Depression: could someone give some advice?

[oxyladron]

Oh, hey guys! Long time no see, how y'all doing? First, sorry about the long message. I've tried to be detailed enough so that you have enough information to help me and, as always, sorry for my bad english.

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So, I've been on and off unprescribed Ritalin, with at least one to two weeks without then a week using, mostly because the past two months I didn't had any money to buy my prescribed antidepressant (here in Brasil Pristiq is very expensive) and Ritalin is cheaper so I've decided to use it as some sort of crutch until I go back to my psychiatrist and talk to him about prescribing some alternative to Pristiq, which will happen the next Monday 25.

Yeah, I know that I shouldn't be using Ritalin as an alternative to Pristiq, but I've been in a f*cking hell on earth, let me try to explain.

I'm diagnosed with Bipolar Type 2 after I got a hypomania crisis while I was on Prozac treatment. I went back to my psychiatric and talked to him, explained that since as a kid I experienced long depressed times but also highly energetic ones, which he told that those ups and downs were my Bipolar talking. Although I've told him that I've always been that typical energetic person that couldn't focus on only ONE THING but instead I was always constantly changing my focus to, I don't know, most than five things in a row, he insisted that I'm a bipolar guy. Okay, I obviously wasn't willing to debate about this with him cause he's the autority, right? So after changing meds for almost four times, since January/19 I've settled with:

- Pristiq, 50mg, 1 per day
- Depakene, 500mg, 3 per day
- Valium, 10mg, 1 per day

And the outcome is: since Pristiq is freaking expensive I could only afford buying the first box, Depakene was making me depressed so I stopped taking it and the only thing that is actually helping me is the Valium.

Some of you may remember me, I've started taking Ritalin (Insufflated) with some strictly rules, since I'm prone to abusing any substance (alcohol, benzos, soda, porn... basically anything) so I've made three rules for myself:

1 - Never use Ritalin to suppress any bad feeling, only recreational and to help studying.
2 - Have a journal and write down the time of each intake and never go further than 70mg or 100mg a day (100mg if the first intake is in the morning and 70mg if the first intake is after 12 noon) and with strict time between the dosages. Example: 30mg at 9am > 40mg at 1pm > 30mg at 8pm. Always with 10mg of Valium after 2 hours of the intake, so if I insufflated 30mg at 9am, I'm taking 10mg of Valium at 11am to help with the comedown. This has been pretty useful for me, actually.
3 - Drink a lot of water, eat even if I'm not hungry, try to sleep well every night and take some weeks off after a week using it, not only to prevent my body to get used to but also to help staying out of any trouble.

So, here we are. March 24 and after almost two months without the Pristiq, I fell on a HUGE and CRUSHING depressive crisis. Since I don't have much money, I'm used to not having my medicine for some days and a maximum of one week. And I'm almost two months without it. I've experienced the first signals of my depression coming back in the same time I was on my week off Ritalin, so I started overthinking that I was in some kind of withdrawal and that I had f*cked up my life and now I'm a addict and blah, blah, blah. But then something clicked on my mind and I recalled that I WASN'T TAKING MY PRISTIQ. Holy CHRIST! It's obviously that I'm falling in this depressive spiral because I have never been without any antidepressants for most than a week. And since the beginning of this month, I'm trying to reach my psychiatrist to make an appointment and talk about changing Pristiq to another medicine that the public health system distributes for free so I don't have to depend on anybody to buy it.

My relationship have been hugely affected by my actual state and probably I'll be single in a couple of days, I don't know anymore how to shower, I sleep almost the whole day and I've disappeared from internet and this situation brought me here because I need some help. Although I have these rules, I'm desperate. So I'm using Ritalin to help me get through the days, being at least productive and not only a dark sleepy ghost. Acting this way makes me feel even worse, cause I'm breaking the rules and using to suppress my depression but this is the only thing that helps me not thinking about suicide, self-injury and other f*cked up stuffs. My question is if there is any possibility of some misdiagnose? Since Ritalin erases my anxiety, helps me focusing (something that I've always complained since kid) and adding the fact that since that Prozac-induced hypomanic state (occurred in April/18) I didn't had anything like even without taking the Depakene. What if I actually have ADHD? How do I approach my doctor with that? I know that the way I'm using it isn't therapeutic but Ritalin helped me a lot while I was using it with Pristiq and now that I'm using it as a mechanism to stay alive until next monday, it is pretty effective too.

