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PostPosted: Wed Aug 24, 2016 10:10 pm 
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Finally got to see the doctor yesterday. She prescribed a new medicine,and said to take it in the mornings. Given that I didn't get it filled until yesterday afternoon, I took my first dose this morning.

Surprise! I'm allergic to it. Benadryl + sleep = better now, but that doesn't fix the fact that I still need medicine, so hopefully she can find an alternative tomorrow that doesn't make my body think it's being carpet-bombed.

Goddammit.


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PostPosted: Thu Aug 25, 2016 8:34 am 
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What medicine was it?

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PostPosted: Thu Aug 25, 2016 8:38 am 
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Celexa. The doc's nurse called this morning and said they were switching me to Wellbutrin. I'm glad I didn't take but a half a tablet of Celexa (since it was the first SSRI I've ever taken, the doc wanted me to start slow).


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PostPosted: Thu Aug 25, 2016 5:38 pm 
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I haven't had neuro yet, so not familiar with that one yet. But I remember some family med guys telling me it's always best to titrate up slowly on SSRI's, but I didn't think anaphylaxis was the reason. :)

Glad your airway didn't close up!

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PostPosted: Fri Aug 26, 2016 12:30 pm 
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many SSRI's have a long halflife too. Typically 6 weeks each direction on some of the older ones. Some newer drugs are just a couple of weeks.

On the flip side, Lithium, Is in and out of the system in a day.

Had to learn way too much about Antidepressants in the last 2 years.


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PostPosted: Fri Sep 09, 2016 6:28 am 
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Monday I began doubling my bupropion dosage (one tablet twice daily) after an initial ramp-up period of a week or so. I don't *think* I'm having any major side effects, but I have noticed my tinnitus (which I've had for years) seems to have gotten louder. I worked myself into a frenzy this morning at 3am (got up to order the new iPhone, and talked myself out of it at the last page of order confirmation...maybe the medicine is helping more than I realized) after doing The Thing You Should Never Do, look up health issues on the internet. It seems most were saying that yeah, it happens with most antidepressants during the ramp-up period while your body adjusts, then goes away, or abates after you stop taking the drug and it clears your system. Then there were others saying their lives were now a living hell because they stopped taking the drug due to the tinnitus and it never went away.


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PostPosted: Fri Sep 09, 2016 8:05 am 
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So, I guess either way, don't stop taking the medication?

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PostPosted: Fri Sep 09, 2016 11:26 am 
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I've got a call in to the doc, just to let her know "Hey, I have these side effects, are they normal and will they likely subside as I adjust?" I figure more information is better than less.


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PostPosted: Wed Sep 14, 2016 5:41 pm 
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We actually just covered that in Pharm. This is what we were given:

- insomnia, tremor, difficulty concentrating, and gastrointestinal symptoms. More likely with higher doses.
- decreases seizure threshold
- Has been associated with an increased risk of suicide (Black box warning)

Got the below from a more detailed, subscription-based resource if you wanna go that deep into it. Tinnitis is listed in there.
Spoiler:
>10%:

Cardiovascular: Tachycardia (11%)

Central nervous system: Headache (25% to 34%), agitation (2% to 32%), dizziness (6% to 22%), insomnia (11% to 20%)

Dermatologic: Diaphoresis (5% to 22%)

Endocrine & metabolic: Weight loss (14% to 23%)

Gastrointestinal: Xerostomia (17% to 28%), nausea (1% to 18%)

Ophthalmic: Blurred vision (2% to 15%)

Respiratory: Pharyngitis (3% to 13%)

1% to 10%:

Cardiovascular: Palpitations (2% to 6%), cardiac arrhythmia (5%), chest pain (3% to 4%), hypertension (2% to 4%; may be severe), flushing (1% to 4%), hypotension (3%)

Central nervous system: Confusion (8%), anxiety (3% to 7%), hostility (6%), nervousness (3% to 5%), sensory disturbance (4%), sleep disorder (4%), migraine (1% to 4%), abnormal dreams (3%), memory impairment (≤3%), drowsiness (2% to 3%), irritability (2% to 3%), pain (2% to 3%), akathisia (≤2%), central nervous system stimulation (1% to 2%), paresthesia (1% to 2%), twitching (1% to 2%), dystonia (≥1%), depression

Dermatologic: Skin rash (1% to 8%), pruritus (2% to 4%), urticaria (1% to 2%)

Endocrine & metabolic: Weight gain (9%), menstrual disease (2% to 5%), decreased libido (3%), hot flash (1% to 3%)

Gastrointestinal: Constipation (5% to 10%), abdominal pain (2% to 9%), diarrhea (5% to 7%), flatulence (6%), anorexia (3% to 5%), increased appetite (4%), dysgeusia (2% to 4%), vomiting (2% to 4%), dyspepsia (3%), dysphagia (≤2%)

Genitourinary: Urinary urgency (≤2%), vaginal hemorrhage (≤2%), urinary tract infection (≤1%)

Hypersensitivity: Hypersensitivity reaction (including anaphylaxis, pruritus, urticaria)

Infection: Infection (8% to 9%)

Neuromuscular & skeletal: Tremor (3% to 6%), myalgia (2% to 6%), weakness (2% to 4%), arthralgia (1% to 4%), arthritis (≤2%), dyskinesia (≥1%), neck pain

