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Re: Dopamine increasing drugs, worsen depression » meffect

Posted by ed_uk2010 on January 24, 2015, at 14:49:28

In reply to Dopamine increasing drugs, worsen depression, posted by meffect on January 24, 2015, at 2:07:39

Hi.

>I'm so confused. Depression runs in my family and I seem to have an extreme sensitivity to emotions - since i was born.

OK, are you also diagnosed with depression or something else? Like borderline personality disorder, for example? What sort of illness runs in your family? Severe/recurrent depression... bipolar disorder (manic-depression) etc?

>I overact on almost everything. I avoid social situations because I usually end up interpreting someones words, tone, facial expression, etc as negative (even though I tell myself its not) and I end up feeling extremely depressed and I often times end up crying that night and wanting to kill myself. sometimes i wish an accident would happen and kill me because i cant do it myself

Do you feel temporarily OK when things are going better? It sounds like your emotions are very over-reactive to the situation/circumstances. Have you ever had cognitive-behavioural therapy?

>i have an dependence on benzo's, i feel bored all the time. ssri's help but they make me tired i think

What medication are you taking at the moment? Tell us about the benzo situation... Long-term use of benzos can aggravate depression. I expect you'd do better on an antidepressant alone (assuming you find the right one), an MAOI could potentially be very effective if you could tolerate one and stick to the dietary restrictions. Nardil, for example. MAOIs do often aggravate insomnia unfortunately. As for SSRIs and related antidepressants.... what have you tried? Some tend to cause more tiredness than others.

>I'm tired all the time, i take naps at lunch and i have rem sleep and i hardly get any rest.

Do you mean you have vivid dreams?

>im tired all the time so my docs give me stims.

You must be in the US? That's the only place (pretty much) where docs think amphetamines and similar drugs are a sensible solution to fatigue. Clearly, for you, they are not. This is not unusual. In general, it's best to remove the cause of the fatigue where possible. If one antidepressant is making you too tired it would be worth trying another. I understand you've already tried several but I imagine there are still options.

It is common for stimulants to give an initial confidence boost but this may (at times) be followed by a roller coaster of emotions, and a rebound 'crash' when the med wears off. Of course, potent stims often cause further sleep disturbances and increased anxiety in the long run. They rarely improve severe depression beyond the initial stage of treatment, if at all. It was known in the 1960s that stimulants are a poor treatment for chronic depression. Fatigue may be improved temporarily but then potentially worsened, especially if sleep is negatively affected. Stimulants can be useful to give a short term 'boost' in special circumstances eg. in palliative care, but for someone with such long term problems as yourself, they really aren't very suitable. You need something which is likely to help you in the longer term. If you stop the stimulant, you may feel very tired and depressed for a couple of weeks but you should then feel better.

Mild stimulants such as caffeine may be tolerable, assuming that caffeine doesn't worsen your anxiety. You should certainly avoid caffeine in the late afternoon and evening if you suffer from sleep problems.

>i cant handle epinephrine increasers, but it seems to cause more anxiety than heightened emotional responses.

Which drugs in particular are you referring to? Wellbutrin?

Take care.

 

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