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Treatment How did you decide to take antidepressants?

thegreenhand

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Thanks @dalpat077

i have my psychiatrist appt in a few hours, so I’ll update once it’s over

and yeah I know that suicidal thoughts can happen with these sorts of drugs. Especially in younger folks I’ve read. and given that I’m 20, I guess I’m more prone to it

I wish ketamine therapy was available to me but my understanding is that you need to be “treatment” resistant i.e. two different drugs have failed for you.

also in the US the esketamine nasal spray is the only form of it that is easily covered by insurance. Racemic ketamine infusions (which the literature indicates are more effective) generally are an out of pocket expense which runs about $500 per session…
 

dalpat077

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Thanks @dalpat077

i have my psychiatrist appt in a few hours, so I’ll update once it’s over

and yeah I know that suicidal thoughts can happen with these sorts of drugs. Especially in younger folks I’ve read. and given that I’m 20, I guess I’m more prone to it

I wish ketamine therapy was available to me but my understanding is that you need to be “treatment” resistant i.e. two different drugs have failed for you.

also in the US the esketamine nasal spray is the only form of it that is easily covered by insurance. Racemic ketamine infusions (which the literature indicates are more effective) generally are an out of pocket expense which runs about $500 per session…
Holding thumbs for you. Had no idea you were in this state to be honest. And like I said: I really do understand only too well. More than anybody knows anyway.

We're actually trying to dig deeper into this alternate Ketamine issue on the two other Ketamine threads.

And yip: all of the Ketamine Clinics (infusion therapy) are making serious money seems to me. Just based purely on what I've seen as a result of those other two threads and in spite of this: doesn't make sense that the esketamine nasal spray can be covered by medical insurance but not the infusions. At least from a cost perspective let's face it. As much as it pains me to consider the possibility or cop to it: anything to do with red tape and requisite approvals? That would be very disappointing to find out about.


Waking up every morning disappointed I had not died in my sleep.
Sorry to hear that too. Any particular reason? Or just the way it is?

Anyway. Stay tuned. We got this I think. :)
 

thegreenhand

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Holding thumbs for you. Had no idea you were in this state to be honest. And like I said: I really do understand only too well. More than anybody knows anyway.

We're actually trying to dig deeper into this alternate Ketamine issue on the two other Ketamine threads.

And yip: all of the Ketamine Clinics (infusion therapy) are making serious money seems to me. Just based purely on what I've seen as a result of those other two threads and in spite of this: doesn't make sense that the esketamine nasal spray can be covered by medical insurance but not the infusions. At least from a cost perspective let's face it. As much as it pains me to consider the possibility or cop to it: anything to do with red tape and requisite approvals? That would be very disappointing to find out about.
Well the doctor agreed that bupropion was not the drug for me, given that it increased anxiety and suicidal thoughts

she recommended either an SNRI or mirtazipine

I went with the latter. I’ve kinda lost hope on reuptake inhibitors of all kinds I think.

she also referred me to an intensive outpatient program. Three hours long, three days a week… guess I’ll try

And yeah I asked about ketamine, and she said another psychiatrist in this hospital system works with ketamine (and TMS too).

if this outpatient program and the new meds don’t work, I may reach out to him
 

dalpat077

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Well the doctor agreed that bupropion was not the drug for me, given that it increased anxiety and suicidal thoughts

she recommended either an SNRI or mirtazipine

I went with the latter. I’ve kinda lost hope on reuptake inhibitors of all kinds I think.

she also referred me to an intensive outpatient program. Three hours long, three days a week… guess I’ll try

And yeah I asked about ketamine, and she said another psychiatrist in this hospital system works with ketamine (and TMS too).

if this outpatient program and the new meds don’t work, I may reach out to him
Thanks for the update and being so forthright with something that is so personal.

That was my experience with Wellbutrin i.e. the increased anxiety (and seemed to have a sort of speediness to it). Caused myself a fair amount of shit because of it and not thinking straight. But at the time I was told it's the new wonder anti-depressant and who was I at the time to argue with somebody that specialized in anxiety and depression. And I can tell you that with alcohol: not a good mix at all. Not with yours truly over here anyway.

