Tag: depression

  • Depression in Recovery: Do You Have Low Dopamine Tone?

    Depression in Recovery: Do You Have Low Dopamine Tone?

    I just felt like shit and slept as much as I could. I showed up to work. I kept my commitments. I spoke when asked to, but I felt more than unhappy. I felt like I just didn’t care.

    (The Fix does not provide medical advice, diagnosis, or treatment, nor does anything on this website create a physician/patient relationship.  If you require medical advice, diagnosis, or treatment, please consult your physician.)

    I just came out of a six-week depression. That might not sound very long, but when you’re in hell it feels like forever. Good news: I didn’t bone any 25-year-old strangers; I didn’t cut myself; I didn’t get loaded; I didn’t smoke or vape although I really, really wanted to. I didn’t even eat pints of Ben and Jerry’s while binge-watching I Am A Killer. I just felt like shit and slept as much as I could. I showed up to work. I kept my commitments. I spoke when asked to, but I felt more than unhappy. I felt like I just didn’t care. I didn’t return phone calls. I didn’t wash my hair. Suicidal thoughts bounced around my head, but I ignored them like I do those annoying dudes with clipboards outside Whole Foods.

    I’ve suffered from symptoms of depression since I was 19, so it’s an old, old friend. What really annoys me was that some (dare I say many?) people think at five and a half years of sobriety, you shouldn’t feel depressed. What I kept hearing from AA fundamentalists was:

    “It’s your untreated alcoholism.”

    “Listen to these tapes about prayer and meditation.”

    “You’re not connected enough to your Higher Power.”

    “You’re not going to enough meetings.”

    “You need to do more service.”

    Thankfully my sponsor, who has a foot in the medical world, did not say something along those lines.

    One of my big problems with AA is that it looks at every mental problem through the paradigm of your “alcoholism.” If you’re suffering, you should look to the program for relief. Nobody would tell you to “drive around newcomers!” more if you had diabetes or kidney failure, but if you’re feeling down, that’s what you’re told to do. As it turns out, AA is not completely off the mark: “Addiction is a not a spiritually caused malady but a chemically based malady with spiritual symptoms,” addictionologist and psychiatrist Dr. Howard Wetsman told me. “When some people start working a 12-step program, they perceive a spiritual event but their midbrain is experiencing an anatomical event. When they’re working a program, they’re no longer isolated and they no longer feel ‘less than,’ so their dopamine receptor density goes back up [and they experience contentment],” he explained.

    But what if your program hasn’t changed or feels sufficient and you still feel depressed? What if you’re working your ass off in your steps and helping others and you still feel like shit?

    “Well, low dopamine tone experienced as low mood can be brought on by fear and low self-esteem (the untreated spiritual malady part of alcoholism/addiction) but it can also be brought on by biochemical issues,” Wetsman added.

    Huh?

    So was I experiencing the chemical part of my “addiction” or was I having a depressive episode? Perhaps my whole life I’d been confusing the two. Of course, all I wanted, like a typical addict, was a pill to fix it. But as I’ve done the medication merry-go-round (and around and around) with mild to moderate success, I was hesitant to start messing with meds again. I didn’t have a terrific psychiatrist, and SSRI’s can really screw with my epilepsy. And Wetsman was talking about dopamine here, not serotonin. Hmmm…

    Dr. Wetsman has some interesting stuff about brain chemistry and addiction on his vlog. He mentions something called “dopamine tone” which is a combination of how much dopamine your VTA (Ventral Tegmental Area) releases, how many dopamine receptors you have on your NA (Nucleus Accumbens), and how long your dopamine is there and available to those receptors. Stress can cause you to have fewer dopamine receptors and fewer receptors equals lower dopamine tone. He’d explained to me in previous conversations how almost all of the people with addiction he’d treated had what he described as “low dopamine tone.” When you have low dopamine tone, you don’t care about anything, have no motivation, can’t feel pleasure, can’t connect to others. In addition, low dopamine tone can affect how much serotonin is being released in the cortex. Low midbrain dopamine tone can lead to low serotonin which means, in addition to not giving a shit about anything, you also have no sense of well-being. Well, that certainly sounded familiar.

    Dr. Wetsman has a very convincing but still somewhat controversial theory that addiction is completely a brain disease and that using drugs is the result, not the cause. I really suggest you get his book, Questions and Answers on Addiction. It’s 90 pages — you could read half of it on the john and half of it while waiting at the carwash. It explains in detail why most of us addicts felt weird and off before we picked up and why we finally felt normal when we used. Again, it’s all about dopamine, and it’s fucking fascinating. No joke.

