Posted by Questionmark on November 6, 2007, at 2:42:33
Sorry for the exclamation. I just get frustrated when thinking about SSRIs.
But I don't agree (as someone said in a thread above in recent post) that the apathy/numbness from SSRIs only occurs if/when the SSRI isn't working properly. In my opinion, it seems like a time-dependent inevitability. How much time is not certain, but not much.
For me (and i would assume many/most others), when I initially increase my serotonin transmission, I feel ... almost how we should feel all the time, or most of the time. I feel wonderful. Not beaming with pleasure, or even euphoric at all as with stimulants, but... good. Bright; happy; sociable; energized, to some extent;... and still protected (numb) from intense emotional pain, and even numb to certain of those longing and pleasure feelings. And so maybe even it is not "natural", or real. Who knows what it is to feel natural?! But it feels about as close to being happily alive as anything can, without feeling like a DRUG. If only i could sustain that state, i would probably stay on an SSRI indefinitely(while looking for various things to relieve the cognitive and sexual side effects), and would probably actually enjoy life. But alas, that state is not sustainable, which is why I am NOT on an SSRI (I am on Nardil). As various 5-HT2(?) receptors are continuously agonized with serotonin longer and longer, dopamine transmission is inhibited further and further (or how I crudely understand it) until one's reward system becomes all but shut down. The grandest pleasures become mild at best. And motivation is anything but strong. Yes the pain is nearly eradicated too-- nothing is a "big deal." You are a walking, talking zombie. But eventually the one source of pain that does arise is the pain of not being able to feel! It's not terrible, as severe depression is terrible, but it's not good. And it can logically lead to one wondering why they're bothering to live at all (which in my opinion is one of the two primary reasons SSRIs sometimes or potentially lead to increased suicides, and NOT because it "gives depressives the energy" to do it, as the Psychiatric-Pharmaceutical complex so often suggests).
... And then words don't come to you quite as easily, and your experiences become lost in a fog of hazy memory, and... you can't understand why you're on the damn drug anymore! And so you get off. And then after about a week-- oh my goodness!-- you feel alive and your emotions come flooding back and you cry at every sad commercial, but overall you feel good, maybe even great. And this lasts for another 7 to 30 days or so (depending on the dropped drug's half life). And you think you've overcome your depression. You think it's finally gone and you don't need to be dependent on those freaking drugs anymore and you will be able to lead a relatively more or less OK and normal life. And then one day shortly thereafter... all those familiar thoughts and feelings about yourself and humanity and the world and life come flooding back. And you are covered in blackness. (This is the other primary reason SSRIs can sometimes or potentially increase suicidal ideation, and suicide). Then, if you're lucky, you manage to drag yourself to a psychiatrist, and he or she explains that you have relapsed into depression as a result of discontinuing your antidepressant medication. (This is true, partially. It's also true that your body and brain have become physiochemically dependent on the presence of a very powerful drug, your serotonin [and other] receptors having had adapted and altered their sensitivity and quantity to the point that without said drug your central nervous system will be so out of balance that its only function will be to produce a perpetual state of paralyzing despair. .....
So of course you get back on the drug and feel amazing (comparatively at least) for a day or two or three, and the whole cycle continues.
.
This is a gross overgeneralization-- of course-- but one that I think holds a lot of truth.
Of course, even with a miracle drug like Nardil you have the same problems, but the numbness and apathy are not as bad, and it's more effective at helping you feel good. Weird-- and after all that i just had a thought about going back on an SSRI (and drinking coffee every day) (mostly because of the convenience-- 1x daily as opposed to 2 or preferably 3 or even 4 times daily with Nardil-- and the at least perception of significantly less social stigma attached to the all-too-common SSRIs). But no. When I think about it logically I know it wouldn't be nearly as good as Nardil-- even with daily caffeine, or even with daily caffeine and a low-dose benzo, or even with benzo and selegeline and whatever else you want to throw in there.
Maybe one day they'll create a drug or class of drugs that eradicates depression (and etc.) without changing too much else-- and one that doesn't lose effectiveness. Until then, good luck, and there's always Nardil.
P.S. I should have been asleep hours ago. Once again. Damn you, PsychoBabble. Damn you.
(No i'm just kidding i love this site so much more than i hate it. Ooh, kind of like Nardil.)
poster:Questionmark
thread:793535
URL: http://www.dr-bob.org/babble/20071104/msgs/793535.html