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Depressing news FROM my Psychiatrist!!!


LouisZ
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I've been seeing this Dr for about two years for recurrant major depression, anxiety, etc.

I have made slow progress (I think)

I am taking several medicines for depression and anxiety. All rx'd by this same Doc and taken as told.

Now he tells me that all antidepressant meds fail at some time.

I'm in shock.

I'm in fear.

I can never go back to where I was two years ago.

I believe this guy because he never given me any bullshit as other docs have.

I appreciate his honesty, but WTF???

I'm still trying to process this.

Help!

Ever heard of this before?

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I don’t know a lot about medications, Louis, but I recommend asking your doctor to clarify what he meant. It’s possible you’re misinterpreting. It might simply mean you need to be aware of how things are working for you on a day to day basis. Sometimes medications need to be adjusted and changed. It’s hard to know what he meant, though, without asking him. Are you also in talk therapy? If you’ve made progress, I would think that progress is not entirely due to the meds, though I’m sure they are playing a helpful role. In the meantime, I hope you can be in the now moment. How are you feeling today?

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"I can never go back to where I was two years ago."

But, this is true of everyone, all the time: going back isn't one of our options. You'd be sixteen again, and back in high school, and so on. If you mean, returning to health and (occasional) happiness, though, you might not only return, but improve on your past experience, precisely because you've gone through this down period.

"... all antidepressants fail ..."

Yet this is a problem only if you see antidepressants as some sort of life support system, or as a cure for depression. People cope with depression; the cure, if any, is a change in how you view yourself and your moods. Antidepressants only take the edge off and give you the chance to learn those new skills in time. It might also be useful to clarify what the doctor meant: he could mean simply that you would have to change medications periodically, instead of the idea that at some point, nothing will work, which seems to be how you've taken his words.

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Yes, I guess it must be a shock. It's called, among patients, "poop-out". Many doctors don't believe it happens. You've probably found one who has seen it happen. It may be related to some mechanism whereby the body develops resistance to the drug, but that is only one theory. Another is that the body changes over time, as does the illness so that what worked for some time, has to change.

That's the gloomy part. But this doesn't happen to everyone. Many people are on one med for decades and they never poop out. The other thing is that there are enough meds out there (and more being developed all the time) that your chances of finding quite a few for you are good. When taking combinations, they interact with each other so the same drug may behave differently with other combinations, so there are more possibilities there too.

Are you in therapy? Meds AND therapy are like 1+1=3. CBT is one technique that has been proved in clinical trials.

Once you are in remission, enjoy that time without worrying about how long it will last. It may last many years. :) If it fails, there'll always be something else down the line.

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I work in behavioral health in a non clinical capacity but in doing so I read of ton of inpatient/outpatient psychiatric notes and speak w both patients & providers. Many, many times I read or am told that a psychiatric medication that was working suddenly stopped working or even became counter productive. It seems most common for young folks, I would guess its because their biochemistry is changing?

Not trying to alarm anyone, just sharing information.

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Would you say you have matured in the last two years? Has the way you viewed the world changed? Have you learned new coping strategies? If so, you do not have to worry about becoming like you were two years ago.

Antidepressants are not like drugs and alcohol. They do not give you a high, or make you happy in the midst of agonizing events. What they do is chemically prevent the brain from handy-capping itself in response to depression.

See: http://www.researchgate.net/publication/51717768_Cell_atrophy_and_loss_in_depression_reversal_by_antidepressant_treatment

Ultimately, you bring yourself out of depression by becoming a stronger person. Anti depressants are simply a resource. They work by making your brain produce new cells, so that you can adapt in positive ways.

see: http://mentalhealth.about.com/cs/psychopharmacology/a/neurogenesis.htm

What matters in the long term is not whether you stay on antidepressants, but whether you use your new brain cells wisely.

Don't focus on the medicine. Focus on making a better life, and in the process you will build a better brain.

God Bless

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I was so, so terribly depressed 2 years ago.

That is why I stated "I can't go back".

I never, ever want be feel like that again.

So the Doc tells me that SSRI's and SNRI's often lose efficacy over time and become useless.

I have tried so many combo's of these medicines just to get to this "better" state of mind...

and now I fear that I may relapse.

I have been in group therapy (4hrs/day for 1 month)when I was near my worst.

I have not had any therapy since.

I have only enought money to pay Doc and buy medicines.

I have no health insurance, so I subsidise the wealthier whom can afford their insurance and medicines.

Generic Venlafaxine (Effexor) costs me $250 a month. Those with good insurance may pay 1/10 for the real Effoxor.

Genertic Trazadone costs me $45 a month. This stuff has been around since 1970's and is dirt cheap. those with good insurance will pay 1/10.

"The most effective way to get rich is to exloit the disadvantaged." - Sen. Paul Ryan & Sen. Ted Cruz.

The poor ALWAYS feed the wealthy, always.

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Yeah, but Louis, if you go around fearing you will relapse, you will look for signs of it happening, when they are perhaps only normal dips.

Why not rather enjoy the wellness you have now?

The relapse may not come for a long time, it may be treatable with a small tweak of meds, it might not be anywhere as bad as before. There are so many ifs and maybes, you could waste many good years, looking for relapse.

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That's news to me, but there's always other drugs out there, and who knows, if it does 'poop out' you may never notice, if your state of mind has changed significantly enough!

Just like to say, though, don't worry about branded medications. Here in the UK, we often don't even see the popular brands, just many different brands/suppliers, but when it comes down to it, the drug is the same.

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