MDMA Recovery (Stories & Support - 4)

[mf140]

I think the "low serotonin = depression" thing is widespread because the old view was that because serotonin boosters helped depression, depression must be caused by low serotonin. Some psychologists may have never moved beyond stating that simplistic explanation, I guess maybe because it works for the psychologist's purposes. At least depression isn't then viewed as a moral failure or that MDD patients families insist they should just will themselves out of severe depression. You may not be able to will yourself out of some mental illness any more than you can will yourself to grow 6 more inches. Not that cognitive behavioral therapy and attempting to consciously avoid rumination isn't helpful.

The new view is more along the lines of serotonergic signaling, and everything downstream of that (including functional, morphological and genetic changes) may oppose depressive pathology.

Hey, sorry for not expanding on that original link. I don't necessarily agree with the author that low serotonin causes depression, in fact I'm not necessarily sure that's what he is saying. But is it correct to say that those with low serotonin (whether or not it's a cause or symptom, I'm not sure it matters) present with those symptoms? And therefore SSRIs can be extremely helpful.

Here is another article from him discussing the other main neurotransmitters targeted by medication:
http://www.drjoecarver.com/clients/49355/File/Chemical Imbalance.html

I accept the article is old, the somewhat simplistic explanation and that research has come on leaps and bounds. Having said that, please correct me if I'm wrong, the drugs of choice used in treatment remain largely the same?

My symptoms for example match the "low serotonin" diagnosis perfectly and if research has shown those presenting with those symptoms benefit from SSRI's then is right to discount him?

 

[fnono33]

Oh, hmmm, sorry must've read too fast.

If it is the case that drug naive people that have visual snow are less hopeful, I could understand them thinking it's never going to change if they've had it all their life.

While on the other hand people who are used to bad trips, comedowns and hangovers that pass with time might think HPPD will pass as well, even if it does take a lot more time.

Yeah, exactly. People with HPPD have more hope than people with just straight up VS from nothing. Kind of makes sense with what Cotcha said.

 

[Cotcha Yankinov]

My symptoms for example match the "low serotonin" diagnosis perfectly and if research has shown those presenting with those symptoms benefit from SSRI's then is right to discount him?

I think that someone who had those symptoms would be towards the depression side of things, and SSRIs can help with depression (regardless of whether or not there is "low serotonin"). It might not be the case that someone who had "low serotonin" would feel immediately better with SSRIs. It might take some time.

Chronic stress can cause alterations in the quantities and sensitivity of different serotonin receptors (an actual decrease in the neurotransmitter serotonin itself may not be as relevant), and these alterations have been correlated to causing depressive behavior. Chronic administration of SSRIs can help reverse those changes and cause increases in pro-growth, pro-neurogenesis and pro-neuroplasticity factors like BDNF via serotonergic signaling, and these changes can take a while to accumulate and exert their biological effects. These biological effects can then shift biology and behavior in opposition to the stress related biological and behavioral changes. I hope that makes sense.

So in that sense, SSRIs may not be like a drug of abuse in the sense that it may not provide immediate relief, but can oppose depressive pathology when given chronically. Definitely something to talk with a doctor about, as SSRIs are not without side effects and there are many different choices.

I hope you guys all feel better soon.

 

[Amml]

I think that someone who had those symptoms would be towards the depression side of things, and SSRIs can help with depression (regardless of whether or not there is "low serotonin"). It might not be the case that someone who had "low serotonin" would feel immediately better with SSRIs. It might take some time.

Chronic stress can cause alterations in the quantities and sensitivity of different serotonin receptors (an actual decrease in the neurotransmitter serotonin itself may not be as relevant), and these alterations have been correlated to causing depressive behavior. Chronic administration of SSRIs can help reverse those changes and cause increases in pro-growth, pro-neurogenesis and pro-neuroplasticity factors like BDNF via serotonergic signaling, and these changes can take a while to accumulate and exert their biological effects. These biological effects can then shift biology and behavior in opposition to the stress related biological and behavioral changes. I hope that makes sense.

