MDMA Recovery (Stories & Support - 5)

[cserage]

Hey bluelight, long time LTC sufferer here....almost at two year mark that's when I will check back in. I just have a quick question for the community. I have to get wisdom teeth pulled today and I am wondering if using the painkillers prescribed are gonna send me down the rabbit hole. I have felt really really good lately compared to anytime since my LTC started and I don't wanna go back to square one but painkillers aren't a stimulant at all so I am curious to what you guys think or have experienced something similar. If you could get back asap that'd be great. Ps recovery for sure happens I really have felt good for awhile now, not perfect but far far far from living hell as well (living hell in all shape ways and forms was where I was for about a year and quarter or so)?? I can honestly say I am feeling good and happy and motivated. Keep trucking guys in a couple years it'll just be a memory and I have gotten to the point where that isn't a guess anymore it is inevitable

 

[cserage]

Just wanna throw my two cents in. I felt like I had plateaued eternally at the eight month mark as well. This was not the case I made huge leaps and bounds at about a year and a quarter. dont ever let your mind tell you that you are at your "wellness" plateau I feel pretty awesome lately for an extended period of time and I am excited for you and all the others to reach new heights in your overall well being! I applaud you for fighting through the rough times (I've been there too LTC at it's absolute power and severity) I think you are a great example to others who have, are, or will go through similar struggles.

 

[cserage]

Just wanna throw my two cents in. I felt like I had plateaued eternally at the eight month mark as well. This was not the case I made huge leaps and bounds at about a year and a quarter. dont ever let your mind tell you that you are at your "wellness" plateau I feel pretty awesome lately for an extended period of time and I am excited for you and all the others to reach new heights in your overall well being! I applaud you for fighting through the rough times (I've been there too LTC at it's absolute power and severity) I think you are a great example to others who have, are, or will go through similar struggles.

After about 6 months of shifting worsening and plateauing symptoms I could feel it deep down. My symptoms were deeply ingrained. Maybe I would've healed, I was just using my gut and it's usually correct. At this point I am just hoping to manage symptoms.

The above post was directed towards you sorry I am not thread savvy?

 

[fnono33]

Hey man, that's good to hear.

 

[Cotcha Yankinov]

^Yeah I definitely would disregard any plateaus, big improvements can come in strong even after a couple years.

 

[socrilus]

Plateaus suck. I feel like for the last 4-6 months ive literally been in a major playeau of no improvement and only setbacks followed by rebounding to where I was before. Or transient improvement back to baseline

 

[Cotcha Yankinov]

Plateaus suck. I feel like for the last 4-6 months ive literally been in a major playeau of no improvement and only setbacks followed by rebounding to where I was before. Or transient improvement back to baseline

I'll ask this rhetorical question at the risk of sounding pretentious - have you had any real mindset/personality changes in the past 4-6 months?

I think mindset/personality changes are important in recovering. When we hear from people who have "recovered", it seems like their mindsets have changed a fair bit - I don't think recovery is just a return to normality for most people. Returning to the old self might not be the path forward, because it might have been that old self that got us into trouble in the first place.

After I hit a plateau for a long time, there was a fundamental personality/mindset change that seemed to drive the real improvement in symptoms. But personality changes take time, as do all good things. And its not like medications/exercise won't help us be less neurotic/western mindset-ish, in addition to mindfulness. Anything that boosts neuroplasticity should help the brain remodel and thus should assist in personality changes, and medications/activities that make us less neurotic while we're doing them can help solidify that into our personalities.

 

[Regrets9995]

I'll ask this rhetorical question at the risk of sounding pretentious - have you had any real mindset/personality changes in the past 4-6 months?

I think mindset/personality changes are important in recovering. When we hear from people who have "recovered", it seems like their mindsets have changed a fair bit - I don't think recovery is just a return to normality for most people. Returning to the old self might not be the path forward, because it might have been that old self that got us into trouble in the first place.

After I hit a plateau for a long time, there was a fundamental personality/mindset change that seemed to drive the real improvement in symptoms. But personality changes take time, as do all good things. And its not like medications/exercise won't help us be less neurotic/western mindset-ish, in addition to mindfulness. Anything that boosts neuroplasticity should help the brain remodel and thus should assist in personality changes, and medications/activities that make us less neurotic while we're doing them can help solidify that into our personalities.

