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I've turned the corner

Just a little update on the depression that ambushed me awhile back. As I said at the time, I don’t have a history of depression, so I wasn’t sure what to expect either from the depression or the treatment.

I started taking a very small dose of Effexor back in March. My doctor wanted to make sure I wasn’t going to experience any weird side effects, so the dosage was well below what would be considered effective. Two weeks later, she doubled the dosage. A month after that, at the beginning of May, she doubled it again.

Now, three weeks later, I’m feeling pretty good. I don’t feel high or freakishly happy or anything like that; I just feel like me again. I’m optimistic and cheerful. The anxiety is gone, I’m sleeping a lot better, I have more physical energy and mental focus, and I’m interested in the world again. There’s still some residual social anxiety, for lack of a better word, so I’m staying away from large gatherings for the time being. But other than that, I’m feeling pretty good. (And I appreciate feeling good more.)

These days I’m pouring a lot of mental and physical energy into gardening. And I’m reading a really good book about biodiversity, called The Diversity of Life, by Edward O. Wilson. It’s a little outside my normal subject matter, but I started reading a book that Milan wants everybody to read (he’s even buying copies for strangers) called Storms of My Grandchildren. It’s about climate change. I only got a hundred pages into before it was due back at the library, and I confess to being out of my league, scientifically speaking. But the first hundred pages did kindle my interest in science and nature, which led me to Edward O. Wilson, who is changing the way I think about the world.

Anyway. Back to depression. Now that I feel like myself again, I wonder how it all works. Am I still depressed but I just don’t feel depressed because of the antidepressants? What I mean is, if I were to stop taking the pills, would the depression consume me once again, or is it gone now? How does one know when it’s okay to stop taking the pills?

20 comments to I’ve turned the corner

  • Sorry you found Hansen’s book overly technical. My mother did also, though I feel the detailed scientific explanations are a vital part of what makes the book convincing. If he just asserted that his conclusions are correct, without arguments and evidence, his would just be another voice giving an opinion. As it is written, he is much more authoritative than that.

  • Far be it from me to comment on the whole depression thing, but it would seem if you didn’t have a history of it, it was probably just one of those funks people go through every so often. So, speaking as someone who probably doesn’t have a clue what he’s talking about (at least I can admit that much, right?), once you’re sure you were feeling more like you, it might be smart to slowly take yourself off it. Say, start out with decreasing your doses, similar to the way they were increased. I’d confirm with your doctor whether or not that’ll end up doing funky things to you first though.

  • My doctor recently compared seratonin to fuel in a car. So essentially the tank is empty and you’re having trouble producing your own fuel right now and it needs to be manually topped up. The theory is that assuming you are not prone to chronic depression, eventually you will recharge and be able to produce your own fuel again.

    I don’t think there’s a perfect answer. I recently got off SSRIs myself.

  • Mary P

    If you are feeling “normal” on your dose, then you probably need to continue taking it. When you start feeling over-revved, then it is time to talk to you doc and start stepping down the dose.

    I’ve not taken SSRIs myself but I’ve managed a group home where many of the residents were on anti-depressant medications and often discussed dosage with residents’ health care providers.

  • Bob

    I think Lissa’s got a great metaphor there. It’s as if you could produce vitamin C, but suddenly you couldn’t. To avoid scurvy, you’d have to add vitamin C to your diet. The brain and the mind are (is?) amazing things.

  • zoom! I’m so happy to hear you’re doing better! To be honest I was really worried about you for a while — you’re not the kind of person to get down on yourself and so it was upsetting to see it happen. But I knew you’d pull through — you’ve got through a lot worse and been fine. Plus you have GC to lean on and he seems like a pretty awesome guy himself.

    I’m having lunch/coffee with Tara early next week – do you want to meet up sometime? Oh yeah, and you should really come to the forum next Thursday! It’s going to be awesome, Justin Trudeau is speaking, as is a former MuchMusic VJ, plus there’s going to be a youth panel which I’m on.
    And the focus of the rest of the day is a series of workshops — 5 in the morning and 5 in the afternoon. Of course you only get to pick one each session and it’s going to be hard to pick, but I’m helping with the Community Services one so you should come. If you want to come it’s not too late — I can get you registered and in no problems.

