I am really struggling with my mental health at the moment. I am having a bad time with trying to look after my 96 year old mum who has become aggressive towards me and an only brother who has had a stroke and got Parkinson's (they live together). Mum is in hospital at the moment and this has tipped me over the edge and I can't control my anxiety and getting angry with everything and everyone.My GP wants me to take an antidepressant but because of the Sotalol and apixaban is cautious because of the interactions. He says he has given me the safest for use with Sotalol which is Duloxetine but reading the literature it increases risk of bleeds if taken with anticoagulants. As my dad died of a brain bleed aged 60 while taking warfarin I am scared to go down this route.
Do any of you take any antidepressants, or have done, if so what were they?
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Karendeena
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HiNo experience with antidepressants but it struck me that you could do with more support in the care you are giving mum and brother, this seems to be the primary cause of the depression to me.
Could your GP help guide you in this? Or social services?
Thank you. I have tried everything, social services, GPs, occupational therapists, you name it I've tried, no one will help me, they all say mum has capacity! While she is in hospital they are going to do a mental capacity assessment before they release her so hopefully we may get somewhere, it is so traumatic and I am so tired doing a 60 plus mile round trip every day to go to the hospital. It's a wonder afib hasn't risen its ugly head again following my ablation in March. I am so stressed by it all.They won't give my brother any help either until he goes to his own house (which he won't) as it's a different postcode area
Your reaction to what you are going through is not mental illness. It is normal. What you need is support not a chemical sticking plaster which a) might react badly with your current medication b) might not work at all - antidepressants do not work for everybody and as Steve found can make some people actually feel worse.At the risk of being howled down I will suggest that also what you need is a "selfish" pill. Or rather a "put self first in self preservation" pill. Stop making the round trip to the hospital every day. From what you say about your mother's aggresiveness towards you , you need to cut down interaction with her to reduce your anxiety. Start to think about what you need in order to preserve your wellbeing. Family dynamics can be very destructive.
I am always wary of drug interactions as the last thing you need is your cardiac issues to flare and add to your already heavy responsibilities. I discussed anxiety meds with my lovely GP some time ago and she said my issues were situational anxiety and what was needed was some solutions to the situation not meds. She was absolutely correct in my case.
Is there any help you could get with your family, I know its not easy but you cant run yourself into the ground, that serves no one well and adds the risk of further health concerns of your own to your already heavy load. Getting social services help is a nightmare but could the hospital give advice for continued care for your mum post discharge. Surely there must be some level of support out there.
Use what little energy reserves you can muster to untangle the reliance on you as if you go down the family does too and thats too much to carry. Sorry cant help on the meds front has to be your choice. Risk v rewards. Best wishes.
I am just coming off duloxetine. I would avoid it because my GP really dislikes it he considered is it a bad anti-depressant for a number of reasons and trying to stop at once you are on it is horrible for the majority of people. I have been on it for quite a while about five years, I never had side effects actually it also helps chronic pain so that was a good thing at the time. I have been able to tell if no longer doing its job. I had this happen once before with an anti-depressant and then I crashed badly. I actually landed in the hospital. I had such a meltdown.
To switch to anything else when you’ve been on it you have to get at least 50% of it out of your system. It took me 3+ months.
I had been suffering from severe fatigue to the point I could sleep around the clock other things as well, but that was probably the worst part I couldn’t get out of my own way. It doesn’t sound like something you’re gonna need considering what you’re already dealing with.
Well I just went back last week. It’s been the three months and he put me on the generic of Prozac believe it or not one that has been around for ages. of course your doctor has to figure out what it is. You need many of them work on serotonin evidently that was my area. I only started it Thursday of last week. You need to take it in the morning. I prefer things I can take at night. The first day wasn’t bad. It wasn’t good. I felt very wired like I had too much coffee and that night I did not sleep. The following day I took it again same time. I want to tell you how much better I felt. I had energy I have not had , and I can’t even tell you how long it’s been. I only was not fatigued and sleeping. I was able to do things and focus that was something else that had disappeared on everything. I have also had incontinence for the past two nights. I have slept through the night without needing to get up for that. Yes I slept like a normal person. Whatever it does to keep you going during the day where is down evidently so you can sleep.
please keep away from the other as a person who took it for five years and to have a Doctor Who is young and very knowledgeable be so against something there has to be something to it. oh another thing if you miss one or when you stop taking them FYI, he cut my dose in half. He did not stop being cold turkey. Well if you miss it, your body pain is so bad to even roll over in bed makes you want to cry.