Sounds like you're in good hands though no?

If you don't mind my asking: is this something that's just come on suddenly or has it been a long lasting state of affairs? You don't have to answer. And the only reason that I bring it up is because Seasonal Affective Disorder ("SAD") (although I see it's now been renamed and given a fancy spin) is a very very real thing to some people (and I'm one of them). And as far as I know: you should be headed straight for that time of the year i.e. Winter. Just an observation i.e. this, for many years, was never considered a real thing nor taken seriously.

Well. Rooting for ya and holding thumbs that whatever you do works out. There's nothing worse than depression and those constant recurring thoughts. And while the medical fraternity may disagree: not something that too many people can understand unless they've actually been there.
 

thegreenhand

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That was my experience with Wellbutrin i.e. the increased anxiety (and seemed to have a sort of speediness to it). Caused myself a fair amount of shit because of it and not thinking straight. But at the time I was told it's the new wonder anti-depressant and who was I at the time to argue with somebody that specialized in anxiety and depression. And I can tell you that with alcohol: not a good mix at all. Not with yours truly over here anyway.
Yeah wellbutrin was kinda speedy. It is a cathinone derivative after all. I only drank once on it and paradoxically the anxiety was worse while drunk

Sounds like you're in good hands though no?
I do like this doctor better than the last guy. She is much more empathetic at least. But still kinda “robotic” in her prescribing. You can tell she’s just going down a list or a flowchart. But I do understand that has more to do with the psychiatric establishment itself than her as an individual. Some artistry in medicine would be appreciated however


If you don't mind my asking: is this something that's just come on suddenly or has it been a long lasting state of affairs? You don't have to answer. And the only reason that I bring it up is because Seasonal Affective Disorder ("SAD") (although I see it's now been renamed and given a fancy spin) is a very very real thing to some people (and I'm one of them). And as far as I know: you should be headed straight for that time of the year i.e. Winter. Just an observation i.e. this, for many years, was never considered a real thing nor taken seriously.
It sort of came on suddenly when I first started university. At that time I managed to self medicate with both micro and macro doses of psychedelics and didn’t seek any real treatment

then Covid hit in March 2020 as my first year of university was wrapping up. Had pretty good summer all things considered but then when I returned in Autumn 2020 things went downhill again. Quasi online classes and demolished social scene left me alone in my apartment most of the time.

not to mention I was working two different part time jobs + a full schedule of classes. The American way amirite…. The stress was simply too much and I broke. Checked myself into the emergency room one night as I was having a suicidal nervous breakdown. Spent a week at an inpatient facility and have been bouncing around between psychologists and psychiatrists ever since

SAD affects me to an extent but the depression has generally been persistent across all seasons.

Well. Rooting for ya and holding thumbs that whatever you do works out. There's nothing worse than depression and those constant recurring thoughts. And while the medical fraternity may disagree: not something that too many people can understand unless they've actually been there.
The medical fraternity can suck a dick, respectfully.

there are some kind hearted people (like my current psychiatrist) but the field as a whole has done little to really benefit mentally ill people. Despite their claims that the right medications or behavioral therapy can fix everything right up. Psychiatric illnesses don’t even have identifiable biomarkers, yet we have claims of “righting chemical imbalances” and such
 

dalpat077

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Yeah wellbutrin was kinda speedy. It is a cathinone derivative after all. I only drank once on it and paradoxically the anxiety was worse while drunk


I do like this doctor better than the last guy. She is much more empathetic at least. But still kinda “robotic” in her prescribing. You can tell she’s just going down a list or a flowchart. But I do understand that has more to do with the psychiatric establishment itself than her as an individual. Some artistry in medicine would be appreciated however



It sort of came on suddenly when I first started university. At that time I managed to self medicate with both micro and macro doses of psychedelics and didn’t seek any real treatment

then Covid hit in March 2020 as my first year of university was wrapping up. Had pretty good summer all things considered but then when I returned in Autumn 2020 things went downhill again. Quasi online classes and demolished social scene left me alone in my apartment most of the time.

not to mention I was working two different part time jobs + a full schedule of classes. The American way amirite…. The stress was simply too much and I broke. Checked myself into the emergency room one night as I was having a suicidal nervous breakdown. Spent a week at an inpatient facility and have been bouncing around between psychologists and psychiatrists ever since

SAD affects me to an extent but the depression has generally been persistent across all seasons.


