What is reasonable to expect?

Hello there, my first post on here. Been suffering with major 'depression' for 3 years, I'm finally seeing a psychiatrist as an emergency someday soon as I've been pretty damn suicidal and hopeless :( -though better for reading this forum :) I feel dark dark anxiety, confusion about what's real, thoughts and theories going round in crazy ways to twist everything to attack myself and find contradictions, but appear OK/rational to people (and to the part of me that says nothing's wrong!) and holding down a job just. Done CBT, changing my environment and still considering quitting job/where I live, homeopathy(?), psychotherapy (terrible therapist!) therapy, yoga, eating well, exercising in moderation, stoppping alcohol and caffeine - they started messing me up even in small amounts once I stopped my meds. They mostly help but I'm trying to fully accept (part of me still doubts it) that medication is needed in righting the brain. This is because the jury's still out: I've been taking Mirtazapine for over 4 weeks now, 15mg for 2 weeks and then 30mg. 3 weeks in, I went on holiday for some winter sun as i hoped the meds would kick in - they hadn't done much till then, the odd better day, but some pretty nasty ones especially after increasing the dose. Seriously considered suicide on New Year's Eve... Big error - trapped in foreign country, suicidal. Luckily had a friend with me. I got referred to psychiatrist out there. I've come home early - what an expensive mistake!!! She gave me Lactimal and Seroquel at low doses to stabilise me and the mirtazapine. maybe as a stopgap? felt some postive effect first couple days, now back to usual. at least i'm home with more support even if the weather's terrible.... This is my third anti-depressant. I gave Citalopram 4 months with no real difference, even on a higher dose. I was then put on 60mg Cymbalta. I took it for about 10 months. i started to stabilise and had periods of feeling 'normal' after a while, though i *thought* mainly due to lifestyle changes. The loss of libido really worried me - the depression tied in with a long term relationship ending and I couldn't see how i would get another partner and try to move on - major pscyhological issues there. So I stopped it over 5 months, I thought i'd made it through nasty periods each time I lowered it, only to have a couple of months trying to tough it out, manage with dark darkness, feelings of failure (going through all that only to be kicked in the teeth at the end!) and crippling indecision before I finally bit the bullet and went on Mirtazapine - doc suggested as better for side effects. I know I shouldn't see this as failure but I do.. So, i suppose what i want to ask people is: 1. how long do you give the meds to work? I think I've been patient? 2. What is working? Maybe the Cymbalta was the best I could expect? I do expect a lot I guess - a real perfectionist streak that gets twistedly out of hand when depressed..but surely i should expect one that allows me to be me? whatever that is??? 3. What side effects do you accept and how do you deal with them? If I do have to take them for a couple more years or even life I can't cope with the sexual dysfunction.. I just hope I can find a med that works that doesn't hit too hard there. Shame mirtazapine ain't working as supposed to be better on that one. 4. I realise my brain is damged and needs to be treated well, but I'd like to go for a few drinks with friends now and again or dancing or hopefully on dates etc. without it messing me up big style afterwards. Will this ever happen again? It's just another way my life feels different and a pale imitation of what it used to be... 5. I've got a feeling (though could be bull****) that dopamine could be the answer, but scared of venlafaxine/effexor - seems like it's one for life. anyone got an

What is reasonable to expect?

Daily llama, thanks for the response, it really helps. I guess it's hard to say what's working when the doses of meds are going up or down and the brain is acclimatising, especially when it's winter, the huge stress of a 10 hour flight/eing in foreign country without the usual support network etc + overanalysing it all and trying to fight them (?). But certainly so far it's fair to say they're not working too well and may be aggravating me? I'm going to see a psychiatrist rather than a General Practitioner finally - I wish I'd done it earlier but at least I'm doing it now.. I just want find the right one even if I doubt it's out there. I have to accept I'm going to be on them for a decent while so it needs to be helping me and not giving me bad side effects. That's got to be reasonable to expect? I'll talk to the psych about Effeoxr, the doc did mention it as a possibility. I don't think my depressed symptoms are totally typical - I sleep well, have a good appetite, look healthy to the casual observer, just have a raging storm inside from the moment i wake up - maybe not everyone has had the drug for them manufactured yet?? If only there was a test for levels of serotonin etc - this medication trial and error is nasty - especially when it's not a controlled experiment with what's going on in your life always changing. The scientist in me gets frustrated!! The sexual side effects really really bug me - I need to work on this as there's undoubtedly a major psychological element here (my friends tell me this) - huge anxiety about sex drive doesn't help sex drive! It's ironic as I split from my partner in part because i wanted to see what else was out there but now am so far from feeling confident in enjoying what else is out there even though I'm a nice, decent looking guy etc Perhaps back to the devil I know of Cymbalta + working on psychology + somehow finding an understanding woman is the best bet. Similarly once i stop being so anxious and negative my system and me will be able to do the occaisonal few drinks - I was able to do that when stable on Cymbalta. I agree that a good therapist is required. CBT helps in managing things but I think I need to go deeper into some of those core beliefs and buried stuff, that despite my constant self analysis I don't properly realise are there so i can let go of stuff and start to change the self destructive and overanalytical way I think. Hopefully the psychiatrist will recommend someone. An expensive business but what can you do eh? Have to accept this is my life now....

