Depression

Well after 2 weeks I finally realized I wasn't taking my prescribed dose of the Effexor XR. Pharmacy gave it in 2 bottles, one 75mg and one 150mg and I didn't notice the 150mg and was thinking it was a second month's worth. Now after taking the full dosage of 225mg I'm starting to feel less depressed. Next thing is getting my ADHD sorted. I used to be anti-drug but nowadays I feel like the science is so strong and the need for meds is a real issue, like Caddy said, disabled people may need a ramp or wheelchair and it's no different for mental health sufferers. Not sure why I'm writing this, just happy to be able to feel better getting out of bed today! Hope you're all having a wonderful day.

Man, there is no living person (except kids) who never got depressed.
But IMO meds have just a temporary effect. Go longterm. Trash all gadgets and electronics then find someone to love.

I have used several different antidepressants -paroxetinre nefazodone, citalopram, and now venlafaxine (Efexor). Response to these type if drugs may vary from person to person. For instance, citalopram was for a long time well received, but I didn't like it, everything turned flat and grey, much more than the other drugs. Efexor OTOH is the drug that has been most efficient for me. It's especially good at combatting inactivity - I don't get as passive a I used to after switching to that one.

I've had very few problems with Efexor, just the occasional feeling of unwellness and the infamous "brain zaps" in the evening, when I forgot taking my medicine i the morning. Brain zaps are commonly described as a feeling of electrical sparks/shivers shooting through your brain, often provoked by moving your eyes. They're not painful, and in no way dangerous, but they are unpleasant.

75 mg is a very low dose, I think 225 mg, like I'm using is the most common dosage. When did you go from 75 to 225 mg?

It's great that you are improving.

pibbur

PS. If you as described discover in the evening that you forgot your morning duties, don't take a full dose - too close to your next normal dose, 75 mg willl be enough. DS

PPS. One more thing, but I guess your doctor told you, you should continue using the drugs for at least 6 months after recovery. And when stopping, do it slowly with decreasing doses over a period of around 4 weeks. DS

It's cool having a former Doctor in these threads.

TheRealFluent said:

Not sure why I'm writing this, just happy to be able to feel better getting out of bed today! Hope you're all having a wonderful day.

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Doing a daily inventory of all the little positive things you're thankful for have helped me get through hard times (and can be as strong as medication). Hard to do at first, but long term practice makes it an easier habit. Like working a muscle.

Always glad to hear a fellow Watcher is feeling better. Way to go Fluent!

pibbur who said:

I have used several different antidepressants -paroxetinre nefazodone, citalopram, and now venlafaxine (Efexor). Response to these type if drugs may vary from person to person. For instance, citalopram was for a long time well received, but I didn't like it, everything turned flat and grey, much more than the other drugs. Efexor OTOH is the drug that has been most efficient for me. It's especially good at combatting inactivity - I don't get as passive a I used to after switching to that one.

I've had very few problems with Efexor, just the occasional feeling of unwellness and the infamous "brain zaps" in the evening, when I forgot taking my medicine i the morning. Brain zaps are commonly described as a feeling of electrical sparks/shivers shooting through your brain, often provoked by moving your eyes. They're not painful, and in no way dangerous, but they are unpleasant.

75 mg is a very low dose, I think 225 mg, like I'm using is the most common dosage. When did you go from 75 to 225 mg?

It's great that you are improving.

pibbur

PS. If you as described discover in the evening that you forgot your morning duties, don't take a full dose - too close to your next normal dose, 75 mg willl be enough. DS

PPS. One more thing, but I guess your doctor told you, you should continue using the drugs for at least 6 months after recovery. And when stopping, do it slowly with decreasing doses over a period of around 4 weeks. DS

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I thought they were lifetime drugs, I didn't know I'd be getting off them. The anti-psychotic is lifetime, I believe. Thanks for the info.

I only realized I hadn't been taking the 150mg dose 2 days ago. Since then I've immediately felt better taking it in the morning. 75mg was indeed very low and my psychiatrist prescribed 225mg but I misread the bottles.

I've also had brain zaps while on another anti-psychotic medication, Geodon. They don't hurt but they certainly are a bit unpleasant. So far, no side effects of Effexor XR (extended release) other than slightly decreased libido, which according to my psychiatrist should resolve after awhile. I was told the pills also take 4-8 weeks to fully start working, and it's only been 3 or 4 weeks so far, so hopefully I feel even better in the coming weeks.

Thanks for the response, pibs. Appreciate it. And the rest of you, too. I'm glad it's a bit easier to get through the days now, but I fear that it might be a rough winter. It's starting to get cold and days are getting shorter so hoping it doesn't affect me that much.

