Answer Addiction

Tag: antidepressants

  • Double or Nothing: The Two Diseases That Want Me Dead

    My depression didn’t entirely cause my alcoholism, but it certainly played a key role.

    I have two diseases that want me dead.

    One is addiction, a progressive, incurable and potentially fatal disease that presents as a physical compulsion and mental obsession. I am addicted to alcohol and, as an alcoholic, can never successfully drink again.

    There is no cure, only ways of arresting the vicious cycle of binge, remorse and repeat that leads to ever-deeper bottoms. My alcoholism took me not only to unemployment but unemployability; not only selfishness but self-destruction; not only deteriorating health and heartache but abject desperation and insanity.

    My other deadly illness is depression. By this, I mean clinical depression – a necessary distinction considering the widespread, ill-informed use of the phrase “I’m depressed” to describe mere sadness. The difference is that sadness is rational while depression decidedly is not. Depression is not an emotion; it is a chemical imbalance that leads to hopelessness and self-loathing and, for that reason, is the leading cause of suicide.

    Mourning a loved one is understandable and altogether appropriate; that is sadness. Climbing to the roof of a six-story building and nearly jumping because I considered myself toxic and worthless, as I did in my mid-20s, is not normal and certainly not healthy; that is depression.

    I will be an alcoholic and depressive for as long as I am alive. But while neither is curable, both are certainly treatable. And increasingly, I’m finding that my progress in recovering from one disease is paying substantial dividends in combatting the other.

    Weller Than Well

    I took my final drink on October 10, 2011, the last in a long line of cheap beer cans littering my car. Wherever I was going, I never got there; instead, I crashed into a taxi and kept driving. Police frown upon that. I spent the night in jail and the next six months sans license. I was in trouble physically, spiritually, and now legally, and I had finally experienced enough pain to seek salvation.

    I got sober through Alcoholics Anonymous. There are several programs effective in arresting addiction; AA just happens to be the most prolific, and embodied the sort of group-centric empathy I needed during the precarious early stages of recovery. There are few things more alienating than being unable to stop doing something that you damn well know is destroying your life. Meeting consistently with others who’ve experienced this tragic uniqueness made me realize I wasn’t alone, and provided a glimmer of something that had long been extinguished: hope.

    Unlike traditional ailments, addiction is largely a “takes one to help one” disease. I needed to know that others had drank like me and gone on to recover by following certain suggestions. AA provided both the road to recovery and, through those that had walked the path before me, the trail guides. 

    It isn’t rocket science. AA and other forms of group-centric recovery thrive on a few basic tenets. I admitted I had a problem, and saw that others had solved that problem by adhering to certain instructions. I accepted that my addiction had been driven by certain personality flaws, and that active addiction had only exacerbated these shortcomings. I made concerted efforts to begin not only amending my actions through face-to-face apologies, but also diminishing the underlying character defects that had fueled my alcoholism.

    In the process, I did not recover so much as reinvent myself. Nine years into my recovery, I am not the same person I was before becoming an alcoholic. I am better than that catastrophically damaged person.

    Like no other illnesses, recovery from addiction can make sufferers weller than well. I am not 2005 Chris – pre-problem drinker Chris. I am Chris 2.0. Stronger, smarter, wiser.

    And that brings me to my other incurable illness.

    So Low I Might Get High

    My battle with depression predates my alcoholism. In fact, the aforementioned rooftop suicidal gesture came before I was a heavy drinker. Like many people with concurrent diseases that impact mental health, one malady helped lead to another. My depression didn’t entirely cause my alcoholism, but it certainly played a key role.

    For me, bouts of depression descend like a dense, befuddling fog. At its worst, I have been struck suddenly dumb, unable to complete coherent sentences or comprehend dialogue. My wife once likened my slow, confused aura to talking with an astronaut on the moon; there was a five-second delay in transmission, and my response was garbled even when it finally arrived.

    My depression is clinical, meaning it is officially diagnosed. I am medicated for it and see a psychiatrist regularly. Upon getting sober, the first cross-disease benefit was that the anti-depressants I took daily were no longer being drowned in a sea of booze. The result of this newfound “as directed” prescription regimen was the depression tamping down from chronic to episodic. For the first time in nearly a decade, there were significant stretches where I was depression-free.

    Still, come the depression did, in random waves that enveloped me out of nowhere, zapping the hopeful vibes and purposeful momentum of early recovery. The sudden shift in mood and motivation was stark, striking and scary. Above all else, I was frightened that an episode of depression would trigger a relapse of alcoholism.

    In recovery from addiction we are taught, for good reason, that sobriety is the most important thing in our lives, because we are patently unable to do anything truly worthwhile without it. If we drink or drug, the blessings of recovery will disappear, and fast.

    Ironically, and perhaps tragicomically, by far the most formidable threat to my sobriety was my depression. One of the diseases trying to kill me was persistently attempting to get its partner in crime back. Inject some hopelessness and self-loathing into a recently sober addict’s tenuous optimism and self-esteem, and there’s a good chance he’ll piss away the best shot he’s ever had at a happy, content existence.

    For months and even years into recovery, my only defense against depression episodes was intentional inactivity. Upon recognizing the syrupy sludge of depression draining my energy – a quicksand that made everything more strenuous and, mentally, seem not worth the extra effort – I would do my best to detach from as much as possible. My routine would dwindle to a questionably effective workday and, if any energy was left, what little exercise I could muster, an attempt to dislodge some depression with some natural dopamine – a stopgap measure that rarely bought more than half an hour of relief.

