MDMA Extreme Depression - please help.

[Charlotte8]

Hi everyone, I am suffering badly (and I mean badly) from serotonin receptor downregulation/damage after taking MDMA pills - possibly with speed in as well.
I am here to try to find a solution as it has been 5 years now since I've been clean and I am still seriously depressed.

I used MDMA heavily for 9 months.
Before taking MDMA I was a highly productive person, after the 9 months I became extremely depressed. I now find it an immense effort to cook for myself. I cannot enjoy anything and to be honest every second I am awake I am in hell.

Each time I took MDMA I would get more depressed.

What I have tried:
Going to doctors. The doctors I have seen know nothing about serotonin receptor downregulation. Here in the UK we have a national health service (kind of like Obamacare) so I only have access to state doctors who know nothing about this condition.

I have tried taking both zoloft and tianeptine after hearing that they could help upregulate serotonin receptors. Tianeptine made me a lot worse so I discontinued, zoloft made me feel slightly better but when I stopped taking it (after 3 years) I went back to the way I was before - so it obviously only temporarily masked the problem and did not cause any noticeable up-regulation.

I have tried exercise, sunlight and a healthy diet.

Since it has been 5 years it is obviously not going to get better on it’s own, so I am desperately looking for something to repair my serotonin system.

I am extremely confused because my knowledge of neurochemistry is not as high as some of the people I have seen posting on this forum. I think I should first get clear in my mind what the actual problem is.

As I see it the 3 possible scenarios are:

1) Receptor downregulation – ie I still have the same number of receptors, they are just not as sensitive. (In this case why have they not upregulated themselves seeing as it has been 5 years. I thought the whole upregulation/downregulation system was there to attain homeostasis. Is it possible for receptors to be downregulated and stay ‘stuck there’? )

2) Serotonin receptors have been destroyed – leaving me with less. No regrowth has occurred.

3) Serotonin receptors have been destroyed and in 5 years my body would have regrown them but now the axons/dendrites are skewed (beaten up and bent) and don’t work properly.

Which of these 3 scenarios do you think is most likely?

Is there anything anyone can suggest to regrow/fix the damage?

 

[ScaredFirstTimer]

Have you been completely sober for 5 years? If not, what kind of drugs (inclucing alcohol, weed, prescription, otc) have you used, and how often?

 

[Charlotte8]

No illegal drugs, no alcohol. As I put in my post I was on an SSRI for 3 years (Sertraline/zoloft) but I have come off it recently because I am interested in fixing it permanently and I know I won't be able to do this if I'm on the SSRI because whatever I take will likely interact.

 

[Bad Bulldog]

Have you ever tried the vitamin/supplement 5-HTP? It can be purchased OTC and is sold at every pharmacy (CVS, Walgreens, Rite Aid, etc.) It is the precursor to serotonin which is why people with depression take it. I haven't used MDMA since I was probably 19 (I'm 25 now) but I would always take really high doses of 5-HTP a day or two before I was planning on rolling and then the day after I rolled I'd take really, REALLY high doses for several days afterward and then slowly begin to lower the dose after maybe 5 days or so and it REALLY helped a lot. I've been on many different anti-depressants (including Zoloft) for most of my life since I was probably 12 years old so you can take the 5-HTP with or without already being on an anti-depressant. The Zoloft didn't really help with the MDMA depression but the 5-HTP did so do some research and then get some at a local pharmacy if you want. But I know how you feel.

 

[ScaredFirstTimer]

There is some debate about whether it is smart to supplement with 5-HTP. It's definitely risky to take it in the long term as it causes some enzyme depletion and neurotransmitter imbalance which can result in further depression.

 

[JWills20]

Hi Charlotte,

It's unlikely that, 5 years down the line, your serotonin system is still impaired from MDMA. There is, however, a very realistic chance you did incur some sort of damage from 9 months of heavy abuse, depending just how hard you abused MDMA? There is also a realistic chance that MDMA triggered an underlying psychiatric condition that is still affecting you now. But try to realize that 5 years is a long time and it is highly unlikely, yet not impossible, that whatever you are experiencing now is related to your prior use of MDMA and brain damage. The very obsession with serotonin neurochemistry is probably a symptom of your anxiety, as opposed to the cause of your anxiety. Do not lose faith in your doctors, they know far more than we on this forum do, and you should go and tell them everything you have told us. Have you also tried to speaking significant others in your life? I'm sure they'd be more than happy to try and support and help you.

I'm going to move this thread to our recovery forum where hopefully they can provide you some more support.

Best of luck!

 

[Allein]

Hi Charlotte8, welcome to TDS

I'm from the UKand used MDMA quite heavily for nearly 10 years so have some experience with this stuff, we've had a few threads over here of late it would be worth you checking them out.

I'd rather we kept the speculation about brain damage etc. for other areas of the site, there are no reliable or accessible tests for such things and the part serotonin plays in depression isn't even properly understood so there are no facts to debate anyway.