    And Wednesday is the Youth Recognition Awards, being held at Sala San Marco on Preston Street from 5-7 or so. You’d be more than welcome at that one as well, and it should be pretty friggin cool. I helped out with it last year and it was awesome.

    Anyway, glad to hear you’re okay :)
    -JM

  • Connie

    Check with your doctor, but it takes 6 months for the brain chemistry to change. When you do stop, do it gradually or you will feel like crap. Some people take SSRI’s for years and years….I’m one of them. When I stopped I felt depressed again after a few months to a year, so now I just stay on it. To me, the difference was like seeing color after looking at a world in black and white for a long time. For others, one course is enough, and you might never experience depression again. But you won’t get high or addicted to it, that isn’t how SSRI’s work. Glad you feel better!!

  • Kathleen

    Zoom, I am glad to hear the you are doing much better. I think that Lissa and Connie are right on, in what they say. Connie is right that SSRI’s are not addictive. Follow what your doctor says, he know best about when to cut back on your pills.

    Take care,
    Kathleen

  • I took Effexor XR for a year and a half from late 2004 through May 2006 for depression and anxiety. And I just kind of *knew* when it was time to stop. Now, I just stopped. Which, apparently is *really* not recommended, because Effexor is said to have some strong withdrawal effects. I was lucky. As I said, I stopped overnight because I forgot to take a few doses and just decided to see what happened.

    Besides the stupidity of my method, I found that I was fine. Felt normal and just plain okay still. These days I sometimes feel residual anxiety popping up, but that’s relatively recent and has been manageable without the medication.

    I think my brain just needed to start producing the proper chemicals again, and needed to *remember* how to produce them, if that makes sense. I needed a year and a half kick start, if you will.

    Plus the meds were combined with therapy (a condition given by my GP in prescribing them).

  • The pills are the bandage, take it off before you’ve healed and you start to bleed again.

    Keep in mind you still have to deal with the underlying problems… you still have to answer the question, “why am I depressed?”. Unless you’ve got a case of the bipolars then your depression has a cause — big or small. The meds don’t cure the problem, they give you the opportunity to deal with the problem with a healthy mind.

    Make sure you keep in regular contact with your doctor, and keep track of the side effects and how your moods fluctuate.

  • Grasswren

    I was on Effexor for a year. As Gabriel said, its function is to make you able to deal with the underlying causes, which will be different for everyone. You’ll have some idea when you’re ready, but you should come off Effexor slowly, in consultation with your doctor. Doing that, apart from any other issues, if it turns out it’s not time yet, you can just put the dose back up and keep working on the things you need to sort out.

    One of the best things about Effexor is that it is not addictive. When it’s time to come off it, you can. It should be slow and steady, but it’s not difficult.

  • I’m not sure if you are asking for advice about going off the drugs or just thinking out loud but I am very glad for you that you have turned the corner.

  • grace

    I’m so happy you’re feeling better.

  • I’d add to Lissa’s “fuel tank empty” analogy. Serotonin works by being created in one part of the neuron, and being transmitted to another part. It’s on the receiving end when you feel its effects. Sometimes the serotonin gets ‘returned to sender’ before it can be received. I guess in the car analogy, you’ve got a hole in your fuel tanks, and maybe your spark plugs aren’t working too well. SSRI stands for “Selective serotonin reuptake inhibitor”, which is a fairly intuitive name.

    Zoom – As Connie said, never miss a dose. Unlike April, I felt it hard. I’d often forget to take my (relatively low-dose) pills on the weekend, and I’d feel like shit all Sunday until I realized why. My prescription ran out on the first day of my recovery from getting my wisdom teeth out, so I wasn’t in a position to go to the shrink to get more pills, so I figured being in bed with painkillers was the best time to suffer the effects of going cold-turkey.

    After getting off the pill (after being on it for many years), I felt like a weight had been lifted off my shoulders and I could think more clearly. I later went back on something for a bit, but they take a couple weeks to take effect, and often bouts of depression only last a couple weeks anyway (unless it’s severe or prolonged).

    Now if I’m feeling depressed (or stressed, or burned out), I just manage it myself and I’m able to recognize the (largely uncontrollable) underlying causes, and I stubbornly push myself through it like a fight with the telephone company or a very long committee meeting.