    Most alarmingly, during bouts of depression I would disconnect from my recovery from alcoholism, often going weeks without attending meetings or reaching out to sober companions. In depressive episodes, the hopeful messages of group-centric recovery rang hollow, and at times even felt offensive. How dare these people be joyous, grateful and free while I was miserable, bitter and stuck.

    Over an extended timeline, though, life had improved dramatically. As a direct result of sobriety and its teachings, my status as a husband and an executive improved drastically. In rapid succession I bought a house, rescued a dog and became a father. My depressive episodes grew fewer and further between.

    But when they came, I was playing a dangerous game. I now had a lot more to lose than my physical sobriety and, despite being rarer, my depressive episodes were almost more intimidating for what they represented: irrational hopelessness amid a life that, when compared to many others, was fortunate and blessed. So when depression descended, I did the only thing that seemed logical: I whittled life down to its barest minimum, and waited the disease out. I put life on pause while the blackness slowly receded to varying shades of gray and, finally, clearheaded lucidity returned.

    Essentially, I became depression’s willing hostage. I didn’t want it to derail me, and didn’t have a healthier means of dealing with it.

    And then suddenly, I did.

    Beating Back a Bully

    For the second time in my life, I have hope against an incurable disease where before there was hopelessness. And though I can’t place into precise words exactly how it happened, I’m hoping my experience can benefit others. For the countless battling mental illness while recovering from addiction, my hope is to give you hope.

    Last fall, just as I was celebrating eight years sober, I hit a wall of depression the likes of which I hadn’t encountered in a while. Like most depressive episodes, its origin was indistinct. It had indeed been a tough year – I had lost a close relative and had an unrelated health scare, among other challenges – but trying to pinpoint depression triggers is generally guesswork.

    Anyway, there it was. A big, fat funk, deeper and darker than I’d experienced in years. But for whatever reason, this time my reaction was different. Always, my routine was to place mental roadblocks in front of my depression. I justified this by telling myself, understandably, that depression’s feelings were irrational and, therefore, not worth confronting.

    This time, for whatever reason, I took a different tack. For the first time, I leaned in rather than leaning out. I stood there and felt the harsh feelings brought on by depression rather than running from them. Whether it was sober muscle memory or simple fed-upedness, I had had enough of cowering in a corner while depression pressed pause on my life.

    The result? It hurt. A lot. But if battling depression is a prize fight, I won by majority decision. And having stood up to my most menacing bully, I fear the inevitable rematch far less.

    This would not have been possible – and is not recommended – earlier in recovery. In hindsight, I’m realizing that at least part of the reason I finally confronted my depression was that, after eight years of recovery work and a vastly improved life, I had placed enough positives around me that depression’s irrational pessimism couldn’t fully penetrate them. I had built up just enough self-esteem through just enough estimable acts that the self-loathing pull of depression couldn’t drag me down as far. I stumbled and wobbled, but I did not fall.

    Depression also prompted a highly unexpected reaction: gratitude. Its wistful sadness made me pause, sigh, even tear up. It made me look around longingly and grasp the blessings that, during my typically time-impoverished existence, I often take for granted. It made me feel guilty for not fully appreciating the positives in my life… but this guilt was laced with vows to cherish life more once depression invariably lifted, as it always did. There’s a difference between hopeless shame and hopeful guilt; the former yields self-hatred, the latter self-improvement.

    In this way, the tools acquired in recovery from addiction were wielded effectively against depression. There is a retail recovery element at play here: Though not as simple as a “buy one get one free” scenario, I’ve learned that fully buying into continued recovery from alcoholism can lead to significant savings on the pain depression can cause me. I have a craziness-combating coupon, and it’s not expiring anytime soon.

    To be clear: This is by no means a “totally solved” happy ending. Confronting my depression meant facing some demons that have been stalking me for decades. You don’t slay dragons that large in one sitting. I have, however, made a promising start. I have discovered that progress against complicated chronic afflictions is indeed possible, and can sometimes flow unexpectedly from sources one wouldn’t expect.

    View the original article at thefix.com

  • Lake Bell Details Traumatic Home Birth To Destigmatize Psychiatric Meds

    Lake Bell Details Traumatic Home Birth To Destigmatize Psychiatric Meds

    “I barely take Advil but I was like, this is absolutely imperative in order for me to function.”

    Actress Lake Bell was a believer in the “organic f—ing kumbaya way of living,” but that did not stop her from seeking medication after a traumatic home birth in which she nearly lost her son.

    “It was like I need something, I can’t be a person. I don’t know how to be… I had never felt that before,” the Bless This Mess star said on a recent episode of The Conversation with Amanda De Cadenet. “My heart aches for those who feel that through the hardship of their life every day, like, I have felt it. I know what it is and it’s a monster. It’s a demon.”

    Bell is hoping to lessen the stigma around psychiatric medication by sharing her story. She said that turning to Zoloft after her son Ozzy’s birth in 2017 allowed her to function and feel like herself again.

    Taking Antidepressants To Feel Normal

    “I took a medication called Zoloft, a very low dose and this was again, a person who was afraid of Advil, and I begged for it for my own well-being and for my family’s well-being… and it took me to a place where I could be. I could just be,” she said. “It was rational. I needed to just be Lake and I felt finally like I could breathe the air that Lake breathes, not like some other person that I don’t recognize.”

