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MDMA Recovery (Stories & Support - 5)

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socrilus said:
@cotcha

I am talking about somebody who is confident, successful, has everything, has an internal monologue which is "normal" (everybody has an internal monologue--i think I would be more scared if I had 0 internal monologue. Absolute 0 is physically impossible). Even thinking and fantasizing about having sex is technically internal monologue--just not negative.

And then this person goes on to develop depression or anxiety for no known obvious causes. And then notices that he or she has developed a negative internal monologue *after the fact* and they know that they are thinking negatively but are not able to stop it but instead wonder what it is that caused the sudden neural shift.
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RE: the internal monologue is normal - I'm personally not prepared to say that talking to ourselves in our head is healthy regardless of whether it's negative, neutral or positive. Sure it's extremely common, but so are lots of other unhealthy things in our western society, and indeed our western society is rampant with mental illness, including depression.

There are probably other societies where the internal monologue isn't common, such as Buddhist temples that are often part of a silent mediation retreat. I bet that those societies have a much lower incidence of mental health issues.

It's possible that speaking or reading aloud in our heads can (in some people particularly, maybe some others not so much) activate these areas like the default mode network regardless of the quality of the inner monologue.

As a specific example here, the subgenual cingulate increases in metabolism when people are essentially sad, and there is a very high level of serotonin reuptake transporter expression in the subgenual cingulate as well (the mechanism by which MDMA increases serotonin - it reverses these transporters and causes them to pour out serotonin).

While one person may have "natural" (no drugs involved) brain activity due to an environment gene interaction that leads to activation of the subgenual cingulate, MDMA could also cause the same issues pharmacologically.

The subgenual cingulate is participating in wider circuitry, sometimes known as the socio-affective self referential circuitry, similar to the default mode network. Different therapies, be they pharmacological or cognitive, can both decrease the power of the default mode network.


It's not entirely clear to me why some people are suddenly above-threshold and suddenly experience symptoms, but I have a feeling that some of the relevant biology is brewing for years (being a in a highly linguistic society et cetera, or in general over-thinking and being analytical, which LTC sufferers often are).

But one specific example by which the threshold could be reached is reversal of the direction of neural oscillations. People with the "short form" of a gene called 5-HTTLPR have a higher risk of adverse effects including depression after MDMA use, and a higher risk of depression after stress, but a "normal" risk if they had an average environment (a gene x environment interaction).

There is evidence that some people with the short form have weird coupling theta rhythms (neural oscillations that connect brain regions) between an area of the prefrontal cortex (mPFC) and the amygdala.

Animals models that essentially simulate having this short form gene have shown that these theta rhythms that connect the amygdala and mPFC can reverse direction with "social defeat stress".

I would bet that the biology that permits/encourages this reversal can brew for many years while the symptoms may only really surface once the oscillations reverse (maybe with the prodding of MDMA and a few nights of poor sleep).

So I think there are mechanisms by which past events aside from the E can contribute to the current state we are in. As another example, Parkinson's disease really only occurs after 80-90% of dopamine cells degenerate, and liver failure is similar.

As a non-neurological example, having bad posture and bad musculoskeletal mechanics for years will increase the risk of serious injury from a fall (hip break, disk herniation), but we wouldn't 100% blame the fall - we would consider the historical component wherein muscles were too tight to allow proper range of motion et cetera
 
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Cotcha Yankinov said:
A lot of people with neck/jaw problems (commonly co-morbid) have tinnitus, neck muscles like the SCM can cause both jaw problems and tinnitus (the muscle attaches up into the ear). I posted a study a while back about Botox into a muscle for tinnitus
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Thanks, I might talk about it with my dentist. I do have some jaw issues but it wasn't anything really to worry about before all this. I think the stress of all this is getting to me and starting up its own symptoms.
 
Thank you for the support and hope, this is hell and no way to live! Does anyone get headaches? I get a pretty awful feeling like someone is drilling into my forehead, it's horrible.
 
I'm never going to get better. Each​ day that drags on without improvement is another day towards permanency.
 
ADubbs said:
I'm never going to get better. Each​ day that drags on without improvement is another day towards permanency.
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I swear it does feel like that and has for me quite a bit. The time is the WORST aspect of this all. Its not like a broken arm or leg where its like oh ok 6-8 weeks it will most likely be all back to normal after a cast/rest and everything.

The "indefinite" time factor is terrible.

And I know some say use mindfulness etc but that also becomes such a dissapointment to me since its so slow :( I am like ok this very second I can accept the problem but how the hell do I chance it in the next second.

I get so confused with the whole "present moment" shit cause its like ummm we are constantly moving into the future?? Present means this very moment but this moment is gone 1 picosecond later. The whole definition of "temporary" also completely throws me for a loop too cause temporary to me is so indefinite it can be 1 picosecond all the way to the next 20 years and still would be classified "temporary". Ughhhhhh
 
socrilus said:
I get so confused with the whole "present moment" shit cause its like ummm we are constantly moving into the future?? Present means this very moment but this moment is gone 1 picosecond later.
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Some neuroscientists argue that our conscious experience is essentially a memory, and that it's trailing behind the present moment a tiny bit. But by "present moment" I think people really just mean to try to avoid being lost in thought with the voice in your head blabbing away, to try to connect with whatever sensory input we experience (good or bad) and to focus our attention on something like the breath that is also "currently" (whatever that means) happening.

