So for seventeen years I've had pain depression. It especially feels like it's squeezing my heart. It hasn't historically been *about* anything. I've just chalked it up to biochemistry, heredity. And I've thought about suicide, most days, for at least fifteen years - because pain sucks. Ups-and-downs. Roller-coasters. Probably every person on here has done time at the worst torture theme park in the world.
Two years ago, my cocktail started working. There was some CBT and DBT in the mix too. I decreased my daily Ativan from 3mg to 2mg. Plus 20mg Latuda, 300mg Sertraline, 100mg Topamax. I actually felt happy, for about two years, until this October. Then it stopped working. And I stopped working. I work in a level I trauma center, where I identify cancer, anemia, and the effects of the coronavirus on the human body. I feel like I have a front row seat to human suffering, without being empowered to ameliorate it, and it's another kind of torture.
I am very tired of fighting. If there was a euthanasia travel agency, where I could just walk in, plan my funeral and end-of-life arrangements, plan my ideal death, and just call this thing at 38, that would be a somewhat attractive option (not telling, The Tallest Man on Earth, flaming-Viking-burial-at-sea.) I'm tired of fighting this disease, personally. And I'm tired of coming up against the tsunami of "world suck" (H/T Vlog Brothers) which seems to be hate-fucking itself ad astra.
So the strain theory, which I haven't read much on yet, is that we consider the termination of our lives when under one or more types of strain. I personally find this theory hopeful, as targeting the sources of strain, i.e. "world stuck," could reduce the inducements to terminate one's life. The General Strain Theory, according to one Wik I. Pedia cites loss of positive stimuli, addition of negative stimuli, or the inability to reach a desired goal, as three possible sources of strain. I will follow up on this with my tdoc on Wednesday. I think work is introducing negative stimuli, and I have a shit ton of unreached goals, but am starting to care about goals less and less. Basically, it pisses me off that I've had to dramatically reduce my goals due to my diseases, and it's kind of tempting to just leave the party. Please feel free to weigh in if you have personal and or academic experience with this.
I'm also meeting virtually with my pdoc tomorrow... to tweak the cocktail. Would love recommendations. My current rx mix, dxs and rx, failures are in my signature. Lamictal induces hives and vomiting. Depakote causes dyskinesia. Lithium ruined the thyroid and causes acute renal failure. Medicine. Ha ha. Organ roulette.
So the observation about different species of depression is that while for a decade-and-a-half I experienced what seemed like purely biochemical, chains-around-my-heart, tar-and-shark-filled, basements-beneath-basements depression. This feels more like a rational(?) depression, which has me concerned about whether it will be responsive to biochemical therapy.
I'm having a hell of a hard time and experiencing rather weird symptoms. Whether they've anything to do with Mirtazapine (Remeron) is something that I strongly feel but can't quite convince any doctor of. I was put on 15 mg of it in spring 2015 for depression and a severe insomnia - I hadn't slept an hour like since 25 nights back then! The benefits showed immediately within a day and surprised myself and my family. I would sleep well and be in a very happy and cheerful mood. Then however, from summer 2016 I developed some strange food intolerances; caffeine, sugar, fruits containing high amounts of fructose, yoghurt, butter and so on. Eating anything of that would cause me jitteriness and insomnia. I steered clear of those foods. From autumn last year though, a lot of those food intolerances have relented and it changed into intolerance towards medicines and supplements that I was on; the thyroid medicine for hypothyroidism, Vitamin D, Calcium, Vitamin E and could never again tolerate any new medicine or supplement. Symptoms resulting from these are, again, jitters, insomnia and a strange kind of feeling of being struck on the head, like I can't hear anything and the thinking becomes very unclear and blurred. Coupled with this is a weird sensation that if a medicine has any potential side-effect (even physical, such as urine retention), I get it at all costs. So I'm steering clear of the culprits here too. However, avoiding the culprits doesn't end my misery, it just helps in avoiding a whole new set of symptoms, because since autumn 2016 I'm under constant brainfog anyway, have heart palpitations immediately after every meal (but worst after breakfast), have concentration and focus issues, lead a life without any hobbies, wishes or desires. Nothing excites me, nothing interests me and nothing catches my attention. Leave tasks pending for months (the most unlike me habbit), have badly lost my sense of humour. My sense of humour was something that I literally used to pride on, and friends from around the world would call me to fresh up if they were having a dull day. My mind feels numb, although it isn´t as if it´s the sedating effect of the Mirtazapine because 90% percent of the nights I don´t sleep well, and on a lot of nights I feel as if I´m asleep with an awake mind! The GP who put me on it considered it to be just the effects of anxiety and depression and recommended the doubling of the dose to 30 mg. When I contested that, given that I´ve my doubts of a lot of these issues being brought upon by Mirtazapine itself, she referred me to a psychiatrist. He too strongly denies of Mirtazapine having any hand to play on it and instead thinks it´ll be best to combine it with another antidepressant for day-time. He put me on Paroxetine, boom, a flood of side-effects! Then changed to Fluoxetine (Prozac) - third day on it and having weird feelings. The heart poundings are one and is in fact making me very depressed and hopeless!
