*Mental health* meds

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I’ve suffered from Agraphobia most of my life, but things got a lot worse winter of 2018 / 2019 I didn’t leave the house at all apart from work, and that was a major stuggle, and started self harming just to leave the house. Was starting to recover and the pandemic destroyed me, as the one things my fears wanted me to do, the government made me do

I was put on Fluoxetine and … an other one beginning with S, They made me groggy in the morning, and have removed my sex drive, I’m in the process of coming off Fluoxetine. Throughout I’ve had no trouble doing sessions (indeed I’d argue that my FTP and fitness is highter than it’s ever been) but I have to time it, I can’t do anything more than Z2 before 9am, but it’s not stopped me doing group rides (infact it’s help me do it) at the weekends, if I want to do V02 e.t.c, I leave it till lunch or evening

Yes it’s has affected my ability to train at certain points in the day, but it’s allowed me to sort my life out, and doing so much more, have international races in my calender, doing a ultra in April, went to Iceland and did The Rift gravel race

I think sorting my mental health out (don’t take, taking the pill as sorting health out, you have to address what got you to that point) has unlocked so much for me

… Anyway, I hope i answer the right question, sorry if I rambled

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Hi @OwenL

I was contemplating to DM you, but I think these topics deserve more visibility. So here we go!

I’ve been taking antidepressants for close to 3 years now (escitalopram 20mg). I’ve gotten lucky and the first ones I tried worked and had only minimal side effects. The first couple of weeks there was a slight nausea (quite common), but that went away (also common). Otherwise I didn’t see any negative or positive direct side effects regarding training. It is quite common though to see some weight gain, depending on the medication and person. Depending on your relationship with food, that might also be offset though (less binge or crappy eating).

I can’t stress enough though, what a positive effect it had on my life and the positive indirect effects on training. The meds didn’t solve everything, but they gave me a helping hand to change other behaviors that had a negative impact on my training (and life in general):

  • I reduced my alcohol intake from several drinks several days a week to once every fortnight, usually just one drink, rarely two. In hindsight, I did have a problematic relationship with alcohol.
  • I started sleeping more regularly and better (also related to alcohol).
  • Before, I had way more negative thoughts. I strived for perfection or nothing. This led to phases in training, where everything went perfect and I had great adherence. The life happened and I “fell off the wagon” and stopped training completely. Now my long term consistency is way better, as I am kinder towards myself.
  • No more missed workouts because of depressive episodes or hangovers. There were plenty of those before.
  • I have much more “drive” to do things, including exercise.
  • My nutrition has improved, as I tended to not have appetite during depressive episodes and/or eat crap as I couldn’t be bothered to prepare healthy food.

These different things feel like they supported each other and cumulated over the months and changed my life quite radically. I don’t think one was the “magic pill” (pun intended), but I believe medication made it so much easier to get the stone rolling and change other aspects of my life that again have a positive impact on my training and well being in general.

I have also looked into the topic quite extensively and have found no information that SSRIs would negatively impact performance in any way, apart from a slight weight gain in some people.

Wish you all the best!

TL;DR: Antidepressants did have no direct negative effect on my training, but many positive indirect ones.

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I so badly want to pitch in with my experience. But I’m afraid something I will say will just be really bad an negatively impact someone else’s desire to get better.

So, the best way I can think of to help is to just shut up :joy:

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I’m honestly surprised this thread is still open. Some of these comments are borderline medical advice.

Talk to a psychiatrist. Get a second opinion, but take their advice over literally anyone on this board.

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You’re not wrong. Too many of us are looking for mental health fixes that are just a pill. It’s not too different than “If I buy this thing, I’ll be faster on the bike”

The reality is both require work. For me it’s a therapist that knows how to work with folks that have my condition, that alone was a lot of work. A man in his 50’s acknowledging I needed help and not giving up until I found one that has experience with my disorder.