    She was on the medication for about a year before she tapered off.

    Bell said she was overcome by guilt after insisting that she have a home birth for Ozzy. The birth of her first child in 2014 to daughter Nova was “empowering,” she told Bless This Mess co-star Dax Shepard on his podcast Armchair Expert in July, and inspired her to have a second home birth.

    Nova was born with the umbilical cord around her neck, but Bell and her husband watched as “she came to life” with the help of the midwife.

    The Trauma Of Almost Losing Her Son 

    Ozzy was also born with the cord around his neck, but did not recover as well as Nova did. The newborn was rushed to the hospital and spent 11 days in the NICU. Having been deprived of oxygen for “longer than the four minutes that is associated with being okay,” the parents were informed that “he could [have] cerebral palsy or never walk or talk. That was our reality,” Bell said.

    She struggled to cope with the guilt and trauma of almost losing her son.

    “I’ve dealt with that since,” she told Shepard. “You could blame the midwife, you could blame yourself, but ultimately the result is the only thing that matters. I’ve gone through therapy and was medicated for a year and a half. I did wean myself off but I was on antidepressants to help kind of regulate. I barely take Advil but I was like, this is absolutely imperative in order for me to function.”

    View the original article at thefix.com

  • Can SSRIs Interfere With Opioid Pain Relief?

    Can SSRIs Interfere With Opioid Pain Relief?

    A new study examined whether patients who were on SSRIs received less pain relief from certain opioids.

    SSRIs—the most common type of antidepressant—can make some opioid pain relievers less effective, exposing patients to higher levels of pain, according to a new study. 

    For the study, published in the journal PLOS ONE, researchers examined medical records of 4,300 patients who underwent a major operating room procedure at a medical center between 2009 and 2016. They found that patients who were on SSRIs and who received a certain type of opioid had less pain relief following their operations. 

    To understand the study, it’s important to note that opioids come in two varieties, according to NPR. Direct opioids, including morphine and OxyContin, begin working as soon as they are administered. Prodrugs, which include Vicodin and hydrocodone, have to be broken down in the liver before they can begin relieving pain. 

    SSRIs interrupt this process. This is because they affect a liver enzyme that is needed to break down prodrugs. With less of the enzyme breaking down drugs, the pain relief is less effective. 

    “There was theoretical evidence that suggested SSRIs might block prodrug opioids, but we didn’t know if it actually affected patient outcomes,” said Tina Hernandez-Boussard, who authored the study. 

    People on SSRIs who were prescribed prodrug opioids were in more pain up to two months after their procedure. 

    Because SSRIs and opioids are some of the most common prescriptions in the country, the study could have widespread implications for how pain is handled, said Jenny Wilkerson, a professor who teaches pharmacodynamics at the University of Florida.

    “This is an important study,” she said, before calling for additional research. 

    People who get less effective pain relief from opioids are likely to take more pills, which “could lead to misuse or abuse down the road,” Hernandez-Boussard said. 

    “If the opioids aren’t being activated and you’re not getting appropriate pain management, you’re going to take more opioids and you’re going to take them for a longer period of time,” she said. 

    One way around this would be to prescribe direct-acting opioids to patients on SSRIs. 

    “Every opioid has a side effect, not one opioid that is better than another. Possibly for patients taking SSRI, morphine or oxycodone, direct-acting drugs which don’t need to be broken down by the liver might be a better choice,” Hernandez-Boussard said. 

    Wilkerson said that patients should be confident in advocating for themselves when it comes to effective pain relief. 

    “Patients shouldn’t feel stigmatized for being depressed or in pain. Patients have to advocate for their best personal care.”

    However, Hernandez-Boussard acknowledged that this can be difficult for people who are depressed. Instead, she believes the medical community should work to better understand the interaction of SSRIs and opioids. 

    She said, “We need to think about how we can tailor treatment towards more vulnerable groups. More work needs to be done, but this is a good first step.”

    View the original article at thefix.com

  • Not Crazy: How I Overcame My Double Standard About Taking Psychiatric Medication

    Not Crazy: How I Overcame My Double Standard About Taking Psychiatric Medication

    Women hold themselves to this standard where we’re supposed to be perfect. We all have our own image of what that should be, and it doesn’t involve taking psychiatric medication.

    I’m walking up Lexington Avenue towards the subway on a cold Manhattan winter day from my psychiatrist’s office. It’s a route I’ve walked for five years, at varying frequencies, depending on the intensity of my mental health issues.

    My doctor is warm and nurturing with a great sense of humor, and I always walk out her door with a smile on my face. But once I hit the street, my mood can quickly shift: frustrated that I need yet another medicine to achieve some semblance of normalcy or disappointed in myself that I can’t cope. I scan the faces of the crowds in busy Midtown. Can they tell I’m crazy? Do they see some vacant look in my eyes I can’t see? Or, conversely, I wonder about them: is she, that pulled-together woman over there, also buoyed by a bevy of psychiatric meds?

    When I started an anti-depressant four years ago, I immediately started calling it my “crazy pill.” I want to say that’s just because I have a self-deprecating sense of humor, but that’s not the whole truth. Deep down, I thought it was because I was crazy.