Can definitely relate to this, even though I'm only 6 months in. My main issue has been that I was a perfectionist and this whole thing did not fit in with my perfect plan of what my life was going to be. In accepting it and trying to see the positives, whereas before I was a very negative person, the past month has been much better. Symptoms wise nothing much has changed but mood is improving massively.

 

[socrilus]

What do you mean "symptoms wise nothing has changed but mood is improving massively".

Isnt low mood a symptom?

Or are you referring to other non mood symptoms like anxiety or DP or HPPD?

Low mood/motivation is the primary symptom for me at this time.

--
I guess I do not understand what mindet/attitude change is needed for that anyways. "Alright I have low mood but ill still do what I need to do."

"I can feel the sun shining on me and my feet on the floor"

Thats mindfulness supposedly but im not getting any effects from from changing my thinking to that.

I have trouble with this stuff bc its very abstract and in general I am a very "literal" person. Reading comprehension or analysis was always my weakest point

 

[Cotcha Yankinov]

I guess I do not understand what mindet/attitude change is needed for that anyways. "Alright I have low mood but ill still do what I need to do."

"I can feel the sun shining on me and my feet on the floor"

Thats mindfulness supposedly but im not getting any effects from from changing my thinking to that.

I have trouble with this stuff bc its very abstract and in general I am a very "literal" person. Reading comprehension or analysis was always my weakest point

Another way to think of mindset/personality is how someone handles an illness or symptoms like seen in the LTCs. There are basically two possible scenarios, although its certainly a spectrum and people drift back and forth.

1. Active obsession with the biological cause of the symptoms and possible biological treatments
2. Passive acceptance and non-judgemental mindfulness

Lots of the neurotic LTC or otherwise illness sufferers end up doing what I did and they research obsessively, trying to find out what the neural cause of the LTC is and therefore how to cure it with a silver bullet etc.. I think its really common for people with mental illness to look for a cause to their symptoms, and often they end up chasing fruitless leads while neglecting other approaches.

I've seen this before and have learned to spot the neurotic mental illness sufferer that is obsessed with biological treatments but won't put effort into a more fundamental approach like mindfulness, or they won't believe that there is anything fundamentally wrong with their mindset. This is probably the extreme end, the epitome of a westernized, over-analytical and neurotic mental illness sufferer.

One person talked to me a lot about their depression and they'll be giving me all these theories on medications combos and how they would work and yada yada and what neurotransmitters they respond best to and what drugs they can use to boost those neurotransmitters, then I'll say something like "You should try mindfulness, try this app and listen to some guided meditations some time.."

And they'll say: "Mindfulness?.. Yeah... No...". I wish that person good luck with their medications. Who knows how much better they could feel with a fundamental mindset/personality change, although its certainly not easy and is harder for the people who need it the most. Intuitively its also something that is easier for a younger person as well, although old dogs can certainly learn new tricks.

A person with another mindset (lets just say non-westernized, buddhist for example) might look at the situation completely differently. They might be much more accepting and non-judgemental, non-reactive, instead of over-analyzing the situation and resenting/regretting/ruminating.

This might seem more like a difference in knowledge rather than a difference in mindset, but they wouldn't be thinking in terms of neurons and serotonin, they would be thinking in terms of spirit and mind (even if they were aware of the existence of neurons and serotonin).

 

[socrilus]

There *are* people though who do get better without any of that so that person is probably just hoping to be one of them. Without a doubt people exist who recovered with meds or biological treatments alone (and im talking not just LTC specific).

The selfhacked guy actually has philosophy posts on this that some people need a change in mindset while others can just recover+it depends on the person. The posts are definitely interesting.

It seems like this whole LTC can be lumped in with all other 'mystery' illneses like CFS or drug/med induced mental health problems.

I think in some ways I have been spoiled by glimpses of recovery when using benzos or HC (hydrocortisone). especially When HC works it seems like all the symptoms vanish and I am like "hmm I didnt need a mindset change--it just went away and I am for all intents and purposes my old self". Now the issue is somehow these biological treatments don't "stick" but at the very least glimpses seem to indicate that being back to my old self is possible.

