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Everything posted by Saros

  1. Effexor (and the related Pristiq) have a reputation for side effects and discontinuation symptoms. I don't believe they offer a "typical" antidepressant trial.
  2. Congrats on going public with it - a sense of shame can be a big hurdle. I think you'll find a lot of people have had similar experiences, so you're not alone in with these things. At this point, you may need a lot of patience. Finding a med (or meds) that works for you can take a lot of trial and error, and each trial and error can take months. And there are many different meds that might be apprproriate to try. You might want to check out of the zoloft subforum and see what kind of person has been helped by it, and how, but keep in mind every person iss different. If someone has been experiencing depression for years, it's going to be be more difficult to pull out of it. A good psychiatrist (if you want to be on meds) or psychologist can help you with therapy. Therapy can be just talking about things, indentifying behaviors you can add or change, modifying your expectations or perceptions, or something else. It would be great if zoloft completely turns your life around, but for many, managing depression includes a learning process that takes much more investment. Good luck for now.
  3. A good psychiatrist won't draw a dividing line of nature versus nurture between depression and the patient because firstly, he won't have any means to ultimately make that determination. Secondly, the barrier between the two is fuzzy, and they continuously and reflexively influence one another. Treatment does not necessarily depend on origin. Therapy may take some time to find an effective means to manage your symptoms. My depression is several times over determined to primarily be biological, but all my (good) doctors have nonetheless looked for psychological means to help me get by (in addition to medication). Just relate your history, your concerns, and expectations: what you want out of the doctor-patient relationship. You should have at least an hour.
  4. Big yuck. If you go the source, you may note an abundance of confusion between corollary and causative agents in Andrew's paper. Between review and experiential study. A highly-biased selection of literature from which they quote, indicating the opinion they want to publish (or the ax they mean to grind) before they've had time to state it. And "conclusions" not really supported by evidence presented. I have no doubt these are intelligent people, but the paper would not have made it out of my university graduate work group or committee. But it's published in a peer-reviewed journal, right? I don't know. "Frontiers" was created and placed online (and only online) in 2010. A manuscript writer might submit the article and a high fee, and the "journal" farms out reviewers wherever it can with minimal investment. This format is called "PAY TO PUBLISH", and is not regarded very highly by modern science departments. Is it an appropriate label? I don't know, but I have to consider it. Some other info that may have bearing on "Frontiers" (but not saying anything about the quality of Andrews' paper): http://scholarlyoa.com/2013/11/05/i-get-complaints-about-frontiers/ The fact the publisher let a biased and (in my opinion) poorly-written article through suggests a lousy review process. Which is a shame, because articles like these will inform, whether they are right or wrong. More than a grain of salt is cautioned. I would dismiss ALL of it's claims altogether, the claims on their "published" paper, and just look at the true source material, free of Andrews' interpretation. Keeping it mind it's a purposefully limited selection of the available literature.
  5. It's a single-study laboratory-developed test (by Rules/Veripsych) (not approved by the FDA) authored by people with significant financial ties to the company which stands to profit from positive results (and has financial investment). I could find no outside verification in a peer-reviewed journal. The research does not identify a "schizophrenia molecule" that distinguishes one person from another. It does not delineate between categorical "healthy" and "disease" states. It is a collection of 51 biomarkers - 20 of which were included for unclear reasons. Any predictive model will improve as you add additional variables. A model's "goodness of fit" is improved when increasing model complexity - use of additional variables has to be scientifically and statistically justified. They use the data to create an algorithim, a posteriori. An algorithim isn't a researched hypothesis that is then validated by the data. It's a decision rule used to capture and classify all the variability in a given data set. That algorithim is not included in the paper. I don't see much of the math at all. The test does not diagnose schizophrenia. According to their own (Veripsych) statements, it is an aid to the psychiatrist to diagnose schizophrenia. It generates false positives, false negatives and inconclusives. The test yields a statistical likelihood. How valuable is a statistical likelihood to a psychiatrist and patient trying to diagnose a mental health condition? That decision should also be weighed with consideration of all the potential red flags at this stage of it's development. Note the test was pulled and (as of March 2014), according to Veripsych, somewhat cryptically "needed further refinement". If google results can be believed (grain of salt), it was a few thousand dollars during initial deployment.
  6. I suppose it's a highly subjective choice. I've felt numb for many years (in varying degrees), but particulary during the last 2 to 3. I might welcome any sort of change.
