Mental Health Why as a significantly depressed person do antidepressants do nothing for me?

[paranoid android]

Anti-depressants of any kind are only meant to treat Endogenous depression which means major depression without any life cause. If your life is shit you can eat whatever pill you want and it's still going to be shit. I should know . I have taken every drug under the sun including Alcohol, Opiates, Cocaine, Amphetamines, various benzos and Z-hypnotics as well as actual anti-depressants to try and make me feel better when my life has sucked. Needless to say it never worked for very long. You may feel great after a dilaudid+coke speedball but is your life actually any better for it? Nope and you end up even more miserable when you come down off it.

I hate shrinks as well and i don't even have one now. It was a waste of gas money going to see the fat script writing cow as all she would do was ask me a few stupid questions and just stare dead ahead with those dead cow eyes of her's until the 30 minutes or so was up then she would just refill my stuff. Jeez doc thanks your almost as useful as a telephone 8)

All the same i have found psych meds to work for me and i am sure i would be dead now if not for Lamictal and the various anti-psychotics i have been on. I used to get mixed states all the time before i went on lamotrigine but thankfully that med seems to stop the mixed states for me as well as the rapid cycling and usually stops either side of the manic spectrum from getting too far out of control. If i go really manic or mixed state for some reason and the Lamictal and seroquel just isn't enough some Zyprexa or if i don't have that some risperidone (not my first choice by any means) or even Chlorpromazine aka good ol Thorazine aka Largactil will usually knock out the mania.

Anti-depressants do work for some people but i will never understand why there are dozens of SSRI's and a few SNRI's that basically all do the same thing. Sure some people find that citalopram or escitalopram (Lexapro/Cipralex) works for them when Prozac or paroxetine does not but is there any fucking need to keep coming up with anti-d's that all effect the same receptor? The only actual anti-depressants that work on dopamine in North America are Wellbutrin (bupropion) and the MAOI's and why this is i don't know. It wouldn't hurt if they came up with a few more dopamine reuptake inhibitors as it would be nice to have the option of switching to another dopamine reuptake inhibitor if the Wellbutrin craps out. Besides these drugs the only other ones that act on dopamine and are rarely used to treat treatment resistant depression are Methylphenidate and the Amphetamines such as Dexedrine and Adderall. Those of course come with their own set of problems such as addiction and worsening of mental state if overused. Drugs such as Ketamine and even Scopolamine are being tested for use in treating major depressive disorder and they both seem very promising. From personal experience i have found Ketamine to be great for treating bipolar depression and scopolamine worked for me as well. However the use of these drugs in treating mental illness is at this stage very experimental.

Saying that all the anti-depressants don't work is a rather blanket and misleading statement imo as they do help some people. They are not going to change your life for you but they may get you out of the black pit of depression just enough so that you are able to work on that. Assuming anything is wrong about your life at all.

 

[Eva 33]

I've suffered with serious depression for quite a while and have been prescribed serotonin-effecting antidepressants (Zoloft) as well as norepinephrine/dopamine re-uptake antidepressants (Wellbutrin), both for months which should be long enough for them to start working, and neither of them do a god damn thing. Is this abnormal? To be honest I can't figure how anything that doesn't have immediate euphoric effects can be an effective antidepressant but pharmacological research maintains that they can. I'm just wondering if anyone else out there feels that antidepressant meds are useless because for me they seem to be just that.

Back when I was going through some teenage angst, I tried both SSRI's and the 'old school' tricyclic antidepressants. Neither one did a darn thing to help me, either. I've always felt that if there was truly a 'drug' that elevated mood, it would get outlawed for being too 'euphoric' and that people would abuse it. That's just my personal opinion.

I ended up ditching Western psychiatry and 'antidepressant' drugs, as they only made me feel worse.

The path I took to wellness was quite unconventional, but it worked. My treatment plan involved addressing some unresolved emotional and spiritual issues. It also involved entheogens, under the strict supervision of an experienced psychologist. (Of course, there are legal issues with this, so I'm not recommending it outside of a very structured environment, with the guidance of a therapist who has extensive knowledge of the use of entheogens in psychotherapy.)

That's what worked for me. I wish the US government would allow more research into the psychotherapeutic qualities of MDMA and LSD. Until that day comes (if ever) I'm not sure what to suggest.

