RE: Stress or depression = physical weakness?

RE: Stress or depression = physical weakness? (Full Version)

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Aswad -> RE: Stress or depression = physical weakness? (2/20/2008 6:08:28 PM)
quote: ORIGINAL: CuriousLord Can depression and stress cause serious physical and mental fatigue? Yes. quote: How does it feel to be depressed or stressed? Feeling stressed is like you're all dressed up with nowhere to go. When there's nothing you can do to set things right and the frustration builds up. Some might say it's when you don't have control over the situation, but I would not be inclined to concur without serious reservations. Your definitions and mileage may vary. I've done 16 hour days and 48 hour shifts at a high pace without feeling the least bit stressed about it. Some people can't relate to not being stressed under such circumstances. I guess you could refactor it into a question of good stress vs bad stress, if you're thus inclined, but I doubt you'd ask if you were talking about good stress. Being depressed will vary from person to person. Usually, there will either be significant despair or lack of volition. Emotional flattening isn't uncommon, either. Some experience suicidal ideation, or a preoccupation with death. Many lose weight or find it difficult to eat. A lot of people experience disturbed sleep (although it should be noted that disturbed sleep can also cause depression). Motivation is, as a general rule, hard to come by. Things tend to seem hopeless. Blaming oneself for things, even irrationally, is fairly common. All in all, though, I would have to say that is a highly individual thing.. Why don't you describe what you're experiencing, instead; putting the horse in front of the cart, so to speak. If you'd like to discuss it via CMail, I'm used to (unlicenced) counselling and confidentiality. quote: Is it possible to be depressed and/or under panic attacks without consciously feeling it? Yes. Particularly anxiety, which is often experienced as a sort of referred anxiety, i.e. physical anxiety. quote: As a side question, are there any other conditions (physical or otherwise) that can cause heavy fatigue in an otherwise syptom-free person? Yes. Malnutrition, sleep deprivation, chronic fatigue syndrome, fibromyalgia, chronic pain, and a host of other things. Health, al-Aswad.

Aswad -> RE: Stress or depression = physical weakness? (2/20/2008 6:12:17 PM)
quote: ORIGINAL: popeye1250 One thing that really helps depression and stress is a good brisk walk for 45 minutes or an hour a day. It gets your circulation going, gives you an oxygen flush and is good for your heart of course. Try doing that everyday for a week and you'll feel 100% better! Exercise does help. But it is often not enough. Health, al-Aswad.

Aswad -> RE: Stress or depression = physical weakness? (2/20/2008 6:16:21 PM)
quote: ORIGINAL: Rayne58 I was unaware of the stress because I'd been living with it for so long (read emotional abuse) that it felt normal [&o] Sounds familiar. A while back, I was surprised to learn that most people don't feel their own heartbeat all the time, and that you're not supposed to feel your pulse at the spot where the clavicles meet. When I got by BP down to normal, I actually got worried at those things, until I learned that they are how things should be. It took a while to get used to the difference, but it was rather comfy once I did. Health, al-Aswad.

