Posted by bulldog2 on February 10, 2010, at 17:23:24
In reply to Re: Opioids for Depression, posted by kirbyw on February 9, 2010, at 23:12:53
> I think we are all missing something in this discussion.
>
> 1) I would agree that in the worst cases of endogenous depression where the person is acutely suicidal that opioids would probably be of use, but only until an anti-depressive could kick in.
>
> 2) The problem with the opioids is that you feel good "for no reason" This was very dangerous in my case, as instead of instigating behaviors that would improve my life, I was content to just sit around and "feel good," and this on a very small dose of Vicodin only about 1 or 2 pills per day.
> It took away that horrible depressed feeling and made me feel relaxed and confident. But the next morning I had to do it again, and the next afternoon etc. This was happening from last July until January 6th, the day that I took my last Vicodin.
>
> So there is some biochemical property of these artificial opioids that has a temporary effect, but doesn't stimulate any kind of permanent change in neurotransmitters. And it also gives you a false sense of well being. In extremes people on these drugs, feel great as we know, while they lose weight, lose their jobs, steal money from their families, etc.
>
> 3) Even worse, your mind/body creates symptoms which cause you to have cravings for the drug.
> These can be psychosomatic, in my case a sensation of shortness of breath, or my supposedly incapaciting prostate pain. Well, now that I am 33 days without Vicodin, the shortness of breath has almost completely disappeared. And the severe prostate pain when sitting is managed by 1 extra strength Tylenol.
> In fact, sometimes if I forget to take the Tylenol the pain seems minimal anyway. I have not to take more than 3 tylenols in any one day.
>
> Before, I always would be conscious of the pain, and would immediately take half a vicodin if i thought I would be sitting on a hard chair, or on a plane, or in a theater etc. for more than a few minutes. I took these pills for seven years. During that time certain aspects of my life went ok, but I was constantly feeling good on a low dose of Vicodin.
>
> When the time came for me to take steps to respond to some crises in my life, my response was to relax and take the Vicodin and more or less ignore the impending disaster. And those disasters led to my first severe depression in over 20 years. So then I was taking the Vicodin
> just get out of bed in the morning, to get something done etc. I was on Parnate, but I was feeling "too good". I was self medicating my depression with an opiate, and creating a sense of well being based on nothing.
>
> Only since I stopped the Vicodin have I returned to a point where I am trying to really solve my real life problems. I found a therapist, I am going to Narcotics Anonymous groups, and to another mental health support group, etc. I am much more active generally and this contributes to a sense of well being that I hope is far more significant for my life, than the "well being" I felt on the drug.
>
> As the crisis became worse, the use of Vicodin was, I feel, creating or at the very least enhancing the symptoms of depression, so as to
> "trick" me into taking some more Vicodin. Its hard to explain, but thats how I see.
>
> Now I am taking only Parnate, and I am do so many more things focused on improving my life than I was previously. I still feel bad on some days, I adjust the dosage of Parnate and can improve my mood rather quickly, although the higher the dose the more insomnia that I have. But that's a different issue.
>
> The term "self-medicating for depression" with drugs or alcohol is used all the time. It is actually a meaningless catch all phrase, until it is defined in terms of what is going on very specifically with a given individual.
>
> By the way, I had Vicodin cravings every day for the first week I stopped taking it. The depression was worse, even with Parnate, I had shortness of breath, pain in my chest, pain when sitting. Gradually this has diminished and now I just realize that these are symptoms of Vicodin withdrawl. In any case, if I really think they are "real" I can always go to the Doctor.
>
> Vicodin has a strong mind/body effect. Perhaps there should be an investigation into how to create a codeine based anti-depressant that will not have this effect. But I think that this may be almost impossible.
>
> One final example: When I was hospitalized for a severe endogenous depression in 1982, before I had ever taken parnate, the psychoanalytically oriented Psychiatrist at the hospital decided to give me a "sodium pentathol interview" in order to dig into my childhood or whatever. For one hour, I was only semi-concious. I didn't recover any signficant childhood memories but I remember that I felt, normal for the first time in two years, that is to say the endogenous physical pain of the depression disappeared on the sodium pentathol interview. The Doctor thought that this was some kind of catharsis because I kept saying "I can feel. I feel normal" etc. etc. Well, about an hour after the interview was over, and the drug wore off, I felt exactly the same pain that I had been feeling before this experience. The physiological effects of the Pentathol wore off and that was the end of feeling good. Now if good old Dr. Freud had given me a small dose of Pentathol every hour or so, I probably could have continued to feel better, but I would have to have been hooked up to a sodium pentathol machine for the rest of my life. It was a different drug, parnate, (in a different hospital with a different Doctor) that got me out of the depression.
>
> I regret that I used Vicodin for almost seven years, even though I functioned adequately most of that time. The end result was as I have said a severe crisis and a relapse into endogenous depression.
>
> The Vicodin was orignally prescribed for the prostate pain when sitting. And I got letters from a pain clinic enabling me to continue to get Vicodin prescriptions from other Doctors. For all I know I could have gotten by on Tylenol the whole time.
>
> Rick in Costa rica.There may be a subset of depressives who have a shortage of endogenous opiates. They may not respond to standard ads and their opiate systems may never kick in and produce enough internal endorphins. That is why they need their opiate meds every day.
poster:bulldog2
thread:935598
URL: http://www.dr-bob.org/babble/20100204/msgs/936602.html