Depressive moods/Anxiety induced by MDMA

[grose100]

Hi - I am new and would like to ask some questions about depression/anxiety to members in the groups who are experienced about MDMA
Recently, I have been diagnosed with depression which manifests in anxiety in areas that I cannot control. The anxiety became very accute recently, but in retrospect, I suppose I have been quite flat/mildly depressed for about a year, with anxious episodes. I am very concerned that this has been caused by MDMA.
I started using 2 years ago (mid-2010), quite regularly, for about a year. There could be months when i wouldn't use at all, but then there could be a fortnight where I would hit it hard - thre was no specified pattern, but I did have fun with MDMA. After this pattern of use for about 8 months, I completely stopped. 5 weeks later, I felt very sad, but put this down to hormones, but now I am unsure - could it have been 'withdrawal'? I didnt think I had taken nearly enough, but I didnt take anything again until a few months later in the summer. At the end of August (2011), I took over one gram of MDMA in one day and suffered hugely as a consequence, really depressed for about a month, which scared the shit out of me and I stopped using for ages, only taking little bombs here and there with at least a month apart when I felt stronger. Looking back though, I think I was generally quite flat all year but didnt really notice, with a few random anxious episodes which I put down to high stress levels relating to work. Now, at the end of the summer, I have had this v intense anxious time after quite mild use in the summer and my mood can swing into depression, but then swing out almost as quickly.
I eat well, exercise regularly and keep busy. Depression runs in my family and I used to a bit of an anxious child. The anxiety I have seems to be not random, but triggered my certain events/thought processes, but my mind whirls and I seem unable to cope in situations I deem important (eg. relationship/work) where I exercise 'no control'. How viable is it that drugs have set off this? My therapist doesn't seem to think so as my heavy use of MDMA was over a yearago, but I'm unsure and a bit of afraid to start anti-depressants, which has been recommended to me. I like to think I haven't brought this on to myself, as I know young women my age do develop these things, but with drugs in the mix, who knows....

Any information/advice would be great. Thank you

 

[futura2012]

Hello grose100 Thanks for your contribution to Bluelight.

Recently, I have been diagnosed with depression which manifests in anxiety in areas that I cannot control. The anxiety became very accute recently, but in retrospect, I suppose I have been quite flat/mildly depressed for about a year, with anxious episodes. I am very concerned that this has been caused by MDMA.

If you have depressive/anxiety related issues in your genes. From the type of use you have described I would put my money on MDMA being a large influence on the cause of this.

After this pattern of use for about 8 months, I completely stopped. 5 weeks later, I felt very sad, but put this down to hormones, but now I am unsure - could it have been 'withdrawal'?

It is very difficult to isolate a particular episode in this way and necessarily blame the drugs. What can be said is in your overall perception of life drugs will have made some changes. These changes can sometimes be negative ie anxiety/depression sometimes be positive. There is no absolute guaranteed answer to this question.

At the end of August (2011), I took over one gram of MDMA in one day and suffered hugely as a consequence, really depressed for about a month, which scared the shit out of me and I stopped using for ages

Wow thats a very heavy dose. You were lucky you were only depressed for one month. This kind of dose can often trigger comedowns lasting in excess of a year.

I think I was generally quite flat all year but didnt really notice, with a few random anxious episodes which I put down to high stress levels relating to work. Now, at the end of the summer, I have had this v intense anxious time after quite mild use in the summer and my mood can swing into depression, but then swing out almost as quickly.

Hard to say the exact cause of this but MDMA I am sure has a part to play. Large, frequent and excessive doses are usually the culprit.

Depression runs in my family and I used to a bit of an anxious child. The anxiety I have seems to be not random, but triggered my certain events/thought processes, but my mind whirls and I seem unable to cope in situations I deem important (eg. relationship/work) where I exercise 'no control'

The anxiety can come in many different varieties. This sounds very common to drug induced anxiety issues. Again though very difficult to pin point an exact cause or symptom.

