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Depression, Purely A Chemical Imbalance... For Some?


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9 replies to this topic

#1 brightlight83

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Posted 20 July 2009 - 03:25 PM

Hi,

I'm a 25yo male and am currently suffering from a bout of depression - I am out of work about 6 weeks now waiting for meds to kick in.

I have done a lot of reading about this illness and have seen a lot of specialists. Most books I've read and people I have talked to acknowledge the place medication has in aiding recovery but most suggest a combination of both drug and talk therapies (usually CBT). My question is, are there any other here, like me, who feel that for them, Depression is purely chemical and not much other then Medication can really lift it?

Just to give you a quick run down of my story. For the first 23 years of my life I had never encountered depression. I had a great upbringing, enjoyed life, did well in School and college and got a good job in Investment Management. Then in November 2006 I started to feel unwell. It started out being stressed about my relationship with my girlfriend, which itself was uncharacteristic, but when that was resolved the low mood remained. My appetite disappeared, I was waking really early and the simplest of tasks were mountainous. I struggled for about 8 months just trying to get through the days, there was no joy left in anything, I didn't want to do the things that used to give me pleasure - it was just a matter of survival.

I went to a few different counsellors and specialists - but I had little to talk about other then the fact that I felt so bad for no reason. I was afraid to accept that I was depressed (a bit of a family history of the illness) so I kept going. But after about 8 months of pure torture I gave in to the advice that countless doctors had provided and started on anti depressants.

I first started on 10mg of Lexapro, having seen no improvement after about 8 weeks I changed to 75 mg of Effexor, which was upped to 150mg after about 5 weeks. After about 2 months of being on Effexor, light started to shine back into my life and I started to enjoy the things I did normally. In the period prior to taking the med I had done 8 weeks of CBT, while it was useful as a coping mechanism I couldn't see how it was going to lift the cloud that I woke up with every morning.

I spent about 6 months on Effexor before really really slowly coming off it. It wasn't really a problem to get off it (contrary to what you'll read on most forums) but in saying that I never did feel quite 100% on the drug. I had a looming kind of haziness from time to time so I'd say I only ever got to 90% - Still a vast improvement on the 30% I had been.

Anyway, after about a year on the med and a further year of the med (where I did feel myself again), I've now relapsed. While the last time there seemed to be an obvious trigger, this time I couldn't see one. I'm back on Effexor, about 7 weeks now and I'm up to 225mg without feeling a lift yet.

But coming back to my question, despite being in very bad form all day every day, and despite having little energy, I still feel fine about myself. My self esteem is high and I feel confident. I'm trying everything to help myself out of this but almost every book focuses on challenging the negative thoughts you have towards oneself. Thankfully these don't exist for me so I can't really see what else I can do other then wait for the med to lift this haze.

Are there any others out there who feel similar to me?

Thanks for taking your time to read this.
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#2 Sheepwoman

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Posted 21 July 2009 - 10:13 AM

There are 2 types of depression (from what I understand from my tdocs): situational/clinical (caused by an external trigger) and organic (chemical imbalance.)

In either case, ADs can help lift mood in order to function/think at a higher level. ADs do not "cure" either type of depression. If ADs are used in conjuction with therapy, you are better able to make changes in your thinking and behavior. CBT requires a great deal of effort and self-work and if you're depressed, you're not able to do the work needed.

The biggest mistake many of us make is coming off ADs too soon. We start feeling well and figure they're no longer needed. Somewhere down the road we relapse. Sometimes going back on the previous AD will work again and othertimes it doesn't. We all respond/react to meds differently and it's trial and error to find the right one that will work for us. Talk to your pdoc in regards to Effexor and not feeling it's helping you like before. 7 weeks in, you should be experiencing something.

I've had clinical depression in the past (maybe present, too), but I have an organic mental illness: Bipolar. It's inherited via my family. It requires lifetime medication to manage it. I also do therapy as a back-up. If you have a family history of depression, you may be predisposed to depression. That would be a good question to bring up with your pdoc.
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#3 brightlight83

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Posted 21 July 2009 - 11:57 AM

Thanks a million for the reply Sheepwoman.