I have to say, I wouldn't think that mindfulness would ever upset someone if they were really practicing it 100% correctly (which no one ever does anyways, hence the use of the word practice), I think what would instead happen is that someone could be fairly successful at mindfulness for a couple minutes, then if they don't notice a good difference in their mood they get impatient after that - but that period after the successful mindfulness is the only place the anger should happen if the mindfulness practice was truly perfect. I hope this makes some sense..

As another example, how long could somebody stay angry without having thoughts, and thinking about what angered them in the first place? 30 minutes?

I hope this doesn't seem condescending, it's not meant that way (I know how mindfulness is for most people)
 
ADubbs said:
I'm never going to get better. Each​ day that drags on without improvement is another day towards permanency.
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Regrets9995 said:
If this is permenant then I don't know what im going to do.
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Do keep in mind that there is normally a progression of treatments for an illness if it doesn't improve, in this case the list for LTCs could be something like

1. Cardio/mindfulness, address physical illness
Then a trial medications in something like this order

2. SSRIs/SNRIs
3. Atypical drugs - mood stabilizers like Lamotrigine and Depakote, and atypical antipsychotics like Risperidone


But my main point is that its certainly not like "Well SSRIs didn't help so we have zero more options for you" - I would hope that a psychiatrist would recommend trials of drugs in the mood stabilizer category like Lamotrigine and also a trial of an atypical antipsychotic like Risperidone, because SSRIs are certainly not all there is to psychiatric meds.

The mood stabilizers in particular are very unique. Even in the category of mood stabilizers itself, Lamotrigine is very unique.

See for example this case study concerning chronic (I'm sure she thought it was permanent) HPPD after LSD successfully treated with Lamotrigine (Lamictal) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736944/

Its not like Lamotrigine is 100% safe and effective though, so its definitely something to talk to a doc about.
 
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@cotcha
Yes the scenario where someone gets frustrated *after* it due to impatience is what I am talking about. Not necessarily during. Its the same frustration as with CBT or anything else.

I dont know why they dont study the "frustration" effect more. Ive spoken to my dr and I was told that he has a whole slew of people who get the frustration.

It seems like a very important factor to study before people can go on claiming that mindfulness is a depression/anxiety treatment.
 
One possibility is that the frustration is actually partly rebound activity.

So let's say that some people have issues with a particular circuit called the DMN, and normally the brain cells are really active, releasing lots of neurotransmitters onto receptors there.

If one begins to quiet that network with e.g. mindfulness, it's possible that when the release of neurotransmitters there decrease, the receptors sensitize a bit temporarily to compensate. Then when mindfulness ceases and activity resumes (or when mindfulness becomes harder due to compensatory sensitization) the brain cells of the DMN begin releasing neurotransmitters onto now temporarily sensitized receptors.

I don't know if something like this is happening and if this rebound activity is contributing to frustration after a mindfulness session for some, but I suspect that there would be a big difference in the acute vs. chronic effects therein.

Chronically, I would expect that the brain cells of the DMN would eventually atrophy and be harder to activate as you used them less during mindfulness and started encouraging different thought patterns throughout the day that didn't use the DMN as much as well. The latter part goes back to the whole "keep your mind focused on something" thing, rather than googling all day I suppose.


RE: "It seems like a very important factor to study before people can go on claiming that mindfulness is a depression/anxiety treatment."

I suppose the analogy here would be that you get pain and soreness during and after working out, (which is actually required for growth) and there is increased dysfunction/weakness for a few days after working out - some patients don't do physical therapy specifically for this acute reason and furthermore aren't motivated to push through it when they don't see results in a month.

This is a big problem that we need to work on (this is 2017, you think we'd be able to just signal a muscle to grow like crazy already) but for now all providers can do is assure the patient that the muscle growth et cetera is coming in the long run if they stick to their physical therapy. I wish the analogy were as airtight as mindfulness -> guaranteed results in the long run just like exercise -> muscle growth, but I suppose everybody gets to decide where to place their bets and their efforts

The efforts and bets placed should be based upon evidence and I wish we had more evidence, but what we do have clinically and anecdotally suggests mindfulness can help with the salad of mental illness that humans are bestowed with
 
Well i guess I should be grateful that I am pretty much guaranteed 24 hours of relief from depression with Klonopin which is traditionally anti anxiety.

But of course relying on Klonopin is what I am trying to avoid. I want to get off the stuff and ive been using it 1-2 times per week for over 1 year. Im concerned there is a dependency.

Is it normal for Klonopin to relieve depression? I strongly think GABA has gotta be involved in this LTC either by itself or by way of serotonin+hormonal pathways that indirectly disrupt GABA signaling. Other anti anxiety meds targeting norepinephrine didnt work.
 