Aswad -> RE: Stress or depression = physical weakness? (2/20/2008 6:38:50 PM)
quote: ORIGINAL: TheHeretic And sometimes that is the worst thing you can do. Sleep. Eat decent food instead of vending machine garbage. Exercise (a quick paced game of basketball is good). Oh, yeah. One last thing that will do wonders for depression. Laugh, long and hard. I think what Alumbrado is alluding to by pounding his head against the wall is that you have *no fucking clue* what depression is. Feeling depressed is not the same thing as having a clinical case of depression, which is an illness that has a 10-15% chance of you killing yourself at some point, as well as a significantly higher standardized mortality rate and a higher incidence of accidents, falls, fractures and various other things. This is on average, whereas severe cases include psychotic breaks and a host of other problems. A Catholic priest who suffered from clinical depression explained it fairly well. He would pray (literally) for death every day, and now that he is well, he prays daily to die, rather than fall ill again. Having experienced the sensation of spilling boiling water over his groin area by accident, he commented that he would honestly rather spend a thousand years experiencing that pain continuously, than to experience another day of depression. I can only say that I wholeheartedly concur with his assesment in that regard. Lots of people go to the docs when they feel blue, and some idiot docs prescribe medication for that, which doesn't do jack shit. Depression, however, is not the same as feeling blue in any way, shape or form. Consider for a moment that the doctors are willing to run 0.9 *amps* of current through your brain, repeatedly, taking with it memories every time, in order to put an end to it, if you don't respond to medication. Consider that they are willing to use drugs that significantly prolong your QT interval, at the risk of having you go into ventricular fibrillation (a.k.a. sudden cardiac death). Consider that they are willing to prescribe amphetamines and opiates in severe cases, combined with drugs that list these as a strictly contraindication. Leaving aside "first, do no harm" and the notion that doctors are human, consider the malpractice suits they'd see if it weren't called for. Then consider for a moment, if you can wrap your head around this one, that during my depression, I found the side-effects of drugs that most people can't live with, along with a drug whose effect is equivalent to 2 grams of morphine I.V. (an experienced addict may use a quarter that amount in a day, but this sort of dose will kill you), to be entirely tolerable. There was no euphoria associated with it, just the usual nausea and vomiting and such. No big deal. The usual response from doctors who were told what I was on, was little more than the sound of their jaw hitting the ground, followed by a long silence, and then... "you walked in here? .... unaided?" Quitting when the therapy was done was no big deal. A week of cramps, pain and general hell. Nothing substantial. Circulatory collapse, cardiac infarction... these are trifling matters, compared to severe depression. But, sure... eating some food... sleeping another 12 hours a day... exercise... that'll do it. Laughing would probably have been good too... if one can remember *how. If I weren't irked at your confident proclamations, made from the comfort of utter* ignorance, your post would be my best laugh this year. I hope you remain ignorant, but I'd appreciate if you STFU about things you're clueless about. Health, al-Aswad.

Aswad -> RE: Stress or depression = physical weakness? (2/20/2008 6:48:39 PM)
quote: ORIGINAL: TheHeretic And if the internet weren't so full of people insisting a simple cause and effect has to be treated like a complex medical condition, the forums would be a lot less interesting. As far as I can tell, CL has not provided enough information for determining the causal relationship of whatever he is going through. A lack of sleep does tend to point at that as a cause, yes. But he has also voiced other opinions and concerns that reflect a pattern of thought that is tending in directions that can indicate something entirely different at work. He has also noted that his situation has a poor coupling between effort and payback, which is the exact set of circumstances to which one can most likely ascribe a higher prevalence of depression in modern times, compared to the past (where payback was more immediate and/or palpable/tangible). Again, as Alumbrado has said: you're not in a position to determine the cause and effect here. Doctors make mistakes, yes, but do you honestly think a bunch of people on a forum on the Internet will be less likely to do so? quote: For some, a diagnosis becomes an excuse to spiral into worthless victimhood. Start simple. Of course he should fix his sleep pattern. And get some exercise. And eat healthy. While waiting for his appointment. CL does not strike me as likely to be looking for an excuse to assume a victim mentality. Health, al-Aswad.

lighthearted -> RE: Stress or depression = physical weakness? (2/20/2008 8:00:50 PM)
another reason to see an MD, to rule out mono...extreme fatigue, and contagious.

TheHeretic -> RE: Stress or depression = physical weakness? (2/20/2008 8:43:19 PM)
I'm not a pshrink, Aswad, but I'm a lot more familiar with the effects of severe, chronic depression and the related physical diseases than you seem to think. I grew up in a home with someone who had/has pretty much all the symptoms you describe. Her 'pain patch' would kill me. When you live with a severely depressed person, you learn to pay little attention to what they say about how they are feeling and watch behavior. Other than the OP using the word depression (possibly just because he has a paper due) what else do we have? He's active and engaged, when he posts in the wee hours. We get mentally unbalanced/disturbed/ill/coo-coo for cocoa-puffs people around the boards sometimes. Medication is going to be the right route for some. It can be disasterous for others. I think our disagreement is not in whether treatment should be sought and used, but where we find that line. I won't go down the duality of man path, but I firmly believe that the output of the brain is based on as much on 'mind' as it on chemistry. The unique paths carved by a lifetime of un/sub/conscious activity play their role. It is very possible for people with mild to moderate depression to change that by a choice and act of will. Going to the doctor is an act of surrender (And no, I'm not talking about those who can't get out of bed). I have to believe this. It's just like knowing I come from a long line of alcoholics, yet I frequently indulge and sometimes to excess. Whether by attitude or good fortune, collapse aside, I can always fight my way out of the house of dark mirrors. There are a lot of treatments other than a drug regimen. Beyond the advice already given, here are a few other treatments. Magickal/wiccan rituals: Not so hot for winning the lotto or turning your exboyfriend into a toad, but an awesomely powerful tool of personal empowerment. Hallucinogenic mushroom therapy would be illegal in the US of course, but taking a mild altering substance that wears off in a few hours has to better than a weeks/months/years regimen that happens to be legal, even though we know far less about long term consequences. Or hey, here is one we've discussed around these forums before, a good, heavy flogging http://english.pravda.ru/main/18/90/360/15176_whipping.html I'll offer you a perspective very few people with these conditions ever seem to grasp, but those those around them know. You ain't better since you started on the drugs. Now you're just high ALL THE FUCKING TIME too.

