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Dr. Bob is Robert Hsiung, MD,
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Posted by Klavot on January 13, 2007, at 3:31:27
In reply to Re: Do people feel medications help or mask sympto » SLS, posted by yxibow on January 13, 2007, at 2:37:23
Well said, Jay. I have begun taking Zoloft and Wellbutrin again, because after about a 3 month absence, I have concluded that I am simply a much better person using these medications. If I analyse the past 10 years of my life, I have definitely been a better person during the times that I have used psychotropic medication versus the times that I haven't. To me, it doesn't really matter whether medication treats or simply masks my depression; what matters is that I have *QUALITY OF LIFE* while on medication. Three doctors now have suggested to me that I stay on antidepressants long-term, possibly for the rest of my life. In the past I have rebelled at the idea, but I am starting to realise that I probably do have a pathologically based tendency towards depression.
Klavot
Posted by SLS on January 13, 2007, at 4:55:42
In reply to Re: Do people feel medications help or mask sympto » SLS, posted by yxibow on January 13, 2007, at 2:37:23
Real quick, Jay.
Did 9/11 affect you in any way?
Have you tried Paxil?
- Scott
Posted by Meri-Tuuli on January 13, 2007, at 10:44:04
In reply to Do people feel medications help or mask symptoms?, posted by leo33 on January 12, 2007, at 20:06:57
Hey!
Well, for me, medications have been of no help whatsoever. In fact, they only make things worse for me. I'm doing far better off meds than I was on them. Okay, so things might be a little shaky at times, and sometimes its great and others not so great, but I'm far better off without them. I'm making alot more progress without drugs than I ever did on them. Now, I'm able to look at things and address problems I have etc. On celexa, for instance, I only cared about eating, sleeping and shopping. I wasted several years like that, not addressing any of my problems when I could have really been sorting myself out with therapy etc.
So for me, drugs really just mask symptoms and I don't make any progress. I'll come off them, crash and then try a different drug. Now I haven't crashed majorly in quite a while and I'm really working hard to address my 'issues' and low self esteem etc which are at the root of my problems.
For me, I think my mental problems are entirely psychological and have no biological basis whatsoever. I've given up completely with seeking a chemical solution to my problems - although I do try some herbs, although I never actually take any at any theraputic doses.
But this is just me, and my own experience. I don't say for others. But I will say that I know I went through a phase of denial, and thinking that I must have a biochemical imbalance or something. Its alot easier to cope with, and I think doctors and drug companies do tend to push the biological component of depression etc. I know that here in the UK, therapy is very very limited (on the state healthcare system at any rate) so GPs will dish out SSRIs like candy rather than getting to the roots of problems with therapy.
I mean, I distinctly remember telling a psychiatric nurse during my first ever depressive episode that prozac just felt like a pain killer - it didn't address the cause of the pain, just blunted it.
Kind regards
Meri
Posted by yxibow on January 13, 2007, at 12:18:03
In reply to Re: Do people feel medications help or mask sympto » yxibow, posted by SLS on January 13, 2007, at 4:55:42
> Real quick, Jay.
>
> Did 9/11 affect you in any way?
>
> Have you tried Paxil?
>
>
> - ScottYes, a good observation of a devastating trauma to myself and our country -- it is believed that my disorder may have been triggered by the extreme anxiety that happened just after 9/11. My reaction was disproportionate to those around me. I would be constantly checking my cellphone for news, be worried at night that nuclear war was going to break out, and a myriad of things that led to a total breakdown of my grip on life.
Of course, these threats to our way of life were always present, we just lived through the Reagan me generation, and the relative calm of the Clinton era (we can ignore the politics here, at any rate for the sake of this discussion, but anyhow...),
But somehow spontaneously, and I believe it was about Nov 17, because I was driving up the local mountains for my somewhat annual viewing of the Leonids (meteor showers, only visible in the southwest usually because of weather, anyway) and I was seriously almost blinded by the light of cars coming and going and I saw a few meteors and got off the mountain as safe as possible.
I thought this was some sort of fluke or illness that would pass and I went out to a more local dark sky area, and again I was hit by car lights and I remember passing a gas station and seeing purple blotches in my vision on the way home.
(Yes, I have had several opthamologist appointments, an MRI, every test imaginable including Lyme, etc.)
I haven't tried Paxil, but I did try and respond to Luvox, mostly for the hysteria that followed the hysteria -- 16 hour a day discussions and breakdowns with my parents about my disorder and what medications might be doing to me (it doesn't really help a disorder if you are acutely vigilant about every nuance of medication that is attempting to help you -- it is sort of counterproductive.)I was up to 450 when the electric shocks while excercising got a bit too much, and backed to 400. I was on it for a while before Cymbalta came out and I was switched, primarily because I believe my doctor felt it was better for what had become a secondary (or primary, who knows) MDD.