    YMMV.

    – RG>

  • Carmen

    Well, not sure how the pharmaceutical stuff works but I do know one thing…you have to leave as you came in…that is, when you and your physician think you’re ready, you must decrease gradually…. Happy you’re back to your sunshiny self!! I’ll make a knitting date with you!

  • Milan, I agree, the scientific stuff needed to be in there for credibility. Absolutely. I just didn’t understand it as well as I would have liked, and it made for a slow and sometimes frustrating read for me. This might be one of the major stumbling blocks for the environmental movement – that many people lack the scientific education to fully comprehend and care about the issue. (For the record, I do care. And I believe the science, even if I don’t understand it.)

    James, I’ve gone through normal funks before, and I don’t think this was one of them. It was qualitatively different, and much more difficult to manage, which was why I asked for my doctor’s help with it.

    Lissa, I like that analogy. I wouldn’t be surprised if I used up all my serotonin last year.

    Mary, I might actually like feeling over-revved. :)

    Bob, true enough – I take other supplements without batting an eye, like Vitamin C and D.

    JM, I’d love to go to the forum, but I still have another week of the Experience in Motion course. Maybe I can come to the Youth Awards thing on Wednesday evening. And yeah, let’s go for a coffee sometime the week after next, okay?

    Connie, it makes a world of difference, doesn’t it? Depression feels like an anchor.

    Kathleen, thanks. I’ll see you tomorrow.

    April, that’s interesting that you just kind of ‘knew.’ I hope that happens to me. (But I will ease off them. My doc said that some people, if they stop abruptly, experience symptoms like, if they turn their head, their vision doesn’t go with them – they’re still seeing the thing they were looking at before they turned their head. Sounds freaky.

    Gabriel, that makes sense. I think I know why I’m depressed – I’m not really sure how to deal with it though.

    Grasswren, thanks, that’s what I’ll do.

    Redfraggle, it was a little of both (looking for insight and advice, and thinking out loud). And also just letting people know where I was at. I like that you’re happy for me. :)

    You too, Grace. I’m happy you’re happy I’m feeling better.

    Grouchy, that’s interesting that you felt you could think more clearly after you stopped taking them. I find my thinking is okay so far but my words aren’t as accessible as usual, especially when I’m writing.

    Carmen, I’ll be looking forward to that knitting date. :)

  • Gillian

    Glad you’re feeling better.

  • Arden

    I’m really glad that you’ve turned a corner. As most people have said, you’ll probably need to be on it for a time, but you will mostly likely be able to come off it at some point.

    It’s a really good drug, but don’t miss a dose, don’t even change the time of day you take it by more than a couple of hours, you can get very weird kinds of dizzy (described by some as champagne bubbles on the brain.) It also makes my restless leg syndrome way worse, but it’s worth it.

    I’ve got a wicked family history of depressions on both sides of the family, and will likely always be on a drug, the only thing that will change is the brand and dosage.

  • You can’t just stop effexor. You and your doctor have to wean you off of it so keep that in mind. (it causes nasty withdrawal symptoms).

    If you had(are having) a single episode of depression, you may not need the medication forever. If, however, the depression becomes a daily thing, you may need it to keep yourself on an even keel. I liken it to taking synthroid for my thyroid or bp medicine so I don’t have a stroke. I work as a psychiatric social worker and this is what I see and talk about all day every day.

    The important thing to remember is that you are an individual and things that work for someone else may not work for you. You have to feel your way through. Don’t be afraid of the medicine. I think there’s such a stigma about it because you can’t see depresion (like you can see the flu), you just feel it. We get suspicious of things we can’t see.

    Good luck with this. You’re a level headed person. You’ll make the decision that works for you. (sorry for the novel here)

  • Really accepting the science basically means accepting that rich countries must totally abandon fossil fuels within the next few decades, with the rest of the world following not long after.

    At least, that is what is necessary if we are to avoid a really dangerous amount of climate change.

    Lots of people who accept that climate change is a real problem have not gone on to accept those implications. One o the best things about Hansen’s book is how he demonstrates the tight linkages between all those ideas.