How to know if your medication is working 'enough'?

[AmZ]

Hi people,

Hope everyone is having a nice weekend.

I know there isn't a yes or no kind of answer to my question, but in general terms, it would be very helpful to get some feedback...

I'm not sure 'how much' the medication is meant to be helping me or what I people usually feel or don't feel from when the medication and dosage is working for them. I'm going on Thursday to the psychiatrist and we'll then see about staying at 225mg Effexor or moving to 300mg. Do I just base it on whether I am managing to cope or not with daily stuff in general or can there still be those very bad days where I literally can't get myself out of my apartment and feel very bad?
I know that I can't base it on what others have described as their experiences with anti-depressants, but from what I've heard from literally everyone (albeit, 3 people) are things like 'I was on anti-depressants, and I felt great'. Bearing in mind that these people weren't even in therapy, so I am trying to relate and compare this to my situation... Basically, in therapy twice a week and have been since the end of August, and on the medication for 3 months, now 3 1/2 weeks at 225mg and am far from feeling great but know that it's not all about the medication so am not going to listen too much to other people.
But Wednesday for example, I was feeling very bad and with all of my determination that I have had at other times, even the day before or night before or whatever and going out and doing things, I just turned the lights off and stayed in my apartment all day until 6pm, and it's the first time that I've felt that bad that it stopped me for going out for more than a couple of hours.
I maybe feel a little too 'up' and 'down' from one minute to the next and it's not balancing me out enough. The ups are not great feelings, but just a general feeling of being calm in my body and in my mind, which can last for several hours but has only happened a few days out of the last 3 weeks or so. The rest of the time, I can be anywhere from getting on with things and feeling fine in doing so, sitting feeling normal but then just starting to cry or like Wednesday, which was the first time it happening, staying in my apartment and not wanting to go out, but feeling very irritated in my apartment and can't even just lay there on the sofa and relax or sleep.

My psychologist had said after Thursday's session that I should not wait even another 6 days to see the psychiatrist and should already call and ask for an earlier appointment. She was only basing this on me not being able to stop crying for the 1 hour session we had and said that the medication should be helping me enough so that this kind of thing doesn't happen. True? Opinions?

Many thanks as always.

 

[David Baxter PhD]

I think you pointed out in your other thread that the earliest you can see the psychiatrist would only be 3 days or something like that before your scheduled appointment. I doubt that's going to make a difference.

Wait and talk to your psychiatrist about this.

 

[AmZ]

Will do.
Grr, I think this is where the language barrier is going to be a bit difficult... To try and explain these things, but anyway, will have to do my best.

Thursday is going to be the funnest day of them all.. Got called back about that biopsy so going on Thrs about that also. Ah, life... Someone's gotta do it, right?
Just trying to keep it together.

 

[David Baxter PhD]

I think this is where the language barrier is going to be a bit difficult...

What language barrier?

 

[AmZ]

They told me that she speaks decent English and that turned out not to be the case.
So it's my OK Hebrew but with little knowledge of vocab to explain these kinds of things and a few English words that she knows here and there... If only I knew some Russian also (she is originally), that would help me out along the way.

 

[David Baxter PhD]

You have 6 days. You can learn a lot in 6 days: Free Online Language Courses

 

[AmZ]

LOL - Well, I can't say that languages are my fort? as such.

6 days vs 4 years I've been here and learning Hebrew (well, not a lot) I don't have much hope for 6 days of free courses haha - That's what happens when you work and study in English. Now I am dealing with the consequences. But is bad luck that she doesn't really speak English. Usually doctors of all kinds know English here, because (surely?) they need to know or will learn whilst studying to become a doctor. (Course material, English-only terms for things, etc). You'd think so anyway.

 

[David Baxter PhD]

Exactly. Once you learn Russian, your first priority should be to give her the frowning of a lifetime (in Russian).

 

[AmZ]

Hehe... I think I'm just going to perfect my Russian frown for now and the rest will be left to doing the best I can with what I've got to work with. At least from what I feel, before Wednesday and Thursday I was feeling quite a bit better and think that the medication has a lot to do with that. But Wednesday and Thursday were pretty bad and it wasn't like I'd had days like these in the past (any uncontrollable crying for more than 20 minutes or so and not getting out of my apartment all day) - So, as I often do my posting here, is answer my own questions. No Russian needed. I would hope that some form of medication would help me enough to not have days like those, so my only answer would be that the current dosage isn't working as much as I need it to in order to be able to function properly/enough...
In a way, when I heard that some people I know where on anti-depressants and 1 is still on after 9 years, I was thinking that I don't want to feel like they were describing - Like some unnatural 'high' feeling just covering up depression (none of them were in therapy) - But maybe I'll go for that right now. Does this happen to many people or did I just get an unlikely ratio of experiences there? I remember my dad even on Prozac about 12 years ago. He was in his bed all day every day and the doc put him on medication after 2 months of this and after 2 weeks or so of going on the medication, he was like a different person.

Does make me wonder if I am immune to these meds or something! I saw that 3mg Lorazepam is given to people who suffer with insomnia. I took 3mg and slept for 2 hours and that was it!
At least I'm going to get the go ahead to stop the Lorazepam because I'm only now taking 1mg at night and my anxiety is a lot less (I hope that will continue), so good to get off of that. I don't need any help in falling asleep, it's just staying asleep which is the problem. Always sleep 3-4 hours and wake up and then several times more after that for the rest of the night.
Sleep thing is an issue, but from what I read, I don't want to go on anything to help me sleep, (it's still tough to say that). I think I'd rather just wait until I naturally sort this out. Those meds don't look too fun for me. Maybe fooling myself once again like before I didn't want to go on the SSRIs, and look how that turned out! Just want them to work already and not even bothered that I could be on the highest dosage. Not even thinking about what happens after a possible 1 more month at 300mg... That would be 4 months. Pffft, think I'd quite frankly give up.

 

[AmZ]

Either feel very tired at 11pm-12am, (have to) get in bed and fall asleep straight away, or like tonight, still awake at 3am and hardly end up sleeping at all. Have done this 3 times now I guess in the last couple of weeks.
Doesn't matter about the daily routine I had. i.e. it was busy today. Awake at 7am, worked til 6pm, was out the rest of the evening walking around the city and the mall and traveled back home which took 2 hours, got back at 10.30pm...
Just don't understand.
Wish I could understand some things, I really do

 

[David Baxter PhD]

A priority for discussion with the psychiatrist. Disrupted sleep patterns are common in anxiety disorders and mood disorders. The psychiatrist may decide to add something to your medication to help with this issue.

 

[AmZ]

For sure.

Do you have any recommendations on the most common meds given to help with sleep? Or any good resources I can check out before going on Thursday. I refuse to go on something before reading about it myself beforehand.

I have no clue about what types are available and the side effects or pros and cons which I would want to know beforehand.

Many thx.

 

[David Baxter PhD]

It's not that simple.

There are several options for helping with sleep disorders, but in this case where the sleep problem is almost certainly a symptom of anxiety or depression the doctor has the option of using a sleep specific medication or a medication which will help with anxiety/depression as well as sleep (e.g., a small amount of Seroquel added to an SSRI or SSRI/SNRI is sometimes used to provide additional help for all three problems). But you've also had a bad reaction to medication in the past which the doctor will need to take into account in choosing any medications.

This really isn't something for you to research on your own. First, the information you get from the net is likely to be inaccurate and unnecessarily alarming no matter what medication is selected. Second, trying to research this would be bad for you personally given your OCD tendencies.