    In his vlog, he explains that dopamine production requires folic acid which you can get from green leafy veggies (which I admittedly don’t eat enough of) but it also requires an enzyme (called methylenetetrahydrofolate reductase or MTHFR for short) to convert folate into l-methylfolate. Certain people have a mutation in the gene that makes MTHFR, so they can’t turn folate into l-methylfolate as effectively, and those people are kind of fucked no matter how many kale smoothies they drink.

    But it’s not hopeless. If people with this genetic mutation take a supplement of l-methylfolate, their brain can make enough dopamine naturally. Of course once you have enough dopamine, you’ve got to make sure you release enough (but there’s medication for that) and that you have enough receptors and that it sits in the receptors long enough (and there’s meds for that too).

    So this all got me wondering if maybe my MTHFR enzyme was wonky or completely AWOL. Dr. Wetsman urged me to find a good psychiatrist (since I’m on Prozac and two epileptic medications) or a local addictionologist in addition to taking a genetic test for this mutation. In his experience, patients who had a strong reaction to taking the l-methylfolate supplement were frequently also on SSRIs. They either felt much better right away or really really shitty. But if they felt even shittier (because the higher serotonin levels work on a receptor on the VTA which then lowers dopamine), he would just lower their SSRI or sometimes even titrate them off it completely. And voila. Success.

    It’s all very complicated, and this whole brain reward system is a feedback loop and interconnected with all kinds of stuff like Gaba and Enkephalins (the brain’s opioids) and Glutamate. But you guys don’t read me for a neuroscience lesson so I’m trying to keep it simple. The basics: how do you know if you have too little dopamine? You have urges to use whatever you can to spike your dopamine: sex, food, gambling, drugs, smoking, and so on. What about too much dopamine? OCD, tics, stuttering, mental obsession and eventually psychosis. Too little serotonin? Anxiety and the symptoms of too high dopamine tone. Too much serotonin? The same thing as too little dopamine tone. Everything is intricately connected, not to mention confusing as all hell.

    Being broke and lazy and having had decades of shitty psychiatrists, I decided to go rogue on this whole mission (not recommended). I mean I used to shoot stuff into my arm that some stranger would hand me through the window of their 87 Honda Accord so why be uber careful now? This l-methylfolate supplement didn’t require a prescription anymore anyway. What did I have to lose? I did however run it by my sponsor whose response was: “I’m no doctor, honey, but it sounds benign. Go ahead.”

    I ordered a bottle. A few days later I heard the UPS guy drop the packet into my mail slot. I got out of bed, tore open the envelope and popped one of these bad boys. A few hours later I started to feel that dark cloud lift a little. Gotta be a placebo effect, right? The next day I felt even better. And the next day better still. I didn’t feel high or manic. I just felt “normal.” Whoa. It’s been weeks now and the change has been noticeable to friends and family.

    Normal. That’s all I ever really wanted to feel. And the first time I felt normal was when I tried methamphetamine at 24. It did what I wanted all those anti-depressants to do. It made me feel like I knew other people felt: not starting every day already 20 feet underwater. I found out later that my mother and uncle were also addicted to amphetamines which further corroborates my belief that there is some genetic anomaly in my inherited reward system.

    When I emailed Dr. Wetsman to tell him how miraculously better I felt, his first response was “Great. I’m glad. The key thing is to take the energy and put it into recovery. People go two ways when they feel amazingly better. One: ‘Oh, this is all I ever needed. I can stop all this recovery stuff.’ Or two: ‘Wow, I feel better. Who can I help?’ Helping others in recovery will actually increase your dopamine receptors and make this last. Not helping people will lead to shame, lowered dopamine receptors and it stops being so great.”

    So no, I’m not going to stop going to meetings or doing my steps or working with my sponsor and sponsees. Being part of a group, feeling included and accepted, even those things can create more dopamine receptors. But sadly I’m still an addict at heart and I want all the dopamine and dopamine receptors I can get. However, I also know that enough dopamine alone isn’t going to keep me from being a selfish asshole…. But maybe, just maybe, having sufficient dopamine tone and working a program will.

    View the original article at thefix.com

  • Can Ketamine Use Trigger Opioid-Like Dependency?

    Can Ketamine Use Trigger Opioid-Like Dependency?

    Researchers investigated whether ketamine works on depression by acting like an opioid in the brain.

