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Re: Docs get serious about weight/sex -Jay Bob

Posted by nightlight on November 27, 2001, at 23:09:05

In reply to Re: Docs get serious about weight/sex long term?DrBob?, posted by bob on November 27, 2001, at 21:00:30

Dear Jay & Bob,

Question-
when you are in the grips of a depressive episode, or dysthymic anhedonia, and are not on meds, does sex still interest you? I know, for me, it becomes a non-issue. I have zero interest, nor can I bear the intimacy it entails.So, maybe the 'great whomever' intended for all (or most) depressives to simply be eunuchs, whether treated or untreated, ya think?
I have never been successfully treated with any of the many A-D's I've tried, so I don't know what it's like to feel 'normal', have energy, and yet, have no interest in sex. And, to have interest, but be unable to comply, well, that must be miserable. Although forcing oneself to be intimate w/one's partner when even only slightly depressed, fatigued, uninterested is no great thrill either (but, has *some* potential to be a positive experience).
Now, the weight subject is INDEED a weighty one. I know we are all sensitive on this issue. Desipramine gave me a sweet tooth and dry mouth that wreaked havoc on my waistline and my teeth. I stayed on it for 4 months (it was supposed to help w/chronic pain, my pain did get better, but it did not get worse after I stopped the A-D). It did nada for depression.
The only AD I ever responded to, even minimally, was Wellbutrin at 350mgs., and, no, I never lost a pound. I gained 5-7 lbs. Overeating is (usually) symptomatic of my depressive states. But the WB did help minimally with hypersomnolence and I needed all the help I could get.
I lost weight while taking Zoloft over the course of about 6 wks., but, I think it had nothing to do with the Z. and everything to do w/the fact that I was caring for my mom, who was at home with me, in the last stages of Alzheimer's. I lost 25 lbs. in 3 months w/o trying. Appetite was zilch. I stopped the Z. after a wk. at 100mgs.50 had been no problem. I couldn't sleep, felt agitated, but, I don't know if it was the Z. or simply grief added to depression.

That was only 7 months ago, mom's gone now. I went into a much deeper depression when summer came, finally found a new therapist and pdoc 2 months ago. Was prescribed Adderall and started low-dose Zoloft, which we will titrate up. My diagnosis is mixed at present, we are treating symptoms, but ADD is definitely a sure thing. The good newa is that it IS easier for me to think about something other than food now that my concentration has improved and severe anhedonia has lifted. But even on 60 mgs. daily of Adderall, there was no lasting anorectic affect on my appetite. I don't have to force myself to eat. I eat my raisin bran in the am, but I still want something at noon and I am STILL hooked on icecream, a terrible habit I acquired during pregnancy, and the later tricyclics for pain/depression trials. God gave me a sweet tooth that will not die!!!
I've read so many posters say they have suicidal tendencies, yet they will not take a certain drug b/c they might gain weight. It sounds so crazy, yet, who wants to be fat AND suicidal? No one. But, many of us have kids, or pets, or just have found other ways to entertain ourselves...or simply feel the need to LIVE w/our meds and responsibilities, overweight or not.
But, diet drugs DO help many, in the short run (6 wks. or so), but they are psychotropic and can screw with 'the balance'some of us have finally achieved. It's all just a crap shoot anyway...No answers here, just hope the pharm co.s come up with something one day that doesn't make a lotta people gain weight. They have performed miracles before...and ya know it wd. sell like hotcakes!

nightlight

> Jay:
>
> I could not have said this better myself. I have had these thoughts for years. Doctors downplay the long term effects of lack of sexual ability and weight gain. The longer you deal with it, the worse of a burden it becomes. I have been on meds for 10 years, and have been overweight the whole time, until Topomax, which I had to get off of for other reasons. Not once during those 10 years was I the slightest bit amused my the weight gain. It has an undeniable psychological effect, as well as the obvious physical ones. I always hear the "it's a small price to pay" line, but it becomes bigger and bigger as time goes on. Even people I know who are well aware of the fact that I'm on medications sometimes comment about me being overweight. It's VERY annoying and frustrating. The fact that there's a billion dollar industry out there for people who want to lose weight tells you a little about what it means to people psychologically. Just look at a magazine rack. The only topic more pervasive is sex!!!
>
> That brings us, of course, to your second point... being deprived of sexual desire. It's not merely the inability to get an erection once in awhile, but often a complete lack of desire, and the eventual inability to be intimate. This is very, very serious. As you have said, it is an innate part of who we are. One could even make a controversial point that we have evolved for this sole purpose - to produce the next generation. Loss of intimacy and all sexual ability is a very, very, very high price to pay, in my eyes. It's an undeniable part of being human. If you find a medecine that helps you, but adds the two aforementioned problems, they eventually loom just about as large as the original disease -- the only differences being the lack of urgency, and immediate threat to well-being and life. Thus, they are on the back burner for being eradicated.
>
> It's always been very sad to me that we who suffer from mental illness have to make such compromises. The solutions to our conditions produce or aggravate two conditions that a large part of the humanity strives to address through pharmacology regardless of the presence of mental illness, i.e. Viagra, etc. It's really a terrible paradox.
>
> Bob


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poster:nightlight thread:85329
URL: http://www.dr-bob.org/babble/20011123/msgs/85360.html