I guess I just don't believe that our "old selves" got us here because that may be true for more "external stress induced" psychiatric illness but seems like when its biological its almost like any other medical illness.

taking the drug (and recovering vowing never to do it again) but then suddenly getting symptoms a month or so later I do not see how I could have "prevented" the onset of the symptoms. Prevention would be don't do the drug of course and it was a lesson learned/acute comedown recovery had already occured. And no panic attack has ever happened either. Just random onset. I do not see how I could prevent random onset even if I was some sort of CBT god.

Sometimes the passive acceptance itself feels like completely giving up and seems to create even more anxiety.

With #1 at least that person can have some hope. #2 involves giving up hope seemingly and maybe they arent ready for that yet.

After all--who WANTS to accept their mental symptoms? When I think too much about that it definitely makes me really agitated bc it feels like giving up.

Lets also not forget about the #1 reason #1 may be more attractive: IMPATIENCE. Everybody wants to be better yesterday. That is #1 thing that is extremely difficult to let go of.

But again--I was always extremely bad in my lit classes when it came to the "big picture" overaching theme stuff so I could very easily be misinterpreting all that.

 

[socrilus]

I have tried mindfulness but I just cannot do the whole "non striving" part throughout the day.

I was just thinking all right ill do mindfulness for a few weeks. I want it to be 3 months (12 weeks) for full recovery so from this point on i should see 6% recovery every week. But then that is inherently striving.

So then I get all wound up in the whole philosophical aspect too.

The way I see it why should there be some kind of "quantum" physics effect? If it works it should work whether I expect it working or not.

I should be clear actually its never the actual meditation/breathing exercise but its all of the philosophical stuff that I simply cannot take.

https://www.everyday-mindfulness.org/forum/viewtopic.php?t=3256

Scroll down--what i don't get is there is someone who says they have been doing it for a while and they still get negative thoughts/feelings but just don't get pulled away as much by them.

Im not content with that result. I will, however, be content with 0% depression/anxiety.

If visual snow and I guess tinnitus stays, that is the one (or two) and ONLY "battle scar" from this I will be "ok" with.

 

[Cotcha Yankinov]

There *are* people though who do get better without any of that so that person is probably just hoping to be one of them. Without a doubt people exist who recovered with meds or biological treatments alone (and im talking not just LTC specific).

The selfhacked guy actually has philosophy posts on this that some people need a change in mindset while others can just recover+it depends on the person. The posts are definitely interesting.

One of the ideas behind major depressive disorder is the depressive episode - typically people will enter into an episode, either after a clear external stressor or idiopathically, and during the episode they'll often display elevated stress hormones. Then they can go on to be just fine forever, or remit and relapse a few times, and then at that point it becomes major depressive disorder.

After a few episodes, they become more vulnerable to falling into an episode in the future. It could be that the first external stressor was a loved one dying, or it was idiopathic - but after they recover from that initial episode, the latter episodes can tend to be more idiopathic, with no clear acute cause. This is likely because chronic exposure to stress hormones decreases the brain's ability to shut down the stress response (ironically) - the stress hormones then run a muck and affect the cortex and mood related areas of the brain.

So people certainly spontaneously remit without any medications/therapies, but I think people who remit spontaneously without much real accompanying mindset/personality change are probably not as protected from future insults as someone who underwent a major mindset change. Whereas there are people who have recovered from LTCs with mindset changes, and then gone on to use MDMA several times again without problem (Budal comes to mind).

Its possible that the (for lack of a better term) "neurotic mindset" predisposes one to develop issues after MDMA use because the biology is vulnerable, in the same sense that people whose depressive episode is initially triggered by e.g. loss of a loved one often have a history of chronic stress that didn't result in depression. So we may say "The loss of the loved one is the cause", but I don't think we should forsake the previous years of chronic stress or a neurotic mindset.

especially When HC works it seems like all the symptoms vanish and I am like "hmm I didnt need a mindset change--it just went away and I am for all intents and purposes my old self"

I don't think anybody would argue that certain drugs can't cover up symptoms in the short term - take benzos for anxiety for instance. But when the benzo comes out of somebody's system and anxiety returns, they shouldn't say to themselves "Well look the benzo cured me so I don't need a mindset change - its nothing to do with my mindset, its just a chemical imbalance".

