Citalopram | My Side Effects

I woke up the other morning and sat thinking about the side effects, both good and bad, that I have experienced since September 2015 when I was started on Citalopram. I thought it would make an interesting blog post for those of you who have no idea what Citalopram is or be interesting and insightful for those of you with a close one on the medication or if you're on it yourself. 

So Citalopram is a Selective Serotonin Reuptake Inhibitor or SSRI and basically means it ensures there enough serotonin to flow around my brain to have a positive influence on moods and emotions. If I wasn't on Citalopram, my brain would absorb all the serotonin and there wouldn't be enough floating around to have a positive impact on my emotions. It is classified as an anti-depressant medication due to its chemical use within mental health conditions, but it is also used with panic disorders as the brain acts in a similar way. It is a prescription only medication so cannot be bought over the counter, and they are definitely not given out like sweets. Taking SSRIs can have a real positive effect on people whose brains lacks enough serotonin, but they are unsafe to be used for people who have no chemical imbalances in their brain. Despite them being a real life-saver for me, Citalopram in particular is a medication that is known for it's many side effects, many of which I have experienced. When I was first prescribed them, my doctor told me it was likely I would experience some side effects for the first 2-4 weeks while my body adjusts to the chemicals readjusting in my brain and this was certainly true.

I once counted the side effects listed on the information leaflet that came with my tablets and there were a grand total of 48 side effects. The list surprisingly included 'anxiety' and 'panic attacks' which blew my mind, but if you look at the information leaflet for paracetamol, it says it can cause headaches!! I did experience 3 weeks of worsened anxiety and panic attacks which was awful and did land me in A&E on one occasion but once I got over the initial 3-4 weeks, everything seemed to settle down. During these first few weeks, I also experienced loss of appetite, fatigue, headaches, dizziness, terrible nausea and lack of sleep, so as you can imagine it wasn't fun for me. I actually met up with friends at a local pub during the worst week for side effects and I can honestly say it was one of the worst experiences of my life, especially because only three of the 8 friends sat round the table knew I wasn't well. 

They all wore off after 4 weeks and I slowly started to notice the good effects of Citalopram. I was feeling positive, I didn't have the sinking feeling I was used to feeling every day and I started smiling and laughing a lot more. To this day, I still do often feel nauseous in the mornings and do get very bad headaches and these are because of my tablets, but its nothing I can't handle, and the benefits of my tablets outweigh the negatives. The main inspiration for this blog post was one of my more stranger remaining side effects which is vivid thoughts and dreams. This side effect has again been confirmed by my doctor to be medication related and it's something that makes me laugh sometimes. I experience vivid daydreams, so much so when I enter real life is it very difficut for me to believe what I was daydreaming about hadn't actually happened. Similarly, the dreams I have are dreams that are so real life and vivid that I honestly believe they've happened. I don't dream about being in a different country or people turning into animals, I dream about my Dad waking me up and making me come downstairs for breakfast, or a normal shift on the ward or going shopping and buying milk and gherkins. The other weird thing is that when I'm at home, my dreams are at home, when I'm at my uni flat, my dreams are at my uni flat or when i'm staying with Ben, my dreams will be located at his house. However funny this may sound, I also have real life and vivid nightmares, like a family member dying, which is obviously horrible and more upsetting after I wake up than if I dreamt about a lion chasing me across a field. 

Another side effect worth mentioning just as a finishing point is that if I take two tablets too close together, my mood can go one of two ways; I either get hyperactive, excitable and show the same effects as drinking 5 cans of Redbull, or my mood increases my anxiety and I feel very nervous, scared and worried. For this reason, I am very particular about when I take my tablets. This was just a small insight into the side effects of my medication but will write another post regarding Citalopram and its functions in more detail and my thoughts about it if this is something people would like to read? Remember all medication works differently with different people and all medications have their risks alongside their benefits.

Love  Luce xo

10 Things You Probably Didn't Know About Anxiety and Panic Disorder

Within the breaks of my dreaded dissertation work, I decided to do some research on unknown or surprising statistics and facts about my conditions. So here they are...

1. People between the ages of 35 and 59 are more likely to suffer from anxiety than any other age group in the UK. 

2. 4 in every 10 people that suffers with anxiety claim that work or education triggered  their condition.

3. Anxiety can affect balance. Studies have found that those who have problems with balance or find themselves swaying or having 'dizzy spells' usually correlate positively to suffering with anxiety. It has also been found that treating the balance problem helps the individuals anxiety! 

4. Unless there is an underlying heart problem, it is very very unlikely that a panic attack will lead to a heart attack. Even though the symptoms are very similar and those of you who have suffered from any form of panic attack will know you do feel like you are dying, the responses are purely caused by hormones being released into your blood stream, not a dysfunction in your heart. 

