Psycho-Babble Medication Thread 53130

Shown: posts 1 to 10 of 10. This is the beginning of the thread.

 

chemical imbalance or not or both?

Posted by gwen on February 1, 2001, at 19:16:26

OK, I'm confused.

Today my pdoc and I were talking about another AD he'd added to my cocktail two weeks ago to see whether I felt anything and to see if the side effects I'd been having were dissipating or were tolerable enough to give the drug awhile longer before giving up on it.

Meanwhile, I've been having problems with my boss at work for some time. But some big things got resolved between us in the last week, so a chunk of anger and resentment and stress has kinda gone away -- just like that.

So within his quizzing me about the drug, this other thing about my boss came up, and he commented that maybe I wouldn't need this third drug after all.

Now I have a friend who was on Prozac for a little while because her marriage was breaking up, but now she's off it and fine. I always thought that my depression (which my pdoc has termed chronic and treatment-resistant) was mostly a chemical imbalance, not so much event-related. I think it was triggered by events, but things have settled down in the last 3 years. Since then, my pdoc has quizzed me regularly to see whether the depression was lifting, but it never has, which is what makes me think it's more chemical. So why would he suggest that it might not be? At another point in the conversation on side effects, he said I've always been sensitive to drugs that help serotonin levels (such as this new one), to which I quipped that maybe I didn't need any serotonin. But he chuckled and said that I did because I've been irritable. In the end, we decided that I'd stay with it a little longer, so now I'm thinking in the chemical imbalance direction again.

I've read Listening to Prozac, and know a little about this debate. I also think this kindling theory is pretty relevant to my situation. But if depression is chronic, can a little less stress make that much difference?

Am I asking the impossible, unanswerable question?

Thanks for any input.

 

Re: chemical imbalance or not or both?

Posted by dennis on February 1, 2001, at 20:12:01

In reply to chemical imbalance or not or both?, posted by gwen on February 1, 2001, at 19:16:26

I believe stress can and does cause depression, even a little bit of stress, I think people percieve and deal with stress differently and so some are more sensitive to stress than others. I dont think serotonin levels are the key to being happy, I think SSRIs are overprescribed. It would be nice if there were drugs that relieved stress without makeing you into a zombie, because I think stress can be a major problem, maybe even the only problem causeing depression, and its often not realized how much stress is affecting a person. Depression, anxiety, stress, I think they are all connected, rather than being completely different things.

 

Re: chemical imbalance or not or both?

Posted by Shell on February 1, 2001, at 21:54:53

In reply to chemical imbalance or not or both?, posted by gwen on February 1, 2001, at 19:16:26

> OK, I'm confused.
>
> Today my pdoc and I were talking about another AD he'd added to my cocktail two weeks ago to see whether I felt anything and to see if the side effects I'd been having were dissipating or were tolerable enough to give the drug awhile longer before giving up on it.
>
> Meanwhile, I've been having problems with my boss at work for some time. But some big things got resolved between us in the last week, so a chunk of anger and resentment and stress has kinda gone away -- just like that.
>
> So within his quizzing me about the drug, this other thing about my boss came up, and he commented that maybe I wouldn't need this third drug after all.
>
> Now I have a friend who was on Prozac for a little while because her marriage was breaking up, but now she's off it and fine. I always thought that my depression (which my pdoc has termed chronic and treatment-resistant) was mostly a chemical imbalance, not so much event-related. I think it was triggered by events, but things have settled down in the last 3 years. Since then, my pdoc has quizzed me regularly to see whether the depression was lifting, but it never has, which is what makes me think it's more chemical. So why would he suggest that it might not be? At another point in the conversation on side effects, he said I've always been sensitive to drugs that help serotonin levels (such as this new one), to which I quipped that maybe I didn't need any serotonin. But he chuckled and said that I did because I've been irritable. In the end, we decided that I'd stay with it a little longer, so now I'm thinking in the chemical imbalance direction again.
>
> I've read Listening to Prozac, and know a little about this debate. I also think this kindling theory is pretty relevant to my situation. But if depression is chronic, can a little less stress make that much difference?
>
> Am I asking the impossible, unanswerable question?
>
> Thanks for any input.