  7. Only that after living with depression for so many years, it's part of how I define myself, consciously and probably unconsciously. Losing that depression feels like losing an important part of myself - without it I don't feel complete. I don't really know who I would be without depression. Redefining myself in the absence of depression sounds strange and difficult. At least, that's the sense I've gotten during a few periods of relative reprieve.
  8. Just wanted to re-iterate the issue of identity, I think it's important. When you've been depressed for years and years, it becomes part of your identity. When comtemplating the remission of depression, there may be feelings of being undefined, incomplete. My personal experience, anyway.
  9. I don't mean 'celebrate' in the literal sense. It would have been better if I had said 'indulge' - as in you freely indulge in hating things, but dismiss true love/happiness as "chemical". To me, in the OP, your willingness to engage with one emotion is contradictory with your readiness to dismiss another emotion. Your premise for dismissal applies to both. But, as you say, it was over a month ago, and maybe things have evolved a little. Glad you're not so down anymore.
  10. Some people think the tendency to isolate after or during episodes of psychic pain is a protective mechanism to hide from risk of further pain (colloquially, we put up a defensive wall). Others think it's to hide our pain (and our weakness and vunerability) from others. Could be both simultaneously. It's sometimes clear when that tendency is maladaptive. For some people getting past it might involve challenging the unconscious beliefs that underlie that tendency with real-world practice, and simultaneously teaching themselves some new behavior to replace it. Maybe a certain kind of therapist could assist with identifying and unlearning those tendencies. Or maybe it's something else. I really have no idea.
  11. However hurt and betrayed you feel, I doubt that was her intention. And while you feel you are being controlled, I would guess by her threat she feels quite out of control as well. Without going in to who is to "blame", what is justifiable behavior, and whether she's actually paranoid or not, it is clear you crossed her comfort boundaries. Whether those boundaries are defensible or not, you'll have to respect them, for your own sake as well as hers. In a similar situation I would advise my friend to let go immediately, including figuring out how to let go of personal feelings and the need to feel "equal". I imagine it will take some time. Best of luck.
  12. Continue to be supportive of her efforts to help herself. In the meantime, you may need to redefine your expectations of the relationship.
  13. For me, it's like being a corpse.
  14. I wouldn't dismiss it, but also statistical noise happens. Post hoc ergo propter hoc is what's kept a lot of parents from immunizing their children. That being said, google "fluoroquinolone antibiotics depression". Apparently carries a risk of damaging the CNS (and inducing potential psychiatric effects).
  15. No cable TV, so limited options. However, lately, 'It's Always Sunny in Philadelphia' is rebroadcast on basic around 3am. I occasionally watch it, because it sometimes really makes me feel better to see people categorically more dysfunctional and self-destructive than I am. Schadenfreude.
  16. I think it's odd you completely dismiss love and happiness, because it's "just chemical", but seem to de facto celebrate hate as the default position, despite that it is also "just chemical".
  17. Welcome to the forums. Aside from trying to get better with things like healthy lifestyle changes like exercise, sunshine, socializing, a healthy diet, therapy done in good faith, and/or medication, My advice is to not feel too guilty about it. Despite being proactive about your mental health, low periods can happen regardless. So try not to beat yourself up over it.
  18. There's going to be people who said it helped, and those who said it didn't. Setting aside anecdotal comments via "correlation is not causation" (I know this is possible unfairly dismissive), I don't think there's enough scientific evidence to support the claims by the CES companies, including that it induces neurotransmitter release. I see a lot of conjecture, drawn from a limited number of studies with small sample sizes. The most recent literature review (Harvard 2010) available on their website (Noninvasive Brain Stimulation with Low-Intensity Electrical Currents: Putative Mechanisms of Action for Direct and Alternating Current Stimulation) states that, reviewing the body of research at hand, evidence is inadequate to assert AC stimulation stimulates serotonin/norepinephrine activity. They also take issue with several studies' experimental design. And I'm highly discouraged by the author's comments of "our review of the CES trial literature reveals the importance of providing certain basic information. Research results should include means, standard deviations, Ns, statistical tests used and their p-values..." etc. Without going through the literature, I'm suddenly pretty biased against it. Also, consider this sentence: "Since at least several of the published studies were conducted by individuals with a commercial interest in a specific CES device...". Red flag. For what it's worth, they did find an improvement to anxiety scores. BUT, all they're doing is a meta-analysis - synthesizing the results of multiple older studies. New results will only be as valuable as old data were. If you google "cranial electrotherapy stimulation -or- Fisher Wallace -and- Depression Forums", you'll get quite a few hits.