    Though ketamine has gained the support of some mental health professionals as a possible therapy for depression, a new study suggests that the drug’s anti-depressive qualities may also have a hidden and potentially dangerous side effect: ketamine may offer relief from depressive symptoms by activating the body’s opioid system, which in turn may make some users dependent upon it, like an opioid.

    In an editorial that accompanied the study, Dr. Mark George, professor of psychiatry, radiology and neuroscience at the Medical University of South Carolina, wrote, “We would hate to treat the depression and suicide epidemics by overusing ketamine, which might unintentionally grow the third head of opioid dependence.”

    The study, conducted by researchers from Stanford University and published in the August 2018 edition of the American Journal of Psychiatry, was comprised of a double-blind crossover of 30 adults with treatment-resistant depression, which was defined as having tried at least four antidepressants and receiving no benefit from them.

    The authors looked at 14 of the patients—of which 12 had received, in randomized order, two doses of 0.5 mg of ketamine—once after receiving 50 mg of naltrexone (or Vivitrol) which blocks the brain’s opiate receptors and diminishes cravings for opioids; and once after receiving a placebo instead of the naltrexone—with the injections occurring about a month apart. 

    The goal of the study was to determine whether the naltrexone and ketamine combination would reduce the latter drug’s antidepressant qualities, or its dissociative or opioid-like response.

    The authors’ analysis found that when patients received the placebo/ketamine combination, they experienced what Live Science called a “dramatic reduction” of their depressive symptoms. But the naltrexone/ketamine combination appeared to have no effect on their symptoms.

    Additionally, those participants who received naltrexone experienced the dissociative effects of ketamine, which include hallucinations, which prompted the authors to cut the study short to avoid exposing more participants to a “clearly ineffective and noxious combination treatment,” as the study noted.

    The scope of the study was small, and as George (who was not involved in the study) noted, additional research is required in order to determine if the ketamine’s antidepressant qualities are caused by its impact on opioid receptors or another receptor. He ultimately expressed caution in regard to using ketamine for the treatment of depression.

    “Ketamine clinics that do not focus on accurate diagnosis, use proper symptom rating instruments and discuss long-term treatment options are likely not in patients’ best interests,” he wrote in the editorial. “We need to better understand ketamine’s mode of action and how it should be used and administered.”

    View the original article at thefix.com

  • Singer JoJo On Mental Health: I Named My Depression Burlinda

    Singer JoJo On Mental Health: I Named My Depression Burlinda

    In a recent Instagram post, the pop star described the self-destructive habits that fueled her depression and anxiety.

    Depression and anxiety affects millions of Americans—and celebrities are not immune. Recently Noah Cyrus, Demi Lovato, Ariana Grande and Emma Stone were among a slew of young artists who’ve been public about their inner struggles.

    Now, singer JoJo (born Joanna Levesque) expanded on her experience with depression—which she nicknamed “Burlinda”—in a recent Instagram post.

    In the caption accompanying a candid photo of herself, the “Too Little Too Late” singer announced that she will log off of Instagram “for the week to see how it impacts my mental/emotional state.”

    “There’s no peace inside the anxious mind. Sporadically, for years, depression and anxiety have convinced me I’m unworthy of love, patience, (real) self-care, and forgiveness. Made me question if I’m ‘good enough’ to do anything consistently. Made it hard to follow through and to have healthy long-lasting romantic relationships without sabotaging them,” the 27-year-old singer wrote.

    Levesque described the self-destructive habits that fueled her depression/void, named Burlinda. “In so many ways I’ve invited [Burlinda] to stick around… feeding her instantly gratifying treats that keep her growing… late night food binges, mind-altering substances, gossip, sex, comparing my life to what I see my peers doing on social media, etc.”

    JoJo’s next steps include “changing habits that no longer serve me, reclaiming my time, re-evaluating the relationships in my life.”

    “I love to sing and perform more than anything I’ve ever loved and I’ve always wanted to be the soundtrack to your lives,” she wrote. “But sometimes I feel paralyzed. Time for a reset. I deserve me at my best. So do you.”

    In past interviews, JoJo addressed her parents’ history of alcoholism and addiction, as well as her own struggles with drinking.

    “(My 2015 single) ‘Save My Soul’ is a song about addiction, and I grew up seeing addiction very close to me: Both my parents have struggled with it. So as a kid, you don’t kinda know when the bottom is going to fall through or what’s gonna happen next,” she said.

    The song is “about feeling powerless, and I’ve struggled with addiction in different forms, whether it’s addiction to love, to a person who’s not good for you, to food, to negative feelings,” she said.

