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Duck in Distress


Posted Thu Oct 25th, 2012 1:16am Post subject: Unipolor Cocoction - Phychiatrist's Desperate Attempt or Actually Worthwhile?

I have suffered with Depression and Anxiety since I was 19 and in that 13 years I have had 4 serious episodes requiring lengthy hospital admission. I am desperately trying to get through a recent serious severe episode that required hospitalisation and ECT Treatment. I have always maintained quite a reasonably responsible job but this time around have had to give up my work and are at my wits end.

I was put on and are still taking Lithium 900mg (however I am not bipolar) and Venlafaxine 300mg (which appeared to have worked before in previous instances) and underwent 10 sessions of electroconvulsive therapy (ECT) towards the end of last year. I am more stable than when I first went down with this episode (I required hospitalisation, was a high suicide risk) and came out from hospital in December last year after a four month stay.

It is now October and nearly 13 months after all this started I am nowhere near 100% better and had to give up my job (I have always worked and have had rather responsible positions). I spend most of my time at home as I am not in a good way but get out whenever I feel I am able to and are under a community NHS psychiatrist and see a NHS Cognitive Behavioural Therapist once a week.

My psychiatrist today has presented me with two options. To go and be an impatient again and have some more ECT which I am reluctant to do as I am no where near as ill I was when I was in hospital last year and I don't want to go back to that environment as I feel it would be a step back for me and mentally make me worse. Or add yet more medication (mirtazapine) to the current high levels of Lithium and Venlafaxine that I am on.

It has never taken me this long to fully recover from a serious episode and I am worried and at loss as to what lies in store for me, apart from misery and constant depressive lows.

I know nobody has my golden answer of when I will be completely better and when I can resume a regular working life. But this is the longest time it has ever taken me to get to a stage where I am not feeling down all of the time and in such a fed up state. I am losing all faith in everything after, what I feel is enduring high dosage drug therapies, hospital admission and even ECT.

Sorry for the extra long post but I just wanted to set the scene. My overall question is, is this unipolot cocoction my psychiatrist's desperate attempt or is anyone on or have been on this sort of drug therapy before imvolving these three drugs?

Any help or assistance would be very much appreciated - it didn't help when I googled it eaither to see that mixing Mirtazapine and Venlafaxine is often known as California Rocket Fuel!!!! It sounds uplighting and appealing from that description but who knows?!

DIDSY - Duck in Distress

“Don't walk in front of me; I may not follow. Don't walk behind me; I may not lead. Just walk beside me and be my friend.”

Albert Camus Quotes

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Posted Wed Oct 31st, 2012 6:36pm Post subject: Unipolor Cocoction - Phychiatrist's Desperate Attempt or Actually Worthwhile?

I began experiencing serious depression just after puberty, around 1975. The norm until I started with psychopharmaceuticals in 1993 was daily swings between relative normalcy and deep depression with constant thoughts of suicide. Like you, I was able to keep a job, but, for me, everything else was pretty hellish. After 2 years and 6 different drugs, the lowest dose of Effexor provided "some" relief in reducing the swings. I still had a lot of problems but my Psychiatrist didn't go any further and I thought that it was about as good as it was going to get. 5 years ago, a friend who is smarter and even more messed up than I am found a Psychiatrist who really worked with him and helped him out. I had to travel two hours and she wasn't covered by my insurance but she worked with me and I am now in a place where I am rarely bothered by the depression as long as I eat right, exercise. maintain healthy relationships and have a support network. Before the correct balance of drugs, I couldn't do any of those things. I take the minimum doses of Effexor and Welbutrin and the maximum dosage of Concerta. The Effexor and Welbutrin helped with the depression but I would fixate on religion and politics and adding the Concerta has almost eliminated that. I meditate regularly and watch it when it does flare up and I feel that I am able to control it, as opposed to the lack of control without the Concerta. This may be a little long but I wanted to convey the massive difference that not only different drugs but different doses can have on depression. Even though the standard dosage for Effexor and Welbutrin for someone my size is much higher than the minimum doses I take, any increase and I become extremely unstable. That was one of the features of medication that this new Psychiatrist was very interested in working with. The efficacy of minimum dosages. The other element I discovered is that although I was much better on those two drugs and was relatively "happy" as I felt better, I still had a problem with obsessing on religion/politics and that this could be relieved with the Concerta. Without a dedicated Psychiatrist I never would have known that, and they are hard to find. Psychotherapy never helped me until I got stabilized with the meds.

I guess no one can know the motivations your doctor has for the meds you're on but, if they haven't helped I wouldn't hesitate to let them know that you want to try something else, if you do. If you're not happy with the response, don't be afraid to try a different doctor. I had to go through 4 before I found someone really willing to work with me, and that took a lot of extra time and money but I'm now much better than I ever thought that I could be. It was scary and a pain in the ass but "It's your life"! I found that it can get better, but I had to really work to find the right doctor and the right meds. It seems to me that this whole treatment thing almost a crap shoot and you really need the right doctor to help you through it.

I don't know if this helps or not but I can't convey how much I hope you can find a way through your situation. My depression, and learning to own it as part of me as opposed to some alien that took over part of my brain, has taught me a lot and helped me in ways that people who don't go through that kind of soul crushing pain can understand but I had to get past the actual depression to see it and I hope beyond hope that you can get there. Best wishes, Dave

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