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About MichaelBlue

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  1. I hope you had a fantastic day :)

  2. I agree with Trace on this. Before going on meds for my depression, I tried plenty of "natural" supplements, including SaMe. It didn't do the trick at all. And I'd be wary of mixing it with the bupropion, since SaMe can be activating just like bupropion is. For what it's worth, I was put on Lex and Wellbutrin and it worked wonders for me -- as one balances out the other very well. Eventually I went generic, due to insurance coverage -- and have now long been taking generic celexa and generic wellbutrin (the former at bedtime, the latter during the day). The transition was virtually seamless, and it's a great combo for many, many people. A little off-point, here............The thing to always keep in mind is that these meds can take 1-2 months to truly kick in for people. Every hour on depression feels like 24 hours, I know. Believe me, I know. But if there was ever a time in a person's life to have patience, this is the time. One needs to muster up ALL their resources and resolve to have that patience.
  3. Hi Safety: On the one hand, upping the dose suddenly can magnify the start-up anxiety, but on the plus side, you may get to that place you need to be much sooner. To use an analogy, it's like walking up a flight of steep stairs a grueling step at a time, or having a crane terrifyingly hoist you up with a rope. I know that's small comfort right now, as every minute feels like an hour, and every hour feels like a day when you are severely depressed. A year ago, I was in that place, too. The 40mg of citalopram (generic celexa) I take has worked wonders for me. I take it all at bedtime, as it can make me drowsy. And in the mornings and afternoons, I take some generic wellbutrin, which is more activating. I feel very balanced now. Have you considered asking your pdoc about combining -- perhaps at some stage? Whatever you do, you should follow your pdoc's direction. The anxiety was unbearable for me during those initial weeks, as was the joyless mental stupor I was in. I now believe it was all chemical. It took a good six weeks on the med for things to really start getting better. You'll get there, just you wait and see. MB
  4. Hi everyone: I haven't been here in a long time, but I want to tip my hat as well to Hopeful One. We both went through a similar passage last fall/winter, when we helped hold each other up. And I will always be grateful for her for being there. This forum kept me from being totally alone, and the meds (i.e. Lex) eventually took me entirely out of the depression after about 4 months on them. The hardest thing is to have to wait, hour after horrendous hour, in the hope that the medicine will do its job and you really will get better. Nothing was harder for me, except perhaps NOT being on that road. You WILL get there, too. Have courage, have patience, believe and trust in yourself, try very hard (as impossible as that sometimes seems) to like and love yourself right now. Time is on your side. With warm regards, Michael
  5. I think wellbutrin is excellent and, as Burgy said, combines very well with an ssri. Good luck!
  6. Hi everyone. I've been away, but it's nice to return and see the thread still active. I'll be doing some more posting over the next week. Just a few quick responses to some recent posts: GREG: I, too, was concerned about wellbutrin stoking my anxiety when my Pdoc added it to my Lexapro. But when I researched it, I found that most people seem NOT to suffer from increased anxiety from bupropion (wellbutrin). In fact, it appears the opposite is true. The following excerpt is from a leading psychopharmacology text: "Perhaps because of the chemical similarities between bupropion and psychostimulants, there is a common clinical belief that anxiety levels will not be improved with bupropion treatment and may even get worse. Most studies that have examined the effect of bupropion on anxiety in patients, however, have found either no change relative to placebo (Croft et al. 1999) or modest improvement on both self-and clinician-report measures (Zung et al, 1983). Studies in depressed individuals comparing bupropion with SSRIs have found comparable reductions in anxiety (Feighner et al 1991, Trivedi et al, 2001)." ---------ESSENTIALS OF CLINICAL PSYCHOPHARMACOLOGY- edited by Alan F. Schatzberg, MD, and Charles B. Nemeroff, MD (2001) I have to say that the Lex/Wellbutrin combo has been very good for me. And the wellbutrin did NOT add to my anxiety. Moreover, once the depression became managed, the anxiety disappeared (as they are often linked). I say all this with the obvious caveat that we're all different. ANDY13: Sorry to hear of your troubles. The brain-gut nexis is critical, and the more you study it the more fascinating it is. For example, more serotonin is produced in the gut than the brain. Serotonin excites nerves in the gut, and those nerves then trigger reflexes that signal the brain. A few