5. Anxiety is considered a genetic condition and can be passed down to children or grandchildren, however you can develop it without your relatives having suffered from it and you don't necessarily inherit it if your parents suffered with it. 

6. Your body suffers physiologically as well as psychologically from having anxiety. Aside from a panic attack where your body is literally attacked in all senses by itself, on a day to day basis, anxiety can leave a person tired, feeling sick or nauseous for no reason,with aching muscles from unconscious tensing, loss of appetite, ground down teeth, a permanently fast heart rate, random shaking or shivering and experiencing smells and tastes differently. (I personally suffer from all of these things and until reading up on it didn't put two and two together.)  

7. Despite there being many different forms of treatment for anxiety and panic disorder, nearly 2 out of 3 people who suffer actually seek  or accept treatment and help for it.

8. Medication is not the only way! Treatment such as meditation, exercise, eating healthily, cognitive behavioral therapy, counselling and psychotherapy are all non-pharmaceutical ways of helping people to cope with anxiety and panic disorder. Studies show that just 20 minutes of meditation can reduce anxiety by 40%. (I was personally told this fact by my own doctor. He explained that medication is the last option of treatment to be able to tackle the hormone imbalance head on, and strategies that don't involve medication are usually favoured.)

9. 5 in every 100 people suffer from anxiety as a mental health condition, and 10 in every 100 people suffer with mixed anxiety and depression. There are a lot more people that you think. 

10. 1 in 10 children aged 5-16 suffer from some form of treatable anxiety but this usually goes unrecognised and untreated due to their age, mental development and perceived influence of peer groups or 'phases'.  

Some of these facts really shocked me. Before I told people about my condition, I knew people suffered too but I didn't realise how many and I didn't realise how complex it really was. I've learnt a lot just by doing this research for myself and I hope these facts have helped you understand and learn a bit more too. 

Love Luce xo

Please Don't Tell Me To Stop Worrying.

I wanted to write a blog post discussing the not so good responses, thoughts, phrases and words I have personally heard being used with regard to my anxiety and panic disorder. Although the people saying these things may not be purposely trying to upset me, or make me feel worse, they do not help. Close family, friends, strangers and even nurses have used the phrases I want to discuss so I know how common it is to 'say the wrong thing' and I hope this post helps those of you who do have someone in your life suffering from something similar to my condition understand how some phrases don't always help and give you some ideas on how to approach the situation differently. 

"Well that's just silly/stupid/irrational" "It's all in your head"
9 times out of 10, I know. I know what runs through my head is irrational but right there and then it is something that I am struggling with, something that I have come to you about for help. Please don't disregard it as 'stupid' or 'silly' or tell me 'it's all in my head'. It makes me feel bad, annoying and like it's wrong of me to be the person I am being. I feel like i'm doing wrong by asking for help, and no one should ever be made to feel like that. 

"Have you taken your medication today" "When was the last time you saw your doctor?"
Yes. I take my medication as soon as I wake up, everyday, and I see my doctor on a regular basis for checkups. These phrases, when used out of context, makes me feel like the person on the receiving end of my thoughts and feelings believes that I need more help than I'm already being given (Side Note: when I say 'out of context' I mean if my Mum is genuinely curious as to when the last time I saw my doctor was, as I don't live at home so she wouldn't know that sort of thing, that's fair enough). It makes me feel like I am worse than I am and subsequently makes me question whether i'm not well or if my mental health has declined a bit. I'm allowed bad/down days as much as everyone else. I'm allowed to be upset or angry when someone winds me up, or something annoys me. Before I was diagnosed, I had a firey, loud side to my personality anyway and I have always been very easy to wind up, especially around close family and friends, so why is it when that side of me comes out now, do people assume I haven't taken my medication, or haven't seen my doctor?

"Stop thinking about it" "Stop worrying" "Stop overthinking"
Unless you can give me a really good technique to enable me to do any of theses three things, please don't tell me to do them. Anxiety itself is a mental health condition which involves being nervous, uneasy or scared about something with an uncertain outcome, so telling me to stop worrying is the same as telling me to get rid of my illness. I wish I could. I completely understand that 'don't worry' is the first thing you want to say to someone who is worrying, I say it to people myself, but when I am clearly very distressed, very anxious, or struggling to calm myself down, hearing these phrases, without any backup reason or explanation why I should, can really make me very uneasy and very aware of my anxiety. It's really not that easy to just stop worrying or thinking about something. 