What is reasonable to expect?

wildcat, thanks to you too for the helpful response. I do have high expectations generally about a life - an idealist i guess. and they get higher and more unrealistic when i get depressed. 'why can't i be as talented as my favourite musician', 'they're really happy, i'm pathetic', why can't i just go back in time'.etc. when people i know care about me and say i've got a alot going for me - i forget this. I need to do lots of work on this once i stabilise again. But I still partly stuggle with the idea of taking the meds: 'why should i need these when my friends don't' 'how will i know *i* have changed if the meds have made me better - who am *i*', 'i'm weak for needing these', 'these aren't natural' 'i'm gonna be on them for life', 'they're going to change my brain chemistry so i always need them' of course this is in part depressed thinking... Like you first did, I did expect to have to take them for a year or so and then I'd be OK again. I did feel more stable and the doc was happy for me to come off. That's why coming off the Cymbalta to feel so awful again has been so hard to bear. it's not surprsing I suppose as though I've made some progress through CBT etc I'm still not happy with my job/relationships/home environment- still stuck in the same rut, plus guess my brain is still damaged. i should have researched it more before coming off, but you have to try and live and learn.. It's almost like I want to understand how something works before I'll let it work. I'm trying to be an amateur psychiatrist/psychotherapist about myself when extremely negative - pretty dangerous i think but i can't control it. It is good to be informed and to take control of the depression but often this is not what i'm doing... I like your explanation about the way the meds slows down the thoughts so you can recognise the patterns and learn to change - they get so out of control and go all over the place. positive thoughts always get drowned out... also that the meds are not just plugging a gap that will start leaking once you take them out (?) - i still have concerns about this. it seems that many people are on them for life - maybe their brains do get used to them so that it's so hard to come off. drug companies are commercial enterprises after all. But I'll try to worry about that later. This whole epidose was triggered by a year of intensive studying with major major stress combined with difficult new home environment, followed by falling apart and lots of ongoing big stuff going wrong/major disappointments. So it's no wonder my brain is damaged and I am hurting.. I guess a lot of people on here have been through similar dilemmas. It's good to share them though. Keep learning and growing despite the senselessness of it all at times :)

Taking time off work??

Hey lovelybones, i hope everything worked out for you with getting time off. I've got the same dilemma. I'm officially on holiday until next week - i went to get some winter sun but came back early as was in a really bad way. I've been having major troubles since finishing coming off some meds in september and now. I took the odd day off in the autumn on flextime and then a few days off sick before Christmas when starting some new meds that made me incapable of working - really drowsy and depressed! The doc is going to sign me off for a couple of weeks while i see a specialist but I'm debating quitting and going on disability or at least medium/long term sick. problem with long term sick is i broke my ankle last February and took two months off (felt better - that's a good clue to take some time off i guess!) and so used up most of the full pay.. I agree with all the comments about office gossip and the stigma - I know I shouldn't care but it does get to me. I'm also worried that by doing this I mess up my career - it'll be on my record and while it's illegal to discriminate against depression as it would be any disability in practice th stigma is rife - 'he can't be trusted to work under pressure'/'he's going to be off on the sick lots' I should say that while there are some good people there - importantly including an understanding boss - and it allows me to live to a comfortable standardwas planned as a stepping stone to something else, I have little in common with the people there, it's never felt right and i'm underused as a resource. But it is something stable in my life and gives me money to live. I get stuck in the chicken and egg - am I depressed at work because I'm depressed or because the job makes me depressed. The only way to tell is to quit - could be a big gamble...what if I have more time on by hands to get depressed? aaaggh Anyone got any advice - I know it's my call but any thoughts?

What is reasonable to expect?