years ago, a team at Columbia University created a breed of mice with irritable bowel syndrome. And they later discovered that these mice also lacked serotonin transporters in the brain. It's all linked -- far more than we understand today. Treat the depression and the bowel problems may resolve themselves -- and/or vice-versa! GREG: I have discovered that when I'm suffering from depression, I am convinced that I made poor choices about everything (including work, where I live, etc), but when I successfully treat the depression, those feelings pretty much vanish. I realize we're all different and that you may regret choosing dentistry regardless of the state of your own mental health, but have you ever noticed a similar link? Also, have you ever considered making dentistry work for YOU, in terms of shaping that career differently. For example, by taking a month away every year to treat people in an undeveloped country? That could be very fulfilling, and exotic. Or maybe by specializing in just one aspect of dentistry that you DO love? That said, we only have one life. If 100% of dentistry is now wrong for you....As scary and difficult as it may be to change careers entirely, it may be even scarier and more difficult NOT to (which may be what you are actually discovering physically and mentally). Hope none of that comes across as presumptuous (after all, we barely know one another!). HSJB: Kind regards and many thanks! Warm greetings all! MB
  7. Me, too -- WITH A BELATED HAPPY BIRTHDAY WISH TO WAYNE!! (and thanks for being there with early support for me when I first joined here). WARMEST WISHES!!!!!!!!!!!!!! -Michael
  8. Hi all: I've been away, but it's so good to return to so much illuminating activity on this thread! GREG: I've had 3 major depressions in my life. I don't recall any considerable anxiety during the first two, but most certainly did have it on the third one. It's my understanding from all I've read that -- while all cases are different -- they often go hand-in-hand, and that once the depression is dealt with, the anxiety typically evaporates, too. OBIWAN: Thank you SO MUCH for your note. Just hearing how much my first post helped you made it so worthwhile for me to have taken the time. When I was in the depths of my last depression a few months ago, I couldn't have written it. So hang in there -- you will get through your rough patch, too. BUBBA, HOPEFULONE, DOUG, BEARSTRAIL, NUIT: Excellent discussions about whether men blame themselves or others (versus women) for their depressions. Generalizing here about the sexes can certainly be a land mine, but I think HOPEFULONE (a female) made a great point about how men experience self-loathing and women can just as easily blame outside forces/abuse/people for their pain. I'm not aware of any studies probing this differential, but that doesn't mean there shouldn't be some! As for me, I have never blamed an outside force for my depressions, other than a biological/genetic inclination that I need to watch out for (and that I clearly had no choice about). But even with a rough upbringing to boot, I have NEVER been able to seriously link it -- or other environmental factors -- to my later depressions. And I'm wondering if perhaps that is due to how I was raised as a male in our culture -- the 100% self-reliant, rugged-individualistic, blame-nobody mode of thinking. Very interesting stuff here!! I could have been physically beaten and whipped as a child (I wasn't!) and I have a feeling that I still wouldn't be able to say to myself that this could be a reason for my later depressions. Wow. GREG: I like Martin Kantor's work because he is provacative and makes me question things from a different angle. But I'm not sure I totally buy that idea that "depressed men who complain that people abandon them have often in fact driven these people away." I mean, of course that's true in many cases, just as it's not true in many cases. But I'm not sure I see a real difference between depressed men and women in terms of "driving" others away. True, depressed men may do it in a more passive-aggressive manner, just as many depressed women might drive others away by perhaps being less subtle. No?? (Eeeyk...then again, this is all WAY too much stereotyping for my taste.) BEAR'STRAIL: I agree with others who have said that Welly and Lex are a great combo -- and I currently take both. PERKY: Why do you conclude that your 'Save the World' activities mean that you no longer know what you need for yourself? You clearly were engaged in it because you needed it, no? And maybe now you're just morphing into a new stage of life that is still fuzzy and thus painful (but can also be exciting as it emerges). At any rate, you might especially enjoy the Elaine Aron book I recommended on various threads ("The Highly-Sensitive Person: How To Thrive When the World Overwhelms You"). It might make you feel a whole lot better about who you are (or were) and perhaps what your role on the planet MAY be (or was). At the very least, her theory is great food for the brain. Regards, all.