The medical fraternity can suck a dick, respectfully.

there are some kind hearted people (like my current psychiatrist) but the field as a whole has done little to really benefit mentally ill people. Despite their claims that the right medications or behavioral therapy can fix everything right up. Psychiatric illnesses don’t even have identifiable biomarkers, yet we have claims of “righting chemical imbalances” and such
Wonderful and insightful and honest post.

Yeah. COVID and the ensuing lockdowns threw me for a loop. Keep forgetting about that. Truth be told: at the time I then got a prescription for 20mg Flouxetine and 2mg Alprazolam. The Flouextine didn't seem to be doing anything and I couldn't justify the cost therefore (no insurance me). So just stayed on the Alprazolam that was prescribed at the same time. Until eight days ago. This probably answers your question/thread directly. I just simply decided one day (last week) to give Fluoxetine another bash (just couldn't take the dark moods and the blackness and lack of motivation anymore and figured I'd give it a good last shot) but at 40mg (which is what I was on some many years ago). Fortunately discovering by sheer accident that there was a much cheaper generic on the market that's manufactured here. And from the very first day (last week) I had a hop, skip, and jump back in my step and those plaguing thoughts are all but gone. That's why I say I'm lucky and obviously this shit works for me even although it's early days. Not something I've been open about. But given that I'm now on top of the world and I'm feeling better it makes me feel good to try and help. Especially as it's you i.e. if you can remember you and I almost single-handedly resolved the UK Cocaine Pharmacy distribution issues! :ROFLMAO: And I believe that I know what you're capable of as an individual (intelligent, educated, and with all the potential in the world and all that). So yeah. Rooting for you big time. :)
 
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thegreenhand

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Wonderful and insightful and honest post.

Yeah. COVID and the ensuing lockdowns threw me for a loop. Keep forgetting about that.
yep I’m sure it certainly wasn’t all COVID related, but damn it didnt help


Truth be told: at the time I then got a prescription for 20mg Flouxetine and 2mg Alprazolam. The Flouextine didn't seem to be doing anything and I couldn't justify the cost therefore (no insurance me). So just stayed on the Alprazolam that was prescribed at the same time. Until eight days ago. This probably answers your question/thread directly. I just simply decided one day (last week) to give Fluoxetine another bash (just couldn't take the dark moods and the blackness and lack of motivation anymore and figured I'd give it a good last shot) but at 40mg (which is what I was on some many years ago). Fortunately discovering by sheer accident that there was a much cheaper generic on the market that's manufactured here. And from the very first day (last week) I had a hop, skip, and jump back in my step and those plaguing thoughts are all but gone. That's why I say I'm lucky and obviously this shit works for me even although it's early days. Not something I've been open about.

Glad you found a regiment that works for you. And it’s nice that fluoxetine has a generic, drug prices are outrageous

But given that I'm now on top of the world and I'm feeling better it makes me feel good to try and help. Especially as it's you i.e. if you can remember you and I almost single-handedly resolved the UK Cocaine Pharmacy distribution issues! :ROFLMAO:

And yes I remember our recreational drug pharmacy debacle lol, quite the rabbit hole that one was. Still waiting for my paycheck from Drug Policy Alliance… I will say that I feel quite a bit of shame for not engaging in DitM like I was back then. I can (sort of) manage my mod duties, but anything beyond that I don’t have the will to do. No posting articles or having discussions like I once did

And I believe that I know what you're capable of as an individual (intelligent, educated, and with all the potential in the world and all that). So yeah. Rooting for you big time. :)
I appreciate that, pal. I really want to get back to university. I feel like I’m wasting away without that sense of direction it provides. Hopefully I can return to classes come January, but it may not be until next fall :( I don’t want to restart and be unable to do well in classes due to my mental state
 

chinup

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not been on mirtazapine but venlafaxine destroyed me coming off it and i swear it permanently altered my physiology. so because obviously my one anecdote is applicable to all people on all SNRIs, you made the right choice.