Indeed, there came an eventual epiphany for lack of words one day when we hit 80 on Cymbalta -- didnt have that lilt after it but I knew something was better -- Cymbalta is subtle and takes a while to take its final effect. I now take 120.
I have thought and we have occasionally discussed adding something like a small dose of Lexapro to the mixture but there are now several 5HT agents on board (Seroquel and Cymbalta) that a reduction of one or the other would have to occur because I am on polypharmacy and even the presence of Robaxin, which was made before standard P450 challenging, caused a minor Serotonin Syndrome.
But, at the moment with a slow reduction plan in Valium and Seroquel that may be something to try in the future. In the meanwhile, my treatment plan of expanding my life outside the house, volunteering places several days a week and taking several extension classes in certification for a video editing program (to add to my forte which is video editing, ironic with my visual problems), is occupying time at the moment so rocking the boat with a third variable wouldn't be good right now.
But at a later point, yes, I do wonder how much an anti-OCD (Cymbalta doesn't do much for secondary garbage thoughts in my mind which isnt my primary concern at the moment though it can be annoying) agent would add to the mixture.
Curiously, before I agreed to a neuroleptic fully on board (we did try Zyprexa but the pseudoparkinsonism was much greater than Seroquel and I was more than a bit concerned even though I swear it wiped out most things -- but then at each stage of "more wellness" its hard to judge what "wiped out" really meant today), Remeron sort of acted I think like one, at its highest dose, 45 (52.5 was a bit much), with its 5HT blockade. It was rather good for things except for adding massive pounds, so it was dropped.
At any rate, even before all of this I have had issues with getting jobs and the like, frustration and slowly giving up. I sometimes wonder if I didn't panic about possible loneliness causing suicide and have myself moved home from where I graduated from college, what fork my life might have taken. I still miss it back there and I want to return. I still go most years on a roadtrip (I still loath planes, have for a long time, but these days... ugh) back to visit though they say you can't go home and my friend circle there and everywhere I've been including home has dwindled.
And that's where getting out more and possibly pushing the darkness out of my mind might happen. But as I say, we -- or I really, don't know that this could occur.
As for ever trying Paxil, I think I was switched to it when I had my worst OCD, I don't know, I forget now -- I may have used it for dysthymia in college, or Zoloft -- my mind is fuzzy there.
But one thing in common with most all of the agents on board is -- sedation. And that alone may play a role in treatment itself though it can obviously be a detriment in managing daily affairs.
Thanks for your observation-- Jay
Posted by notfred on January 13, 2007, at 15:43:29
In reply to Do people feel medications help or mask symptoms?, posted by leo33 on January 12, 2007, at 20:06:57
Whichever it is I could care less as I have been in remission for over 20 years with just a few breakthru depressive episodes. This statement would suggest they treat but I do not spend time wringing my hands over is issue. It works, move on.
Posted by laima on January 13, 2007, at 16:04:31
In reply to Re: Do people feel medications help or mask sympto, posted by notfred on January 13, 2007, at 15:43:29
I think the drawbacks of masking would be evident if and when the meds konk out. They do konk out for a lot of people, so real cures would be worth pursuing.> Whichever it is I could care less as I have been in remission for over 20 years with just a few breakthru depressive episodes. This statement would suggest they treat but I do not spend time wringing my hands over is issue. It works, move on.
Posted by SLS on January 14, 2007, at 7:05:23
In reply to Re: Do people feel medications help or mask sympto, posted by laima on January 13, 2007, at 16:04:31
> I think the drawbacks of masking would be evident if and when the meds konk out. They do konk out for a lot of people, so real cures would be worth pursuing.
But I don't think that the fact that meds konk out is de facto proof that they only mask symptoms. Such can also occur if symptom relief is the result of remission of the illness itself. Note that remission does not equate to cure. As with so many other illnesses, antidepressant treatment can produce a complete remission rather than a partial mitigation of selected symptoms. And as is also true with other illnesses, treatments sometimes fail to remain effective indefinitely, in which case there is a relapse into illness. This failure to produce an indefinite remission does not make the remission any less complete. It does not all of a sudden warrant us to redefine the remission as symptom-masking.
Yes, a cure is worth pursuing, but so is remission. Too many people experience incomplete responses to treatment with residual symptoms. This is not good enough. I encourage people to continue to explore treatment refinements until they find something that hits closer to the target and brings about remission. It is my impression from the results of the STAR*D study that at least 66% of people can attain remission after only 4 drug trials. Think of the possible combinations of drugs we have to work with and the number of trials that represents. I think the odds are in one's favor that they will eventually find something that works well if they are persevering.
