Depression Talk

One of the best ways to know that the meds (antidepressants, mood stabilizers or whatever) are working is that you feel so much better. You’re sleeping better, you’re eating better, you have more energy, you’re able to have fun sometimes — and so you think, “I guess I don’t need the meds anymore. I’ll stop taking them now.”

Worst thing you can do.

Pain And Problems

After a couple of weeks, your body is used to receiving a certain level of that prescription drug every day. Your body will get very, very cranky if you suddenly switch off. The withdrawal symptoms might take a couple of days to kick in or a couple of hours.

Withdrawal symptoms from anitdepressants, anti-seizure medications and mood stabilizers include:

• Headaches or migraines
• Shakiness or tremors
• Sweating
• Insomnia
• Dizziness or balance problems
• Inability to concentrate
• A return of the depression symptoms you had before

So, Are You Stuck With The Meds For Life?

Not necessarily. Although some people (like me) will most likely be on Prozac until I croak (or until Western civilization implodes, whichever comes first), many people do not need to be. But that’s up for your body and your doctor to decide.

What you can do is either take a smaller dose of your medicine or gradually taper off. For example, I started at 40mg of Prozac per day in April of 2003 and now I’m on 20mg per day. At one point in 2007, I tried to take 10mg per day. However, that didn’t work out too well. I saw someone throwing part of a pizza in the trash and I thought about all of the homeless that would love to have that pizza and I burst out into tears. So, now I’m back on 20mg.

Concentrate of getting better before contemplating reducing medication.

If you’ve just started taking a new medication for depression, chances are you feel pretty strange. I remember when I first started taking Prozac back in 2003. I was very dopey for two weeks. My boyfriend at the time was really alarmed, but after two weeks, my body got used to the new drug and I began sleeping normally instead of nodding offf at a moment’s notice.

I guess my boyfriend should have been alarmed. About a year and a half later (still on Prozac) I realised what a bully he was and left him.
Moral of the story is: the meds work gradually.

Making the Best Use of Your Waiting Time

Medication alone can’t do all of the work to help you manage your depression. You also have to help the medicaine along by noticing your thoughts. Although it may sound twee, your thoughts can have a profound impact on how miserable you feel.

Begin to pay attention to all of the self-incriminating or downright insulting thoughts you have abut yourself. Even say “Stop” out loud to help you not only recognize how often you think badl of yourself, but to interrupt that train of thought.

When you have these thoughts, try thinking, “That’s just the depression talking. I’m just as good as anyone else!”

Other things you can do to help raise your self esteem in this time are:

• Taking a slow walk every day in sunlight
• Writing in a journal
• Listening to the problems of others (so you see that you aren’t so crazy)
• Clean something

Keeping yourself busy and not putting pressure on yourself for instant improvement will also help the medications work. If you feel even more depressed, however, contact your doctor or therapist immediately.

Even if you only have one medication to take once a day, it can suprisingly difficult to remember to take it. This is further complicated by having to take multiple doses every day and having to take several medications or vitamins. This is even complicated further when you have any sort of depression, because short term memory can often be affected due to lack of sleep or lack of ability to concentrate.

Prozac Headache

Some medications will let you know that you’ve forgotten to take them, because you’ll get some sort of side effect. For me, if I forget to take my Prozac in the morning soon after I wake up, then I get a headache in the afternoon.

But usually you don’t get such a quick warning that you’ve missed a dose — or two, or three, or more. This can be dangerous, over time, because the medicine just doesn’t have a chance to work if taken sporatically.

Tell Others

One way you can help remember to take your medication(s) is by asking anyone who lives with you to help you remember to take them. The effectiveness of this, of course, depends on how reliable the person is that you are asking.

Or, you can take your medication when another person in the family has to take theirs. Just seeing them taking their dose can help your subconsious remember the meds waiting for you.

Other Tips

Other things you can do include:

• Tie the medication bottle to an alarm clock
• Always take the pills at the same time so it becomes a habit
• Use pillboxes with days of the week or AM and PM on them

Hope this helps.

