Depression

MusicForFish · Dec 6, 2017

Leadsalad said:
Seizure/anti convulsant?

Also used as a mood stabilizer around 150mg. Very few side effects. I've recommended it to a lot of chronically depressed types over the years with every single one of them dramatically regaining control over their lives within 4 weeks of it kicking in.

*Lamictal is it's non-generic drug name

Vanderhoof · Dec 7, 2017

Lamictal is FDA approved for bipolar disorder. If that's the correct diagnosis, I've had fantastic luck treating patients with it. Otherwise, SSRI/SNRI is considered first line treatment for unipolar depression.

OneofOne · Dec 7, 2017

As mentioned, just be his friend, and let him talk, and share a little of yourself, if you feel comfortable. Don't push, but if and when you get to the right point suggest he see someone, if not for him, then so his daughter has a dad. In the end, only the depressed person can make the move to regain (or even gain, for the first time) control of their life. I found a support group that helped a lot, that's another suggestion. It's nice to be around people like you, so you feel like less of a freak, and talk open and honestly without worrying about stressing our your family and friends and feeling like a drag. If you hit the point where you do feel something bad is going to happen, by all means tell someone, but not until then.

And last but not least, don't let him be an anchor that weighs you down, should it start heading that direction. I know that sounds cold and harsh, but you can only help so much. They need to take the first step themselves and you can't MAKE anyone do that.

Mrs. Gravy · Dec 7, 2017

Hey,

Vanderhoof have you/the docs utilized genesight for testing to assist in determining which medications may be more or not effective?
I participated in a 3 day conference on "dementia capable care" and it was discussed. Some of the agents participating have used it successfully with other individuals (who have a mental illness or a DD and potential pain).
Genetic Tests & Products | GeneSight

Vanderhoof · Dec 7, 2017

Ya, we use Genesight. I don't use it very often, only if someone has failed multiple medications and I'm convinced it isn't personality disorder or some other psychosocial cause. Ive seen a lot of serotonin transporter and MTHFR mutations, which is pretty interesting. In psychiatry, its not always useful for guiding treatment because, most of the time, its more than just brain chemistry causing mood symptoms.

Mrs. Gravy · Jan 4, 2018

January can suck it.
I just want to sleep and tell people to go fuck themselves.
I realize that is the combo of season and deathiversary talking but I hate it.
...gonna go try to find the energetic, loving me now.

moonarchia · Jan 4, 2018

Mrs. Gravy said:
January can suck it.
I just want to sleep and tell people to go fuck themselves.
I realize that is the combo of season and deathiversary talking but I hate it.
...gonna go try to find the energetic, loving me now.

Eat some good food. Have some good sex. Get some good sleep. Gravy might be gone, but the good memories still remain. Tell us more of his bad jokes if you want.

Mrs. Gravy · Jan 4, 2018

moonarchia said:
Eat some good food. Have some good sex. Get some good sleep. Gravy might be gone, but the good memories still remain. Tell us more of his bad jokes if you want.

I keep waiting for the opportunity for a couple of them - mostly this one: any time the number 9 would come up in conversation between us and he would tell me that is what his German girlfriend used to tell him, you know "nine/nein".

The best part of that is that he did have a German girlfriend, turned out she was telling him no for a good reason - she was a lesbian!! Oh my god, I never tired of that.

I will eat good food, have good sex, sleep and have good memories. The movie in my head of that particular night; well about that, I am a bit masochistic. I don't want to forget it, and I want to forget it. I can still feel his hand on my shoulder, I can still feel the crumple, I can see him on the floor, breath...life leaving him, me begging him to stay... every bit of it, I see it, hear it, feel it.

Anyway , every January 12 I will eat pizza and make a donation to a charity he would have preferred in his honor and memory. I have asked my family and friends to do the same but to whatever charity they want and in honor or memory of whatever person or even pet they want, but to think about my beloved Brian when they do so. I try to turn it outward and into love.

TBT-TheBigToe · Jan 24, 2018

Chronic depression and anxiety suck.

Azrayne · Feb 25, 2018

Any FOH people tried Mirtazapine? Hit a bit of a slump and my shrink is pushing it pretty hard. I've never had an luck with antidepressants in the past (all side effect, no therapeutic benefits), but this isn't an SSRI, so maybe it'll go better. Kind of in a "can't hurt to try" place at this stage.

Little concerned about the fact that weight gain is listed not just as a side effect but a potentially desirable benefit, since I just spent 3 years adjusting my diet and exercising to get back down to my normal weight, but I guess my diet is solid now and I can always bust out the treadmill again.

Anyway just interested to see if anyone out there has actually benefited from this stuff. Or tried it and not benefited. Whichever.

DrSpooge · Feb 25, 2018

I've been on mirtazapine for a decade now. I've honestly not found its antidepressant effects to be especially potent, buf if you have trouble sleeping, it's incredibly effective and it's non-addictive.

I did gain 5 lbs or so, and I kept it, but weight gain stopped there.

Azrayne · Feb 26, 2018

5lb I could handle. I'm actually on the lower end of healthy since I cut bread and went straight meat/fruit/veges, although I'm also about where I was before my weight went to shit in 2010, so who knows.

I'm pretty good for sleep atm, funnily enough. Better than I've been in a long time, at least in terms of having a regular sleep cycle. What I really need is something that will just kickstart a boost in mood and motivation for a few months, because right now it takes me 4 hours or so just to summon the impetus to get up and going every morning. Doctor seems convinced that mirtazapine is the next in line for a try.