  9. Nuit- I'd like to hear more about your experiences with the 'compassionate interpersonal therapy' you're getting. I tried traditional psychoanalysis years ago, and cognitive therapy more recently. Both have been valuable, but both left me hungering for something more -- but I can't quite put my finger on what. Daisho: Glad you ordered that book ('The Mindful Way Through Depression'). Let us know what you think after reading it. As to your great question, I think I'd have to say that depression has NOT lessened my goals, but it has been making me approach them differently, in terms of starting to recognize that perfectionism is not my friend. It fuels tremendous stress, which can lead to my unraveling. So I think I'm definitely continuing to reach for the same goals with the same overall energy -- but lowering my perfectionism/ mental self-mutilation, as well as my expectations if I don't achieve all of them. Does that make any sense? I actually think my depressions have made me a better, smarter and more compassionate person (not that I ever want to suffer another one again!). Each depression has been a growth spurt. (Heck, might as well get some positive growth as long as you gotta suffer so much!) Your question made me think a lot about that Harvard professor, Dr. Tal Ben-Shahar, whose course on Happiness is the most popular class now at the university (even more than introductory economics!). The reason it's so popular is because stress/depression levels are at epidemic levels. Ben-Shahar says depression levels are 10x higher today than in 1960. And, even worse, the mean age for depression is 14.5, versus 29.5 in 1960. In his view, as material wealth wordwide has risen, so have depression levels -- and he believes they are linked. One of his popular books is called "Happier: Finding Meaning, Pleasure and the Ultimate Currency." And he's coming out with a new book this year called "The Permission to be Human." Those titles sound like the usual psychobabble and self-help poppycock, but I think Ben-Shahar has got some great ideas -- some of which we know but tend to forget/ignore/repress on a daily basis. Among them: 1. "We are constantly bombarded with perfection. Adonis on the cover of Men’sHealth and Helen on the cover of Vogue; women and men getting together on the larger-than-life screen, resolving conflicts in two hours or less, delivering perfect lines, making perfect love. Parents and teachers exalt the flawless ‘A’; college admission officers expect resumes without end. We’ve all heard our self-help Gurus tell us that there is no limit to our potential, that what we can believe we can achieve, that where there’s a will there’s a way. We’ve been told that we can find bliss if only we follow the road not taken, or the road taken by our serene spiritual leader—the one with the best smile on the cover of the New York Times best seller. Who among us has not, at times, allowed an awareness of our shortcomings to overshadow our triumphs and achievements? The antidote to perfectionism is acceptance. When we do not accept our flaws, we focus on them constantly—we magnify them and deny ourselves the silent satisfaction of serenity. Imagine spending a year in school—reading and writing and learning—without concern for the report card at the end of the ride. Or being in a relationship without the need to mask imperfections. Or getting up in the morning and embracing the man, or woman, in the mirror." 2. "Give yourself permission to be human...When we accept emotions - such as fear, sadness, or anxiety - as natural, we are more likely to overcome them...Our emotions are more likely to control us, to deprive us of choice, when we resist them -- we create a schism between mind and body. Paradoxically, when we fully recognize the existence of our emotions and allow ourselves to experience our dis-ease, our emotions either disappear or weaken to the point of being manageable...An internal battle rages between our feelings and our thoughts—our thoughts refusing to grant these feelings the permission to exist. This inner conflict weakens and enervates us." 3. "Simplify!... We are, generally, too busy, trying to squeeze in more and more activities into less and less time. Quantity influences quality, and we compromise on our happiness by trying to do too much." 4. "Refusing to accept reality for what it is initiates a vicious cycle.... We are creatures of feeling and reason—once we feel a certain way we have the need to find a reason for our feeling....Any attempt to suppress innate feelings lead to their intensification—sometimes to the point of obsession and loss of control...Refusing to accept/feel an emotion is like refusing to accept the law of gravity because I don’t like the fact that I cannot fly. We have no choice about the existence of the law of gravity, it simply is." 5. “In our time, depression is on the rise...More and more students experience stress, anxiety, unhappiness. Until a few years ago, we didn’t have e-mail; now, students check their e-mail 20 times a day. Students work longer hours and are having to build up their r
  10. Daisho: That is truly a great question you tossed out for everyone here. And great responses. I'm going to have to dwell on it more tonight and respond tomorrow! I certainly have some thoughts on it. Greg: Sounds like it could be a form of rebellion, especially given his age (15). He's also going through a lot of physical changes. Is he drinking, smoking or using recreational drugs? How's his diet?