TheRealFluent said:

I thought they were lifetime drugs, I didn't know I'd be getting off them. …

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A single episode of depression (or two episodes years apart) is in itself not a reason for lifelong treatment (the 6-month rule still apply). For recurring depressions, and probably also when there are complicating factors such as other mental problems, lifelong treatment is indicated, with the same drug and at the same dosage as used for treating the episode.

Well, that's how we do it in Norway. Things may be different over there, your doctor will know, and you should trust him/her more than me.

pibbur whose statements regarding medicine should be considered just a bit more reliable than educated guesses.

Work. Work as much as you can.
And not just lawn moving, or similar stuff. Do Serious Work.
If you have a job, do it with extra effort and try to excel in it.
If you do not have a job, create yourself one that has a goal, can be done constantly, and requires serious concentration: e.g. write a book for real (that is: want to finish it ON TIME).

Work works wonders.

I agree that activity is important when recovering. But when you're deep down in an episode of clinical depression, both initiative and concentration is (almost) gone, even small tasks seems completely out of range. Setting yourself goals that you cannot achieve does not help at all, quite the opposite. Last time when I was down (this spring) I gave myself 20-minute tasks each day. Like working in the garden for 20 minutes - sometimes I worked more, but the important thing was that I could, without feeling guilty, go inside again after 20 minutes. On that level tasks became achievable, and there was in addition the satisfaction of managing to do what I had decided. Succeeding by lowering expectations - very important.

pibbur who

TheRealFluent said:

...I'm glad it's a bit easier to get through the days now, but I fear that it might be a rough winter. It's starting to get cold and days are getting shorter so hoping it doesn't affect me that much.

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If you're starting to improve, there's a good chance you will continue doing that, even during winter. No promises of course, but that's my experience.

As I use to say: Few things in life feels better than coming up from a depressive episode.

pibbur who

pibbur who said:

I agree that activity is important when recovering. But when you're deep down in an episode of clinical depression, both initiative and concentration is (almost) gone, even small tasks seems completely out of range.

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Dunno, I'm no doctor. The only somewhat similar experience I had is this:
A few years ago, one of my colleagues, a graphic artist, turned into a class-A junkie.
His close colleagues turned him down, while I, his Friendly Evil Boss, overwhelmed him with work (for practical reasons, mind you: there were tasks that only he could do).
The only empathy I gave to him was to cover his ass towards our client, otherwise he was on a very short leash.
Yeah, shock therapy of sorts. And it worked.
Job done, client was happy, and, while I had to fire the guy eventually, we are still on friendly terms (I think )

pibbur who said:

I agree that activity is important when recovering. But when you're deep down in an episode of clinical depression, both initiative and concentration is (almost) gone, even small tasks seems completely out of range.

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That's what I remember from my depressions in the late 90s as well.

Alrik Fassbauer said:

That's what I remember from my depressions in the late 90s as well.

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Ya the problem is when people tell others "just get out and do stuff", they don't understand that the 'get-out-and-do-stuff' part of the brain is broken. It's a physical issue with the limbic system in the brain. It's like telling someone to 'just start your car' if the battery is dead.

duerer said:

Dunno, I'm no doctor. The only somewhat similar experience I had is this:
A few years ago, one of my colleagues, a graphic artist, turned into a class-A junkie.
His close colleagues turned him down, while I, his Friendly Evil Boss, overwhelmed him with work (for practical reasons, mind you: there were tasks that only he could do).
The only empathy I gave to him was to cover his ass towards our client, otherwise he was on a very short leash.
Yeah, shock therapy of sorts. And it worked.
Job done, client was happy, and, while I had to fire the guy eventually, we are still on friendly terms (I think )

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This sounds like a classic case of Inattentive ADHD. Addictions to satisfy his lack of dopamine, and broken inhibitory/impulse control. You inadvertently used a Behavioral Modification technique on him, by increasing pressure and stress, which in turn increased the dopamine and epinephrine response, fixing the other issues temporarily. This is what educated school teachers will do to ADHD students, by giving them much stricter timelines.

The problem is mental difficulties often have comorbidity, which can often prevent this from being effective.

Caddy said:

This sounds like a classic case of Inattentive ADHD. Addictions to satisfy his lack of dopamine, and broken inhibitory/impulse control. You inadvertently used a Behavioral Modification technique on him, by increasing pressure and stress, which in turn increased the dopamine and epinephrine response, fixing the other issues temporarily. This is what educated school teachers will do to ADHD students, by giving them much stricter timelines.

The problem is mental difficulties often have comorbidity, which can often prevent this from being effective.

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They tried doing that for me in grade school, in a gifted class. It was really just more busy work, and it was not effective for me. Made me want to do things even less, and that gifted class eventually fell apart. They didn't know what to do with me honestly. And I wasn't being medicated back then, only for very short times because of fear of side effects and becoming a "zombie" from the meds.