The thing is that to me, a neurotic mindset = a chemical imbalance, and drugs like benzos can very powerfully affect mindset and of course chemical imbalances. For somebody with anxiety, there is a dose of a benzo that will just tip the scales back to normality.

Cortisone is turning up the tone of the hippocampus, which is ironically the structure that tends to weaken with repeated depressive episodes until people fall into episodes more so idiopathically. Part of what I'm getting at is that if your issue is your hippocampus (of course its more complicated than that), then years of a neurotic mindset or stress prior the MDMA experience could have also contributed to the vulnerable biology. There were a couple things that happened right before your LTC that seemed like they could've contributed, so I do thinks its interesting if you see there being no relationship there, the very long term neurotic mindset aside. I believe there were school finals and stuff with a girl that happened before your MDMA use, I hope my memory serves.

taking the drug (and recovering vowing never to do it again) but then suddenly getting symptoms a month or so later I do not see how I could have "prevented" the onset of the symptoms.

I suppose the question is really whether your lifelong mindset leading up to the LTC had anything to do with developing the symptoms. Its known that some "genes" stick around in the cells for an extended period of time, take for example a gene called DeltaFosB that is expressed in mood related brain regions with amphetamine use and chronic stress. Stress hormone related cell changes can also be delayed.

When the stress hormones affect cortical circuitry, there could be a domino effect that takes a while to reach a symptomatic phase, and these genes will of course be interacting with the neural activity to affect the neurobiology. There are many reasons why symptoms could be delayed after the insult, and many reasons why things that happened years prior (even things that happened in the womb) can add up to becoming symptomatic.

I'm actually surprised that people get so caught up in the idiopathic vs. environmentally induced vs. drug induced thing, I think for the most part people will still have success focusing on treatments that work for symptoms regardless of the cause.

I think Socrilus has said that LTC related depression must be different than MDD because LTC people have these weird drug sensitivities, but there are arguments against this notion:

1. People with MDD do have bad/weird reactions (normal people have bad reactions to 5-HTP, even melatonin), and an initial worsening with SSRIs is very common and well known
2. LTC sufferers also frequently have anxiety, and lord knows that people with anxiety have all sorts of weird stuff going on when it comes to med reactions
3. The very nature of the LTC being drug related can often give rise to pharmacophobia, which doesn't necessarily help

In a perfect world we would distinguish between symptoms that had some drug induced component, but for our purposes I don't think mindfulness is out of the question as a treatment because "LTCs are drug related and mindfulness is just for people with external stressors as the cause"

If it works it should work whether I expect it working or not.

I think this is like saying "If I do it, it should work whether I do it with proficiency or not".

Scroll down--what i don't get is there is someone who says they have been doing it for a while and they still get negative thoughts/feelings but just don't get pulled away as much by them.
Im not content with that result. I will, however, be content with 0% depression/anxiety.

This is the kind of stuff I hear from people with mental illness that leads me to believe that a fundamental personality change can be helpful, but anyways as far as "still having negative thoughts but not getting pulled away as much", I think that is really the non-reactive/non-judgmental state. So even if the inner monologue is saying that same things or you're having the same thoughts, those thoughts don't hold as much sway over your moods and emotions.


TL;DR - People think their brains were flawless before MDMA, but I say people had some vulnerable biology and MDMA just added some more vulnerability and lit the fuse

 

[socrilus]

There weren't finals but yea there was stuff with a girl and just regular midterm exams but those things went well (I recall scoring near 100s on those exams and then a week or two later developing LTC and wondering if it was really me who did those exams and whether I was normal etc not knowing wtf was wrong with me) and then scoring with a girl for the first time lol. Not exactly "stressful" things.

So its pretty weird that idiopathically (something hormonal definitely as you imply, and since I now know after the fact that Cortisol and probably T got messed up) happens and then triggers all of this. So kind of like "postpartum" depression except instead of Progesterone+Estrogen swings somehow I may have developed it through nutritional issues (I was underweight) that went on to deregulate T/C and then once hormones are fucked mind gets fucked and its a vicious cycle that may go beyond hormones. That I agree on.



