Mental Health Support Society Mk X

Eurgh, saw my psychiatrist today. I've been in a really, really bad place recently, after seemingly being so much better. A lot of it stems from putting on so much weight on mirtazapine.

She thinks that I'm not actually having a relapse and that I'm not having a depressive episode right now, and that all my bad feelings stem from BPD. According to her, medication is going to do nothing because BPD is psychological so I have to just deal with it until my referral for psychology goes through. She said I can take less mirtazapine in the hope that I might lose some weight that way, but knowing that I'm going to feel like this and be unable to do anything about it is really hard.

Now I'm just in a real dilemma because I've been feeling so low anyway that I really can't deal with crashing if the reduced dose does't suit me, but on the other hand, being so much heavier is making me feel worse in itself so it's a vicious cycle.

ED triggers

Eurgh, saw my psychiatrist today. I've been in a really, really bad place recently, after seemingly being so much better. A lot of it stems from putting on so much weight on mirtazapine.

She thinks that I'm not actually having a relapse and that I'm not having a depressive episode right now, and that all my bad feelings stem from BPD. According to her, medication is going to do nothing because BPD is psychological so I have to just deal with it until my referral for psychology goes through. She said I can take less mirtazapine in the hope that I might lose some weight that way, but knowing that I'm going to feel like this and be unable to do anything about it is really hard.

Now I'm just in a real dilemma because I've been feeling so low anyway that I really can't deal with crashing if the reduced dose does't suit me, but on the other hand, being so much heavier is making me feel worse in itself so it's a vicious cycle.

ED triggers

I've always been under the impression that mirtazapine had higher side-effects at lower doses, so you'd possibly be better off increasing rather than decreasing? I've had one or two really bad experiences from blindly trusting psychiatrists to know their stuff about meds before, so if I were you I'd do your own research before making any med changes. Especially when they're going on about not being able to do anything for you because you have BPD - I may be slightly paranoid on this front, but I think it's all too easy for psychs to use this as a get out clause for themselves.

/paranoid ravings

I'm not totally sure, but I think it's only the sedating side effects of mirtazapine which get less strong at higher doses. The way my psychiatrist explained it to me is: mirtazapine works in lots of ways, one of which is to block histamine receptors and one of which is to increase noradrenaline. Blocking histamine receptors is what makes you tired, and increased noradrenaline is actually activating. But whilst it doesn't take a high dose at all to max out on blocking histamine receptors, the noradrenaline keeps increasing as you increase the dose - so at lower doses the sleep effects of the histamine receptors is very strong, but at higher doses it is counteracted by the noradrenaline effects. As far as I'm aware, the hunger side effect is also related to histamine receptors and thus stays doesn't really increase with dose increases, but I don't think noradrenaline or any of the other neurotransmitters decrease hunger, so I don't think it decreases either? Not sure if anyone understands any better, please correct me if I'm wrong because this is just what I've read online and got from my psych. I haven't had many side effects myself so not a lot of experience.

I've always been under the impression that mirtazapine had higher side-effects at lower doses, so you'd possibly be better off increasing rather than decreasing? I've had one or two really bad experiences from blindly trusting psychiatrists to know their stuff about meds before, so if I were you I'd do your own research before making any med changes. Especially when they're going on about not being able to do anything for you because you have BPD - I may be slightly paranoid on this front, but I think it's all too easy for psychs to use this as a get out clause for themselves.

/paranoid ravings

I'm not totally sure, but I think it's only the sedating side effects of mirtazapine which get less strong at higher doses. The way my psychiatrist explained it to me is: mirtazapine works in lots of ways, one of which is to block histamine receptors and one of which is to increase noradrenaline. Blocking histamine receptors is what makes you tired, and increased noradrenaline is actually activating. But whilst it doesn't take a high dose at all to max out on blocking histamine receptors, the noradrenaline keeps increasing as you increase the dose - so at lower doses the sleep effects of the histamine receptors is very strong, but at higher doses it is counteracted by the noradrenaline effects. As far as I'm aware, the hunger side effect is also related to histamine receptors and thus stays doesn't really increase with dose increases, but I don't think noradrenaline or any of the other neurotransmitters decrease hunger, so I don't think it decreases either? Not sure if anyone understands any better, please correct me if I'm wrong because this is just what I've read online and got from my psych. I haven't had many side effects myself so not a lot of experience.

I'd heard this as well, so I'm suspicious. She's been amazing up till now but it's making me a bit concerned. She did say that if I still have problems on the lower dose I could maybe switch to trazodone, but I don't know if that's going to be any better...

Now I've really scared myself by reading loads of webpages about weight gain. I hate this.

