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Success after repeated tries (long story)

Posted by DMLVT on January 31, 2006, at 13:55:35

I've been kind of lurking around here for a while, as I've been going through an 18 month introduction to brain meds and brain diseases.

I see lots of posts from people that seem frustrated and I've been frustrated a lot over the last 18 months, but I think I finally got things under control, for now, at least.

I knew something wasn't right for a while, probably for years. Depression has destroyed my mom in many ways. At age 64, she is suffering from dementia and lives in a long-term care facility. She started on Valium in the 70s and never really got the help she needed until it was too late.

I probably had my first serious depressive episode in the fall of 1996. I had just moved and my family wasn't with me yet. I lost my desire to run (I run crazily long races in mountain ranges for "fun") and all I could think about was that I was going to die eventually, so nothing else mattered.

Over the years, I've used lots of things to deal with episodes like this - alcohol, exercise, church, etc. Eventually, I realized none of them were working well enough any more. Being a guy, it was really hard to admit that I needed help. But, I have a great wife who talked things over with me repeatedly and supported me the whole way.

Then, I somehow made the best decision of the whole process. I admitted to my own doc that I needed a psych referral, rather than just seeing my PCP. The guy I ended up seeing has been great.

First, he thought it was ADHD and disthymia (sp.?). I started on Ritalin. I felt great at times, but terrible coming off it at the end of the day. I lost my temper a lot. This has always been a problem for me (not any more!), but it was getting worse. One night, I lost my temper to the point where my son was afraid I might hurt him. I knew that wouldn't happen and my anger was always directed at inanimate objects, but the fact that my son was scared worried me a lot. So, after a few months on Ritalin, back to the doc.

We talked about the anger and other outbursts over the years. He decided I needed an anti-depressant. He started me on Cymbalta (40mg). I felt better the very first day on a single 20mg dose. I started seeing a therapist and had a bunch of great sessions with him. Everything was great, except one thing - sexual side effects. It was like I'd been numbed and while things still worked, the fun was gone completely.

Back to the doc. We cut the Cymbalta dosage in half. Feeling returned, but so did the depression. Also, cutting the dosage was no fun at all. Back to 40mg. Then, we added some Wellbutrin, 100mg per day, moving to 200mg per day. I felt great mentally, but no improvement sexually. Then, after the WB had a chance to take effect, we cut the Cymbalta again. Things were great all around. I felt the best I'd felt in years. This was great.

I had a follow-up appointment and thought I was going to be released back to my PCP. But, on the two ADs, and still using some Ritalin, my blood pressure was way high. So, we dropped the Cymbalta and switched to WB XL (300mg). My mood stayed even, but the overall level seemed to be lower. I was sort of numb - getting by, but never smiling.

I saw my PCP about the blood pressure. We worked on it, got it down, and he suggested that I should be able to add the 20mg of Cymbalta back safely. We got it down without drugs, luckily (weight loss, reducing sodium, some dietary supplements, etc.)

I've been able to do that. I feel great for now, the sexual side effects are very low, and while I'm not thrilled that it took 18 months to get here, I feel "normal" again. My home life is improved, my job performance is improved, my running and other exercise habits haven't been curtailed, etc.

From reading all the stories here, I know it's possible that this will change. But, I thought some people might want to see a "success" story since we see so many others struggling.

I'm so glad that I've had an open-minded psych and a supportive wife and family through this. I never imagined that I'd be using these kinds of meds, and thought that I should be able to just "fix things" in my own brain. But, I guess life doesn't always work out quite that way. It's amazing the process that we need to go through to find the exact right combo, huh?





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