Antidepressant Meds

A very good friend of mine had her second psychotic episode this summer. She has started medication last week.

The first one was last summer. We initially went to a psychologist. He is part of a team that are against medications but in contact with psychiatrists. This team has a political background as well so money was not an issue. So we were 2 friends beside her with 24h hour "shifts". For about 2 months I was every other day with her. The psychologist's approach was not suitable for her case. He suggested for 2 trained people to go to her house on a daily basis so we (her friends) could take a breath, and for her to start going to group meetings. She thought that even us (her friends) were spies so having new people in her house was impossible, and going to a group meeting was also impossible because of all of these new people, but also because she wouldn't get out of her house easily. And when she did, well that's another story.

At that point and since their approach could not work, I would have expected him to suggest the psychiatrist. This never happened. Also, my friend, she didn't want to go back to any sessions with him anymore (and I don't blame her for that cause I was also present in these meetings). Still, she was positive to go to a psychiatrist. We found one that was suggested by another friend of ours. The anti-psychotic medication started working within a day or so, and all three of us could start to unwind a bit.

She continued the medication for a few months, but did not want to even consider going to do psychotherapy. By christmas, she was feeling so much better that she started smoking weed again, drinking alcohol among other substances I suppose. I am not sure because at the time we were not seeing each other much. It's like we chose 2 opposite paths. She chose to go back to all the habits that gave her comfort since her teen years, which was two decades ago. I chose reevaluate everything so I won't feel that lost again, and started psychotherapy for the second time in my life. We started seeing each other less and less.

Now that you have an overview of the situation maybe I could say a couple of things about my case. It's relevant because I would like some input. It was not my first time to be the carer of someone. Sometimes I feel that most of my adult life I've been taking care of other people. I was the main carer for 3 other persons. I say "main" because everybody else, even if they showed up at first, they all at some point left. So it was for several times with this friend who is bipolar (during and after his episodes). I also had a partner for some years that was struggling with psychiatric issues but the diagnoses were many and very different. And another partner who had manic episodes. All of them are actually fine. They all gave up drugs, first. Btw I consider alcohol to be a drug as well, and I am not a straight edge kinda person myself.

My way of coping with the pressure I got from these situations was to do "work therapy" as I used to call it. I would work intensively and I felt that it was good for me. This time I knew "work therapy" would not do it. Thankfully at some point in the past I did go to psychotherapy for something totally unrelated and my experience was positive. This time I could say therapy is going even better.

Last time I saw her, it was a few months back. I was told about her incident by a common friend of ours. I am not sure I have the strength to be a carer at this point, I don't even know if I can be in contact with her. This "work therapy" of mine had the long term effect of having all these previous experiences piled up, and did not contribute in resolving them. The last times we saw each other it kinda triggered all the pain, exhaustion and despair, that got accumulated by all these people I took care of. Something like that.

But my friend needs me. And I know she feels I abandoned her, because I have. Sure, I had to put myself together but this doesn't change how it made her feel. Now, she is surrounded only by people who either give her drugs or are fine with her abusing any substance. She feels safe in this environment due to habit. And she never liked change, at all. I believe my presence in her life could provide her another point of reference, one that is different to her current approach but in the same time familiar as well.

Of course, I will talk about this with my therapist next week but I would totally appreciate more input. I thought that maybe I could find another group, and maybe if they are fine, I could maybe convince her at some point to come along. The problem is that I am not sure that there is another group like that were I live. I will totally look for it.

If you have any advice or any link with text, audio, video or whatever that you consider relevant, please do share. I hope the above makes some sense, and thank you for taking the time to read this.

>In recent years, discussions around the impact of climate change on mental health have tended to focus on climate anxiety. > >This distress regarding the future of the Earth and humanity in the face of global warming is, however, far from the full picture. > >Research is helping to build a better understanding of the damage that climate change, particularly extreme heat, can cause to mental health. > >The latest assessment report on climate impacts from the Intergovernmental Panel on Climate Change (IPCC) concluded with very high confidence that rising global temperatures have “adversely affected” mental health in regions around the world. > >Research indicates that heatwaves can trigger increases in both the hospitalisation of people with mental-health challenges and emergency psychiatric visits. People with pre-existing mental-health problems also have an increased risk of dying during periods of high temperatures. > >In addition, suicide rates have been shown to increase in higher temperatures and are expected to rise in a warmer world – although the links with climate change are complex and compounded by other factors. > >Despite these research findings, significant gaps remain in understanding the biological, psychological, social and environmental interactions between mental health and heat. > >And policymakers have a huge amount of ground to make up, with mental health barely featuring in climate-related policies and commitments around the world.

https://archive.ph/zDBkC

>A small new study shows reactions in the brain in people who were given psilocybin in a controlled setting.

>The scans, published Wednesday in the journal Nature, offer a rare glimpse into the wild neural storm associated with mind-altering drugs. Researchers say they could provide a potential road map for understanding how psychedelic compounds like psilocybin, LSD and MDMA can lead to lasting relief from depression, anxiety and other mental health disorders. > >“Psilocybin, in contrast to any other drug we’ve tested, has this massive effect on the whole brain that was pretty unexpected,” said Dr. Nico Dosenbach, a professor of neurology at Washington University and a senior author of the study. “It was quite shocking when we saw the effect size.”