    But this time leaving her office was different. My doctor used the words “in recovery,” (probably not the first time she used the phrase) and something inside me shifted. Of course I’m in recovery. I suffered myriad traumas last year: losing my mom, my job, needing to give up my dog, and, hey, let’s throw a summer fling breakup in there for fun. Needing to take medicine to recover from emotional trauma should be the same as if I had been in a car accident and needed painkillers…right?

    The word recovery resonated with me, and I finally internalized this: depression is a very real condition, and my doctor is treating me for it. I’ve written that depression can be like an emotional cancer—entirely pervasive and something that may go away. Or it may worsen.

    On the outside, I pen essays, like this one, where I tell others that they should treat depression and other mental illness just as if it were any other disease. That it shouldn’t hold stigma. And I meant it…for them.

    But why the double standard? Why would I be proud, even, to hear a friend was taking care of her health and taking antidepressants—but think that it made me crazy?

    “Women hold themselves to this standard where we’re supposed to be ‘perfect,’” says Dr. Carly Snyder, a Manhattan-based psychiatrist. “We all have our own image of what that should be, and it doesn’t involve taking an antidepressant.”

    In our culture, memes abound about wine being “mommy juice,” yet “there’s still stigma in trying to feel better in an appropriate way,” Snyder says. “’I’m seeking treatment for an anxiety disorder or depression’ becomes seen as ‘I couldn’t hack it on my own.’”

    For me, I see others dealing with grief or job loss “better” than me, and I wonder what’s wrong with me. I’m doing all the “right” things: I ran the NYC Marathon (my seventh marathon) last year, I picked up personal training and yoga teaching certifications this year, and I have tried every last wellness trend known to woman in hopes that crystals, or maybe hypnosis, will be my magic bullet.

    “We are in a really positive wellness kick right now [societally], and there’s a sense of ‘I didn’t do enough to help my mental health issues,’” says Snyder. Yet, “if someone were struggling with another disorder, a physical disorder, people wouldn’t say not to take care of it. Running is not going to get you out of a major depressive episode.” I constantly joke that if running a marathon isn’t enough to cure a depressive episode, maybe I just need to run an ultramarathon, but I know that’s not actually the answer.

    But while a 50K isn’t the answer, it is important to care for our bodies to care for our brains, says Snyder. (In case you forgot—your brain is a part of your body!) “It’s important to give one’s self the leeway to not feel OK and realize it’s a process to feel better.” People with depression tend to see the world in black and white, and if you wake up every day and say: “I’ll feel better today,” then as soon as you don’t, it becomes a bad day, according to both Snyder and my own experience. “There has to be room for disappointment and some gray area—and allowance for time of healing. It’s not going to happen overnight in the presence of significant illness and trauma.” She likens it to a bad bruise: it can come on quickly but take a long time to go away.

    If you’re already depressed though, that still sounds bleak. You want immediate gratification, right? Of course you do. Here’s the thing: we have control, and we’re not failures for having depression and anxiety. (Take a minute and write that down or say it out loud. Let it really sink in.)

    You don’t have to let your mood disorder dictate your self-worth or how you see the world—things I was guilty of. I identified myself as a depressed person, I threw my hands up in the air and blamed depression for my behavior. Snyder says that “when we are depressed, we deprive ourselves: I don’t deserve to feel better, I don’t need to feel better. There’s this bleakness that comes in. You know in your heart that this is not what it feels like to live in your day-to-day life, but it becomes harder to see a way out.”

    But you win, she says, by taking control—by going to therapy, by going to a psychiatrist, by not listening to that voice in your head that says you don’t deserve it.

    And although I’ve been treated for years—through therapy, medication, hospitalization and myriad holistic approaches, some legit, some snake oil—it was only on that cold day that I finally internalized it, that I really believed I deserved to feel better, and that depression was an actual diagnosis I had that needed to be treated. I saw my psychiatrist as a partner in my recovery, rather than someone who held all the power to cure me via her prescription pad.

    This realization took some of the power from the disease and allowed me to (eventually) reframe subsequent flares as just that, something that might happen to anyone with a chronic illness.

    View the original article at thefix.com

  • New Subtypes Of Depression Discovered

    New Subtypes Of Depression Discovered

    For a new study, researchers set out to identify the subtypes of depression using “life history and MRI data.”

    New research sheds some light on why not all depression can be treated with medication, according to Medical News Today. 

    Researchers from the Okinawa Institute of Science and Technology Graduate University (OIST) in Japan have identified three new depression subtypes. 

    According to Professor Kenji Doya of the Neural Computation Unit, there has always been speculation about different subtypes of depression, but it had never been proven. 

    A research team led by Doya studied data from 134 participants, half of which had recently been diagnosed with depression. Through questionnaires and blood tests, the research team gathered information about each individual’s life history, mental health, sleep pattern and other potential stressors in their life. 

    The team utilized functional MRI scanners to gather information about each person’s brain activity. In doing so, they mapped 78 brain regions and the various connections between them.  

    First study author Tomoki Tokuda, a statistician at OIST, says the challenge in this research was developing the right tool.

    “The major challenge in this study was to develop a statistical tool that could extract relevant information for clustering similar subjects together,” he said, according to Medical News Today.

    Tokuda was able to create a new statistical method from which researchers could categorize more than 3,000 “measurable features”—such as childhood trauma and level of depressive episode—into five data clusters.

