Cat,
That is indeed the million dollar question. Every last one of us desperately wants to know if we will ever be the same again....and if so when?
In my opinion, the researchers are performing the wrong tests. Word recall and self-reported improvements in depression only elucidate so much of the picture. But it does help to know that former heavy users tend to describe their depression as a thing of the past.
I have found encouragement from these types of postings to be quite valuable, especially when I was desperate. At the same time, I understand that they are somewhat limited, especially since most of these people are still drug users and tend to discuss very little in detail. I want to shake them, honestly, and demand more information! (Like you ColtDan....how long was your recovery?)
What I really want to see is a long running tally of hundreds or thousands of ex-users online. I want them to describe the depression/dysfunction they experienced and for how long. Only with a large amount of such data can we extrapolate the real statistical information that you (and I) so desperately desire.
So far, almost all of the abstracts I have read indicate that self-reported depression lasts up to two years. Yes that is the magical number, Cat. Think about it in terms of months, not years. Also of importance, in most of these limited studies, the lifetime exposure as well as the typical nightly exposure both correlate with the length of depression. The more you took, the longer it takes. There are exceptions, I imagine. I have only consumed 30 tabs or so in my life. But it was 500mg dosing, twice in 7 days that fucked me up. Re-dosing, in my opinion, is a greater danger than long-term controlled use...others on BL seem to agree with this assessment.
Does 12 months really sound like that long of a time period? Not to me. At least, not anymore. In the rat, 12 months seems to be what is required for near-complete recovery of the 5-ht network. Keep in mind they have two vast advantages here: the have a much less complicated brain structure and a much higher metabolism. Not only is there less work to do, but they can do said work at a faster pace.
So 12 months for rats...
Yes, they are giving these rats proven toxic doses.
Even if you did not go so overboard with your dosing, you should count on one year being the
minimum. More important than the timeline, is the curve of the line. These rats experienced a 'protracted' recovery. That literally means the scientist had to use a protractor to draw the line on the chart.
In other words, in the first few weeks of recovery, a LOT of progress is made. More axons pop up in this time period than any other. Remember when you were in your first few weeks? Remember the height of your endocrine response? Wasn't that shit intense? The brain got that shit done very efficiently. Some people have a fucking stroke in the first week! I felt like I almost did...
But then, the recovery enters a phase of slower progress. The curve is less steep, but luckily for the rats, and for us, it continues over time. By the 6 month mark there is still a long way to go, but at 12 months they return to control levels. And this is not just one rat, this is many rats they are following. And sacrificing at different time intervals.
Now monkeys are harder to do this with, obviously. And we have yet to carve up human brains for this type of study. But this suggests, that no matter how long your recovery does take, no matter how complete or incomplete it is....it continues for a long time. It goes on.
How much experience do you have with babies? The reason I ask is because with infants, everyone tends to use months to describe the development process. Also, once the '24 month' mark is passed, most parents switch from 'months' to 'years'. I wouldn't describe a 4 year old as a 48-month old...right?
I think that has something to do with developmental milestones. By age 2, or 24 months, they are starting to function like little people. They are walking and running, they are using single words, or phrases. They can feed themselves. The smarter ones can start learning not to shit on themselves! Of course their brains are much more malleable than ours...
So 1-2 years seems like a confident yardstick to me. It's the best we have. I can definitely track my personal progress over the last four months. Don't get me wrong, I still have bad days where I believe I haven't changed at all, and never will. But on my good days, I can tell that every few weeks I have made small steps of progress. I can 'feel' the evolution of symptoms. My good days get a little 'gooder' each time! I would say by 2-3%. YAY!
Can you feel any evolution?
If so, chances are you will fall into this 1-2 year guideline.
Think about it this way, if most people stayed fucked up for more than a year or two, I bet we would see a lot more of them on BL or other internet communities asking for help. Their absence suggests a pattern of recovery.
What worries many doctors is the possibility of problems as we age. If we are already living with a deficit, then age-related decline may exacerbate this condition. This is known as 'sequelae'. Symptoms to follow, down the road. This should probably be of greater concern for you and me than our initial recovery. But here we are, focused on the here and now...just like our endocrine system demands.
I have seen a few posts from former meth users claiming it took them 4 years to normalize. They are regrowing the dopamine network, which is much more resilient than the serotonin network. However, most meth users become 'daily' users. I have yet to meet the occasional speed head. They either do it and walk away, or they do it every day. It's because the body is equipped to replenish dopamine so quickly that they receive continuous rewards day after day. Even the dumbest MDMA users notice a drop-off in pay-off after a few days or weeks.
So recovering METH addicts are also of value in this discussion. Research shows they typically take 1-2 years also!
MDMA is a type of amphetamine. It just targets a different system.