First of all, I want to start by saying I am no expert and what I say is simply my opinion. Since even professionals have some disagreement on this topic, I can hardly pretend to have the answer.

I personally think there is both depression that is primarily situational, that which is primarily of a physiological nature (which often triggered by an event) and that which is caused by a combination of both factors.

I'm not sure that your doctor necessarily implied that he now feels that yours is more due to circumstances (at least not from what you have written). When you told him that a large source of stress had been eliminated, he said that the third drug might not be necessary. He did say *might not*. I think it is entirely possible for depression that is mostly caused by chemical imbalances to be made worse by an external stressor. When the stress is removed, it would make sense that the level of depression will lessen. A lower level of depression may require fewer medications and/or a smaller dose to treat (and with side effects being what they are, that is a good thing).

I think he was probably just thinking that since a large source of stress had been removed, it might reduce the severity of the depression (since the addtional stress had probably increased it) which might possibly eliminate the need for new medication that has had some negative side effects. It's as if you had some baseline level of depression with a biochemical cause which was increased by a stressful situation. Remove the stressor and the depresion returns to its baseline level.

And yes, I do believe that a little less stress can make a big difference in someone who is already predisposed to depression (but you said some "big things" had been worked out, so I tend to think it might have been more than a "little less stress".

I hope that all made sense..it's kinda late and I think I may be a little fuzzy.

Shell


 

Re: chemical imbalance or not or both?

Posted by ChrisK on February 2, 2001, at 5:45:03

In reply to chemical imbalance or not or both?, posted by gwen on February 1, 2001, at 19:16:26

Here's a place where you can go to take your own quiz before you need to see your doctor. I go there to check my moods after starting new meds and find that if you are honest it will give you a pretty good line on where you stand with depression. It's a simple little thing that only takes a minute. It's not meant to be a true diagnosis but can put a quantitative number on where you stand. Keep track of your scores and note when you are stressed or when you start new meds. I go back to it about every other week and share the results with my pdoc so that we both know what is helping and what isn't. Give it a try.

http://mentalhelp.net/guide/dep2quiz.htm

As far as your question about chemical imbalance vs. situations, I think it's the chicken and the egg question. They feed off each other in such a way that I don't know that there is one answer. Depression and stress seam to feed off of each other and it's hard to say which one leads the way.

Good Luck with your new med combination.


> OK, I'm confused.
>
> Today my pdoc and I were talking about another AD he'd added to my cocktail two weeks ago to see whether I felt anything and to see if the side effects I'd been having were dissipating or were tolerable enough to give the drug awhile longer before giving up on it.
>
> Meanwhile, I've been having problems with my boss at work for some time. But some big things got resolved between us in the last week, so a chunk of anger and resentment and stress has kinda gone away -- just like that.
>
> So within his quizzing me about the drug, this other thing about my boss came up, and he commented that maybe I wouldn't need this third drug after all.
>
> Now I have a friend who was on Prozac for a little while because her marriage was breaking up, but now she's off it and fine. I always thought that my depression (which my pdoc has termed chronic and treatment-resistant) was mostly a chemical imbalance, not so much event-related. I think it was triggered by events, but things have settled down in the last 3 years. Since then, my pdoc has quizzed me regularly to see whether the depression was lifting, but it never has, which is what makes me think it's more chemical. So why would he suggest that it might not be? At another point in the conversation on side effects, he said I've always been sensitive to drugs that help serotonin levels (such as this new one), to which I quipped that maybe I didn't need any serotonin. But he chuckled and said that I did because I've been irritable. In the end, we decided that I'd stay with it a little longer, so now I'm thinking in the chemical imbalance direction again.
>
> I've read Listening to Prozac, and know a little about this debate. I also think this kindling theory is pretty relevant to my situation. But if depression is chronic, can a little less stress make that much difference?
>
> Am I asking the impossible, unanswerable question?
>
> Thanks for any input.

