Mirtazapine?

[beckyboo]

Hoping someone can help with something thats been bothering me. 

When i presented at hospital with some extreme anxiety due to having thoughts of self harm. 

duty teams quickly passed off as post natal depression ...even though i was diagnosed with OCD a couple of years ago. 

it was catastophizing that led me to going there as i didnt feel safe. 

they didnt ask me anything to do with my OCD and quickly put me on Mirtazapine 15mg. 

i found them great for getting me to sleep but found the next day it took hours to wake up fully 

after a couple of good weeks, the thoughts came back with a vengence ..still causing anxiety symptoms so psychiatrist said they were not working so she increased them to 30mg 

ive been on 30mg 7 weeks now and although they help with the psysical sensations of anxiety so im not succumnbing to psyical compulsions im now left with ruminizing alot and a fair few mental compulsions along with avoidence & reassurence seeking & doubting all the time. 

 

I just realised that mirtazapine isnt even an SSRI, i know the more common choice in medication is SSRIs so im now wondering if the mirtazapine isnt working because this has been OCD all along causing depressive symptoms rather than having the post natal and ocd ...i certainley dont feel depressed just fed up of rhe thoughts & ready for some therapy & recovery! 

ive asked my gp but he says the mirt is the best for me to be on and il get therapy once stable.....

not sure what that means ...but if im not on the right medication to help with the OCD along with therapy then seems to me that theyre being cruel in letting me suffer rather than give me a medication known to help with ocd.  

mirtazapine is known for both depression & anxiety ..taking 4 - 6weeks for depression & up to 8 for anxiety. 

the next dose up is max dose at 45mg. 

[beckyboo]

is anyone else on mirtazapine?? 

have you found it helpful? 

i have tried citalopram & sertraline before but didnt give either of them a chance one of them i didnt even take because of the potential side effects and the other i took maybe 3 days worth as they made me incredibly nauseaus. so ive never really given any medication a try except the mirt. 

[snowbear]

Hi becky,

The purpose of medication, including mirtazapine, isn't about reducing or controlling the intrusive thoughts. It's about reducing the anxiety (or treating secondary depression) which can make it harder to do the necessary CBT work.

So the right dose for you is the one which enables you to realise when you're facing a compulsive urge and take action to try and stop yourself doing - without being so anxious you feel overwhelmed and incapable of applying the skills you've learned, and without making you so drowsy you don't care what's going through your head. The sweet spot in between where you're able to take charge of the anxiety and start fighting back is what you're aiming for. 

Have you got some ideas in place to break the cycle of ruminating and other compulsions when they hit? 

[beckyboo]

not really apart from using some distraction 

plus i still have alot of doubt & fear surrounding the theme that im stuck on. previous themes were difficult and distressing but far easier to overcome because the content was sooooo far fetched and rediculous i knew i would never harm any of my children ...the ones i have now i cant seem to apply the same because the theme is something thats real & really happens to people so i still have alot of doubt wether its ocd or not (i know this is a common thing with OCD) so sometimes it feels safer to hang onto the fear just incase does that make sense?? 

[snowbear]

Oh it always feels safer to hang onto the fear just in case! If it didn't none of us would suffer OCD, we'd just accept some doubt/risk as normal and forget it.

Sorry, I can't recall if I asked you on another thread, are you getting any CBT?  Or did you say your doctor is waiting for you to 'stabilise' on medication first?

If you've not started therapy yet, consider reading a self help book to gain some insight to your OCD and how to challenge it. Break Free from OCD is a good book to begin learning more, or of course you can ask questions on the forum.  

[beckyboo]

I bought & read it yesterday ...also.completed a viscous flower (formulation) & did some theory A & B thoughts too. it certainly all points to OCD and from all of my own knowledge, common sense and rationality knows it is...its those pesky doubts. i think im more unable to let go of fear because the risks are dangerous especially when it comes to having a fear of self harm ...because it would mean game over 

im not sure about the safest way to challenge ruminizing ocd. problem is everywhere we look it says ring 999 or crises teams if you have thoughts of that nature lol so that really does not help. 

im havnt started CBT but really want to! my care co is changing to someone whos training in cbt and runs cbt classes ...i see her on the 16th of this month, which will have been a month since seeing someone. so im keeping my fingers crossed. i did write out my vicous flower to give the her. 

[snowbear]

Fabulous, Becky.   Excellent start. A month is a good length of time to allow the ideas you've learned to settle in. By the time you get to discuss your vicious flower with her you'll probably have quite a good grasp of what's going on and where you need to intervene. 

[beckyboo]

i actually just stopped myself from having compulsive behaviour...

i was attempting to search for a post in the forums for someone else who has the same thoughts as me....i think i was doing it for more reassurence that this is OCD and not actual Ideation! ...i knew by doing it, it would confirm its OCD ...and also realise by doing so it would bring me some comfort for a little while until i doubted it again ...then go in search again! 

i also thought if i couldnt find one on here then maybe google this type of theme with OCD but I know what i was doing and not done it. woohoo!! 

I think for me ....its fearing the 'it'll get worse before it gets better' i dont fancy that at all especially with something so risky but i know i gotta take that chance on myself because its far riskier living like this and missing out on living my life and that of my kiddies! 

 

onwards!