# SSRI Withdrawal



## Hip Priest (11 May 2013)

I know a few on here have experienced mental health issues, so I was hoping for some advice.

I was put on Seroxat about 10 years ago after developing panic disorder. However, thanks in large part to cycling, I'm now in tip-top mental shape, so I decided to come off the tablets. 

My doctor suggested I drop by 5mg every couple of weeks, in order to avoid unpleasant withdrawal effects. I initially dropped from 20mg to 15mg, and felt alright, bar a little bit of a fuzzy head.

Then two weeks later I dropped from 15mg to 10mg and all of a sudden I entered my own personal twilight zone. I felt like I was on another planet, and was on the verge of tears at all times.

So yesterday I went back up to 15mg, and I'm right as rain once again.

Is this to be expected? Do I need to withdraw more slowly? Has anyone else done this?


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## fossyant (11 May 2013)

I would say do it slowly so give it a while then drop a bit more. Don't forget you initially dropped a quarter of your dose, then another third (or half your original dose). You've been on them a long time so drop slowly.

I went cold turkey on some nerve pain drugs I'd only been taking 4 months, but I was sick as a pig within 48 hours of stopping the dose. Went back on them, then reduced slowly over the next few weeks. It may take a while after 10 years.


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## Nigel-YZ1 (11 May 2013)

I was pulled off Citalopram immediately. Dizziness, nausea, loss of balance (I fell off a chair!) and changes to my eyesight followed.
After that week I'd definitely recommend steady decreases.


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## mydodgyfeet (11 May 2013)

Slow withdrawal every time. 

That's both from experience as a "user" and as someone who's worked with people with mental health issues. Rome wasn't built in a day.


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## coffeejo (11 May 2013)

It were me, I'd give it another couple of weeks on 15mg and then try again. You could even cut a tablet in half to take it down to 12.5mg and then try for 10mg.


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## Martyn H (11 May 2013)

It took me ages to come off Citalopram. I was prescribed a reducing dose over a period of three months. During that period there were a couple of scary moments when I wanted to argue with everyone, and also became very tearful, just bursting into tears at the slightest thing however, I came through it with the support of my doctor. Just recently after a period of four years without medication I have been given a further prescription to help me get back on top of things. I was reluctant to accept the medication this time around as I had been quite well for a while without anything. I was also reminded that it was no weakness to admit to a further period of depression and that it is ok to ask for help. Am now looking forward to a better Summer and being out on the bike again.


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## T.M.H.N.E.T (11 May 2013)

I too have had issues. Slow reduction did the job the first time, something like a month-6weeks a time.

I can't fully remember details.


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## Cletus Van Damme (11 May 2013)

Different drug but I dropped from 30mg of mirtazapine to 15mg about 2 weeks ago. I had crippling headaches for about a week and could hardly function at work. I am determined to get off that crap totally, but I am going to stick to 15mg for a few weeks before I go to 7.5mg. Good luck


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## Nigel-YZ1 (11 May 2013)

Good Luck to everyone both on the pills, and facing a new future without them. You are never alone


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## the_mikey (12 May 2013)

I've been on and off fluoxetine and citalopram numerous times, and coming off them slowly seem to be the way. Some medicines have their own unique effects when coming off them, citalopram causes weird electric shock like sensations when coming off them, not unpleasant but they can be distracting. The biggest downside of citalopram for me was the demotivating effect it has on my head, it made cycling seem like an unpleasant struggle.


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## coffeejo (12 May 2013)

I inadvisedly took myself off citalopram a couple of years ago. Was too much of a wreck to notice any side effects of the withdrawel but had to go through the painful process of going back on them once my GP twigged.


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## shouldbeinbed (12 May 2013)

Former pal of Seroxat here too, I'd echo the advice to come off them slowly and in small increments. After a couple of years on them it took several months to wean down, firstly and incrementally to a low daily dose then taking it every other day then a couple of days gap then just kept letting the gaps get longer, the latest gap is 4 years and counting.


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## chernij (12 May 2013)

Hope you're okay getting off them. I find that going for around a month on the lower dose before changing can help. It takes a while for the body to get used to the lower dose.