I was diagnosed with Avoidant Personality Disorder last year. It was one of those things where when explained was like “yeah, that makes sense.” Oddly well managed (just by luck) until I got into the wrong work environment.
There was a long build up to an event triggered by my manager while I was IN LEADVILLE. Just amazingly bad timing. I really should have quit on the spot, but that’s not how mental health issues work. You’re not rational and part of you knows it’s not rational, but unless you already have the tools on hand and practiced, it’s a bad place to be.
That’s why I’m sticking with therapy. I need to know how to use those tools, so I can head off the irrational behavior before I set myself up for another trigger event. (they suck, not recommended)
I’m finally addressing the work environment side of things, but there’s a lot to do before I can reclaim Leadville from being attached to the negative event.
It’s work. If you need help, get professional help. Doctor, Therapist, someone you can talk to openly. (that’s not always your significant other) just don’t try to do it alone.

Also whether or not you think you have mental health issues, watch Inside Out 2. It does a pretty good job of showing what’s happening on the inside during a panic attack. I wish I could have solved my issues in 90 minutes…

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I find it valuable, how many different experiences have been shared here. Positive and negative! I think they illustrate many individual experiences and also some problems with the health care industry.

  • Medication can be a valuable tool. I also believe it is handed out by GPs (and some specialists) too nonchalantly though.
  • I strongly believe it should be one tool in a whole toolbox (therapy, lifestyle changes, exercise, mindfulness practice are some, that have been valuable for me personally)
  • There can be negative side effects.

Medication is no magical fix, but can be helpful for some. It is not for others. People will have to make their own experiences.

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oh, i forgot to mention I was drinking ALOT on paxil. (not on lexapro though)
its liek the “reward” from drinking wasnt enough so I drank more and more.

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This is most assuredly not a safe space to discuss medications for mental health, bravo to those that do however because I think it can be helpful for many.

FOR THE CHILDREN READING; THIS IS NOT MEDICAL ADVICE OR A PERSCRIPTION FOR HOW YOU SHOULD TREAT MENTAL HEALTH ISSUES.

I had great success, life changing success with CBT. In particular with ERP. I was officially diagnosed with OCD about 25 years ago. While growing up, I presented as a child with ADHD but that was nothing more than my 9 year old brains attempt to deal with what that forgotten side of OCD did to me.

I told my Doctor that if she offered me a shot that would instantly cure my OCD, I wouldn’t take it. Because it would be like losing my closest companion, I couldn’t go on without them. Traditional psychotherapy/counseling or talking interventions didn’t work…would never work. She suggested CBT and we worked on exposure response prevention. Tools, it gave me tools and worked for my logical man brain. Like a revelation. I’m not cured, but better I’m confident in my ability to live with that little bent wiring in my head.

FOR THE CHILDREN READING; THIS IS NOT MEDICAL ADVICE OR A PERSCRIPTION FOR HOW YOU SHOULD TREAT MENTAL HEALTH ISSUES.

If I were talking to a friend or relative someone I cared about. And that person had a mental health issue that they were not dealing with very well, I would recommend that they seek professional help from a Doctor who specializes in CBT.

Good luck to those dealing with these issues. Take care…

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Sure, but the topic at hand is meds, and CBT and meds together is quite often an effective treatment plan. They aren’t mutually exclusive.

The Op should find a licensed professional and take advice from them, not strangers on the internet.

The condescending tone wasn’t needed or really appreciated.

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Yes, and it sounds like they have, it seems to me that the OP was asking “did meds affect your training”, and a forum of cyclist is a sensible place to ask, if you ask a doctor, will affect my training they will view the question in the context of the general population, not somebody who races / trains hard

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Thinking back, I can’t imagine training under the influence of some of the meds I was on as being a comfortable situation. With Prozac, I developed ‘serotonin syndrome’ as one therapist labeled it. I would experience what could only be seen as ‘power surges’, where everything would just seem to go WOW, and then back to normal. My vision would change, I had auditory sensations, it felt like my skin was electrified at times. A really unnerving thing to happen. And the sweating I mentioned, I could be sweating in an air conditioned room. riding like that wouldn’t be pleasant. I also felt like I had something in the back of my throat. It made swallowing a little difficult. Put together, getting off it was so much the best thing as I seemed to be just treading water in my ‘therapy’. (Which again seemed to be ‘do you need refills’, ‘should we try something else’). And I just felt ‘weird’. Sedated some of the time, and yet some things would freak me out. I don’t know if what I was feeling meant that I didn’t need it, or it was the wrong thing, but it seemed to get very gradually worse over the couple years I was on it. And I guess I thought I needed drugs too, and was receptive to taking all of them.