See the bit I struggle to understand is what CBT can really do for me? I consider myself a very positive thinker and have remained that way - my main symptom is a low mood, like there's a cloud over me. It doesn't make me think badly about myself, it just takes the fun out of things and makes work and simple tasks incredible difficult and stressful. The last time, when the med kicked in these symptoms just dissappeared. I think CBT could be incredibly beneficial for many (if not most) sufferring from depression but I'm just not sure if I see its benefit for me.

Next question I have is in relation to the med. I didn't realise that if a drug worked once there was a chance it wouldn't work the second time around. I just go to my GP (although I have seen pdoc's last time round) - he basically said effexor is the "strongest" of the antid's and there wasn't much point in trying anything else... Is this incorrect? I've already tried Lexapro, but didn't work (albeit, I only tried 10mg)

One last question, just out of interest. For someone like you, who is on mediciation all the time, are u still capable of holding down a job in a stressful environment? Do you have periods where you have to take leave or can u function just like anyone else once you are on your med?

Thanks again for your time and help,

#4 Goozie

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Posted 21 July 2009 - 12:50 PM

Hi,

I'm a 25yo male and am currently suffering from a bout of depression - I am out of work about 6 weeks now waiting for meds to kick in.

I have done a lot of reading about this illness and have seen a lot of specialists. Most books I've read and people I have talked to acknowledge the place medication has in aiding recovery but most suggest a combination of both drug and talk therapies (usually CBT). My question is, are there any other here, like me, who feel that for them, Depression is purely chemical and not much other then Medication can really lift it?

Just to give you a quick run down of my story. For the first 23 years of my life I had never encountered depression. I had a great upbringing, enjoyed life, did well in School and college and got a good job in Investment Management. Then in November 2006 I started to feel unwell. It started out being stressed about my relationship with my girlfriend, which itself was uncharacteristic, but when that was resolved the low mood remained. My appetite disappeared, I was waking really early and the simplest of tasks were mountainous. I struggled for about 8 months just trying to get through the days, there was no joy left in anything, I didn't want to do the things that used to give me pleasure - it was just a matter of survival.

I went to a few different counsellors and specialists - but I had little to talk about other then the fact that I felt so bad for no reason. I was afraid to accept that I was depressed (a bit of a family history of the illness) so I kept going. But after about 8 months of pure torture I gave in to the advice that countless doctors had provided and started on anti depressants.

I first started on 10mg of Lexapro, having seen no improvement after about 8 weeks I changed to 75 mg of Effexor, which was upped to 150mg after about 5 weeks. After about 2 months of being on Effexor, light started to shine back into my life and I started to enjoy the things I did normally. In the period prior to taking the med I had done 8 weeks of CBT, while it was useful as a coping mechanism I couldn't see how it was going to lift the cloud that I woke up with every morning.

I spent about 6 months on Effexor before really really slowly coming off it. It wasn't really a problem to get off it (contrary to what you'll read on most forums) but in saying that I never did feel quite 100% on the drug. I had a looming kind of haziness from time to time so I'd say I only ever got to 90% - Still a vast improvement on the 30% I had been.

Anyway, after about a year on the med and a further year of the med (where I did feel myself again), I've now relapsed. While the last time there seemed to be an obvious trigger, this time I couldn't see one. I'm back on Effexor, about 7 weeks now and I'm up to 225mg without feeling a lift yet.

But coming back to my question, despite being in very bad form all day every day, and despite having little energy, I still feel fine about myself. My self esteem is high and I feel confident. I'm trying everything to help myself out of this but almost every book focuses on challenging the negative thoughts you have towards oneself. Thankfully these don't exist for me so I can't really see what else I can do other then wait for the med to lift this haze.

Are there any others out there who feel similar to me?

Thanks for taking your time to read this.


Just speaking for myself. For the most part I know my depression is genetic...but now I feel it's more situational due to issues I have in my life now. I'm wondering if one day if the road ran smoothe for awhile if alot of that situational depression would let up...but I think I'll have to manage the genetic part with meds for the rest of my life.

#5 frostfern

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Posted 21 July 2009 - 11:33 PM

My general experience is that a stressor initiates my depression but then after the stressor is removed it often gets worse rather than better. It's counter-intuitive as to why this is the case but that's just how it goes. Organic changes must occur that don't reverse quickly.