Aswad -> RE: Stress or depression = physical weakness? (2/20/2008 10:36:26 PM)
quote: ORIGINAL: TheHeretic I'm not a pshrink, Aswad, but I'm a lot more familiar with the effects of severe, chronic depression and the related physical diseases than you seem to think. Your posting still does not seem to support that assertion, but it wouldn't be the first time I was wrong about something. If this is one of those times, you have my apologies, of course. quote: I grew up in a home with someone who had/has pretty much all the symptoms you describe. ~nods~ The question being one of degrees, then. quote: Other than the OP using the word depression (possibly just because he has a paper due) what else do we have? Differences in posting style, topics and thought patterns. That's about as much as we can get via a forum. A personal consultation can unearth a lot more precise information, which is sort of my point. quote: He's active and engaged, when he posts in the wee hours. Not uncommon. Sleep deprivation is widely recognized as effective in temporarily alleviating depression. quote: Medication is going to be the right route for some. It can be disasterous for others. No argument there. Most doctors aren't nearly as knowledgeable as they should be. Few shrinks are. Many of both make huge mistakes on a routine basis. Yet it's pretty hard to argue that we're in a better position to avoid making similar mistakes. And it's something only a handful of us appear to have any experience in diagnosing and/or treating. Hell, there's a whole industry built on selling ineffective drugs to a population that doesn't need them, with the side-effect of adding unneccessary suffering for those who actually do, along with stigma and "easy solutions" that are often offered by people who have never seen depression, but rather just think they have. You can probably see this point, and how such an assumption was initially made. quote: I think our disagreement is not in whether treatment should be sought and used, but where we find that line. I would hope that is the case, yes. quote: I won't go down the duality of man path, but I firmly believe that the output of the brain is based on as much on 'mind' as it on chemistry. A model that will suffice for layman's use, and probably first- and second-line therapy, as well, is what I sometimes call the triangle of mental health. It consists of psyche, biology and environment. There are bidirectional feedback paths between each of these factors. Drug therapy addresses only the biology. Shrinks usually address either the psyche or the environment. There are exceptions to this, of course, but they seem to be rare. In order to minimize the work that needs to be done in any given department, working on all of these factors is useful. A large crate is easier to move when pushing on one end and pulling on the other. What bears keeping in mind, is that the primary goal of drug therapy is to lock one side of the triangle in place and breaking the feedback loop. If the biology has been affected, that is usually very effective, provided it is done by a competent psychopharmacologist. Being someone whose natural approach to life and problem solving encompasses both cognitive behavioral therapy and eastern thought, I would say that one can definitely do a lot by addressing the psyche, but that it isn't necessarily enough to break a latch-up in one of the other factors. Even moderate depression (moderate in a clinical sense) tends to require additional measures. And there are definitely some good reasons for attempting to address those early on, if done properly. Kind of like removing a suspicious mole, or giving antibiotics when a periodontal abscess is accompanied by a fever. quote: It is very possible for people with mild to moderate depression to change that by a choice and act of will. Bearing in mind that moderate depression is about the range where forced inpatient care is considered, I think you may be using that word more colloquially than I am. What is colloquially refered to as severe depression is light in a clinical sense. What is severe in a clinical sense is pretty much "fucked-up raving mad basket case" in colloquial terms. The correctness of your statement depends on the scale you are using here, in my opinion. quote: Going to the doctor is an act of surrender (And no, I'm not talking about those who can't get out of bed). The ability to get out of bed can be present at severe levels, and absent at light ones. It's not a reliable indicator of anything. Going to the doctor is not an act of surrender. Handing over responsibility for your well-being to the doctor, however, is. The difference may be subtle, but it is also rather profound. Similarly, the notion that the drugs are going to do the job for you is also surrender, whereas the notion that they *may* be neccessary for you to manage the job isn't. Again, a subtle but crucial difference. quote: Hallucinogenic mushroom therapy would be illegal in the US of course, but taking a mild altering substance that wears off in a few hours has to better than a weeks/months/years regimen that happens to be legal, even though we know far less about long term consequences. A lot of these are rather questionable, and most involve actions that are duplicated in one or more antidepressants. Bear in mind that there is a major difference between treatment and good treatment. Also, some drugs have been extensively studied and characterized, including long term studies. Hell, there are people who started Parnate 35 years ago, and simply never saw any reason to stop taking it. The main impacts on their health are lower blood pressure, resistance to depression, somewhat raised cognitive performance, a halving of the risk of developing Alzheimers, and an 80% reduction in the risk of developing Parkinson's. Hardly something to be excessively worried about. "Antidepressant" and "SSRI" are not synonymous. quote: Or hey, here is one we've discussed around these forums before, a good, heavy flogging http://english.pravda.ru/main/18/90/360/15176_whipping.html Correct. Heavy flogging causes the release of endogenous opioids, which has a beneficial effect. Of course, in order to get the levels that you can produce with a synthetic, you will at the very least need to inflict complex fractures and deep lacerations. Which hardly constitutes safety or sanity. Concerns about tolerance are significantly reduced with modern opioids. The one that is most commonly used for this sort of thing is buprenorphine. It has little to no tolerance buildup, doesn't affect respiration nearly as much, and has the additional beneficial effect of acting as a kappa-antagonist (in fact, the most potent and specific one I'm aware of). quote: I'll offer you a perspective very few people with these conditions ever seem to grasp, but those those around them know. You ain't better since you started on the drugs. Now you're just high ALL THE FUCKING TIME too. I've no idea what drugs your points of reference have been on, but you're clearly missing a few things here. Antidepressants, correctly used, will not make anyone high, although some of them can be sedative (those are rarely used, though). Apart from that, there are three people who lived with me that can attest to the improvement, and about four that didn't, yet had sufficient direct contact to evaluate (and who concur that the effect was a net improvement, although some combinations were not unequivocably so). Incidentally, this is why responsible doctors track progress with clinical rating scales. Health, al-Aswad.