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## Andrew_P (12 May 2013)

I have bad memories of mine, like some sort of electrical storm in my brain, full on electric shocks. I was on Citropalm took me 8 weeks to get off them but I still suffered some re-bound effects. I didn't cycle way back then but they do say exercise helps with Serotonin levels so hit the Gym quite hard as well during the tapering.


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## BigonaBianchi (12 May 2013)

Citalopram is a truly horrid drug. Gp's should be ashamed of themselves for prescribing it when they know full well of the horrendous side effects it can have and withdrawel issues . It's dished out like smarties and those who have not taken the wretched stuff can never know how it feels to lose your 'self' to this shoot...yet how many GPs have ever taken this poison?


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## chernij (12 May 2013)

BigonaBianchi said:


> Citalopram is a truly horrid drug. Gp's should be ashamed of themselves for prescribing it when they know full well of the horrendous side effects it can have and withdrawel issues . It's dished out like smarties and those who have not taken the wretched stuff can never know how it feels to lose your 'self' to this s***...yet how many GPs have ever taken this poison?


Agreed. It was the second SSRI I tried but had to get off it after 3 weeks. Horrid side-effects. Luckily withdrawal wasn't too bad for me as I went on to another straight after.


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## BigonaBianchi (12 May 2013)

...the longer one is on citalopram for and the higher the dose the worse things get... it's a masking drug, it shields from reality, 'waking up' from it to realize your reality can be truly frightening. Slowly does it...docs make stupid suggestions like cut it 10 mg a week!!! W T F??? that's dangerous.....take it way slower...cut it 1mg a week...and when the tears come, when the anxiety comes, when the dizziness etc comes tell yourself it's the pills, it's not me , I am ok...tell yopurself you are a victim of this drug, fight it and win, little steps...one day at a time smell the flowers taste the wine.


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## PK99 (12 May 2013)

BigonaBianchi said:


> Citalopram is a truly horrid drug. Gp's should be ashamed of themselves for prescribing it when they know full well of the horrendous side effects it can have and withdrawel issues . It's dished out like smarties and those who have not taken the wretched stuff can never know how it feels to lose your 'self' to this s***...yet how many GPs have ever taken this poison?


 

A word of caution, it is unwise to be so dogmatic about anything mental health related. All you can speak about is your own experience of the drug, you would do a disservice to others by scaring them off something that my be useful to them.

My experience of citalopram was the polar opposite of yours, and many other patients i spoke to at the Priory also had positive experiences.


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## Hip Priest (12 May 2013)

Cheers for the advice all. I guess slow and steady wins the race. I've not tried Citalopram, but Merseyside pop band The Wombats actually realised a song about it.


View: http://www.youtube.com/watch?v=ti1W7Zu8j9k


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## mrandmrspoves (12 May 2013)

PK99 said:


> A word of caution, it is unwise to be so dogmatic about anything mental health related. All you can speak about is your own experience of the drug, you would do a disservice to others by scaring them off something that my be useful to them.
> 
> My experience of citalopram was the polar opposite of yours, and many other patients i spoke to at the Priory also had positive experiences.


 
Absolutely agree with you. Citalopram is a useful medication for SOME people and many people would have a hellish life without it and the increasing number of alternative anti-depressants.
Yes side effects can be horrid - but not when compared with the medicines I was working with as a psychiatric nurse 30 years ago!

BOAB is right to be critical of doctors for over prescribing, but unfortunately they do not have many options - try getting to see a counselor on the NHS and you will probably have to wait over 6 months.....and a lot can happen to a person suffering depression in 6 months.


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## Hip Priest (12 May 2013)

mrandmrspoves said:


> Absolutely agree with you. Citalopram is a useful medication for SOME people and many people would have a hellish life without it and the increasing number of alternative anti-depressants.


 
Would echo that. I found Seroxat really helpful at the time. I was 21 when I developed panic disorder, and I quickly became housebound. The medication helped me back on my feet. 30 years ago I'd probably have been given valium. 60 years ago I'd have been put in an asylum.

I just wish it was easier to come off!


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## BigonaBianchi (12 May 2013)

Point taken

My experience has been horrendous, it's my opinion/view based on my experiences. 