Based on your symptoms though it might be good to check that there isn't something physiological other than clinical depression going on. Thyroid issues would be the most obvious to check but you might want to ask a doctor about other possibilities.

Anhedonia is one of the very worst symptoms, way underrated by most people who've never experienced it. Even if it's the only symptom you experience it's a nasty one. Lack of activity makes it even worse for me so I have to force myself to do things even when it feels like there's no point - just to stop myself from going completely off the deep end.

I sincerely hope you find something that works for you and find your old self again. I haven't had too much success myself with the anhedonia.

#6 S38

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Posted 29 April 2013 - 12:30 AM

Brightlight83!!!! I am SO hoping you will get this!!! I don't know why or how it took me this long to find this post :( but i am SO GLAD i did!!! :) SERIOUSLY - in the 19(!!!) yrs. i have been dealing w/ my depression, you are the FIRST i've heard to agree w/ me that you feel it is entirely chemical!!! AT LAST!!! :) It has been so lonely for SO long!!! :( Anyway - don't want to write too much if you don't see this :( I am SO looking forward to hearing from you!!!! :)
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#7 sc2

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Posted 29 April 2013 - 01:13 AM

Depression usually occurs follwing life stress, but not always, esp. in those with a genetic predisposition. Serious depresison, like you describe, can also have many medical causes, like thyroid issues, cancer and other ilnesses related to hormnal dysfunction. Also your doctor said effexor is the strongest med for depression. This is simply false. 

There are dozens of older meds that are however associated with more significant and potentially serious side effects, (not that you will die or anything) such as the MAOIS and tricyclic antidepressants.

 

I stronly urge you to seek professional care, it seems like you were perscribed these meds by your GP? Seek treatment in a specialty mood clinic or at least a psychiatrist. GPs dont know what they are doing. 


Edited by sc2, 29 April 2013 - 01:18 AM.


#8 sc2

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Posted 29 April 2013 - 05:09 AM

By the way the following features of the depression you describe; anhedonia, avolition, lack of appetite, early morning awakening, familiy hisotry of depression and  depression appearing out of the blue are all textbook features of depression with melancholic features. Melancholic symtpom features are traditionally and in science regarded as indicative of  a presumed ' biological cause'. Before in the previous century the term was endogenous depression, which however also included what we now call bipolar disorder. In the latter disorder the features that I highlighted from your story are also frequently present. Melancohlic depresison is further characterized by an intermittent course, with more recurrences, whereas neurotic depresison is often characterized by a lot of relapses (recurrent episodes with incomplete recovery between episodes).

 

The distinction between melancholic and non melancholic depression is pretty important from a clinical management point of view and I think it would be worthwile to study it a bit, to see if you belief that you have that. If so that is another reason to get specialized treatment.

 

Finally aside from pharmacological treatment, ECT is also sometimes used in resitant cases with a high succes rate.


Edited by sc2, 29 April 2013 - 05:12 AM.


#9 Faramir

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Posted 29 April 2013 - 10:57 AM

I would say both.  For some people like myself, medications just don't seem to do the trick.  I am still searching and hopefully one day I will find that medicine that makes the difference.  Knowing is half the battle.  Knowing that people are NOT conspiring against you, but that your problem is of your own making, actually is helpful.  A conselor will recognize the value of medication but also believes that your habits and thinking can be rewired.  I am a reassurance seeker, and my conselor wants me to break the habit.  For example, I look at my spouse, and if she avoids eye contact, I assume something is wrong.  This can be called "testing" or "measuring" but is a form of irrational assurance seeking.  But I totally see your point of view.  Sometimes my emotions are so strong, so powerful, I do not even recognize that the problem is me.  I think "If my emotions are so powerful, then something must really be wrong, right?"



#10 bookmage

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Posted 29 April 2013 - 12:09 PM

Hi brightlight83. I know what you're talking about, thinking it's all chemical and everything you're doing may not actually be helping or even be able to help. I have clinical depression, meaning it's in my genes/brain. Nothing happened to make me this way, I just am. The meds help with the day to day stuff and ESPECIALLY with keeping the bad moods away. I'm talking depths of despair moods. But I still have some trouble getting things done that I need to. I think for clinical depression, it helps you be ABLE to do/handle things. You have to do the rest on your own.


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