Buprenorphine is legal and has been investigated for its antidepressant qualities for 20 years. Some psychiatrists will prescribe it for depression. It's worth a try. Best of luck to you! I know how frustrating it can be when meds don't work.

 

[bees_knees]

those dead cow eyes of her's

hahaha I love that expression. Thank you for the lulz.

 

[Eva 33]

I was on anti-depressants from 14-17 years old and honestly, I don't think they helped at all, I only stayed on them because I feared I'd get worse if I quit taking them. I'm glad I chose to stop cold turkey, I wouldn't suggest it to others because you can have a seizure but I was thankfully just fine. I was taking Effexor XR and Cymbalta daily before I quit and really, I feel like my mood improved after quitting them. I once even had what I'd consider a psychotic reaction while on them combined with heavy cannabis use and I tried actually killing myself, now tell me that the SSRI's helped me then, yeah right! I think that sometimes doctors prescribe anti-depressants to people who are suffering from depression but it's depression caused by shitty life situations, not by a lack of the right chemicals in the brain, I'm pretty sure that's what happened to me.
I think someone needs to start a thread about people who have taken anti-depressants and either had horrible side effects or they just didn't work and it'll be a list of all the misdiagnoses of depression that are made and the risks of taking them. I feel like it's one of the most over prescribed classes of drugs in the US and when prescribed to the wrong person, they can be really, really dangerous!

Sorry you went through that. I totally agree that SSRI antidepressants are WAY overprescribed in the USA. One of my main health issues is migraine (not depression) and I've had several doctors push SSRI's at me for migraine. SSRI's really have not been proven to reduce the incidence of migraine one bit.

I also had a family doctor try to push an SSRI at me for alleged 'depression'. When I told the doctor "I don't feel depressed," he responded that 9 out of 10 people with depression don't feel depressed. Huh, doc? I don't believe that one for a minute. Yeah, I'm supposed to be depressed, but I just don't feel the depression? When I insisted that I was NOT depressed, the doctor then said, "Actually, I'm getting more of an anxiety vibe from you". I then told the doctor that I was in the midst of a severe migraine and in horrible pain. The doctor then gave up trying to push SSRI's, finally realizing that I was in terrible migraine pain and just wanted to get home.

I swear these doctors are getting kickbacks from the drug companies that make SSRI antidepressants. I've never seen doctors try to push any other class of drug like that. The docs always claim that the SSRI's have 'zero side effects', too. By contrast, try being in chronic pain and in need of opiate medication to relieve your pain. You will likely go through years of being treated like a junkie and being denied adequate pain relief for your debilitating pain.

 

[paranoid android]

Sorry you went through that. I totally agree that SSRI antidepressants are WAY overprescribed in the USA. One of my main health issues is migraine (not depression) and I've had several doctors push SSRI's at me for migraine. SSRI's really have not been proven to reduce the incidence of migraine one bit.

I also had a family doctor try to push an SSRI at me for alleged 'depression'. When I told the doctor "I don't feel depressed," he responded that 9 out of 10 people with depression don't feel depressed. Huh, doc? I don't believe that one for a minute. Yeah, I'm supposed to be depressed, but I just don't feel the depression? When I insisted that I was NOT depressed, the doctor then said, "Actually, I'm getting more of an anxiety vibe from you". I then told the doctor that I was in the midst of a severe migraine and in horrible pain. The doctor then gave up trying to push SSRI's, finally realizing that I was in terrible migraine pain and just wanted to get home.

I swear these doctors are getting kickbacks from the drug companies that make SSRI antidepressants. I've never seen doctors try to push any other class of drug like that. The docs always claim that the SSRI's have 'zero side effects', too. By contrast, try being in chronic pain and in need of opiate medication to relieve your pain. You will likely go through years of being treated like a junkie and being denied adequate pain relief for your debilitating pain.

Your right SSRI's don't work for migraines at all as far as i can tell. Various Tricyclic anti-depressants such as amitriptyline, nortriptyline, imipramine, etc are anti-depressants that work well for migraines as well as neuropathic pain. Even though Cymbalta which is a SNRI is approved for neuropathic pain from everything I've heard it's not nearly as effective as tricyclics. I have never been on a SSRI but i haven't read anything about them being used to treat migraines nor have i heard of anyone being prescribed it for this purpose.

