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Re: to sls again rose45

Posted by SLS on March 16, 2023, at 22:06:49

In reply to to sls again, posted by rose45 on March 16, 2023, at 15:22:03

Hi, Rose.

I'm glad you posted today.

> Can you see why I have lost all hope?

Yes.

However, I have logical reasons to believe that you are treatable. The NHS is an impediment to you, though.

Your depression and anxiety are ganging up on you right now. They are affecting your OUTLOOK. My guess is that you are being crushed by feelings of doom. A pessimistic outlook is what brings on or adds to crisis. I am not saying that you don't have legitimate reasons to have a pessimistic outlook. However, you are currently in an altered state of consciousness. That's what depression is. It is impossible to have the same outlook in the depressed state of consciousness as you do in a healthy state consciousness. I am suggesting that you take this into consideration as you evaluate your current thoughts and feelings. From experience, you know how quickly this changes when you begin to respond to treatment and are no longer lost in a cloud of darkness. I am suggesting that you really can't trust your thoughts and feelings while your brain isn't working properly. I disagree with you if you think it is time to stop trying. For now, do things that distract you from your painful thoughts. It's hard to pay equal attention to two thoughts at once.

So yes, I can see why you have lost all hope for yourself. Can you see why I haven't?

The first thing that comes to mind is that 150 mg/day of lithium might not be enough. I don't recall your indicating that you went higher than that dosage. As a low-dosage treatment strategy, I think more people will respond to 300 mg/day of lithium. Like I said, lithium was the augmenter of choice to add to Parnate in the 1980s. Upon the advent of SSRIs, these old tricks were forgotten. Doctors don't know how to use MAOIs anymore. Even if you don't respond fully to lithium in combination with Parnate, I would keep taking low dosages of it indefinitely. First, you can't know right now that lithium won't be a critical component to future treatments. You know it has a positive effect on you, even though it didn't stick. I would not call it tolerance at this point. I don't know. The term just doesn't sit right with me right now in your case. You might have to explore the whole range of dosages for lithium: 150-1500 mg/day. As I mentioned in a previous post, Harvard found that 600 mg/day of lithium in combination with Prozac worked less well than lower dosages.

The second consideration for taking low dosages of lithium indefinitely is that most investigations indicate that it reduces the risk of developing Alzheimer's Disease. This is really not a new finding. It's just that it has escaped everyone's attention. By the way, kidney and thyroid functions are affected by lithium in a dosage-dependent manner. At 300 mg/day, the risk approaches zero. I have been taking low dosages of lithium just for this reason, even if it were no help for depression. I got lucky because of this. It turns out that lithium is necessary for me to achieve remission.

Is there any history of bipolar disorder in your first degree relatives?

You are doing a great job for someone in your position. You ought to appreciate your inner strength. Please don't give up just yet. Right now, the NHS is perhaps your greatest impediment in exploring drugs that will help. By the way, I am not at all surprised that you responded favorably to Zyprexa (olanzapine). It gave me a boost about 25 years ago while I was taking Nardil. Shortly after Zyprexa came out, there were reports that it induced a manic state in some people. I haven't heard a peep since. I think most of the newer "atypical" antipsychotics have the potential to exert a stronger antidepressant response when added to certain antidepressants. I have had brief improvements when I added Zyprexa, Abilify, Saphris, or sulpiride. If you haven't tried amisulpride (Solian) yet, it can help with depression and dysphoria, but only at lower dosages. 25 mg/day seems to be the sweet-spot, but I have seen 50 mg/day used, too.

Hang in there. That's what I had to do for 38 years. You and I had a BIG advantage, though. We both know what it feels like to be live in the absence of depression. Make sure you look back and remember what you felt during you times of remission. Life was more than worth it, right? Let that be your carrot to keep you moving forward.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

 

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poster:SLS thread:1121922
URL: http://www.dr-bob.org/babble/20230117/msgs/1121923.html