Okay, I've always had EXCELLENT blood sugar, and I know the data about Cymbalta and A1C (that there can be an increase, but it's typically marginal and generally considered worth the risk). Anyway, there seems to be a correlation between me starting Cymbalta (initially at 30 mg. coming off Viibryd and gradually getting to my current 90 mg. dosage). At first the blood sugar spikes weren't very big, but now they are...my blood sugar is high way too often. My A1C is still within totally normal range, but it's noticeably up. My pdoc and the NP I see at my primary care doctor both think Cymbalta probably isn't the cause. There is no other reason I can think of. I've lost 20 lbs., my diet hasn't changed. As far as I know there's no infection in my body. Now this has been going on since December. The numbers have only really become concerning to me since April. I used to have blood sugar that often dipped a bit too low, so this is just so weird to me. I was wondering if anyone else has experienced a significant rise in blood sugar on Cymbalta? Nothing else changed with my medication, except I went off Buspar (and I doubt that is a factor). I have tried so many anti-depressants like many of you, and I really like Cymbalta, so I'm really hoping I don't have to go off it, because Viibryd and Trintillex were my other 2 best options, and I had side effects with both of them. I can't do things like Pristiq because of extreme sweating, which is too bad, because that was the only side effect I had. There are very few anti-depressants I haven't tried. I ended up on Cymbalta (and my pdoc, who I have seen for 15 years was shocked we'd never tried it), because we discovered that Viibryd was a big contributor to my tiredness (I have what is currently diagnosed as Idiopathic Hypersomnia, although my doctors believe it could be Narcolepsy II...it's not Narcolepsy I, because I had a Lumbar Puncture. I've also had 2 MSLTs, but my doctor says they are irrelevant, because I was on my meds...they did still show Idiopathic Hypersomnia. After going off all psych meds last Summer (and feeling like I was suffocating most of the time and just feeling like I was living outside my body), I never want to do that again, so I'm content with not knowing which sleep disorder it is since the doctor says it really doesn't make a difference as far as treatment). It was in slowly going back on my medications that I realized Viibryd was making me tired. My pdoc and I also then concluded I no longer needed the Buspar. I haven't missed it at all. Any experiences with blood sugar and Cymbalta would be helpful! I appreciate you all!
What are the overall best (atypical) antipsychotics for Depression, Anxiety, Agitation, OCD, Bipolar...?By Adolf
"Best" as in being effective with fewer side effects. Which ones were the best for you? Which ones did you take? What condition(s) did you treat? What side effects did you get? How did the antipsychotics compare to "conventional" antidepressants?
Can antipsychotics be an alternative to "conventional" antidepressants? What are the risks? What are the benefits? Do they make you a tomato with time? Psychiatrists prescribe them more often in recent times, it seems.
I started process of switching from Cymbalta to Remeron on March 25, and took my last dose of Cymbalta a few days ago. Other than a few days of extreme irritability, things have been going surprisingly smoothly. Except that I can't sleep. Not really. I'm rapid-cycling between moments of being awake and instantly dreaming as soon as I close my eyes. The waking moments seem precipitated by startling effects in the dream state, that usually have nothing to do with the content of the dream itself. The worst of these is the sudden sensation of being physically attacked by an evil presence. It seems to take me a little bit longer to wake up during these instances. Or at least that's how I perceive it.
How much of this is potentially the residual Cymbalta withdrawal effects, and how much of this is the "strange or unusual dreams" listed as a possible side effect of the Remeron?
And more importantly, how long can I expect this to last? If you experienced disturbed dreams while on Remeron, how long did it last for you, and did it turn out to be a deal breaker?