How viable is it that drugs have set off this? My therapist doesn't seem to think so as my heavy use of MDMA was over a year ago,

Unfortunately many therapists and doctors have no clue of the dynamics of MDMA. My psychiatrist for example doesnt even know what MDMA is. I mentioned BZP to my GP and he had to look it up on google. If your therapist has limited knowledge about drugs then I would take their opinion with caution.

The depression aspect of MDMA can last for many years. Particularly if you have some 1G esk sessions then I personally think the therapist is wrong to make this assumption.

but I'm unsure and a bit of afraid to start anti-depressants, which has been recommended to me. I like to think I haven't brought this on to myself, as I know young women my age do develop these things, but with drugs in the mix, who knows....

Worrying about the cause unfortunately is anxiety driven.

What you have to be spending your efforts and time on now is how to get well.

The first thing to assure you is 90% of any of these problems are reversable with effort and time. If you can fix this 90% the 10% will be mild and not effect your day to day life. Try not to worrey too much about what you might have done.

Anti depressants I would also approach with serious caution. There is a lot of evidence to suggest the majority of them dont work particularly well if you have done some temporary damage via MDMA use. There is also evidence to suggest that certain ones cause further damage. SSRIs in particular. Recently a friend of mine Cope who is on this forum has started on Valdoxan. This is an unusual antidepressant not often prescribed.

http://en.wikipedia.org/wiki/Agomelatine

From what I can see this is working well with MDMA related damage.

I mentioned this antidepressant to my GP and once again he hit google to look it up.

I would personally advise you consider Piracetam, Lithium, Omega 3, Krill Oil. Please research all these suppliments before choosing what to take and what not to take. Also have a look on bluelight for additional suggestions.

Start on a regular exercise schedule this will work wonders against all forms of depression, anxiety and assist you to rebuild your brain chemistry that might be a bit out currently. You may find your HPA axis is also a litle off. This may also need to be rebalanced with exercise and a healthy lifestyle. Much evidence points to MDMA causing an excess of cortisol from the HPA out of balance. The antidepressants that cope is taking reduce cortisol and this may be one of the benefits.

Try and axe alcohol, cigarettes, sugars, caffeine. You will need to give your body every chance possible to repair itself.

Do a search on bluelight and have a look for posts from "First Bad Comedown" have a read of what he has to say.

You also need to take a serious appraisal of your drug taking. Its risk analysis time. Weighing up benefits vs negatives.

From what you describe I would advise you to stop taking all drugs for at least one year and re assess from there.

Once symptoms start to appear it doesnt usually take long for further drug taking to do a lot worse damage. This is because your serotonin netork is already low and damaged. The last thing it needs now is further abuse.

I hope this is helpful.

Please stay on this thread and keep us updated with your progress.

Futura

 

[grose100]

Thank you so much for this Futura, I'm so appreciative for the time and effort you put in to your response.
Yes, definitely going to stop taking drugs, no question.
I've heard that drug-induced depression is non-reversible, but am comforted when you say that I will get better with patience and efforts to really look after myself.
I'm thinking of starting CBT, and I will let my GP know of my concerns that MDMA might have something to do with my mental health at the moment. I've only used little bits this summer, so seems so weird that this all started now. I'm reluctant to put more chemicals into my poor brain, though I'm wanting to nip these anxious episodes in the bud.

Many thanks again,
GRose

 

[cope]

hi grose,

regarding the antidepressants, don't let your doctor talk you into taking ssris or snris, asides form the problems u will get from taking them they will make the serotonin receptors less sensitive over time.

we want the opposite.

i am taking agomelatin for a week now, it makes me sleep better and gives a little bit more energy for the day, but my main problem is verbal fluency and having no feelings from my mdma and (unknowingly) piperazine use.

i am working out almost everyday for two month now, don't do any mind altering substances and going to bed early as i am willing to do as much as possible to recover.

from my research i will now give inositol and ginkgo a shot. that are the only two supplements i haven't tried yet *sigh* ;-)

good luck to you and keep us updated.