i really hope it helps. it does sound like you have someone receptive and that is really great.

maybe i should speak to my doctor about changing my anti depressants. possibly could help me stop purging? but then i'd have to tell someone irl i've been purging. urgh the shame.
 

thegreenhand

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not been on mirtazapine but venlafaxine destroyed me coming off it and i swear it permanently altered my physiology. so because obviously my one anecdote is applicable to all people on all SNRIs, you made the right choice.
Lol seems like pretty conclusive evidence to me. I did have pretty serious sexual dysfunction on SSRIs so I’d like to avoid serotonin reuptake of any kind if I can, hence the choice of mirtazipine.


i really hope it helps. it does sound like you have someone receptive and that is really great.
I hope it helps too. She gives me some autonomy in what medications to try which I appreciate, as my last psychiatrist didn’t really listen at all.

maybe i should speak to my doctor about changing my anti depressants. possibly could help me stop purging? but then i'd have to tell someone irl i've been purging. urgh the shame.
mirtazipine supposedly increases your appetite by a lot. Granted I’m not sure if that’d be good or bad for purging, I don’t have experience with it myself.

The shame is indeed the worst part. She asked on my way out if I had any immediate thoughts of harming myself to which i said no. Don’t really know how to say I pretty much always have those thoughts… I just feel shameful for having them
 

chinup

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The shame is indeed the worst part. She asked on my way out if I had any immediate thoughts of harming myself to which i said no. Don’t really know how to say I pretty much always have those thoughts… I just feel shameful for having them

thats so sad. no one deserves that. i hope you don't act on such thoughts frequently. though i guess i'm not one to talk right now. how long is it supposed to take to feel a difference? are you seeing a therapist and being honest with them?

how is your self care? i find it makes such a difference for intense depression. even if i have to break things down into tiny chunks. so like have a shower, it doesn't matter if it then takes you an hour til you feel up to getting dressed. at the end you will be showered and dressed and that makes me personally feel less like a useless failure when in that state of mind. or if that's too much moisturise your hands or something else super quick, and work up to bigger things.

i hope the mirtazepine helps. i don't think it would be safe for me to go on something that would increase my appetite right now (also ED says no and obviously gotta do everything that bitch says).
 

thegreenhand

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thats so sad. no one deserves that. i hope you don't act on such thoughts frequently. though i guess i'm not one to talk right now. how long is it supposed to take to feel a difference? are you seeing a therapist and being honest with them?
i have not acted on them yet. I’m not sure i could bring myself to physically do it. the thoughts are more violently intrusive as opposed to true motivation

i was seeing a therapist for about 4-5 weeks. but i really didn't vibe with the guy, at least not like previous therapist i had. he never really probed with me questions to allow me to articulate what i'm feeling. he'd just sorta sit there with a look of deep concern on his face. tried showing me various psychological theories with flowcharts and diagrams and such. they all had pretty big flaws in their logic if you ask me

how is your self care?
pretty bad. wont brush teeth for hrs after waking up most days. little to no appetite most times. very irregular sleep. bedroom has clutter everywhere.

i hope the mirtazepine helps
my impression so far is ok. it caused a pretty deep and restful sleep last night. today has been kinda mellow since. physical comfort is greatly increased when laying down. not so good when you're already lethargic, but at least it's kinda pleasant now.

i don't think it would be safe for me to go on something that would increase my appetite right now (also ED says no and obviously gotta do everything that bitch says).
have you been able to keep anything down lately? after those two big climbing efforts, i hope you're able to replenish at least a little. speaking of, are you back home from your trip yet?
 

chinup

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i have not acted on them yet. I’m not sure i could bring myself to physically do it. the thoughts are more violently intrusive as opposed to true motivation
well done. i think its normal to not be able to bring yourself to do it physically. i feel literally sick about some of the self harm i used to do. i haven't done it in years. did it a fair amount when i was a teenager then got it in check and only did it when i was in a particular state of mind characterised by hugely excess energy and negative emotion.

