Hey PMZ,
I am 2 years and 7 months into recovery.
No matter what anybody else says, you know the cause of the problem was the drug and the dosage that you chose.
The first few months of my recovery were, without a doubt, the most difficult and traumatic period of my entire life.
There will never be a suffering that can equal this experience.
I was certainly an OCD personality type prior to my drug use.
Always have been...
But after my MDMA-induced neurotoxic brain damage, my OCD nature seemed to take over.
I researched to the point of exhaustion.
My mind, while suffering, seemed fueled beyond reason.
I literally read THOUSANDS of research articles, including a large number of meta analyses, which are research papers written by a qualified research scientist that have spent a LONG time reviewing the literature on MDMA toxicity.
I felt as if I was capable of learning as much as a seasoned doctor, in a period of months.
On the internet...
Was I right?
Maybe...
Was I crazy?
Absolutely.
I was a very bright young man and an excellent student.
I pushed myself to the limit mentally, trying to understand the neurological and chemical basis of what had happened to me.
I telescoped my efforts solely on the function of serotonin as a neurotransmitter and the known toxic effects of MDMA.
I prayed that somehow, in my brilliance and desperation, that I could discover the treatment or medication that could STOP what was happening to me.
I was wrong.
Read through some of my old posts, and you will understand the lengths that I went to.
If I never located the 'cure' to MDMA brain-damage, then perhaps you can accept this process as inevitable.
Yet I recall a rather insightful revelation from long ago, something I would have said in the initial research phase...
There is no way to stop the racing mind.
At least not completely.
There is a trend among the 'victims' of MDMA to research, to read, to write, to ramble....some endlessly.
The energy that fuels the suffering mind is almost without limitation.
Those who do not experience this type of 'brain damage' simply cannot understand the nature of it.
Therefore, advising those early in the recovery process to simply 'let go' or 'calm down' is foolish.
Its a joke.
Cue laughter!
It is not POSSIBLE to stop thinking about the dysfunction of emotion that you find yourself in.
The brain is FORCING the victim to worry, to wonder, to suffer.
And those who look back at their own recovery and proclaim that acceptance is the key - they forget (necessarily so) that it was the process of suffering that ALLOWED them to accept their fate.
You will not be able to understand this until later.
You will not be able to think and learn enough to alter the course of your suffering in a substantial way.
The thing that allows the suffering to improve is the suffering itself.
Are you familiar with the relationship between serotonin and cortisol?
It is a critical relationship, if you are to understand what is happening to you...
The more serotonin transmission that occurs, the greater the release of this stress hormone.
With MDMA use, cortisol can skyrocket to 800% of normal levels in some people.
But all users experience a spike in cortisol of some kind.
After the peak, cortisol tapers off and both prolactin and dopamine flood the brain.
Cortisol is a defense mechanism against serotonin.
It increases the metabolism of serotonin, thereby reducing it.
The brain fights back when serotonin levels rise.
Why is this?
Serotonin is a modulator, a control mechanism with widespread effects upon other neurotransmitters and capillary beds in the brain.
It also has a profound impact upon the hypothalamus-pituitary-adrenal axis.
This is a structure you should also become familiar with.
When damage to the serotonin nerves occurs, serotonin levels don't simply drop.
Yes, MDMA depletes serotonin stores and inhibits the enzyme that produces more...
But when the actual nerve structure that branches from the brain stem through the hypothalamus and into the frontal lobes experiences a neurotoxic event - the re-growth of new serotonin axons is NOT associated with positive emotional or cognitive experiences.
Serotonin INHIBITS brain cell function.
As the tree of nerves starts pulsating with serotonin, your highest brain structures are literally being dimmed or shut off.
The suffering that you feel is a result of this process.
Your mind is fighting back.
Cortisol is released in an ongoing relentless pursuit of homeostasis.
One that is never achieved.
No matter the amount of cortisol released, your nerves are damaged.
You can put a leash on the process, but you cannot stop it.
Every day you awaken to a new reality, one in which your stress levels simply do NOT relent.
It is unreal and unimaginable.
Welcome to the world of mental illness.
Yes, this is what major depression or psychosis feels like for some people.
Understanding and accepting this came easily to me, and intellectually it helped.
The good news is that plenty of research on MDMA has been done that shows depression and anxiety do eventually resolve.
But it takes a year or two.
Two months is only the beginning.
But it is the hardest part indeed.
The first four months were absolute hell for me.
Words cannot express...
One day your cortisol levels will drop, perhaps due to exhaustion.
This is known as chronic fatigue and it is a serious metabolic and cognitive event.
It took six months to hit me.
When it finally did, two things happened.
