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Re: Social Support/Therapy while on meds Dinah

Posted by jay on October 4, 2001, at 14:50:10

In reply to Re: Social Support/Therapy while on meds jay, posted by Dinah on October 4, 2001, at 8:08:56

> Hi Jay,
> I have to agree with you that medicine/therapy doesn't have to be an either/or proposition, but are often best used together.
> Unfortunately, medicine has always been a double edged sword for me. It makes some aspects of life much better, but there has always been a price to pay in my own experience. I'm never quite as sharp mentally on psychotropic medicines and they tend to exacerbate the existing problems I have with not experiencing my emotions, leaving me with anhedonia, and an inability to feel appropriate sadness or anger.
> I've also had some problems with cognitive behavior therapy in that the "energy" associated with any given symptom tends to express itself in another way if that symptom is dealt with. I think my body just has a need to express that psychic energy in some way.
> Anyway, I work with both medicine and therapy and think that neither is the perfect answer, but both have the capacity to help me help myself.
> I've purchased "Noonday Demon" and hope to read it soon. Right now I'm having trouble comprehending the comics.
> Dinah

Dinah:

It seems that *energy force* is much of what feels like is "sucked out" of us in depression. We are too tired to do much; anxious because of the fatigue; don't sleep well because of being "over-tired" and anxious. I find that I can gauge my depression by some of my sleep. In particular, it is not *how long* I sleep, but that feeling whe I wake up that I just had some very light, restless sleep, no matter how long it was.

Regarding meds, (I know this is the 'psycho-social' board...but we can't split messages in two all the time..), have you ever tried quite lower than normal doeses of meds? (i.e. 1/2 to 1/3 the dose of the "lowest" reccomended dose.)

Dr. Michael Norden suggests this in his book "Beyond Prozac", and he was one of the first to report research using liquid Prozac in much, much smaller doses than suggested. Here are some of my past experiences with doses that have *worked* (my problem was in my social situation...being in abusive relationships, etc..)
If my current med stopped right-out working, I would go back to these. I have found we *must* really supercharge our ego to make this stuff work, and that is hard as hell when you are completely depressed, and don't even want to get out of bed. Remember, I am talking about a fraction of 'success' after dealing with this for almost 10 years!

-5-10 mg's of Elavil (usually 5mg's)..although this was the first med I was on 10 years ago...and the reason I stopped was because not only was it my first med (I didn't know any better), but it did cause a bit of weight gain.
I honestly wouldn't reccomend this as 'first-line'.

-12.5 mg's of Luvox (25mg in half.) Maybe even smaller if needed.

5-10 mg's of Nortriptyline. I found this med a bit "activating", so besides some extra anxiety, it helped with the "morning" part of depression.

-37.5 mg's of Effexor XR. (I can't tolerate even a tad more.) Most docs seem to start at 75mg's, but this drives me crazy.

Also, for the first few weeks,a benzo seems to help keep any anxiety in some check.

This is all anecdotal, and I would never say it *would* work for everyone else. I just think like our way of thinking and healing (and it is a constant battle...I will always consider myself a *depressive* treated with meds), we might have to be as unconventional as possible.

Sorry for the long post...I hope it doesn't sound like I am lecturing. I don't ever expect what applies to me would apply to anyone/everyone else.

Thanks...and take good care...you deserve it.

Jay


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