# Help and Advice > Related Illness/medication/alternatives >  First timer - questions about sertraline?

## CharlieJackpot

I've been struggling with depressive moods for years, and after a few weeks of near-crisis I finally plucked up the courage to see someone about it today.

I saw the nurse practitioner who prescribed 100mg sertraline daily and made a referral to counselling.  She admitted she didn't know a lot about mental health but has given me a month's worth of meds to try while I wait for my referral.

After coming away and reading up a little on sertraline I'm getting a bit worried - is 100mg ok to start with? Lots I've read says 50mg is more usual, and side effects might be more likely with the higher dose?

I'm also worried about some of the side effects I've read about, mainly how the meds affect sexual function.  One of the main problems I've had for years is very low sex drive, and this has caused major issues in my relationship (I'm female btw).  I've always assumed this had something to do with my moods and anxiety, but I'm worried that sertraline will make this much worse.  

I realise I should speak with my doctor about this, but I'd have to pluck the courage back up and I'm sat at work now worrying!  Any thoughts or experiences would be very gratefully received  :):

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## Paula

Hi and welcome  :(hi): 

I haven't used sertraline but plenty of members here have so will be able to let you know their experiences.  Additionally, there's a section on the forum with information On this drug http://www.dealingwithdepression.co....eiw-Sertraline

Try not to worry too much about the list of side effects. Every medication has long lists, and most are unlikely to happen to you.  However, everybody reacts differently to meds so, if sertraline doesn't suit you, there are a myriad of other drugs to try.

Finally, ADs can take up to 2 months to really begin to help, so it's not an overnight fix.  All I can say is, talk to your family and friends and ask for support, be kind to yourself - if you need to rest, rest, and talking here will always help

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## Suzi

I can completely agree with Paula. 
Hi and welcome to the group!

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## Angie

Hi and welcome to DWD

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## rose

ADs can cause problems with sexual function, but so can depression.
Everyone is different but I can't say I've seen a difference with sexual function apart from the first few weeks (it can be more difficult to orgasm, for example, but that side effect seems to go away after a few weeks)

50mg is usually the starting dose for sertraline as far as I know. If you start at 100mg you are more likely to feel side effects; that said if the nurse felt that you need a higher dose straight away then it might be best to give it a go.
My suggestion is that you keep a simple diary of how you feel and go straight back to the doctor if you feel like you are getting worse; don't be afraid to seek support.

I've been on Sertraline. It didn't actually work that well for me, but that said, that's why there are so many different ADs out there, because some work better for some and not others.

Unless you were told otherwise, it would be best to take it in the morning.
Welcome to DWD  :(hi):

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Paula (27-03-15)

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## CharlieJackpot

Hi everyone, thanks for the lovely welcome  :): 

I think I'm probably worrying about taking the meds so much that I'm causing myself to feel worse than I really do.  I think it's also made worse that the nurse didn't really tell me anything about them or discuss side effects or dosage with me, so as soon as I picked them up I immediately googled and found all these horror stories!

I spent most of yesterday feeling sick and I've had a mega headache since last night, but I'm sure they can both be explained by the fact I've barely eaten for a few weeks and am worrying like mad.  

It's lovely to speak with people who get it - the only person who knows about this is my partner, although that's very rocky at the moment so we're not even speaking a great deal.  I wouldn't even know how to begin talking to my family about it and I don't really see close friends enough to bring this up with them.

Do people generally find that meds work better than talking therapies or vice versa, or a mixture of both? Is it usual to do both at the same time?

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## rose

In my personal experience, therapy was useless at the beginning because I was so caught up in how I felt.
The meds took the edge off in order for me to start thinking straighter again. Then I started doing some CBT on myself and went through NHS therapy which worked really well.
Its really common to feel worried about taking a new medication. Remember that you will see horror stories online because people tend to talk more about the bad stuff than the bad stuff.
Sertraline was the medication that I had the least side effects with. If you are worried about the dose then go back to the doctors. Have you taken your first dose yet?

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## Paula

With depression, a combined approach of meds and therapy is normal. As Rose says, the ADs give you some breathing space to start talking through how you feel, and how you can change the way you think.  You'll probably find you'll have enough time for the ADs to start doing their job before you get your therapy appt.  

Wrt your oh, are the problems you're having because of the depression, or are they part of the trigger?  A good resource to talk to family and friends is www.time-to-change.org.uk

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## Suzi

Do you know why things aren't great with your partner?

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## S deleted

Hi there and welcome tp DWD.

I have used sertraline in the past and I was started on 50mg and moved up to 200mg. I can only echo everything that Rose has said. I personally didfn't suffer any side effects when taking them, but everybody is different, and usually they will die down within approx. 2 weeks anyway.

In regards to therapy, I tried that route before medication and it was a disaster. I actually felt worse than I started out but later when using AD's the therapy was more helpful.

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## rose

> Remember that you will see horror stories online because people tend to talk more about the bad stuff than the bad stuff.


That should have said 
_Remember that you will see horror stories online because people tend to talk more about the bad stuff than the GOOD stuff._

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## CharlieJackpot

I took my first dose yesterday and have taken my second this morning.  Feeling a bit less worried about it all today especially after reading your replies.

Things with my partner have become extremely complicated, and this is one of the main reasons I've finally sought help.  We've been together nearly 5 years and in that time I have always had episodes of low moods, pushing him away, struggling to let myself feel close to him and the already mentioned low sex drive.  I can also be very critical and when we argue I find it hard to control my emotions.  He also finds it difficult that I cope with different aspects of my life by compartmentalisng, so for instance I would always rather see my friends without him, where he's much more of a 'we come as a package' kind of person.  

