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Everything posted by PoeticProse

  1. Hi Emme, The answers to those questions are not simple. First, your therapist's concern is due to the fact that most people who are diagnosed with alcohol use disorder, or people who struggle with alcohol, typically don't remain abstinent without support groups, but this is not true for everyone. It is a very complex issue that doesn't have a cure, otherwise people would not have this problem. It is common for people to think that a medication will solve the problem and forget to focus on the other important elements of treatment. Naltrexone doesn't prevent the physical act of drinking, it takes away the rewarding, pleasurable dopamine rush from drinking and counters its effects, so you lose interest in it. Upon discontinuation, the hope is that the desire to drink is gone. But the medication itself will be out of your system. Now, there is a small group of people who don't utilize support groups and remain drug-free, and this could be you. But that is a warranted concern on the part of your therapist, who has probably seen hundreds of people go back to drinking. As for naltrexone, there is statistically significant evidence of its efficacy (in short-term < 12 weeks) in reducing alcohol craving, lowering risk of relapse during treatment and at follow-up, reducing number of drinks, days of drinking, etc. compared to placebo. General follow-ups are at 6- and 12-month intervals for these types of studies. The biggest issue with naltrexone treatment in the literature seems to be adherence - many people stop taking it. When compared to AA, naltrexone acts more quickly on cravings but is not as promising in the long-term, which is likely due to the fact that AA is always available when someone has a craving, and focuses more on the act of drinking, rather than making alcohol undesirable. The main point is to manage expectations, and realize it is an excellent first-step treatment, not a cure; alcohol support groups almost always add to the effectiveness of this drug. As long as you are seeing a therapist, that could serve as a support system during your naltrexone treatment, which is likely to do wonders for your cravings. It is also likely that its effects will last, not because it will still be in your system, but because you will be accustomed to abstaining. With a relapse, though, you will get the thrill and buzz again, because you will no longer be taking the medication. In the long-term, support networks are clinically the main difference between those who relapse and those who do not. But there are always exceptions. I am glad to hear that the naltrexone is proving itself for you, and hope that it will help with the desire to drink in the future. Stay strong, and be sure to keep us posted on your progress!
  2. I guess that doesn't surprise me. Psychiatrists aren't trained in in-depth assessment, though there are plenty out there who would just prescribe medication anyway. Psychotherapy is far more effective than people think, and that depends a lot on where you live. Psychotherapies are types of talk therapy, some of which don't have as much to do with talking as they do with confrontation. Many do not approach past experiences, childhood, or any of the stuff seen on television. Often times, it is about the present and learning how to live in the present. In combination with medication, it's proven to be more effective than medication-alone, across the board; in comparison with medication, its effects maintain remission for longer upon treatment discontinuation - but its effects are not as quick as they are with medication (at least not for most, depending on how you respond to medication). Now the literature I'm referring to is with doctoral-level clinical psychologists, who have expertise in evidence-based therapy and assessment. Some of the less trained therapists and counselors, though not all, offer a generalized talk therapy that is so varied in presentation that it would be difficult to study its effects empirically. If you say different things with different patients, how can you say that one type of therapy is effective? Evidence-based psychotherapies stick with the same process, with the same goals and phases, and often the same phrases and reflections, for every client. The processes are objectified so as to allow for measuring results scientifically. For PTSD treatment, EMDR and CBT are proven quite effective. Depression can be helped through CBT, as well as some others depending on the specific symptoms of the patient. Another added benefit to seeking out these specific people is that you will discuss your treatment plan, the type of therapy you will receive, why the psychologist has chosen it, and what to expect over the duration of treatment. If you're wanting to stay away from medications, this is the only other professional treatment with statistically significant evidence of its efficacy. Just be sure to find someone with the right credentials and who makes you feel comfortable. If you go in for an assessment, he/she will either take you on as a patient if he/she specializes in the therapy you need, or will refer you out to someone else, and a psychiatrist if you need medication. Good luck! Be sure to keep us posted on your progress!
  3. Hi looking for something, and welcome to DF! This is a wonderful community to share experiences and learn from others. I hope you find what you're looking for, and look forward to hearing more from you!
  4. Hi there, Do you still think you meet the criteria for PTSD over the last five years, or have you mostly overcome those symptoms - at least prior to giving birth, and this episode? I wouldn't be surprised if your doctor re-evaluates that diagnosis at some point. Fortunately, psychiatry generally treats symptoms, not a particular label. Because of the pharmacodynamics of certain medications, antidepressants can treat depressive disorders as well as depression associated with other disorders; anxiolytics can treat anxiety related to depression and other disorders. So if your doctor thinks you meet the criteria of both PTSD and postpartum depression, or is unsure which is the major culprit, you can still receive treatment that will work. For example, Prozac, Zoloft, and Effexor (SSRI antidepressants) are the typically the first line of defense for PTSD treatment . As for psychotherapy, if that interests you, that's another story. Psychotherapy proven to help with PTSD, such as EMDR, may not work for all people with depressive disorders. I'm sure you and your doctor will be able to work on an effective treatment that focuses on your specific symptoms. There are certain diagnoses that can be problematic if wrong, such as depression and bipolar - treatment with an antidepressant alone can cause a manic episode in the latter. But in this case, don't get too wrapped up in the label. Everything will work out, so stay positive. Keep us posted!
