re: SSRI/SNRI med question?

Isn't a couple days of funk pretty normal? I mean, are you expecting zero funk?

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I don't know what's normal with any of this. 

For 34 years I had zero issues with anxiety/depression until this summer when I convinced myself I was dying and couldn't recover even when I knew that wasn't true. 

This is all new to me. 

I wouldn't say I was expecting zero funk but the feelings I was experiencing yesterday were eerily similar to those when my issues were at their worst. 

I went to bed early last night and feel a little better today so far but definitely not back to normal

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Its all stress related. Had a spell of this myself around your age. 41 now. TCM was only thing that worked for me. Still do acupuncture 1-2 times month. Only thing I take is Garden of Life Mood probiotic and Vitamin C when I feel a cold coming on.

Stress is an absolute motherfricker. Once body is in fight or flight mode from stress its can be hard to turn off.

Good luck.

You may not feel like it but exercise does wonders for this. Force yourself to go do some cardio, or at least a long walk around the block.

Exactly! Bingo.. not every day is going to be anxiety or depression free. They are both natural human emotions.

That's where I'm kind of stumped.

Do I need to call the psych every time I'm having a bad day or two?

I'm not having that anxiety that I'm dying again it's just feeling those same symptoms like butterflies in my stomach, increased heart rate, just feeling down and my anxiety is just that it's happening again or that this is something I'm going to be dealing with forever.

Is it possible, once established on meds, to have minor setbacks that will correct themselves if I just stay on the meds, or am I going to have to go through the trial and error process again trying to find something else that works?

I'm thinking I'll give it the weekend and if I'm still feeling like this Monday give the psych a call.

You should just set up regular visits. Every week when you're feeling really bad, for therapy. Then every two weeks, once a month, etc.

As for going through down periods, it's ok to go up on the medication for a month and then go back down. When I was on Paxil I did that several times for the bad months and it helped.

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Have you done any genetic testing? You are probably a CYP2C19 poor metabolizer and/or a SLC6A4 Short/Short or Long/Short if you went from a SSRI to a SNRI and had better results.

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What does all of this mean?

Yea if I end up having to call the pscyh back if this last more than another day or two that's what I'll have to do.

Given the fact this came out of nowhere I was kind of hoping it was a fluke thing that once it went away wouldn't come back but it's starting to seem like that may not be the case unfortunately.

I'm not against therapy but having never really gone to it can you put your finger on exactly what it is that helps? In my head I don't think it will work for me but I'm willing to do/try pretty much anything to get back/stay my normal self.

I'll chime in here, as I've been on some form of antidepressants for 20+ years (high school).

The people above saying that antidepressants lose their efficacy after a while is true, based on personal experience. Every few years--sometimes a year or two; sometimes several years--my meds have essentially stopped working, and I've had to switch over to something else. Sometimes its within the same family of meds (e.g., switching from one SSRI to another SSRI) and sometimes it's switching to another class (e.g., I started on tricyclic antidepressants, and moved to SSRIs, and most recently switched to SNRIs). Each class and each med within each class has its own set of benefits/drawbacks. I haven't found a holy grail, yet, but i'm hoping that as time progresses, so does our understanding of mental health issues, and improved meds should follow...

in the interim, i'd echo the others here who say you should speak with a professional about this. we're all working with a limited set of info here based on a posting.

The Psych meds are metabolized by enzymes in your liver. There are 6 major "CYPs that break down the drugs. Some people metabolize meds slowly=bad side effects, some people metabolize meds very fast=doesn't work or for just a short period of time, some are normal and some are just kinda slow. Lexapro is metabolized by the CYP's (CYP2C19, CYP2D6, and CYP3A4.) You "may" have a mutation in one of these enzyme's which makes you metabolize your meds slowly which gives you side effects over time.

FYI Cymbalta goes through CYP 1A2 and CYP2D6.

The SLC6A4 Gene helps determine if a SSRI or SNRI may work better for you. It is either Long/Long, Long/Short, or Short/Short. These code for serotonin transporters. Basically if you are long/short or worse short/short it doesn't help that you get more serotonin because you don't have enough transporters to get it to where it needs to go. Think of it as trying to get a bunch of kids to school at a bus stop. They keep on adding more and more kids at the bus stop to get them to school, but we only have 2 buses. We don't need any more kids, we need more buses. Thats where the SNRI come in, those are the buses.
Based on the fact you said you did much better and had less side effects I thought you may be a SLC6A4 L/S or S/S. It's just a guess. If your psych offers genetic testing I would ask for it. It helps the guessing game, trial/error part and they can tailor your meds with your specific genes.