Remember, from my earlier post, that it may well be dopamine that is the key to the MDMA high after all. Although METH is a much stronger dopamine releaser, MDMA still causes a release of dopamine. In fact, it may be able to cause a release in targeted areas of the brain like tactile sensation and emotional well-being. The theory I like says that 'the increase in serotonin activity in the frontal lobes causes a flood of dopamine down the mesolimbic reward pathway'. Its a type of amphetamine high that METH just can't quite pull off.
Now that your serotonin network is frayed and fucked, especially in the frontal lobes, it is nearly impossible to obtain this release of dopamine anymore. Your serotonin defect is resulting in a targeted loss of dopamine! The result? Less tactile sensation. A feeling of disconnection from the physical world, including your own body. Blunted emotions. Lack of pleasure during sex! This is 'anehdonia'.
Why is this exciting? Because this may be why recovery is possible. All the serotonin system has to do is reinnervate these regions 'just enough' to cross a threshold. Once there, the dopamine can flow again!
In fact, it is shown in research that former MDMA users show a hyper-sensitivity to stimulants like METH and cocaine, both powerful dopamine agents. Sounds tempting, to be honest. But only a little....my brain has learned its lesson.
Imagine that serotonin is the great regulator of other brain functions. Serotonin in the smooth muscle of the intestine as well as the genitalia, somehow manages to send a message all the way up your fucking spinal cord. Then the base of your brain send this signal all the way to the fucking frontal lobes! This is quite a long way to send a complex message, don't you think?
Once these frontal regions receive the message that CatintheHat is pounding his pud, the dopamine network in the frontal lobe responds with the reward of sensation. Wow! Say 'wow' boys and girls...
With ecstasy, we achieve a level of sensation that our brains never intended us to have. Now that your serotonin axons are all withered and limp, the nearby dopamine neurons are getting no release signals, regardless of what your body is doing.
Suggestions for dealing with this fucked situation? Other than waiting two years?
Piractem, for one. By making the cellular membranes more permeable, the dopamine is allowed to flow. The serotonin reaches its target, which is probably less than a millimeter away. It seems to work great for me, although the affect tapers off after a month or so. That's why I cycle on this stuff. And always, always take fish oil.
So making the cells communicate easier is one approach. What about increasing the amount of dopamine available?
No, not meth....bad idea. I'm sure it would work, but would not be worth it in the long run.
In research regarding SSRIs, they have discovered that sexual problems are more common than they once thought. There is also concern that, for a portion of patients, sexual function does not recover for months or years after discontinuation. In at least 7 case reports I have come across, it appears to be permanent. It was nearly a decade for one man.
For these pitiful few, there were still treatment options. In larger studies of post SSRI sexual dysfunction, about half of patients responded well to yohimbine. This is an herb, and it needs to be respected. Use with caution!
The yohimbine seemed to worked better than the other dopamine agents they were using, which were amantadine and wellbutrin.
However, the effects of all these seemed to wear off after several weeks of use...
I recommend these options be delayed until your serotonin recovery is complete. Just because a doctor will prescribe it, doesn't make it a good idea. However, if you must try something, yohimbine looks like a good option, when used in proper doses.
Don't expect these benefits to last forever. Just like the serotonin receptors, the dopamine receptors can down-regulate after a period of over-exposure.
So what else?
Exercise! A lot!
I would do this before you try anything else.
I lift weights five days a week. By day three I feel much more in tune with my body. But cardio may be more important.
Studies have also shown that cardio, performed daily for six months, led to a measurable increase in total brain volume. It does this by increasing the amount of capillaries present. That's right, running every day for half an hour will help sprout more bloodflow in your brain!
And, somedud, in elderly patients with shrinking hippocampus, cardio was shown to increase the size! They also reported improvements in short-term memory, especially navigating and remember directions. Also, the hippocampus is one part of the brain they have demonstrated can regrow new cells! Apparently stem cells are delivered to this region, especially upon injury. That is one part of the brain that is more capable of adaptation.
I imagine that cardio does a great job at getting the dopamine flowing. That's what the runner's high is all about. The most difficult thing with exercise is to repeat it often. I have been working out for over a year now, and I can tell you that the benefits do not become obvious for days or weeks.
So get out there and run until your heart feels like it will burst. Do this every day for two weeks. Then come back and tell us if you can feel your penis yet!
I have heard about, but haven't researched, medications that cause up-regulation in the serotonin system by starving the receptors. This is like the opposite of an SSRI. Apparently, these meds will actually cause depression and anxiety. But you may be rewarded for the extra suffering, because new axons will re-sprout in response. I assume it would feel a lot like we feel now, only worse... When I know more about these, I will let you know.
Once again, I must conclude my ramblings.
I hope it isn't too much to digest.
Good luck!