 

[futura2012]

Thank you so much for this Futura, I'm so appreciative for the time and effort you put in to your response.
Yes, definitely going to stop taking drugs, no question.

No worries grose. Good call on the drugs. Any dose of MDMA right now will do you harm avoid it. No coke, weed anything that will hit the neurotransmitters. Avoid alcohol also.

I've heard that drug-induced depression is non-reversible, but am comforted when you say that I will get better with patience and efforts to really look after myself.

Drug induced depression is definitely reversable I speak from first hand experience I know. Many other members will confirm this for you. The key is NO MORE DRUGS!

As soon as you read this hit the search bar in the top right of bluelight and look up "First Bad Comedown" The detail in this chaps posts will be very enlightening for you. It wont just provide comfort it will provide you with fact about what has happend. It will explain why it will explain the way out. Please do it. I promise you wont regret this.

The majority of your issues are in your mind. Understanding your condition, knowing what to do and seeing recovery is how you will get better.

I'm thinking of starting CBT, and I will let my GP know of my concerns that MDMA might have something to do with my mental health at the moment. I've only used little bits this summer, so seems so weird that this all started now. I'm reluctant to put more chemicals into my poor brain, though I'm wanting to nip these anxious episodes in the bud.

CBT is good no harm in trying. It wasnt for me but it will have no bad effect if it doesnt work. Personally I found it too simplistic.

GPs in the UK have a nasty habit of hearing the word drugs and spitting benzodiapines such as diazapam and SSRI Antidepressants such as Citralopram at you. You wont be surprised to hear these are one of the cheapest brands of ads and benzos out there. Many of their choices are driven not by your symptoms but sponsor driven by the relevant pharma companies. You will not be surprised to hear bribery, expensive lunches and back handers are frequent occurances in their pharma driven lifestyles.

I dont want to sound cynical but please bare these theories in your mind before deciding to take any antidepressant prescribed by a GP. First Bad Comedown addresses these issues in his posts. He also explains why the use of 5HTP for your condition is ill advised. He also discusses the dangers of SSRIs and benzos.

I am very sceptical of gps with drug related issues I think in many cases they do more harm than good.

If you can try some of the supps. Particularly piracetam first. Try some exercise (core and cardio highly recommended). Give it two months before taking any ads. Try this then evaluate. You can always try the ads later. Trying the ads then coming off them will be a lot more difficult.

Ads provide you with a mask. They mask who you are and numb you of your personality. Many take three weeks to work and once you are on them can be awful to come off. They also have side effects. SSRIs are notorious for total loss of sex drive for example. Some make you gain weight. Like with all things where there is a good there also comes a bad. Ads are no exception.

Everything I express is only my opinion and it is important I must make this clear particulalry when advising people to ignore a doctor. My opinions are based on my personal experience and frequent users I talk to on Bluelight.

Keep us updated.

Take care.

Futura

 

[grose100]

Hi Futura and Cope,
Thank you for your replies. Since my last post, I went to see my doctor and he has prescribed me a very mild dose of 'Cipralex' which is an SSRI. He is a very close family doctor who my family trust, and I told him my concerns about MDMA - however, he seems to think this is the best way forward (though he obviously didnt know too much about MDMA etc). However, after reading your posts I'm quite apprehensive about taking them and might wait a few weeks beforehand. Because I can't be sure why the anxiety has crept up right now, it's very hard to know what advice to take - and I'm sure you appreciate the fact that we have not met etc, it makes things more complicated! My doctor was very very positive about these ADs though..
I might also forward all that you have written to my doctor so that he can read what you guys have said.

I can't find the link to 'first bad comedown' unfortunately, could you maybe point me in right direction? Thanks

I cannot

 

[futura2012]

Hello Grose

Thank you for your replies

No worries

He is a very close family doctor who my family trust, and I told him my concerns about MDMA - however, he seems to think this is the best way forward (though he obviously didnt know too much about MDMA etc).

