Back From The Psychiatrist

And thus begins the new treatment regimen with Venlafaxine (Effexor), starting tomorrow.

Everything went well; I was a little nervous first and not particularly in the mood for dealing with a stranger, but the psychiatrist turned out nice. He asked: “What leads you here?” I told him that I was in therapy for chronic  depression for two years and generally was really satisfied with it, but couldn’t get a handle on some symptoms like concentration problems and energy, and wanted to see what medication could do for me in that regard. He knows my therapist and has a superficial idea of the CBASP programme I’m in, and I guess that was enough credit to not let me do all the lab tests and ECG again. I also gave him permission to send reports to my general physician.
I recounted a brief history of symptoms and the treatment I received so far: First depressive episode at 12, second at 16 (this time with suicidal ideation), since the age of 19 / 20 only oscillating between different stages of major depression; panic attacks at 30, treated with citalopram, then therapy; therapy major success, but then the start of a slow decline. The psychiatrist asked about living situation, family, family history of depression, school education, what I am studying. Whether I smoke, drink, ever did drugs, take any kinds of medications.
He performed some tests on my cognitive capacities, because I had complained about them:
– “Spell the word ‘radio’ backwards.”
– “What’s the difference between a river and a lake?”
– “What’s the difference between a ladder and stairs?”
He had me memorize the words “street, traffic lights, flower” and asked whether I remembered those in between other questions, and had me do a chain of mathematical exercises: 100 – 7, then subtracting 7 from the result again, and again, and again. I scored 100% and obviously am not demented.
Some questions on differential diagnoses: do I see or hear things nobody else sees or hears, do my thoughts race, do I think I am being watched or that people talk about me behind my back, etc.?
The most difficult question actually was, “How do you feel these days?” I honestly had to think about that, and answered, “On average days, I feel subdued. Pessimistic.” I told him about the insomnia, problems falling asleep and the stomach aches, that I like to withdraw from people, worry a lot and occasionally get anxiety attacks because of the worrying.

All of that took about half an hour, then he proposed that due to my previous experiences with SSRI in the form of citalopram, I should try out what an SNRI does for me. He explained that SNRI give most people more energy, explained possible side-effects and finally gave me a prescription for venlafaxine. Unless I experience really bad side-effects, I’ll see him again in four weeks.

Edited to add: Yikes, maybe I shouldn’t have googled venlafaxine / effexor, because the results sound pretty bad… “The antidepressant everyone loathes to have taken.” Sounds like I am in for a bumpy ride…


4 thoughts on “Back From The Psychiatrist

  1. From my experience with Effexor, you probably will have some side effects, but hopefully they will go away after a week or so. The effects I can remember include some light-headed sensation, odd auditory hallucinations, and being slightly manic at times, but of course everyone is different. Good luck with the new meds.

    1. Thanks for the comment – that doesn’t sound too bad. I decided that it’s better to not google and read 20,000 different accounts of what could possibly happen or not, but just take the side-effects as they come and see how I can deal with them.

  2. Mara

    Everyone is different. I had to tried a few meds before discovering that Effexor was the right one and it took some time to find the right dose. I think I did have some side effects to start, but they have long faded from memory. I do feel a little woozy if I miss a dose, but when I weigh that against life without Effexor, it is definitely worth it. Effexor has been nothing short of a life saver for me, but effectively treating my chronic depression did take some work of going back to my doctor explaining which symptoms were helped and which I was still worried about along the way. And therapy as well. There are options, and I hope you find a really good one for you!

    1. That sounds hopeful! I was in the process of replying to your comment this morning when the side effects hit me hard… but thank you for commenting, I hope it gets better soon!

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