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About Cerberus

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    The Abyssal Inn

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  1. Today I was contemplating my grey cloud on a sunny day when it occurred to me that the current state of depression that I cope with - that is, the current level of treatment-resistant Double Depression treading water with my nose just above the suicidal ideation threshold - is what I consider my stable standard. And then I thought: When the hell did that happen? When did this state of abject misery become an acceptable, let alone desired, goal of any sort? The thought took me aback somewhat. I began to realize that I've been in the trenches fighting for so long that the "new normal" keeps getting worse and worse as time grinds on and the condition deteriorates, yet I become more numb to it. I do notice the creeping anhedonia - more and more things that once brought me some small moment of pleasure have disappeared. I make do without them because they are simply no longer available to me. I wonder what I will do when there aren't any more at all. I think, @water, I would hold this up as part of the answer to your original question - at what point have you lost too much of what makes life enjoyable? When has the depression stolen too much? I think that for a time one can maintain a balance in the struggle against it by pitting positive against negative, while one still has the positives to use. But for someone in my position, almost all the ammunition has been fired, the enemy is at the gate as powerful as ever, and there's only one charge left in the cannon. If rice pudding ever fails to tempt me, it's all over. Really.
  2. Hypothetically, indeed. Where do we draw the line? We talk a lot on CB about our personal experiences with various cocktails that have been prescribed for us, their dismal failures, their mediocre mehs, and occasionally, their successes. The great benefit of this sharing is to give each other ideas for new lines of discussion with our pdocs for new things to try when our cocktails aren't performing as desired, or to help us understand why we're suddenly having dizzy spells, seeing dancing bananas, or have forgotten what sex is. When the conversation treads over the line is when we start speculating about idiotic things to do, like take as many antidepressants as possible at once. You're not planning to do this yourself? Just curious about synergy? Mm-hm. Whatever. Let's talk for a second about serotonin syndrome. There is such a thing as too much of a good thing. Serotonin syndrome is a really good example, and when you're taking antidepressants, it's not that hard to achieve if you're doing absurd things like, oh I don't know, trying to take as many of them as you can at once to see if they synergize in your head. Stocking up too much serotonin (The second "S" in SSRI) can lead to: agitation, restlessness, confusion, rapid heart rate, high blood pressure, dilated pupils, loss of muscle coordination, muscle rigidity, heavy sweating, diarrhea (fun), headache, shivering, goosebumps, and even threaten your life with high fever, seizures, irregular heartbeat, and unconsciousness. How's that for some synergy? And that buproprion(Wellbutrin) that pdocs sometimes add to an SSRI? Even that can contribute to serotonin syndrome if the mix isn't right. So can the tricyclics and MAOIs. Oh, and your anti-migraine meds. And any opiate pain medication you might be taking. And lithium. Even those herbal supplements (like St. John's wart, ginseng and nutmeg, for God's sake) and OTC cough medicine can do it. And people who like to play fast and loose with their meds on their own (I have no idea whether you're one of these) sometimes also like to play fast and loose with things like MDMA, LSD, cocaine and amphetamines - which also play hell with serotonin. But let's take a larger view. Chemistry is tricky. In a lab, trying to get molecules to form into desired compounds requires precise measures, regulated temperatures, and exacting technique - special stirring, subtle shaking, timed dripping, ice baths at the right moment and so forth. Contrast this with an eight-year-old with a chemistry set throwing things into a glass jar to see if they explode. Mixing one's own meds cocktail to see how many antidepressants one can take until they synergize is an example of the second scenario. (*~BOOM~*, and a mess afterward) Can meds work together positively for better results? Of course they can. That's why our pdocs combine them. But the body and brain are a sloppy chemical stew, and even the best pharmacologists on the planet are only best-guessing about the full effects of these medications on our systems. Our care teams are challenged to administer what are often harsh chemicals to try to regulate poorly understood imbalances in our minds while doing us as little harm as possible. We don't assist that process by treating our brains like a beaker and doing our own ad-hoc chemistry. We do research. We share knowledge and experience. We consult with each other and then we take the information we gather and use it to ask informed questions to our pdocs because we are involved in, and advocates for, our own mental health. But at CB we don't speculate on woolly-headed ideas about DIY prescribing. Beware of wool. Where do we draw the line? 🔻 ______________________________________ Right there. Topic closed. Cerberus Moderator
  3. I don't like the sound of this new pdoc compromising his patients' treatment options and his prescribing options on the basis of what his insurance will and won't cover. If a pdoc's going to treat me, he's or she is going to have to have the courage to take the risks associated with the profession. I wouldn't keep a pdoc who told me, "I could improve your situation, but it would cost me too much to prescribe the meds you need." My response would be, "I see. Fuck you and that pseudo-sheepskin on your wall. We will not meet again." I'm sorry that this is disappointing after the long wait, but in my opinion, becoming a patient of this person would likely not be to your benefit. The idea of telling a patient that he or she will be stopping an effective medication because it would be too expensive for the pdoc to prescribe it is outrageous. When you call back to tell the woman that you will not be signing on as a patient of this gormless excuse for a pdoc, be sure to explain why. You say you are waiting to hear about two other possibilities - you might do yourself a favor to call each of those practices ahead of time and find out if either of them have a policy similar to this one, so that you won't be disappointed after a long wait for them as well.