My alarm bells ring hearing this.

GPs in the UK have a nasty habit of hearing the word drugs and spitting benzodiapines such as diazapam and SSRI Antidepressants such as Citralopram at you.

Does this sound familiar?

Grose what you choose to do is obviousley your own personal freedom. We can offer advise and you can take as much or as little of this advice as you like.

What ever you choose I will of course respect but please reconsider this choice.

I guarantee you NOT taking SSRIs is the best choice.

(though he obviously didnt know too much about MDMA etc)

If he is a true friend then he should step back from this and not be prescribing you things for a condition caused by a drug he has no understanding of. By the very least he should refer you to another doctor who does understand MDMA related conditions.

however, he seems to think this is the best way forward

This unfortunately is a story I hear time and time again. Some Doctors think because they are a Dr they have this amazing sense of "magical Power" where by they can have no clue about someones condition yet amazingly know "the way forward" and "how to cure you".

In relation to drugs many Drs suffer this problem. 9/10 times a GP does not even know what MDMA is let alone what harm it does. They might have heard the term ecstasy tablet but thats usually about as far as it goes.


Please read the latest post by Cope about SSRIs and the kind of effects they have when people come off them. It is no surprise to any of us that the symptoms of coming off SSRI antidepressants are almost IDENTICAL to the symptoms of ODing on MDMA.

Why? because they cause down regulation of the Serotonin Receptors. This is exactly what ODing on MDMA has done. This is why a drug that causes further down regulation is a very bad plan.

However, after reading your posts I'm quite apprehensive about taking them and might wait a few weeks beforehand.

Waiting for a while I strongly advise. Please try some suppliments and a health regime first. Antidepressants will zap you of your spirit and just set back the recovery clock.

it's very hard to know what advice to take

and I'm sure you appreciate the fact that we have not met etc, it makes things more complicated!

This I fully understand.

What do you do? Do you take the advice from a professional doctor or a random "pseudo" named user you have met in an MDMA drugs forum?

In your position the way I would approach this is as follows:

Assume the Dr has no clue. Assume the advice from the random bluelight user "Futura" is also bunk.

Of the two paths you could follow say if the advice is bunk in either case which could be more harmful?

Doing a few months exercise, trying a range of suppliments, looking after your body?

OR

Taking some SSRI antidepressants plus maybe other medication such as benzodiapines?

If either set of advice is wrong which has the potential to do you more harm?

Why dont you try the Bluelight recommendatons which is based on a very good understanding of MDMA related issues.

If they dont work after say 3 months (allow a good time for the repair process to work) then at that point switch to the Medication?

The only thing you loose is some time. No other danger with this choice.

Choose the med road first not having given the supp option a go you may find yourself in further mental complications.

My doctor was very very positive about these ADs though..

Ask him if he would be kind enough to briefly explain why? make some notes then repost on the forum. See what other bl members think.

I might also forward all that you have written to my doctor so that he can read what you guys have said.

Oh dear as you can hear when it comes to drug advice I am no great Dr fan. Maybe you should tone it down slightly :D

I can't find the link to 'first bad comedown' unfortunately, could you maybe point me in right direction? Thanks

Login to bluelight. Start here:

http://www.bluelight.ru/vb/threads/593647-how-long-till-you-recover-from-ecstasy-side-effects

Then click on his user name and a drop down appears select "view forum posts"

Highly recomended read.

good luck grosey.

Keep us updated

 

[i against i]

i don't really have anything to add besides, mdma induced depression is quite common, and many people recover from it, it just takes time off.

 

[grose100]

Hello,
Thought i would keep you updated on things and also ask for more advice.
I decided to give myself a few months of healthy living before trying the ADs as suggested - going to the gym regularly, eating well etc. It's been a really difficult 2 months but there have been some strong days.