  5. Hi Autolx, and welcome to DF! I'm sorry to hear this - it is clearly tearing you apart to see her this way. Of course, it is not your fault. You may have been the target of many accusations and harsh words, but that's because you are very close to her physically and emotionally. No one is to blame for mental illness, unless you want to blame genetics, life experiences, and the brain. There is not always a triggering event or a sign of an approaching psychotic episode. The best thing to do is receive treatment as soon as issues arise, and to prevent future occurrences; unfortunately, it doesn't sound like she was following through with her treatment. You are certainly struggling as well, as being in your position would take a toll on anyone. I'm sure you're therapist will explain the same thing. I really hope you get to feeling better, and that you come to realize that you are not to blame for any of this. In fact, you saved her life by getting her to the hospital. You were thrown into a very serious and frightening situation, and you handled it better than most people would. Stay strong, and be sure to keep us posted!
  6. Outpatient simply means that you go to therapy at a certain time and then go home. It's the opposite of an inpatient unit, where you stay during treatment. The other details of the actual sessions depends on the specific program. But DBT is very effective.
  7. Hi there, Your doctor is correct about the effects. Even on your previous medications (SSRIs), you shouldn't binge drink with them for the same general reason. Pristiq is an SNRI and has greater effects on the liver. Some doctors will just assume people will abide by the rules listed on the prescription, while others will be sure to remind the patient (like yours did). As far as religion, any professional is trained to be objective and unbiased, so she would not be pushing her beliefs on to you. She is ensuring the safety of her patient. Now, you are not the first person to mix alcohol with antidepressants, and you will not be the last. Some experience few side effects and others end up in the hospital. But there are definitely serious risks involved, particularly when starting a medication. Alcohol, as I'm sure you know, is a depressant. So it works against an antidepressant - it's simple pharmacodynamics. If you are to give Pristiq a try, and determine if it will work for you, it might be best to slow the drinking down until your symptoms are improving. Antidepressants take time, and not every medication will prove effective for a given individual. The more alcohol you drink while starting it, the longer it'll take to notice improvement - if you improve at all. It is a choice that is obviously yours to take. It is a matter of how important treating the illness is to you, and whether alcohol is worth the risks that come with its use. Whatever you decide, be sure to keep your doctor apprised. You can't be treated adequately if she is not informed of your circumstances. Good luck!
  8. Hi Dolphin, I'm sorry to hear about your history with depression, but glad that you're taking this tremendous step and venturing out of the room. I think it will do you a world of good. I look forward to hearing more from you!
  9. Hi myako, I'm sorry this has been happening to you - it sounds like a very difficult life circumstance. The unfortunate reality is that you need to see a doctor in order to know what is wrong with your body. If WebMD was enough to diagnose and treat illness, we wouldn't need doctors. Each person has a unique medical and psychosocial history, and these make a difference in diagnosis and treatment. These symptoms you describe would take a tremendous toll on anyone, and they are clearly affecting your life in countless ways. You deserve to be happy and healthy, but it is up to you to take the first step. Denying yourself treatment for what could very well be a treatable, somatic disorder is unnecessary. The opinions of others are trivial in comparison to medical conditions, and no one should ever prevent you from taking care of yourself. I really hope you give yourself a chance, and make an appointment with a doctor. Things can and will get better, whether you believe it or not, with adequate treatment and self-care. I wish you the best of luck. Please keep us posted!
  10. Hi Angie, I'm so sorry to hear that - panic attacks can be extremely frustrating, and the problems only worsen when it affects your sleep. It's possible because panic disorder, or attacks in general, occurs in the brain like other disorders. One of the main emotion regions of the brain is hyperactive, and being asleep does not change this. I've experienced this in the past, more times than I can remember, and have talked to a lot of people who struggle with it. At times, it becomes a combination of panic and severe anger because of sleep deprivation. Another problem is that it is quite easy for the brain to associate certain situations with a fear reaction, and you don't want to spend each night worrying about an attack. I strongly recommend seeing a doctor, preferably a psychiatrist, if you currently are not. He/she will be able to review your situation and determine if there are other symptoms besides the panic attacks. But at minimum, you could be given an anxiolytic for bedtime/prn use for panic attacks. This will allow you to catch up on sleep without worry, and then you can focus more on what might be contributing to these. I hope this helps. Good luck, and keep us posted!
  11. More than likely, yes. You're nearing the end of that phase. If it becomes too much to handle, you should inform your doctor.