Caddy said:

Doing a daily inventory of all the little positive things you're thankful for have helped me get through hard times (and can be as strong as medication). Hard to do at first, but long term practice makes it an easier habit. Like working a muscle. ...

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This is important, and very good advice to combat negative thinking.

I have a looong list of things I regret, including things from way back when I was a kid. Yes, it's not entirely rational. They were almost always present, and whenever I managed to close one of them, it just went back to the end of the queue, and another one popped up. It was quite painful. However, over time I've worked on handling them a bit more rationally, like an adult. Nothing I can do to change the past, no one is perfect, and was it really that bad? And frankly, childish behaviour when you're a child - gimme a break! The list is still there, but after those years of training, it's no longer dangerous and doesn't affect me much (except when I'm really down).

So yes, training is important.

pibbur

TheRealFluent said:

They tried doing that for me in grade school, in a gifted class. It was really just more busy work, and it was not effective for me. Made me want to do things even less, and that gifted class eventually fell apart. They didn't know what to do with me honestly. And I wasn't being medicated back then, only for very short times because of fear of side effects and becoming a "zombie" from the meds.

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I'd be very reluctant to suggest a strategy like that. Certainly if a person is depressed in addition to their ADHD, you could get a very bad outcome by overloading them, and potentially adding extra stress and anxiety to the mix. Even just with ADHD it could backfire on you. The brain has its limits, and by exhausting it you could create whole new problems.

Hi Fluent!

I've been a fan for a while of your youtube channel as your content uniquely appeals to me and moves me in good ways. I went traveling for a month and returned to find the youtube deleted so I have been doing my best to find out what's up. I still miss the youtube content but this thread has given me some closure in my search. Thank you for putting it down on internet paper. Get well get well soon we want you to get well.

Sincerely,

Clayton from Canada

One more thing about training: Physical exercise has also been shown to have good effect on depressions.

pibbur who exercises (almost)every day.

Ripper said:

I'd be very reluctant to suggest a strategy like that. Certainly if a person is depressed in addition to their ADHD, you could get a very bad outcome by overloading them, and potentially adding extra stress and anxiety to the mix. Even just with ADHD it could backfire on you. The brain has its limits, and by exhausting it you could create whole new problems.

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That's what happened to me. I completely burned out. Within a year or two I was giving up school completely, not caring, didn't want to do anything at all. I ended up "redshirting" for basketball but it was really an excuse to do no work at all for a year in class. I quit school at the start of 11th grade due to social anxiety, but I received my GED years later.

pibbur who said:

This is important, and very good advice to combat negative thinking.

I have a looong list of things I regret, including things from way back when I was a kid. Yes, it's not entirely rational. They were almost always present, and whenever I managed to close one of them, it just went back to the end of the queue, and another one popped up. It was quite painful. However, over time I've worked on handling them a bit more rationally, like an adult. Nothing I can do to change the past, no one is perfect, and was it really that bad? And frankly, childish behaviour when you're a child - gimme a break! The list is still there, but after those years of training, it's no longer dangerous and doesn't affect me much (except when I'm really down).

So yes, training is important.

pibbur

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It is, and I'm working on that. Counting blessings, telling myself things could always be worse, which they can of course. Trying to keep my mind occupied on hobbies and crafts. I regret a lot too and it still haunts me a lot, but it only happened in the last 10 years or so. I have a lot of skeletons in the closet that need dealing with.

Quejonbar said:

Hi Fluent!

I've been a fan for a while of your youtube channel as your content uniquely appeals to me and moves me in good ways. I went traveling for a month and returned to find the youtube deleted so I have been doing my best to find out what's up. I still miss the youtube content but this thread has given me some closure in my search. Thank you for putting it down on internet paper. Get well get well soon we want you to get well.

Sincerely,

Clayton from Canada

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Hey Clayton, thanks for the kind comment. I was in a bad spot mentally when I erased all my stuff, but I'm happy I entertained you for the time I did. I made a few new videos on my J Dumont channel. Just search for J Dumont - Sword Coast Legends is not Dumbed Down on YouTube to find my new channel. Not sure how much content is coming, but there's a few things there. Appreciate the love and support!

pibbur who said:

One more thing about training: Physical exercise has also been shown to have good effect on depressions.

pibbur who exercises (almost)every day.

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I just can't get into exercise right now. My body won't let me. I'm still too depressed to exert a lot of energy, energy I barely have as it is. Mentally I'm feeling a bit better but physically still feel dragging and worn down. I used to exercise and got good benefits from it (boxing is a great full body workout!) but it's been years. Maybe in the future I'll try again.