I think many people suffering from mild depression are given this stuff as a matter of course, when other treatments should be explored first. There are cases where the condition is so severe that getting an ssri into the system can be a life saver. Personally this was the case. However my experience was that citalopram took too long to get onto as well. My experience of fluorextine was more positive, both going on and off. Mirtazapine is a maoi and had a totally different effect, as did lustral, venlafaxine, paroxetine, and another rhorrid blue and white one that made me puke.

Getting off citalopram (I was on 60mg) (and Diazipan) was so tough...the gp even told me to take mirtazapine at the same time as citalopram in an attempt to reduce the witdrawels of citalopram...madness imho.

Anyway...my experiences tell me that taking the decision to get off this stuff is the best thing in the long run, just do it very slowly....


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## chernij (12 May 2013)

PK99 said:


> A word of caution, it is unwise to be so dogmatic about anything mental health related. All you can speak about is your own experience of the drug, you would do a disservice to others by scaring them off something that my be useful to them.
> 
> My experience of citalopram was the polar opposite of yours, and many other patients i spoke to at the Priory also had positive experiences.


Fair play. Apologies for my additional comments, I meant it to simply be sharing my experiences. I think unfortunately a lot of SSRIs are over-prescribed in the UK; CBT/counselling should be the first-line option but unfortunately the resources simply aren't there for everyone to have one-to-one sessions quickly. Waiting-lists are ridiculously long.


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## coffeejo (12 May 2013)

chernij said:


> I think unfortunately a lot of SSRIs are over-prescribed in the UK; counselling should be the first-line option but unfortunately the resources simply aren't there for everyone to have one-to-one sessions quickly. Waiting-lists are ridiculously long.


FTFY


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## PK99 (12 May 2013)

chernij said:


> *CBT/counselling should be the first-line option* but unfortunately the resources simply aren't there for everyone to have one-to-one sessions quickly. Waiting-lists are ridiculously long.


 


The Priory model uses both in tandem:
Meds to facilitate clear thinking combined with psycho-education to help understand the illness, symptoms and processes with talking therapy (normally CBT in the first instance) to delve into personal issues and processes.


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## chernij (12 May 2013)

coffeejo said:


> FTFY


You say CBT second-line? Or not at all?


PK99 said:


> The Priory model uses both in tandem:
> Meds to facilitate clear thinking combined with psycho-education to help understand the illness, symptoms and processes with talking therapy (normally CBT in the first instance) to delve into personal issues and processes.


I hear what you're saying. I wasn't aware of the Priory model, but I understand where it comes from.


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## BigonaBianchi (12 May 2013)

I did a full years counselling (one on one and group based), CBT and person centred mostly with some psycho dynamic (Freudian stuff).
The thing is that the CBT etc all sounds great while they are talking with you about it etc....it's applying it every day that's tough to keep on top of once you leave the course/clinic whatever...especially when your mind is being scrambled by high doses chemicals like citalopram.

The NHS counselling I got was a joke. All it did was open up old wounds and leave me to stew on them...the total opposite of what it was supposed to do. I wish I had never bothered with the NHS counselling.

Couple of things I have found for myself that worked better for me were The linden method (more to do with controlling serious panic attacks) and Budhist ideas about how to change my mind and how it thinks and deals with life....and more than anything distract distract distract which is where cycling has been good.


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## coffeejo (12 May 2013)

chernij said:


> You say CBT second-line? Or not at all?


Like all the different meds, it's only one option of many. Works for some, not for others.

The current attitude in (some) NHS mental health services seems to be a one-size-fits-all model where CBT is offered as the default but IME, it deals with the symptoms not the cause. For many people it's nothing more than a short term fix: the equivalent of constantly pumping up a deflating tyre instead of taking the tube out to mend the puncture.


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## BigonaBianchi (12 May 2013)

I found much of what is written in a book called Buddha's Brain useful.


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## chernij (12 May 2013)

coffeejo said:


> Like all the different meds, it's only one option of many. Works for some, not for others.
> 
> The current attitude in (some) NHS mental health services seems to be a one-size-fits-all model where CBT is offered as the default but IME, it deals with the symptoms not the cause. For many people it's nothing more than a short term fix: the equivalent of constantly pumping up a deflating tyre instead of taking the tube out to mend the puncture.


Good point - I think in an ideal world it would be CBT in conjunction with meds but unfortunately this isn't always the case. I find it interesting the extremities in views between psychologists and psychiatrists (very generally).