Seroquel (quetiapine) is an antipsychotic made by British Big Pharma giant AstraZeneca. It’s their second biggest cash cow (only behind Nexium). It’s been out for over ten years now and has helped a lot of people with the manic phase of bipolar disorder and schizophrenia. AstraZeneca is hoping the FDA will allow Seroquel to be used for major depression and general anxiety disorder (GAD). It is perscribed to some people for those conditions, but strictly on an off-label basis.

Just one snag — many people takng Seroquel gain weight. Lots of weight — as in, now they have Type 2 diabetes weight. And just last week, it has been discovered that AstraZeneca knew of this side effect and decided not to mention anything about it.

Oops.

But Seroquel Works For Me

If you are already taking Seroquel and know you have been able to better manage your symptoms on it, please do not go into a panic over this bit of news. I’m sure your doctor has told you about the importance of regular exercise and eating a low-fat diet. You just need to keep that up while on Seroquel — or many other drugs that have been known to cause weight gain.

Don’t just stop taking Seroquel cold turkey. The withdrawl symptoms can be painful, including headaches, dizziness and a return of panic attacks.

How Does It Cause Weight Gain?

FIrst off, not everyone on Seroquel gains weight. But it can make you sleepy and make you hungrier than usual. I couldn’t find any numbers about what percentage of people taking Seroquel gain a lot of weight.

So, if you stay active and eat lower-calories fresh foods instead of always turning to processed foods and sweets, then it’s theoretically possible to keep the weight gain to a minimum.

Better to be fat and peaceful than to be thin and suicidal.

The fun thing about depression is that it rarely comes to you without bringing along a few uninvited guests. Many depressives also have chronic pains (like migraines) or neurological disorders (like epliepsy). But more and more depressives also have Type 2 diabetes — although you can get diabetes before getting depression. Diabetes also increases the risk for getting dementia, but we’ll save that for another blogpost.

About Medications and Weight Gain

In developing Type 2 diabetes, most people are overweight or even obese. The too rich diet throws off the blood sugar (and not necessarily too much sugar). Now, if you have depression or anxiety and are taking certain medications, you have to be aware they can increase you appetite and make you sleepy, thus leading to weight gain. These medications include Xanax, Wellbutrin and Lexapro, which may be linked to causing Type 2 diabetes in some people. (Oddly enough, these same medications can cause weight loss in some other people. The fun of prescription medication!)

If you already have diabetes, then you know that controlling your wieght and exercising regularly is essential. Some medications can make you drowsy, give short-term memory loss and increase your appetite. Be sure your doctor or therapist know that you are diabetic.

Things You Can Do

If you have to take medications which may cause sleepiness and weight gain, you need to plan in advance to eat less calories, more fiber, more fruits and vegatbles and drink more water. If you can make double or triple the servings for healthy meals and freeze the leftovers, then you will be less tempted to call for a pizza because you are too tired to cook.

If you can also cut out smoking and alcoholic beverages, then you will help the drugs help your body do it’s job without the extra weight-gain.

Also, try your best to keep to a schedule. In this way, you can keep yourself busy and try not to think about taking a nap.

Hope this helps.

If you’ve been online for more than ten minutes, you’ll know that there is a lot of conflicting information on just about any medcial condition, especially depression. Anitdepressants have been especially targeted with misinformation campaigns. Just type in “how antidepressants work” in YouTube’s search function and you’ll come up with hours of detailed and empassioned explanations why antidepressants are the biggest con since W was declaired President in 2000.

Antidepressants are big business and I am no fan of Big Pharma, but there are synthetic medications made that can be life-saving. (Unaffordable medication is my beef with Big Pharma — not he quality of some medications like Prozac). Just because it’s made in a factory doesn’t mean it’s no good for you.

Prozac has been around so long that it now comes in generic form, fluoxetine. In fact, I’ve only taken the generic form and never the brand name, but “Prozac” is easier to say. If you have depression, post traumatic stress disorder or are going through a prolonged state of grief, then you may be prescribed Prozac.

