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
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.
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…
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.
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.
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…
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
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:
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!
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!
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.”
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.
Shortened to say - if you can, have Pharmacogenetic Testing to see which meds might work for you. When you see a professional, ask if they can carry out this test while you are under treatment.
Speaking from experience, the right diagnosis and meds that jibe with your genes work better than those that don’t.
And my experience is that many physicians (all?) don’t want to do testing, and I think it’s because they are watched by the insurance companies and if they order too many tests, they get dinged and possibly ejected from covering their patient subscribers. The only time I’ve heard of testing for people on drugs was for patient drug trials, where testing is part of the process to get approval.
Physicians that don’t do periodic testing don’t do their patients any favors, but the practice is widespread. They get support for pushing pills because the insurance company doesn’t have to pay for therapy, but at what cost. One pill I was on ‘required’ periodic liver enzyme testing which never happened, and generally there was no follow up care/questioning except for refills. Given the recent incident with a patient on SSRIs, maybe physicians should buck the insurance companies and do more follow ups and follow through.
I tried to go off of lexapro last year (for 6 months) because I was tired of being reliant on a pill and noticed no performance differences. I am back on it because I was mentally unstable and simply not functional every day. It almost immediately brought me to a functional state. Not to say it’s perfect but it was clear there is no way I can function without it anymore. Just my experience.
Happy to see I shared a completely legit article on this topic and it got flagged. Good work “community” 
I do all the classic ‘healthy’ things.