Posted by Noa on March 22, 2001, at 16:31:30
In reply to Re: treatment resistant depression (part 2), posted by Lorraine on March 22, 2001, at 10:20:40
Each of us has a different story--I like your request for some success stories. Here is mine:
I have had "double depression" (of the "atypical style") for years and finally feel successful in the treatment.
Initially, when I was in my early twenties, psychotherapy and a brief hospitalization helped, as did group therapy. Then, a few years later, with a recurrence, Prozac helped, but I only took it for a year. Repeated this again a year or so later.
Still struggled with the dysthymia, but held my own for a couple more years. But, then the major depression came back again.
Tried several ADs, including Prozac, which had less benefit this time around. It pooped out and then I couldn't tolerate the side effects at higher doses. Same with Paxil. Wellbutrin didn't sit well with me--ringing in my ears.Then, had some success with Effexor. It, too started to poop out and I had a hard time with higher doses. We added cytomel (thyroid T3)--with good improvement lasting for a while, but leveling off somewhat after a while. Then, added ritalin, also helped, but started to level off some. Then, added synthroid for more thyroid effect, which also added benefit, but started to level off after a while.
At some point, switched from regular effexor to XR, which helped a lot with some side effects, so I could tolerate a bit more of it.
Then, discovered I have sleep apnea. Got that treated (use cpap machine) and saw big improvement in fatigue, and initially, with depression, too, but but still had nagging dysthymia and anxiety, and after a while, went back to having the major depressive episodes several times a year. Increased effexor dose.
Increased stress in my life triggered even worse major depression. Added serzone, both to replace trazodone, which was to help with sleep (countering side effect of effexor), and to add more AD effect. Seemed to help some but then got even more depressed a couple of months later.
This time, the depression was also accompanied by fatigue (which hadn't been as much of a problem since started the cpap treatment a few years back), and vague aches and pains, as well as cognitive slowing ("brain fog"), and other non-specific symptoms like swollen ankles.
Pdoc speculated about some kind of bipolar spectrum depression, because of frequency of episodes--ie, could it be "cycling"? Recommended trying lithium regardless, as it has AD benefits as an augmentation strategy. Started lithium, mood got gradually better for about 8 weeks, then drastically worse (as did the physical symtpoms) due to lihtium effects on thyroid. Stopped lithium.
Got thyroid looked into more carefully, endo dxed hypothyroidism, increased cytomel and synthroid doses, then really started seeing major improvement.
Autumn saw a bit of incrased sleepiness again, and some "grumpiness", so I also suspect some seasonal component, and am hoping to get a light box before the fall season next year.
Also, I switched from Ritalin to Adderall and find it much better for me--helps me feel calm and focused.
Current cocktail:
Effexor 262.5
Serzone 350
Adderall 10 mg 2x plus 5 in late afternoon
Synthroid 50
Cytomel 12/5 2xI also take Allesse 28, an oral contraceptive, for symptoms of insulin resistance/polycystic ovary syndrome, and this might be helping my mood, too. It certainly seems to be helping to lessen my cravings for carbohydrates, which helps the overall picture.
I also started exercising in December and this helps my mood a lot. There is an especially powerful short term antidepressant/calming/anxiety-reducing effect that is unlike any med I have ever tried (including Klonopin).
Have had to "tweak" the cocktail here and there because of activating effects of effexor, and probably will do a bit more tweaking as I am still working on some of these (particularly what seems to be overactivity in the bladder), but pretty much, I would call this cocktail successful for me.
I still have a lot of "mess" (literal and figurative) to clean up after all these years, but it has been almost a year that things are better for me, and this is the steadiest period of improvement I have seen ever. Enough so that I no longer walk around in fear of depression's "other shoe falling". I can get up in the morning relatively sanely and cheerfully (and often without the alarm clock, which is still a shock to me!), can go to work in a decent mood and actually get work done and not fall to pieces all the time, and can enjoy things and get together with people on weekends, etc etc. It is a world of difference.
Through all of this, psychotherapy helped me survive and adapt, and now that I am functioning better, I feel I am able to use it to move forward more. And, not to forget....started participating here about a year and a half ago, which helped get me through some of the worst times because of the emotional support, but is also a major factor in my success story because the of how empowering the information and support has been. I think it was an important aspect of getting it all sorted out.
poster:Noa
thread:57143
URL: http://www.dr-bob.org/babble/20010319/msgs/57197.html