I'm not totally sure, but I think it's only the sedating side effects of mirtazapine which get less strong at higher doses. The way my psychiatrist explained it to me is: mirtazapine works in lots of ways, one of which is to block histamine receptors and one of which is to increase noradrenaline. Blocking histamine receptors is what makes you tired, and increased noradrenaline is actually activating. But whilst it doesn't take a high dose at all to max out on blocking histamine receptors, the noradrenaline keeps increasing as you increase the dose - so at lower doses the sleep effects of the histamine receptors is very strong, but at higher doses it is counteracted by the noradrenaline effects. As far as I'm aware, the hunger side effect is also related to histamine receptors and thus stays doesn't really increase with dose increases, but I don't think noradrenaline or any of the other neurotransmitters decrease hunger, so I don't think it decreases either? Not sure if anyone understands any better, please correct me if I'm wrong because this is just what I've read online and got from my psych. I haven't had many side effects myself so not a lot of experience.

Oh, I didn't mean to say that you thought it was ED stuff, just want to make sure that you're not overthinking it too much and reassure you that it's normal. When I have depressive bouts of low appetite it isn't normally followed by binging - normally I'm more likely to binge if I'm deliberately restricting for a while, rather than just because I'm not hungry.

I agree that it's a good idea to eat once a day. I've just personally found it's funny but when I say to myself "you MUST eat at least 600kcals per day" suddenly that target can get really, really hard to reach and it feels like I'm shovelling food in. If I take a more relaxed approach and just snack on fruit and nuts or cereal throughout the day it suddenly gets a lot easier to hit a much better amount. Now I don't focus on hitting targets so much anymore even during low appetite phases I can snack my way up to about 1200kcals, but overthinking it just makes my appetite go away more.

Hate those ****ing useless tossers who do that. That has happened to me throughout my life. Even teachers in school did that . And those people who ****ing justify it.............

The only positive thing I suppose is that you don't have long left here . Not possible to join in I guess? If not then maybe music or something could help?

This is kind of a rant so feel free to ignore.

Hey guys, not been on here for a few days since me and ppl have been discussing a big jump we're gonna take regarding us getting an office to work in, and moving to a new house. We're likely gonna be needing £1500 to get our equipment, paying £240 each month for the office, and then we'll need to get a loan of sorts for our living costs. Its all rather scary, im probs gonna be about another £3000 in debt at the start if i go through with this so its pretty scary. We'd be paying a lot of things gradually or after 2 months but its still some scary numbers.

Not got much sleep the last few days, been feeling reeeaallly crap, but ive had to be awake to meet people and go to interviews, i still have an interview for something on friday. I feel like everything is just getting on top of me and im kinda worried i'm gonna have a breakdown or something Also my housemate is being really negative, or so it feels, which isn't helping. He can't understand why some of us cant just work from our bedrooms. This is a guy that watches TV while he works, he actually manages to watch a TV series while working, i dont get it and i dont think anyone else does. He also gets really excited sometimes about stuff and will reel off like an hour of stuff to you when you may not be in the mood. He's also scared of food, yeah. Despite all his quirks he can't understand while me and the others just can't work from our bedrooms. Theres too many distractions at home for me, and my mental health doesn't help either.

I've just had too much on my mind...glad im seeing my therapist tomorrow.

So tired and generally meh today. Spent all day trying not to fall asleep. Just had no interest in anything. Practically fell asleep on my friends sofa while they had lunch then slept for 3 hours when I got home (was meant to be revising). Haven't eaten much. All I want to do is curl up in a ball and sleep. Everything just feels like i'm having to push through jelly or something it's like there's more pressure than usual. On top of that I handed in my letter for special consideration to exams office today... they read the letter, which I really hoped they wouldn't cos it contains a piece of information I really don't like people finding out about, and then they were just so blunt about everything and it unsettled me. I was feeling so much better about exams last night and now i'm getting worried again. I just want to curl up in bed and cry myself to sleep!
I feel bad cos my friend are having problems with relationships and stuff and I'm so out of it all I can manage to do is nod and "hmm" when they talk to me about it. I feel like such a bad friend. I'm trying to still act like me and be positive around people but it's hard.
I just feel so horribly mediocre at the moment. I hate this feeling! I can't be bothered to do anything. I'm not eating or drinking as much as I should and it's been like 3 days since I last had a shower. My hair's getting all greasy and all I need to do is jump in the bloody shower for like 5 minuets but I just can't be bothered.
Only 2 days left. I don't want to leave college!! It's all I have to keep me sane!!!!

But trying to look at the positives... ["always look on the bright side of life" ] I'm not as anxious as I have been recently- late for lesson and didn't freak out. win!- and I have the most lovely friends. I spent a lot of today either curled up on my friend's lap like a cat or continuously hugging them and they just went with it. I swear they're like the only reason I can function sometimes <3

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Hope everybody's feeling okay. Hugs to anyone who isn't and hope you feel better soon.

Are you going to be doing anything in particularly exciting in your office or just having it as a work space? /nosy

Good luck for your interview!

sigh, I despair of humanity sometimes

I can relate with a lot of that, i know without my family and friends i would be even more of a mess than i already am. I also get troubles with eating enough, having showers etc, i have a lot days where doing anything at all is a massive effort, and i feel so drained, lifeless and hopeless.

I'ts good you're trying to look at the positives, there's almost always something positive happening, even if its just a small thing, but those small things add up, and the next thing you know you will realise you've come a long way.