    She, too, has been down dark paths. “I’ve definitely abused alcohol; I’ve been depressed. You can just kind of go down a black hole and find yourself addicted to almost anything,” she said.

    “For a while, I coped by drinking too much. I wanted to get out of my mind. I wanted to stop picking myself apart. I just wanted to feel good, to chase that high. I wanted to stop worrying about my career.”

    View the original article at thefix.com

  • Noah Cyrus Talks Anxiety, Depression

    Noah Cyrus Talks Anxiety, Depression

    On her new EP, Miley Cyrus’s younger sister opens up about depression and “how it’s okay to feel those feelings.”

    Noah Cyrus is the other famous daughter of country star Billy Ray Cyrus and she also has showbiz in her blood. She made her acting debut on the show Doc at the age of three, and sang the theme song for the animated movie Ponyo at the age of eight.

    Now Noah is one of a number of young pop stars who is getting candid about her depression and anxiety struggles.

    Noah says that her experiences with anxiety and depression shaped her upcoming EP. She told L’Officiel her latest release is “mostly just about how my emotions have been, and about my anxiety, and how I’ve been struggling with depression, and how it’s okay to feel those feelings.”

    Noah has dealt with the struggle of becoming a celebrity in the day and age of social media, adding, “A lot of people like to judge you, and make fun of you on the internet, and people make you feel crazy whenever you’re in a depression or having anxiety or having a panic attack.”

    Noah’s new music also deals with “being sad and having your emotions and not being able to ignore the feelings you’re having.”

    Her new music has been an outlet for her emotions, and with her latest single, “Make Me (Cry),” a duet with Labrinth, she’s showing the world more of her self-proclaimed “emo side.”

    Noah says that releasing a single where she’s more in touch with her feelings may have been influenced by her brother, Trace Cyrus, the lead singer of Metro Station. “I think [it] probably stems from growing up with Trace in my house because he was the king of emo.”

    In addition to being more in touch with her mental health in her music, Cyrus has also been dating rapper Lil Xan, who has been outspoken against drug abuse in the hip-hop community. They’ve already recorded a song together, “Live or Die,” and Cyrus told People, “He’s a little teddy bear.”

    In the past, Noah’s sister Miley has also been open about her own struggles with anxiety, depression and substance abuse. She announced to the world that she quit marijuana last year, and she told ABC in 2014, “I went through a time where I was really depressed. I locked myself in my room and my dad had to break my door down. It was a lot to do with, like, I had really bad skin, and I felt really bullied because of that.”

    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

  • Can Nerve Stimulation Help Depression?

    Can Nerve Stimulation Help Depression?

    Researchers discovered that using vagus nerve stimulators to treat depression changed patients’ quality of life.

    A new study has shown that nerve stimulation can improve quality of life for depression patients, even if their symptoms aren’t totally alleviated. 

    “When evaluating patients with treatment-resistant depression, we need to focus more on their overall well-being,” lead author Charles R. Conway, MD, a Washington University professor of psychiatry, told Science Daily. “A lot of patients are on as many as three, four or five antidepressant medications, and they are just barely getting by. But when you add a vagus nerve stimulator, it really can make a big difference in people’s everyday lives.”

    For the study, published in the Journal of Clinical Psychiatry, researchers followed about 600 patients who were being treated for depression. Some continued “treatment as usual,” which could include medication, electro-convulsive therapy, talk therapy or a combination of these.

    The researchers compared these individuals with 328 people who continued with their usual treatment, but were also given vagus nerve stimulators, which are implanted in the neck or chest and deliver regular, mild pulses of electricity to the brain. 

    Comparing 14 measurements including relationships, physical health and ability to work, researchers found that people with the stimulators had a better quality of life. 

    “On about 10 of the 14 measures, those with vagus nerve stimulators did better,” Conway said. “For a person to be considered to have responded to a depression therapy, he or she needs to experience a 50% percent decline in his or her standard depression score. But we noticed, anecdotally, that some patients with stimulators reported they were feeling much better even though their scores were only dropping 34 to 40%.”

    This suggests that the nerve stimulation can improve life for people with depression, even if it doesn’t put the depression into remission. Study participant Charles Donovan was hospitalized for depression multiple times and found treatments ineffective until he got a vagus nerve stimulator. 

    “Before the stimulator, I never wanted to leave my home,” he said. “It was stressful to go to the grocery store. I couldn’t concentrate to sit and watch a movie with friends. But after I got the stimulator, my concentration gradually returned. I could do things like read a book, read the newspaper, watch a show on television. Those things improved my quality of life.”