LadyHibiscus -> RE: Stress or depression = physical weakness? (2/21/2008 9:15:38 AM)
I am by no means high all the time on my meds. Quite the opposite, actually. I've experimented with an array of antidepressants, and have settled on one (Effexor XR) where I am at the maximum dose. Every day I think about going off them, and becoming the intense, vibrant, creative person that I remember. My family says no. :) And I say no, because even though the side effects are not enjoyable, I can live more easily with them than with the uncontrollable surges of brain chemicals that affected my life, and the lives of everyone around me.

camille65 -> RE: Stress or depression = physical weakness? (2/21/2008 9:21:21 AM)
quote: ORIGINAL: LadyHibiscus I am by no means high all the time on my meds. Quite the opposite, actually. I've experimented with an array of antidepressants, and have settled on one (Effexor XR) where I am at the maximum dose. Every day I think about going off them, and becoming the intense, vibrant, creative person that I remember. My family says no. :) And I say no, because even though the side effects are not enjoyable, I can live more easily with them than with the uncontrollable surges of brain chemicals that affected my life, and the lives of everyone around me. I don't understand how someone/anyone could get high from an antidepressant to be honest. It isn't that sort of drug.Hell if I could get high off them I'd double my Wellbutrin and never smoke weed again. I don't get high from any of my drugs, not the morphines, the soma, the flexeril and so on. Now going off an antidepressant can cause some serious mind confusion, but not just taking them.At least not in my body.