if you've managed not to so far then hopefully that will continue. its not a good thing to start doing.

i was seeing a therapist for about 4-5 weeks. but i really didn't vibe with the guy, at least not like previous therapist i had. he never really probed with me questions to allow me to articulate what i'm feeling. he'd just sorta sit there with a look of deep concern on his face. tried showing me various psychological theories with flowcharts and diagrams and such. they all had pretty big flaws in their logic if you ask me
that does sound a bit odd. can you find a different therapist? mine does to the theory occasionally when its relevant, but mostly its her penetrating insights that i see her for. there will be someone who can do the same for you and when you find that person it will be a massive help.
pretty bad. wont brush teeth for hrs after waking up most days. little to no appetite most times. very irregular sleep. bedroom has clutter everywhere.
so you have loads of tiny things you can do!! well, if they would make you feel better. eat something small- make sure you have things that don't require much prep, do 30s decluttering, just little things that add up to making you feel more human.
my impression so far is ok. it caused a pretty deep and restful sleep last night. today has been kinda mellow since. physical comfort is greatly increased when laying down. not so good when you're already lethargic, but at least it's kinda pleasant now.
sounds like a reasonable start. when i started with sertraline i could barely sleep at all, was a nightmare.

have you been able to keep anything down lately? after those two big climbing efforts, i hope you're able to replenish at least a little. speaking of, are you back home from your trip yet?
i kept all my food down yesterday!! i was very busy all day which helped, and had smaller portions so i would hopefully not feel it sitting in my stomach taunting me. today is take out night so don't think i'll be able to do so well today.

and yes i'm back from my trip.
 

thegreenhand

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Sorry @chinup , I’ve been visiting my sister this weekend. Haven’t really been on BL much. Drank way too much last night, but miraculously no hangover

I’m glad you were able to eat something and keep it down.

I begin an intensive outpatient program tomorrow. Three hrs long, three days a week. Not really looking forward to all that but I figure I can try.
 

Nas47

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So I’m sort of at a decision point…

my depression has been worsening over the last couple months, even with semi regular psychotherapy. The physical effects are the worst part. I can’t bring myself to eat most days, I can’t sleep at night and then I’m tired all day, not getting out of bed or leaving the house, etc.

the emptiness and pain aren’t much better but I can at least somewhat attend school and work with those happening… So now I’m reconsidering medication

i was on SSRIs (fluoxetine 20 mg initially and then switched to escitalopram 10 mg since I found the former too stimulating) for about three weeks. But I ended up quitting them because I felt very unlike myself. Almost felt high tbh.

something didn’t sit right with me ‘psycho-spiritually’ about being dependent on a substance either. But it seems I may be non functional without one.

LSD helped when I first started using it but that was short lived and given that I’m only 20 I think I want to let my brain finish development before trying psychedelics again

sorry for the long rant. I guess I’m just wondering at what point did you decide an antidepressant was right for you? And are you happy with your decision?
Decide to start sertraline after years of depression.Despite I am addict,i have a good diet,yoga every morning,bycicle a lot.Also exproffy sportsman years before.It help,but not to big degree.First two weeks feeling sick a little bit.Allways on smallest possible dose-50mg.Now on 25mg daily.It decreases libido somehow,but its have a possitive impact on sexual performance,cause you finish not so easy.Theres a people I know that use this stuff only for that purpose.So cannot day anything bad about this ssri,but is also a no big deal.Plan to quit fully about X-mass,when i accomplish 6 months.
 

thegreenhand

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Found a surprising amount of success with the mirtazipine. Suicidal ideation has all but disappeared. Sleep more regular, but certainly not optimal. Activity levels are still low, but are on the upward trend

i decided to try adding in another med to see if things might improve more quickly… 37.5 mg XR venlafaxine. So far the only thing that’s happened is worse sleep (waking up many times) and a sense of agitation throughout the day. Not sure if I really wanna finish it out for another month until I meet with the psychiatrist again…
 
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