bad person but rather a very uninformed one - he must have read, very briefly, a little blurb about the disease, the rages and mistreatment of spouses caught his eye, he disregarded the other 99%, and reacted to what he thought was relevant. In turn, she did not like that. But it was not his abusing her or mistreating her or anything like that. Just, suboptimal response to the illness in the spouse.

Randy - yes, we will see. But then everyone can be said to have issues...

The was a thread on relationships and communications here. A guy is married and the wife had what is called "an emotional affair" and ended it. I do not know what an emotional affair is, but whatever, she ended it. She is the guy's best friend. She talks to him about their vacation together. She does not turn his children against him. She does not abuse him or anything. She does not gamble his money. She just is unsure that she is actively in love with him and when she is sick and he gives her crackers and ginger ale, she does not show visible, positive signs of appreciation. And that is the extent of it. And she goes into therapy with him, and does not raise the issue of divorce at all. Just an emotional affair in the past and lack of visible appreciation of his efforts in the present. No other bad deeds on her part. He is seriously sad. Well, in that case, his underlying biological depression, which preceded the emotional affair, in other words, which started under the circumstances that were EVEN BETTER than the current circumstances, affects how he reacts to the stressors which I would call minor. And when it is being pointed out to him - look, in the best case scenario, the marriage survives, in the worst case scenario, it does not, but you would split up amicably without animosity as civilized people and co-parent happily for the rest of your lives, what is so bad about it?? - he agrees, that yes, his situation is not so bad compared to what it could have been. But he has something underlying or else he would have been more upbeat. He needs something, I am not sure what, or a combination of things, may be CBT to reframe catastrophic thinking and mindfulness to learn to appreciate the moment at least a bit. A lot of guys would be ecstatic to have a wife who plans vacations together with them.

The friend who participates in the defense of tortured people - my point was that she has a very tolerant husband. She, at one point, caught a rat. By accident. What did she do with the rat? She cooked it... and ate it. She used the skills she learned in her Stone Age workshops. And the husband, who is the exact opposite and never camps and enjoys the vacations with all the luxuries the modern world has to offer, was not disgusted. He did not eat the rat, but he was, like, whatever. She wants to do social causes such as with tortured people - fine. She has not done anything for money for years and years, despite being a Harvard Law School graduate. She did want the stress and hours connected with the legal career. He has always been fine with everything.

So if you imagine the spectrum of husbands from the most abusive on the left to the most tolerant on the right, her husband would be on the very, very far right - off the spectrum, in fact. Some of the common friends wonder how he is SO tolerant. Because, you know, the incident with the rat is unusual, to say the least.

So her situation is enviable. A lot of people would give a lot to be in her shoes.

But she has depression and her mother is schizophrenic. No abuse in her family of origin either, her father is very sweet and caring and took early retirement to care for his wife, so peace and quiet. But - mental illness.

I am not saying relationships are the ONLY factor. Your friend seems one of the intelligent people who kinda drive themselves crazy. Maybe depression comes with high IQ. I have not met person with high iQ without issues.

But was just opposing the whole "depression destroys your brain and ADs protect it" claim. Especially since this "illness" is very hard to define.

I could come up with claims of past life, hypersensitivity, psychiness... but that's kinda far off in drug forum, heh.

Yeah, past life would be far off.

Well you cannot graduate from Harvard Law School without a high IQ - the test used to get into law schools correlates with IQ, so no way out of it.

I think more people believe in past lives though than in "chemical imbalances". I do have my own sets of how past existences influence us. and many found exploration in that domain helpful.



let's not OT this though.

yes, that would be very tangential.

I guess that I should have placed a much heavier disclaimer on my post aside from "I believe..."

Now I believe that it is very factual that mental illness has deleterious effects on the brain. This is what I meant by 'researching the facts.'

The question of whether ADs are good, bad, better, or worse in this situation is no where near a solid answer or even a tenuous one.

My last comment about the AD not working was kind of a shrug: If OP's med is not working for mood than there's not much reason to think it could be working for a hypothesized 'neuro-protecting' factor. So even if there's a potential long term benefit, I don't see how OP can experience possible benefit if the med isn't keeping the illness at bay in the first place.

But otherwise, long term AD use to prevent relapse seems is how Psychiatrists prescribe them.

You are misinformed. They can and do "poop out."

Google it.

Re: meds "pooping out". Not all depression is due to low serotonin. If you're taking an SSRI and it works for a while, then "poops out", it's likely that you are having depressive symptoms due to a different chemical issue than serotonin. For example, low norepinephrine or low dopamine. It's not so much that the med poops out, but rather that it no longer is the appropriate one to use.

