Epictetus

I was helped enormously by a book called "The Worry Cure." The author is Robert L. Leahy. I am not trying to give this guy free advertising since there may be many better or more helpful books out there. But this one helped me most. Anxiety is brutal. It has been a constant companion of mine since I was a little boy. I sure hope you find things that help you!!!

I really hope the medication helps. Wish I knew how to help. Seems like you are in a living nightmare right now. Will you keep leaning on us for support during these difficult times. You should not have to face all this stuff alone.

I'm so very, very sorry you are in that situation bbwolf! I think I would be having the same thoughts and feelings as you are if I was in your shoes. Since I suffer from panic disorder I think I would be going through constant rolling panics attacks. The worst kind of stress comes from the unknowable, unpredicatable, uncontrollable. How are doing right now?

I am sorry you are in this situation. Are you sure that you are the problem here? Nowadays a lot of people are very troubled and so are motivated by unhelpful subconscious forces. Because of that, a person can be really attractive and yet still get rejected. Relationship problems are very common in the world from inability to get a first date all the way to the inability to maintain a relationship even after 50 years of marriage, so I don't think you should blame yourself or want to end your life because of what is actually the failure of "problem people" who are unwilling or unable to be attracted by you. Have you discussed these issues with a licensed psychotherapist?

I am so sorry you are suffering. I wish I knew how to help but sadly I am at a loss. Here are some random thoughts that may [or may not] be helpful to you . . . Good and bad behavior forms a range of values. At one end of that range are the behaviors of people like Hitler and Stalin . . . people responsible for the destruction of tens of millions of human beings. I don't believe your actions have caused the destruction of tens of millions of men, women and children, or millions, or hundreds of thousands, or tens of thousands or thousands or hundreds so I think if you look at your situation with perspective you will see that you are far, far, far, far, far, far away from being a bad person. The human brain often has a mind of its own and drags us along with it. People sometimes forget that we are free and responsible human beings, but our freedom is not infinite. We have neither infinite knowledge, awareness or strength. So our freedom is limited. Things from our past can present obstacles not to our freedom but to the full exercise of our free will. Strange emotions like fear impede the full exercise of our freedom. And stress and mental illness have a profoundly limiting affect on our knowledge and freewill. So I think you should not be so hard on yourself about what happened and what is happening to you. I don't believe that you have willed the things you have willed with all your heart, mind, strength and spirit. Clearly you have been profoundly effected by circumstances. As knowledge, awareness and freedom are limited, so is responsibility. You are not totally responsible for the situation you describe. Others have played a part too. Your wife and her illness. Your internet friend. Unhappiness has weighed heavily upon you. And that is a potent impediment to full exercise of a person's free will. Do you think sessions with a psychotherapist might help you sort things out and help you to get some peace of mind and joy of living again? We tend to think that the things that pop into our mind need to be taken seriously and without question as though the thoughts came from an Infinite Being. But the truth is that our little 3 pound brain is generating these endless thought streams and it is up to us to try to step back from the stream and decide how much of it we are going to take seriously and how much of it we are going to ignore. The human brain is amazing. But it is not an all-knowing, all-seeing, all-powerful and all-perfect Infinite Being. Beating up one's brain from things doesn't really help. Our brain works 24/7 to keep us alive and healthy but sometimes in generates odd thought streams especially when it is suffering. Although the people here are sufferers of mental illness, none of us are medical professionals. We are not qualified to give advice that you or anyone could or should rely upon. But please feel free and welcome to lean on us so you are not all alone with your pain and distress. You are a good person in a terribly difficult situation. Hopefully we will be able to provide you understanding and compassion, encouragement and consolation. I apologize if my words have not been helpful to you. It is so very difficult to know what to say to someone in pain that will be helpful and not hurtful. Hopefully others here, others with more knowledge, experience and insight will see your post and respond to it with better and more helpful words than my poor words. My heart goes out to you!