When I started the new one, I had the option of taking the other until the new one kicked in, but I decided to try to go without it. I did not have a problem with that another perk. I think I’m feeling with this is I also seem to be having help with my body pain which is a whole other story nothing to do with a fib. I was hit by an 18 wheeler.
now they have meds for anxiety and for depression. I have both plus PTSD it sounds to me as though you are very overwhelmed. I can imagine what you are dealing with.
my depression has been so bad, especially the past couple of months for no apparent reason other than the other med just stopped working pretty much. I can’t tell you about brain bleed, etc. I do know Prozac has been around for ages. I was surprised when I found out the generic was actually that, there are a lot of choices. Watch herself though if you suddenly feel really bad, I don’t mean physically I mean mentally. They tried one on me that by the third day. It was a wonder. I was not in prison. I had such anger inside of me, I had someone that had really really done damage , including killing my five cats. I kept picturing her showing up at my door and I literally snapped her neck. You could look at me even my doctor said I was scaring him. I would talk with my hands balled up so don’t ignore feelings. call the doctor ASAP and say I can’t take this one.
you need something for your anxiety because of your heart my EP was the one who got on me about taking my med. It used to be as needed. Everything I was feeling and blaming on my heart and pacemaker, etc.. He said he was anxiety and that my take as needed med needs to be taken much more than I think I do. I have an incredible pacemaker and program on my phone plus I am monitored 24 seven nothing showed a problem with my heart. I was causing the problems with my stress and anxiety although I didn’t even know why I had it , PS you have plenty of reason. Please get help. Tell him to the one he’s pushing. m
Thank you, useful comments. Goodness you have really been in the wars. I hope your medical team are squarely on your side. We all need good people around us to help get us back on track. Sounds as though you have really been through the mill and I so hope you get back to your best self asap. Take care.
Mum has been assessed with a mental capacity assessment at the hospital, they say she has capacity to make her own decisions even though they may not be wise ones!! She has been discharged and won't accept any help or care package so I am back to square one. She has started the screaming, shouting and nanr calling again today. I know she is dreadfully unhappy too.
Oh dear this all sounds dreadful both for her and you. Have they any suggestions at all to help you or are they leaving it to you alone to deal with. Surely there is some help somewhere for you. I assume you have tried social care services. You cant go on like this thats for sure. So sorry you are having all this, your mum too, its so unfair.
caringtogether.org. Tel: 0345 241 0954. I don’t know what area you live, or what area they cover, but they may be able to help you, or direct you, It’s free. You need support for the situation you are in, not more pills.
You sound like a very caring person and you are obviously doing the best you can to look after your mum and brother.
If you weren't there, what would they do?
That is the question my mother's doctor asked me when I was caring for her and my dad, and I couldn't answer him, but I was becoming ill myself because of the stress and the relentless physical work. My parents expected me to do it, if I was a son it would have been different.
I wouldn't have walked away of course, but he made me realise that if I became too ill to carry on they would really be stuck. Sometimes you are so wrapped up in it that you need someone to tell you about the bigger picture.
My mother was the one who was seriously ill and she didn't want to go into a home, and the doctor gave me information to find help. My dad resisted it at first, but I said I couldn't go on and asked him what was going to happen if I wasn't there, and he reluctantly agreed to let me arrange carers. And once they had the carers they were happy about it, they looked forward to them coming.
I still looked after them both but it eased the pressure.
I don't know your personal circumstances, but any help is better than none and I would urge you to look into getting something in place.
Sounds like it would be helpful to you to "let it all hang out" so to speak. Maybe you've been down the talking therapies route before. Are there any carers support agencies in your area that could give you the opportunity to access more help for family members, and more importantly at this moment, you. The surgery may have contacts.When your Mum is due home, insist on a proper discharge planning meeting to which you should be invited. Explain she cannot come home without some formal care input, if that is what you would like and a tough conversation may be needed with her and your brother. It won't be easy but otherwise if you spiral as has already been said, life will be more complicated for you all.
I totally understand how you feel and what you are going through. My sister and I tried to look after my elderly Mum and Dad between us - my wife was still working and we lived a couple of hundred miles away. My sister lived close and is 10 years younger and was also working full time and helping to look after her own grandchildren before and after school - as you do for your children to help them. In the end all of us became ill. My wife had an elective surgery coming up and about 3 weeks before I got a bad infection and had to have an emergency operation at 3am one morning and my sister was hospitalised as well and nearly died. It was quite an exciting time and we can laugh about it now. This all happened in the October and in the December when my wife and I were both recovered enough to travel we went to visit my sister who was still in hospital and my wife looked at our reflections in the window and said we looked like 3 ghosts we were all so pale. My Dad was a gentle soul and even though he had dementia he was so sweet and nice but my Mum was agressive - she had Parkinson's and had lewy body dementia so was seeing and hearing things and then becoming so "wound up" we couldn't control her - there seemed to be nothing we could do to try and calm her down.
You really can't shoulder all the responsibility for looking after your Mum and Brother so get in touch with your local social services or Age Concern and get help. We left it far too late and My Mum and Dad had to go into a home whilst my sister and I recovered. A similar thing has just happened with my daughter-in-law's grand mother who is nearly 101. Her Mum aged 78 was looking after her full time having a holiday when her sister would come over from Spain where she lives for a few weeks 3 times a year to help out. 3 weeks ago my daughter-in-law's Mum collapsed and had to be hospitalised with a stomach bleed then an infection and has only just been released from hospital on antibiotics. Daughter-in-law and son both work full time so it has been really hard to get social services to pick up what they can't help with. What I am trying to explain is that if you take the full responsibility not only can it make you ill but it means that if anything happens to you - even something small that incapacitates you for a short time it is hard to get some form of care or the right form of care put in place at short notice. I therefore think it is better if some care is already in place even if it is only one visit a day to help in the morning or evening it takes the burden off you and it is generally easier to arrange more when it is needed. You really need to look after yourself and I do think that getting help so that you can have a break now and again - even for an hour or so a day and don't shoulder all the responsibility for looking after your Mum and Brother is the best help you can get.
