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Hi, Amy,

I'm glad to hear from you again :(. I'm sorry you're still in this terrible uncertainty about meds :(. I don't have any experiences that could be helpful in this regard... (so I hope others will comment on it)

This stands out for me:

Over the last 3 weeks, I've been increasingly distancing myself from things and the behavioral action that I need to be doing in order to get myself happier and sort myself out... This hasn't been because I don't want to go and do things, I really do.. But I feel that bad, I haven't quite managed to get myself out to do things.

Could you try to specify what are the 'obstacles' that prevent you from doing something you like? Do you have too big aims that can't be achieved in your depressed state, or just don't care enought about these things? (I know the reasons can be different, these two just occured in my mind.) Have you a friend (/a colleague) who could encourage you to go out with her sometimes and spend a nice time?

I've luckily all along still been managing to go to work and basic functioning so should I just be 'happy' with this and get on with therapy?

As these days, I'v been reading V.E.Frankl's Man's search for meaning, I'd like to share one of his main ideas (only by my own words!) that seems appropriate also in this context: It's up to us to assume an attitude; in every situation where we can't change the circumstances, we still are free to assume the right attitude - not only 'free', but also responsible.

So... I know it's hard to 'feel happy' when you feel so bad. But the point seems to be not in 'foring yourself to feel happy', but in searching for the right attitude and find what you can do for feeling any better. And it seems to me that that's what you're already doing, you just need some encouragements :o... The therapy sessions are the place where your effort is somehow 'concentrated', but your everyday life surely can (and 'should') be the time when you 'work' on this, too. I'm sorry I can't be more concrete. It's all very hard for me, in my life, too; I don't have any 'recipes'...

Maybe it would be helpful to read some more threads on these forums - there are often very insightful ideas...

Best wishes!


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Guest ASchwartz

Hi AmeyH,

Welcome back to the community. While I am not a psychiatrist there are a few things I have learned about meds.

For example, the maximim dose of of effexor is 300 mg.

Lamictal is given very gradually because, if not, there are side effects.

Lamictal is for Bipolar but now we know a few new things about Bipolar:

You do not have to have mood swings. There is something called A Typical Bipolar. It carries with it deep depression that does is not helped very much by anti depressants. I know of a number cases just like your where anti depressants helped a little, they were put on Lamictal and the depression lifted. Its a slow and gradual process.

Anyway, without being a psychiatrist, and in my opinion, you are onto something that could help lot but it will take time.


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Hi again Amy. I'm better with giving information, so here goes:

I wish I didn't have to say this, but you'll need to give the Lamictal time to get to a therapeutic dose (100-200mg) (Once you get to 100mg you can jump faster each increase eg by 50 or even 100mg in one jump, instead of 25mg at a time.) The slow start is to reduce the chance of you getting a horrible rash, which means you have to come off it. Lamictal is a mood stabiliser, particularly good for depression, and sometimes used as a adjunct to an AD in unipolar, not only for bipolar. So you're right it doesn't mean you're bipolar. It can boost the effect of an AD but may also be effective on its own. So, in effect, it's like you're trying another med now. I don't know if that gives you any hope?

As for the Efexor: I don't know. 5 months is a long time. It could be that the combination with Lamictal is what is needed. Edronax works on norepinephrine (noradrenaline) only, not on serotonin. You might want to ask your pdoc how he feels about Wellbutrin - it works on noradrenaline and dopamine, which may help.

Therapy is a slow process. It's very effective but changes don't happen overnight. CBT is supposedly faster, you could ask your therapist if s/he would do a little of it with you as part of what you're doing.

I don't know if any of that will help, but there it is.

You are having a rough time! It's good to keep functioning, it prevents you sinking lower even though it's hard. We're still here.

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