    Conway said that stimulating the vagus nerve might enable people to concentrate better, which makes their day-to-day lives better.

    “It improves alertness, and that can reduce anxiety,” he said. “And when a person feels more alert and more energetic and has a better capacity to carry out a daily routine, anxiety and depression levels decline.”

    View the original article at thefix.com

  • Treating Teens’ Depression Can Benefit Parents Too

    Treating Teens’ Depression Can Benefit Parents Too

    A new study explores how a family member receiving mental health treatment impacts their loved ones.

    Depression touches not only the individual—often, it affects the community around them, too.

    For teens, parents are often a significant part of this “community,” and can experience depression second-hand. But when a teen receives treatment, the benefits will ripple through the whole family, according to preliminary research presented at the annual convention of the American Psychological Association on Saturday (August 11).

    The study of 325 American teens and their parents—which has yet to be peer-reviewed and published—analyzed data from a larger 2007 study of how teens living with depression responded to antidepressant drug treatment or cognitive behavioral therapy.

    The team observed that regardless of which kind of mental health treatment the teens received, the psychological health of the parents improved as well.

    It’s easy to guess why this would happen. The official symptoms of depression include irritability, a lack of energy, anxiety, and loss of interest in normal activities. It’s not hard to see how any one of these symptoms could negatively affect the people around the depressed individual.

    “It’s possible that the feedback, the control, and the involvement in the treatment may have been beneficial,” said Kelsey Howard, co-author of the research and a doctoral candidate at Northwestern University. “It could be in how the family is interacting with each other: The kid is more pleasant to be around, the kid is making less negative statements, which can affect how other family members think.”

    As one writer noted in Psychology Today, “[Families] contribute powerfully to the emotional atmosphere the depressed person inhabits, and so can be agents of recovery.”

    Some treatment professionals say the family’s input is necessary to correctly diagnose depression.

    S. Nassir Ghaemi, assistant professor of psychiatry at Harvard University, says he’ll ask patients seeking an evaluation to bring in a family member. “Then I ask the family to feel free to call me any time the patient is developing mood symptoms of any variety,” he told Psychology Today.

    Ghaemi also uses the family to keep the patient on track with medication, if necessary. With the support of family members, the patient can stay on track of taking his or her medication. And if the family is not on board with the treatment plan, Ghaemi teaches patients how to navigate this challenge.

    View the original article at thefix.com

  • "Hilarious World of Depression" Podcast To Feature Andrew Zimmern, Neko Case

    "Hilarious World of Depression" Podcast To Feature Andrew Zimmern, Neko Case

    The hit podcast is set to return for its third season on August 13th. 

    TV personality and chef Andrew Zimmern will be a guest on this season’s Hilarious World of Depression podcast, the podcast that sheds light on the dark world of depression.

    In each episode, host John Moe and his guests untangle the mystery (and stigma) of depression through candid conversation.

    Rachel Bloom, co-creator and star of the TV series Crazy Ex-Girlfriend, was a guest last season. Moe described her character, Rebecca Bunch, as “one of the most truthful portrayals of mental illness that I’ve seen, both the devastating effects and the just-getting-through-the-day parts.”

    The pair discuss Bloom’s childhood in Manhattan Beach, her upbringing, love of musical theater—and, of course, her history with depression.

    “At around age 9, I started to develop really, really intense, intrusive looping thoughts,” she told Moe. “And so for me, depression has always been wrapped up in intrusive, looping, negative thoughts.”

    Former guests also include singer-songwriter Aimee Mann and Jeff Tweedy of the band Wilco.

    Moe shared that the new season will incorporate the podcast’s listeners more, so they may comment and ask questions.

    “This is our audience season. We will continue to have celebrity guests and hear their stories, but we’re also going to have more of our listeners be part of the podcast,” said Moe. “This show has evolved to become part of the mental health discussion, and that brings even more voices to the conversation.” 

    The Hilarious World of Depression is part of the Make It OK campaign by HealthPartners, to reduce stigma surrounding mental health issues.

    “Humor can open a door for conversation about mental illnesses and begin the healing process,” says Donna Zimmerman, HealthPartners senior vice president for government and community relations. “The Make It OK campaign works to reduce the stigma of mental illnesses and we are delighted to continue our partnership to reach new audiences this season with messages of hope and recovery.”

