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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by rainbowbrite on February 12, 2005, at 0:21:23
Ok I am not sure if I am posting on the right board but i am trying to figure something out. Is a person dependent on medication forever once they are on them for and extended period of time?
i am really struggling to understand disorders of the brain. I feel in some ways that I do not need medication, but when I lower my medications I really feel low and high and there is no consistancy.
Once we are on medications do we then create a dependancce on drugs unless we want to SUFFER endless days of mental anguish until our brains go back to the way they were before?
the whole idea of CBT really confuses me. If it is our thought processes that create depression than why are we still on meds?
Is it healthy to be on drugs for extended periods of time?
How have people come to terms with accepting that they are going to have to take drugs forever and rely on something to keep your mood even? I think about the possibility of being stranded in a country where my med does not exist, what would I do? Does anyone relate to this?
i am so lost right now, feeling like Im dependant on chemicals to be ok.
And what is the possibility that these drugs just have a placebo affect adn thats it?
i apoligize for all the questions im just trying to understand
Thank you
Rain
Posted by mair on February 12, 2005, at 0:21:23
In reply to Are we chemically dependent forever?, posted by rainbowbrite on February 9, 2005, at 22:22:25
Rain - I have a limited understanding of how or why certain drugs work, but I've often asked the same questions you are now asking. This is my very imperfect layman's understanding. Someone on this Board several years ago posted that depression can result from a chemical reaction to environmental triggers. Some people can handle alot more without producing the chemical reaction; it doesn't take alot for others. Depression tends to be a remitting-relapsing illness. The name of the game, in the view of my ex-pdoc, is to lengthen the period of time between episodes, and take steps to make sure that the episodes are neither as long nor as intense as they might be otherwise. I think the drugs give us greater protection in that they make is less likely that a stressful event, say, will trigger the dreaded chemical reaction or maybe the chemical reaction triggered isn't as acute. (I'm getting pretty fuzzy here) CBT and other therapies help people manage the symptoms when they do come along, so maybe an episode isn't as long or as acute, but I also think, theoretically, that they make it less likely for us to react to environmental factors in a way which will lead to the chemical response.
I think people who have had just one discrete episode which had a pretty identifiable cause are not likely to be kept on meds, particularly if the meds and the therapy have been highly effective. The more episodes you have, the greater the likelihood that you'll continue to have multiple episodes. I wasn't on drugs between major episode #1 and major episode #2, although now I wonder if #2 might not have been as bad if I had been. I've been on drugs ever since major episode #2, which was about 10 years ago.
Some pdocs might rearrange things depending on how you're doing. In other words they might have you on a lower maintenance dose, and then ratchet things up when things get bad. If you wander over to the meds board, you'll probably see lots of people complaining that a drug that worked once doesn't work as well anymore so I guess that must happen too. The "poop out" effect.
My pdocs have always told me that I'm not jeopardizing my health by taking these things long term. Of course the long term studies done by most of the drug companies were for considerably shorter periods than what we would consider long term. And maybe the argument is that whatever their effect, it's less than the problems which can occur if you're not treated.
I used to really struggle with the drugs-for-life concept. Now I hardly even think about it anymore, particularly when things are going well. Sometimes I do get these urges to take myself off everything because maybe I start thinking that the drugs blunt my ability to feel and enjoy things, but those usually aren't the healthiest urges, and tend only to come when I'm otherwise really down on myself. I've been on one of my drugs, Wellbutrin, for at least 7 or 8 years. It's been effective, but it's never really been enough by itself and I've been through alot of trials of other drugs to find a better augmentation agent to Wellbutrin. However, I think it would take alot for me to take myself off WB altogether to try something else because of a fear that if that something else didn't work, WB might not work the second time. I have heard horror stories like that on the meds board although I have no idea if there is a scientific basis for that.
