I was diagnosed with clinical depression, and due to the lack of motivation being a symptom of the condition, I tend to avoid social interactions. I feel little desire to engage people in conversation, but I know that this is an essential part of alleviating depressive symptoms because humans are social animals. I just got prescribed an SSRI (Lexapro) to take for 4 weeks. I’m also going to add some aerobic work after my strength training routine because of evidence pointing to a reduction in depressive symptoms. I am doing CBT and I have a meditation routine going as well. I think my sleep is good, but I wake up depressed, and I live in a cold, dark winter climate in the midwest right now.
What is your recommendation for how often I should be socializing (frequency and length)? How do I force myself to do it, and should I start small and work my way up? Any other recommendations for mental health?
I’m sorry you’re going through a tough time, but it sounds like you’re tackling many of the right things here.
We don’t have specific recommendations for socializing, and I think that these questions are best dealt with collaboratively with your psychotherapist and psychiatrist.
Hey cshadyp, even though this probably means nothing coming from a stranger on the other side of the country, I hope things start looking up for you soon. If you’re ever in the Orlando, Florida region and need a training buddy let me know and we can get a few lifts in
Hey, cshadyp, Austin’s right that you should talk about this with your therapist and psychiatrist, but I just wanted to share a couple things that worked for me when I went through a bad bout of depression a few years back. Hopefully, you’ve got some people in your life that you can be fairly open with about the fact that you’re having mental health struggles. It was a lot easier for me to socialize with people to whom I could say, “Hey, my mental health is crap right now and if I seem weird or low energy, it’s not you, it’s me.” The other thing that helped was to pick social activities that were low key and low stress for me, like going for a walk (difficult in the crappy weather, I know) or going to see a movie and then getting a cup of coffee and talking about it for a bit. Something that allows you to be companionable, but doesn’t necessarily require you to be “on” socially and gives you other topics of conversation than what’s going on in your head.
CBT and Lexapro worked wonders for me, and I hope they work equally well for you!
The Lexapro worked for me from day 2. Day 1 was the only day where it felt uncomfortable, but now it’s working very well for me. Why did it work almost immediately when people often say that SSRIs take from 2-4 weeks to work?
The side effects are only a few things - trouble falling asleep and reduced sexual pleasure. I wonder why the sexual anhedonia is a thing on SSRIs. Shouldn’t a lack of depression increase pleasure?
I don’t want to take SSRIs for long, so I’m creating new habits and coping strategies. Do SSRIs change the levels of serotonin in the brain after discontinuation?
The Mayo Clinic website has resources on this matter. However, unless you are trained in medicine/pharmacology, it would be quite difficult to interpret the primary literature on this matter. I would first recommend discussing any concerns with your psychiatrist.
With SSRIs, we sometimes do see a very rapid response. Part of this is likely placebo, or more specifically, a benefit from the relief you might feel from finally taking some positive action to get relief from your depression. Most people don’t feel much for 1-2 weeks, so we tell everyone to expect that so that patients don’t give up on the medicine prematurely. For FULL effect, we would tend to expect 6-8 weeks. So getting a benefit on day 2 is unusual, but fortunate. And you should expect continued benefit, perhaps even beyond what you are noticing already.
Sexual side effects are common with SSRIs. You are correct that depression also reduces libido, so some people have increased sex drive with SSRIs, but many patients report reduced interest or reduced physical sexual response. This side effect does tend to fade away after months. If the medication is overall helpful for your quality of life, and the sexual side effects remain bothersome, talk with your doctor about dose adjustments, med change, or augmentation with another med.
there is no evidence of long-term changes to serotonin “level” after taking SSRIs ( strictly speaking, they don’t really change the amount or level of serotonin, but moreso change how it is distributed in the brain). If your depression and anxiety are in remission after a while on an SSRI, you may decide to see if you still need it. It’s important to talk this over with your doctor, and to gradually taper off the med rather than stopping abruptly, if you do decide to come off the med.
congratulations on getting into treatment. For most of us, it’s harder to talk ourselves into getting help for mental health issues than for other kinds of health issues. You’ve taken an important step forward and deserve credit for doing so. And keep training! That helps a lot too, and may even have an equivalent effect size to the meds and psychotherapy. Combine all three and you’ll likely be amazed at the changes you experience in months and years to come.