Aswad -> RE: Stress or depression = physical weakness? (2/21/2008 10:22:46 AM)
quote: ORIGINAL: camille65 I don't understand how someone/anyone could get high from an antidepressant to be honest. It isn't that sort of drug. Depends on the antidepressant, and whether the person using it is depressed or not. Too high doses of unselective monoamine reuptake inhibitors (such as para-hydroxy-trans-(±)-2-phenylcyclopropylamine) can make you high. Too high doses of opiates, dopamine reuptake inhibitors, dopamine agonists, amphetamines and other such compounds can also make you high. However, except for Efexor, no serotonergic drug has ever made me high. And it only did so for the first day, then I became apathetic and suicidal. That said, adequate doses of a potent serotonergic can probably do it; that's an early stage of serotonin toxicity, after all. quote: Hell if I could get high off them I'd double my Wellbutrin and never smoke weed again. Wellbutrin is not particularly good for that, as the risk of seizures goes up drastically at the doses that will make you high. Survector (amineptine), however, is quite suitable for abuse. Which is, frankly, the reason it was withdrawn from the market. It happened to be the first bona-fide aphrodisiac known to mankind (spontaneous orgasms have been reported, and an increase in libido was normal), and about the only drug that could be abused safely. Clearly not a thing the drug authorities want on the market. Never mind that it had a tendency to bring remission in a matter of days at therapeutic doses. It's currently classified as a schedule 2 substance, available only by special dispensation. Also carries a 1 in 10.000 risk of liver toxicity, but that's less than paracetamol/acetaminophen. Nomifensine is about the same, if memory serves. The high from those will be different from the high from weed, though. Not that I've actually tried this myself, but I know a lot of people who have. quote: I don't get high from any of my drugs, not the morphines, the soma, the flexeril and so on. Some people do. There's a lot of individual variation in how people respond. In a major double-blind study, a prison population was unable to distinguish between soma and placebo, for instance. But some people metabolize it differently, such that it has a different effect on them. For most of us, it's essentially just a quicker-acting form of meprobamate (Miltown/Equanil). Health, al-Aswad.

LadyHibiscus -> RE: Stress or depression = physical weakness? (2/21/2008 1:27:00 PM)
Effexor did the lethargy thing for you? Prozac took away my ADRENALINE response! I was in a car accident and literally had no change in my pulse, blood pressure, nothing. Of course, that probably helped save the life of the guy who hit me..... [:D] The thing is, these psychotropic drugs are a total crapshoot. No one knows exactly how they work, or which ones will.