I'm what my T refers to as a partial responder. Drugs make a difference but there has been no magic bullet. I relapse alot, so depression for me is really a chronic problem, but there is no question that my episodes, if that's what they are, are definitely of much shorter duration. (it's been posited also that I may be dysthymic as well, so maybe that's why it seems so chronic) Fortunately it's been this way for a long time now which means that when I do feel really depressed, I can nearly always convince myself that it's only temporary. This is a huge improvement for me. Depression used to have a much more permanent feel. That I now don't consider the worst depressive feelings to be permanent, I assume is partly the result of the protection I get from my imperfect drugs, and partly that years of therapy have made me a little more resilient. There's probably also a benefit to me to having someone I can really look to for support when I'm particularly down, which is why I've been in therapy for a long time too. CBT was never particularly effective and I've never really developed the skill to draw on support from others. My T does tend to be my bedrock when I'm at my worst.
I hope this helps. Again, I'm pretty much of an idiot about anything science-based so I could be pretty far off, but this is the way it's been explained to me.
Mair
Posted by rainbowbrite on February 12, 2005, at 0:21:23
In reply to Re: Are we chemically dependent forever? » rainbowbrite, posted by mair on February 10, 2005, at 7:23:26
WOW thanks,
That was really really Helpful!
rain
Posted by ratcatcher on February 12, 2005, at 0:22:14
In reply to Re: Are we chemically dependent forever? » rainbowbrite, posted by mair on February 10, 2005, at 7:23:26
What a brilliant reply. Informative, well written and a joy to read.
Posted by Dinah on February 12, 2005, at 0:22:14
In reply to Re: Are we chemically dependent forever? » mair, posted by ratcatcher on February 11, 2005, at 18:56:55
Now this is an example of another reason why some posts don't get many replies. Sometimes the first reply is so perfect that anything else seems superfluous.
Except of course for admiration expressed. :)
Posted by Dinah on February 12, 2005, at 0:22:14
In reply to Agreed. And welcome. » ratcatcher, posted by Dinah on February 11, 2005, at 19:15:17
Posted by 10derHeart on February 12, 2005, at 0:22:14
In reply to Re: Are we chemically dependent forever? » rainbowbrite, posted by mair on February 10, 2005, at 7:23:26
I knew this would really be helpful to Rain, even before she said so.
Ratcatcher took the perfect words right from my brain.
Your post has been printed and saved. It's so good I think some T's ought to use it.
You have a special gift for this type of writing, Mair. Truly. Thanks so much for being here and posting as often and eloquently as you do.
Posted by Toph on February 12, 2005, at 0:22:14
In reply to Are we chemically dependent forever?, posted by rainbowbrite on February 9, 2005, at 22:22:25
The only comment I would add to mair's excellent response is my experience as a 25-year user of lithium. The concern we have regarding a life-long dependence on medication is certainly a universal theme for individuals with mental illness. I resisted for years my psychiatrist's advice to take lithium despite recurring hospitalizations for both psychotic manic and clinical depressive episodes. I could not accept a self-image of myself as someone who was permanently flawed in my bio-chemistry. It took the birth of my son while I was hospitalized to convince myself that I could no longer deny my condition. I have been free of significant mental decompensation for over 23 years and counting. The irony of the question posed by rain is that my current fear is not whether I will be dependent on lithium, but rather an increasing fear that my medication will someday no longer be effective. I have indeed come to peace with my dependency on medication and, with time, have come to embrace it.
Toph
Posted by flmm on February 12, 2005, at 9:28:55
In reply to Re: Are we chemically dependent forever? » rainbowbrite, posted by Toph on February 11, 2005, at 23:53:01
That post really was helpful to me as well! Somehow I feel like I felt better without meds, but that really is not true. I think we all wish we were "normal" but the reality is we do have mental disorders that need treatment. In that regard, it is quite amazing how effective these meds really are for me and I should thank God they exist, rather than bash the negatives of them all the time. But then, focusing on the negative is the nature of our problem isn't it!