    Season 3 is set to debut on Monday, August 13. This season will also feature Scott Thompson (Kids in the Hall), singer-songwriter Neko Case, and comedian and actor Charlyne Yi, among others.

    View the original article at thefix.com

  • Could Depression Be Diagnosed By A Blood Test In The Future?

    Could Depression Be Diagnosed By A Blood Test In The Future?

    Researchers may have discovered a possible biomarker for major depressive disorder.

    A blood test is in the works that may be an important new step in fighting depression.

    In a new study, researchers in the U.S. and Sweden have been examining a chemical in the brain, acetyl-L-carnitine, or LAC for short, to determine if it plays a role in depression. 

    Natalie Rasgon, a professor of psychiatry and behavioral sciences at Stanford University, who is a senior author in this study, told ABC News, “Previous animal studies convincingly showed the role of LAC in models of depression. This study is the first confirmation of the results from animal studies in human subjects with depression.”

    A previous study on LAC was conducted on mice and it did improve their depression symptoms. LAC could be used as a biomarker in patients, meaning a measurable chemical in the brain that shows the presence of a disease, and it could eventually be a way to screen and diagnose people with serious or treatment-resistant depression.

    Newsweek reports that among the 116 people who participated in this survey, 71 had depression and 45 did not. The participants with depression had lower levels of LAC than others. For the participants with severe depression, their LAC levels were very low. This study revealed that LAC levels were lowest with women who had treatment-resistant depression, and who endured childhood trauma.

    There could also eventually be supplements that could improve people’s LAC levels down the road, yet Rasgon adds, “We are at the very beginning of this discovery and can’t recommend people to buy this supplement at the GNC store… There are many questions to be answered—who will ultimately benefit from taking this supplement, what is the right dose, what is the appropriate duration of use.”

    Over 300 million people live with depression worldwide, according to the World Health Organization. It is a complex mental health issue to fight. “Depressive disorders can present differently in different people,” Rasgon says. “What is known now is that depression affects not just the brain but the whole organism.”

    Still, Rasgon is enthusiastic about the early results from this study. “We are working on extending them to further understand the role of LAC in patients receiving treatment for depression,” she says. “It is one of the pieces of a very large puzzle that constitutes depressive disorders as an illness.” 

    View the original article at thefix.com

  • Hay Fever's Link To Mental Health Issues Examined

    Hay Fever's Link To Mental Health Issues Examined

    Researchers examined the link between hay fever and depression in adolescents for a study.

    For many people, itchy eyes, sneezing and a scratchy throat are a right of passage every spring as the flowers bloom and the pollen begins to blow.

    However, although it might be common, one report found that hay fever is linked to depression and anxiety in adolescents.

    A review published in the Annals of Allergy, Asthma & Immunology looked over 25 studies of individuals with hay fever, concentrating on patients who were between the ages of 10 and 19. The review found that adolescents with hay fever had a lower quality of life than other teens, were more likely to have their sleep and routines disrupted, and have academic consequences.

    “Although [hay fever is] sometimes perceived as trivial conditions, this review indicates that [the] effect on adolescent life is negative and far-reaching,” the authors wrote. “It is critical that clinicians gain a greater understanding of the unique burden of [hay fever] in adolescents to ensure they receive prompt and appropriate care and treatment to improve clinical and academic outcomes.”

    “The emotional burden of hay fever can be huge for adolescents,” lead study author Dr. Michael Blaiss told Medical News Today. “Three of the studies in our review examined how adolescents are emotionally affected by hay fever […] and hay fever with eye allergies (allergic rhinoconjunctivitis). They found adolescents with hay fever had higher rates of anxiety and depression, and a lower resistance to stress. [They] also exhibited more hostility, impulsivity, and changed their minds often.” 

    Blaiss pointed out that adolescents are particularly vulnerable to the effects of disruption to their sleep. 

    “Lack of sleep or poor sleep are both huge issues for adolescents, and it can be made worse by the symptoms of hay fever with or without eye allergies,” he said. “Poor sleep can have a negative impact on school attendance, performance, and academic achievement.”

    Between 15 and 38% of teens have hay fever, so understanding the social and emotional consequences is important for public health. It’s also important economically, since millions of doctors visits and sick days are caused by hay fever each year.

    Researchers also pointed out that teens might have their hay fever present differently from younger children or from adults. For example, teens are more likely to say that itchy eyes or sneezing is their most pressing symptom.

    However, symptoms like snoring at night and night waking are the cause for the most concern, since they can lead to sleep disruption. 

    View the original article at thefix.com