    In doing so, researchers found that three of the five data clusters connected to different subtypes of depression. Additionally, the brain imaging shed light on the “functional connectivity” of brain areas connected to the angular gyrus, which is the region of the brain that has to do with procession language, numbers, spatial cognition and attention. 

    The connection could predict whether or not SSRIs—the most common type of antidepressant—could effectively treat depression. 

    According to the researchers, one of the subtypes that did not respond to medication correlated with “high functional connectivity as well as with childhood trauma.”

    The other two subtypes of depression did respond to medication. Researchers found that this subtype had low brain connectivity and no instance of childhood trauma.

    The results of this study could help doctors predict how effective certain medications and treatments may be for a patient, according to Doya.

    “This is the first study to identify depression subtypes from life history and MRI data,” said Doya, according to Medical News Today. “It provides scientists studying neurobiological aspects of depression a promising direction in which to pursue their research.” 

    View the original article at thefix.com

  • A Month of Heart Attacks: Withdrawing from Antidepressants

    A Month of Heart Attacks: Withdrawing from Antidepressants

    My doctor tells me not to worry. The medication is safe. I worry he doesn’t know what he’s talking about. I worry this was a big mistake I made at 18 and am paying for the rest of my life.

    My obsessions start as small thoughts. Random sparks catching kindling in my mind, eventually blazing into a wildfire. I’ve always been this way. I couldn’t run for fun, I had to run marathons. I couldn’t go to school for one degree, I had to get my PhD. I couldn’t write a few articles related to my work in digital design, I had to write a book. I couldn’t drink a little bit of alcohol, I had to drink until I passed out. This same thinking led to my decision to stop taking my anti-depression and anti-anxiety medication.

    I began taking medication to treat depression when I was 18. Melancholy was my constant companion the last two years of high school. It stuck around after my graduation as well. Depression had me incapacitated and numb to self-improvement. My first adult visit to a general practitioner took me 30 seconds to describe how I’d been feeling for years. I left with a prescription for Zoloft. 

    I didn’t start taking the medication immediately. I was smoking and drinking to self-medicate. Taking a pill seemed weak. I grew up as part of a generation over-exposed to and under-educated on anti-depressants. Particularly Prozac, which seemed to enter the lexicon of my peers overnight in the early 1990’s.

    “Quit being a spaz! Take a Prozac.” we’d tease each other. Even worse, “Her parents put her on Prozac.” we’d whisper in the hallway. We didn’t know what that meant. Only that being on Prozac meant you weren’t normal. Commercials and TV shows told us it was used for depression. You had a mental illness if you were depressed. Mentally ill people are crazy.

    I knew crazy was bad. My father had a mental illness. He took lithium for a good part of my childhood. He hallucinated aliens were sent to kidnap him. He was crazy. I constantly worried this secret would be exposed. I was the son of a mentally ill man.

    I struggled with what the decision to take medication would mean for my future. What would my future partner think? What would my future children think? Maybe I’d only need to take if for a few months, I thought. I wanted to feel better. I wanted to live up to the potential I’d always been told I had. I decided to take the medication.

    ———

    Medicated

    Zoloft worked. I could get out of bed easier. I could deal with the ups and downs of everyday life. I functioned. My thoughts dwelled less on negative aspects of life. But the stigma of taking medication for a mental illness was always present in my mind. The elephant in the room when I was getting to know new people. What if they wanted to get closer? Would I have to disclose I took medication? Was it worth it to cultivate relationships if I were going to lose them? Or, should I stop taking the damn medication?

    Over the next 15 years I ran through the alphabet of anti-depressant/anti-anxiety medications. Zoloft stopped working at low doses. Larger doses left me unable to sleep. It was on to Paxil, Wellbutrin, and finally Effexor. I constantly questioned my decision to take medication. During this time, I moved from Maryland to rural Ohio, I got married, had kids, got divorced, worked multiple jobs while attending school, and eventually enrolled in a PhD program. I promised myself I’d stop taking medication when life settled down.

    My quest to live medicine free started in May of the last year I was getting my PhD. I always feel positive in springtime. Sunshine removes my spirits from winter’s chest of darkness. You should stop taking medication, an inner voice whispered. At first a dew-covered bud, the thought bloomed alongside my uplifted mood. I have to admit these thoughts were assisted by the confidence of nightly drinking. Soon it was all I could think about. I’m a man earning a PhD. I’d been through marriage, divorce, and poverty over the years and not cracked.

    My life wasn’t perfect. It never would be. I had two kids with my ex-wife. She had custody. Worrying about them was my most ingrained behavior. But I should be able to handle things. I’m a good dad. I didn’t need medication to stay that way. The pills were a crutch. I’m strong. Medicine is for the weak. These thoughts cycled in my head for weeks.

    ——–

    Unmedicated

    I didn’t contact my doctor when my Effexor prescription ran out. I went cold turkey. I immediately found, to my surprise, my depression wasn’t as severe as it had been when I started taking medication. I also found out the medication had been masking crippling anxiety I’d developed.

    I wasn’t a stranger to the nausea and dizziness that accompany the first 72 hours not taking Effexor. I’d missed doses more than a few times. Forgetting to take medication for a day or two was not unusual. I’d realize I’d missed a dose when my gums would start feeling numb near the end of the day. Not taking a dose for another few hours would lead to what I called the snaps in my head. Bright pops that brought me in and out of reality. Micro explosions of light going off behind my eyes. I imagined it was my synapses going nuts. I have a powerful imagination.