I don't recall any life stress prior to the LTC. I just had the regular stresses of school and when it came to STEM I was pretty good. I got decent grades without stressing much. That could be Warrior genes though overpowering any other potential short serotonin transporter issue at the time. So its not like I've been a "Worrier" all my life lol.

What exactly is the role of therapy/mindfulness etc in idiopathic "1st" episodes? Like CBT argues thoughts cause feelings. But in idiopathic depressive episodes can we really say its thoughts that cause feelings? If that were the case, then idiopathic episodes wouldn't exist right?

Also, a lot of things about mindfulness do say its better for relapse prevention than as acute care in the midst of a depressive episode. Makes sense too cause people won't be feeling so desperate when they are not in the midst of an episode and hence they don't feel an urge at the time to force something to happen.

I actually recall going to my school counseling center the week after the LTC started (I gave it a week at first to not panic and to let it subside on its own) where they suggested CBT and then I immediately was like alright lets CBT this motherfucker problem up. And then I anxiously agreed was like lets modify ALL my thought patterns in this session and cure this disorder right now just like it came overnight. The therapist was overwhelmed and couldn't really help. They didn't know wtf to say. They were going to say "This doesn't happen overnight" etc but then in front of them there is a case where it happened overnight. I gave it a full week to correct itself with no panicking and did not even know about LTC back then. Its only when the dysfunction did not correct itself in the time frame of 1 week that I started panicking. I also had trouble identifying my thought patterns that were causing the symptoms during that session since there were no obvious thoughts and I had enough "metacognition" to see that the thoughts I did have were being driven by my emotional/mental state but that doesn't make the emotional/mental state any less problematic

Thats when I got so agitated about psychological therapies in general so my early experiences with it (aka when I probably shouldn't have done it and when I should have juts focused on biological treatment with something like phosphatidyl serine alone to solve the LTC when it was in that acute high stress hormone stage) may still be influencing things.

I went to a CBT support group for 2 months again and even they were like overnight idiopathic anxiety+depression is rare but that I should focus on the solution. I agree with the solution part. Idgaf about why as long as the problem is solved but I'm trying to quickly solve the problem and that is difficult with CBT/mindfulness techniques alone.

If I could find a medicine that is effective then maybe I would get more mileage with it though.

Also, on a related note, why is there seemingly a contradiction between CBT techniques and mindfulness? In one you try to change your thought patterns actively and in the other you are observing and noticing sensations accepting etc.

 

[Cotcha Yankinov]

2 points that may be helpful

1. I think we should be placing more emphasis on the underlying neurobiology because hormones would be pointless unless they could affect the neurobiology. You may not have had chronic stress pre-MDMA but the stuff that happened pre-MDMA certainly affected your neurobiology, and could have shifted the biology in the same direction as stress.

As a practical example for people who took MDMA + amphetamine or for people who got a meth bomb/bath salts - amphetamine is not only going to increase the stress hormone release seen with MDMA, but it's also going to increase oxidative stress which can cause the same changes as stress hormones.

So in other words, the effects that stress hormones have on the brain aren't specific to stress hormones, you could even exert similar changes with a particular mindset even if you don't feel particularly stressed or anxious.

That being said, I thInk it's highly likely your HPA was functioning a tad differently in the weeks leading up to the MDMA, even if it didn't "feel" stressed. As an example, peoples cortisol can spike 800% while on MDMA at a rave, but it's a very incredible euphoric experience and there's no real "anxiety" involved. You in particular can also take cortisone and actually feel better, so it's still possible that there was some elevation of stress hormones prior to the MDMA.

People also love to play video games and do adrenaline junky type things that's are spiking stress hormones, but people don't usually feel "stressed" even if their cortisol is riding high.

So let's say you were a chronic video gamer for years prior to the MDMA - you may not include this in the category of chronic stress, but I think psychiatrist might. Video games are also going to affect the brain in other ways, stress hormones aside.


2. RE: thoughts cause feelings vs. idiopathic mental illness - I think a better way of framing the "thoughts cause feelings" thing from a mindfulness standpoint is that "mindset helps determine neurobiology which helps determine mood"

I think the points in the "mindset -> neurobiology -> mood" triangle where we can intervene are mindset and neurobiology, and I guess mindfulness and CBT are focusing on mindset rather than meds which are more of a direct neurobiological approach, even though the placebo aspect is still mindset.

