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Re: depression, etc. Elizabeth

Posted by sid on February 4, 2002, at 17:35:04

In reply to Re: depression, etc., posted by Elizabeth on February 3, 2002, at 23:42:49

> I think that what I need right now is mostly to get my life back on track: depression has been incredibly disruptive to my education and my career plans. So now I'm trying to get on track, to salvage some scrap of those plans.

I know about that! There have been delays in my Ph.D. and now in my career. Because of them, I am not sure I still have a career. Had I survived cancer, I could explain it in a presentation letter, while looking for a job. But depression still has a stigma to it; that would possibly ruin my career for good instead of help. This is really unfair. We are sick, we suffer AND there are long term consequences to it too.

> A big roadblock is my inability to drive; unlike Boston and New York (and even, sort of, Jersey), this North Carolina town doesn't have any public transportation to speak of. My difficulties controlling my attentional focus (maintaining focus, or shifting it -- shifting is actually the bigger problem) have prevented me from being able to drive safely enough to get a license (just one screwup is all it takes). I haven't had a seizure since September, but that's something that's been at the back of my mind too. Anyway, I've gotten to the point where I'm just not improving with practice; the limiting factor is my attention problem. I worry about how this would affect my ability to work, too. But that's sort of moot at the moment. I could go back to Boston, but I'd need some money to pay the rent until I could find a job (rent in the Boston area is painfully high); so I'd have to work here for a while at least.

Well, I hope you get well enough soon to get some attention back and get the driver's license. You could then be more active and that could possibly help a lot in the healing process.

> How long have you been taking the 75 mg? I've been on 225 for a couple of weeks.

I was on 37.5mg Effexor XR for 6 weeks (I felt better already; after 10 days or so, there were some improvements), and I've been on 75mg for about a month now. I'm seeing my doc on Thursday.

> Why scared (of meds)?

I told you a few months ago, but I'll tell the story again. My father was hospitalized with major depression when I was 20 years old. After a few weeks in the hospital, he'd come out on weekends. One weekend he decided not to take his meds, and we knew nothing about dosage, etc, it basically his responsibility without supervision. He "lost it" threatening to kill himself or us if we didn't leave him alone, etc... Major crisis. I managed to reach our family doctor, and he said that he probably didn't take his meds, that we needed to put him to bed and force him to take his meds, physically control him if we needed to. When it's your father, you freak out, and I did. Else we needed to call an ambulance and get him right back to the hospital. That threat is what I reasoned him with to go to bed, rest, and take his meds. Thereafter, I swore I'd never take ADs.

> Being able to advocate for yourself as a patient is crucial, and this creates big problems in doctor-patient relationships (especially in psychiatry, where patients are particularly unlikely to be able to speak up for themselves).

I have a general doctor, which may make things easier relationship-wise. I know that she treats a lot of people for mental illnesses, so she developed some expertise over time. I'll go see a pdoc if I feel the need to, but for now, things are going OK.

> it's possible that 75 will prove to be enough for you. Remember that generalized anxiety is a really broad diagnostic category; people with GAD are a very heterogeneous group.

That would be great. We'll see, on Thursday I should know better whether I'll increase the dosage or not.

> I'm eating more now that I'm feeling better, but I'm also more active.

I'm more active and I eat less. Thank God because I loaded up on carbs like crazy during the depression and I gained a lot of weight. I find myself physically repugnant now. I'm not too severe in the sense that I went through a lot of hardship, but I want to improve my physical appearance. I've been a mess for a long time and it shows still. It's not my priority, but it's on my to-do list.

> I'm still struggling uphill, but that's more a lifestyle thing than a mood thing. (Still, I wouldn't say I'm on an "upward spiral!")

Upward spiral was strong. Let's say that I don't have to do as much as before to feel good. That in itself makes me feel even better!

> Any SSRI would be fine; it doesn't have to be Paxil. Remeron or Serzone could be good too. And the MAOIs (Nardil especially) are the best antidepressants for most anxiety disorders, IMO.

OK, thanks. I'll take note of it in case it's needed later. I know my doc told me we'd augment at some point with another molecule in order to affect the brain in a different way and cover more bases (or something like that... I don't know much about it).

> I'm a mathematician by training, and more recently I was taking classes (a couple of the basic sciences that I didn't take in college) to prepare for the MCAT. I haven't worked in a while. But neurobiology and psychopathology (and the bridge between them) are among my interests(one could even call them hobbies -- I have a lifelong history of weird hobbies).

Cool. I love math. I use it rather than develop it, but I do use it (pretty basic stuff) everyday.

> I have trouble even understanding what it's like to be "normal." You know?

Oh yeah. A couple of weeks ago I asked on this board how it felt to be "OK". My doc said I'll take the meds at the same dosage for at least 1 more year, providing it doesn't poop out, once we consider I'm "OK." Then we'll taper and see what happens (I pray not to have to take meds all my life, but I may have to). I asked what she meant; she simply said "one thing at a time." So I'm not too sure. Perhaps I'm close to it, perhaps I'm still far. No idea.

Take care, and take your meds (this is Psycho-Babble after all)!

- sid




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