Bin the pills, your body has its own built in pharmacology lab that can make all the feel good chemicals you need without the side effects. Stop using the car/bus etc & start walking everywhere, you're not working so you have the time, better still buy a bike and get the map out everyday & go somewhere. Sign up for some voluntary work, soup kitchens etc ..sometimes seeing people far worse off than yourself helps put things into some much needed perspective. Doing the above will help you stay active and get some exercise, which will have a much more positive effect on your mood & general health than any pill.
T_G, just wanted to say that I'm really sorry to hear how bad things are, but that you will get through it even if things seem really bad right now. As far as the anti-depressants go, as Cei has said, ignore the "advice" on the internet (however well-meaning) and speak to your GP if you have any concerns - you wouldn't ask a random punter on the internet how best to treat a broken leg, you'd go to a qualified medical practitioner instead If I can contradict my own advice slightly, I would say that you shouldn't expect instant results from anti-depressants, and hang in there. I sincerely hope everything works out for you. All the best.
GPs hand out pills like candy & don't even bother to monitor the patients properly, why is their advice any better? There are some studies around that show anti-Ds are no better than placebo. It's quite funny that people are saying 'don't take medical advice from the internet' then going on to do exactly that. as you said yourself:
I would also add that since your mind is "racing" right now eating properly becomes even more important, the brain is the part of the body that consumes most energy, and right now it needs plenty of fuel. Eat as healthy and nutritious as you possibly can. And as tuk said, exercise. I wish you all the best buddy hang in there. PS: Doctors are prescribing anti-depressants today as if they were sweets, they many times appear to be more of drug dealers than doctors. A quick "fix", no pun.
Tuk, I really don't want to engage in your baiting, but please, provide those studies that show no improvement over placebo? The Cochrane Foundation have a meta review, for primary care, showing that they are effective, and as evidence goes that is the strongest possible category. As for giving advice, all I said is available from a copy of the British National Formulary (Edition 64 if you're interested), which isn't exactly giving my personal opinion as to prescription. Telling somebody to stop tablets because you believe there is no evidence and you believe in "body, heal thyself" is more damaging. T_G: Best wishes. Don't roll over without a fight, and consider every move you make.
baiting? I only posted good advice, if you feel your being baited I suggest your suffering from paranoia. Cool story bro, this post only displays your complete inability to read & understand the written word. http://jama.jamanetwork.com/article.aspx?articleid=185157 or the short version as concluded by Jeffrey Dach MD: SSRI antidepressants are no better than placebo for most cases of depression. The authors reviewed 30 years of data and concluded that "the benefit of antidepressant medication compared with placebo may be minimal or nonexistent in patients with mild or moderate symptoms". http://www.science20.com/natural_me...i_antidepressants_no_better_placebo_says_jama
Seriously, just stop. This isn't the right thread to get into a discussion about the merits or otherwise of anti-depressant medication.
I think you meant this comment for post #47 .as that is the first post trying to start a debate, assuming of course that you are an unbiased bystander. & as the OP is taking anti-depressant medication & saying they 'don't work', whats wrong with discussing the relative merits of said anti-depressant medication against much safer and more effective alternatives. There he is
This is my last post on this, but did you even read that paper? So, to break that down, for severe depression, medication is markedly superior to placebo. One more time? Markedly. Superior. T_G, is on the starting dose for severe depression, indicating that his clinician has assessed his mental well being and risk and decided it is severe. So, using your paper, the indication to start medication is strong. Your advice is fine, to a point. Exercise is indeed a valuable tool for those suffering from depression, but isn't sufficient by itself in severe cases. Your advice to ditch the medication on the other hand is just...wrong.
Guys, can we all take the chat about anti-depressants to another thread, please? Tuk, my post was addressed to you as you are the most... vociferous... voice in this thread. Nothing personal, but it's not helpful to T_G to have an argument about medication at this point in this thread, so take it elsewhere, please.
complete nonsense coming from the guy telling people what and when to post. I posted my advice other people didn't like it & decided to engage me on it, but that makes me the most 'vociferous', think u need to pull your head out of your arse ...nothing personal.
Cool, man, you're absolutely entitled to your opinion, as am I. All I've asked is that this thread not be derailed and instead be left to serve it's original purpose - which is to support a good guy who's going through a horrible experience. On that note, I'll bow out and try to avoid further derailment.