  12. Oh man, that can raise Celexa in the blood to toxic levels, right? You live and you learn. I'm glad you're set with the new dosage. Hopefully it works out for you!
  13. It is activating because of its chemical structure, but there are people who experience a paradoxical sedating effect. Now, by that I mean that it often boosts energy, which can cause one to feel jittery or restless. Sedating would be more of a slower, calm feeling. Sorry to hear about the appointment - it's unfortunate that it takes so long to see doctors, and totally counterproductive with psychiatric medications. I would just explain symptoms and concerns to the nurse and let him/her talk to the doctor and get some answers. If you are clear and thorough, maybe they will fit you in earlier. I suggest writing down your questions and thoughts in advance, narrowing them down to be very concise, then talk to the nurse. We often forget important details when under pressure. Keep us posted!
  14. Hi there, I will say that most people depression, at one point or another, worry about the same things. But with depression, it is not a matter of self-control or willpower, but of causes beyond your control. It is best to discuss your symptoms and concerns with a doctor who can review your medical and psychosocial history before drawing a conclusion. Depressed mood most of the time is only one criterion of the diagnosis, but loss of pleasure is a very important one. Then there are a variety of other criteria, and mood swings or moments of clarity are common with depressive disorders. Therapy is always a good option as well, so you can ask the doctor about that. At the end of the day, it's better to get a professional opinion than allow a potential illness to run its course. I wish you the very best of luck, and hope that you keep us posted!
  15. I feel the need to watch an episode of Impractical Jokers.
  16. Check this one out: Incognito by David Eagleman
  17. Hi dawn, Effexor is an activating antidepressant, although some people experience it as sedating at low doses. This could potentially affect sleep, at least until your body becomes accustomed to the current dosage. As for drawing a solid conclusion on its recent efficacy, it would be quite difficult to do so with any significant degree of certainty due to all the variables at play. Maybe discuss with your doctor and consider waiting another week or two to let life slow down, which would allow you to focus on the effects of the medication. You clearly know the issues with alcohol use with antidepressants, mainly that it counters the effects. Then the rebound anxiety can seem much worse the following day. But you're not the only person to do this, and you won't be the last. But it would definitely help to abstain at least so you can see the effects of your medication. I hope this helps a little. Good luck tomorrow, and be sure to keep us posted!
  18. “So, this is my life. And I want you to know that I am both happy and sad and I’m still trying to figure out how that could be." - Stephen Chbosky, Perks of Being a Wallflower, 1999
  19. Bipolar is a difficult diagnosis, so a doctor who can look at your medical and psychosocial history would be the most accurate. There is rapid-cycling that would consist of short episodes back and forth, but the average episode duration in bipolar is 10-13 weeks. In those who do develop rapid-cycling, it usually is not permanent. It is true, though, that rapid-cycling can occur after stressful events (kindling) and due to hormone issues like hypothyroidism. But there are a variety of factors that can cause these types of mood swings, including depression, postpartum, and hormonal imbalances, which is what your doctor is talking about. The thing about bipolar is this: mania is very intense, not just a happy, elevated mood or moment of clarity. A manic episode is an extremely euphoric state consisting of grandiosity, staying awake for days, excessive energy, recklessness, over-spending, rapid speech, and impulsive behavior. Hypomania is generally the same symptoms but less intense. In short, I'm sure your doctor will take all possibilities into account. If he/she still disagrees with bipolar, it's because you don't seem to be experiencing manic/hypomanic episodes. Mood swings between happy and sad are common in depressive disorders. Keep your head up! As long as you stick with treatment and be open and thorough with your doctor, I'm sure you will start feeling like yourself again.
  20. Hi kc, and welcome to DF! I'm sorry to hear you're feeling so poorly, but glad you have a scheduled appointment coming up. What do you mean by "bi polar type depression"? What do those symptoms feel like on an average day?
  21. Hello again, It is unfortunate that some people don't understand the science behind depression, but that doesn't make the illness any less real. If they saw the brain scans, they would be more likely to understand. At least 10% of people are being treated for it, and many more are being treated for other neuropsychiatric illnesses. I do think it is worth the investment, whatever the case, just to get an opinion. As far as medication, if the doctor were to recommend it, that is obviously up to you. I will say that denying yourself treatment for depression is equivalent to refusing treatment for Alzheimer's and other incurable, progressive diseases. But again, that is your decision to make. Just as a background (it's always good to be informed), antidepressants are not happy pills, nor do they make you artificially happy. This is because of their pharmacodynamics. What they do is get rid of the depressive symptoms. Getting better is the absence of symptoms, not an addition of fake happiness. Also, they work slowly over a few weeks and you never truly feel yourself getting better in most cases; it's a gradual decrease in depression, and one day you just don't feel depressed or uninterested anymore. That's my take. Whatever you decide, I hope you get feeling better. Even if you don't want to be "happy," it would still be a load off your mind to not have the negative symptoms. Keep your head up!
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