>Dr. Jan Ramaekers, a professor of psychopharmacology at Maastricht University in the Netherlands who was not involved in the study, said...“Treatments with psilocybin, even though they are effective, don’t last forever,” he said. “At some point, they need to be done again.”

Had a nightmare so bad and so vivid it took me an hour to recover.

I guess next time I'll listen to something happier or something idk.

I started taking fluoxetine yesterday, and now I feel awful. I was wondering if anyone had tips in order to reduce stomach aches, or any tips in general in order to get through the beginning.

I would also like to hide the fact that I'm taking some for personal reasons. Any tips for that aswell?

Thanks in advance!

I want to switch up Zoloft for another ssri, but they often dulls myself in a way I can't act spontaneously and become more like unintrested which Zoloft is free of. I tend to associate this phenomena with Zoloft's weak activity as a dopamine reuptake inhibitor. And since wellbutrin is illegal in my state, I can't have it (as well as adderall, ritalin)

What I do have are atomoxetine, phenylpiracetam

Many people out there suggest doing CBT while taking antidepressants, but I don't see what problems CBT could potentially cure for me. Anxiety? Fixed by drugs (or should be fixed), Depression? Fixed by drugs, and so on. If my drugs fails at fixing problems, there's a good chance that drug dose should be adjusted or I need other drugs that's simple. What's the relevance of cbt here?

Has someone got success stories with this transition?

The first year on Zoloft went good, I felt no extreme lows, didn't cried once. What I can't say about the next year. I won't say much, but felt like a crying mess at times. Although I had some conflicts in college, and was totally unsatisfied with the way I was living, I tend to think it had not as much to do with the reality of the situation as with the drug wearing off.

What's interesting is that despite the apparently disastrous mood I've had lately, Zoloft has still done a good job of removing my shyness and social awkwardness.

Some new research out of Amsterdam finds that running regularly with a group achieves the same anti-depressant effect as anti-depressant medication.

The catch: they study is inconclusive about solo running (perhaps not even studied). You must run in a group to get some certainty of the effects and you can’t slack off.

I looked up a few papers and tables and found different perspectives. Generally, citalopram is allowed in the range of 20-40 mg, and zoloft 50-200. In one table, it was stated that the starting dose of citalopram is 20 and zoloft is 50, which is quite logical. From that, I can infer that 100 zoloft is 20+20 = 40 mg of citalopram, but it looks quite doubtful because 40 is the max dosage.

Furthermore, I found one study in which citalopram and zoloft were compared in the ranges of 20-40 and 50-100 respectively. In another study, they were 20-40 and 50-150. I’m still a bit confused. I took 40 mg for a couple of days and it didn’t strike me with a surge of apathy, but I felt it definitely more potent than just 100 mg of zoloft.

What are antidepressants?

Antidepressants (ADs) are drugs that make you feel less miserable. They are supposed to cure depression, apathy, abulia, anxiety (where they overlap with anxiolytics), OCD and other mental woes. Sometimes they do, but they also come with various side effects.

SSRIs - selective serotonin reuptake inhibitors. There are six main SSRIs (fluoxetine, sertraline, citalopram and escitalopram, fluvoxamine, paroxetine). The most famous and prescribed drugs. Many people benefit from them and they are probably the best ones to start with. A common side effect of all serotonin ADs is the loss of libido, or in plain words, the inability to get it on.

(S)NRIs - more powerful ADs that regulate not only serotonin but also norepinephrine. Examples are venlafaxine, duloxetine, milnacipran. They work effectively, but their side effects/withdrawal are somewhat worse.

Tricyclics - one of the first antidepressants. Their chemical structure has three cycles with a tail, hence the name. They act as powerful SNRIs, but with additional effects on histamine, cholinergic and other receptors. Very effective, but have a lot of side effects and are very dangerous in overdose. In most countries are represented by amitriptyline, as well as clomipramine and imipramine. There are also doxepin, trimipramine etc.

SNDIs - act on norepinephrine and dopamine. Apart from bupropion there are not many of them.

MAOIs (monoamine oxidase inhibitors). Inhibit the enzyme that breaks down serotonin, norepinephrine and dopamine. There are two classes, reversible and irreversible (as well as affecting MAO-A and MAO-B)

• Irreversible MAOIs. Examples are phenelzine, tranylcypromine, isoniazid, isocarboxazid, selegiline. Some of the most powerful antidepressants, but also serious side effects. Absolutely not to be taken with SSRIs and other serotonin drugs because of the terrible serotonin syndrome, as well as cheese because of the tyramine syndrome (severe blood pressure rise).
• Reversible MAOIs - widely represented by moclobemide. Not the strongest ones, but their side effects are mild. With SSRIs, however, it is better not to mix.

Various antidepressants (mirtazapine, trazodone, vortioxetine, agomelatine, etc.). Act on different mechanisms and differently.