fair enough bawjaws, I'm not exactly a kid & have been around the block more times than I care to remember ..my advice is solid. I'm sure TG is more than capable of looking through the various suggestions and cherry picking what suits him without other members policing alternative suggestions cos they think their suggestions are better. ------------------
Whilst I agree that this should be tried first I am an advocate for medications designed to help with psychological issues. I would, given that my Asperger's co-morbidity is Bipolar 2. I am a huge advocate of eating properly and exercising. Sadly in practice for those who are either seriously ill or going through a patch of negativity so great that they need help sometimes you need that help. Throughout my teens I had no idea what was wrong with me. I was angry, stressed out, depressed and close to breaking point most of the time. It really didn't take much to send me over the edge causing me a complete meltdown. So initially I dabbled with illegal drugs (14 when I started taking MDMA and smoking weed) and used those to control both my depression and my anxiety and manic phases. Eventually something had to give, and after years of smoking cannabis (7 years, I was 21 when it went wrong) I had a full nervous breakdown and had to stop using anything. The next four years were the worst of my life. I was still too stubborn to look for help and tried your methods above. Nothing worked. When I was 27 my wife left me (see other post) due to my moods and problems. That was when I started playing the pharmaceutical lottery. Since then I've taken every anti depressant known to man. From Sertraline, to Prozac, Efexxor, and finally Citalopram. I can not exist without them. On top of that I take Seroquel as a mood stabiliser and Pragabalin for my terrible anxiety. Without any of that? Well last year I was put on Lamictal (AKA Lamotrigine) which had some pretty severe side effects, raising my white blood cell count and making me feel constantly sick. I also had problems with IBS caused by the meds. I was taken off of them and prescribed Seroquel but due to me being worried about more side effects I decided in my infinite wisdom that I would stay off meds for a while, using your regime above. Two weeks later my doctor had to sedate me, and told me that if I did not take my mood stabilisers he would have to place me under a civil admission order (AKA section). I crapped it and started taking them, and tbh? I love them. They relax me, take the edge off and allow me to almost function normally. With the anti depressants and Pregabalin I don't sit here all day every day thinking of ways to end my life. I wouldn't say I'm happy, as I will never be 'normal' nor live a normal life (I can't work for example as I still suffer with mood swings even now !) but I am at least at a point where I feel somewhat comfortable. I guess what I'm saying here is sometimes conditions can be unbearable and without help we would be in trouble. I'm not saying that swallowing pills are the answer to everything, but, when used correctly DO help. We don't always get to pick and choose what happens in our lives and some things are beyond our control, but these medications are designed to help and do help. If you had a headache that wouldn't go away you would take paracetamol or Ibuprofen. If you had a broken leg you would put it in a plaster cast. When life takes a **** on you and you see no way out there are medications out there to make you feel better. Honestly, if I were to try taking your advice above again I would be lucky to see out two weeks before taking a swallow dive into a concrete slab.
So, lets start from the top shall we? Depressive disorders can be categorised as mild, moderate or severe according to the ICD-10 system used worldwide (and in the UK). Severe depression can then be further divided in to the presence or absence of psychotic symptoms. Now, for treatment, it really is important to get to the bottom of which one of these categories your patient falls in to. Whilst there is going to be variation, the key things to look for are a diurnal variation in mood (feeling worse in the morning), suicidal ideas (that are frequent, prolonged and intrusive), delusions of guilt and even bodily disease. Concentration and memory can go, particularly in the elderly. So why does this matter? The main theory for depression, particularly the more severe forms, is that of a monoamine deficiency. The 5-HT receptors are also downregulated, which is what we know as serotonin, and is the target of the SSRI drug group. Stress also plays a big role, especially in situations where the patient is predisposed with a lack of social support/social traits. Stress triggers the release of hormones (corticotrophins and serotonin), both of which have altered receptors in depression. As such, depression isn't just a biological model, but an integrated biopsychosocial model. Treatment then falls in to several avenues: 1) Physical - stopping depressing drugs, regular exercise (good for mild to moderate), antidepressants 2) Psychological - CBT, education & follow up, psychotherapy 3) Social - Finance, employment, housing, family etc Anti-depressants are not a cure-all, but are of particular importance to those who have moderate-severe depression. These patients are at the highest risk of suicide, self harm and all the other horrible things that happen, and the studies demonstrate the efficacy of the drugs. They don't cure depression, but 'smooth out' the mood, preventing the lows that can lead to harm, but most certainly not creating 'normality' (ie: pre-depressive state). A return to the pre-depressive state is achieved via the other methods, but the anti-depressants make that long term slog possible. Lots of people think anti-depressants are addictive. Fact check - they aren't, but they aren't pleasant to come off. They also take time (2-4 weeks) to start working, and this is a dangerous period where depressed patients are actually at a higher risk of suicide/harm as they are expecting their pills to be working. Exercise does create feel-good chemicals, namely serotonin and norepinephrine. However, you can have as many of these chemical molecules in your brain as you like, but if your receptors that accept the molecules are blocked, inhibited or not present then they do no good floating around in a synaptic cleft until reabsorption. With mild depression, you'll still have a decent number of working, active receptors to accept the molecules, hence the effectiveness of exercise, but as the depression becomes more severe this effect wanes. Of course, the exception would be if you exercised flat out constantly, 24/7, to maintain high levels of serotonin. This is what the SSRI medications acheive, by blocking the reabsorption of the serotonin at the synpatic clefts, and allowing it to saturate the available receptors at all times. Sure, some doctors give out citalopram too easily. That's because they a) actually want the placebo effect to work, and the patient walks out the door with the feeling that they were listened to, and that they DO have a problem, because they have a prescription, or b) that they're lazy. Yes, we could probably deal with most mild-moderate conditions without using drugs, but CBT/psychotherapy is hugely expensive in comparison. Citalopram costs £1.39 for 27 tabs. EDIT: Sources Kumar & Clark, Clinical Medicine 7th Ed Rang & Dale, Pharmacology 7th Ed British National Formulary, 64th Ed Oxford Handbook of Clinical Medicine, 8th Ed Oxford Handbook of General Practice, 3rd Ed
I didn't give you any advice, you obviously have a inherent condition, the person I was responding to is experiencing temporary depression cause by an event. Therefore your long winded story that somehow proves my advice is useless and even dangerous is completely irrelevant.
T_G is going through a hugely traumatic time. His entire life has been turned upside down, and you call this a "temporary depression"? The poor guy has lost his house, his kid is being turned against him, he has quit his job and worst of all has clearly expressed suicidal thoughts. That is not "temporary". It is going to take him months, if not years to sort out all the practical aspects of this out, and the emotional side is going to be terrible for him - because his ex is never going to let this go, and will use his child as a pawn in the fight. He is severely depressed, and has every damn right to be. He is not going to feel better in a few weeks, because the consequences will not be over in a few weeks. You're literally saying he should "get over it" and man up, then go for a run to make it all better.
these two thing have nothing to do with the other. he wasn't depressed before this happened & it wont last forever therefore its temporary