My friend recommended to me Rhodiola Rosea as a very good supplement for depression, as it works on serotonin and dopamine levels. I was wondering if this is safe to use, if i have potentially damaged myself with MDMA use?

thanks x

 

[Dawglaw]

Hey,

I can tell you first hand you will get better.

It has been five months for me and I am feeling much better.

I think the secret is mindfulness and time. The quicker I moved on and stopped obsessing with my new post MDMA problems, the better I felt.

Acceptance is a big part of that. When this first happened, I was TERRIFIED. I did not know how I could go months like this. Over time, I realized that it's out of my control. As morbid as this sounds, think of this as a short stint in jail, you can sit around and feel sorry for yourself or you can keep living your life and better yourself.

Compared to baseline, I am at 99% functionality and about 60% comfortable, if that makes sense. However, many times during the day I feel great and cannot tell there is anything wrong.

If I do not think of my derealization and anxiety, it goes away, it's just when I'm bored when I notice it and it flairs.

I think I would be 100% better if I had not slipped and done a bump of coke a few weeks ago. The answer for me was time and sober healthy living.

I still drink on the weekends, it is important to me to maintain my social life and keep myself busy. I am sure this is slowing down my recovery a tiny bit, but for me, it's important.

I tired the supplements early on when I was looking for a magic cure. IMO, they didn't do anything for me but if you find they make you feel better then take them. Just remember, even though they are not drugs, they can still act on your brain chemistry.

As the post MDMA mess our brains are in is not understood by doctors, supplements are somewhat of an uncharted territory.

Healthy eating and exersize.

Stay strong and good luck.

 

[Foreigner]

I did most of my MDMA use (or should I say abuse) from age 18-20. I was dosing regularly at once a week, raving a lot, etc.

I didn't suffer extreme clinical depression until a year after I stopped using when I was 21, and it was triggered by a traumatic situation. In hindsight, I think the MDMA damage was not obvious until I was met with a situation that required a lot of emotional strength to deal with, and my serotonin system just couldn't handle it. Within a week I went from baseline to suicidal and needed crisis intervention in the form of an SSRI.

I'm not saying this will happen to you. I'm just sharing my story to demonstrate that you could still suffer mental health issues a year after quitting. It takes the brain a long time to regrow that receptor tree. Looking back, within the year after I quit I was prone to way worse anxiety than normal. My threshold for anxiety tolerance was much lower.

If your doctor doesn't know anything about MDMA then I would proceed with caution. Even though I don't like SSRIs, if you're in crisis then one might be called for in the short-term. That said, things like healthy diet, exercise, and doing activities that regulate your mood are all important because they will directly relate to your neuro-chemistry.

 

[grose100]

Hi,
Thanks for these. It's been almost 3 months now since all the anxiety/depression started. It's been such a rollercoaster, but I feel that the anxiety/depression is less amplified - if that makes sense - and sort of muted a bit. Still feel fragile and there are days that are really low and scary but I think its starting to relieve, and the mood-swings less extreme. Is this a normal trend? I'm trying to learn to stop looking at the past and stop obsessing - I fixate sometimes on past regrets (including drug usage) but this definitely is so counter-productive, but it's a real trick to learn to look forward, not back. The gym has become my best friend, a sure sure part of the day that I know is doing wonders and keeping me healthy and pumping endorphines. The bad days make me so frustrated though and want to take ADs...

Does anyone know about Rhodiola Rosea ???

 

[rave_itsrealfun!!!]

Hey grose, my Mdma binge was in 2010. I did it all the time - 4 days in a row once from morning until night, for instance. I got extremely vividly high at first, and near the end it was hit or miss (the last 3.5 grams I picked was gone like the wind...). I was right flying on it around 40 times. I loved it more than anything and the whole lifestyle vibed with the core of my being. Nowadays though, you couldn't pay me too take the purest stuff - how karma can be a bitch like that. I simply had way too much fun and I'm not allowed to have fun that way anymore. One day, as I no longer even drink alcohol and my lifestyle is very health oriented, I have faith that I will be able to use again in moderation but next time it will be AMT. My personal social life is at an all time low apart from my girlfriend, and I seem to be incredibly cool with this because people are usually a bad influence on me anyway. For now, I'm so anxious with anything stimulatory that at no time have I the smallest sip of coffee.