I think you are at the stage when you need to ask for help and assistance is caring for your mother and brother, there are several organisations that can help but you need to ask for it first. Have a word with your GP surgeries for info, also Age Concern, your Local Council and also to make sure you claim attendance allowance etc., to give you some financial assistance in getting paid help. As for the Antidepressants, I took them for a short while after having a stroke, they will help you to cope with these issues and to hopefully move forwards, but please ask for help, you don't have to cope with this alone x
can you ask your cardiologist or EP? I spoke with the EP about my anxiety and he said it can worsen what cardiac stuff you already have. So we both agreed anti anxiety medication was worth a try. You have so much going on I really feel for you.
The EP went away and looked into what was the safest for me with my meds. He told me not to take anything until he’d looked into what was best for me. I’m on riveroxaban not warfarin. For me the safest is sertraline and I’ve kept this on the lowest treatment dose. Nothing can be 100% safe but the benefits can outweigh the issues otherwise caused.
The sertraline has helped me to manage stuff in my life and put the anxiety in a place that is more manageable Good luck I’m thinking of you
I take Bisoprolol and Lixiana (anti-coagulation med) together with Sertraline, as per my GP’s and cardiologist’s instructions. Have been doing this for 5 months now. Still alive & kicking.
Sorry to hear you are struggling Karendeena. I know from experience just how complicated situations like yours can be and how patchy the support can be. It is cheaper (in the short term) for the system to wait until we need antidepressants than provide support when we need it. If you need the antidepressants you shouldn’t feel a failure for taking them, but you have a right to a second medical opinion and this might be wise given your concerns. Meanwhile there are some good suggestions and leads above, I hope at the very least you find yourself a week or two respite.
My experience in the early 2000s of using SSRIs twice to help anxiety, despite promising myself after the first bad experience, "Never again!", along with trials of other anti-depressants is that I would never try any of them again.
That said, a friend is using mirtazapine ("Zispin") and finds it useful. It's a different kind of tablet, so maybe worth asking about. SSRI drugs work in around a third or so of people, maybe 40%, it seems, but only help somewhat.
My honest view is that SSRIs are not really a treatment for anxiety but have been sort-of co-opted into that role because of fears doctors have of prescribing the anti-anxiety medicines, the benzodiazepines. This family of drugs includes diazepam is the only true anxiolytics yet discovered, so far as I know (I am rather out of date on this). For use only when symptoms of stress and that "can't cope" feeling peak, I think they are useful and generally safe iid not used regularly.
Perhaps your GP will give diazepam a cautious trial? As well as that, I think, given your circumstances and genuine difficulties, for which you deserve a medal, a course of counselling or CBT ("talking therapy") would be very much better. Someone to talk to is the best way to help, without doubt. CBT itself has only around a 40% success rate but it still is safe and will help somewhat.
I agree with those who say you need help not medication. From my own experience with social services and this sounds quite cruel, if you completely refuse to help your mother, what would they do? My mother had heart failure but was looking after my gran who was living with us and had severe dementia.. Mum would manage 3 months but then would have to drive her 3 hours up to Newcastle to my uncle who could get her into respite care because his wife had MS but that would only last 3 weeks until mum had to bring her back. In the end she absolutely had to put her foot down and refuse to collect her and social services were forced to act. I had to do the same when my dad was dying. We were living with him but I also had a 2 year old child and I was getting no sleep at all. I managed to get night time care for him, a laundry service and carers for morning and bedtime. Dad didn't like it at first but once he got to know he carers he realised I couldn't carry on. Every meeting with soc services was a real battle b ut if you stick to your guns you can get help. Have a word with carers UK for advice.. Use yor heart condition as a reason for needing help rather than yoru mental health.
citalopram is the most effective and benign SSRI IMO based on personal experience 20 or so years ago. Ditto for a couple of friends. Just smooths out the peaks and troughs but with no obvious peripheral psychological downside. Sertraline did not agree with me at all - horrendous multilayered nightmares. Prozac didn’t ‘feel’ at all right either. So if I ever need 6 months or a year of an SSRI, citalopram it will definitely be. But as others say, SSRIs can exacerbate arrhythmia issues, but then again so can the anxiety itself and hard to know which is the lesser of the available evils heart-wise. I hope your present situation settles/alleviates one way or another soon.
Thank you. I was on citalopram for several years and it worked well for me but my EP wanted me off it. I couldn't take sertraline either, it made me feel so sick and slowed the production of urine! Were you taking any antiarrhythmics or anticoagulants at the time?
Hi again, no I wasn't on any AAs or Acs at that time - sorry I should have mentioned that. I guess your EP didn't want you on citalopram for a good reason.
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