So, here’s a little film made by Illumistream, which is one of the more reputable medical YouTube channels. It just gives a basic description of how Prozac works or how it works for many people.

However, I’ve never had a “state of well being” produced from Prozac, as mentioned in the film. All it did for me was regulate my appetite and sleep patterns. But for me, that was enough to get my body stable and really listen to and apply cognitive-behavior therapies.

Hope this helps.

The UK tested ten popular antidepressants for moderate to severe depression and discovered that, contrary to what a 2006 American study showed and what Big Pharma has been telling us, not all antidepressants are alike. Two anitdepressants did just a wee bit better than eight others — Zoloft/Lustral (sertraline) and Lexapro/Cipralex (escitalopram).

These will most likely be the first drugs now prescribed for UK depressives. If they don’t work, then they would move on to other antidepressants.

Study Specs

This superstudy was a massive one, following over 26,000 patients from 1991 - 2007. Basically, what it did was compile information from 100 other antidrepressant studies in that time period. It was just published last week in Britian’s premeir medical journal, The Lancet.

The other antidepressants (which seemed to then be rated in no particular order) Prozac, Cymbalta, Celexa, Ixel (minalcipram), Efexor, Luvox, Zyban and Seroxat/Paxil.

Zoloft and Lexapro won Best In Show based on three factors:

• Cost (gotta be generic)
• How bad the side effects were, including nausea, sleep problems and sexual whoopsies
• How well a depressive improves

But, the study warns that if you are doing fine on your current medication PLEASE don’t switch.

What This Means

Patients have been telling their doctors for a long time that not all antidepressants are alike and act on them differently. It had been assumed that any differences were slight or just a result of the quirks of an individual patient.

So, this study will probably do more change to how doctors prescribe drugs than to actually anyone who takes these drugs. But if you’ve never been on antidepressants and have just been diagnosed with depression, then hopefully this will shorten the trial and error time of finding new medication.

Hope this helps.

If you go into the hospital suddenly, you will still need to be on your antidepressants or whatever class of medication you need to take for your type of depression. A hospital is a very confusing place, and even more confusing if you are ill and disoriented.

So, when a nurse comes with your medication and calls it by another name, you can’t help but wonder if you are getting a generic version of the brand name you are used to hearing or getting the wrong medication. You’re not overrreacting by wondering if you are getting the wrong medication. Mistakes happen a lot, no matter what country you live in.

To give you one less thing to worry about when you’re at the hopsital, here’s a conversion list of popular brand name antidepressants and their generic names. This list is geared more for American readers, but I’ve tried to include Canadian or UK names when I find them. If I miss a name, feel free to admonish me and I’ll make a correction later. Hope this helps.

Elavil and Trypitzol: amitryplaine
Asendin: amoxipine
Wellbutrin and Wellbutrin XL: bupropion
Celexa: citalopram
Anafranil: clomipramine
Norpramin and Pertofane: desipramine
Prothiaden: dosulepin
Adapine and Sinequan: doxepin
Cymbalta: duloxetine
Lexapro and Cipralex: escitalopram
Luvox: fluvoxamine
Prozac: fluoxetine
Tofranil: imipramine
Marplan: isocarboxazid
Ludiomil: maprotiline
Remeron and Zispin: mirtazapine
Serzone: nefazodone
Aventyl and Pamelor and Allergron: nortryptaline
Paxil and Seroxat: paroxetine
Nardil: phenelzine
Vivactil: protriptyline
Zoloft or Lustral: sertraline
Parnate: tranylcypromine
Desyrel and Molipaxin: trazodone
Sermontil: trimipramine
Effexor or Efexor: venlafaxine

There are such things as natural antidepressants, but they only work for only the mildest type of depression, which is triggered by a traumatic event and goes away after some time. St. John’s Wort is the best known natural anti-depressant, although it’s effectiveness has been rather over-hyped in recent years. If you do take St. John’s Wort, be sure to not take manufactured antidepressants, because they will clash.