- Scott
Posted by naughtypuppy on January 14, 2007, at 9:48:34
In reply to Do people feel medications help or mask symptoms?, posted by leo33 on January 12, 2007, at 20:06:57
I call it the antidepressant vs anathesia effect. Tegrol made me so apathetic that I didn't know that I was depressed. I just couldn't get off the couch and attend to daily affairs.
Posted by Phillipa on January 14, 2007, at 18:22:02
In reply to Re: Do people feel medications help or mask sympto, posted by SLS on January 14, 2007, at 7:05:23
Scott and who better to say that than you. Love Jan
Posted by laima on January 15, 2007, at 17:43:19
In reply to Re: Do people feel medications help or mask sympto, posted by SLS on January 14, 2007, at 7:05:23
Yes, good point, a remission is nothing to turn one's nose up at.
The more I think about it, the more it seems to me that the answer to the remission/cover up symptoms question is probably varied and fuzzy. There's probably some of both, and of course, everyone's circumstances are a little different. After experiencing dramatic poop-outs for both prozac (extended to inefficacy of other SSRIs) and benzos, I'm not going to hold my breath- but will take what good opportunities I get. I have a doctor who won't make any promises about how long the therapeutic effects of drugs will last, and I'm finally heeding his urgings to work at therapy and making improvements in my lifestyle. Just no guarentees in life.
Posted by notfred on January 16, 2007, at 17:55:46
In reply to Re: Do people feel medications help or mask sympto » SLS, posted by laima on January 15, 2007, at 17:43:19
"The more I think about it, the more it seems to me that the answer to the remission/cover up symptoms question is probably varied and fuzzy."
Remission is a very specific word. Google it.
It is not related to "cover up".
Posted by laima on January 16, 2007, at 19:14:06
In reply to Re: Do people feel medications help or mask sympto, posted by notfred on January 16, 2007, at 17:55:46
Yes, I know very well it's a different word and don't need to google it. Perhaps it was my fuzzy punctuation that was confusing. We were debating whether medications covered up symptoms OR helped induce remission, and I concluded that they can do both, either, or neither. In other words, perhaps pointless to debate since there isn't an absolute answer that fits everyone. Well, I've got my copy of Eats, Shoots and Leaves sitting here next to me, maybe I'll look into it.
> "The more I think about it, the more it seems to me that the answer to the remission/cover up symptoms question is probably varied and fuzzy."
>
>
> Remission is a very specific word. Google it.
> It is not related to "cover up".
>
Posted by shadowplayers721 on January 16, 2007, at 19:54:10
In reply to Do people feel medications help or mask symptoms?, posted by leo33 on January 12, 2007, at 20:06:57
IMO, people with drug addiction take a drug to the totally numb out and it's a cycle. It's complicated. It's a roller coaster controlled by the user. Drug addiction is not a form of functioning.
Antidepressants don't give a high to me. They try to level me to function. In other words, I am not bottoming out in depression. I don't feel it's masking my depression. I feel it's actually treating it. I don't know if I explained this well. better go back to the shadows>>>>>>
Posted by Quintal on January 16, 2007, at 20:01:20
In reply to Re: Do people feel medications help or mask sympto » notfred, posted by laima on January 16, 2007, at 19:14:06
"Eats, Shoots and Leaves" Great book.
Q
Posted by Quintal on January 16, 2007, at 20:04:41
In reply to Re: Do people feel medications help or mask sympto, posted by shadowplayers721 on January 16, 2007, at 19:54:10
>IMO, people with drug addiction take a drug to the totally numb out and it's a cycle.
I take codeine to help me function better. It generally takes my pain away and leaves me sanguine. Is codeine really treating my depression or simply masking it? What's the difference?
Q
Posted by SLS on January 16, 2007, at 20:22:07
In reply to Re: Do people feel medications help or mask sympto » shadowplayers721, posted by Quintal on January 16, 2007, at 20:04:41
> >IMO, people with drug addiction take a drug to the totally numb out and it's a cycle.
>
> I take codeine to help me function better. It generally takes my pain away and leaves me sanguine. Is codeine really treating my depression or simply masking it? What's the difference?What is the constellation of symptoms associated with your disorder?
- Scott
Posted by shadowplayers721 on January 17, 2007, at 0:27:28
In reply to Re: Do people feel medications help or mask sympto » shadowplayers721, posted by Quintal on January 16, 2007, at 20:04:41
Well, I feel you have much wisdom deep inside to give an answer to the proposed question. If I were your true inner self without any inner critic to comment at the side, what would be my answer to you from this question?
"Is codeine really treating my depression or simply masking it?"