Aswad -> RE: Stress or depression = physical weakness? (2/21/2008 3:01:09 PM)
quote: ORIGINAL: LadyHibiscus Effexor did the lethargy thing for you? Very much so. I would say it significantly worsened the condition. quote: Prozac took away my ADRENALINE response! Not surprising. quote: The thing is, these psychotropic drugs are a total crapshoot. No one knows exactly how they work, or which ones will. Actually, that is not the case. I have had a success rate of 4 in 5 on the first attempt so far when advising people on that subject. And a lot of pdocs actually do know what works or not. The thing is that the modern drugs (with a few notable exceptions, such as Edronax, Wellbutrin, Survector, Stablon and Subutex) are ineffective. For the most part, the color of the capsule makes a bigger difference than the actual drug chosen. They are used because an overdose is unlikely to fuck you up, and because it's not a big problem to prescribe them without knowing what one is doing. Well, that, and the advertising gets to the doctors. For instance, let's have a look at some of the effective, but less popular, ones: Monoamine Oxidase Inhibitors (MAOIs) Parnate (tranylcypromine) is a pure MAOI at low doses. At high doses, it also acts as an unselective monoamine reuptake inhibitor. It has robust mood elevating properties and will alleviate depression for 85% of treatment refractory patients at 2.4mg/kg/day, and is about as effective as ECT, without the side effects. Occasionally causes sedation, but is far more likely to be stimulating. Causes weight loss in most patients. Lowers blood pressure. Lowers risk of Alzheimers and Parkinson's significantly with long term use. Requires adherence to a strict diet, as well as having interactions that absolutely must be accounted for. The closest thing to a miracle drug available, but must be taken seriously to avoid dangerous interactions. Nardil (phenelzine) is a MAOI, and has the same caveats as Parnate. It also inhibits GABA-transaminase. May cause sedation and weight gain. Does not have stimulating properties. Will nullify severe anxiety in virtually all patients that take it, and is the gold standard for treatment of anxiety and depression with anxiety. As with Parnate, it must be taken seriously. Tricyclic Antidepressants (TCAs) Anafranil (clomipramine) is the gold standard of serotonergic drug therapy. It works in a manner similar to what Efexor and Cymbalta try (and fail) to do. Usually stimulating, but can cause sedation. Some people will experience mild memory issues, but these are hard to distinguish from the memory impairment that results from the depression itself. Will affect libido in the same way as the SSRIs. Highly effective. Potent 5HT2A-antagonist. Some interactions. Blood level assays should be performed, but are not critical. Toxic in overdose. Should not be taken if you have a heart condition, as it prolongs the QT interval. May cause dry mouth, necessitating extra care in dental hygiene. Must under no circumstance be combined with a MAOI at any dosage. Aventyl (nortriptyline) primarily acts on the noradrenergic system, and is a useful addition to MAOIs. This combo is strictly contraindicated due to an early misunderstanding that has been propagated by lazy researchers. It actually lowers the risks associated with ignoring the dietary restrictions of a MAOI. For US residents, it is the alternative to Edronax, as Strattera simply doesn't compare in terms of efficacy or risk profile. Can cause difficulty in urinating, particularly in men (who may also experience delayed ejaculation). Some interactions. Blood level assays should be performed, but are not critical. Toxic in overdose. Prolongs the QT interval. May lower blood pressure, which may cause a modest compensatory increase in beats per minute. May cause dry mouth, nnecessitating extra care in dental hygiene. Noradrenaline Reuptake Inhibitors (NRIs); that's norepinephrine to US folks. Edronax (reboxetine) is the most selective noradrenergic drug available. Effective in endogenous depression. Has mild to moderate stimulating properties. May exacerbate anxiety in some patients, but has also been used to treat anxiety in others. Lowers or eliminates risk associated with ignoring the dietary restrictions of a MAOI, though the dose should be reduced to ¼ in that combination. Can be administered once daily, but is usually given twice daily. Can cause difficulty in urinating, particularly in men. Likely to cause delayed ejaculation, and may cause reflux during ejaculation. Should be used with care in benign hyperplasia of the prostate. Appears safe with heart conditions, but will lower blood pressure and raise beats per minute. May cause dry mouth. Not available in the US, as a matter of protectionism. Dopamine Reuptake Inhibitors (DRIs) Survector (amineptine) increases libido and may cause spontaneous orgasms. Withdrawn