What is important is that you are suffering from depression and that is the condition you need treatment for, your focus on past MDMA use is of no help to you now, as I've said in other threads you can't untake these drugs.

I've also suffered depression in recent years, at one stage it was bad enough for me to need care in a secure care unit so i have great sympathy for those suffering with this difficult condition. I've tried numerous antidepressants including several SSRIs which I was unable to tolerate due to severe side effects ( vomiting , hallucinations, disorientation etc ) I've had some success with others. Doctors I have seen have said that this is often the case, peoples reaction to these drugs is more diverse than with many medications, what works for some may not work for another and could even make them quite ill.

If we are to believe modern medicine then conditions like clinical depression are the result of imbalances in certain chemical in the brain. It also follows that if a person recovers from this condition that the imbalance must have been resolved and some people recover without medication and sometimes following talking therapies. All this says to me that the mental and the physical are inextricably related, so addressing one without the other is likely to be less effective. ( sorry about the ramble )

Have you tried Cognitive-behavioural-therapy ? this should be something your GP can sort out for you, it's been recently further promoted as a treatment in the NHS.
I found it really useful both at the time and since, if your not finding medication is working for you this may be a good next step.

 

[Tjackad-tullare]

Hi Charlotte,

It's unlikely that, 5 years down the line, your serotonin system is still impaired from MDMA. There is, however, a very realistic chance you did incur some sort of damage from 9 months of heavy abuse, depending just how hard you abused MDMA? There is also a realistic chance that MDMA triggered an underlying psychiatric condition that is still affecting you now. But try to realize that 5 years is a long time and it is highly unlikely, yet not impossible, that whatever you are experiencing now is related to your prior use of MDMA and brain damage. The very obsession with serotonin neurochemistry is probably a symptom of your anxiety, as opposed to the cause of your anxiety. Do not lose faith in your doctors, they know far more than we on this forum do, and you should go and tell them everything you have told us. Have you also tried to speaking significant others in your life? I'm sure they'd be more than happy to try and support and help you.

I'm going to move this thread to our recovery forum where hopefully they can provide you some more support.

Best of luck!

I agree, can you write how much MDMA did you take during this 9 months?

 

[ScaredFirstTimer]

Hi Charlotte8, welcome to TDS

I'm from the UKand used MDMA quite heavily for nearly 10 years so have some experience with this stuff, we've had a few threads over here of late it would be worth you checking them out.

I'd rather we kept the speculation about brain damage etc. for other areas of the site, there are no reliable or accessible tests for such things and the part serotonin plays in depression isn't even properly understood so there are no facts to debate anyway.

What is important is that you are suffering from depression and that is the condition you need treatment for, your focus on past MDMA use is of no help to you now, as I've said in other threads you can't untake these drugs.

I've also suffered depression in recent years, at one stage it was bad enough for me to need care in a secure care unit so i have great sympathy for those suffering with this difficult condition. I've tried numerous antidepressants including several SSRIs which I was unable to tolerate due to severe side effects ( vomiting , hallucinations, disorientation etc ) I've had some success with others. Doctors I have seen have said that this is often the case, peoples reaction to these drugs is more diverse than with many medications, what works for some may not work for another and could even make them quite ill.

If we are to believe modern medicine then conditions like clinical depression are the result of imbalances in certain chemical in the brain. It also follows that if a person recovers from this condition that the imbalance must have been resolved and some people recover without medication and sometimes following talking therapies. All this says to me that the mental and the physical are inextricably related, so addressing one without the other is likely to be less effective. ( sorry about the ramble )

Have you tried Cognitive-behavioural-therapy ? this should be something your GP can sort out for you, it's been recently further promoted as a treatment in the NHS.
I found it really useful both at the time and since, if your not finding medication is working for you this may be a good next step.

Very good post. CBT (Cognitive behavioral therapy) has worked wonders for many suffering from drug-induced depression.

Charlotte8, what do you mean exactly by quitting the SSRI meds recently? How long since you quit them completely?

 

[Allein]

well thanks , good point on the SSRIs, coming off antidepressants can cause a host of symtoms, they like to call it discontinuation syndrome. Tapering off with the help and advice of your doctor is vital. I came off Venlafaxine after about 2 years of 150mgs and even with tapering I had problems that took many weeks to subside.

I agree, can you write how much MDMA did you take during this 9 months?

I'd rather we didn't start going down that path, for one thing it serves no purpose and such things are only vague estimates based on vague estimates of the contents of unknown pills and powders.

 

[Charlotte8]

I probably took it 15-20 times. The last few times mega doses. I am 100% sure it was the MDMA that caused the depression - before this I was a happy and productive person. Every time I took it I got worse. I can now barely get dressed. I had to make the decision to come off the SSRI because I could not take anything that is rumoured to help with serotonin receptor downregulation while on it (it would be dangerous). I weaned myself off the SSRI in October last year. I am not interested in 'masking' the symptoms anymore - I would much rather fix the root cause. I have had CBT and counselling - they didn't help, the people I have gone to see agree that there is a high probability that the drugs have damaged my serotonin system - they just don't know how to fix it.