"You're boring" "Fine, your loss" "Don't be the fun police" "Come on. Live a little"
I get these a lot from people who don't understand my type of anxiety, or people that know I don't like certain social situations but don't know why. It is a very uneducated response to me saying no to something I don't feel comfortable doing. I cannot put myself in a situation I know full well will create enormous amounts of anxiety and will probably end in a panic attack. This is definitely not to say I don't push myself out of my comfort zone to reach goals I have set for improving my mental health but as I talked about in this post, I find it very uneasy being on a typical 'student life' night out without my boyfriend or my best friend, so I often have to say no to people who invite me out. Whether or not it is the wrong thing to do, I need to protect myself and I know my limits better than anyone else does. Calling me boring, the 'fun police' or even telling me I'm a bad friend for not doing something (which yes, I have been told more than once) just brings me down knowing I can't be like 'normal' 20 year olds. Please remember, I didn't ask to be this way. 


And by far the one that hurts the most...
"There's people far worse off in the world than you are"
Oh trust me I know. I'm a nurse, I care for these people day in day out and they never leave my thoughts. I often feel guilt for suffering with a mental illness when MY patients who I'M looking after are laying in hospital unable to maybe move, maybe feed themselves, maybe speak, maybe remember their loved ones or even remember who they are, maybe feel lonely, maybe feel pain 24 hours a day, maybe unable to breathe for themselves and maybe even dying. When I come to you for help, don't make me feel  like my problems don't matter because they do. Everyone fights their own battles and everyone is important. I'm not telling you my thoughts and worries for you to feel sorry for me, I'm telling you because I need to tell someone and get it out of my thought processes. I care for those suffering every day as a job and I come to you in the hope that you can care for me. 

This post is predominantly focused at some of the responses from those close to me who (I assume) have no intent to upset or hurt me, so for strangers who are uneducated and small minded about mental health and say mean things just to be mean, ignore them. People often say things to me then realise it has upset me and apologise, and I know it can be hard to say the right thing straight away. Please remember that your loved one or friend who is suffering with anxiety, panic disorder or any other condition that may cause you to respond in ways like these, feels very alone, very scared, will probably have had to build up a lot of courage to talk to you about their worries and may not want you to say anything at all. They may just need you to listen to them and know you're there for them. Respond in a way that is useful and helpful for the person, for example 'how about you try...' instead of just 'stop worrying about it. It'll be fine'. If you don't know what to say, tell them. Whenever i'm anxious, hearing someone say 'I don't know what to say but i'm here for you' is all I need to calm me down and know i'm not alone, and i'm accepted for who I am. Even when friends and family send me links to stupid YouTube videos, or tag me in photos and videos on the internet for me to watch and laugh at, it really help me smile again and I know they're trying their best to be there for me even if they don't know what to say. For those of you reading this who can relate to me, don't get mad when people say these things. Instead, help them understand why they shouldn't use these sorts of responses and what would be a better way of responding to you. Hope this helps.



Love Luce xo

Anxiety and Panic Disorder | My Diagnosis.

I never thought I would be someone who would suffer with a mental health condition. Before starting my nursing degree, I thought that someone with mental health conditions were the type of people you see on Shutter Island or on documentaries looking into insane asylums. I couldn't have been more wrong. I have always been a worrier, always been clingy, always panicked and got anxious and upset over the smallest things even as a small child, and I will talk about all of this in a future blog post. 

Over the summer months of this year, I felt my anxiety and fear of everything get worse and worse to the point where I stayed in bed, feeling homesick, feeling physically unwell and struggling to talk to anyone about it. One morning, I was on a shift at my placement, setting equipment up, no patients had even arrived yet when, out of nowhere, I started to feel that well known drop in my stomach, flood of heat from my feet to my head and suddenly my heart started racing. I had to take a breather in the treatment room. I had told myself that if my anxiety ever bothered me while i'm at work, I would do something about it and so finally decided to call up my doctors surgery for help and advice. I saw a doctor that evening and he spent a long time talking things through with me, explaining what anxiety is and how it affects the body and how I have been suffering with it and coping with it. I told him that as soon as I feel my heart begin to race, everything escalates and makes me worse. With this, he took my pulse, which although I was calm, was around 117bpm (normal resting heart rate is between 60 and 100bpm) and prescribed me Propanalol 3 times daily. Propanolol is a medication which targets the natural pacemaker of the heart (sinoatrial node) to help calm the heart rate down to a normal level in hope that when I experienced a particularly anxious moment, my heart wont beat out of control as is had been doing. Although doing what it was meant to do and keeping my pulse at around 60-70bpm resting, it gave me awful side effects which included terrible insomnia, lack of appetite, fatigue and tiredness all the time and I just generally lost my energy and motivation to do anything.