from the market, ostensibly due to a slight chance of liver toxicity, but that's pretty much a sham, as several OTC drugs have more than twice the risk of causing the same. Rapidly alleviates depression, with several documented cases of remission occuring after three days. Classified as schedule 2 due to abuse potential, but available via special dispensation to a licenced psychiatrist. CNS Stimulants Dexedrine (dextroamphetamine) is sometimes used when other things fail, usually in combination with something else. Can be combined with a MAOI, but that should be done under careful supervision, as some people have adverse reactions to that combination. Routinely used in inpatient care in treatment refractory cases. Mood elevating and stimulant properties. Reduces fatigue. Causes weight loss. Increases libido. May cause dependence, but this is rare in therapeutic use. Should not be used with patients that have a heart condition. Will not be used with patients that have a history of drug abuse. Serotonin Reuptake Enhancers (SREs) Stablon (tianeptine) is a fairly neutral drug in all respects. May increase libido. Frequently alleviates asthma. Occasionally cures asthma. Small chance of liver toxicity (on par with OTC painkillers). Not particularly widely used. Must be special ordered. Monoamine Reuptake Inhibitors Merital (nomifensine) is stimulating. Highly effective. Somewhat rapid action. Likely to increase libido. Can be abused in overdose, at significant risk to the abuser. Available by special dispensation. Some chance of liver toxicity. Opioids Temgesic / Subutex (buprenorphine) alleviates distress and can have an antidepressant effect. Useful as an adjunct to other therapies. Small risk of tolerance buildup which can be reversed with PKC-inhibitors. May initially cause euphoria. Nausea and vomiting can happen with high doses. Offers rapid relief from the symptoms of depression and anxiety (can replace benzodiazepines for the latter), but has limited long-term effect on its own (on par with SSRIs). Can cause sedation. Unlikely to be prescribed by anyone but an expert pdoc or university clinic. A relevant detail to the BDSM community is that it is a powerful analgetic; pain play is a non-option on this. Used for anxiety in doses from 0.1mg to 0.4mg, from 1-4 times per day. Used in doses up to 24mg per day for treatment refractory depression. NMDA-antagonists Ebixa (memantine) has shown some promise, but is most effective as an adjunct to other therapies. Prevents buildup of tolerance to opiates and stimulants, if used properly. Can cause cognitive impairment. Questionable long term safety, and a theoretical risk of developing Olney's Lesions. Normally used for Alzheimers. Ketalar (ketamine) is a general anaesthetic, and used as a one-time thing. The duration of treatment is, if memory serves, about three days. Appears to be a promising novel treatment option, but should probably remain in the arsenal of "last resorts," rather than general use. Severe side effects during the treatment period. Requires hospitalization. Theoretical risk of Olney's Lesions. Other / Unknown Wellbutrin (bupropion) is frequently used as an adjunct to SSRI therapy, and becoming more common as a standalone. It is somewhat stimulating. Can cause weight loss. May increase libido. Should not be used in patients that have a risk of seizures, at least not in high doses. Should probably be avoided in patients with a heart condition. Fairly good choice to try early on in patients that are not actively suicidal. Initially used as a smoking cessation aid. Putative mechanism of action is cathecolamine reuptake inhibition (noradrenaline and dopamine), but the evidence does not seem to support this as the sole mechanism of action, so its mode of action must be considered unknown. I'd bet most patients haven't heard of half of these. A lot of docs sadly haven't, either, or don't realize the benefits. Note that the above is just off the top of my head, and I'm having a slow day. It's not advice, let alone medical advice. I've probably missed a bunch of important details. If you feel like tallking to your doctor about having the doc investigate some of these options, that's another matter, but don't self-medicate with any of these. They are not like SSRIs, and should be treated with respect and used by a competent doctor with a reasonably rational patient. But, yeah, they are also in an entirely different league of efficacy when used properly. Having the doctor consult with an expert like Ken Gillman seems like a good idea. A competent doctor can treat depressions in a manner that does not resemble the lottery that most doctors expose their patients to. To quote one good doctor, "I have never encountered a treatment resistant depression." For some of us, it will always be a shot in the dark. It shouldn't be for most of us. Health, al-Aswad.

