Posted by Elizabeth on February 7, 2002, at 13:04:06
In reply to Re: depression, etc. » Elizabeth, posted by sid on February 4, 2002, at 17:35:04
> I know about that! There have been delays in my Ph.D. and now in my career. Because of them, I am not sure I still have a career. Had I survived cancer, I could explain it in a presentation letter, while looking for a job. But depression still has a stigma to it; that would possibly ruin my career for good instead of help. This is really unfair. We are sick, we suffer AND there are long term consequences to it too.
Yeah -- some people at least pretend to believe depression is a medical condition like any other, but we do still get treated differently, and there's plenty of reason for us not to want to "come out of the closet," so to speak. Maybe if people pretend long enough, future generations will really believe it.
> Well, I hope you get well enough soon to get some attention back and get the driver's license. You could then be more active and that could possibly help a lot in the healing process.
I agree. The concentration thing is a real problem for me, though. And I'm sort of hesitant to ask for a stimulant when I'm already taking buprenorphine (which is also a stimulant for me).
> I was on 37.5mg Effexor XR for 6 weeks (I felt better already; after 10 days or so, there were some improvements), and I've been on 75mg for about a month now. I'm seeing my doc on Thursday.
Wow, that's cool. You've been increasing it pretty slowly, but it sounds like it's paying off for you. The 225 is definitely helping some, but I think I could stand to go up to 300.
> I told you a few months ago, but I'll tell the story again.
I'm sorry! I have trouble keeping up with all the stories people tell here, although I do like to read them (I almost typed "hear" instead of "read" there!).
> My father was hospitalized with major depression when I was 20 years old. After a few weeks in the hospital, he'd come out on weekends. One weekend he decided not to take his meds, and we knew nothing about dosage, etc, it basically his responsibility without supervision. He "lost it" threatening to kill himself or us if we didn't leave him alone, etc... Major crisis. I managed to reach our family doctor, and he said that he probably didn't take his meds, that we needed to put him to bed and force him to take his meds, physically control him if we needed to. When it's your father, you freak out, and I did. Else we needed to call an ambulance and get him right back to the hospital. That threat is what I reasoned him with to go to bed, rest, and take his meds. Thereafter, I swore I'd never take ADs.
Things have changed since then, I think. But I would have been scared of *not* taking meds based on what you've told me there!
> I have a general doctor, which may make things easier relationship-wise.
I don't know. I think that the attitudes of GPs toward us (psych patients, that is), overall, are probably similar to those of psychiatrists. If I had a GP who I had known for a long time and who I felt was qualified to treat my depression, I'd see him/her instead of a psychiatrist.
> I know that she treats a lot of people for mental illnesses, so she developed some expertise over time.
A lot of GPs treat depression and anxiety, at least -- not so much the more serious things like schizophrenia, and I think that most GPs would want to make a referral to a psychiatrist if someone had severe treatment-resistant or psychotic depression, bipolar, OCD, ADHD, or borderline personality. Most of them have experience prescribing the new ADs, TCAs, and benzos, at least. I don't know how exceptional your GP is.
> That would be great. We'll see, on Thursday I should know better whether I'll increase the dosage or not.
Are you getting any side effects? I haven't noticed any so far.
> I'm more active and I eat less. Thank God because I loaded up on carbs like crazy during the depression and I gained a lot of weight.
That's always surprised me, that some people do that. Like, "who wants to eat when they're depressed???"
> I find myself physically repugnant now.
I felt that way when I was depressed. I avoided mirrors.
> I'm not too severe in the sense that I went through a lot of hardship, but I want to improve my physical appearance.
So do I (I'm not fat as such, but I am out of shape), but it's no longer something I worry so much about.
> I've been a mess for a long time and it shows still. It's not my priority, but it's on my to-do list.
Yeah, that's how I feel too.
> Upward spiral was strong. Let's say that I don't have to do as much as before to feel good. That in itself makes me feel even better!
I had given up on feeling good and settled for feeling flat. Being *able* to feel good feels like such a blessing now.
> OK, thanks. I'll take note of it in case it's needed later. I know my doc told me we'd augment at some point with another molecule in order to affect the brain in a different way and cover more bases (or something like that... I don't know much about it).
That's a typical strategy, adding something that has a different mechanism or affects different neurotransmitters. One of the first things that I tried when I became depressed in college (this was my second diagnosed episode -- I may have had one episode before I was diagnosed) was prozac + desipramine (this was 1993, and the SSRIs were the only "new-generation" ADs around). Augmenting SSRIs or Effexor with Remeron or Wellbutrin is also a popular strategy. Sometimes stimulants or direct dopamine agonists are used. I'm finding that the Effexor + buprenorphine strategy is working nicely, activating the endogenous opioid system in addition to monoamines.
> Cool. I love math. I use it rather than develop it, but I do use it (pretty basic stuff) everyday.
Maybe you've said this already, but what do you do?
> Oh yeah. A couple of weeks ago I asked on this board how it felt to be "OK".
Ahh yes. Well, I wish you luck in your search for OKness. :-) I'm really beginning to regain my confidence, feeling like "I can do this" ["this" being living life]. It was scary feeling like I might have to depend on my family for the rest of my life. I don't know how close I am to getting back to where I was (living on my own, working, taking classes, etc.), but I know that I now feel like it's a real possibility. And that's a big step in itself.