The negative schema and enhanced negative emotional salience stuff may seem abstract, but as a practical experiment what you can do is put people in the lab and show them sad things and happy things and tell them to hit a button as fast as they can only when they see sad things, then switch it up and tell them to only hit the button when they see happy things.

People with depression, people undergoing tryptophan depletion and previous MDMA abusers with a short form of the serotonin transporter gene don't do so well on these tests - they tend to react faster to sad faces and stimuli and react slower to happy faces and stimuli.

I realize that we may not consider ourselves as people with messed up schema and that crap, but it's certainly possible that you could show enhanced sensitivity to negative stimuli in such an experiment as described above. Hopefully that puts a bit more practical lens on the negative schema stuff if you can't find the negative schema in your thought patterns themselves

Sorry for the novels people

 

[Cotcha Yankinov]

Also, on a related note, why is there seemingly a contradiction between CBT techniques and mindfulness? In one you try to change your thought patterns actively and in the other you are observing and noticing sensations accepting etc.

An adage might be that "CBT is about changing one's lens from a negative lens to a positive lens, while mindfulness is more about removing the lens entirely". I've mostly heard about thought manipulation when it comes to treating phobias with CBT. So if someone has intrusive thoughts of dying in a car crash when they try to drive again after a car crash, the therapist would have the patient imagine successfully driving the car (imagined competency training)

I have no doubts that there are different kinds of depressions, and co-morbidities change the optimal treatment route as well, so there may be some people that just don't jive as well with CBT (no matter the initial/chronic cause of the symptoms).

It also comes down to specific therapists. There are certainly shitty doctors and psychologists out there, and there generally needs to a be a good fit between a therapist and a patient (one therapist may be a horrible match for one patient and a great match for another)

 

[socrilus]

So basically something which isn't stressful for you can be stressful for your body?

Anyways, I do find CBT more helpful for the non-LTC related thoughts. Like when the other day I had asked a friend to hang out and got no response my mind started going down the path of "what did I do.... etc" but I got out a piece of paper, identified the distortion, changed the thought and IMMEDIATELY felt better about it and moved on.

Its just not as helpful for the 70-90% of the time when the thoughts are LTC symptom focused.

For that 10-30% of the time when they aren't and some negative thought appears, it is more helpful.

 

[Cotcha Yankinov]

So basically something which isn't stressful for you can be stressful for your body?

Correct, you don't always have to feel "stressed" during a cortisol spike. There is also a big difference between the acute effects of cortisol (RE: hydrocortisone) and chronic stress hormone exposure.

A lot of that sort of stuff is also context dependent. Someone once told me that a roller coaster drop can be an exciting thrill for many but the same exact feeling while falling to your death is horrifying.

 

[ADubbs]

I agree with cotcha that we were predisposed to this situation. I had some really bad experiences with weed a few times before all this.... Puking, shaking, anxiety.... Granted those all passed within a day, but still no body else i was with experienced it like I did. My some and uncle also both had issues with available where they had flashbacks for a few years anytime they'd touch alcohol or weed

 

[socrilus]

Correct, you don't always have to feel "stressed" during a cortisol spike. There is also a big difference between the acute effects of cortisol (RE: hydrocortisone) and chronic stress hormone exposure.

A lot of that sort of stuff is also context dependent. Someone once told me that a roller coaster drop can be an exciting thrill for many but the same exact feeling while falling to your death is horrifying.

I could see that being true.

Using exercise as an example-- doesn't cardio or maybe more so even weight training raise cortisol levels?

I sometimes find myself getting nauseaous when doing weight training in particular its like I cannot tolerate it as much. Happens less often with cardio but I've had it happen.

Theoretically though why aren't we seeing bodybuilders (who are natural--I don't want to count the ones who do anabolic steroids because androgens may counter cortisol) develop MDD, anxiety, OCD etc from training very hard? Aren't they exposed to chronic stress hormones?

What counters that?

Exercise induced cortisol release is somehow "good" I guess but its still the same stress hormone.