4 weeks later, at my medication review, my doctor was not happy with the side effects I was experiencing and explained that in the long run, it could have a detrimental effect on my health and energy levels, especially because I was on my placement at the time which wouldn't help the situation. I came off Propanolol and was prescribed Citalopram 1-2 times daily. Citalopram is a selective serotonin re uptake inhibitoror SSRI, so stimulates the release of more of the 'happiness' hormone, serotonin. I was wary about starting on Citalopram due to the fact that it belongs to the family of anti-depressants, and although I was experiencing periods of very low moods, I was not depressed. I was anxious. My doctor explained how it would benefit me and help me and also explained how it was very common to experience some side effects from the medication for up to 4 weeks while the body becomes accustom to it, however I trusted my doctor and began taking them. It was here that I got given the diagnosis of 'Anxiety and Panic Disorder'.

2 days into my Citalopram, I woke up, took my tablet and got ready for my 13 hour shift. I felt fine. I walked to the bus stop, caught my bus, walked onto the ward. I still felt fine. The night staff began handing over any over night changes to us. As we walked into the last bay of patients, I said 'Good Morning' to my patients one by one and listened to the night nurse hand over. Three patients in, I began to feel very shakey and my heart began to race like I have never felt it race before. I could also hear only my heart beat - it was almostlike someone had turned the volume off in the world and all I could hear was my heartbeat. My fingers and right side of my face went numb and my vision became distorted, not blurred, sort of like blotchy and like I was looking at a TV on static, and then a rush of heat flew up to my head. As I turned to tell the nurse I was working with that I was going to take a breather, I collapsed. I never lost consciousness and luckily, my knees buckled under me so I didn't hit my head on anything. The staff grabbed an observation machine and checked my vitals. Everything was sky high and the nurse in change told me to get to A&E so they can check out my heart as my heart rate and blood pressure was scarily high. 

In A&E they did an ECG, did my vital observations again which had slowed down slightly. After being poked and prodded, I saw a doctor who looked at my symptoms, looked at my doctors notes from recent appointments and quite bluntly said 'you've had a panic attack'. I didn't believe him. I told him that i've had a panic attack before and I know that what just happened wasn't a panic attack, nothing had triggered it - I was fine before. He explained that all my symptoms, 13 hour shifts, other stresses from personal life, plus the side effects still remaining from the Propanolol had exhausted my body and just put my into a state of panic . He then leaned over his desk and said "My dear, panic attacks don't always need a trigger. Its your body thinking you need to escape from somewhere, or sometimes even escape from yourself". He also explained that for the first few weeks of starting on Citalopram, anxiety can get worse before it gets better (he was spot on!). So he prescribed me one dose of Lorezopam, another anti-anxiety medication, told me to take one and go to bed for the rest of the day. I did.

The next day, I emailed my personal tutor at university to let him know what had happened as it's university-placement protocol to let your personal tutor know if you have had a day off or have been absent. The reply I received back told me to phone my placement, tell them I wont be returning (I had 4 weeks left) and to see my doctor as I didn't sound well enough to continue caring for others. I saw a lovely doctor the day after who took one look at me and signed me off sick for a month. I went home to be with my family but I struggled a lot for those 4 weeks mainly due to the fact that my time off sick possibly meant I would have had to move back 6 months on my course to redo an exam I would be missing and to redo my last placement. I tried my hardest to push against all of the side effects and bad thoughts I experienced and 2-3 weeks in, with the help of my family, I finally began to feel better.  

My medication is working well and my doctor is very happy with my progress. It also helps that my lecturers, personal tutor and programme leader are all nurses and so showed empathy and support when I returned back. I wasn't in the end made to be deferred 6 months due to the circumstances my sickness was for which was a huge relief for me. As anyone with anxiety will know, I still have my bad days, but I also have amazing days which I never experienced before I started my medication when my anxiety was bad. Everyday I wake up and tell myself to be thankful and happy for who I am and the opportunities, people and things I have in my life. I'm working on becoming healthier and happier and continue to help myself with my anxiety while helping others with their struggles too.

Here are some great links that I personally used when understanding what my diagnosis was and I even used them to help my family, boyfriend and best friend to understand how I was feeling, the struggles I go through at times and to learn how they can help me.


http://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/#.ViusP_mrTNM

http://www.nhs.uk/conditions/panic-disorder/pages/introduction.aspx

I will be writing more posts in the near future detailing what goes on in my mind when I am anxious, how other people in my life see it and deal with it and where my anxiety began and started but if anyone reading this wants to know more information or wants help and advice, please leave a comment or email me - I am always more than happy to help. 




Love Luce xo