Sometimes there isn't a vocabulary which is adequate to what we want to talk about. At least that has been my experience. From the East we know of a someone who saw things in terms of how suffering was caused by striving. That whole thing has been built up, deepened and expanded over the centuries. The ramifications of all this are endless. From the West we know of someone, who according to one philosopher turned conventional values on their head. In place of seeing people as blessed by success, wealth, power, aggressiveness, drive, striving, and contentment we got the idea that the really blessed people are lacking, are mourning instead of celebrating, are meek instead of pushy and aggressive and competitive, are failures and losers as world sees success. The "world" sees things quite differently. The lucky are those who are courageous not meek. The lucky are those who push, who get the better of others, who get the bigger piece of pie. The lucky are those who mock those who are compassionate and fair-minded as dopes and losers and nothings. Depressed people are often those who have lost things, who are marginalized, who don't "fit in." They are often people who don't stand up for themselves or who don't push to the front of the line or cut in ahead of others. But depressed people are often softened by their misfortune. They often grow big hearts. They often become heroic in values the "world" mocks and despises. There are a lot of people on these Forums who are people of dignity and stature in my book. It is no disgrace to be poor, in whether in possessions, in power, in influence, in strength and courage, in smarts, in competitiveness and aggression, in success. It is no disgrace to get the short end of the stick. It is no disgrace to be humble and meek. It is no disgrace to count our loses as gains if it makes us better human beings. So I think there is large body of literature from both East and West on how it is possible to learn to see values differently, to call into question "common sense." The perfectionism of "the world" is quite different from the perfectionism taught by the two I mentioned. Do I need to name them? Maybe we need to become good at things the world despises? What do you think? And maybe we are already becoming quite good at things that really matter.

I'm so sorry you are in that situation. I wish I knew what to say to help, but sadly I am pretty much at a loss. I always thought that friendship involved give and take so a friendship that is lopsided seems to me to be lacking in certain ways. And perhaps intolerably so! A psychiatrist once told me that depression at some point can involve pathology in the brain itself: reduced size, mass and density in certain regions of the brain, reduced regional cerebral blood flow and energy utilization [glucose metabolism], atrophy of brain cell architecture, loss of protective glial cells and so on. So he told me . . . , at some point it is almost impossible to judge the depth of a person's depression from just the losses or traumas that initially caused it. According to that psychiatrist, a person suffering small losses can sometimes enter a very deep depression while someone else suffering terrible trauma and loss might not have the same level of brain pathology and vice versa. This confused me. When I was hospitalized for depression, I saw a woman who according to others seemed to be someone who had it all and yet she was in a catatonic state. I shared a room at the psychiatric hospital with a fireman who had lost his mother, father, sister and his only son to an automobile accident. He seemed to recover from his terrible loss and trauma better than the catatonic woman so perhaps there is some truth to what the psychiatrist told me. I don't know. I could very well be wrong. I am often wrong about things! But whether he is right or wrong or partly so, it seems to me that a good friendship involves a healthy and mature give and take and it seems like you are doing a lot more giving than the friend you write about. So it seems that the friendship is causing you frustration, aggravation and suffering on top of the suffering you are experiencing from the terrible loss of your parents. I am so sorry for your loss! It would be helpful if your friend were to show more empathy for you during this season and in general. Since he is depressed himself, I don't know how much his lack of empathy is the result of ill-will and how much is the result of other causes including his depression itself. Empathy is sometimes one of the first things to go in depression in some people. I read somewhere that the difference between sadness and depression is that in depression, in addition to other losses, there is a loss of self-esteem. Loss of self-esteem, I read, is usually absent in sadness. When one is low on self-esteem it can sometimes happen that one is more prone to importing understanding and compassion than exporting it because one is operating from a deficit. One who hates himself or herself cannot easily love in a healthy way. This is just something I read. How much a brain illness can reduce full knowledge, awareness and freedom of choice is a question for moralists and ethical philosophers. I try not to judge people although I seem to always fail at it. It is heartbreaking that you are in the situation you describe. That is undeniable. I won't say I know how you feel since I am not in your shoes and would not want to trespass on the absolute uniqueness of your experience. But it does seem very heartbreaking to me as an outsider. There is a thread here on the Forums here called "How do you feel today?" It is a very active thread where members here post their thoughts and feelings and we each try to support one another. Perhaps that thread would be a place where you could meet people with kindly hearts and understanding minds. I am not saying that this would be a substitute for the understanding and compassion you deserve from your friend, but maybe it would be helpful to you in some way. I leaned on people here when my father passed away. And it did provide a refuge for me from the lack of understanding and compassion I was getting from others in my life. It can't be easy for you to bear the tremendous burdens you carry. Wish I knew how to lighten those burdens. I hope others here with bigger hearts and better minds will see your post and respond to it with more helpful words than my poor words. You deserve better than to be just a giver of compassion!