First, the cognitive changes started setting in.
Second, I got VERY tired in the middle of the day - especially after eating.
I decided that when cortisol levels are finally exhausted, after months of suffering, the brain's serotonin network is finally able to sprout new axons in the cortex.
This means life-long alterations in structure.
And long-term changes in personality and cognitive abilities.
But until your cortisol levels finally drop, this is not possible.
You are currently fighting an inevitable process.
Right?
Well there is one other approach, other than waiting for exhaustion and cognitive decline to set in...
It involves going the other direction.
What happens if cortisol were significantly increased?
Beyond what your mind is capable of doing on its own?
No, I'm NOT talking about taking another dose of neurotoxic MDMA!
I'm talking about Electro-Convulsive Therapy.
ECT.
Yes, it is still in use.
And some psychiatrists swear by it, while others demonize it.
But it seems to be the ONE treatment with the potential to resprout a significant amount of your cortical serotonin nerves and restore your mind to working order.
ECT releases powerful waves of BDNF, or brain derived neutrophic factor, a protein that literally grows serotonin nerves.
It is also released by physical exercise, but in much smaller amounts.
Nothing comes close to the BDNF release of ECT.
It also releases cortisol.
In fact, the level of cortisol release is associated with recovery.
The patients with higher cortisol response to ECT are the ones with the most reliable and successful recoveries.
Those with lower cortisol levels during ECT are predictive of poorer long-term prognosis and the need for re-treatment in the future.
A massive wave of cortisol and BDNF at the same time might be the one thing that can 'cure' the re-wiring process that you are experiencing right now.
And it is my humble opinion that this treatment is most effective EARLY ON.
The same is true in other mental illnesses - with severe depression the sooner treatment of any kind (including ECT) is performed the more likely recovery is going to happen.
With schizophrenia, evidence exists that if ECT is performed within the first year their is an 80% chance of life-long remission.
For me, I felt like the first six months were the opportunity I missed.
Beyond this time, I felt like long-term changes in brain structure had already occurred that rendered ECT treatment less effective or even damaging.
But if I could return to the initial first months of this process, if I had a time-machine to travel back to that era of unimaginable suffering, I wouldn't hesitate to seek out this treatment.
I would search until I found a doctor to administer it, no matter the risks.
Memory loss? Big deal, worse things can happen than forgetting names, faces, and how to read quickly.
All that happened to me anyways.
ECT may be the magic bullet.
It may not be.
As with many areas of brain research, it is too complicated to fully understand.
What we do know is that ECT causes remarkable recovery among a percentage of severely mentally ill people.
And significant short-term memory loss in about a third of them.
There are miracle stories.
And I would BET that MDMA victims, those that report major anxiety along with elevated prolactin and cortisol plasma levels, would benefit very clearly from this treatment.
We should be testing this treatment out on primates to prove it.
Or disprove...
Through all of my research, no doctor that studied MDMA offered treatment opinions other than the lack of effectiveness of SSRIs.
But I did find a case study of severe depression in an MDMA user that was cured with ECT and showed no return of symptoms within the one year follow-up.
And many psychiatrists offer support for this treatment - pointing to the robust growth of serotonin in the hippocampus as evidence.
This may also explain memory loss in some patients - remember that serotonin inhibits neuronal firing.
Even if you chose to avoid this treatment, which is a very big decision...
You can be comforted by the knowledge that significant amounts of MDMA research have shown that severe depression among its users does eventually resolve - with abstinence from drug use.
Alcohol is to be avoided or used with reason - it kills nerve growth factors in the brain.
Moderation...
But 12 months is the typical recovery period for anxiety - many papers bear this out.
The first four months are always the worst.
You may still get lucky and see resolution in the next few weeks.
But if you make it past month four with continued struggles, then count on twelve months.
Mark the weeks off the calendar.
And start working out.
Every single day.
Exercise is the ONLY coping mechanism that really works.
It will increase BDNF more with each consecutive day of effort.
This restores some serotonin axons, thereby reducing overall serotonin transmission and cortisol levels.
At least for a while.
Constant exercise will help your brain rewire itself.
Believe me.
No excuses, get out there and run.
I did many pushups with tears streaming down my face - wondering when the suffering will end.
It took a VERY VERY long time, but here I am 2.5 years later telling you it gets better,.
Start sweating and wait for month 6 - you will feel alive again.
By month 12 you will believe that you will be ok and you can accept whatever fate has in store.
By month 24 you will really understand what 're-wire' means.
And every month beyond that you will understand that you have the rest of your life to work on 're-wiring' who you are.
Life is still ahead of you, in the distance.
Stay strong.
FBC
