Posted by SLS on August 5, 2008, at 6:26:25
I think that the longer one spends in the depressed state, the longer is the recovery process. This is a generalization. I don't know to what degree this is true.
I am 1 1/2 years into my biological recovery process, and still have some residual depression to watch dissipate. It will take quite awhile for brain tissue to recover. I suspect that my cognitive impairments will take the most time to resolve.
I have added N-acetylcysteine (NAC) and fish oil in an attempt to speed up the recovery process. However, if these substances do not accelerate recovery, I will still glean antioxidant, anti-apoptosis, and anti-hypertriglyceridemia effects. In fact, I had planned on taking NAC well before discovering that a blinded study reported its usefulness as an adjunct treatment for bipolar depression.
My improvement has been substantial and has allowed me to attend school and achieve high marks. I am also just about ready to return to work. That will depend on whether or not I decide to take a few more college courses.
My point is this: I suspect that some people terminate a treatment trial prematurely because they perceive that the treatment is only partially effective. I keep mood charts to aid in my evaluation of my response to treatment. I am better now than I was a month ago. This has been a stable pattern since early on in my recovery. However, the Deplin has accelerated and stabilized further my improvements. Sometime, changes are subtle. They can be subtle enough as to be overlooked. Mood charts can be of great utility in teasing out trends in antidepressant response. Unfortunately, not all partial responses lead to remission. A plateau can usually be seen in the mood chart, though.
Here is the mood chart I use:
http://www.slschofield.com/medicine/mood_chart_beam.pdf
Since my baseline state was of severe chronic depression, I modified my scoring of the chart so that the top score representing severe mania becomes 100% remission of depression. Doing this doubles the resolution of mood tracking.
As usual, I offer no guarantees that a partial response will bloom into a full response. One may plateau instead of ascending. One other thing is critically important in understanding the antidepressant response. It is almost never linear. There are biological ups and downs that sometimes have one believe that a "recession" into depression is, instead, total poop-out. It may not be. I believe that tracking mood using some kind of charting can help tease out the differences between plateau and gradual improvement. Still, I would keep in mind the idea that one may then leave the partially-effective treatment in place and augment it with other drugs that have either shown a partial effectiveness also, or are of a different drug class.
Just a few things to think about.
- Scott
poster:SLS
thread:844262
URL: http://www.dr-bob.org/babble/20080805/msgs/844262.html