  4. [raises hand] I'm a little off... At least, that's what people keep telling me. 🧐
  5. Will - I understand, and agree that the tone I sometimes take when I reply to posts in "moderator mode" sometimes gives the impression that I have a stick shoved farther up my ass than I actually do. It's because in those times I'm speaking not only for myself but for the entire Moderating Team and the site owner. That said, I never say anything I don't stand behind, but I may not say everything that I believe. I am right there with you in support of therapy. When I beat back my first round of MDD, I did it entirely with therapy, without any meds at all. That had the benefit of giving me a very solid base of Cognitive-Behavioral Therapy skills that have really carried me through the rough patches as time has progressed. But in subsequent bouts of my treatment-resistant Double Depression, I realized there was no reason to suffer (or take a risk with suicidal ideation knocking at the door with a battering ram) when help was at hand in the form of meds. I personally believe therapy should be the first line of defense for MI that can respond to rational self-intervention. I personally detest taking medication of any kind, and view it as a necessary nuisance. But not all MI fits this description. Those suffering from schizophrenia, delusion, persistent OCD, PTSD, DID, and other disorders where normal rational function is confused or preempted, usually need the help of chemical adjustment to "level their mental playing field" before they can gain the full benefit of therapy. You're right - the human mind is a grand frontier, a mystery waiting for exploration, and I am the first to say that my ignorance of it feeds my fascination with it. Because of that, I try to glean as much understanding from the varied positions held by all our members, including yours, and I respect your position and the thought you put behind it. I'm glad you have found therapy that works well for you. (Gallifrey, by the way, is a planet in the British science fiction programme Doctor Who. The Gallifreyans who inhabit the planet are known as the Time Lords.)
  6. Will - I am not familiar with that book, but if its core premise is as you suggest, I doubt I would agree with it. I do believe that not every upset of the human mind is the result of mental illness, and not every upset needs pharmaceutical treatment. The trick, however, is determining what is and what isn’t a case of bona fide mental illness, and for that you need the aid of a qualified psychiatrist or psychologist. Let’s say a person is suffering from a case of Major Depressive Disorder, though not debilitating. Should the person be treated, or not? He certainly should not attempt to treat himself without the assistance of a specialist, would have difficulty getting the meds without a prescriber in any case, would likely find “alternative” treatments disappointing, and if he chose a therapy-only route, would find that relief took longer. But there’s this to consider also - it is well-documented that relapse of MDD significantly increases the likelihood of further episodes, until repeat episodes become a certainty. If it is possible to gain control of this patient’s condition early, in a moderate state, and prevent relapse, is that not a sound argument for treatment before the mental illness becomes severe? There may be times when we feel frustrated that we are not making better progress, and feel that our pdocs are slow or unwilling to try new strategies. That is why we encourage all our members to become as informed as possible about their own conditions and the available treatments - not so you can strike out on your own, but so you can go into that next pdoc appointment loaded for bear, and get your pdoc to discuss your treatment plan to a point that you’re satisfied. I’m not sure if this replies directly to the point you were trying to make in your post, but I hope it helps.