The only reason i can see a doctor scripting a SSRI for migraines is if the doctor thinks your pain is coming from depression. Doctors do get loads of sample packs of the newer anti-D's on the market and i know that in the US atleast they get some perks for scripting them. In most cases though doctors have no clue as to what they are prescribing actually works for. They all too often just go by what the drug reps tell them. Hence why you have to do your own research on any meds you get prescribed before you take them.

 

[bunnyrabbitz]

Anti-depressants were designed for depression caused by imbalances in the brain. If your depression is circumstantial, YOU HAVE EVERY RIGHT TO BE DEPRESSED. Try CBT.

 

[Shrooms00087]

I've suffered with serious depression for quite a while and have been prescribed serotonin-effecting antidepressants (Zoloft) as well as norepinephrine/dopamine re-uptake antidepressants (Wellbutrin), both for months which should be long enough for them to start working, and neither of them do a god damn thing. Is this abnormal? To be honest I can't figure how anything that doesn't have immediate euphoric effects can be an effective antidepressant but pharmacological research maintains that they can. I'm just wondering if anyone else out there feels that antidepressant meds are useless because for me they seem to be just that.

"Because for me they seem to be [useless]"

Well it seems you can't be swayed so you have to examine your depression further. You want "immediate ... effects" but the doctors do tell you to give it two weeks (+) to stabilize the chemicals they think are destabilized. You said you gave months and had no effects. So it seems you have to acknowledge what has got you so depressed; develop some passion. If you're not going to do the drug route you're going down the route of mental discipline which means the drugs cannot kill that which upsets you, so it is up to you. It is a pretty bleak message, well, that is --if you think it's a bleak message then it is.

God speed.

 

[belfort]

Anti-depressants were designed for depression caused by imbalances in the brain. If your depression is circumstantial, YOU HAVE EVERY RIGHT TO BE DEPRESSED. Try CBT.

i agree, you should not go on anti-depressants if you just broke up with girlfriend or lost your job..in these situations, changing your life is the answer, not medication..anti-depressants should only be used imo if you have a constant malaise that surrounds you no matter what living situation you are in..

 

[treezy z]

^ya if you're depressed for a real reason you don't need anti-depressents. depression can mean you're doing something the wrong way.

 

[Jean-Paul]

it can be helpful, later on, to have the shitty, disappointing, disorienting experience of trying out meds so that you can find out what doesn't work by process of elimination. and get a better idea of what you want. it can also be beneficial to just take a break if you need and go through the shit without the pill haze. to pare away the bullshit. i say that from my own experience, obvs no one here is qualified to tell you if you should be on meds or not. it's a touchy subject. i always trusted myself the most. i had to. know what you are taking.
also in the -realm of mental illness- there is no actual 'realer' reason to be depressed, although of course objectivity and environment factor into experience just as they do for someone without a mental illness. the idea of 'expected pain' turns into 'understandable pain' turns into 'acceptable pain' which leads to qualifying and shaming. -_-

 

[AdBenz]

I have watched my severely depressed sister try every single SSRI on the market over her lifetime (from early prozac onwards) while her depression continues to get worse. She has been convinced that her depression is "chemical" and has nothing to do with her life. Not one doctor has ever prescribed therapy, analysis or self help treatment. Imagine if you had a physical ailment and you had been given a certain class of medications for over 40 years that not only did not work but your symptoms kept worsening--what kind of medical professional would continue the same course of "treatment"?

That's really heartbreaking but I could not agree more with the notion that the psychiatric/mental health system in the country right now is a f*cking disgrace and a joke. I was a psychology major who opted for a heavy course-load in the scientific side of the program (psychobio class & lab, psychopharm, clinical neuroscience) and I'm often baffled at how inept -- and often unsympathetic -- the "professionals" in this field are. You know it's bad when you feel like you have to strategize for a doctor's appointment in order to be helped at all, and that's how I've felt about a couple of past psychiatrists (to be fair, not all) I've seen who were looking up information I had learned in college online during my $85 appointment (and that's not bad) and mixing up pre-established Rx dosages regularly.

