Too many anti-depressants?

[suessmayr]

I'm 23 now and was put on Zoloft at about the age of 19. It's hard to remember what the reasons were as I was at that time playing massively with benzos and my moods were all fucked up. But whatever the case, I have intense underlying anxiety and depression.

Between then and now I have been on bupe for most of the time, but have also been variously on: Cymbalta, Prozac, Pristiq, Lithium, Epilim, Abilify, Lamictal, Modafinil, Seroquel and lots of benzos.

I'm 34 days off bupe and am currently taking just Avanza and Lexapro. Since stopping bupe everything has become so much worse to the point where I feel like I'm holding on to life by the fingernails. It would take so little to push me over the edge and I feel like I need a basically more happy state to work with, as atm everything is fucking impossible and revolting. So my question is this: given that I've been on so many different meds, would continuing to change my meds at this stage just be a waste of time? I feel like I'm getting nothing from the present combination. So I don't know whether I need to just get totally clean, or whether I need better/more appropriate meds or even ECT.

 

[n3ophy7e]

My first question is, are you having or have you had concurrent psychotherapy sessions whilst being on the anti-depressants? Whilst anti-depressants sort out the neurochemical side of things, it has been widely shown time and again that meds PLUS counselling usually has a much greater effect on depression that just meds alone. Do you only see a psychiatrist, or a psychologist as well?

Secondly, as I'm sure you're abundantly aware but I am obliged to say, after having been on anti-depressants for a few years it could be really dangerous to stop all meds, so you will need to thoroughly discuss this with your therapist before cutting down any of your meds. Also, (again I'm sure you realise this) you need to remember that you've just quit bupe after having been on it for 3-odd years, so it is completely expected that you're experiencing some withdrawal-related depression. I know this fact might not really make you feel any better right now but if you can keep it in mind that the withdrawal depression WILL subside the longer you're off bupe, it might make things a bit more bearable.

Ultimately I think that if you're really struggling with your depression right now you really need to speak with your psych specialist and agree on a plan of action with them. They are the ones who know your history best and will also have the most relevant information regarding suitable meds/combinations of meds. And of course you will need to be absolutely 100% honest with them about how you're feeling, i.e. if you're feeling suicidal or having any other disturbing thoughts don't be afraid to tell them that, because if you're having those feelings/thoughts it's really important that they know.

On the other hand, here is my personal experience: Anti-depressants helped me for a couple of years but then the one I'd been on (fluoxetine/Prozac) was having less effect. Then I started seeing a psychiatrist and we tried a few different types of anti-depressants, which all made me feel incredibly worse, and I started self-harming and just being generally self-destructive and feeling like I was completely losing my mind. So I actually stopped seeing the psychiatrist (he was a real douche by the way) and tapered off my meds on my own (after researching how to safely do so), and haven't been on any anti-depressants since (this was almost 2 years ago). So just remember that being on meds for depression is not the ONLY option you have.

Just as a side note, it is my personal opinion that ECT is the absolute last resort treatment option for depression, and if you haven't already done so you really need to give counselling/psychotherapy and/or other medication a serious go before even thinking about ECT.

 

[suessmayr]

Thanks n3ophy7e.

I have only ever received these meds from psychiatrists. Most of these guys literally would just prescribe me shit and ask about symptoms; there was no talk or 'therapy'. I've been with my current shrink for about 6-8months and he's foremost a psychotherapist. I suppose that this constitutes therapy, but I feel like I'm basically not receptive to it most of the time. I feel like I know all the things I'm supposed to do, and all the things I'm supposed to think, but that I either can't do them, or that, if I do, it has fuck all effect.

I seem to remember last feeling 'normal' and 'content' before I was ever on any medications, but this could be me romanticising the past. My shrink recently suggested I increase me Avanza dose, and so I took it from 30mg to 45mg. He is also willing to bring me off the Lexapro - which never seemed to do anything for me - and replace it with something like Zoloft. Alternatively, he suggested that I could replace both my medications with an older, tricyclic anti-depressant.

As I've just gone back to Uni and am unbearably anxious, dysphoric and fucked up as it is, I thought that now may not be the best time for changing meds. But today we got assignments and just being around people made me realise how fucked I am. I have no idea, for instance, how I'm going to give a presentation in a few weeks. I can barely stay in a room for more than a few minutes - it's like anxiety mixed with claustrophobia.

 

[Legerity]

I also think that it's important to have other forms of treatment while taking medications, like n3o said. And if you've just gone through withdrawals it may just be a part of that process.

I do use medications but I've never been on antidepressants so I can't really say much about comparing one vs. another. But the way my psychiatrist explained it, and which I think is a good approach, is to really just use medication at the minimum dosage possible to make things more bearable but not overly comfortable. By taking the edge off or helping with certain symptoms it can be easier to process and work through the underlying issues rather than being completely overwhelmed. There's not really any magical solution that will provide comfort from all symptoms.