  7. No. The difference between you and me and the “doctors” is 8+ years of study in an accredited medical institution under the guidance and supervision of experienced professionals, which has earned them the title of Doctor of Medicine as well as other specialized degrees. Part of their rigorous study involved obtaining a comprehensive understanding of human biochemistry, and of the action of pharmaceuticals, so that they would be qualified to prescribe them to patients. A doctor’s “trial and error” is nothing like yours or mine. The doctor makes careful, judicious decisions based on a depth and breadth of knowledge across his discipline, and on a knowledge of the specifics of your individual case. He has an ethical imperative to ensure that any treatment of uncertain effect will at least do you no harm. Your own research, unless you happen to also be an advanced graduate student in the field of medicine, biochemistry, and/or pharmaceuticals, is not going to provide the kind of information needed to make the kind of safe and fully informed decisions that would allow you to experiment with your own meds cocktail. You said it yourself - you’re not a doctor. You’re not qualified to make such decisions. Do you have the right to? Sure, it’s your brain, you have the right to fuck it up as badly as you can. But in the end, you know where you’ll end up? At the doctor’s. And do you know what you’ll do at that point, once you’ve finished train-wrecking your own brain with your ill-informed experiments? You’ll do what he would have told you to do to start with. Listen up, all you lot - here at CB we ask a lot of questions of each other about our meds and our personal experiences with them not so we can go all Doc Brown and shit trying to cure ourselves, but so we can better assess how our meds are affecting us, so we can take more informed questions and suggestions back to our care teams, and so we can make better decisions as active participants and advocates in our own care. So knock off all this rubbish about making wild changes to your meds on your own without talking to your docs. That’s not what we’re about here, and we don’t support it. While we’re at it, we take a very dim view of members telling everybody they’ve decided to just come off all their meds altogether, for whatever reason, without their doctor’s sanction. Because we don’t do stupid around here. Cerberus Moderator
  8. In that case, the Moderating Team wishes to reiterate that any existing chat room utilized by Crazyboards members is in no way affiliated with Crazyboards and that CB Management and Moderators are in no way responsible for, nor can be of any assistance with, matters that arise there. Crazyboards does not offer a chat room, and should any entity exist using the term “Crazyboards” in association with its chat room, that entity would do so without the sanction or authorization of the owner of this site. Crazyboards - Accept No Substitutes.* *Your mileage may vary. Chatrooms are known by the State of California to cause butthurt and asshattery. Please talk to your doctor before breathing in an enclosed chatroom. Do not remove this tag under penalty of law or wear it over your head as a bag. Paper or plastic? Keep away from children. Don’t let them have the tag, either.
  9. Add to this that right after our official CB chat ceased operations, members took it upon themselves to establish new chatroom of various sorts ostensibly related to the forum. Those efforts did not end well. Running a chat for the Mentally Interesting requires experienced Moderation, along with the collateral resources of the forum. These cannot be dispensed with under the circumstances. Oh, and the forum software needs to have a chat feature, which as Gearhead points out, ours does no longer. We regret the inconvenience, but at the current time, a new CB chat is not on the horizon, and from our prior experience, we strongly discourage our members from trying something independently. Really, things end in tears... Cerberus Moderator
  10. When I originally took Wellbutrin solo, it made me so wiggy I had to stop. Now, taking it as an adjunct to Effexor (as an on-again-off-again alternative to Adderall) it kinda-sorta does the job. Except right now, not so much and it's making me clench my jaw like a nutcracker. So, Idunnomaybe.
  11. I think the Ents, with Old Entish, have the proper attitude about small talk: "It is a lovely language, but it takes a very long time to say anything in it, because we do not say anything in it, unless it is worth taking a very long time to say, and to listen to." - Treebeard
  12. Which mythological creature casts no reflection in a mirror? All of them.
  13. To get to the oth- <Semi truck zooms past> - Never mind. [and with apologies to Confused, because I just used this one in a comment in her blog:] If you have an "accident" in your shorts, what are they called? Dungarees.
  14. My dear, you know that I am a great admirer of your analytical and observational skills, but in this rare instance I fear I must challenge your characterization of the situation, to wit: a dumpster fire. A dumpster has a bottom. Thus far, no bottom seems to be present to impede the Trumpapalooza’s headlong dive. I must say, that although speculation runs rampant about the genuineness (or deficit thereof) of D. Trump’s hair, the mop of B. Johnson looks to be quite actual and properly connected to his scalp, because it appears to become more frazzled (if that were possible) in direct proportion to him becoming more flustered.
  15. I don't have a sociability time naturally. I have to manufacture it from sheer willpower, when absolutely necessary, and even then it's largely a performance. But the construct is a fragile thing, because as an autistic I spend a great deal of time wondering what the hell these neurotypicals are on about and when it is explained to me, I spend more time being baffled as to why they would do it. I do not suffer fools well. At all. Have you met the general public? I will say not elaborate. No one is allowed to bore me, and small talk bores me instantly. I just want to climb the walls when I'm trapped with it.' And then the music - it's always socializing plus the MUSIC SO LOUD YOU CANNOT HEAR WORDS COMING OUT OF YOUR OWN MOUTH. Combine the inexplicable behavior of neurotypicals, the torture of talking talking talking talking about nothing of any consequence whatsoever, and the sensory bombardment of sound and light that routinely seems to pass for "entertainment", and within roughly ten minutes I get this very peculiar feeling that I can only describe as being like a cat flattening its ears back, and I have to GO. Even if I can't leave, I go outside, or find an unoccupied room, anything to get away from the humans.
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