Which medicine can be a good alternative to Pristiq? If I'm not being an *sshole, can I ask a list of these medications so I can search on the list of medicines provided by the government.

Thank y'all so much, really. This forum helped me so many times for years, even when I didn't had an account. Just lurking here brought me some knowledge that allowed me helping friends in time of need.

 

[oxyladron]

Just a quick reply, adding a question that I forgot in the main post: the mix of Ritalin and Valium can be considered "speedball"? I'm thinking about this because in some way I'm mixing a upper with a downer, so am I asking for trouble when using Valium in the way I told in the text?

Thank you, guys!

 

[falsifiedhypothesi]

First, no ritalin and valium is not a speedball, actually if you take too much ritalin it would be a good idea to use valium to help calm yourself down. In some hospitals they give benzos to people ODing on stimulants. I'm not promoting this combo, it's actually a very hard balancing act to use these recreationally. Valium can take too much edginess off of the ritalin and you might want to take more ritalin to counter this, then you might feel too stimulated by the extra ritalin and take more valium, etc.

If you want to use ritalin for depression or for supposed adhd then you cannot take it recreationally. Using recreationally will only lead to a worse roller coaster ride of high and low moods. I've fallen into this trap and it's caused my depression to be better in some rare moments but generally worse.

It's possible you have been misdiagnosed but we couldn't possibly tell from over the internet. Keep in mind that just because a drug makes you feel better, especially one with recreational potential, does not necessarily mean you have whatever disorder the drug is used to treat. I don't want to dissuade you from trying something that might help you but you should really discuss this all with your doctor.

As for the pristiq, it's a antidepressant of the SNRI class so if you are looking for a cheaper alternative that might work just as well you should start looking at other SNRI's. We aren't allowed to discuss prices here and they are going to vary for different parts of the world anyway so you'll just have to see what's available on your own.

 

[lionheart90]

Antidepressants work by boosting certain brain chemicals like serotonin. Serotonin is thought to be a key regulator of mood.

Lets just say you were pretty depressed and suddenly you took an anti-depressant. Just by how it works its going to make you seem hypomanic. Anybody taking it is going to seem like they are hypomanic, especially if they find a brief freedom from intense depression.

the doctor isn't the authority on what you feel. All they do is give their opinion of your self described symptoms.

And sometimes you fuck up describing your symptoms, causing the doctor to fuck up their diagnosis.

bottom line. it's not set in stone because one doctor said they think you have bi polar. You can re-examine your situation and possibly get the help of another or multiple different therapists/psychiatrists.

and definitely do, becuase bi polar is like a therapists/psychiatrists favorite diagnosis these days. They just fucking love to hand them out.

 

[Chris42393]

Im not sure if you can get Ketamine over there, but if you're able to get it through a prescription or simply buying on the streets... I would try it. Ketamine literally cured my depression. I took 25mg twice a week for 5 weeks and I literally have no more depression (after several several years). It was a miracle. I felt the effects just after 1 use. Recently here in the United States, they made ketamine available for depression as well.

If you can get it, I DEFINITELY recommend it. Using it literally changed my life (for the better). I was originally trying it for recreational use, but after I took it... I seemed to feel much much better. Once the effects wore off (the high) I went online to do some research and I found out that it can help for depression and decided to take it for several weeks. I dont personally like it for recreational use, but it worked AMAZINGLY for depression. Its also very safe too.

 

[oxyladron]

First of all, I'll answer the previous replies:

Chris42393, getting cetamine round here is pretty much impossible, unfortunately.

lionheart90, I think if I go well with Zoloft without Depakene maybe the doctor will give a second thought about my Bipolar diagnose... at least I think it will.

falsifiedhypothesi, thank you very much for all the insights. I certainly shouldn't be relying on good effects of a stimulant in my depressive state to "self-diagnose" with ADHD, you're 100% right. Zoloft is now my new friend even if it isn't a SNRI drug - this being the fact that brought me here again to update this thread -, I'm hoping for a help with my depressive state.