 

Re: chemical imbalance or not or both?

Posted by Noa on February 2, 2001, at 7:24:32

In reply to Re: chemical imbalance or not or both?, posted by ChrisK on February 2, 2001, at 5:45:03

Both is a good answer--innate and environmental contributors to depression are mutually influential.

 

Re: chemical imbalance or not or both?

Posted by MarkinBoston on February 2, 2001, at 13:44:07

In reply to Re: chemical imbalance or not or both?, posted by dennis on February 1, 2001, at 20:12:01

My situation is both. I have baseline dysthimia with major episodes that have always followed stressful periods. I'm usually off meds until the next major episode because the Effexor side effects are worse than the dysthimia. I've tried many other AD's and none has worked as well as Effexor. I don't suffer from withdrawl, by the way, and even have felt better taking the original short acting version every other day.

As to who is affected by stress, I read one paper where cortisol levels were measured in subjects over a week where they talked and did arithmetic in front of an audience. All had elevated cortisol (stress) the first day. During the week, one third of the subjects maintained high cortisol levels from the exercise, while 2/3's adapted to it with lessened cortisol increases.

So, about a third of people don't get accustomed to stressful situations, and are more at risk for depression, heart disease, and obesity. I don't think many studies on the effect of stress differentiate between subjects who do and don't adapt well to stress and thus get less definitive findings.


> I believe stress can and does cause depression, even a little bit of stress, I think people percieve and deal with stress differently and so some are more sensitive to stress than others. I dont think serotonin levels are the key to being happy, I think SSRIs are overprescribed. It would be nice if there were drugs that relieved stress without makeing you into a zombie, because I think stress can be a major problem, maybe even the only problem causeing depression, and its often not realized how much stress is affecting a person. Depression, anxiety, stress, I think they are all connected, rather than being completely different things.

 

thank you

Posted by gwen on February 3, 2001, at 7:28:12

In reply to Re: chemical imbalance or not or both?, posted by MarkinBoston on February 2, 2001, at 13:44:07

Thank you all for your thoughts and ideas.

Chris, your suggestion of taking that test periodically is a good one. I took it a long time ago, but had forgotten about it.

Sincerely,
Gwen

 

Dysthimia?

Posted by LauraD on February 3, 2001, at 19:51:33

In reply to Re: chemical imbalance or not or both?, posted by MarkinBoston on February 2, 2001, at 13:44:07

> What is Dysthimia?

 

Re: Dysthimia?

Posted by lettie on February 3, 2001, at 21:36:20

In reply to Dysthimia?, posted by LauraD on February 3, 2001, at 19:51:33

> > What is Dysthimia?

Dysthimia is defined by my doctor as a chronic,
long term depression. In my case, I've probably
had it all my life. It certainly explains a lot
about my childhood. Many people also experience
periodic bouts of major depression.

 

Good advice ...

Posted by willow on February 4, 2001, at 11:29:06

In reply to Re: chemical imbalance or not or both?, posted by dennis on February 1, 2001, at 20:12:01

Dennis's perception is a good one. Everyone is different and wether it is physical or psychological doesn't make a difference. Getting to a "good level" that makes each of us comfortable is what is important.

For myself this adjustment has been hard. I use to thrive on stimulation. Now I find my stress tolerance is in the negative, so less is more for me. I'm able to accomplish more when I plan on doing nothing.

I believe it was Chris who suggested doing the self-test. This has helped me alot, especially during the first months of a depressive period. I've been taking effexor and initially wondered if it is worth it. Having the feedback from quizzes like this helped me to see that there was improvement even though I wasn't well enough to realize it.


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