 

[Rybee]

Anti-depressants were designed for depression caused by imbalances in the brain. If your depression is circumstantial, YOU HAVE EVERY RIGHT TO BE DEPRESSED. Try CBT.

Bullshit.

There's no such thing as a chemical imbalance of the brain that leads to, or causes, clinical depression. Or Major Depressive Disorder as the DSM calls it.

Not one single study in the entire history of medicine, has ever proved that.

 

[Rio Fantastic]

Bullshit.

There's no such thing as a chemical imbalance of the brain that leads to, or causes, clinical depression. Or Major Depressive Disorder as the DSM calls it.

Not one single study in the entire history of medicine, has ever proved that.

You're right that the monoamine hypothesis is vastly oversimplified, but I don't think anyone could argue that depression isn't some kind of brain dysfunction.

 

[theSpruceGoose]

I've read many reports stating that AD's don't do much for many people. They sure as heck are helping me. After initial success with Elavil, the Elavil stopped working. I tried many different AD's over the years to no avail. Then I was put on Effexor. 150mg, then up to 225; now I'm at 300mg's. This drug does not work as well as the Elavil did, but at least I can get through the day without severely negative thinking etc. I'm just telling you what works for me. Another thing I've found out about boosting one's mood is to do light exercise. I do weight training; very little of it, and high repetitions. For example I will do overhead presses with a light weight so that I can get at least 60 reps before fatiguing. I might do another set after a rest with a slightly heavier weight; hopefully getting 40 reps. That's it for the day. No more. It works for me, don't know if it would work for you.

 

[paranoid android]

The monoamine hypothesis of what actually causes depression has come under scrutiny as of late due to the abysmal results most people get from the newer anti-depressants like the SSRI's, SNRI's, etc. Elavil which is a tricyclic worked for me for years before it crapped out. I was taking it for trigeminal neuralgia as well as depression (later found out to be bipolar disorder) and it helped both my nerve pain and depression. Trimipramine also helped my depression and despite there reputation for triggering mania tricyclic anti-depressants along with the norepinephrine dopamine reuptake inhibitor bupropion are the only anti-d's to really work for me and not trigger mania.

Also anti-psychotics that work as dopamine antagonists as well as the ones that act as serotonin and dopamine antagonists are used for treatment resistant depression and i have seen quetiapine, olanzaine, etc as well as some typicals help peoples depression when nothing else seemed to work. The atypicals are mostly known for effecting serotonin more then dopamine although some of the "dirtier" older anti-psychotics such as chlorpromazine (good ol Thorazine aka Largactil) and loxapine among others also act as serotonin antagonists. Although there main method of action are still stronger dopamine antagonists as opposed to being serotonin agonists. I have found olanzapine to work great for my bipolar disorder on it's own and i had no real side effects even at 20mg's a day (too bad i can't get it covered and can't afford it) and quetiapine seems to help the depression more then the mania. Risperidone unlike seroquel and zyprexa doesn't help the depression side of my bipolar at all and that's the only other atypical i can get covered besides seroquel. Risperidone is a really potent dopamine antagonist and is more like the typical high potency anti-psychotics such as haloperidol then newer atypicals such as quetiapine and olanzapine. Right now i am taking 200mg's of lamotrigine a day as my mood stabilizer, 300-400mg''s of quetiapine to help with the bipolar as well and sometimes especially during the winter i take bupropion to help my SAD induced depression. Trimipramine also helps my depression.

So i would have to say that for the most part i agree with the monoamine hypothesis on depression and mental illness in general. Although i think that the serotonin theory on depression is for the most part very oversimplified in my opinion. Before i got on the proper meds i was a fucking wreck. I have rapid cycling bipolar and without lamictal that can get really out of hand for me. Zyprexa will pretty much stop rapid cycling or mania right away too. Still not all people are depressed for the same reason. So for me these meds do work it just took a long time to find the right combo. Also we are only now really figuring out that other neurotransmitters such as acetylcholine (hence why they are testing the anti-muscarinic drug scopolamine for bipolar depression) as well as the NMDA receptor (hence why ketamine helps alot of people depression) play a important role in depression

But not everyones depression is created by chemical imbalances. You could take the most slap happy person on earth and put them in a shitty situation and they would end up depressed. The only thing that will make you feel better about a bad situation is by removing yourself from it.