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## coffeejo (12 May 2013)

chernij said:


> Good point - I think in an ideal world it would be CBT in conjunction with meds but unfortunately this isn't always the case. I find it interesting the extremities in views between psychologists and psychiatrists (very generally).


Do you mean CBT with meds or *therapy* with meds?

CBT is different to many other therapies in that it deals with current behaviour/thinking and not the reasons behind the depression etc etc etc. It's ONE method. It's not the only one. It's not the best.

Nobody can say that one approach (with or without meds) is better than another because everyone's experiences, needs and responses to therapy (and therapists) are different.


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## BigonaBianchi (13 May 2013)

My understanding is that depression is divided into different causes...

Re active ( a reaction to an event/trauma/loss/life change for example)

Clinical (some kind of inherited tendancy/in your genes)

Substance related ( alcohol/drug abuse)

CBT looks at the thought processes. I believe some people are prone to depression due purely to their thought process, in which case they may respond to CBT. Others may have experienced an event which changed the way they think about things, CBT will help to a degree but it won't make the issue go away in itself. However it may provide the sufferer clarity of thought to be able to make changes to the underlying problem themselves. Some underlying events can never be changed (berievement ) so CBT will only help how we deal with it in our heads.

CBT is just one tool to be used where appropriate. I don't think it's the be all and end all 'cure' and again it's often used and a blanket 'default' therapy option. Person centred is however the most common form of counselling I think. I suspect psychodynamic schools are less common, perhaps because they are more expensive and time consuming?

I came to a conclusion after many years that the answer does not lay with others, or with treatment (chemical or otherwise) the real answers lay inside oneself. Having said that to reach that conclusion one may have to go through this med/thearapy rollercoaster and reach that conclusion ones self.


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## chernij (13 May 2013)

coffeejo said:


> Do you mean CBT with meds or *therapy* with meds?
> 
> CBT is different to many other therapies in that it deals with current behaviour/thinking and not the reasons behind the depression etc etc etc. It's ONE method. It's not the only one. It's not the best.
> 
> Nobody can say that one approach (with or without meds) is better than another because everyone's experiences, needs and responses to therapy (and therapists) are different.


I meant therapy, apologies for not clearing it up.


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## coffeejo (13 May 2013)

chernij said:


> I meant therapy, apologies for not clearing it up.


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## Hip Priest (20 May 2013)

Been feeling awful the last few days, culminating in an anxiety attack this morning at work. I've been allowed to go home early, and I'm pondering whether to go back my original dose of medication. Having not experienced any serious anxiety problems for a couple of years, this has really taken the wind out of my sails, but I'd feel like a failure going back on the drugs. Thoughts?


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## coffeejo (20 May 2013)

I don't think it's a failure to be on meds. In all honesty, as I think I've said before, if you had any other medical condition that required medication, would you view it as a failure? Or a a tool to enable you to live your life? Do you beat yourself up if you have to take paracetomol? Personally, of all the consequences of poor mental health, I find swallowing a tablet every night to be the least of my concerns. 

OT, I had a really weird dream last night where my primary care trust were forcing me to come off meds and using me as a guinea pig for some experiment.  Not sure I want to go to my appointments this week.


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## PK99 (20 May 2013)

BigonaBianchi said:


> My understanding is that depression is divided into different causes...
> 
> Re active ( a reaction to an event/trauma/loss/life change for example)
> 
> ...


 

I think your understanding is incorrect:





> Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods.
> *Clinical depression* is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for a longer period of time.




The key point making the depression clinical, is the interference with everyday life over extended periods

Further, CBT comes from the idea that it is not events that result in mood disorders, but how we think about events: Thoughts drive Emotions not the other way round. 
CBT addresses the problem by addressing the underlying thinking errors

Have a look here>>> http://www.harleytherapy.co.uk/cognitive-distortions-cbt.htm


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## Hip Priest (20 May 2013)

coffeejo said:


> I don't think it's a failure to be on meds. In all honesty, as I think I've said before, if you had any other medical condition that required medication, would you view it as a failure? Or a a tool to enable you to live your life? Do you beat yourself up if you have to take paracetomol? Personally, of all the consequences of poor mental health, I find swallowing a tablet every night to be the least of my concerns.