My emotions were all over the place in 2011, everything from my post-LSD mania to severe depressive phases of previously unthinkable misery and despair. I wasn't in the greatest place but I think all the raving led to more of a tendency towards negative belief systems, for a year or so.

Nowadays, I am definitely not normal and my body has taken a hit. I use cannabis habitually and I'd probably be insane without it, but I'm for the most part super chill and rarely have outbursts anymore, plus I hold a great job so I am happy now. I go to raves and smoke cannabis, having some nice green tea. If this sounds appealing to you as your hardest night out on the town, then I'd encourage you to use a lot more Mdma, even though it sounds like it's already too late.

 

[First Bad Comedown]

Hello Grose100.

I don't spend much time on Bluelight as of the last few months.
I intend on keeping up my recovery story so others can benefit from a truly long-term perspective.
I'm sorry to hear about your significant problems in life - and I applaud your efforts to fight them.

Exercise is very difficult for some former MDMA users - doctors have noted that they are nearly incapable or intolerant of real exercise even YEARS later.
And this is a problem because it is the ONE thing that might cure the diseased state of the brain.

I did extensive online researching and reading books written by neurologists.
I have also been in contact with a Post SSRI recovery group that describes a VERY similar form of depression and physical symptoms seen in some MDMA users. One of the leaders in this group has been researching the damaged serotonin system for over a decade.

Both he and I agree - the primary culprit as the cause of lasting depression and mental dysfunction is loss of serotonin transporter protein or SERT.
This protein is expressed by the DNA of brain cells in regions of high serotonin axonal density - and SERT expression is strongly believed to be linked to axonal density.

The protein itself can be labeled with radioactive ligands and seen on PET scans - our most advanced neuroimaging technology.
And sure enough former MDMA user have been found to have significantly reduced SERT expression in the frontal lobes and Prefrontal Cortex up to 2.5 years post MDMA.

The italics in that sentence underlies the fact that many studies have failed to show loss of SERT in the group of users they tested.
Some scientists and even drug users on BL point to these findings as proof that MDMA may not be neurotoxic.
In fact, the existence of a few studies that clearly show substantial SERT loss in a portion of the MDMA population demonstrates that it is clearly neurotoxic for some people (or at some doses).
Further, it suggests that modest or currently undetectable forms of neurotoxicity are indeed occurring to the larger MDMA using population.

Loss of axonal density is the true cause, but SERT protein expression might actually be erased from the DNA as well.
Or perhaps important neurons encoding this protein are themselves lost during the re-wiring of the brain, making reestablishment of the SERT (regardless of axonal density) impossible.

None of this is known.

It is known that while SSRIs down-regulate the receptors and axons - they do NOT destroy the SERT in MOST people.
Nevertheless, serious side-effects including sexual dysfunction are common and the majority of patients experience a worsening of their previous depression upon discontinuation.

But my friend is correct, in a crisis mode they may be warranted.
And there is a possibility that they may protect SERT expression in some cases of MDMA neurotoxicity.
This is a study that should have been done LONG ago on primates - what is the effect of SSRI treatment after MDMA neurotoxicity?

Anecdotal data strongly suggests that former MDMA users simply do not respond to SSRIs - the neuroendocrine response is lacking.
The prefrontal cortex can no longer be reached because of disrupted transmission.
Those that do respond take weeks to months and may require co-administration of lithium - which is known to enhance BDNF in the cortex.

That is what exercise is doing for you, by the way.
BDNF is a wonderful protein that actually has the potential to increase axonal density in the higher cortical serotonin nerves - including SERT expression.
But it takes VERY intense exercise and VERY long-term commitment.

It is your only hope right now.