Main thing is no major adverse effects I guess. When you say you find it non-addictive, do you also mean non-dependent, as in you can take it daily for extended periods then stop it with no withdrawal type symptoms? Or just that it doesn't cause the kind of psychological dependence a lot of other sleep meds do?

DrSpooge · Feb 26, 2018

Cessation shouldn't leave you worse off than you started if that's what you mean, but ask your shrink as I've been on it continually since I started. I HAVE come to depend on it in the sense that it's the only sleep aid I know of that doesn't lose efficacy over time and I probably wouldn't sleep without it, but that's how it was before I started on it.

The fact that you're already having trouble getting out of bed is something of a red flag, though. The sedating effect isn't as immediately potent as, say, ambien - you can mitigate it fully by just standing up - but it also has much longer duration. Sedation doesn't cease abruptly and give you that clean 6-hour sleepfest that ambien does. I have to set two alarms for work amd once or twice a year sleep through both, and I was a lighter sleeper than anyone I'd ever known before I started the med. Factor that as you will.

Mist · Feb 27, 2018

Can't tell if tired or depressed. I just want to go to sleep forever.

Azrayne · Mar 1, 2018

Mist said:
Can't tell if tired or depressed. I just want to go to sleep forever.

Yeah... sound depressed. It's kinda like that.

DrSpooge said:
Cessation shouldn't leave you worse off than you started if that's what you mean, but ask your shrink as I've been on it continually since I started. I HAVE come to depend on it in the sense that it's the only sleep aid I know of that doesn't lose efficacy over time and I probably wouldn't sleep without it, but that's how it was before I started on it.

The fact that you're already having trouble getting out of bed is something of a red flag, though. The sedating effect isn't as immediately potent as, say, ambien - you can mitigate it fully by just standing up - but it also has much longer duration. Sedation doesn't cease abruptly and give you that clean 6-hour sleepfest that ambien does. I have to set two alarms for work amd once or twice a year sleep through both, and I was a lighter sleeper than anyone I'd ever known before I started the med. Factor that as you will.

The thing is, problem getting up in the morning isn't so much physical as psychological. Just have a hard time getting the momentum going unless I have a very concrete goal to achieve. If I do have something to force me to get up and going, I tend to manage it and be ok after an hour or two.

Anyway I spoke to my doctor about the sedation and weight gain, and she acknowledged them as valid issues, but also said that it becomes less sedating and more energizing as you increase the dose. I figure it's worth a shot at this stage - worst case scenario I gain a few kg over 2 weeks and feel tired, but best case scenario is some combination of mood boost, energy boost and drug craving reduction (big issue since I dropped suboxone - stayed off opiates but keep finding myself using speed). Apparently Mirtazapine is the go-to for amphetamine craving reduction, but even if it doesn't help with that, any kind of mood boost or extra energy would be beneficial right now.

Anyway figured wtf, give it a shot. Appreciate the input dude.

Mist · Mar 1, 2018

I've been depressed for 20 years. This is something completely different.

moonarchia · Mar 1, 2018

Time to give a little @a_skeleton_02 a try?

Azrayne · Mar 1, 2018

Mist said:
I've been depressed for 20 years. This is something completely different.

I mean obviously everyone is different, but my experience is that it fluctuates immensely. I was doing pretty awesome for most of this year, especially when I got out of town for a bit, but hit a slump on Saturday and ended up like you said - just wanting to lie in bed and sleep all day. Some of that was definitely environmental, but there was also an intense mood shift, so intense it was actually easy to ignore because it was obviously just some funk of brain chemistry, instead of the usual, much more subtle "voice in the back of the head" type of depression.

3301 · Mar 28, 2018

Vanderhoof said:
Lamictal is FDA approved for bipolar disorder. If that's the correct diagnosis, I've had fantastic luck treating patients with it. Otherwise, SSRI/SNRI is considered first line treatment for unipolar depression.

This little piece of information about lamictal sent me down the path to researching bipolar and realizing I’ve been bipolar since childhood. Too bad I had to first go through a year of ssri/snri which made things epically bad.

I’ve been titrating up and now have been on 150mg for almost two weeks...I can do things again. Mid December when I was still on 15mg Lexapro and 450mg Wellbutrin, I couldn’t leave the house, or if I did I avoided social contact at all costs.

I was a zombie around friends, everything pissed me off, I couldn’t even file for unemployment because I couldn’t get my shit together to job search. Now? I’ve got a good job prospect, I’m feeling like me again more and more each day, and I’m able to be social again.

Dude, thank you.

Vanderhoof · Mar 28, 2018

mcdj22 said:
This little piece of information about lamictal sent me down the path to researching bipolar and realizing I’ve been bipolar since childhood. Too bad I had to first go through a year of ssri/snri which made things epically bad.

I’ve been titrating up and now have been on 150mg for almost two weeks...I can do things again. Mid December when I was still on 15mg Lexapro and 450mg Wellbutrin, I couldn’t leave the house, or if I did I avoided social contact at all costs.

I was a zombie around friends, everything pissed me off, I couldn’t even file for unemployment because I couldn’t get my shit together to job search. Now? I’ve got a good job prospect, I’m feeling like me again more and more each day, and I’m able to be social again.

Dude, thank you.

Depression

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