Things came to a head in Feb this year and we ended up barely speaking apart from some pretty heated arguments for around 6 weeks.  In this time he began to see someone else.  

I couldn't even tell you where we're currently at.  He's no longer seeing this person, however we both have reservations about our relationship continuing for obvious reasons.  My trust in him has taken a huge knock and he doesn't think I will do anything to look at the way I've behaved in our relationship or deal with my depression.  

No idea where things will go with us, but despite all of that I know that I really need to sort myself out for whatever comes next, and if this has been the catalyst for me finally admitting that there is something I need to sort out then at least I've found the silver lining!

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## CharlieJackpot

> Wrt your oh, are the problems you're having because of the depression, or are they part of the trigger?


Sorry to post again but in answer to this; I think it's been a bit of both.  There are definitely major problems that have been caused by the depression, but these problems have in turn created a situation which triggers my depression even more.  For example, when I've made him feel unloved or unattractive, or made it clear that I don't want to be around him, he feels low and so stops helping around the house.  This then triggers my moods because I can't cope with dirt when I'm feeling low.  

At the moment we've both taken a step back from the relationship, although we're still in contact and have come to something of an understanding.  I'm staying weekends with my parents, and when we're both in the house we are able to at least talk to each other again.

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## Paula

I sincerely hope getting the right treatment for your depression will help you to understand where you are in your relationship.  I've been with my husband for 16 years, and I too push him away when I'm low. Fortunately he knows it's the illness and just keeps loving me anyway, but it's taken a lot of effort to keep us together. Doing what you're doing is a very common symptom of depression  :(bear):

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## magie06

I'm wishing you the very best in your recovery. I too have problems with my relationship when I'm sick. It's difficult but I've got a very caring OH and although at the beginning it was hard for him. He had to take carers leave to look after our little girl, and me when I came out of hospital. He started looking after my medication around that time too, and still does. And I'm happy with that. 
It does get easier, but you won't feel better tomorrow. It takes time and a lot of hard work but it does happen.

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## Suzi

ERM you've been together for 5 years and in 6 weeks he started seeing someone else????  So why is it you who stays with your parents at weekends?

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## CharlieJackpot

Staying with parents is my choice really, we both needed space and I didn't want to be alone in the house, dealing with housework and looking after the dog, etc.

It's a long and complicated story; I'm in no way justifying his seeing someone else (secretly I might add, I still thought we were 'together' although having a very bad time) but I have to contextualise his betrayal in terms of my own actions and behaviour too. He did something very wrong, but I've done a lot of wrong too. Whether we'll be able to forgive each other is something we can't answer right now.

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## Paula

Have you considered relationship counselling?

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## Suzi

I'd suggest something like RELATE too...

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## CharlieJackpot

Relationship counselling is something he's asked for many times and I always refused, in the same way as I refused to seek help for my depression, because 'there's nothing wrong with me'.  It's been mentioned again by both of us recently and I think it's something we should definitely do providing the relationship survives long enough.  Baby steps though, this week has seen lots of changes in me and I'm trying to take things one day at a time.

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## rose

I suppose it was probably a case of timing; your relationship was very much on the rocks and this other girl came along at just the right time. I am glad that he has finished with her and you are working on yourself so that in time you can work on your relationship together.
It sounds like you are being very sensible, now, about your illness, even if you haven't been in the past.
Have you been ok today with the Sertraline side effects?

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## Paula

Relationship counselling isn't always about how to stay together. It can be used to ease a break up, or to help both parties come to a decision either way.  I'd say that now would be a good time for you both ......

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## CharlieJackpot

I'm sure you're right Paula, we'll talk about it over the next few days when I'm back at home.

Feeling much better about the meds now, only side effects I'm really feeling are shakiness and needing to drink more water. I do feel a bit 'different' in myself but that could just be something I'm creating myself by worrying.

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## CharlieJackpot

Hi all, just a  quick update.  Day 5 and I'm really struggling today.  I'm absolutely shattered but am finding it really difficult to sleep.  Is this normal?  Should it pass?  I could barely function today at work and I'm dreading tomorrow  :(:

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## Suzi

Are you taking it at the same time each day? Are you eating sensibly?

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## CharlieJackpot

I take it just before I start work on a morning, and no I haven't had an appetite lately although I forced myself to make and eat a proper dinner tonight.  Hopefully that might help?  I'm feeling a bit more together emotionally this week and I've definitely noticed a return in appetite today so hopefully that will continue.

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## rose

The first few days can be a bit rocky but it should pass soon. 
Finding it difficult to sleep sounds about right, when I started citalopram (which is similar to sertraline) I could only manage a few hours each night.

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## Paula

It's going to take some time for everything to settle but, if the side effects become too difficult, please see your Dr again

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## Suzi

Glad you are noticing your appetite returning.

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## CharlieJackpot

Thanks everyone.  I got about 3 hours sleep last night and I'm really feeling tired today.  Had a lovely relaxing walk at lunch time to get some fresh air, and my amazingly lovely colleagues brought in cheese scones and cornflake cakes because they're concerned I've lost too much weight! 

I recently joined a sports team and I've got two hours of training tonight... Really not feeling up to it but I know I need to get myself there, get some exercise and hopefully a good night's sleep.

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## Paula

Awww bless them - keep at it, hunni, it's early days yet

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## Suzi

That sounds so lovely of them!

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