Rhodiola has modest serotonin boosting effects and will be very unlikely to improve SERT in any meaningful way.
I had one associate on Bluelight that was a post grad specialist in herbs and Ayurveda.
He even traveled to China and India seeking truly experienced and trained specialists, seeing many doctors including in the US.

He tried a long list of the most potent adaptogens and serotonin boosting herbs.
Ashwaganda holds the most promise of all for its SERT effects - but according to this guy all the herbs he tried over many months did NOT offer the results he hoped for.

Perhaps there is a magical combination of plants or pills that COULD work - but all of my reading and those of the people I have known in our situation have reached the sad conclusion that there simply is NO cure.

The only exception in all of my reading would be ECT.
The seizure that results releases powerful waves of BDNF unlike anything seen in exercise, and an impressive sprouting of serotonin axons - including mossy sprouting in the hippocampus.

There is a good chance that such a treatment can protect or regenerate SERT, but my reading did not progress to a full understanding of this treatment.
I do remember several authoritative opinions from experts proclaiming the impressive results they have seen in both severe depression and schizophrenia.
There is evidence that if administered during the first year of symptoms, schizophrenia can be cured by ECT - life long remission.
The effectiveness of ECT treatment in depression is associated with the level of cortisol response.

The more cortisol released the greater the potential for recovery.
Poor cortisol response is associated with poor response to initial ECT, relapses in the years that follow, and the requirement of subsequent retreatment.
There was a single case-study of a young male who was 3 years abstinent (approx.) from MDMA and suffering severe depression.
ECT was effective and a year later he reported continued success.

More research needs to be done, which is true of everything.
ECT may also cause damage to cortical pathways resulting in memory loss - about a third of patients report substantial memory loss that impacts their quality of life. But for many others ECT is a miracle.

They know for sure that ECT grows new brain cells in the hippocampus, which houses one of the primary sites of neurogenesis in the brain.
This is also seen with SSRI treatment, but ECT results in a much faster and more robust response.
Serotonin neurons are not the only type of neurogenesis occurring!

When my anxiety began my cortisol levels were SO unbelievably high that simply being touched by my cat swiping its tail against my leg would make me feel like I was DYING inside. It was literally shocking to experience.
And looking back I am forced to conclude that a SHOCK is exactly what my brain needed, but was unable to achieve on its own.
If I could go back in time I would not hesitate AT ALL.
I would find a doctor to administer the treatment as early as possible, because the early stages of my recovery were associated with the highest levels of cortisol. I wish I had known to use that opportunity.
It is worth the risk.

BUT, after passage of time significant changes to the brain are made.
And ECT is less likely to result in remission of depression, esp. long-term.
And since the finding in ECT is neurogenesis and BDNF....

Exercise is the ONLY substitute.
And when you stop working out, the sorrow and emptiness will return.
It happens to me even now.

Maybe I will just have to work out every day for the rest of my life.
Maybe it will just take another two years...

But there is NO herb or medication (yet) that can increase cortical axonal density to the point of restoring SERT function.
If SSRIs did this we should know about it!

Stay away from the Cipralex in particular.
Lexapro is one of the most powerful SSRIs and is very 'activating' - meaning the energy and anxiety that can result are serious.
We are talking heart-palpitations, sweating, nausea, pacing, RLS, akithisia, insomnia, sexual dysfunction....

If you must, try one of the milder ones like citalopram (celexa).
Stay AWAY from the escitalopram! (lexapro/cipralex)

If you must try something, lithium is the only thing that has shown promise for me.
But it builds in your system and can cause toxicity if not monitored carefully - weekly blood tests, ok?
And the BDNF effects, which were quite amazing to experience, lasted a week or two.
Then it felt like nothing was going on, until one day it was WAY too strong and I couldn't function.

I may try it again.
I may one day opt for ECT.
If I EVER find a good pharmaceutical treatment I will post about it loudly on BL, but I'm not holding my breath.
Except in between lifts.

Good luck.
Keep fighting.