Posted by fachad on March 24, 2002, at 3:41:38
In reply to Re: depression feelings - sadness vs. emptiness » fachad, posted by BarbaraCat on March 24, 2002, at 1:07:53
BarbaraCat wrote: "I wonder what thoughts you'd have about someone (me) who has both kinds - the blunted dreary AND the severe major type - two very different symptomologies, ..."
Well, after I took Ritalin and a HUGE component of my depression resolved, I realized that there were actually (at least) two components to my depressive symptomologies.
First, there was the obvious "affective depression". That was the emotional sadness, etc. That "affective depression" responded very well to SSRIs.
Second, there was what I call "somatic depression", which consisted of lethargy, anergic, apathetic, physical dysphora, and general feeling of bodily yuckiness. This is what responds to psycho stimulants like Ritalin or Dexedrine.
The strange thing for me is that while SSRIs treat the affective depression, they worsen the somatic depression.
And for me, affective depression comes and goes, but the somatic depression is chronic.
So if the affective depression is really bad, I can take an SSRI until it is resolved, and then quit the SSRI.
But the somatic depression has always been there, way back when I was a teenager, and even as a pre-teen. (I'm in my mid-thirties now) And a course of SSRI treatment always makes it worse.
So pstims are my main treatment modality. I don't have to adjust dosage except after a course of SSRI's has increased the severity of the somatic depression. Ritalin definitely helps with the “blunting”.
For me, this whole distinction between affective and somatic depressions became evident when Ritalin was added. Medication response has been used before to define illness, so it wasn’t unprecedented in principle. I'd just never heard of that distinction in depressive symptoms before. But is sure has been an accurate and useful model for me.
> You might want to give SAM-e a try. It helps with the blunting. I liked your insights on this topic, especially your 'novocaine for the brain' theory, and the protective emotional blunting statement.
>
> I wonder what thoughts you'd have about someone (me) who has both kinds - the blunted dreary AND the severe major type - two very different symptomologies, but feeling very tied in to each other (the same illness but opposite poles). I don't have chronic dysphoria and have 6-7 month breaks of OK-ness (if I'm lucky) then 1-3 months of one or the other and sometimes both together of the sad vs. empty types. I've gone through just about every one of the newer AD's and my pdocs have all said that my profile is difficult to pin down.
> Regards, Barbara
poster:fachad
thread:99188
URL: http://www.dr-bob.org/babble/20020322/msgs/99800.html