  11. Hi Croser- Like HopefulOne, I had start-up anxiety with Lex that lasted a few weeks -- it was really upsetting to me -- but it's different for everyone. It went away as the body/brain adjusted to the Lex. I'm now on 20mg taken at bedtime, which seems to work fine. After two months, I added Wellbutrin in the mornings, which really helps a lot with energy. (Lex can be sedating, while WB is often activating. But, again, everyone is different. Lex could turn out to be activating for you.) And, yes, be real careful if you opt for Ambien (technically called a 'hypnotic,' like Sonata) or any of the benzos (clonazepam, Valium, Ativan, etc), which are known technically as 'tranquilizers.' Both of these families of drugs work similarly on the brain. And studies show that most people start seeing signs of tolerance/addiction after just a few weeks, as well as memory problems. Also, the reasons these medicines (benzos, as well as Ambien and its ilk) can cause or aggravate depression is that they are 'central nervous system depressants.' Specifically, they work to enhance GABA, a neurotransmitter whose role is to send 'inhibitory' messages from one brain cell to another. What scientists suspect they are doing (it's still not entirely certain) is this: In some way, directly or indirectly, these meds are telling the neurons to slow down or stop firing (which quiets down the brain). This is done electrically in a way that 'supercharges' the neuron. But it also makes the neuron LESS RESPONSIVE to other neurotransmitters that would normally excite it. Result: The brain's output of the excitatory neurotransmitters (i.e. serotonin, noradrenaline, dopamine, etc) are reduced! And you know what happens when those things get reduced, right? DEPRESSION! That's why you really have to use those meds sparingly! When starting on Lex, I held off a long time before taking a little clonazepam for the anxiety, because of the risk of aggravating depression. That said, I'm really glad I finally took some (!) for a few weeks (okay, one month- I admit it). But I'm equally glad I stopped. If you do go that route, here's my two cents: Go with clonazepam. Its half-life is much, much less than valium (meaning it exits the body sooner). And while its half-life is longer than xanax, I think the consensus among docs is that it's less addictive than xanax. You asked about trazodone and remeron. These are antidepressants, and so there's no evidence of the risks that the benzos and hypnotics have (memory loss, addiction, etc). But since both tend to be very sedating, they can help a lot with sleep and anxiety. All that said, here's an idea you might want to at least consider: Just following the body's lead in terms of sleep. Worst-case scenario: You go to work on just an hour or two of sleep, but so what? Then you'll be good and tired when you get home and can naturally sleep again. I know it's easier said than done, but it's always seemed to me that people (myself included!!) worry too much about getting a good night's sleep EVERY SINGLE night -- as if some horrible tragedy will unfold if they just follow the body's lead and sleep when their body is ready to. And it WILL eventually be ready to, much sooner than you think! Hang in there!!! Cheers.