I'm more familiar with anxiety than depression. Meditation, yoga, exercise, deep breathing exercises; these are all quick ways of relieving stress and improving mood. There are lots of good books on mindfulness that can help with being able to experience difficult emotions without having to suppress them.

It sounds like things are pretty intense for you right now but I really think they will change after a bit of time. If getting off of the subs didn't cause at least some sort of emotional upheaval, I'd wonder what purpose the opiate dependence served in the first place.

 

[Snarky91]

I think anti-depressants are for feeble-minded people. Face up to the fact that we all gotta die in the end, so why diminish what existence we do have by taking anti-depressants for the sake of feeling 'normal' or living up to other people's expectation of how to live and act successfully? If life really is so awful that some pfizer pills are the only things between being dreadfully unhappy or not wanting to live at all, what's the sense in relying on these pills for happiness? At the end of the day, you're not genuinely happy and you don't have any feeling of inner peace. There's still the underlying knowledge that you're living a dumbed down life and practicing self-trickery by thinking you've made any progress toward self-fulfillment. You're basically forfeiting your right to learn anything real from life. This is just my opinion.

 

[Legerity]

^Using anti-depressants is not a sign of being feeble-minded. A person may make the decision to improve their mental health and this may manifest itself in part through using medication. Certain medications can be very helpful is used appropriately and make it easier to work at the underlying issues in other ways.

Medication does not bring inner peace. No drugs in themselves bring inner peace. They are a tool that can be used.

 

[sarcophagus.heels]

I think anti-depressants are for feeble-minded people. Face up to the fact that we all gotta die in the end, so why diminish what existence we do have by taking anti-depressants for the sake of feeling 'normal' or living up to other people's expectation of how to live and act successfully? If life really is so awful that some pfizer pills are the only things between being dreadfully unhappy or not wanting to live at all, what's the sense in relying on these pills for happiness? At the end of the day, you're not genuinely happy and you don't have any feeling of inner peace. There's still the underlying knowledge that you're living a dumbed down life and practicing self-trickery by thinking you've made any progress toward self-fulfillment. You're basically forfeiting your right to learn anything real from life. This is just my opinion.

Anti-depressants can be enormously helpful - I know many people who have benefited greatly from them. Of course, they don't always help, and I also know a handful of people that tried various anti-depressants and found them to be useless. I've just started on Lexapro, so we'll see if that helps me any. Saying that people using anti-depressants are feeble-minded is ignorant - have you never known anyone suffering from severe depression? Because it is damn impossible to find this "inner peace" when suffering from a paralyzing depression.

 

[cire113]

dont listen to the idiots talking smack about anti depressants... I take lexapro and it has helped me tremendously with anxiety; They help tons of people the problem is finding the that works and reacts to your body...

 

[Snarky91]

In a recent article in The New York Review of Books, Angell deconstructs what she calls an apparent "raging epidemic of mental illness" among Americans. The use of psychoactive drugs—including both antidepressants and antipsychotics—has exploded, and if the new drugs are so effective, Angell points out, we should "expect the prevalence of mental illness to be declining, not rising." Instead, "the tally of those who are so disabled by mental disorders that they qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased nearly two and a half times between 1987 and 2007 - from one in 184 Americans to one in seventy-six. For children, the rise is even more startling - a thirty-five-fold increase in the same two decades. Mental illness is now the leading cause of disability in children." Under the tutelage of Big Pharma, we are "simply expanding the criteria for mental illness so that nearly everyone has one." Fugh-Berman agrees: In the age of aggressive drug marketing, she says, "Psychiatric diagnoses have expanded to include many perfectly normal people."

An excellent article by al-jazeera:

http://english.aljazeera.net/indepth/opinion/2011/07/20117313948379987.html


It seems some of you would do well to read the article thoroughly and see how closely it hits home.

 

[n3ophy7e]

I think we all need to stop and respect the fact that we are all entitled to our own beliefs, experiences and opinions.

Snarky, while I completely respect your opinion, you need to understand that a few journal/media articles cannot weigh up against the positive anecdotal feedback from hundreds of thousands, perhaps millions of patients worldwide who have had good results with anti-depressants. Anti-depressants have literally saved people's lives. Having said that though, anti-depressants are not suitable for everyone and in some people can either have no effect or even make them feel worse. Everyone is different. But please do not diminish the horrible experiences some people have had with crippling severe depression by insinuating that if they just changed their attitude a bit they could've been happier, because this is just not the case for people who are suffering from bona fide clinical depression. Clinical depression is caused by disordered levels of neurotransmitters in the brain, particularly serotonin, norepinephrine and dopamine. If these neurotransmitters cannot get back to normal levels in the brain on their own they may need pharmacological intervention in order to do so, and thus reduce the symptoms of depression. It is no different to needing asthma medication, or heart medication, or insulin for diabetes, etc etc.