I'm so sorry you are burdened with mood swings. They can be brutal. Since I suffer from unipolar depression, I don't know much about bipolar so hopefully those with bipolar experience will see your post and respond to it with something helpful. There is a famous professor of psychiatry in the US who suffers from bipolar disorder. She has written books about the illness. Her name is Kay Redfield Jamison. I don't remember the names of all of her books. One is called "The Unquiet Mind." Another book, I think is called "Night Falls Fast." Since she teaches in the Psychiatry Department at John Hopkins University and also suffers from bipolar, I wonder if you might find her books helpful to you? Sorry that I don't know how to be helpful. My heart goes out to you.

I'm sorry you are suffering these feelings. I have felt similarly although our circumstances are different. I am often wrong about things, but I tend to think we are all "works in progress", and that it is possible to make little moves that often have inestimable value. I found these Forums when I was going through a deep depression and I decided to use my free time to try to help others going through similar unhappy situations. To be honest, I did not have much to offer in the way of wisdom. And I was kind of reduced to offering small things like empathy, compassion, encouragement, consolation and understanding. To my surprise I often got messages here from others; messages saying that my words helped them feel less isolated and alone with their distress. A couple of times, to my utter shock, people messaged me that they felt I had helped saved their lives. I am mobility limited and so the computer is my main connection to the outside world. But feeling that at any time, I can log on to this site and offer a little kindness gives my life meaning. What is that old saying? "Better to light a small candle than curse the darkness." There are people here who literally saved my life when I was in my darkest hour and I don't think there is anything greater than saving someone's life. I think that is the most noble and heroic thing a human being can accomplish. There is a place on this site called "How do you feel today?" It is an active thread. People read each others posts and offer a little kindness and encouragement. I don't know if this would help you. It helps me a lot. There is a homeless woman in my town who many would consider a complete failure in life. She lives day to day by begging money by street intersections. But she does something special. Whatever money she gets each day she puts a little in those little charity boxes at gas stations and convenience stores. Perhaps you've seen those little boxes: March of Dimes, American Red Cross, St. Jude's Children's Hospital and so on. I admire this lady. Her misfortunes in life have not triumphed over here. She transcends her difficulties and I imagine she has self-esteem issues when she compares herself to others. But heroism doesn't have to be some extraordinarily difficult feat. There are opportunities for heroism everywhere. There was a man named Oscar Schindler. He failed at so many things in his life: businesses, relationships, virtues. But at one point in his life he became a Holocaust Rescuer. He saved lives. And nowadays no one remembers him for his losses or failures or weaknesses. After the Second World War he was reduced to near poverty and lived by selling light bulbs door to door. But he is not remembered for this. You mention that you are the mother of an eleven year old daughter. That alone and all by itself shows me that you are a person of stature, nobility and heroism. There are few things in life requiring as much as motherhood does so please, if you can, try not to sell yourself short. There is a lot more to you than you think and I believe there are more chapters to be written in your life. Please forgive me if my words have not been helpful. It is so hard to know what to say to someone that will be helpful. Hopefully others here will see your post and respond with better words than my poor words. I am going to stop typing now since I have pain in my hands, but I want to tell you that I admire you and that I hope you will learn to admire yourself. You are worth it!