  12. Molehill, even the recent research from that study shows that, in the severely depressed, the response rate to ADs is significantly higher than placebo. And Dr. James Potash of Johns Hopkins School of Medicine just wrote a column yesterday on ABC News (you can get it online) that says ADs might still work for the mild-to-moderately depressed. SHAME on so many of the media outlets that are distorting the data!
  13. I was about to lay out Harvard's Dr. Peter Kramer's take on all this, but I will resist. I already laid it out in the thread that Wayne here just posted a link to -- so have a look if you're interested. Bottom line: Kramer has dissected all this supposedly "new" research and says it's not new at all. And that antidepressants DO work. Also, just yesterday, Dr. James Potash of the Mood Disorders Program at Johns Hopkins University posted his 'Report Card' on antidepressants at ABC News, which is easy to find online. Again, bottom line: ADs show a significant advantage over placebos for severe depression and MAY STILL work for mild-to-moderate depression. Cheers.
  14. The data from the recent studies is not the problem -- it's how many in the media are spinning it that will do the most harm. And, Helly, I agree that it will hurt the most vulnerable people -- especially those who will be scared off to trying ADs. ABC News carried an excellent column yesterday by Dr. James Potash of the Johns Hopkins' Mood Disorders Program. Folks can easily find it online (it's called 'The Report Card on Antidepressants.') The bottom line: Antidepressants showed a significant advantage over placebos for the severely depressed patients but not for the mildly and moderately depressed patients. And there STILL MIGHT BE some advantage to antidepressants even for mild and moderate depression. Similarly, I'd strongly encourage people to read Harvard's Dr. Peter Kramer's column in Slate in late January called 'Sunny Side Up: Screw-ups over unpublished data or no, antidepressants still work.' Again, it's easy to find online. Sadly, many vulnerable people may make the wrong decisions without reading such columns.
  15. Hi All: Glad to see the thread strolling right along in my absence! Thanks, Burgy! Great point about brain neurogenesis, as there has been a universe of science in recent years on how ADs and therapy help create new cellular-related growth. And I have no doubt, as you found for yourself, that the meds were necessary for treating my severe depression before I could gain ANYTHING from therapy (other than hand-holding to help me remember that I'll eventually get better). Once the ADs started to kick in, the negative thoughts started evaporating. And only then could I make therapeutic gains. I couldn’t put it better than Burgy did when he writes: "All the negative feelings about depression are caused by depression. The disease has a morbid strategy of self-preservation, a way of sucking the life out of you and causing debilitating guilt and hopelessness, making it very difficult to seek help. Please try to see the disease for what it is, and use every resource available to treat it." In fact, I’m totally in awe of how depression transforms you into a self-loathing, fearful, negative-thinking, hopeless person – and NOT the other way around! That’s my two cents, anyway. PITTGUY: Sounds like you're in good hands at the Univ med center. Lamictal, btw, is not just prescribed for bipolar, but also for hard-to-treat non-bipolar depressions (often in combination with SSRIs). You probably know that, of course. To me that seems to back the ever-widening ‘bipolar spectrum’ theory of depression. Whatever the diagnosis, what matters is getting you on the right meds that work for YOU. Any progress on that front? GREG: Thanks for the Star*D update. I had actually posted info a month ago from the November 2007 phase of Star*D, which concluded that perseverance pays off (i.e. trying different meds or combining them) for most depressed people. Interesting to see the latest results about anxiety. Speaking only for myself, I found that my last depression was severe AND (for the first time ever) accompanied by high anxiety. But the meds are treating both problems successfully. Would love to see more such studies done, and maybe Star*D will now spark them. Also, real sorry to hear about your son. Sounds like he may be suffering from depression or another illness, no? Is he in therapy at all? It's obviously tearing you apart, as his experience is so opposite to yours and your wife's. Could that very fact be contributing as well (psychologically, even unconsciously) to how he is acting? I shouldn't be an armchair shrink, but it's just a half-baked thought based on what you wrote.
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