Just to add one note about Wim Hof and why I mention that - some are starting to think that depression is actually a condition that comes from inflammation in the body. There is some research that may point to that truth. Inflammation can be addressed in various ways, and one of them is through the use of cold to shock the body. Hard to explain exactly how that works, but I’m exploring it myself.
Here’s one look at it:
This has been on my mind A LOT since I started on my very first ever psych meds, a selective serotonin antagonist, mirtazapine, 15mg daily. I had resisted “taking the plunge” (as my doctor ominously put it) for about five years longer than I should have; growing up my mother had one of those multi-drug resistant cases of clinical depression and I got the idea that SSRIs etc are something between useless and damaging. But it is not like I was ever above doing DRUGS, booze, weed, caffeine, psychedelics, salvia. I was all for drugs so long as it was an imprecise dose of what was on hand in an attempt to crush my feelings with a sense of “control” over my psyche; really I was giving over control to the drug and whatever it triggered. And that got boring, and life moved on, and last month I got to hopelessly thinking, “it sure would be nice if I could feel happy sometimes.” So I decided I would do a totally different kind of psychonautical adventure and ask my doctor for a prescription. “Medication” has such a disempowering connotation for me so I’m doing my best to frame it as “doing drugs” which always felt like a righteous act of self determination. The first week was a wild ride of dyspepsia, weird energy, shrooms-like revelations, and crippling sleepiness. Now it’s the end of week two and I feel like I have more focus? maybe? the “it takes a month to take effect” is outrageous, I am mildly outraged. But I guess I’m just going to keep going, because I’ve noticed a tiny difference, and I will take whatever foothold I can get. I’m hoping it gives me the wherewithal to build up the habits I need for healthy living. Here’s hoping 
i take several meds to control my high blood pressure. one of the meds i take three times a day has the useful side-effect of helping to control attention deficit disorder. i’ve always had focus issues and for an hour or two after i take each dose i am more focused. it’s usually taken as an adjunct to other add meds but it has been helpful by itself.
@SeamusBellamy I’ve been taking medications for depression off and on for 30 years. Mostly on. I’m not including adventures in self-medication*. Currently I take an very high dose of a SNRI and an anti-seizure medication that is prescribed to me off label for its mood stabilization benefits. Honestly, I don’t think they really work very well because I still have frightening plunges. But they work better than any other of the many cocktails I’ve had**. And I don’t think they hurt. And they pacify loved ones.
You should be wary of physicians bearing new drugs. They may part of a pharma marketing plan with prescriber incentives. Having said that, there is a lot of interesting work being done on Treatment Resistant Depression with applicability to longterm PTSD***.
*marijuana and exercise work well for me.
**except for one that included a high daily dose of modafinil prescribed off label. Unfortunately, I can’t find a physican willing to give me that now.
***I’m currently trying to bully my insurance company into paying for ketamine.
I view my anxiety as a disability, and that I’m not going to feel bad for having it, nor will I feel broken for taking a pill every morning to deal with it. Should a blind man feel bad for needing a seeing-eye dog? I’m sure he’d be quite happy to take a pill instead.
The problem ain’t the meds, at least not in principle. It’s the prescribers. You were on something that was “good enough.” “Good enough” is, like, as good as it gets for someone with chronic anxiety disorders. Big pharma seduces prescribers with still-under-patent wonder drugs and the promise of total remission. But they’re playing medi-jenga, removing a block from the base of a stable-but-wobbly tower and replacing it with a novel one at the top. Keep the stabilizing piece. Be your own advocate. The amount of pressure on psychiatric prescribers from drug company reps is tremendous, and they push new drugs HARD. Keep what kind of works, because most things don’t work at all (or they make it worse).
You’re not alone in this journey, that’s for sure.
I first read “wherewithall” as “withdrawal”. I hope you do not suffer those (withdrawals) in your adventure with these so-called approved/legal drugs. We will accept and expect a full report, thankyouverymuch.
I had a bad year last year. One incompatible job I took lead to a nervous breakdown and major depressive disorder. I couldn’t do anything. It was like being at the bottom of a deep well. All I did was either lie on the couch, or if I was unable to get on the couch I’d lie on the floor. My every thought was a circle that lead to the conclusion how I would die.
Luckily I was able to get cheap and efficient psychiatric help. I’m on my third set of meds now. The first ones kept me ticking over but after a couple of months I was unable to walk, and I had to have a stool in the kitchen because I couldn’t stand up long enough to wash the dishes for example. I also got tinnitus, which is worrying since I work as a sound engineer. The second one removed the physical symptoms but I couldn’t sleep.
My current medication is just simple paroxetine. It sits somewhere in between. I can walk half a mile to the office but if I overdo it then I have to take a few days to rest. I don’t need to take sleep meds unless I’m stressed. I’m able to go to work and do my job. I can socialise with people and smile and laugh and crack jokes. I can enjoy the blue skies (currently living in Greece) and food and good music.
But at the same time it’s impossible for me to get excited about anything. I moved here two months ago and I haven’t even seen the acropolis. I went to the beach once but even then I got off the tram halfway to my original destination because I just couldn’t see the point in it. I just feel kinda flat all the time.
But I’m still alive.
ER Nurse here, chiming in.
Please keep yourself safe through this difficult time. Writing about your current experiences is an excellent idea. So is talking to friends and family about what is going on Right Now. As well, calling your physician to let them know how it is going would also be wise. People do better with difficult stuff when they can communicate.
All medications have tradeoffs. Some people are lucky enough to find ones where the tradeoffs are easily tolerated. It can be a long road to finding what works, and some folks never do. Then they have to decide what level of ‘not perfect’ is tolerable. You seem to have a great understanding of your self and your reaction to what is going on.