Some people find certain benzodiazepines abusable and euphoric, but it's possible that for some people benzos aren't necessarily inducing euphoria as much as they are inhibiting circuitry that causes depression symptoms.

GABA isn't necessarily like a resistor that just inhibits the brain, GABA rather can coordinate neural activity. Maybe there is something stabilizing about a GABAergic drug that calms some aberrant neural activity, essentially an anti-epileptic.

Which is essentially how lamotrigine is supposed to work in some senses, and it's probably a much better bet long term as far as dependency (although the side effect profile is different).
 
Cotcha Yankinov said:
Do keep in mind that there is normally a progression of treatments for an illness if it doesn't improve, in this case the list for LTCs could be something like

1. Cardio/mindfulness, address physical illness
Then a trial medications in something like this order

2. SSRIs/SNRIs
3. Atypical drugs - mood stabilizers like Lamotrigine and Depakote, and atypical antipsychotics like Risperidone


But my main point is that its certainly not like "Well SSRIs didn't help so we have zero more options for you" - I would hope that a psychiatrist would recommend trials of drugs in the mood stabilizer category like Lamotrigine and also a trial of an atypical antipsychotic like Risperidone, because SSRIs are certainly not all there is to psychiatric meds.

The mood stabilizers in particular are very unique. Even in the category of mood stabilizers itself, Lamotrigine is very unique.

See for example this case study concerning chronic (I'm sure she thought it was permanent) HPPD after LSD successfully treated with Lamotrigine (Lamictal) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736944/

Its not like Lamotrigine is 100% safe and effective though, so its definitely something to talk to a doc about.
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So in terms of the hierarchy where do you reckon hormonal interventions would fall under? Ie anabolic steroids like bioidentical T or PCT drugs if the HPTA is found to be suppressed from MDMA usage?

Could the high cortisol induced by the MDMA experience also be a catalyst to downregulation of Testosterone production?
 
I imagine that where hormone therapies fall in the hierarchy for a person would be dependent upon factors like labs on the hormones, the person's age and gender. But I wouldn't assume that more testosterone and less estrogen is always better - the selective estrogen receptor modulators used in PCT can have severe side effects when they decrease estrogen, and estrogen was investigated with some promise to treat traumatic brain injury.

There are also treatments like mood stabilizers that tend to decrease androgens but yet can be markedly effective for some mental illness like bipolar depression. Our society might be a little obsessed with testosterone. "Do you have low T?".

But I'm not too familiar on that matter of testosterone/depression, although I will say that we should be careful when reading studies related to that.
 
I was wondering if anyone could shed some light on to what's going on with me right now. I've been feeling incredible amounts of anxiety and bouts of crying. I don't think I've felt stress for a long time. As I mentioned before I started lamotrigine just over a week ago and am at 50mg a day at the moment. Today is the second day I've taken place the 50mg dose.

I have a TON if stress in my life that has been building for the last few years and it's all coming to a head right now. My parents have a rice farm and the price of rice is so low that it's not even worth it to plant this year so they may be broke next year and they are already in debt. I'm going through a break up that's been a long time coming. I've had depersonalization for the last year while I haven't felt this connected to my self in a long time im confused as to why I've been feeling this overwhelming anxiety that sits in the middle of my chest.

Lamotrigine is supposed to be a mood stabilizer but it feels like the opposite right now. I was thinking maybe it's reconnecting me to my emotions and I'm feeling all of the stress and anxiety that I couldn't feel since the depersonalization started. Maybe it's something entirely different and I'm having a bad reaction to the meds .

I'd like to hear your guy's thoughts.
 
Reconnecting you to your emotions sounds like a logical and neat explanation but either way it's something to talk to your doctor about and figure out if the dosage needs to be adjusted down or something. Maybe it wasn't the best time to jump up to 50mg I suppose.

Hang in there and let us know how you're doing.
 
So I am guna be attempting Ketamine infusions soon for the LTC.

I am just scared of any possible HPPD which i don't have right now. I only have visual snow+tinnitus as part of that and those were *not* directly induced by MDMA but by an SSRI I started way too close to the MDMA incident starting. Like after a month of it. So my serotonin system may have been hypersensitive and the problem didnt go away after stopping it. I shouldve just waited a reasonable amount of time before even trying it.

But im concerned about the impact of repeated Ketamine infusions on VS/tinnitus and whether it can trigger HPPD. Ive had it with the mild-moderate depression that is preventing my dreams. My psychiatrist said I should be ok so ive already asked a medical professional but im still so apphrehensive.

Ive been scouring the internet to no avail in finding info about people with VS doing ketamine.
 
I personally think getting persistent HPPD symptoms from non-ecstasy type drugs is extremely rare. Actual HPPD from mushrooms for example is extremely, extremely rare.

I personally did a fair amount of other drugs (ketamine-like drugs included) without a worsening of visual symptoms.

The biggest thing that can worsen VS/tinnitus in my experience is sleep deprivation, but that seemed to be a temporary thing for me.
 
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