 

[bees_knees]

I don't think we should shy people away from using antidepressants by letting rip with our theories and our own experiences, because they might just get what they need from these things, for every failure story there is a success story. I mean like antipsychotics it's probably at 50%.

 

[AuraLee]

It depends on the person. Some people find antidepressants helpful and some don't. I really wonder what it means that I have had depression my whole life pretty much, yet I can't tolerate most antidepressants. At age 15-17 I could tolerate dothiepin but it didn't do anything to stop my constant hospitalisations. I've tried Zoloft, prozac, citalopram, fluvoxamine, venlafaxine - all gave terrible side effects so much that I couldn't even force myself to continue past a day or two.
Mirtazapine was tolerable but knocked me out, same with olanzapine. Moclobemide is tolerable for me with no side effects- didn't work when I was younger, tried again recently but I kept forgetting to take it! Think I will try again.

I think if antiDs help some people there must be something in it. But with the way my body rejects SSRIs and SNRIs, I don't think it's as simple as a serotonin imbalance.
I would suggest anti depressants are worth a decent try. You do need to try some different anti-D families, and finding a decent counsellor is important too. At the same time you need to be ready for change. Not to say depression is all in a person's head cos it isn't, but sometimes it takes a certain level of maturity before you can see a way out of the mire. I'm climbing out slowly but it ain't easy.

 

[bees_knees]

I'm on Mirtazapine and it only knocks you out the first dose, the second is a little bit sedating and by the third it's not at all.

 

[Rio Fantastic]

But not everyones depression is created by chemical imbalances. You could take the most slap happy person on earth and put them in a shitty situation and they would end up depressed. The only thing that will make you feel better about a bad situation is by removing yourself from it.

This is where the distinction between a depressed mood and clinical depression needs to be clarified. Even in the shittiest of situations, long, protracted feelings of sadness, exhaustion, low self worth etc aren't normal. Most people have a baseline mood that they will return to no matter what the circumstances are - a longitudinal study comes to mind for instnace when formerly able-bodied people were involved in atrocious accidents that left them paralyzed for life, and understandably at first they all reported the expected feelings of depression. However, after six months, all of them were back to their baseline level of happiness before the accident. Unfortunatley, the reverse is also true - lottery winners were also asked to report on their moods etc, and after the initial burst of happiness and elevated mood, invariably after six months or so they were back to their baseline before the lottery win also. So I disagree that you could put the happiest of people in the shittiest of situations and they'd end up with clinical depression - one of the primary features of depression, after all, is that the feelings are unrealistic and not based on anything in reality. Indeed, depressed people can end up in shitty situations due to their depression, and anyone who's gone through depression at the time will feel it to be justified, but your example wouldn't fit the definition of clinical depression in my opinion.

By the by I think there are a category of the most "slap-happy people on earth", and they've been shown to be remarkably psychologically resilient, even in the face of circumstances that would leave most of us depressed messes. The condition is called hyperthymia and it evokes in me both fascination and, to be frank, more than a little jealousy! Also I'm bipolar as well and am shocked at your positive experiences with neuroleptics. I wish I could say the same! Risperidone for me might as well be depression in a pill and I'm convinced that being forced onto the shit for three months is what triggered the worst depression of my entire life. I've been on pretty much every atypical antipsychotic under the sun, and all of them made me feel intolerably slow and tired, not to mention that horrible hangover. When I took them during a depressive episode, they didn't help it at all, just rather than feeling empty and sad I felt empty and numb, which wasn't any better. I'd just like to point out that although SSRIs, SNRIs etc are far from perfect, going by the numbers they work a lot better for most people than neuroleptics to lift people's moods, and although I've been on Zoloft and it did nothing for me other than kill my sex drive, I'll never say a bad word against them because I saw Prozac literally work a fucking miracle on my ex girlfriend, so for some people they do definitely work.

 

[weekend addiction]

They never helped me. I use weed instead. I take klonopin for my anxiety. kratom for motivation. And I drink beer for sleep. Not perfect but I haven't found a medicine that helps me other than benzos for anxiety.