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Re: Some Implications (long)

Posted by sweetmarie on September 19, 2001, at 6:35:33

In reply to Re: Some Implications (long) » sweetmarie, posted by shelliR on September 16, 2001, at 19:17:06

Hi again Shelli

> Yes, I definitely think you are right, that medication cannot completely shield you from real life pain. And in addition, you have had some major changes: getting out of the hospital, parents leaving, and now going to a program that doesn’t feel right for you. Changes definitely bring out vulnerabilities, and since ours is depression, that is what is going to be affected.
>
> I think you will probably return to the baseline at which you left the hospital, but I don’t know if that is good enough. This is where I am not sure how direct to be, but you wanted an honest opinion., right? You’ve been on this combination a fairly long time now; there's a point, after about six weeks to eight weeks, when the benefit pretty much stays the same (at least doesn’t go up) and that is the time to evaluate whether these meds are right, or whether you should be adding or changing something . It is hard for me to understand how after all that time, they would discharge you with only a marginal benefit (at least that’s the impression I would get from you during your weekend posts). I hope that I have misunderstood and that you *were* feeling quite a bit better during your time in the hospital, in which case, yes, you *can* expect to get back up there. In any case you will see a doctor in October (right?) and medication changes can also be made outpatient , of course.

Thanks for the feedback re. meds (above). I HAD got a bit better (i.e. `3 out of 10` as opposed to `0 out of 10` (average)). I think that you are right about `change` - it`s certainly one of my triggers. Also uncertainty - and there`s lots of that in my life - not least the International situation, which still seems very volatile to say the least. I`m really frightened about it.

The thing that I`ve maybe never mentioned is that I suffer from `double depression`, which is Dysthymia (a kind of genetic/`built-in` low mood, which I`ve had since being a child. As this is part of my `make-up`, and I`ve been like it for nearly 35 years now, it`s harder to eradicate. It`s always been a `back-drop` to my life.) plus a severe major episode. The severe episode has been going on since 1995, and has been particularly bad for the past 3 years. I was forced to stop work 3 years ago, and have had very little contact with my friends (some I haven`t seen for over 6 years, despite them living well within travelling distance. I haven`t spoken to my `best friend` for about 2 and a half years). A very large part of the past 3 years has involved being in a state of something nearing catatonia - just lying on my bed, unable to move/speak/eat etc. During this prolonged period, I mostly alternated between desperately wishing myself dead (whilst not being brave enough to do anything about it), and praying to be better.

So, I have an awful lot to `wade through`, if you see what I mean. My thought patterns have always been of the `glass half empty` variety, and I have become even more negative as the years - and illness - have progressed. Continued lack of recovery, together with my self-imposed isolation, plus all the attendant thoughts of my life as a total failure, have meant that my depression is very well established. I.e. I define myself by my depression, as it`s really all that I`ve known. So, meds alone are battling very high odds, if you see what I mean.

I have had positive results three times in the past with medication. The very first I was on worked 100% from day one. I discontinued it after a year (on my GP`s advice), became very ill again, and went back on it. Second time, it took about 7 or 8 months to have any effect. The third time I had a positive effect was `94, when I started on Seroxat (Paroxetine). By the following summer, I was having more good days than bad. But, it took all that time to happen. I was actually on holiday in the States (stayed with a friend who was living in Boston for 2 weeks - best holiday of my life) when I decided to stop taking them. This was July, and by September I was so ill I had to have 5 months off work - and eventually was asked to leave altogether.

I think that in chronic cases like mine - especially when depression is a long-term underlying problem (Dysthymia), then meds will take longer to work. My professor told me that this was the case, and I suppose that I didn`t believe him. However, it does make sense when I think about it logically.

> re: your program
> I am used to advocating for myself my whole life and in the US if you advocate for yourself, you *do* get further (although if your health insurance is "managed care" here, there is often not much you can do.) So maybe this is not the right place for you and they should be looking around and finding something better suited. And maybe you need to fight for this. You should not be in a program with all psychotic patients—that would not be of much, if any benefit to you. Please try not to identify--you are not psychotic; you are depressed. (Maybe there are people like you, depressed, and you missed them among the more dramatic illnesses?) In any case, can you go back and talk to the directors, or to the person you are assigned to?

I think that there probably are depressed people at this day centre - you`re right. And I`m NOT psychotic ... I think I will take your advice and talk to the staff about it. An added complication that I didn`t mention is that there is a bloke that goes there, who I had a kind of `thing` with the first time I was in hospital. This `blast from the past` was (and is) quite unsettling. >

> re your sister
> What is really pissing her off is that she can’t seem to walk down a road/street whatever without getting shouted at by blokes from cars.. She asked me whether or not she should be giving them the `finger`, but I told her under NO circumstances
>
> You are right about that.; she wouldn’t want it to escalate. I don't know what the guys are saying, obnoxious guy things? If so ,there is really no choice but to ignore. That’s strange especially if they are near a university. She might want to discuss it at the university to see how other girls handle it.

Yes - `obnoxious guy things` pretty much covers it. And I think you`re right, however horrible it is (and it`s an awful thing to have to put up with), `retaliating` would be a grave mistake. I don`t know whether she has discussed it with the other girls at college. I`ll ask her. >
>
> When I am feeling really depressed (like now) it is best to distract myself from the depression. I have a hard time even discussing it. That’s why I send you a card via e-mail. Let me know if you got it; you don’t have to write back until you're in the mood, but just click reply so I know it went to the right place.

I haven`t looked in my Yahoo account yet. Actually, the truth is that I`ve tried to get into it, and couldn`t work out how to (how stupid am I?). I`ll give it another go later today - I`m braving the day centre again in about 5 mins. But, thak you ever so much for sending me stuff - it`s really nice of you to think of me. >

> See now I am a little nervous that I said too much, and said things that may not be helpful to you.

Not at all - don`t worry about that. You have been really helpful, and I appreciate it very much. It`s good of you to take the time.

That’s why I want to send you fun things.

Hopefully I`ll discover how to get to them soon. I`ll have another try when I get back from the centre, and let you know.
>
>
I hope you are O.K. - let me know.

Take care yourself,

love, Anna xx


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