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Questions about "poop out"


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Years ago I was put on Effexor and after being on it for close to a week, I woke up one morning completely hypomanic.  It was blissful, it was almost impossible for anything to bother me.  I could still function, if I needed to do something I did it, only difference was it was never unpleasant for me no matter what I had to do.  I didn't understand at the time what hypomania was.  I thought I had found "the answer", something that would keep me from ever feeling any unpleasant emotions ever again.  The reason I've lived in a tiny comfort zone that I only venture out of when life drags me out of it, kicking and screaming; the reason I'm now 44 and the average high school senior probably has as much life experience as me, is fear of unpleasant emotions.  But as it always does (I've been hypomanic maybe half a dozen times in my life and no it's never turned into full-blown mania), it petered out after maybe a couple weeks or so.  And yes I got the crash that happens when the hypomania wears off.  Every time I think I've found "the answer", whether it was a new antidepressant or a really exciting time in my life that brought it about.  Back when the hypomania from Effexor wore off, and I still didn't know what hypomania was, I believe some on this board referred to it as the Effexor "pooping out" on me.  I've started meds or just gotten doses increased, and experienced something similar to hypomania but not as intense.  Then it goes away again.

 

Sorry, just wanted to give you all some background why I'm asking this.  Is what I described what folks on this board consider "pooping out"?  Is it going from feeling on top of the world, nothing really bothers you, and then it goes away?  Is "pooping out" referring to that great feeling, not even necessarily hypomania but something less intense, going away?  The reason I ask is, maybe it's just a matter of finding the right medication that doesn't "poop out"?  I'm not looking to walk around hypomanic all the time, although that would be the ideal it's probably not practical.  But that feeling that I would call a milder form of hypomania that I've felt when starting a new medication or getting a dose increased, has anyone found a medication where that feeling never went away?  

 

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Once you poop out it is pretty well over with that med. It no longer works for me. That's my experience. If an antidepressant is sometimes making you hypomanic that's is not poop-out, it sounds more like mood cycling.

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Well, a poop-out is considered when the drug (most of the time it's an SSRI) stops working. It can happen all of a sudden, but if I recall correctly from studies it happens more gradually most of the time. This is what most people report on forums as well.
The anti-depressant effect wears off and people report that they think the med isn't doing what it is supposed to do. They have more depressive thoughts and feelings or notice strange symptoms in their body (which are later seen as symptoms of withdrawal). People with intrusive thoughts and obsessive behaviors notice a (sudden) increase or start to feel anxious again. 
I'm not sure if you experience poop-out (tachyphylaxis). I've read alot about this topic, since two SSRI's pooped-out on me in the past, and haven't come across anything similar to your story.

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Okay well, can pretty much everyone whose been on antidepressants relate to that fantastic feeling you get when it first starts kicking in?  Maybe this is what I'm trying to ask: does that always go away?  Are antidepressants not intended to make you feel like that all the time?  Or have some folks here found a medication where it didn't go away?  You know the feeling I mean, where shit that upset you a couple days ago you can now easily deal with calmly with no unpleasant feelings about it?  Does that always go away, is it just something you get in the beginning when it first kicks in (or sometimes when you initially get your dose increased)?

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Antidepressants should relieve depression and put you back to normal, mood wise. No, antidepressants are not intended to make you feel fantastic. You sound like you are feeling more than normal which to me sounds like a manic type mood reaction.

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I can relate to this,somewhat.  I have depression, no mania. I have had times where I have felt REALLY GOOD,almost like I could "POP"! Where I didn't get triggered by things that usually would set off a negative thought spiral. Then the feeling goes away,usually after several days. And then I might feel just okay. Not really down or up. I  have lately had longer periods where I feel slightly above "okay" but not REALLY GOOD. I have come to believe that it is  an evening out of my mood.  Kind of stability!  I hesitate to say it bc I don't want  to  "jinx" it,but I feel like I am finally starting to see results of psychotherapy, exercising, eating better and my clinic stay from last year. Like maybe I have gained some long term stability! ( I know that I  am not "cured" of depression and believe that I still need my AD).

I don't know if this information is helpful to you or not...