Thank you. I did my first session yesterday and it helped - even though i've done cbt before some of the ideas in that session material gave me a fresh perspective on things. I have a little time off work and am trying to get to see psychiatrist - hopefully I can get the medication I need, accept that and get working on healing...

Taking time off work??

Thanks for the response, Confused. I've got a couple off weeks of sick in which to think about this and investigate what my alternatives would be. My heart says just quit as I've stuck at it for 2 years now and rest and do some courses and creative stuff to heal but my head still thinks about the practical stuff such as money/career/stability. I don't have a partner or kids to worry about so that takes some pressure off. I tried getting another job. A good opportunity came up at the wrong time (that's life...) soon after I came off medication and was feeling pretty bad. I decided to go for it. I think my adrenaline kept me going as I interviewed well but as soon as it was over I started crashing badly, resulting in going back on meds. Luckily I didn't quite get offered the job as I get so so indecisive when depressed! A lesson in needing medication for at least a while longer and not taking on stressful new challenges I think.... I'll keep weighing it up..decisions aaaggh :8o:

Stigma surrounding mental illness

My personal experience in 'coming out of the closet' is that sometimes people are more understanding than you might think. I had to tell my managers at work as I've had to take some time off sick. I was really worried about it and thought they wouldn't understand but they've been supportive. One manager shared that he too had time off a few years ago for the same reason and had taken medication. I guess I'm very lucky that that is the case. Of course, I know that not everyone in the office will be so understanding - gossip about being a slacker/always off sick etc. But *maybe* I might find they're more understanding than I think they're going to be - part of being depressed for me is thinking people are more critical of me than I think, and having this shame about being depressed. For all I know some or people they are close to may be suffering too. Of course some won't relate - but they'll be the people I care less about anyway I hope. I'll still worry about it though... I'm debating whether to email everyone just so they know and can stop speculating and asking me why I've been off. I'm think this may be taking it too far? On a personal level, all my friends and family know and are supportive, though have differing ideas and advice! But I've got sick (and I'm sure they have) of always talking about how I am. I really need to do that sometimes but sometimes I'd rather change the channel and get on with my life. I don't want to be pigeonholed as 'depressed'. I'm me and I happen to be depressed (which can mean a lot of different things) but I still have OK days and hopefully I'll beat this. Maybe I still have some accepting to do myself. Or do I? I suppose what I want to say is that to some extent, for me anyway, the stigma can be partly in my own head. It can be pretty risky testing that out though.

Myth Or Fact?

So true. I never used to talk about the way I felt - I couldn't see any way that it could change things and that I could only get out by thinking my way out (round and round and up and down..). Also wouldn't people have better things to do than listen to my crap?? This period of depression forced me to but when I started I didn't really know how. As a male and learning from a Dad who doesn't it was very difficult. I still struggle about some stuff but I think it's an ongoing process that gets easier the more you practise. I'm still learning to talk about how I really feel and really get in there. I guess that's where a good therapist comes in. I'm lucky that I have some good friends and family who will listen. And listen. And listen. To a lot of the same stuff. Again. And again. And be logical and pragmatic in their advice. And I've got closer to people - by me opening up to them, they've opened up to me. I really believe the more people you talk to the better. Though you learn who the best ones are. On a slight downside listening to lots of different and conflicting advice and trying to decide what to act upon creates a lot of anxiety for me. I'm indecisive and confused enough with just my own suggestions....:) But overall talking really helps. It literally has saved my life.

CBT Day - Anger

This is good timing - I lost it in a major way two days ago and smashed up a lot of stuff in my room. I was out of control. It was really scary... :gasp: The thing I struggle with with anger is while there may be a trigger - I was feeling really low again I think due to stress about moving out of my houseshare and worrying about being told to stop a medication - I'm not sure where the stuff underneath comes from. I have learnt to try to rationalise emotions such as anger. This leads to me, like others say, to turn them inwards rather than express them. Occaisonally it leaks out big style. I learnt from a father who would never express anger and a mother who was explosive.. I definitely agree that expressing yourself assertively to get your needs met rather than supressing is the way forward and I'm trying to learn how to do that but what if you don't know what you're angry about?

CBT Day - Anger

I know what you mean, I used to bottle up huge amounts of anger, anxiety and suicidal impulses at work. And then it would hit me at the end of the day in a horrendous wave. Maybe it is good I'm off work - I think I'll try to vent it whenever it arises, if possible while I have the chance..and ignore my mind that doesn't want me to.....part of it is almost like huge rage at being angry and depressed and confused so this could go on and on... Off to go and get lots of crockery....maybe a sledgehammer? :eg: