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[msparticularity]

This thread is really making me want to try acupuncture. I have chronic anxiety/depression issues. After nearly two years of being on Lexarpo, its effectiveness is beginning to wane. I'll be going in for an appointment next week that hopefully will result switching to a different medication.

 I also have insomnia (and I'm an under-30 male!!) that the Lexapro was never very effective at treating. I was on Ambien for a while, which was effective, but it was a major battle with my insurance company to get them to cover it and I'm fearful of becoming addicted to it. My psychiatrist had me on Trazodone for a while, which sort of worked, but gave me vertigo before I fell asleep and typically left me feeling groggy the next morning. At this point, I'm desperate to try anything that will get my sleeping pattern back on track.

MG, my experience with the pharmaceuticals was like yours: they offered initial improvement by lifting the enormous load I was struggling under, but did not give lasting relief for the underlying issues. I think they can be very important in helping us get out from under the suffocation of deep depression and crippling anxiety, but at some point I think we also have to deal with why our minds function in the ways that they do, and work on ways to change that. My own interest in integrative approaches developed from my perspective that we're struggling with a mix of thought patterns (our minds really do develop well-worn grooves, according to some cognitive research), and the ways in which those ingrained thought patterns interact with and reinforce our neurochemistry. Also, those of us who have had these issues since early in life may also have brains that cannot produce and process neurotransmitting chemicals in a normal way--thus the need for maintenance meds such as St. John's Wort or whatever.

If you can manage it, repeated studies have found that combined medication and therapy really is the most effective approach--neither is efficacious for getting long-term relief. 

[derigueurdaguerrotyp]

I have been lurking on this thread to get some ideas about how to deal with my own chronic moderate depression, and I just want to say thank you to everyone who's contributed so far. It's been really interesting and helpful! I am in counseling, using an ACT approach, and I have just started doing mindfulness meditation on a regular basis, which I've read has been shown to change neural pathways. It's helped a little bit so far, but it's always good to have more tools.

Given this thread's discussion of alternate or non-traditional therapies, I thought this article from today's New York Times might be interesting. It's an excerpt from a forthcoming book on the "Westernization" of world-wide understandings of mental illness. I'm neither a psychologist nor an anthropologist, so I don't think I can comment usefully on the quality of the author's research--but it's food for thought, at any rate.

Thanks again, everyone!

http://www.nytimes.com/2010/01/10/magazine/10psyche-t.html?th&emc=th

[mountainguy]

If you can manage it, repeated studies have found that combined medication and therapy really is the most effective approach--neither is efficacious for getting long-term relief. 

Yes, absolutely. I finally found a therapist with whom I "click," which has been of enormous help. Medication remains an important part of the process as well, especially since there is a history of depression in my family. I'm no psychologist myself, but it seems plausible to me that chemical imbalances in the brain could be related to some genetic predisposition.

[msparticularity]

If you can manage it, repeated studies have found that combined medication and therapy really is the most effective approach--neither is efficacious for getting long-term relief. 

Yes, absolutely. I finally found a therapist with whom I "click," which has been of enormous help. Medication remains an important part of the process as well, especially since there is a history of depression in my family. I'm no psychologist myself, but it seems plausible to me that chemical imbalances in the brain could be related to some genetic predisposition.

I think this is clearly the case in my family as well. I've never seen such an anxious crowd.

Some famous person (whose name I cannot summon at the moment) said that what one needs for happiness is plenty of money and not too much imagination. I have the opposite: not nearly enough money, and all too much imagination, which fuels my advanced state of existential anxiety.

[mdwlark]

Thank you, derigueurdaguerrotyp for posting this.  I found it very disturbing to read.

I think the author only scratched the surface on why this is so problematic.  I have some very strong feelings about this, but I don't know that I want to get into a big debate here about it.  I am very very grateful I found alternatives to the psychiatric perspective, both as a social scientist and as a patient.  

[alleyoxenfree]

If you can manage it, repeated studies have found that combined medication and therapy really is the most effective approach--neither is efficacious for getting long-term relief. 

