The Cycle That Kept Me From Seeking Help For My Depression — & How I Broke It

I moved 13 times in my life, which made it hard for me to call one place home. I was born in Virginia, but we only lived there for a month or two before moving across the Midwest, Mid-Atlantic, and East Coast. Constantly being “the new girl” wasn’t easy.

I thought I would find some stability once I was accepted into college. I joined a sorority, got a boyfriend, and was doing great academically. I had what I imagined everyone wanted out of a college experience. However, I was often in a depressive mood, and my boyfriend would quip that I wasn’t "fun to be around anymore." I didn't feel like myself: I lost interest in things I once enjoyed, like hanging out with friends, and found myself spending more time alone. On top of all that, I had trouble thinking clearly and felt tired and sluggish most days. When I started having suicidal thoughts, I realized this was something that wasn’t going to go away on its own.

So, during my second semester of freshman year, I sought professional help. I didn’t tell anyone — not my friends nor my boyfriend — because of the stigma that I associated with mental health issues. I discovered that my school had an amazing student health center with psychological services available for free. I booked an appointment with a psychiatrist and was diagnosed with a type of depression called Major Depressive Disorder (MDD). He put me on a treatment plan, which included antidepressant medication and talk therapy, but even after getting this diagnosis, I wasn't committed to following my treatment plan. Rather than speaking with my doctor about how I was feeling, I simply stopped seeing him altogether.

Over time, I continued to ignore my feelings. This became particularly apparent to me when I got my first job out of college and was juggling the demands of the fast-paced corporate world. I shut myself off from my friends and coworkers, and cried all the time. And despite trying different jobs and moving to a new city for a fresh start, I continued to experience general feelings of sadness, lost interest in things I once enjoyed, and had difficulty concentrating.

One day, I experienced an “aha” moment that finally got my attention. I had taken on a new job in the healthcare industry and was reading a patient profile that stood out to me: a young female in her late 20s who shared her 10-year journey to finding the right doctor and the right treatment plan for her. I read her profile and thought, This is me. This is what I’m doing — and I need to speak up.

I realized that what I was going through was more common than I thought, and that I needed to seek professional help from a doctor: someone with whom I felt comfortable having difficult conversations about how I'm feeling. I understood that I needed to follow a treatment plan, continue going to my doctor appointments, and be open and honest when talking with the doctor.

I found a new psychiatrist who re-diagnosed me with MDD following an evaluation, and together we discussed my prior experience with treatments, including selective serotonin reuptake inhibitors (SSRIs), and discussed different treatment plan options. She took a look at my medical history, and prescribed an antidepressant prescription medication called Trintellix^® (vortioxetine) that is used to treat MDD in adults.

My doctor helped me understand what I could expect while taking Trintellix and explained all the potential risks and benefits, like how Trintellix increases the risk of suicidal thoughts and actions in people 24 years of age and younger (of note, Trintellix has not been shown to be safe and effective for use in children). She also advised that I call or get emergency help right away if I had new or worsening depression symptoms, new or sudden changes in mood, behavior, thoughts, or feelings, or if I developed suicidal thoughts or actions. My doctor also said that I shouldn't take Trintellix if I'm allergic to vortioxetine or any other ingredients in Trintellix or if I’m taking, or have stopped taking within the last 14 days, a medicine called a Monoamine Oxidase Inhibitor (MAOI), including the antibiotic linezolid or intravenous methylene blue.

Along with safety considerations, my doctor went over the positive treatment results from the clinical trials in adults with MDD. In multiple short-term studies, Trintellix was shown to help reduce the overall symptoms of MDD, based on an overall score on a standardized depression rating scale vs. sugar pill. Also, no significant change in weight was seen in clinical trials with Trintellix. Some reports of weight gain have been received since product approval.

When discussing a treatment plan with my psychiatrist, I learned that while antidepressants are known to be effective based on clinical trials, there are also potential side effects from these types of medications, including nausea, vomiting, weight gain, changes in sleep, treatment-emergent sexual dysfunction (TESD), and suicidal thoughts and actions.

The most common side effects of Trintellix are nausea, constipation, and vomiting. Serious potential side effects include serotonin syndrome, increased risk of bleeding, manic episodes, discontinuation syndrome, eye problems, low levels of salt (sodium) in your blood, or sexual problems. These are not all the possible side effects of Trintellix.

I’ve been on my current treatment plan for about four years now, and my MDD has been much more manageable. I would be lying to say that every day is perfect. I think anyone with depression understands that there are good days and bad days. I have learned that it's important to have ongoing honest and open conversations with a doctor. I’m prioritizing my health and wellness by staying in close contact with my doctor. There are some things I always say to anyone going through a similar situation:

1. It’s okay to not be okay. Even when your depression is being treated, every day is not perfect. It’s okay to say, “I’m not doing okay today. I need a wellness day. I need a break.” 

2. Speak up. Navigating your mental health may take time, but speaking up, especially to your doctor, can help. I’m sharing my story because I want others to know what having depression may look like. Have an honest conversation with your doctor, so you can find a treatment plan that’s right for you.

