Posted by banga on December 18, 2004, at 18:39:17
In reply to Depression - Night and Day, posted by Cole_B on December 18, 2004, at 17:01:26
I think that there are many many options to still explore before thinking of ECT. I too have unipolar depression, similar life pattern as you describe--initially seemed to be triggered more by outside events, now has a much more endogenous feel. If one were to formally diagnose me, I would be Major Depressive Disorder, Chronic, and Generalized Anxiety Disorder.
I have had partial responses to a couple of SSRIs and TCAs, but it has been far from the magic bullet. I have been on some of the atypical antipsychotics (Risperidone, Geodon), that at least short-term did wonders for me--no anxiety, much less depression; others have found them to be a long-term answer.
I am now trying the first mood stabilizer ever--Lamictal. The second week I already felt better. SOmehow calmer and without these dramatic swings into despair. It is still too early to tell how helpful overall it will be, but I am encouraged.
My medication plan has switched from oncentrating on "which antidepressant" to "which mood stabilizer and which stimulant?" I personally feel that monotherapy with something like an SSRI has not been the best approach. In my mind, I equate the brain to an ecosystem---let's say a lake. And one day you notice that the lake is so very murky, and there are not many fish. You decide--hey it needs snails to clean it up and feed the fish! So you add a whole bunch of snails and sure enough the lake is clearer, and there are more fish. But then you see that there are way too many snails, so you add a bunch of fish. And it gets better, but then the fish eat all the snails, the lake becomes murky again, the fish begin to die out....and it's lousy again.
It would have been better to think it through, add a little of this and that-- to influence but not overwhelm the balance in the lake by adding too much of one thing. All the elements are interconnected; pushing in too much of one may have repurcussions down the line.
sorry about the long analogy, but I simply am becoming very skeptical of monotherapy, now thinking a little of two or three things may be better than a lot of one.
To get back to the original point, many unipolarly depressed people seem to have tried and felt better on a mood stabilizer (often in combination with an antidepressant) than they did on an antidepressant alone. And the atypical antipsychotics are used more and more too. There are many options to still try out--either alone or combined with an antidepressant.
By the way, what do you know about the possible long-term effects of Lymes disease on neurochemistry? Have you researched it, spoken to some docs, found out what may have helped previous people? Have you also considered your family history, to get an idea what the chances are that you inherited the depression? YOu probably have done this, but on the off-chance you havent I thought Id mention it...could give some clue as to what may work best.
For me, family history screams "inheritance!", but with the number of depression, bipolar, Attention Deficit, and anxiety--disordered people among my relatives, it doesn't help zeroing in on the most likely central cause(s) of my difficulties!!
Sorry for the long post!
poster:banga
thread:431351
URL: http://www.dr-bob.org/babble/20041217/msgs/431381.html