I'm going to share my experiences taking Citalopram (branded as Celexa in other countries), a class of anti-depressant known as an SSRI. Overall my experience has been very positive and I wanted to add my voice to the discussion online, which sometimes focuses disproportionately on the negatives.
Recently we've had the recent tragic news of Caroline Flack's death and every so often a story comes up about workplace bullying and the catastrophic effects that come with it. We can be fragile, and mental health is important.
I was originally prescribed Citalopram in early 2019, but I didn't start taking it until August.
I was having issues with anxiety and depression, caused largely by workplace bullying, which had been ongoing for around six months by this stage. Unfortunately, my now ex-employer was not competent in resolving this. A number of my ex-colleagues had commented separately that they felt my boss was autistic and lacked interpersonal skills, and he appeared to struggle to understand that it was his responsibility to provide a psychologically safe workplace. Furthermore, the HR manager he eventually put in charge of the situation was more interested in going out for lunch dates with the other party (i.e. the bully) than in speaking to me, which made it hard to take seriously her claims that she was "impartial". Her actions were inexplicable: She scheduled meetings with me and then failed to attend them and undertook other decisions that affected me without informing me.
Bizarrely, the HR manager's actions alone gave me a case for constructive dismissal. We reached the point where sufficiently advanced incompetence becomes indistinguishable from malice. The actions of my employer injected huge amounts of stress into an already stressful situation, and it became far too much for me.
At one point I came pretty close to killing myself. There was a point in my life where I genuinely did not expect to be alive 24 hours later. I still remember distinctly the absolute serenity I experienced when I reached that point. All the stress, the fear, the nausea, the constant fighting... it all just gave way to perfect calm. If I'd had the opportunity there and then, I don't think I'd still be here today.
I ended up spending around £1000 in counselling. I wanted to leave the job, but my mental health was dreadful and looking for other jobs seemed intimidating. Interviews are stressful and I didn't feel like I had the mental resources to deal with additional stress. In retrospect, this was really stupid and dangerous. The workplace was unsafe for me and I should have just quit.
I was very, very reluctant to start taking anti-depressants because the list of side effects seemed scary. I ended up back at my GP in August because I had experienced some unintentional weight loss and a gastroenterology consultant had recommended I be referred to a dietitian. My GP obliged, but she gave me quite a stern lecture saying that, yes, it's worth seeing a dietitian, but she felt it was far more likely that stress was the cause of my physical health problems, and we should be treating that primarily.
I decided to take the plunge on anti-depressants with the promise to myself that if they helped, I'd use my improved mental health to secure a better job.
The side effects I experienced were short lived and minimal. I was prescribed 20mg Citalopram, but the GP had recommended I start on 10mg as I was concerned about side effects. The side effects I had were: Some stomach upset and nausea for the first few days, and a slightly dry mouth. Nothing major, and the upset stomach and nausea was something I was getting regularly just from stress anyway. After a few days this settled and on day 6 I went up to 20mg. I alternated between 10mg and 20mg for a few days to ease the transition, and have stuck to 20mg ever since. Moving up to 20mg gave another day of slight nausea, but it was really nothing much.
Improvements to my mood were gradual, but over a period of about four weeks or so, I started feeling slightly calmer and more self confident. It was a subtle effect in many ways - I still experienced stress, but I became less intimidated by the prospect of interviewing and making a big step into the unknown. Day to day work became much more manageable and I found less of my mental energy was being sapped by the silly politics I was experiencing there.
I'm glad to say that it didn't make me more tolerant of my employer or more content with what was essentially an abusive relationship. It had the opposite effect - as I became more confident in myself, I became more secure in my view that I deserved better, and more able and motivated to pursue a better employer.
One of the things I'd read about anti-depressants is that they don't fundamentally change you - they just make you feel like yourself again. This is something I strongly relate to - I started to feel like myself again.
In September I began to send out a few applications to other employers and in October I attended three interviews. The process of interviewing was still stressful and anxiety inducing, but the difference is that I knew it would be and I did it anyway. In the interview for the offer I ended up accepting, something had clicked between the interviewer and myself and the anxiety manifested as more of a nervous excitement rather than an overwhelmingly negative and uncomfortable emotion.
I ended up handing in my notice in October, having secured a much better compensation package at a more professional company.
(In parallel to interviewing elsewhere, I also started a salary negotiation with my boss, as I was embarrassingly underpaid by market standards. Although unsurprisingly he did not respond to it with much in the way of professional competence and still hadn't come back to me by the time I had secured a market rate salary elsewhere, the fact I felt confident enough to lay down an ultimatum marked a significant resurgence in my mental health.)
It's now March 2020 - around six months since I began taking Citalopram - and I'm still taking 20mg Citalopram. My GP advised me not to try coming off it while starting a new job, which sounded reasonable, so I didn't. But things are going well and I'm feeling quite settled at my new job and I'm unsure that I still need to be taking the tablets. The GP has floated "the summer" as being the time to think about coming off them, as they want me to have been feeling better for some time before withdrawing to reduce the risk of relapse. Currently, I feel they probably are no longer necessary for me - having addressed the issues in my life that caused me problems initially - and I could withdraw sooner, but on the other hand there's no urgent reason to, so I'm happy to let the doctors make the decisions at the moment.
I feel that the anti-depressants helped me immensely in getting out of a bad situation and into a better one. I feel that they helped me to find the motivation to make changes to my life to safeguard my mental health. My only regret over them is that I didn't begin taking them back when I was originally prescribed them.
I also feel that Citalopram probably helped me settle in to my new job. Supposedly, starting a new job is stressful. In reality, it was the opposite - starting a new job was less stressful than staying in my previous one. I imagine the anti-depressants helped take the edge off that and helped me to focus more on it as being an exciting opportunity rather than a scary step into the unknown.
People outside of work have commented how much happier I seem. My mother was upset by the idea of me taking anti-depressants initially, but in her opinion I'm a different person than I was six months ago and she's very glad with the outcome.
Some people say that SSRIs cause weight gain. I have gained weight - I've gained 4kg. But it's hard to say that this is a problem. As previously mentioned, I had significant weight loss due to stress, and now that I'm happier, it makes sense to be putting weight back on. My BMI is still at the lower end of healthy.
I'm an avid runner and I had concerns that Citalopram might affect my performance by making me sluggish or tired. It didn't. I actually set 5k, 10k and half marathon personal bests within a few months of starting to take Citalopram - I suspect it indirectly helped my performance by improving my health in general!
I was scared to start taking anti-depressants because of the potential side effects. In reality, they were minimal and short lived. But, in the end, Citalopram helped me to make important changes to my life to improve my mental health, and I can say with total certainty that it was the right decision for me.