So in that sense, SSRIs may not be like a drug of abuse in the sense that it may not provide immediate relief, but can oppose depressive pathology when given chronically. Definitely something to talk with a doctor about, as SSRIs are not without side effects and there are many different choices.

I hope you guys all feel better soon.

If this is right, I have two questions:
1) How long should SSRI be taken to benefit in long term from the increased neuroplastic change? Could one month be enough?
2) Curcumin also has a impact on BDNF-levels, what do you think about that? Could it be as effective as SSRI without lots of their side effects?

 

[Cotcha Yankinov]

SSRIs probably need to be taken for at least a couple months, a lot of the first month or two is the autoreceptors desensitizing, and once they are desensitized the serotonergic signaling is allowed to increase substantially. It's some time after that the real beneficial effects start to occur, but they are likely cumulative, and there won't be any single point where you can say "I have maxed out on the benefits I have received from SSRIs".

It is however the case for some people that after taking them for many years, the side effects increase and they decide to taper it off. Although some people have taken them for decades without substantial issues. Anyways, there is probably a sweet spot between a couple months for the beneficial effects to really start, and 10 years where the side effects can really start.

The matter of age is difficult though, I don't know too much about how SSRIs affect development, but we at least know that stress can be harmful for development, and that SSRIs encourage growth of the brain. A psychiatrist with clinical experience treating young adults would be great to talk to about all this.

Unfortunately I've forgotten what I used to know regarding curcumin, other than take the research with a grain of salt. There has been issues with some of it before, specifically with the author Aggarwhal (spelling?). It is an MAOI, although to what extent I can't recall. It also has some anti-inflammatory properties, and to some extent SSRIs can function by reducing brain inflammation that is seen with MDD. I believe curcumin is also an IDO inhibitor. I can't recall anything about curcumin's behavioral effects in animal models of depression, which is what I would look for if I were you. I do recall that it boosts serum BDNF in humans but I don't believe that was in MDD patients.

But the issue is getting it into the CNS. As I recall, liposomal formulations like Longvida are very superior compared to high doses + piperine.

 

[Amml]

Is it possible that the depression is gone after the SSRI treatment?

 

[Cotcha Yankinov]

That the benefits are maintained after tapering SSRIs? Of course. SSRIs differ from drugs of abuse in that short term vs. long term sense.

 

[mf140]

So I've bitten the bullet and started on the SSRIs (Sertraline). Today is my 2nd day at 25mg. Not feeling emotionally better, but certainly less anxious. Though I do have a bit of a headache and slightly nauseous. I guess this is the short term pain long term gain of SSRIs I.e. They make you feel shit to start with?

 

[Cotcha Yankinov]

I believe the nausea has been linked to over stimulation of 5-HT3 receptors (the anti-emetic agent ondanestron works by blocking 5-HT3 on the other hand) - these receptors should desensitize with time. I believe the headaches are known to disappear with time as well. If you notice you get headaches with standing up too quickly, try to be slow with your transition from laying down to upright.

 

[Jabberwocky]

So I've bitten the bullet and started on the SSRIs (Sertraline). Today is my 2nd day at 25mg. Not feeling emotionally better, but certainly less anxious. Though I do have a bit of a headache and slightly nauseous. I guess this is the short term pain long term gain of SSRIs I.e. They make you feel shit to start with?

Everyone is different, every SSRI is different.

When I dried out (quit alcohol) the WD was so bad they doped me up on valium and k-pins combined. And they made me take SSRIs because booze WD and benzos tend to make you suicidal.

Cymbalta is the devil in pharmaceutical form.

Lexapro was tolerable.

Personally, I won't take another SSRI ever. Releasers, take em all the time [snicker]

 

[Jabberwocky]

I have been doing a fair bit of research and I think the problem is a persistent membrane potential imbalance initiated by the massive Ca++ flux caused by the initial and prolonged serotonin deluge.

In some people the intracellular and extracellular balance of Ca, Mg, K, and Na remains skewed causing a hyper-excited state (probably because of increased glutamate and nor-adrenaline).