kittinSol -> RE: Stress or depression = physical weakness? (2/21/2008 4:22:15 PM)
I think Survector is completely unavailable in the United States. Unfortunately. It was also banned in France, alongside with a few other.

Aswad -> RE: Stress or depression = physical weakness? (2/21/2008 4:28:42 PM)
quote: ORIGINAL: kittinSol I think Survector is completely unavailable in the United States. Unfortunately. It was also banned in France, alongside with a few other. The way it went, if memory serves, is that the US banned it first (three guesses as to why), and then they pushed for the UN to add it to their narcotics list. It was added with a reservation, though: you can still get it if your pdoc can make a reasonable case that you need it. That still doesn't change the fact that it must be synthesized specifically for you, since it's not actively manufactured anymore. Health, al-Aswad.

Greylynn -> RE: Stress or depression = physical weakness? (2/21/2008 9:45:20 PM)
I would be in a state mental facility if I wasn't medicated, locked up and found not competent to stand trial for all the murders commited. I'm not being sarcastic. Few details of what drove me over the edge... 11/5/02 - Talking to mom to tell her grandson made class president. Mom ill and last words out of her mouth before she hangs up are "I ought to be dead" Father gets on phone - I ask him if he is sure she should not go to hospital He Says no, doctor called her in drug to help her stop puking and it makes her loopy, she'll be fine. 11/6/02 VP of department comes to get me to come to her office to take a call . Highway Patrol tellng me my father needs to speak with me. Father says "brace yourself...mom's dead" leaving me a father that cannot read or write and who quit school in 8th grade. Mothers death now makes me POA of uncle in group home. Father blames uncle for mothers death along w/93 year old great aunt because if she wasn't running around taking care of them and being upset with them all the time she would be alive. 11/02 Husband has a TIA 3 weeks after mothers funeral thanks to Vioxx. 02/03 end/begin...10 year old pisses husband off and he stuttering, cannot get out what he wants to say - 10 year old laughs and cracks jokes at husband. 10 year old lucky to be alive. - 1/03 Fall in parking lot breaking tailbone - husband still off due to TIA 3/03 Grandfather dies - father does not go to house to be with stepmother while funeral home comes to pickup the body - drives 90 miles to visit moms grave to tell her grandfather is dead. ?/03 Husband back to work from TIA - has to have gallbladder removed. Grandmother in hospital at the exact same time with bloodclot in her lung - run between floors visiting both...still handling fathers shit and uncles shit ??? couple more relatives die - great aunts and uncles. Still handling shit. 10/03 Husband falls off ladder at work shattering entire ankle, breaks leg and fucks up knee. ??/04 Group home calls - tells me father has been there to threaten uncle to tell him to quit calling me, quit calling folks down home or he'll kick his ass. ??/04 Group home calls again - afraid of father because of threats again. I tell them to call the cops on his ass. Confront father - tell him to stay the fuck away or I will let his ass sit in jail. 12/04 - husband pisses me off because he "fluffs" branches on fake tree wrong.I throw the tree out the front door. Husband limps outside on broken . ankle to retrive tree crying fits now start. - Also put myself in time out by going to bed and sleeping - warn everyone to stay the fuck away. 12/25/05 Husband ankle still broke after 3 surgeries -father falls breaks ankle in driveway due to ice. Now I have TWO people who need their ass waited . on hand and foot due to broken ankles. Still handling father and uncles shit Realize not everyone is a fucking idiot and railroad tracks look pretty tempting but who the hell will take care of everyone else? Go off on supervisor at work who ask a qustions that I believe he should know the answer to, after all he has the fucking title behind his name (yep, that's the answer he gets) Call dr - can't be seen for two weeks - have a date now - I can continue to drive over the railroad tracks to work w/o stopping the car. Must NOT talk to anyone at work and everyone at home understands to stay the fuck away. Doctor ask if talking to someone would help - WTF - talk? WTF is that gonna fix - everyone is still alive and I still have to deal with fathers shit and uncles shit. Only child, Aunt won't help with uncle's shit, doesn't have to act like she cares now that mother is gone. Not talking is the only thing keeping me employed and knowing this appointment was made is only thing that kept me driving over the railroad tracks. I have tried to stop taking them and withing days I'm once again ready to rip everyones head off. Co-workers actually ask if I'm off the meds. Maybe, just maybe if I outlive my father and uncle I will get off of them after they pass. Until then, mediation is a must. Wellbutrin has been the best one I've been on. Sometimes I think I should take the 300 mg but that amount cramps up my legs and makes me jittery. 150 mg works well most of the time. On days where I feel a bit out of control I warn everyone that I'm just not in the mood and to stay away, but I am usually over it the next day.

Alumbrado -> RE: Stress or depression = physical weakness? (2/22/2008 12:28:45 AM)
quote: ORIGINAL: TheBanshee Alumbrado - It says your reply was in response to my reply - I NEVER ever said not to see a doctor - I said get a physical!! My only point was not to assume it was depression until he had a full examination - by a doctor and rule out other possible causes. I don't think anyone else was suggesting that either. Siiiigghh... If someone cuts and pastes a specific part of a quoted post instead of using the quote button and getting a possibly confusing mass quote, 'It' being the website inserts that 'in reply to' tag based on who was the last poster when they typed their reply....regardless of who is actually being replied to... In this case, since you posted after they did, and before I hit send, your name came up automatically. That is why I bothered to spell out the names of the people I was actually addressing with the specific issue. The message of 'don't go to a doctor and find out what is causing certain symptoms, just get off your duff and be happy', is a dangerous crock. And yes, that is exactly what was being promoted (as in earlier thread claims of being able to make psychic medical diagnoses via 'just looking' )... I wasn't suggesting that it was being promoted by you.

Aswad -> RE: Stress or depression = physical weakness? (2/22/2008 3:57:14 PM)
Ever strike you that people usually seem to want to either want to make it an either-or issue, or to make it perfectly vague?

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