Posted by finelinebob on May 10, 2004, at 16:33:05
In reply to Re: Preparing... » SLS, posted by NikkiT2 on May 10, 2004, at 14:42:10
Since you meant to post here, Scott, I'm glad I hesistated to reply on the other board....
I had two responses to what you had to say -- one about the meds and the other about life. I was going to put up the meds one first, but let me defer that.
I can understand your position. I'll be turning 42 in a few months. Being depressed and 40-something is such a bee-yatch, isn't it? I mean, I look back 40 years and I look ahead 40 years, and the prospect of living through what I've already been through is more than a little wearying. Too much future too struggle with. The thing for me, tho, is that I really only started struggling productively when I got into therapy at 35. In five years, I managed to work myself into a place where I thought I really had my act together.
Then I lost all of it. I don't know if you read my "I'm back!" thread above, so forgive me for repeating myself if you have. After 9/11, I went on a downward spiral that has landed me in my parents' basement, any chance of recovering what I had lost completely vanished. I feel like my life is over. Not that I want to kill myself -- nowhere near that. But I am halfway through my biological life and my mental/social/productive life is done.
The funny thing about big, complex, unsolveable problems is that they often have simple answers that escape our notice. Kinda like one of those Star Trek movies, I think, where some Vulcan says something like "When all possible solutions have failed, the logical path is to do something that is not possible" or something like that.
So, for ME, the answer to "My life is over" is: "Start a new one."
Okay, I said the answer was simple. I didn't say anything about the SOLUTION being simple. Implementation is always a b!tch. And starting a new life at 40 is an incredibly daunting, frightening, monstrously huge sort of task. But what else is there to do? Sit in my parents' basement till they die? Fine, but when their social security and retirement fund checks stop coming, what then?
Off myself? If I've learned anything, it is NOT to trust my opinion of myself unless it happens to agree with what my friends and family think of me. I'm a poor judge of my own character. And you know, there are a number of people who find it worthwhile -- gadzooks! even enjoyable and valuable -- to be around me.
I've decided that it is worth all the hard work, all the pain, all the despair if somehow, someway in the next 40 years, should I have that much time, that I should find out for myself why my friends feel about me the way I do.
**They** enjoy the life that I am living ... there has got to be the chance the **I** could learn to enjoy the life that I am living, too.
Now Scott, go ahead and tell me that there is no one in your life that qould make you qualify. You'll find many dissenting opinions here ... and if we disagree with you, then I'm sure those who know you "in person" will disagree even more vehemently. And even if it were only one other person, it would still be worth the chance.
So, if you could be willing to abandon your first 40 years for a clean start on your second 40 years, it is time to come up with a plan of action.
For people like us Babblelanders, being thoughtful, analytic, critical and planful about meds is essential. If you've been through the mill, it's time to review. I don't care how tired you are of it -- just treat me like a complete idiot ignorant of your situation and lets go over it again, okay?
At least do this for yourself: have you kept records? a journal? Do you have accurate information about dates, meds, combinations, responses? I'm glad I have Babble because when I reread some of my posts from '99, I realized just how much I had forgotten ... like how lithium ripped my system to shreds at even minimal does.
Putting it down accurately on paper is the only way you will ever be able to determine that (a) yes, you really HAVE been through every variation there is; (b) if that is true, what may have worked in the past that is worth revisiting; or (c) oops! there's an avenue or two that I haven't explored.
Get in writing. Make a chart so you have a visual cue for comparing time periods on different meds. Get it outside of your head and out into the world, because what we think and what we say are two different things. Making thoughts public changes what we think ... it at leasts forces us to be more complete.
Once you've gotten it out and visible, take it to your doctor and analyze it. Break it down by categories of medications. Is there a category that you haven't tried? Is there a category of meds that works better than the others? Is there a medication in that category that you haven't tried? What is it about this category, what do those meds work on? Is there another way of addressing that issue? After you go through them individually -- and you must address each med individually if you want to understand its effect on you -- move on to combinations of two meds. Any combination of two meds means three effects: the effects of the separate meds and the effect they produce together. Go through by category, then by individual meds. When you are done with that, its time to look at any three med cocktails....
Robert Pirsig said that the point to climbing a mountain is not reaching the top. The top of a mountain is barren. It is the sides of the mountain that support life. All of the struggle happens on the sides of the mountain, and if you don't pay attention to the struggle then you are missing what life is about. The struggle is worth it.
Last thing about the meds: are you sure that this Voice of Preparation isn't the chemicals talking to you?
I'm no expert, but I've never heard of memantine before. I did a search on the web and found lots of references to Parkinson's, Alzheimer's, age-related dementia and other degenerative diseases of the nervous system. The only depression-related reference I could find was a mention of interaction effects with SSRIs. No mention whether those interactions could actually mean a boost in their effect, tho.
My concern is that I have no information to help out here and, given what I could find, I wonder if anyone else out there is using that med. If you were a newbie to meds starting up on zoloft, I know I could tell you that two weeks was nowhere near enough time to judge the efficacy of the med and if you were bouncing off the walls, there are things you can do to get you through the next few weeks.
What does your doctor know about its use? Has he informed you about what you might experience building up to a therapeutic level or how long that might take? Have you talked to your doctor at all about the initial success and then the crash you've had? I know these are basic, "obvious" questions ... but I forget to ask them of myself. I'd need your help to think of them if our places were reversed.
Other than a PS, I've said more than enough ... I hope you could bear all my goings on and that maybe you could connect with some of it.
Hang in there,
PS. about analyzing the meds and how it would have worked for me. I'm lucky -- TCAs seem to work for me. It took me 30 months of SSRI hell to get there. If I could have charted out the time I spent on zoloft and paxil, and then the time I spent on wellbutrin (another seratonin reuptake inhibitor in part) and then wellbutrin and prozac ... well, maybe my pdoc and I could have made a better decision eight months earlier. As it was, we decided to retry zoloft with lithium and, when the lithium failed, with nortriptyline. If we hadn't been so set on having an SSRI in the mix, then maybe we would have tried a TCA on its own much, much earlier. It should have been obvious, if I had charted things out, that seratonin was not my problem. So, what does that leave? Norepinephrine and dopamine, or am I missing something? TCAs for the first. It should have been obvious, but juggling things in our heads and in conversation, 30 minutes per month, it escaped me and my pdoc.
Now wellbutrin also made me psychotic. It's a dopamine reuptake inhibitor as well ... also works on norepinephrine. Methylphenidate, on the other hand, boosts production of dopamine (if I recall correctly). Same neurotransmitter, different effect. Turns out taking Ritalin didn't make me psychotic, but in combination with nortriptyline it improves my mood and my cognition both.
Last December, my negative cashflow finally caught up with me. No money for doctors, no money for meds. In April, it finally occurred to my med-free, unadulterated state of mind that I really needed my meds to function. Personally, I don't know what happy is. The only baseline I have for what to feel is my unmedicated state. Being off medication for 4-5 months got me back in touch with that baseline and although nothing worth mentioning happened in my life during that period, I do not regret going off my meds. I learned a lot, and I got back on. Quite frankly, I don't recall nortriptyline working as well for me as it is right now (1 month back on, rock steady mood since about 1 week on). Of course, the circumstances of my life now and the majority of the time I have been on nortrip are radically different but, arguably, I've got a lot more to complain about now. Still, I'm not second guessing myself or how I feel. I've got some "traction" back in my life. I know things can get better from here on out. I refuse to have hope -- its done more harm to me than good -- but I am optimistic nonetheless.
phew ... just hit the Submit button already!....