 

[Allein]

I probably took it 15-20 times. The last few times mega doses. I am 100% sure it was the MDMA that caused the depression - before this I was a happy and productive person. Every time I took it I got worse. I can now barely get dressed. I had to make the decision to come off the SSRI because I could not take anything that is rumoured to help with serotonin receptor downregulation while on it (it would be dangerous). I weaned myself off the SSRI in October last year. I am not interested in 'masking' the symptoms anymore - I would much rather fix the root cause. I have had CBT and counselling - they didn't help, the people I have gone to see agree that there is a high probability that the drugs have damaged my serotonin system - they just don't know how to fix it.

So you started taking SSRIs whilst still taking MDMA ? or you where on it already ?

I'm sorry to hear you didnt get anything from CBT, how long did the treatment last, they tried to fob me off with telephone stuff to start with and I had to push for the real treatment.

These people that are telling you that drugs have damaged your brain but they don't know how to fix it are basing that diagnosis on what ? there is no conclusive evidence that MDMA causes this damage and no viable way to test for it. this kind of 'advice' seems irresponsible to me, first they tell you something with no basis in medical fact and then follow it up with 'we don't know how to fix it' ...shocking, were these people just GPs or psychiatrists ??

Lack of serotonin is thought to be a possible cause of some peoples symptoms of depression hence the use of SSRIs, so even from my, non medical perspective the advice you have received makes no sense at all. I would seek another doctor, you can do this easily by just asking to see another at your surgery or just going to another surgery, you don't have to explain why. I've done this a few times over the years when I haven't been satisfied with my GP or the treatment they provide.

 

[zebrafish]

I think Allein makes a really good point here. There is no utility at your stage to continue worrying about what MDMA did or did not do to your brain. Even if it did cause damage to your serotonin system, it is likely that no one really knows how to fix it at this point. You have given your brain plenty of time to heal by this point if this is neuronal damage, and if you are still symptomatic, I think its worth considering treating your symptoms as best as possible rather than searching for a cure to underlying damage.

If your symptom is depression, then that is what you solely need to focus on. Now that you are off SSRI's since October, how do you feel? Did your depression get worse? If so, I would reconsult your psychiatrist to consider restarting treatment. Even if you need lifelong maintenance therapy, that is ok. It is better to be happy and lead a productive, meaningful life on medications than to suffer while trying to fix an underlying cause that might not be possible.

The good news is there are so many modes of treatment for depression out there, both medications and therapy, so there are a lot of options to try. Under the direction of a good psychiatrist, finding the right combination of medications that maximize your symptom relief while minimizing side effects, in combination with therapy, can really improve your quality of life, which is really all that matters at this point. There are even clinical trials coming out at several academic medical centers that look at the utilization of deep brain stimulation in the treatment of depression, which may prove to be very effective in medically refractory depression while being much safer than older treatments like electroconvulsive therapy. The field of functional neurosurgery is making great strides to find safe surgical solutions to severe psychiatric illnesses that don't respond to medications; this is truly an exciting time for depression treatment.

I would keep your hopes up. I think you need a good psychiatrist who can really optimize your treatment regimen and get you back on your feet.

 

[Chimeric]

Hi there,

Just wanted to chime in with those who said it may not be brain damage. OP's condition could be helped by therapy.

It's possible the drug use just unmasked problems that weren't conscious before.

 

[footscrazy]

The brain is incredibly complex, and I don't think it's possible to reduce your depression down to a specific cause, such as downregulated serotonin. Serotonin's role in depression, and the 'chemical imbalance' theory of depression were only ever theories to begin with, and as more is discovered, there is more and more evidence to suggest that it is not as simple as more serotonin = less depression. For example, selective serotonin reuptake enhancers such as tianeptine - which work in an opposite way to typical SSRI's and reduce the amount of serotonin in the synapse - are just as effective anti depressants as SSRIs. The exact mechanism for how anti depressants work still isn't even known!

As others have said, trying to find out the cause of your depression is probably a hopeless task. But - we do know the brain is remarkably plastic and changeable. Contrary to what was popular belief for a long time, brain cells are able to regenerate, and the brain can learn to compensate and develop new patterns to overcome shortfalls or damage. So even if you have caused yourself damage, it doesn't mean you will experience deficiencies for the rest of your life - you can recover. Every thought or experience you have changes the brain. Your initial depression may well have been caused by the MDMA, and that depression can lead to a vicious cycle where the effects it causes mean it perpetuates itself, leading to you still experiencing it today. But it also means that every experience, thought and behaviour you have now can create new brain patterns and new wiring that are more positive. I agree with the poster who suggested CBT - it can take some time to find a psychologist that you really mesh with, but I don't think you should give up trying. I would also recommend mindfullness meditation. There's nothing in my life that has been more positive that starting practising this. I also experienced severe, severe depression and anxiety due to mdma, and it was this that helped me through that, and continues to be a positive force in my life today.