Another chemical getting hyped in the last twenty years or so is called SAM-e (S-adenosyl-L-methionine). The cost of this stuff is ridiculous and the results are questionable, at best. Although I have not taken SAM-e, I do know family members who have and to say they were disappointed with the results is putting it mildly.

WARNING

Just because somethign is natural or herbal doesn’t mean it’s safe. It can play very badly with all of the other medications in the playground of your body. This is why you have to talk to your doctor BEFORE taking any natural antidepressants or any other natural supplement.

What About Major Depression?

For more serious types of depression like bipolar disorder or endogenous recurring depression (major depression), you are basically stuck with the drugs. For some people, they will be on medication for the rest of their lives. For others, they really only need to be on for a couple of years. It’s different for everyone.

You can use very natural means in order to help make the medications more effective or to make lowered doses of those medications effective. These natural things include getting enough sleep, getting regular exercise and learning how to manage your stress. I also like to munch on some chocolate to get help, albeit temporary help.

Hope this helps.

On the whole, almost any new medication except Viagra will lower your sex drive. This is common for antidepressants, anti-seizure medications, anti-anxiety medications and (ironically) oral contraceptives. This lowering of sex drive can serve to make some people aggravated — especailly if you have an unsympathetic partner who can’t understand why you’re not as interested in doing the mattress mambo like you used to be.

It’s Not Important

If you have an unsympathetic partner who pesters you to have sex when you don’t feel like it, don’t stop the medications. Keep the medications and get rid of the partner. The creep obviously doesn’t have your best interests at heart — especailly if he/she/it taunts you about any weight gain you may get from new medication.

And I’m not just being my usually snarky self here. Think about it — on the ranking of how important sex is in a person’s life, it really pales behind breathing, eating, being able to go the toilet by yourself, laughing and working in a fulfillling job. Lowered sex drive is just not that important. Don’t worry about it.

And don’t let anyone else make you worried about it. Your mental health is too important. You can always get another sexual partner. You can’t get another brain. With the help of your brain’s creativity, you won’t even need a sexual partner in order to fulfill your physical needs. In this way, when you find a partner, it’s because you actually like the person and not because you want to get into his/her/its pants.

Sex Drive And Health

A drop in sex drive is usually a way for the body to say that it’s sick. Sex is just not that important to a body. It’s a luxury item. Hair is like that, too. When you get really sick, it falls out or thins. But in the case of antidepressants or many other kinds of medications, the lowering of sex drive is normal.

It’s also usually temporary. But in the meantime, the body is taking the energy to heal itself. If you have a lowered sex drive, don’t worry about it. Go write a blog. Go read a book. Go bake cookies. Lowered sex drive is the least of your concerns when you have major depression.

Chances are, if you are placed on an antidepressant or a medication to stabilize your moods, you will gain weight. This is because many antidepressants do two things — raise your appetite and make you dopey. Zyprexa in particular is noted for this. If you know that you can gain weight from anitdepressants, then you know that you need to try and stay active.

Remember, like it says on the sidebar, I’m not a doctor, so please talk to your doctor or therapist about the possibility of weight gain with any antidepressant. Don’t just suddenly stop taking any antidepressant, mood stabilizer or anti-seizure medication becauise the withdrawal effects can be painful and just a bit frightening.

Temporary Dopiness

When I started on Prozac, I was more or less knocked out for two weeks, and then my body got used to it and I was up to my usual energy levels. I can also get dopey if my dosage was raised — or reduced. The grogginess would go away in a few days, though. The grogginess can interfere with your driving ability.

Thankfully, I’m too blind to drive and I telecommute, so I didn’t have to worry about driving while groggy. I really recommend getting a ride or taking public transportation if you are changing or going onto a new medication because you may fell spacey. If you can, start the medication at a time when you have two or more days off in a row and don;t have to go anywhere.

Also, for God’s sake, don’t go anywhere near a contract in this condition.