*Tatiana is a paid contributor for Takeda Pharmaceuticals and Lundbeck. Last name withheld to protect subject’s privacy.

What is TRINTELLIX (vortioxetine)? 
TRINTELLIX is a prescription medicine used in adults to treat a certain type of depression called Major Depressive Disorder (MDD). TRINTELLIX has not been shown to be safe and effective for use in children.

Who should not take TRINTELLIX?
Do not start or take TRINTELLIX if you: 
• are allergic to vortioxetine or any of the ingredients in TRINTELLIX
• are taking, or have stopped taking within the last 14 days, a medicine called a Monoamine Oxidase Inhibitor (MAOI), including the antibiotic linezolid or intravenous methylene blue

Do not start taking an MAOI for at least 21 days after you stop treatment with TRINTELLIX.

What should I tell my doctor before taking TRINTELLIX?
Before taking TRINTELLIX, tell your doctor:
• about all your medical and other health conditions
• if you are pregnant or plan to become pregnant, since TRINTELLIX may harm your unborn baby. Taking TRINTELLIX during your third trimester may cause your baby to have withdrawal symptoms after birth or to be at increased risk for a serious lung problem at birth. Tell your doctor right away if you become or think you are pregnant while taking TRINTELLIX
• if you are breastfeeding or plan to breastfeed, since it is not known if TRINTELLIX passes into your breast milk

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements, since TRINTELLIX and some medicines may cause serious side effects (or may not work as well) when taken together. Especially tell your doctor if you take: medicines for migraine headache called triptans; tricyclic antidepressants; lithium; tramadol, fentanyl, meperidine, methadone, or other opioids; tryptophan; buspirone; St. John’s Wort; medicines that can affect blood clotting such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin; diuretics; medicines used to treat mood, anxiety, psychotic, or thought disorders, including selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs); or medicines used to treat seizures or convulsions. 

• Serotonin syndrome: A potentially life‐threatening problem that can happen when you take TRINTELLIX with certain other medicines. Call your doctor or go to the nearest emergency room right away if you have any of the following signs and symptoms of serotonin syndrome: agitation; seeing or hearing things that are not real; confusion; coma; fast heart-beat; changes in blood pressure; dizziness; sweating; flushing; high body temperature; shaking, stiff muscles, or muscle twitching; loss of coordination; seizures; nausea, vomiting, diarrhea.

• Increased risk of bleeding: Taking TRINTELLIX with aspirin, NSAIDs, warfarin or blood thinners may add to this risk. Tell your doctor right away about any unusual bleeding or bruising.

• Manic episodes: Manic episodes may happen in people with bipolar disorder who take TRINTELLIX. Symptoms may include: greatly increased energy; racing thoughts; unusually grand ideas; talking more or faster than usual; severe problems sleeping; reckless behavior; excessive happiness or irritability. 

• Discontinuation syndrome: Suddenly stopping TRINTELLIX may cause you to have serious side effects including: nausea; sweating; changes in your mood; irritability and agitation; dizziness; electric shock feeling; tremor; anxiety; confusion; headache; tiredness; problems sleeping; hypomania; ringing in your ears; seizures.

• Eye problems: TRINTELLIX may cause a type of eye problem called angle-closure glaucoma in people with certain other eye conditions. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are. Call your doctor if you have eye pain, changes in your vision, or swelling or redness in or around the eye.

• Low levels of salt (sodium) in your blood: Low sodium levels in your blood that may be serious and may cause death can happen during treatment with TRINTELLIX. Elderly people and people who take certain medicines may be at a greater risk for developing low sodium levels in their blood. Signs and symptoms may include headache; difficulty concentrating; memory changes; confusion; weakness and unsteadiness on your feet which can lead to falls. In more severe or more sudden cases, signs and symptoms include: seeing or hearing things that are not real; fainting; seizures; coma; stopping breathing.

• Sexual problems: Taking TRINTELLIX may cause sexual problems. Symptoms in males may include: delayed ejaculation or inability to have an ejaculation, decreased sex drive, or problems getting or keeping an erection. Symptoms in females may include: decreased sex drive, or delayed orgasm or inability to have an orgasm. Talk to your doctor if you develop any changes in your sexual function or if you have any questions or concerns about sexual problems during treatment with TRINTELLIX.

The most common side effects of TRINTELLIX include:
• nausea
• constipation
• vomiting

These are not all the possible side effects of TRINTELLIX. Tell your doctor if you have any side effect that bothers you or does not go away.

TRINTELLIX is a trademark of H. Lundbeck A/S registered with the U.S. Patent and Trademark Office and used under license by Takeda Pharmaceuticals America, Inc. TAKEDA and the TAKEDA logo are registered trademarks of Takeda Pharmaceutical Company Limited. ©2023 Takeda Pharmaceuticals U.S.A., Inc. All rights reserved. 1-877-TAKEDA-7 (1-877-825-3327).  US-VOR-0572v2.0 09/23