Posted by bleauberry on July 7, 2009, at 8:42:10
In reply to Time to ditch all the meds and start over?, posted by Frustratedmama on July 6, 2009, at 20:35:30
So, after 8 years of doing pretty well on prozac+zyprexa+modafinil, things were going weird on me. Depression was coming back. New bizarre symptoms were popping up. A couple years of other med add-ons, substitutions, and desperate trials of just about everything, only seemed to fuel the slide into deeper darkness. They could not stop it, and in fact I believe were actually strengthening the slide down. The final hope, or at least I thought it was, was ECT. And that too was a disaster. But that true final hope was....wean off all meds, see what my true baseline is, and go from there. I was so disgusted with the failures of psychiatry I wanted out! I wanted a clean start. I had no idea where I was going or what my future was, only that it was absolutely NOT going to involve any of the meds I was currently on and it was NOT going to involve any of the same doctors I had seen.
While weaning all meds simultaneously, I did so in tiny steps over a 2 month period. I would focus on one med at a time for an aggressive wean, while doing a conservative wean on the others. Once the aggressive one was done and I was ok with it, I would turn to one of the conservative ones and make it aggressive.
There was a strange thing I noticed about 1 week after I had finally reached the end of my weaning journey. I had a great day! I hadn't felt one of those in years! I didn't even know my brain was capable. After that I fell back into my old illness, but it was different. It was milder. It was tolerable. It was manageable. It wasn't that deep dark hopeless place I was when I was on meds that didn't work. I now believe those meds were actually making it all worse, not better, even though they had at one time helped me. Somewhere along the line things changed and the meds became my enemies instead of my friends. Bottom line...I was much less ill off meds than on.
Even with a milder level of symptoms, you know it can wear anybody down over time. So treatment trials were started again. But this time things were different. One med at a time. Very low doses. Don't get in over my head. Stay out of deep water. Nothing fancy. Stick to basics.
I broke many of those rules and paid for it. SNRIs...bad idea. Meds from overseas...bad idea. Exotic combinations...bad idea. Not that these things aren't good for some people, just not for someone with my and your history.
Second only to the MAOIs I do not believe there is any strategy under the sun more effective than TCA+SSRI, both at low or ultra-low doses. My favorites are Lexpro+Nortriptyline, Zoloft+Nortriptyline. I am talking "supposedly" sub-therapeutic doses. My doctor is amazing. He has basically 3 antidepressants in his arsenal, extremely low doses, and quite literally "has never failed to fix a patient's depression" in 25 years and hundreds of patients. Seriously. Amazing strategies that defy the masses of psychiatry.
But a time of cleaning out to see what the baseline is will allow other things to work. Switching directly from one failure to something else, well, I don't know why, it just never worked for me. I see it here every day as well. I think sometimes the best road is to start over. Which means a drug holiday. Very often I have witnessed people feel temporarily better off their meds.
There is the depression of your illness. Then there is the depression from weaning. Say for example you are on a ssri but you feel real dark. You start weaning. Well, even though that ssri was doing you no good whatsoever, and maybe a lot of bad, the fact that there is now less serotonin at the synapse will create a short temporary new layer of depression on top of the true depression. Luckily it only lasts a few days. As the body adjusts, it is not unusual to experience a blip of surprising improvement as the brain overcompensates in the opposite direction. What I am saying is, if you wean off meds, do it slow, do it in tiny steps (custom microdose adjustments), and expect weird things...but know what they are...healing.
I dealt with the depression. Vigorous exercise such as chopping firewood helped. Staying off the couch helped. Doing anything helped. My biggest problem was the anxiety and nervousness. For that I sought the help of a few select herbs to get me through the worst moments. I avoided them unless it was desperate. Maybe once a twice a week that happened. They were Valerian and Passionflower. A supplement with GABA+Glycine was immediately helpful at times as well. And this will sound really weird, but a baked potato with its skin, at bedtime, every night, really took the edge off the next day and gave a better sleep. I think it has something to do with conversion of tryptophan to serotonin, in combination with other factors such as the daily body clock. The daily baked potato did not work any other time except bedtime. There is actually a whole book written on that.
There are a few times in everyone's life where I think we find ourselves stuck on a runaway train and nobody can do anything about it. We can ride it all the way to a crash, or we can jump off, take a few bruises and cuts, find outselves feeling somewhat relieved and better, and wait for the next train. Even though we got off a disasterous train, we still need a ride. I think the next train is going to be a lot friendlier ride.
poster:bleauberry
thread:905343
URL: http://www.dr-bob.org/babble/20090630/msgs/905430.html