Drink Plenty Of Water

One tip for helping battle the bulge and to help give you some more energy when on new medications is to make sure you are drinking at least five glasses of water a day. Okay — four glasses of water. You need to take a glass of water for your pills, anyway, so that’s one glass right there. Water can help give you a full feeling in the tummy. It also helps your circulation system and also cleans out your bladder.

If you don’t like the taste of water or other low-fat foods that are good for you, keep in mind that the taste buds can be trained to like a new food. You just have to give it two weeks.

Prescription drugs have two uses — what conditions the box says it should treat and what are called “off label” uses. For example, I currently take two prescription drugs — fluoxetine (generic Prozac) and verapamil (also a generic). I take generic Prozac for depression. That’s no big deal. Prozac is marketed as an anti-depressant, after all.

But I also take verapamil. It’s a high blood pressure medication. I don’t have high blood pressure. In fact, I have low blood pressure. However, many doctors have noted that many people who take verapamil have less headaches. So, I’m taking verapamil for an “off label” use.

So, if your doctor prescribves you antidepressants and you are not depressed, don’t take it personally. This is just an off label use. In these cases, you need to be very familiar with the drug warnings (just in case). Off label use of prescription medications is still a hot topic among many medical circles.

What other medical conditons can be treated with antidepressants?

Chronic Headaches and Migraines

Chances are, if you have chronic headaches or migraines, then you already have been diagnosed with depression. When you have one, you have a very high chance of having another. the culprit now thought to play a role in depression — serotonin — is now thought to play a part in migraines or some kinds of chronic headaches as well.

Trying To Quit Smoking

If you quit smoking, you will get depressed. How long and how severe this lasts differs from person to person. You can also experience trouble sleeping and will literally bite the heads off nails. Antidepressants like Wellbutrin are now usually prescribed to smokers who have just quit. Usually, the need to be on the antidepressants is only for a couple of months.

Urinary Incontinence

The antidepressant used here is called imipramine (brand name Trofanil). According to the Mayo Clinic’s website:

This antidepressant may occasionally be used in combination with other medications to treat incontinence. It causes the bladder muscle to relax, while causing the smooth muscles at the bladder neck to contract.

Insomnia

One of the benefits that many (but not all) people on antidepressants is that their sleep cycle gets regulated. For example, I was a chronic insomniac until I had Valium, marijuana, a handfull of Nyquil or generic Prozac. I can’t really recommend my first three methods of getting to sleep. Of course, a pill can’t completely cure insomnia. behavior modification needs to happen too, such as getting regular exercise and cutting down caffeine.

Hi, all. I’ll give you an advance warning — I’m curently getting over an attack of the flu, so this post might be a bit wackier than usual. But, as we barrel along with flu season, an important question comes to mind — should you take your meds with an upset stomach? These medicines cost enough as it is — you really don’t want to waste them by tossing them back up.

Don’t fool yourself — as soon as your meds get in the least bit wet, they’re usless. Trust me — I once tried to get a fluoxetine capsule out of my vomit because it wasn’t discolored in any way. But it still dissolved in my fingers. Once down the hatch, there’s no going back.

Call Your Doctor

If you do wake up with the flu and feel queasy but haven’t vomited yet, if you can, call your doctor or therapist to ask if it’s okay to skip a dose. I always seem to get sick on my doctor’s day off, so I have to wing it.

Know Your Meds

The two prescription medicines I have to take everyday are fluoxetine (for depression) and verapamil (for migraine prevention). I’ve been taking fluoexetine since April, 2003. This is more than enough time for me to not the quirks of this drug on my system. Skipping a couple of days is not going to mess me up. But if I skip for a week, then I’m in trouble and start to think suicidal thoughts again.

But I have only been taking verapamil since the spring. I don’t know what would happen to me if I missed a couple of days of it. So, I decided to wait until my stomach calmed down before taking verapamil.