Posted by Toph on February 12, 2005, at 9:41:08
In reply to Re: Are we chemically dependent forever?, posted by flmm on February 12, 2005, at 9:28:55
It was a long time in coming flmm, acceptence of my illness, that is. I guess, all I 'm saying is though unfortunate to have a mental illness, I am really fortunate that I can effectively treat it.
Toph
Posted by mair on February 12, 2005, at 15:31:57
In reply to Re: Are we chemically dependent forever? » rainbowbrite, posted by Toph on February 11, 2005, at 23:53:01
Toph I think that's an excellent point. What mostly does keep me on my primary drug is the fear that I might not be able to go back to it - that and the memory of what it felt like when drugs totally weren't working.
Before I started with Wellbutrin - at least 2+ years into a pretty serious depression - I went through a number of other drugs that all had to be abandoned for one reason or the other. I'd feel so great went i went off whatever the drug was - almost euphoric, probably because the drug du jour was making me feel like cr*p. Because I'd feel so good, it was almost doubly discouraging to crash again a few weeks later. I hated those cruel reminders of why I needed to be on drugs to begin with.
BTW thanks for the note to Bob over on the meds board. I never thought of rain's post as being a meds post when I responded to it. I guess it's one of those crossover posts.
Mair
Posted by mair on February 12, 2005, at 15:33:58
In reply to Are we chemically dependent forever?, posted by rainbowbrite on February 9, 2005, at 22:22:25
Posted by rainbowbrite on February 12, 2005, at 16:52:27
In reply to Re: Are we chemically dependent forever? » rainbowbrite, posted by Toph on February 11, 2005, at 23:53:01
>The irony of the question posed by rain is that my current fear is not whether I will be dependent on lithium, but rather an increasing fear that my medication will someday no longer be effective. I have indeed come to peace with my dependency on medication and, with time, have come to embrace it.
I have had thoughts like that as well. But more often I just wish I could do it without. I hope one day comes where I am accepting of this. I feel like a prisoner at the moment.
Thanks for you post and message to Dr Bob. I figured because I mentioned chemical that there could be a problem but my reason for not posting on the meds board was to avoid it becoming looked at as such. The question was more of a psycholpgical question.
Thanks
Rain :-)
Posted by Mildred on February 12, 2005, at 21:35:18
In reply to Re: Are we chemically dependent forever? » Toph, posted by rainbowbrite on February 12, 2005, at 16:52:27
This entire thread has been so validating and informative! I also have been wrestling with the probability that my need for these meds will be a lifelong burden - and have wondered if they are doing any permanent damage along the way.
Posted by Toph on February 13, 2005, at 1:27:26
In reply to Re: Are we chemically dependent forever? » Toph, posted by rainbowbrite on February 12, 2005, at 16:52:27
>
> I have had thoughts like that as well. But more often I just wish I could do it without. I hope one day comes where I am accepting of this. I feel like a prisoner at the moment.
Boy, can I relate. I think it was Ray Charles or was it Stevie Wonder who said that blindness was a gift. If mental illness is my gift from God, I have to seriously start thinking of regifting.Seriously, I think all of us who have struggled with a fractured brain and unbridled emotions are the better off for it. Like tanned leather, we are tougher yet softer, stained but beautiful. Aren't we? There's a cake with a key inside for you somewhere nearby, mair.
Toph
Posted by Toph on February 13, 2005, at 1:29:10
In reply to Re: Are we chemically dependent forever? » rainbowbrite, posted by Toph on February 13, 2005, at 1:27:26
Posted by Toph on February 13, 2005, at 2:07:00
In reply to Re: Are we chemically dependent forever? » rainbowbrite, posted by Toph on February 13, 2005, at 1:27:26
I meant to post to raindowbright. My head is softer anyway.
Posted by rainbowbrite on February 21, 2005, at 10:39:39
In reply to Re: Are we chemically dependent forever? » Toph, posted by Toph on February 13, 2005, at 2:07:00
>There's a cake with a key inside for you somewhere nearby
thanks Toph
This is the end of the thread.
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