    I figured I’d get over the brief withdrawal period and move on to whatever normal was. I powered through work keeping to my daily routine with manageable discomfort. Kind of. I laid my head on my desk quite a few times as the snaps passed over in waves.

    A few nights into my new life as an unmedicated, unstigmatized member of society I woke from an unsettled sleep. My first thought: my finances are in ruins! I had gone to bed thinking about bills I had coming due. I would need to dig into my savings. This fact disturbed me. But by no means would I have no money.

    My worry about finances had festered and grown while I slept. I felt it crushing me. Sitting on my chest. I inhaled and exhaled through my nose counting 10 second intervals. My brain wouldn’t stop. My body was exhausted. I looked at the clock. 2:15. More inhaling and exhaling. I fell back asleep.

    I woke again at 3:15. I felt pricks of stinging pain throughout my brain and body. As if fire ants had been biting me in my sleep. I’d stood in a fire ant nest once as a teenager. My legs burned for days. The pain I currently felt wasn’t enough to distract from the panicked thoughts – I’m going to be poor. How will I survive? How will I pay child support? I’m going to go to jail. I inhaled and exhaled slowly.

    I woke up hourly for the remainder of the night. My eyes popping open as intense fire-tingles raged throughout my body. Repeatedly falling back asleep while trying to assure myself dipping into my savings wouldn’t lead to my financial demise.

    The next few nights unfolded in much the same way. I broke the cycle with a binge drinking session that left me passed out and then hung over the next day. The alcohol washed away my anxiety. My anxiety resurfaced as vomit in the light of day.

    Still, I refused seeking more medicine. I was going to be normal. Not weak. This pain was temporary. Being strong and off medication would last forever. I knew I’d feel better once I had a few weeks under my belt.

    ——–

    A Week Off Medication

    I’m having a heart attack. This is it. I’m going to die. I was staring at a murder mystery show on Investigation Discovery. I’d stopped taking medication a week ago. Constant noise comforted me. Living alone, I craved hearing voices. I kept talk radio on, or the TV set to this channel constantly playing murder mysteries. My favorite. The show did not comfort me as I thought I was dying.

    I’m having a heart attack. The thought grabbed my throat, choking me. I’d never felt powerless over my survival. I’d been feeling tight in my chest all day. Sure, I’d been lifting weights and doing pushups throughout the week. This tightness was coming from deeper than my muscles. Tightness that started to burn. This is what dying feels like. Battery acid surged up my esophagus.

    Should I go to the hospital? I thought. No. Hospitals are the only thing I hate more than dying. I felt a surge of adrenaline as I imagined dying alone on my living room floor. It was still a better option than dying in a hospital room. Surrounded by the nauseating smell of sterilization and cleaners. Hospitals crystalized the concept of mortality. I stayed away at all costs.

    The pain in my chest continued through the afternoon. I’d been invited to meet up with a group of friends for a sushi dinner to celebrate a birthday later that night. I wanted to live long enough for that. I’d go to the hospital if I still felt chest pain after dinner. 

    I looked around the table at dinner. Everyone else seemed so happy. I’d been able to choke down a few edamame. I felt terrible. Maybe I should mention the fact that I was having chest pain. My jaw felt tight. My arm tingled. Classic heart attack symptoms. I knew this from WebMD and numerous medical-topic message boards I’d checked out to see what my symptoms meant. Unfortunately, I could make my symptoms match both a drop-dead heart attack, or a panic attack, depending on which outcome I thought it should be.

    I didn’t bring up my troubles over dinner. Verbalizing a fear was often the final step off a cliff into a panic attack. I’d learned that from my previous experiences with milder anxiety. Expressing my fears made them real. Bottling them up kept my mind racing, too busy for full blown panic. I kept my mouth shut and avoided eye contact with my friends.

    My chest still hurt after dinner. I didn’t go to the hospital. It must be something else. Surely a heart attack can’t last hours. I fell asleep convinced I’d never wake up. But I did, again and again. My chest still hurt a week later. I started referring to it as my week-long heart attack with my inner-voice. A week later it became my two-week heart attack.

    I was unable to sleep for more than an hour straight during this time. I’d stopped worrying as much about my finances. I was dying of a heart attack! I worried I’d never wake up. I also found other things to worry about. This wasn’t hard for a divorcee with two kids. I stayed up worrying about their future if I were to die. About our future relationships if I were to live.

    ——–

    Five Weeks Off Medication

    It was 11 pm. I was dying. I stood in front of my bathroom mirror. I stared at my bare chest. I watched my chest muscles pulsing in rhythm with my heart. Was this normal? I’d never noticed before. Never had a reason to. I imagined my heart fluttering to a stop.

    The joke was on me. You really can have a heart attack lasting an indefinite period of time. Four weeks to be specific. I knew this was the grand finale. Time to go to the hospital.

    I called up the girl I’d been dating for a couple years while I walked to my front-door. I’d made her aware of my panic and that I’d stopped taking medication during the first week I’d stopped. She was concerned I wasn’t doing well. She said I should take medication. I should look at it as part of who I am. I take antidepressants, like a diabetic might take insulin. She didn’t like who I was when I didn’t take medication

    “I’m having a heart attack.”

    I slid down to the floor with the phone at my ear.

    “What? Are you OK?” she asked.

    “I don’t know. I’m so confused.”