  19. Published recently in Cell. I put it here because it's a theme in this thread for people to assume anhedonia is a dopamine problem, and the reward system is not functioning optimally. Specific anhedonia does not support a global "chemical imbalance" of dopamine, but malfunction in some precursor to the reward system. 'Dissociation between Musical and Monetary Reward Responses in Specific Musical Anhedonia' Healthy people with specific musical anhedonia are identified These individuals do not find music pleasurable, but enjoy other rewarding stimuli They show normal autonomic responses to monetary reward, but not to pleasant music Specific anhedonia reflect the existence of different access to the reward system Abstract: Music has been present in all human cultures since prehistory [1,2], although it is not associated with any apparent biological advantages (such as food, sex, etc.) or utility value (such as money). Nevertheless, music is ranked among the highest sources of pleasure [3], and its important role in our society and culture has led to the assumption that the ability of music to induce pleasure is universal. However, this assumption has never been empirically tested. In the present report, we identified a group of healthy individuals without depression or generalized anhedonia who showed reduced behavioral pleasure ratings and no autonomic responses to pleasurable music, despite having normal musical perception capacities. These persons showed preserved behavioral and physiological responses to monetary reward, indicating that the low sensitivity to music was not due to a global hypofunction of the reward network. These results point to the existence of specific musical anhedonia and suggest that there may be individual differences in access to the reward system. http://www.cell.com/current-biology/abstract/S0960-9822%2814%2900133-X
  20. Regarding the brain as a non-linear, dynamical system at some steady state - steady states being depressed, "happy", and everything imaginable in between - and considering that (AFAIK) there are currently over 60 identified neurotransmitters, each subject to complex rules, global and local feedback regulation - perturbation of any neurotransmitter could change the steady state, regardless if that neurotransmitter is at an abstract "ideal" level or supposedly "deficient". Moreover, though a change in the level of any single neurotransmitter might lift someone from depressed to "happy", (all else being equal) it provides no evidence whether those neurotransmitter levels were a proximate or an ultimate factor in the depression. To reduce this to the simplest analogy possible, think of a washing machine that's running off-balance (a bad steady state). You can kick it in the front (prozac), side (licorice), or back (olanzipine), and all of those actions might rebalance the load inside. It doesn't mean the machine had a kicking deficiency - that perturbation (kick) just changed the steady state. Of course, some perturbations won't do anything, and some will exacerbate the imbalance. I'm saying I don't think that there is strong evidence that there are multiple things "wrong" with your neurochemistry (...though there might be anyway). My last psychiatrist tended to agree with this abstraction, but... she could have been humoring me. Feel free to disregard. I just think the linear "chemical imbalance" concept is not supported by the data that's been explained to me by my MDs.
  21. Welcome to the forums. The forum is here to provide support for people struggling with mental illness. Unless a psychologist has classified you as a sociopath, I think it's too early to use labels like that. Struggling with not feeling sympathy doesn't make you a sociopath. Using defensive mechanisms to avoid feeling hurt (or sympathy) seems like a understandable response given the history you describe. Same comments re: narcissicist. I've met one diagnosed narcissicist, and that label is not applied easily. Labels can pathologize without offering tools for improvement .
  22. If you're in therapy, doing worksheets, and think it's stupid, it might be time for you to find a new therapist. Why not look for a psychologist who makes you feel better about the process? Finding a way to modulate your attitude about the work you need to do will help, if only be degrees.
  23. I had no anxiety issues before beginning bupropion, and detected no change in that after starting. Many posts have been made in this subforum by people with pre-existing anxiety finding their issues exacerbated by bupropion. Really, you won't know unless you try it. However, an increase in your anxiety would not be unheard of. Re: adderall, I'm no doctor, but prescribing it just for energy and wakefulness might be inappropriate given it's potency and potential for abuse. It was prescribed to me off-label for depression, but it did not energize me or wake me up. It just made my thoughts busier.
  24. Get your pdoc's recommendation. FWIW, after maybe 6 months at 300, I tapered to 150 for a week and then quit (per my own pdocs instructions). No obvious side effects.
  25. No one on the forums can diagnose you. You might consult a mental health professional. Depression is identified via a medical diagnosis. The diagnostic criteria are listed in the DSM. They do include a persistent low mood. Your low mood and suicide ideation is real regardless of whether you are classified as clinically depressed or not. You can always try and take steps to help yourself regardless of your clinical status, and some of the techniques used in the various types of therapy are applicable to anyone. All that being said, the DSM is just an abstract line in a suite of symptoms that occur in shades of grey from person to person.
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