I am so very sorry you are so heavily burdened. Depression can be a cruel and brutal illness. Some* scientific research has linked depression to brain pathology: loss of mass and density [as much as 25%] in certain regions of the brain, cortical thinning, atrophy of brain dendrites, disrupted brain cell architecture seen even at the microscopic level, loss of protective glial cells in the brain. Real-time brain scans of people suffering from depression often show reduced regional blood flow in the brain and reduced energy utilization [glucose metabolism]. It is altogether a terrible, terrible illness. Depression does not discriminate in the victims it chooses. It even sometimes afflicts physicians, including psychologists and psychiatrists and medical researchers. Usually the human brain generates attitudes towards, people, things and events . . . attitudes such as "could be better but isn't better" or "could be worse but isn't worse." But for those afflicted with depression, the brain seems stuck in the "could be better, but isn't better" frame of mind. This tends to produce profound feelings of sadness, anger, dissatisfaction, frustration and hopelessness. The "could be worse, but isn't worse" attitude can be inaccessible during depression. People who seem to have everything can be depressed because they are stuck in the "could be better" frame of mind and don't even see that they are. At the same time, people in awful conditions, people from Third World countries who lack even the basic things we take for granted can have a "could be worse, but isn't worse" attitude which engenders in them feelings of gratitude, peace of mind and joy of living. They can have this boundless spark of happiness even in their dreadful misfortune. This seems to point to the fact that depression is not necessarily connected to the circumstances of a persons life or situation or to events in the person's life or world. Otherwise one would only see depression in those who struggle to even find a meal and fresh water each day. Yesterday I read an article on how winners of huge sums of money in the lottery often struggle or succumb to depression and self-harm of the worst kind. There are medications that have proven helpful to those suffering depression. There are many classes of antidepressants that work differently and many specific medications in each class. Some medications work well for some but not for others. And it can be a real trial to find the ones that help. The same goes for various types of psychotherapy. Perhaps you already well informed about these matters. I don't know. I came from a generally good background with "good enough" parenting. Yet I was stricken with long term depression for which at one time I was hospitalized and nearly catatonic. Everything seemed dark and senseless and hopeless. But I was helped. I was helped mostly by medication but also by a type of therapy. There is no shame in being afflicted with mental illness. Many of the greatest people in the world were so afflicted. Hopefully you are in the care of a kind physician who is trying to help you. All of us on these Forums have been stricken by mental illnesses. But none of us are physicians or medical professionals. We try to help each other. Sometimes it is only people who are going through the same or similar things who can really understand what a crushingly heavy burden mental illness is. So I hope you will lean on us in these Forums for moral support. There were no personal computers when I started my dark journey through hopelessness and a feeling of the meaninglessness of everything. I wish there had been such devices so there would have been Forums like this, where I could have met like minded people and thus been less isolated and alone with my misery and distress. I wish I knew how to help you. Hopefully others here with more knowledge, experience and insight will see your post and respond to it with better words than my poor words! All I can say is that my heart goes out to you. I see you in your struggle as a heroic individual and can only admire you for your endurance under terrible conditions. Best to you! Epictetus *All medical research is subject to limitations, such as size of study, objectivity of study, duration of study, confounding factors, new research and so on.

It has been many days since you posted this and I hope people with appropriate experience will see it soon and respond to you in kind and helpful ways. Although I have experience with Lexapro, I do not have experience with the combination you mention.

I wish I knew the answer but sadly I don't. A chemist in the UK or a Doctor of Pharmacy in the US would be able to give information like that. And a licensed physician could too. Sorry you are having to deal with the dry cough. Sounds awful!

Thank you for sharing this. It is quite helpful and will help many people who are members of these Forums or who follow the posts anonymously. You are very kind and I hope things will work out for you as you work with your prescribing physician. Wish I knew what else say. I do wish you the very best and want to welcome you to these Forums!

I can definitely identify with the things you write about although our lives are quite different as to the specifics. Wish I knew what to say that would help but sadly I am sort of in the same boat or at least a different boat in the same pond.

I'm so sorry you're having such a rough time. Wish I knew what to say to help!