    I laid down with my head on the ceramic-squares making up my front doorway. They felt cool. So refreshing. My mind stopped racing. I caught a whiff of lemon scented floor cleaner. A familiar scent. Not one I usually found pleasant. Tonight was different. The scent smothered me in comfort while the floor’s coolness eased my tension.

    “I need to hear your voice.” I mumbled. “I’m so tired.”

    I rolled my head to the side to distribute the coolness across my forehead. “Will you keep me company for a bit over the phone?”

    I woke up at 3 am. The phone had fallen from my hand. The screen was lit. I was still on a call with my girlfriend. The timer stated 4 hours and 24 minutes had elapsed.

    “Hello?” I asked into the phone.

    Nothing. I hung up. I couldn’t believe she had been kind enough to keep the line open. I noticed my chest felt better as I slunk up the stairs to bed.

    ——–

    My Last Day Off Medication

    I made an appointment to see my doctor as soon as the office opened. I couldn’t handle what my life had become. I was falling apart in ways I didn’t know were possible. A constant feeling of having a heart attack. Fixating on small problems until I can’t see a way past them. I was used to overcoming adversity daily in my medicated life. I couldn’t face an uneventful day without a panic attack while unmedicated.

    “It’s going to take a couple of weeks to really feel the effects.” my doctor said. He scrawled Effexor XR 150 across his prescription pad.

    “I think I can handle it.” My body flooded with a sense of relief. I knew I’d feel better the next day. The placebo effect is strong with me.

    I stayed at the pharmacy while they filled the prescription. I took the pill while downing a bottle of acai berry juice. Promotes heart health boasted the bottle’s label.

    Just in case, I thought.

    ——–

    Six Years Later

    I’ve continued taking Effexor. I frequently think about stopping. I’ve expressed my concerns to my doctor each time I’ve had my prescription renewed. My doctor tells me not to worry. The medication is safe. I worry he doesn’t know what he’s talking about. I worry this was a big mistake I made at 18 and am paying for the rest of my life.

    I’ve spent over 20 years on some type of anti-depressant/anti-anxiety medication with only the one month break. I’ve spent more years alive taking medicine than not. I wonder what the medication is doing to my mind. Will I have memory loss at an early age? I wonder what the medication is doing to my body. Am I poisoning my liver?

    It’s been six years since my month-long heart attack. It’s been six years since I stopped taking medication for slightly over a month. I haven’t had any more everlasting heart attacks or phone calls lasting till 3 am. I haven’t fixated on a small problem like my finances until I become incapacitated. I haven’t had my body feel like fire ants had spent the night gnawing on me. I am functional. I love my job. I am remarried with another child. I am generally happy.

    Anyone taking an antidepressant has been told it takes more than medication to properly treat a mental disorder. Counseling, behavior modification, meditation, and other self-help activities need incorporation into your life. However, I use medicine as my main line of defense against depression and panic attacks.

    I understand the importance of going beyond medication to treat depression and anxiety. I know and occasionally practice many anti-anxiety techniques. Nothing I’ve committed to doing on a regular basis. Perhaps I’d try harder at these activities if medication wasn’t such an easy and accessible option for me. I feel good most days. I love many more aspects of my life than I don’t. The medication seems a fair price to pay.

    View the original article at thefix.com

  • Misuse Of Unapproved Antidepressant With Opioid-Like Effects Spikes

    Misuse Of Unapproved Antidepressant With Opioid-Like Effects Spikes

    Though tianeptine isn’t FDA-approved, it’s not illegal and can be purchased online as a dietary supplement.

    An apparent spike in the use of an unapproved antidepressant called tianeptine is poisoning people who are looking to benefit from the drug’s mild opioid-like effects, according to a Centers for Disease Control and Prevention (CDC) report released last week.

    From 2000 to 2013, the U.S. saw 11 tianeptine-related poison control center calls; from 2014 to 2017, there were more than 200. That’s all according to the CDC analysis of National Poison Data System information, which sheds new light on a growing trend.

    Though tianeptine isn’t FDA-approved, it’s not illegal and can be purchased online as a dietary supplement. It’s often marketed elsewhere under brand names Coaxil and Stablon, according to Vice News.

    The drug was first discovered by the French Society of Medical Research back in the 1960s, and it’s been shown to help fight depression and anxiety, according to CNN.

    When it was patented, scientists weren’t entirely clear on how it worked. But in 2014, researchers found that the drug lights up certain opioid receptors. While that appears to help with some depression symptoms, it also means that people taking tianeptine can have opioid-like withdrawal when they stop taking the drug.

    “Tianeptine has an abuse potential in former opiate drug users,” the CDC researchers wrote. “This study further highlights that the withdrawal effects of tianeptine mimic those of opioid withdrawal.”

    But, unlike with traditional opioids of abuse, tianeptine doesn’t show up on drug screens, which can make it a tempting choice for justice-involved individuals looking for a high that won’t land them in legal hot water.

    “I think people have this misguided belief that if you can get it on the internet and it’s not overtly illegal and you’re not going through the dark web to acquire these substances, so it must be OK,” Raphael Leo, an associate professor in the Department of Psychiatry at the University of Buffalo, told CNN.

    But, earlier this year, the Journal of Analytical Toxicology reported on two tianeptine-related deaths in Texas, and more have been reported in other countries.