Posted by laima on January 17, 2007, at 0:50:53
In reply to Re: Do people feel medications help or mask sympto » laima, posted by Quintal on January 16, 2007, at 20:01:20
It's nice, isn't it? :)How'd you get it to turn into a link like that?
I think I was supposed to do that, too. I forgot.> "Eats, Shoots and Leaves" Great book.
>
> Q
Posted by notfred on January 17, 2007, at 9:29:54
In reply to Re: Do people feel medications help or mask sympto » notfred, posted by laima on January 16, 2007, at 19:14:06
I am not sure what the qualifications for remission in depression are, in many illnesses it is quite specific. There is a DSM code for major depression in remission, which is one of my Dx'es at present.
I suspect as with other illness time without any illness is a factor.
Posted by Quintal on January 17, 2007, at 10:34:16
In reply to Re: Do people feel medications help or mask sympto » Quintal, posted by SLS on January 16, 2007, at 20:22:07
I have no specific diagnosed disorder at present, though I was diagnosed with bipolar II years ago and BPD has been suggested. Asperger's Syndrome sounds more likely to be the underlying problem with the anxiety and depression that results from poor communication (in real life) and the isolation it causes.
Q
Posted by Quintal on January 17, 2007, at 10:51:44
In reply to Re: Do people feel medications help or mask sympto » Quintal, posted by laima on January 17, 2007, at 0:50:53
You need to put the book title in double, double quotes and the server will search Amazon and give you a choice of matching titles when you submit your post.
http://www.dr-bob.org/babble/faq.html#amazon
Q
Posted by Quintal on January 17, 2007, at 11:06:24
In reply to Re: Do people feel medications help or mask sympto, posted by shadowplayers721 on January 17, 2007, at 0:27:28
>Well, I feel you have much wisdom deep inside to give an answer to the proposed question. If I were your true inner self without any inner critic to comment at the side, what would be my answer to you from this question?
>
>"Is codeine really treating my depression or simply masking it?"
My point was:>What's the difference?
SSRIs didn't help much but they did lave me numb and apathetic after a short while. They are the drugs that supposedly 'treat' the allegedly medical biochemical problem of anxiety and depression. Codeine revives my spirits and helps me cope with life better, yet opiates are considered to be drugs of abuse with little or no therapeutic potential in psychiatry by some people here. To me the difference seems arbitrary and usually reflects the politics of the individual poster.
Q
Posted by laima on January 17, 2007, at 12:03:38
In reply to Re: Do people feel medications help or mask sympto » laima, posted by Quintal on January 17, 2007, at 10:51:44
Posted by bulldog2 on January 17, 2007, at 13:10:54
In reply to Re: Do people feel medications help or mask sympto » shadowplayers721, posted by Quintal on January 17, 2007, at 11:06:24
I believe in cases where there is a remission the traditional ads do actually work. If they were just masking symptoms they would work from day one. Also from the day you stop them you would relapse into depression when in fact people often go months or years before they have another depression.It would seem their use somehow changes the brain's chemistry and there's many theories as to how they work.
As to the use of opiates or stimulants as ads that's a grey area to me. They often work right away but only work as long as you take them and often need increasing doses to maintain their effect. So maybe I would say they mask symptoms the way an opiate masks pain when in fact whatever is causing the pain (arthritis for instance) is still present.
Posted by Quintal on January 17, 2007, at 14:44:58
In reply to Re: Do people feel medications help or mask sympto, posted by bulldog2 on January 17, 2007, at 13:10:54
>As to the use of opiates or stimulants as ads that's a grey area to me. They often work right away but only work as long as you take them and often need increasing doses to maintain their effect. So maybe I would say they mask symptoms the way an opiate masks pain when in fact whatever is causing the pain (arthritis for instance) is still present.
Well for many people depression does recur when they stop taking their AD and there's often a withdrawal syndrome (which can be severe) to boot if they do so abruptly. It's also a common experience for ADs to 'poop out' and require higher doses to maintain the antidepressant effect or a switch to another drug - could this be a different manifestation of tolerance to the effects of changes in brain chemistry?
When I was taking antidepressants and benzos my life seemed wonderful while they worked. It was only when I was forced to stop them I found it was an illusion. My life had been deteriorating but I couldn't see it and didn't much care either because I was feeling so good.
The pattern of drug use was different but I in many ways I behaved in a similar way as I did when taking drugs of abuse except antidepressants and benzos are legal, obtained from a doctor's prescription and therefore tolerated, but for many years opiates and cocaine were used in a similar fashion and were recommended (and used) by doctors. Are drugs of abuse simply more rapidly acting and effective antidepressants with less abuse potential?
Q
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