If your AD quits working it is time to get force ful with doc about an other AD, as they do quit working. Four years and my zoloft just quit 3 months ago and I end up back in the hospital. Finally got forceful as they just wanted to up the zoloft, I was already taking 200mg and add Welburin 150 xl That made me go pcyhco. I am now on prestiq (it is liver frendly) and I am back to my fat happy self, praise the Lord. I have also started losing weight since going on Prestiq and I am even getting some sex drive again. Not bad for being almost 60, the Zoloft had pretty much wipe it out. Be Kind To Yourself and God Bless. Garry J
I think treating mental illness is a crap shoot and some times takes awhile to win.

yeah, but what do u take if you have low dopamine

?? Sounds complicated...

Back to the original question................. How long should you take an SSRI? You take it for as long as you need to. Maybe months, maybe years. Does a diabetic stop taking insulin? No because they need it. Same to for depression. You go by what your body is telling you. No two people are the same. That's why there are so may meds around and some many dosages.

When and if thing change you deal with it at that point. Always something new on the market. SNRI's are also an option. Ask the person who is prescribing things for you and dont stay on a medication if it makes you feel unwell.

I have been on some kind of mental illness meds for 28 years. I stopped for two years and crashed and burned. The side affects they talk about are after taking them long term. Dry mouth may affect affect your teeth and eyes. So always keep your water up and have chewing gum to stimulate your saliva glands.

Take them forever if they work , why stop and get sick an maybe never find another med that works. I see chemical imbalance in a simple way, like 2 rivers running through your brain at the same speed , when something goes wrong like depression 1 river runs slower than the other throwing of the balance, SO you take AD,s and that speeds it up till they both run the same again, With BIPOLAR 1 river runs fast (mania,) the other( slow) for depression, in bad cases both rivers keep changing speed from mania to depression, so mood stabiliser,s are bought in has a back up the get the rivers flowing the same speed. This is the way I make it simple to understand in none medical jargon, weird I no but works for me. depression has 1 river to sort out , bipolar has 2. PS don't swim the rapid,s

Well for me I shouldn't be on them at all because they either don't work, or don't work and increase my anxiety and they seem to increase the slight bit of paranoia I normally have to ridiculous levels so then I think everyone is against me no matter what they say or do...people don't really appreciate that.

As for meds in general yeah I might need something for life, not that I feel its going to totally prevent relapses into suicidal depression but at least to help manage the anxiety and maybe keep my mood more even instead of going from ok to horrible every other day, or feeling horrible for days at a time.

I personally think cannabis is a great medication, but I am trying to give the pharmacuticals a try so I can get the help I need...cannabis probably doesn't help with trying to get on SSI since then they could say thats what causes my problems. So basically I am trying to give that a break with the help of meds...since I need something to help. Hopefully the new meds I am on help so I can give up smoking cannabis for a while, seems like something I have to do...but to be honest I doubt I'd want to give it up forever.

I've heard that diabetic analogy before... i'm just not sure if i totally agree it. I don't know if its that simple with psych. problems.. The brain isnt totally understood

True infinitesadness........people that have diabetes dont always stay at they same level. Sometimes their diabetes can get better and therefore they dont need insulin anymore or sometimes it gets worse and meds needs to be changed accordingly.

Same for mental illness it can be all over they place and meds also need decreased or increased as needs determine. That's why its always important to listen to your body/emotions in determining needs in accordance with a professional.

All illnesses can get complicated or go the other way. I guess the medical community has more understanding of the body than the mind.

I guess there's no real answer...

There actually is an answer. Unfortunately that answer is: it’s different for everyone. We are all unique flowers under the sun. Some people only have occasional depression and can go off them for a few years until they have another depressive episode some people need them all the time. Also different Meds works for different People.

If one med worked exactly the same for everyone we’d all be as happy as clams

Please remember the meds are supposed to be replacing what your deficient in already. Different meds do that in different ways. So as your brain chemistry changes, which it does when were happy, sad, under stress, changes in environment, even what we eat, how much we drink.....so med requirements change.

They're used to keep us on going. That's a broad term for alive with some quality of life.

Your concern re brain dumbing down, honest, it happens, no doubt about it. I've lost so much memory and motor skills due to meds. But I'd be dead without them. Its a trade off. Those of us are on meds because we didn't cope without them. The side effects, unfortunately not a lot you can do about it other than taking the least possible amount you can function on. Talk to your Pdoc about that and with regular reviews you can find hopefully the optimum dose for you .

On year 14 on the same SSRI. It agreed with me and did not turn on me. All is well. I was on another prior to that for 3 years but at the end it numbed me too much, this one is a better choice for my personal brain chemistry, it lets me have my emotions but helps with the really nasty stuff. Not cured though, but helped a great deal.

All of my meds I’ve been on for 4-11 years.

Which ones to the last 2 posters?