Posted by Anna Laura on April 4, 2002, at 1:41:40
First of all, i thank you for being here and for spending your precious time answering our questions.
I live in Europe (Northern Italy). I have a few questions for you most of pdoc i have been consulting here don't answer to. Sorry if this post it's gonna be a little long but i have to describe my depression history in order to have an accurate answer.
Here's my brief story: i developed major depression at age 21 after severe prolonged stress . Unfortunately I had been misdiagnosed , given benzos at high doses instead of AD's.
Needless to say i got worse as years went by. A few months after a traumatic experience i went psychotic: i felt horribly anxious and i was experiencing a state of permanent horror. The pdoc who finally made the right diagnosis thought i was schizophrenic at first: he eventually told me he believed i suffered from severe psychotic depression.
I was given imipramine (300 mg). I did Cognitive-Behavioural Therapy also.
I got better real slowly and i took two more years to make a substantial improvement.
Major Symptoms of depression had deseappeared within two years. I was feeling much better but still unmotivated/anhedonic, kind of low-functioning.
My pdoc made me quit imipramine: i finally managed to get along fine without it even though apathy and anhedonia subtly and slowly got worse over the years.
Three years after quitting imipramine i noticed an abrupt change: i became socially withdrawn, i lacked sexual desire and i experienced unexplainable personality changes: my character became strangely "feeble": never felt so weak in my entire life; lost every trace of self confidence, (it might sound weird but i was far more confident when i was psychotic, my self esteem was better also) i didn't have any drive whatsoever (again, felt better years before as i was far more active and involved in many activities during the day);
strangely, i didn't feel much depressed, just heavily numbed and anhedonic. My body perceptions got so worse i was experiencing a state of analgesia. Didn't feel anything, not even pain. I could barely feel my feet touching the ground.
Unfortunately i experienced a traumatic event during that period.
I went to my ex-pdoc seeking for advice : he told me i didn't need any meds and he just gave me psychological support which gave me no benefit whatsoever.
After four months of continous stress and pressure (i was taking care of a my fianceé in the hospital) i got suddenly sick. I experienced hot flushes, night sweats, rashes on my arms and chest, nausea, low grade fever, extreme weakness, mind diziness ,vertigos ,severe hypotension and worst of all, a strange "numbed" anxiety which brought about a state of horrible mental confusion. I felt like i was experiencing a benign version of Alzheimer Desease: it was very scary since i didn't have any control whatsoever.
I took Zoloft which improved the situation a little bit (enough to be able to stand on my own feet, more active, less apathetic even though i still had severe blood pressure shifts and neurological like symptoms). Still, i took a few years to recover. I'm currently taking Effexor (300 mg) and Reboxetine (8 mg.)
I was retrospectively diagnosed with a severe form of CFS with neurological symptoms. I've been searching for CFS Syndrome info since then. I found a site ran by Jay A. Goldstein, a doctor who's specialised in CFS syndrome, whic states that CFS could be triggered by a lack of synaptic plasticity; could i have aquired this deficiency through long term synaptic potentiation which possibly led to excitoxic damage? I'm asking you this 'cause i've read that chronic depression might induce brain shrinkage.
A year and half ago i experienced double depression (which was reversed by imipramine) and i noticed that depression was qualitatively different: it was a lethargic/anergic type whereas the depression type i had experienced years before was more like the agitated type. On my second depression, i'd get lost in familiar places and couldn't recognize people faces. It never happened to me before. Is that a sign of deterioration?
Could it be similar to involutional depression ? Is that possible that depression induced brain shrinkage would make the brain age prematurely? And if it was so, would be a nootropic drug like piracetam or memantine a valid augmenting option for me?Second question:
I'm wondering why i went fom extreme hypearousal/vigilance, "vivid" sense of reality down to hypoarousal/dream-like-mental state and mental confusion/numbed anxiety.
Is there a neurobiological mechanism underlying the above mental states?
Is there a reason why anhedonia got worse throghout the years? (May be dopamine deficency?).
Sorry, one more question: could the emotional/sensory numbing i suffer from
somehow related to PTDS? I'm asking you this 'cause when i was psychotic years ago i experienced a state of hyperarousal, constant terror, high blood pressure, and high heart rate which lasted for many months with virtually no breaks.
After that state subsided anhedonia took its place (it's like i experienced a reversed state). Could that endogenous shock be similar to PTDS, neurobiologically speaking? And if it was so, could be the endogenous opiate system play a role?
I've read that extreme, prolonged shock triggers anhedonia via the opiate system.O.K., enough with questions. Sorry if i've been so long. I thank you again for your patience and support.
Sincerely,
Anna Laura
poster:Anna Laura
thread:101755
URL: http://www.dr-bob.org/babble/20020402/msgs/101755.html