“But then, on occasion, a doctor decides that maybe I should be on something new; something different. This happened two days ago. I’m not digging it.”
In the future, I hope you can create a relationship where You decide if you should change medications. I’m hoping that this was a dual decision - your MD offered it and you did some research and looked at your life and decided to agree to their offer. If not, once you are through this and comfortable, it will be time to have a discussion with your practitioner that goes like this: “in the future, I make my decisions with your best advice, or we make them together, but never do you make them for me.”
@SeamusBellamy
I’m one of those whose depression/bipolar is very likely inherited. There have been three suicides out of five of us, my mother and two uncles, who unmistakably had/have depression. My older brother has abused me in some form, emotional/physical/sexual for the first 20 years of my life, until I walked away and never looked back.
Debris, when you talk about the inflammation issue, it makes me think of my two years spent in Chicago where I developed nasal polyps, which has definitely deepened my depression due to side effects like weeping polyps trickling mucus down the back of my throat while I try to sleep, which results in a severe lack of REM sleep, and sheer exhaustion most days. As I was growing up, depression was my security blanket, but now it’s my millstone.
I want very much to go back on Prednisone for the very long term, because it takes care of each and every issue, but have yet to find a doctor who will help me find the right minimum dosage, much less let me take it long term. I know the dangers. I’ve had it repeated many times over, but you know…why can’t I be allowed to take a chance on a shorter, happier life than a long, miserable one?
Don’t be ashamed of having to take meds. If I break my leg I’m not ashamed that I have to use a crutch to walk. You need them to function properly, there is nothing wrong in that. You should feel no shame or distress.
I repeat: IT IS OK TO TAKE DRUGS TO FUNCTION AS A NORMAL HUMAN BEING.
That sounds tough @SeamusBellamy. In my experience, drug transition periods suck. As the French say: Courage!
To answer your questions:
Thanks for sharing. I hope the birds start singing again soon brother 
I spent the better part of 14 years addicted to Xanax. I was put on that stuff in the late 80s to deal with a full on Panic Disorder that mutated into full on agoraphobia and actual OCD (Not the internet fake OCD … I didn’t give two shits about crooked pictures)
It took a long time to overcome those problems and get off the meds and I had been doing rather well though the 2000’s. I did resent the addiction as during the years I was on the stuff I still had panic attacks and it never really fixed the problem and just added the anxiety of drug addiction to the mix. I didn’t like that the withdrawal effects was more anxiety.
What solved my problems was ditching my safety nets and moving cross country. One thing that numbed me to the anxiety of driving was to drive cross country in a caravan with a friend that helped me move.
These days If have some mild panic that I can tamper down and not feed, It isn’t easy but I manage.
These days I have been experimenting with pot as it’s legal here in California. I have arthritis and stiff joints with some range of motions problems. I’m finding a low dose of edible pot about 5mg helps a bit as I have been working my back so it will straighten up.
Good luck with your situation. I find the shit can get better with time.
Many doctors have added incentives to change your regimen from one you feel stable on, to one that pays them more money in the form of kickbacks from Big Pharma.
Look up your doc, and see what he gets.
I know how you feel, bro. PTSD is a bitch.
I’m sorry you’re going through this Seamus. It’s hardest when you feel like something which is supposed to help is making you feel worse. I’ve struggled through a few medication changes, and the only thing which kept me going was focussing on the fact that those feelings weren’t mine. Withdrawls and run-ins suck, but they’re not forever. I know for me it was worth wading through the few weeks of sludge to get to the feel like myself again. Cool showers and meditation particularly helped me keep level during the switches. Not trancindental incense and singing bowls meditation -though if that works for you, totally do it- just sitting quietly somewhere comfortable and taking a step back from your head to sort through all those thoughts and let them go.
You’ve been through worse. You’ll get through this. It’s not forever.
We’re all on your side, Seamus.
Things are getting brilliant (besides Avies Canadensis (what’s Canadian? That.) being affected profoundly in the gloaming of a transitional med.) They’re making double-micelles to make more palatable drugs so that one doesn’t get leaky gut for venlafaxine, but polydopamine seems to be a wonder-plastic. Polyserotonin is slumping to the bench too.
[Remembers the new dispensaries .ca thing.] Seems like a new abstraction could come of it, I hope you can get the kinesis of it worked right. [Goes jogging in the old UA Tick Gear. Not really working…visually.]
Hi Seamus, given that you have just bared your soul it is odd that you become coy about the current medication - is there something in there that makes you feel stigmatized?
I’m not an expert, I’ll say that up front, but we’re only seeing part of the picture here so it isn’t clear if you are getting substandard care or if you are struggling to confront something.
Who is in charge of your care? You or the medical profession? That isn’t meant to be an agressive question but if the doctor is changing your meds so abruptly, I’m wondering if he is driven more by pharma reps and less by your needs. You speak of a cocktail of drugs - which may well be necessary with PTSD or it might be a result of the US pharma industry.
You sound like you have responded well to the therapy which is good - you talk about techniques you’ve learned. What about the other things: exercise, maintaining socialization activities, sleep discipline, avoidance of alcohol and other drugs?
You might be just at an uncomfortable drug transition but if it is as bad as you describe I’d be looking for a second opinion.
Hang in there and, if you need something to reduce anxiety in the middle of the night, try these:
Cleaning
Needlework
… worst case scenario: you are still tired and anxious but at least your house will be clean and the holes in your jeans mended.
Hello @SeamusBellamy,
You write about having a wonderful family, living in a wonderful place, and a doctor that cares. You’re blessed to have people who love and care about you. They sound like very kind people.
Please, be kind to yourself during this time. It’s OK to do that.
I’ve heard great things about about Mindfulness-Based Stress Reduction - could be imho a way out of medication altogether.
Wish you the best.