 
You're absolutely right of course. I guess it's just my disappointment manifesting itself as feelings of failure. I thought I'd overcome these problems, and now it's clear that I haven't.


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## coffeejo (20 May 2013)

Hip Priest said:


> You're absolutely right of course. I guess it's just my disappointment manifesting itself as feelings of failure. I thought I'd overcome these problems, and now it's clear that I haven't.


Nah, mental health isn't a failing. It's not a sign of weakness. You're not less of a person because of it. And it's not a problem to be fixed, but a condition to be managed. So get out there, hold your head up and be proud of the fact that you've got the courage to deal with it head on.


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## Hip Priest (20 May 2013)

Thanks for your support Jo.

I'm off to bed with a book. I'm sure I'll feel a bit better after a rest! Got a 20 mile TT tomorrow, so I need it....


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## shouldbeinbed (20 May 2013)

coffeejo. I stand and applaud your contributions to this thread.

Hip Priest, it is a long slow climb from the depths, even when you are off the meds you still have a long way to go. You will  have setbacks and bad days but all that does is prove you are a human being, not in any way at all a failure. Hang in there, just keep putting one foot in front of the other & you'll get there


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## Martyn H (20 May 2013)

Hip Priest said:


> You're absolutely right of course. I guess it's just my disappointment manifesting itself as feelings of failure. I thought I'd overcome these problems, and now it's clear that I haven't.


 
Recognizing how to deal with MH issues is a huge positive. Knowing that meds may be required to manage the condition for the very long term is so much better that beating yourself up as a failure. I had been off meds for about three years, but recently found myself struggling again. Being able to recognise what was happening to me has helped, and before things got really bad, I spoke with my GP and am now on a course of Sertraline for the forseeable future. This time I have caught myself in time and am still able to work and go out on the bike etc. 

Wishing you luck with your TT tomorrow


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## The Brewer (30 May 2013)

BigonaBianchi said:


> Citalopram is a truly horrid drug. Gp's should be ashamed of themselves for prescribing it when they know full well of the horrendous side effects it can have and withdrawel issues . It's dished out like smarties and those who have not taken the wretched stuff can never know how it feels to lose your 'self' to this s***...yet how many GPs have ever taken this poison?


 

shoot just been prescribed this today and just swallowed my first tablet


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## Andrew_P (30 May 2013)

The Brewer said:


> s*** just been prescribed this today and just swallowed my first tablet


I wouldn't be overly concerned, most of these sort of drugs will have some withdrawal side effects, but if you manage your way off of them they can be kept to the minimum.

For me this drug was a life saver and helped me get through a tough time and come out the other side sane and in good health. I decided to come off of them myself and just did a a gradual reduction over the amount of tablets in my last prescription. For me the benefits far outweighed the negatives, I hope it will be the same for you too.


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## PK99 (30 May 2013)

The Brewer said:


> s*** just been prescribed this today and just swallowed my first tablet


 

As I said earlier in the thread, do not be scared off someting based on comments from some random bloke on the internet who had a bad experience. All they have succeeded in doing is heightening your anxiety

I, and a goodly number i have spoken to, have had a very positive experience of Citalopram.


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## coffeejo (30 May 2013)

It's like food. Some people love tomatoes. Personally, I think they're the food of the devil and are only allowed in puréed form on pizzas or disguised in lasagne/bolognase. But there's only one way to find out.

Oh, and you need to give it 3-6 weeks before you can expect to see any results, longer for some. Unfortunately, this means you're dealing with the side effects before it kicks in. Just take a deep breath and stick with it. They do fade, honest.


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## Archeress (30 May 2013)

Hi there,

I have been on SSRI's for almost a decade, with a few gaps in between. I have been on escitalopram, flouxetine, and am currently on citalopram. For me the first two were the worst for side effects and the citalopram fits very well. I do feel tired most of the time, which I think is the citalopram.

Mental health wise, my depression is said to be endogenous (or as in an earlier post clinical). I have become stable in the past and come off my pills, but usually after a few months I have ended up in a deep unrecoverable depression again and need to go back on the pills. The last time I came off the pills it took me nearly a year.

Since my depression started I have also undergone gender reassignment which has also made me much more stable mentally and now have a successful relationship for the first time ever, but I dont think I will ever come off the pills.

Hugs
Archeress x


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