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It sounds a lot like the kind of pattern I had before being diagnosed with bipolar. I'd be depressed, start new meds, feel fantastic, then level out. Then something good would happen in my life, I'd feel invincible, decide I'd finally found the answer to all my problems, stop taking meds, crash. Then take something new, feel better, feel really good, take on many new projects, overextend myself at work, get really irritable, annoy everyone around me, feel worthless, crash, change meds again. Rinse and repeat. I described this to my current pdoc -who I first saw when I was in the "crash" phase. She basically went, um yeah, sounds like bipolar, let's try Lamotrigine. I've been on it for about a year, and while it hasn't been 100% smooth sailing, it's been better than anything previously. I had some bad lows, triggered in part by some life events, but the duration of these episodes has been way less than it was when I'd crash while on just antidepressants. 

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I only felt really great on cymbalta, which led to mania and a diagnosis change. Before that, I had a small number of meds that let me feel "normal " for a long time, but then required dose increases to maintain, then quit working at all. I never felt great but I felt greatly improved. 

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I'm bipolar II as well and antidepressants do typically do this to me when I start them. You feel extra good for a few weeks and then it levels out. But don't confuse the "leveling out" with "poop out". There's a difference between feeling "normal" like everyone else and actually having genuine depression that's recurring. And I know that after you come down from the AD hypomania startup that it's kinda hard to tell the difference. If this keeps happening to you, you could consider augmenting with lamotrigine to get a more even response.

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On 9/10/2017 at 2:38 AM, notloki said:

Antidepressants should relieve depression and put you back to normal, mood wise. No, antidepressants are not intended to make you feel fantastic. You sound like you are feeling more than normal which to me sounds like a manic type mood reaction.

I have to agree on this ^

Antidepressants do not elevate or brighten my mood unless I'm in a severe depression (they probably would if I was Bipolar, as they are known to trigger mania in people with BP). I've experienced anxiety/insomnia during titration. They are the most helpful when you are in an acutely depressed state (i.e. uncontrollable crying, suicidal thoughts, etc) to relieve the deep lows. If you are already stable, they are supposed to prevent future episodes of severe depression.

It sounds like hypomania type mood-cycling if you are "feeling fantastic" on antidepressants sometimes.

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I totally understand the fear of unpleasant emotions. I suspect this is common for people who have felt really extreme lows associated with depression, especially if it started at a young age. It's taken me a long time to distinguish when I'm experiencing sadness, anxiety, frustration, or other unpleasant feelings as a normal part of life versus when I'm experiencing depression or dysphoric hypomania. It's taken me even longer and lots of therapy to not be afraid of these emotions, because of fear that I'll land back in suicidal depression. But learning to push through unpleasantness is an important skill to learn and therapy can play a huge role in that. Getting on meds that help me stay relatively stable (for me lamotrigine) seems to help too, because it shortens and lessens the intensity of my depressive episodes, although they do still happen. This seems to help reduce the fear of emotions and show me that it is possible to be unhappy for a week or two when something bad happens or feel anxious when I'm dealing with a high stress, high uncertainty time without becoming a total mess. 

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On 9/13/2017 at 0:02 PM, thunder said:

I totally understand the fear of unpleasant emotions. I suspect this is common for people who have felt really extreme lows associated with depression, especially if it started at a young age. It's taken me a long time to distinguish when I'm experiencing sadness, anxiety, frustration, or other unpleasant feelings as a normal part of life versus when I'm experiencing depression or dysphoric hypomania. It's taken me even longer and lots of therapy to not be afraid of these emotions, because of fear that I'll land back in suicidal depression. But learning to push through unpleasantness is an important skill to learn and therapy can play a huge role in that. Getting on meds that help me stay relatively stable (for me lamotrigine) seems to help too, because it shortens and lessens the intensity of my depressive episodes, although they do still happen. This seems to help reduce the fear of emotions and show me that it is possible to be unhappy for a week or two when something bad happens or feel anxious when I'm dealing with a high stress, high uncertainty time without becoming a total mess. 

See, for me life is about feeling good and not feeling bad.  Everything else is just a means to that end.  I can't see anything else that is as important to me as how I feel.  If it doesn't make me feel a certain way, either short or long term it's irrelevant to me.  

And the thing that affects how I feel the most is money.  It's why I have to go to a job every day, instead of just fooling around with women all day, which would require gobs of money to afford that lifestyle.  One way or another I have to find a way to get rich.  I have to be happy, or life just isn't worth living.

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