    The potential dangers of the unapproved drug have sparked some calls to ban it. In April, Michigan greenlit a law banning the substance on the heels of a number of overdoses, according to the Associated Press.

    View the original article at thefix.com

  • No More Psychotropic Drugs For Migrant Kids Without Consent, US Judge Rules

    No More Psychotropic Drugs For Migrant Kids Without Consent, US Judge Rules

    Several migrant children have given disturbing testimony about being forced to take psychotropic drugs at a facility in Texas.

    The Trump administration must end the practice of unreservedly administering psychotropic medication to migrant children in US custody.

    On Monday (July 30), US District Judge Dolly Gee in Los Angeles ordered the government to obtain consent or a court order before administering medication such as antidepressants and anti-anxiety drugs, except in dire emergencies.

    Several migrant children have given disturbing testimony of their treatment at Shiloh Residential Treatment Center in Manvel, Texas, one of many facilities contracted by the US Office of Refugee Resettlement to house immigrant children since 2013, the Washington Post reported. 

    One 12-year-old boy named Lucas R. from Guatemala, who was detained in February, was transferred to Shiloh after refusing to take Zoloft, a popular antidepressant, because it was causing him stomach pain, according to court filings.

    Medical staff at the facility diagnosed the boy with major depressive disorder and informed him that he would continue to be held at Shiloh unless he was declared psychologically sound.

    But the court documents contend that a large part of his depression had to do with “being kept from his family” who had arrived in the US before him, according to the Post.

    Other testimony described the forceful administration of medication on children on multiple occasions. “I witnessed staff members forcefully give medication four times… Two staff members pinned down the girl… and a doctor gave her one or two injections,” said Isabella M., another child at Shiloh who was prescribed “multiple psychotropic medications” at the facility including topiramate, without her family’s consent.

    “Nobody asked me for permission to give medications to my daughter, even though the staff at Shiloh has always had my telephone number and address,” Isabella’s mother testified.

    Other children described being forcibly injected with drugs and being given pills “every morning and every night.”

    Another child at Shiloh, Julio Z., said he “never knew exactly what the pills were.” Court documents list his drug regimen: Clonazepam (anti-anxiety), Divalproex (anti-convulsant), Duloxetine (anti-depressant), Guanfacine (ADHD medication), Latuda (anti-psychotic), Geodon (anti-psychotic), and Olanzapine (anti-psychotic).

    “The staff threatened to throw me on the ground and force me to take the medication. I also saw staff throw another youth to the ground, pry his mouth open and force him to take the medicine,” Julio Z. testified. “They told me that if I did not take the medicine I could not leave, that the only way I could get out of Shiloh was if I took the pills.”

    The Center for Investigative Reporting also found that a doctor at Shiloh had for nearly a decade prescribed psychotropic medication to children without board certification to treat children and adolescents.

    View the original article at thefix.com

  • New Generation Of Antidepressants On FDA Fast Track

    New Generation Of Antidepressants On FDA Fast Track

    The medications, which are still in development, may be able to help those who have not found success with currently available antidepressants.

    Pharmaceutical companies are honing in on the potential of ketamine and more to provide fast-acting antidepressant relief, Healthline reports.

    Two examples are Janssen Pharmaceuticals’ esketamine nasal spray and Allergan’s rapastinel (a different, but similarly-acting antidepressant to ketamine), both which the FDA has granted fast-track approval.

    On May 5, Janssen (a subsidiary of Johnson & Johnson) announced findings from Phase 3 trials of its esketamine nasal spray. The study administered esketamine (a close relative of ketamine) to adults with treatment-resistant depression, in addition to a “newly initiated oral antidepressant,” and discovered a “statistically significant, clinically meaningful rapid reduction of depressive symptoms” compared to the placebo.

    According to a Johnson & Johnson press release, the yet-to-be-approved esketamine nasal spray has the potential to address a “significant unmet need for the more than 30% of people suffering from major depressive disorder who do not respond to… currently available antidepressants.”

    Ketamine is typically administered as a veterinary anesthetic, but off-label use of the drug has become more popular for pain, post-traumatic stress disorder (PTSD), anxiety and depression, according to CNN.

    The initial findings of Johnson & Johnson’s research, reported by the BBC in April, found that the nasal spray led to “significant” improvements in depressive symptoms in the first 24 hours. By 25 days, the effects had waned, the report noted, but this does not detract the drug’s potential value as a rapid antidepressant treatment to initiate therapy, said the study’s authors.

    Another potential new antidepressant on the fast track for FDA approval is rapastinel, developed by Allergan. Currently the drug has completed Phase 2 trials and is expecting the results of its Phase 3 trials in 2019, according to Healthline.

    These “rapid-acting therapies” have the potential to be “game-changing in the treatment of depression,” said Allergan executive vice president and chief research and development officer David Nicholson, PhD, in a statement to Healthline. He continued, “Our studies so far demonstrated rapid onset of efficacy within one day, which lasts days after a single dose and a low potential for abuse.”

    Another recent report opens even more possibilities for alternative antidepressant therapies. New research demonstrated that psychedelics (specifically LSD, DMT, MDMA and DOI, an amphetamine) showed positive effects on neural plasticity, meaning that neurons were more likely to branch out and connect with one another.

    Ketamine is said to have the same effect.

    This is a positive development for people living with depression, anxiety, substance use disorder, and PTSD, since research has shown that their brain plasticity and neurite growth are less active.

    View the original article at thefix.com