 

[suessmayr]

Apart from which:

1) The fact that mental illness is much more common today than ever before does not indicate that every instance of depression is illegitimate and mere 'softness'. Depression and melancholia have been documented for thousands of years;

2) Even if it were the case that every instance of contemporary depression had been generated or influenced by the hysterical state of modern psychiatry, this would not indicate that even the illegitimate cases were insincere - one needs to distinguish between subjective experience and objective severity. The fact that religion is equivalent to delusion does not lead to the conclusion that it is any less fervent as a result;

3) There are many more conditions treated by anti-depressants than just depression;

and 4) If you had actually read a decent sample of the literature you would know that many people believe that the incidence of mental illness is presently so high because of the presently unique state of the world.

For these reasons your post is irresponsible, childish and manifestly uninformed.

 

[n3ophy7e]

and 4) If you had actually read a decent sample of the literature you would know that many people believe that the incidence of mental illness is presently so high because of the presently unique state of the world.

In addition to this I personally believe two other factors contributing to the increased incidence of mental illness are awareness and acceptance.
Awareness of the broad spectrum of mental health issues has resulted in more people seeking professional help when they feel something isn't right.
Acceptance of mental illness as a genuine health concern has resulted in it being a (slightly) less taboo topic in society, therefore people are becoming more comfortable being open about it.

 

[suessmayr]

Yeah, those are good reasons as well. I don't doubt that there are attention seekers out there - every time I've been in a psych hospital there have been dozens of them - but it is unfair to generalise on that basis alone.

Depression is characterised as unreasonable, or unjustifiable sadness, viz., sadness without cause. Therefore it makes no sense to say "harden up, you have no reason to be sad" because that is the whole point! It is unreasonable.

 

[Snarky91]

"The fact that religion is equivalent to delusion (sic)" ... May be the reason I'm depressed and anxious, because, after all, one of the greatest sources of anxiety and other bad thoughts, universal to humans, is existential uncertainty.

 

[paranoid android]

In addition to this I personally believe two other factors contributing to the increased incidence of mental illness are awareness and acceptance.
Awareness of the broad spectrum of mental health issues has resulted in more people seeking professional help when they feel something isn't right.
Acceptance of mental illness as a genuine health concern has resulted in it being a (slightly) less taboo topic in society, therefore people are becoming more comfortable being open about it.

I totally agree. I think awareness and acceptance are the main reasons why people are being diagnosed more with various mental illnesses. Years ago back in the bad old days mental illness was more or less taboo and even today there is alot of judgmental people out there who believe that it's all in your head 8) . No shit Sherlock where else would my brain be? In my arse perhaps? Fucking ignorant cunts piss me off big time. I have even had family members say to me you should just suck it up and go off those meds. Yeah right because the last time i went off those meds went so well 8( . The morons can't grasp the fact that mental illness is as real as diabetes or heart disease and should be looked upon in the same way.

I would not go for ECT and would not even consider it one bit until i had tried everything that can be tried for depression. Have you taken any tricyclic anti-depressants such as amitriptyline, nortriptyline, imipramine, etc or maoi's such as parnate, nardil or selegiline which is in the form of a emsam patch or as pills. Bupropion (wellbutrin, zyban) is one that works well for me personally and if you have not tried it it might be a option. It's a dopamine norepinephrine reuptake inhibitor so it's a lot different then SSRI's or SNRI's. Also anti-psychotics mainly the atypicals such as seroquel, zyprexa and abilify are also used in treating depression usually as a add on to a anti-depressant. The 2 true mood stabilizers which are lithium and lamotrigine (lamictal) are also sometimes used in treating unipolar depression. I take lamictal as a mood stabilizer and it helps the depression side of my bipolar disorder a lot.

The main thing i am trying to say is that there are lots of options out there that you can try so don't give up hope. As for ECT my personal opinion is that it's benefits are very minimal and the risks far outweigh the benefits of it.

 

[suessmayr]

Thanks paranoid android.

I have been on Lamictal previously. I honestly can't remember how well it worked. Things were different then - I sometimes felt manic. Now I am just constantly depressed. Especially when greenlighter trolls come out from under their rocks to bash in multiple threads.

I saw my shrink today and he gave me 3 options: 1) replace the avanza + lexapro with a single tricyclic; 2) replace lexapro with bupropion; 3) something else I can't remember.

In the end I asked for a Zoloft script. He thinks it is pointless but I never ever had a better response to any med than I did to Zoloft. So I'm gonna come off the lexapro and get onto the zoloft. I'm on 20mg lexapro and will go 15mg tomorrow, 10mg day after, 5mg day after, then the next day 50mg zoloft.