 

[Amml]

So I've bitten the bullet and started on the SSRIs (Sertraline). Today is my 2nd day at 25mg. Not feeling emotionally better, but certainly less anxious. Though I do have a bit of a headache and slightly nauseous. I guess this is the short term pain long term gain of SSRIs I.e. They make you feel shit to start with?

I had some side effects in the beginning too like racing thoughts especially in the morning and anorexia, but most of them subsided after one week. I take exactly the same amount of sertraline. Even my appetite is normal now after about 1 month. Keep it up if it helps you

 

[Go Easy]

Hi guys,

Have deliberately been off here for about a month or so, as recommended by some of those who have recovered. Indeed, I am feeling a lot better than the last time I stopped by.

I am just over 11 months in now. Still got my eye floaters and tinnitus, and head pressure can sometimes still be pretty full-on, but very slowly my anxiety is starting to recede.

It is sometimes really hard to notice whether you are improving at all, but I'm doing things like organising after work drinks with friends on a Friday, whereas about 3-4 months ago, I probably wouldn't have even gone to after work drinks, let alone organise it. Little things like this make you realise that you are getting better, even if you might not consciously notice it. I'm able to have relatively intelligent conversations at work now too, which again is such an improvement from months ago where I could barely remember my own name.

One thing that has really helped me is a solid exercise regime - this might be only an Australian thing, but I've been heading to F45 training gyms - the cardio is great for you but it operates in a team environment which I again believe is an added benefit. Worthwhile checking out if there's one near you.

I'll be off here for a while again now, but look forward to providing more updates as I get better and better. I am sure I will get back to the old me sooner rather than later.

 

[ADubbs]

That's great to hear you're recovering still!

I suffer from the floaters and tinnitus as well, almost 6 months in. Some face tingling/twitching as well. What are your floaters like? Mine are pretty big black translucent circles that drift in and out of my vision in predictable patterns, mostly in my left eye.

Cardio needs to be happen more for me, weights and walks aren't cutting it.... It's just finding the time.

 

[ADubbs]

Nevermind, you already answered that back in August

 

[Jabberwocky]

That's great to hear you're recovering still!
What are your floaters like? Mine are pretty big black translucent circles that drift in and out of my vision in predictable patterns, mostly in my left eye.

You do realize that those are actual bits of stuff (blood, proteins from normal aging, microscopic bits of tissue, etc) that is floating in the vitreous humor of your eyeball and is COMPLETELY NORMAL. You are just noticing them.

Don't you?

 

[fnono33]

You do realize that those are actual bits of stuff (blood, proteins from normal aging, microscopic bits of tissue, etc) that is floating in the vitreous humor of your eyeball and is COMPLETELY NORMAL. You are just noticing them.

Don't you?

I wonder if the brain is just swollen. Does the brain just enlarge like any other body part when it's hurt and it just goes down in time for some people?

 

[Cotcha Yankinov]

I would just like to point out the difference between particle/fibril type floaters and the more neurological HPPD type floaters. Some people with HPPD have big blobs of floating colors in their vision that can loosely be described appearing (in quality) like afterimages from looking at something bright, and there could be some convergence there in terms of biological underpinnings, as people with HPPD can have enhanced afterimages. These "HPPD floaters" can change shapes rapidly, and can be very polygonal rather than circles or fibril/cylinder type shapes.

They can be quite strong at times, in my earlier days of HPPD reading was difficult because the blobs of color would obscure text.

 

[Cotcha Yankinov]

I wonder if the brain is just swollen. Does the brain just enlarge like any other body part when it's hurt and it just goes down in time for some people?

The brain can swell with certain conditions (for example hyponatremia, aka water intoxication) but it would be quite apparent if you were suffering from brain swelling. Try not to worry about that

But there is a possibility that neuroinflammation is playing a role in mental illness, including LTCs. If that is the case, it could just take some time for the inflammation to die down, while anti-inflammatory treatments like cardio could speed up the process (if it is the case that inflammation is playing a role).

 

[mf140]

I will do, thanks. Not really feeling many positive effects (day 5), but I'm much more engaging with work colleagues. Was it about a week before you felt anything positive?