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Re: Atypical Depression and Effexor Theresa Rae

Posted by wendy b. on January 17, 2003, at 21:39:04

In reply to Re: Atypical Depression and Effexor, posted by Theresa Rae on January 17, 2003, at 12:12:34

> My husband has been depressed for the better part of 15 years. Just recently I read about atypical depression, and his doctor switched him to Effexor (doctor wanted to avoid side-effects and possible complications of MAOI's, which are normally recommended for those with atypical depression). So, he's been taking Effexor since this fall, and is now sleeping 12 hours a day again (and crawling back into his cave.)

Hi Theresa,

I hope you know you are experiencing what a lot of spouses, parents, or siblings go through when one of their family members is depressed. There are some good web sites to help you cope, such as:

That web site has a lot of other good resources on it, too. Dr Ivan Goldberg's site has some informative reading, try:

to start out with. It's about atypical depression in particular. The whole site is very helpful.

One thing you should know is that Effexor is not well-tolerated in many users. I myself spent the whole time I was on it on the couch; could not get the motivation or the umph to get up and do anything. So your husband's reaction isn't surprising. And it's hell to get off that drug, too. You'll notice MANY threads on this web site (psychobabble) on Effexor. It's probably one of the most-discussed meds on this board. I can't say that I personally would recommend it, though I know it has helped some people. In any case, if it's not helping your husband, and is making him sleep half the day, he should definitely try something else. Looks like one of the studies cited on Dr Ivan's page says fluoxetine (an SSRI, in the same class as Zoloft, Paxil and Prozac) is among the best.

> My husband cancelled his third appointment to see his psychologist, and complains that if he goes in for the "fatigue," he'll just get the run-around as to whether or not he has sleep apnea (sp?)

You would be the one to know if he has sleep apnea, if you sleep near him. Supposedly its symptoms are easy to detect. This is probably producing other symptoms, too. So as far as the canceling appointments goes, you will probably have to force the issue, because you are the one who can tell whether he's doing better or not, you live with him...

> Help! Is it normal for him to be experiencing a relapse? Is it possible he's not taking the right meds? How can I avoid getting dragged down, too?

Just try to gently help him get the help he needs. Trials of different drugs are standard among those of us with mood disorders. So you'll both have to just grin and bear it. Feeling better is its own reward, and he'll get there, don't worry.

> Thanks for the two above replies. My husband seems to be pretty consistent all year (I don't notice that his depression is connected to the seasons at all). And I worry about his self-medicating...lots of coffee, lots of soda, and when he drinks, it's way too much (he has some compulsive behaviors, like hanging on to EVERY little receipt, scrap of paper, movie stub, etc., and has piles all over the house of his things.)

Lots of people with depression, bipolar illness, and ADD hoarde things, and leave piles of stuff all over. It's a pain in the butt, I know, I annoy myself over it. If he's drinking too much coffee and soda with caffeine, he probably IS self-medicating (it could be worse, he might be addicted to prescription or street drugs). But the types of things that he's using indicate he might be helped by a mild stimulant, such as Provigil. Then he might not need the caffeine as much.

> He is definitely doing a little better than previously (he's taking out the garbage, now, and initiates some other chores himself, like reading to our kids, starting dinner, or shoveling...

Sounds like he's not totally lost in despair, so that's good...

>I definitely did not help his situation by doing everything the past dozen years...(all the bill paying, laundry, grocery shopping, cleaning, child care, etc.) But now that he shows a little improvement, I just want him to get better faster; the more he does, the more hope I feel.

That's good, if you have hope, you can fight the good fight and help him. But please go easy on him - relapses are common, and it *is* a chronic illness. Just simple encouragement, no matter what his setbacks, will be very important to him. Pushing him faster than he can go will surely make him feel like a failure if he doesn't live up to your expectations.

> Can anyone give advice to me on how to accomplish a med check for him -- do I talk directly to his doctor, do I schedule an appointment and go with him, or what?

Have a talk with your husband, and solicit his wants and needs, while also telling him what you think. Personally, I think if you went to the appointments with him, it would be best, because he might benefit from an advocate, and also you are the day-to-day witness of his symptoms, so that will be helpful to the Dr, too. So, after getting an idea from your husband about how he feels, tell him you think it would help you as a family and as a couple, if he could have you come along to the meds checks.

By the way, I don't think your husband has schizophrenia, from what you describe - sounds like classic dpressive symptoms to me. (Schizophrenia implies a total lack of awareness of one's surroundings and psychosis.)

Best of luck, please let us know what happens. Besides this one, there are a lot of internet support groups (although ours is the most highly entertaining!), so don't be afraid to ask others for help. People can be very generous with their time and expertise and genuinely want to help...






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