Yes, absolutely. I finally found a therapist with whom I "click," which has been of enormous help. Medication remains an important part of the process as well, especially since there is a history of depression in my family. I'm no psychologist myself, but it seems plausible to me that chemical imbalances in the brain could be related to some genetic predisposition.

I think this is clearly the case in my family as well. I've never seen such an anxious crowd.

Some famous person (whose name I cannot summon at the moment) said that what one needs for happiness is plenty of money and not too much imagination. I have the opposite: not nearly enough money, and all too much imagination, which fuels my advanced state of existential anxiety.

The lot of artists and intellectuals...

[outlier]

Tinnitus and nausea -- any dizziness from vertigo?  If so, has he been evaluated for Meniere's syndrome?

Spork, thankfully, no, no dizziness or vertigo. Meniere's sounds awful to live with.

Mdwlrk, I picked up the supplements you mentioned for tinnitus, except the ginko, which my husband says he won't take. If that's the essential ingredient, or an essential ingredient, he's out of luck, but he'll give the rest a try.

I got a referral to an acupuncturist near where I'll be moving. I don't think I'll have time to get started with it here before moving, and I don't think my husband will go first, as he wants me to be the guinea pig. So even though I think he is in greater need than I am, I think he's going to want to wait till he gets out to new-town.

[mdwlark]

Mdwlrk, I picked up the supplements you mentioned for tinnitus, except the ginko, which my husband says he won't take. If that's the essential ingredient, or an essential ingredient, he's out of luck, but he'll give the rest a try.

No, the rest work quite well for me by themselves.  They are the essential part of the formula, much more than ginko.  They are mostly a synergistic combination of water-soluble vitamins and minerals and should be relatively safe.  I take them and they quiet it down from a loud whistle to a hiss.  YMMV It would depend on what is going on in a particular person's body, head or ears to cause the problem.  I don't get any effect until 24 hours later.  I don't know why they work.  My accupuncturist told me to cut back on the ginko, so I only take one every once in a while. 

Taking supplements you are on your own for risk, effectiveness and side effects. 

[mountainguy]

A quick update for anyone who's interested . . . instead of changing my medication, the psychiatrist upped my dosage of Lexapro to 30mg per day. It'll take at least a week or two before we know if it'll make any difference to my mental state, but the short-term side effects have left me feeling completely loopy. I have a near constant headache and my appetite alters between being almost none at all (for the first few hours after I wake up) to completely ravenous in the evening. 

On a brighter note, I'm also back on Ambien temporarily, which does seem to be working in terms of resetting my sleep schedule.

[msparticularity]

A quick update for anyone who's interested . . . instead of changing my medication, the psychiatrist upped my dosage of Lexapro to 30mg per day. It'll take at least a week or two before we know if it'll make any difference to my mental state, but the short-term side effects have left me feeling completely loopy. I have a near constant headache and my appetite alters between being almost none at all (for the first few hours after I wake up) to completely ravenous in the evening. 

On a brighter note, I'm also back on Ambien temporarily, which does seem to be working in terms of resetting my sleep schedule.

I hope this helps sort things out for you--and that the side effects from the med wear off enough for you to make good progress. This time of year into spring always used to be the worst for me for depression, and apparently that is not unusual because of SAD. You may find that you'll being to perk up a bit once spring is here and it's warm and sunny outside, if you can just stumble through in the meantime. :)

[outlier]

Mountainguy, how are you doing with the new med and increased dosage?

Mdwlrk, my husband tried the supplements; no effect within 24 hours of the first dose, and I don't know if he continued it or just tried one day. Did it work within the first 24 hours for you?

We're in the middle of packing and loading a shipping container to go cross-country, and the process brings out the differences in my husband's and my temperaments. In MBTI terms, I'm INFP and he's INFJ (sorry, Spork, I know you don't have much patience for this stuff!). So when he gets in perfectionist mode, I try to just stay out of his way and follow directions. My suggestions aren't welcome and he cares more than I do, so he can "own" the problem of how to load the container if he wants, even though it's mostly my stuff and I have made plenty of moves without any damage.