Sometimes, You Have To Experiment

Please keep in mind that I am not a doctor, nor do I play one on the Internet. I’m also only talking about depression medicines and verapamil. With some classes of medications — like insulin — you don’t have a choice. Take it, no matter what gymnastics your stomach is doing.

But sometimes you can’t get a hold of a doctor or therapist about your own meds when you have an upset stomach. In these cases, sometimes all you can do is experiment. Cross your fingers, swallow the meds (or however you take them) and note the results.

Hope this helps.

If you have depression, you’re probably struggling to pay for your essential life-saving medication. Even if you have your head above water, you certainly don’t need the floating tree trunk of the December holidays to clonk into you. If you haven’t done so already, the time is NOW to talk to your friends and family frankly about your finacial situation and state limits on gift-giving or nixing gift-giving all together.

Don’t Ignore This

Here at Depression Talk, I try to steer away from talk of the high cost of medical care. I save those rants for Dealing With Headaches. I know that when depression weighs heavily on you, you look for any excuse not to try and get help, because you believe that you can’t be helped. Worrying about money was one of the excuses I had for taking years to go for help about my major depression.

You can be helped. But it takes time to change the habits you’ve gotten into because of your depression. You need to tell yourself everyday that you can be helped. You need to attend your therapy sessions, if you are scheduled for them. You also need to give your medication a chance to work. Going cold turkey from your meds can lead to painful side effects.

You Will Feel Guilty

This is why you need to ration your money to keep your head above water. The winter holidays (Christmas, Chanukka, Dewali, Yule, et cetera) are suppossedly more than about gifts and decorations, anyway. You will feel guilty for telling your loved ones that your finacial situation is bad and you can’t give gifts. You will get over it.

Chances are, your loved ones are in the same bad money situation as you are and they will be relieved that you broached the subject first. This also lets them off of the present hook. There will always be one friend or family member who will complain about you being “cheap”. Ask that person if they’d rather see you dead or hospitalized from not taking your medications (it’s okay to exaggerate a little to make a point to a thickhead). If they still protest, then you know who to cut off from your Christmas card list in years to come.

If they have already bought you a present, ask them to donate it to charity.

Hope this helps.

One of the reasons why people with depression adamatly do not want to take medication is because they do not want their money going to fund Big Pharma. These medications include antidepressants, anti-seizure medications and anti-psychotics. Big Pharma (and even Little and Medium Pharma) doesn’t help its own image by some of it’s spending decisions.

But your mental healh is far more important than making a political or social statement. Get better first, then try to do the activism thing later.

Hard Lesson To Learn

If you’ve read more than three posts of my other 451 Press blog, Dealing With Headaches, you know that I’m not exactly a cheerleader for the pharmaceutical industry. But they do make medication that can save lives — including yours. Currently, I’m on generic Prozac. All it does for me is regulate my appetite and my sleep cycles — but that’s enough! (Please keep in mind that not all people react well to Prozac, so it may not work for you).

I didn’t go on Prozac until 2003. I’ve had major depression since the womb. I should have been on Prozac as soon as it was available (yes — I’m old. I remember when ibuprofen was brand spanking new). But I stubbornly refused all medications for depression until 2003, after many suicide attempts, going homeless and getting beaten to a pulp by a man I ran away fromhome for. One of the reasons I did was because of my belief that Big Pharma is evil, so if I took meds they made, I’d participate in the evil.

Just take the meds. Please.

Besides, Big Pharma may be evil, but it’s not unchangeable. Just because of past evils does not mean that it will ALWAYS be evil. If you have to play mind games in order not to feel guilty about taking the antidepressants or other meds, by all means, do so.

Suggested Mind Games

If you believe in Hell, then that’s where they’re going. Let God juge them and take the meds, knowing you’re going to Heaven and they to Hell.

If you believe in karma, same thing applies, only without the burning in eternal fire part.

Or, you can beleive that by getting better, you will be able to write your political leaders demanding change, writing articles and blog posts, participating in discussions, not buying Big Pharma stocks and one day, they will see the light that you have been holding out to them.

Play any mind game you have to — just take the meds.