I'm back with some (good) updates. My doctor prescribed me Zoloft 50mg which is good because I can easily find the generic one and I think it's fine, right? Obviously I'm gonna try buy the original but for a while I'm gonna go with the generic. Shouldn't be much of a problem, or actually is? I'm also officially off from Depakene and the icing on the cake of all this is that I pretty much decided to stop using Ritalin when I start with the Zoloft.

I've read on some webpages that mixing Ritalin and Zoloft is dangerous because can increase the chances of seizures, weak the effects of Zoloft, etc. So even though I like snorting Ritalin, I've reached a place where I'm not even getting the euphoria anymore and just this makes everything useless.

Although the lack of euphoria and diminished boost on energy only happens with the original Ritalin (which I find very odd, since if I'm getting the "original brand" I shouldn't be having weak effects, right?) and when I snort the generic one I got a lot of euphoria, energy and everything. Only 40mg is enough to several hours of good high. While with the original one I have to snort 50mg to 80mg to achieve some mild euphoria, a weak boost in my energy, not a lot of focus and also end my ability to get erections.

So, I'm here to ask about the safety of snorting Ritalin while on Zoloft and some if you guys have some tips to quit Ritalin. Since I'm using this to get some sort of euphoria/fake-happiness, when the Zoloft effects starts I should feel better and not feel the need to snort anything to feel good. Since I haven't experienced any cravings while not using Ritalin, I have a lot of Valium (5mg) and I can actually buy pretty much any medicine withouth prescription in a local drugstore. So... if there is any medication that will help me getting throught this, just let me know even though I think the best way of going throught all of this is cold turkey.

"Just quit Ritalin, buy the freaking Zoloft and wait for the effects kick in! The best harm reduction advice is not using another substance since you're a person with a high potential of abusing any substance from heroin to Cheetos!" -- I would totally understand if anyone just reply with something like this, hahahha.

Anyway, love you guys. Thanks for everything.

 

[Chris42393]

Taking Ritalin while on Zoloft can cause something called Serotonin Syndrome, which is a drug-induced condition resulting from serotonergic agonism of the central and peripheral nervous system serotonin receptors, which can cause several different problems. The most common are mood changes, nausea, diarrhea, dilated pupils, tachycardia, muscle stiffness, fever, sweating, and hypertension (the worse ones are much rarer, but can be life-threatening). But SS isn't that common, I was actually talking to a doctor about this a while ago and he said never seen it once (he's an ER Doctor).

Some severe symptoms are unresponsiveness, seizures, coma, and irregular heartbeat.

Obviously, the decision is yours if you want to take them together. But this is what could happen.

 

[oxyladron]

Taking Ritalin while on Zoloft can cause something called Serotonin Syndrome, which is a drug-induced condition resulting from serotonergic agonism of the central and peripheral nervous system serotonin receptors, which can cause several different problems. The most common are mood changes, nausea, diarrhea, dilated pupils, tachycardia, muscle stiffness, fever, sweating, and hypertension (the worse ones are much rarer, but can be life-threatening). But SS isn't that common, I was actually talking to a doctor about this a while ago and he said never seen it once (he's an ER Doctor).

Some severe symptoms are unresponsiveness, seizures, coma, and irregular heartbeat.

Obviously, the decision is yours if you want to take them together. But this is what could happen.

Thanks for the insights, Chris. Yeah, I'm actually thinking about stop using Ritalin just because it isn't prescribed (so my Doc isn't taking care of the dosage), I'm snorting it so the dosage isn't always the same and after all I don't wanna risk another seizure after the one I had in a Xanax withdrawal (abusing not for fun but because I have a high benzo resistance and a fear of sleeping so I'd took about ten 2mg pills every night for months just to get some sleep until I had to travel and didn't bought any then seizured in the middle of street while hanging out with some friends, got four stitches in my nose and a good story). So yeah, even if SS isn't common I think it's better not risk it.

 

[Chris42393]

Good choice Seizures are no fun. I have a history of Epilepsy myself and it sucks having them. I work for Fire/Rescue and I have responded to people where they have died because of a seizure...they vomited and aspirated, and choked to death because of it.

Better be safe than sorry.

Good luck.