Mostly, including right now, I think I'm dealing better than I was, but I'm low on emotional resources these days, and I never know when something's going to push me temporarily beyond my ability to talk myself down, and then I'm either in tears or just feeling like screaming or leaving.

[msparticularity]

Mostly, including right now, I think I'm dealing better than I was, but I'm low on emotional resources these days, and I never know when something's going to push me temporarily beyond my ability to talk myself down, and then I'm either in tears or just feeling like screaming or leaving.

I take long, solitary walks when I'm like this, to try to move some of that edgy energy on through my body--or at least exhaust myself. Life gets very ugly when I can't do this due to bad weather or other demands. And I agree that preparing to move is absolutely the worst, and couldn't be better designed to create friction with one's loved ones!

[voxprincipalis]

Mostly, including right now, I think I'm dealing better than I was, but I'm low on emotional resources these days, and I never know when something's going to push me temporarily beyond my ability to talk myself down, and then I'm either in tears or just feeling like screaming or leaving.

I take long, solitary walks when I'm like this, to try to move some of that edgy energy on through my body--or at least exhaust myself. Life gets very ugly when I can't do this due to bad weather or other demands. And I agree that preparing to move is absolutely the worst, and couldn't be better designed to create friction with one's loved ones!

Interthreaduality: I prescribe the Wii.

VP

[mdwlark]

Mdwlrk, my husband tried the supplements; no effect within 24 hours of the first dose, and I don't know if he continued it or just tried one day. Did it work within the first 24 hours for you?

I think it depends on what the underlying problem is that is causing the tinnitus.  It could be different for different people.  I think these particular supplements addressed my particular problem.  I was surprised how quickly the supplements worked on my tinnitus, but it may have taken several days the first time.  Now that I have the problem somewhat under control, they knock out flareups usually about 24+ hours later.  My point was it doesn't work in 45 minutes like a drug.  Even if these are going to work, it may take more than one day the first time, if you are correcting a major imbalance.  Most supplements are foods not drugs.  (Some are actually drugs, even though they are all classified as food supplements.  But the supplements that you got, used in moderation, are foods.)  My acupuncturist/Chinese doctor said, "I love America.  Here I don't prescribe and dispense medications.  I sell food supplements."  He laughed.  Foods don't always help immediately. If they are correcting nutritional deficits, they let you gradually get better.  I think the first time, I would want to give it a little longer before giving up.  

Not you in particular, but Americans are very impatient and either give up or overdose themselves.  This is why I usually keep quiet about my use of supplements.  I just get people mad at me if they try them and I get criticized if I even mention that I use them.  I must be very sensitive to chemicals and/or must have been very undernourished, because every supplement I try seems to help a lot, and medications give me the entire list of side effects including the rare but dangerous ones.  

[outlier]

I think it depends on what the underlying problem is that is causing the tinnitus.  

Yes, it's possible that his tinnitus has a different cause than yours; I, too, hope he'll give the supplements more than one day to work. Then there's the nausea, and headaches, and depression/anxiety. None of the physical symptoms has an identifiable cause, which is very frustrating. They may all (or mostly) be related to stress, but there's always the nagging worry: what if they're symptoms of something that won't resolve on its own, that needs to be diagnosed in order to be treated?

I take long, solitary walks when I'm like this, to try to move some of that edgy energy on through my body--or at least exhaust myself. Life gets very ugly when I can't do this due to bad weather or other demands. And I agree that preparing to move is absolutely the worst, and couldn't be better designed to create friction with one's loved ones!

I usually take long walks with a podcast or camera and a dog. The weather has not been cooperative lately, and I loaned my only rain jacket to one of the staff of the animal shelter here when it flooded last summer, and I never got it back. With my move a week away, I'm not buying anything that will have to be packed and moved! We have an exercise bike and treadmill in the basement; the treadmill belt seems to be out of adjustment and there's no one here to work on it, so the bike it is. That's okay, but not optimal.

So, MsP, are you able to get outside these days?