I still have anxiety at times (flying) and feel generally depressed now, but who wouldn’t. (The election, the weather, the loss of sun, yuck) But at my worst, I developed agoraphobia and was just kind of a mess. I seem much better able to cope, so biking, a morose sense of humor, bubble wrap; I’m good. Just gotta keep riding…

But if you are in a hole, and need a rope to get you out, properly prescribed and monitored meds really can help, but you may need to either stop training, or put zone3 and up on the shelf. Those meds deal with a lot of the bodily systems, just be careful, and don’t give up hope. Keep on keeping on…

Here’s a quote that has helped me immensely, from one of my favorite movies:

Screenshot 2025-01-10 at 1.56.38 PM-small
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:joy_cat: Happy to see I shared a completely legit article on this topic and it got flagged. Good work “community” :+1: :+1:

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Business insider is NOT in anyway shape or form a legit source. I didn’t flag it but almost did.

If you want to know the top 9 things to buy at costco, sure legit source. Well until you realize that the article with the top 9 things not to buy at costco has the same items…

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38

I agree wholeheartedly with this. It just makes so many aspects worse of mental issues and also antidepressants should really not be mixed with alcohol. It may hamper the positive effects of the meds, make side effects worse or even be acutely dangerous in combination with certain kinds of antidepressants.
In my own experience, when starting on my meds, it was like the effect of alcohol was made way stronger. I was disoriented and had blackouts after like 3 beers. That did wear off after a while, but still, cutting out regular alcohol consumption had such a great impact on my life in general. Can only recommend it!

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I never drink. Not since 2022 :smile: I do all the classic ‘healthy’ things.

Changed night shifts for normal hours. No late nights, fruit veg and fresh air. More & less training. No social media or Strava.

My biggest vice is a morning coffee and maybe a can of cherry Pepsi max. And peanut butter.

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ADHD and GAD here. Definitely a combination that has helped and hurt over the years. Sipping my coffee and creatine right now and figured I would finally reply.

I typed up something long, it was probably entertaining since it included oligarchs, but too much for this thread.

Short(er) version.

Didn’t think I could have ADHD as a kid because I obsessed over cars and riding my bike. my brother had it and he just played video games. Neither of us did our homework but would ace our tests, but we were not the same, so how could I.

I started dating someone who was like you really should see a therapist because my attention span was hurting my business and that just fed into my anxiety. I also couldn’t make phone calls to a Dr, I refused to order food like a custom sub where someone might judge my choices that sort of thing (ordering kiosks at wawa/etc best thing ever).

I went on some adhd meds, forget what as its been 20 years, while they mostly seemed to work they also seemed to cause panic attacks because of the anxiety when I did still get behind at my business. I had them before and after the meds but they were very very bad during.

So tried some anxiety meds instead of ADHD meds, don’t recall what I was on first but it killed my sex drive. Previously mentioned GF (redhead) was not happy, got Dr who she called on her own not me having a panic attack this time to change them. Went onto something orange/white forget what it was. It worked but not as well but at the time no sex was not an option.

We split up in the middle of our wedding planning/house selling (mine)/move 800 miles for a job I was taking. New job didn’t have insurance setup had to ween off the orange/whites. But that job was in customer support so I was sort of forced into getting out of my comfort zone and it helped, mostly. The internet forum support and the ADHD did not mix well. When i got laid off from that job 10 years later my mom texted “good”. Current partner was like that was mean, 2 weeks later she was like wow your mom was right.

So I haven’t been on any anxiety meds since about 2007. I started my own business again in 2017 and they both are problems again. I get behind because I get distracted and then I have anxiety/panic attacks over dealing with customers. In 2020ish? I feel like masks were involved I had insurance again for a short bit and a local Dr I wanted to see (runner) moved to an office next to my house so I asked to try some ADHD meds again. They were doing ok, I was basically taking a dose for a 6 year old, but for some reason even with insurance and costco pricing I couldn’t afford to stay on them. Costco also never seemed to stock it. He had a job opportunity with the Air force or something so took it and the new Dr refused to write an RX unless I got retested or showed proof of former tests. You know because there is a big street market for timed release child doses of Ritalin, but ok whatever. After a week of anxiety finally called doc from 15+ years before back and unfortunately record were purged. At this point didn’t have insurance again and couldn’t afford the meds even if I managed to get tested free/cheaply through a clinic or something.

I’ve done no coffee at times, thinking it would help make caffeine work better on race day. But even people in my old office (that tech support job) were like yeah you clearly get more work done when you started drinking coffee again after your race.

I stopped drinking at home start of 2024, I am 100 % sure at times I drank to self medicate. Never a I can’t stop situation, I would regularly not drink for weeks, months, year at a time. But definitely 1 beer turned into 3 or 4 many nights to try and shut down the thoughts to get to sleep.

Currently trying to figure out how to manage getting something for the ADHD again because the other option is shut my business down and go back to work for someone else, which is not easy after this much time. Catch 22 if I shut it down I’ll get a job with insurance.

Part of the reason for the baby dose with runner doc was my concerns with training and the meds since I felt like my HR during panic attacks in the past was elevated because of them. So I haven’t trained much on them, wasn’t doing anything back in the early 00s and wasn’t training hard when I was on them more recently. But I’ve also learned to “love” a higher than comfortable heart rate so I might enjoy it now.

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Except, like I said, the psychiatrist I went to was a high priced drug/pill pusher. I was surprised for sure. But as with anything, if you don’t think that you are getting what you need/want, find someone different. Especially with medical issues. There are bad docs everywhere, but don’t get discouraged if their advice/treatment is ‘hard’. But being an educated consumer is important in just about everything in life!

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Sure there are bad docs but maybe it’s just people doing what they are trained to do. I mean carpenters pound nails. They won’t think to weld something together if it can be nailed together.

Psychiatrists are trained to prescribe. Psychiatry is a black art - try to get the patient on a cocktail that allows them to function. There is very little of “this pill will fix that” with 100% accuracy.

Very few psychiatrists will say to the patient: “Before I prescribe you anything, I want you to exercise 30 minutes per day, quit alcohol, quit marijuana, quit all the junk food, quit the togo food and fast food, and eat fruits and vegetables at least three times per day.”

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Having been down this road myself in the past…

Some ‘mental health’ meds have negative impacts on the body’s ability to recover from hard training.

Fundamentally, many reduce the body’s ability to re-absorb neurotrasmitters like dopamine and serotonine. The body needs to re-absorb many of these neuro-active agents in order to enter full recovery and restorative sleep.
When you take the med, the neuro-actives your body generates start to be re-absorbed by the body at a slower rate than prior to beginning the medication.

SSRIs block serotonin re-absorbtion.
SNRIs block serotinin and norepinephrine re-absorbtion.
NDRIs block dopamine and norepinephrine re-absorbtion.
Benzodiazepines at least initially help the body calm down, so perhaps a boon to recovery.
Anything which has anti-histamine characteristics is also going to mute the body’s response to training.

Obviously the interactions and understanding of mechanism for all of these is only partially understood. It is also sometimes the case that the initial mechanism of a drug has one effect, but the biological system overall effect balances for or even overcompensates for the initial effect.

The absorbtion and reaction mechanisms of different individuals is also extremely unique. If you have closely-related family members who have had positive or negative experiences with particular families of drugs, that might be worth sharing with your doctor.