Otic: Tinnitus (3% to 6%), auditory disturbance (5%)

Renal: Polyuria (2% to 5%)

Respiratory: Upper respiratory infection (9%), sinusitis (1% to 5%), cough (1% to 4%)

Miscellaneous: Fever (1% to 2%)

<1% (Limited to important or life-threatening): Abnormal accommodation, akinesia, alopecia, amnesia, anaphylactic shock, anaphylactoid reaction, anemia, angioedema, angle-closure glaucoma, aphasia, ataxia, atrioventricular block, cerebrovascular accident, colitis, coma, complete atrioventricular block, cystitis, deafness, delayed hypersensitivity, delirium, delusions, depersonalization, derealization, diplopia, drug-induced Parkinson's disease, dysarthria, dyspareunia, dysphoria, dysuria, edema, EEG pattern changes, erythema multiforme, esophagitis, euphoria, exfoliative dermatitis, extrapyramidal reaction, extrasystoles, facial edema, gastric ulcer, gastroesophageal reflux disease, gastrointestinal hemorrhage, gingival hemorrhage, glossitis, glycosuria, gynecomastia, hallucination, hepatic injury, hepatic insufficiency, hepatitis, hirsutism, hyperglycemia, hyperkinesia, hypertonia, hypoglycemia, hypokinesia, hypomania, impotence, increased intraocular pressure, increased libido, intestinal perforation, jaundice, leukocytosis, leukopenia, lymphadenopathy, manic behavior, myasthenia, mydriasis, myocardial infarction, myoclonus, neuralgia, neuropathy, orthostatic hypotension, painful erection, pancreatitis, pancytopenia, paranoia, pneumonia, psychiatric signs and symptoms, pulmonary embolism, rhabdomyolysis, salpingitis, sciatica, seizure (dose-related), SIADH, skin photosensitivity, Stevens-Johnson syndrome, stomatitis, suicidal ideation, syncope, tardive dyskinesia, thrombocytopenia, tongue edema, urinary incontinence, urinary retention, vasodilatation

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PostPosted: Mon Sep 19, 2016 1:11 pm 
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Screeling wrote:
- Has been associated with an increased risk of suicide (Black box warning)

At first counterintuitive, this actually makes a lot of sense.

The typical arc of depression involves a number of symptoms, and among the first things to go is motivation; will to action, even before the crippling despair that goes along with it.
Someone may not want to live, but may not have the initiative to commit a suicidal act.

As anti-depressants start restoring the sufferer's facilities, one of the first things to come back is motivation, even if the individual is still despondent. So now you have someone who is far more capable of action but still not wanting to live.


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PostPosted: Mon Sep 19, 2016 2:37 pm 
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I started having...I dunno, "twitchiness" is the best word I can think of to describe it, but it wasn't like physical jerking or anything. It was more that it felt like the connection between my brain and my muscles, or my brain and other parts of my brain, would occasionally glitch. It was like the signals kinda buffered for a split second, then rushed and caught up. Impossible to quantify, obviously, but I felt as though I was shaky, I seemed to fumble frequently with fine muscle coordination (typing, picking up pens and dropping them, etc.), and found myself searching for words.

These all began occurring after my one-week ramp-up period, a couple of days after I began taking two pills a day instead of just one. After speaking with the doctor, she said to return to one pill a day for another week, then alternate: two pills one day, one pill the next, two pills the day after, etc. Returning to one pill definitely made all of the side effects I mentioned go away. I'm seeing them return now that I'm on the alternating schedule, but they do seem far less severe. Whether that's the dosage only increasing by 50% instead of 100%, or my body adjusting to it, I'm not sure. Probably (hopefully?) a bit of both, leaning toward the latter.


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PostPosted: Mon Sep 19, 2016 4:48 pm 
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It takes about 5 half-lives (which doesn't necessarily mean 5 doses) to reach steady state where your body is clearing as quickly as you're putting it in, so probably is a bit of both.

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PostPosted: Tue Sep 20, 2016 6:51 am 
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A lot of the SSRI's have muscle tremor as a side effect. This was one reason I really wanted off Paxil when I was taking it. this isnt really surprising either when you think about how SSRI's function. Lack of Serotonin is one reason we believe people sufferer from depression. When neurons send messages they trigger the next neuron in the chain by releasing serotonin which triggers the next neuron to fire. Then the neuron basically sucks the serotonin back up through a process called re-uptake. The problem with depression is that you may have not enough serotonin to trigger the next neuron to fire as it should. So SSRI (Selective Serotonin Re-uptake Inhibitors) just leave the neurotransmitter out there instead. Unfortunately that may lead to other nerve transmission glitches such as muscle tremors.


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PostPosted: Tue Sep 20, 2016 11:43 am 
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One note: Wellbutrin is an NDRI, not an SSRI. I am on the generic, not the brand-name, which apparently can be very different. Hmm.


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PostPosted: Wed Sep 21, 2016 11:28 am 
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same mechanism, different neurotransmitter


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PostPosted: Fri Sep 23, 2016 10:42 pm 
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FarSky I know nothing about the drugs you are dealing with, but I fervently hope that you have no more ill affects and will be better soon.

/hugs

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PostPosted: Sat Sep 24, 2016 8:49 pm 
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Thank you so much. *hugs*


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PostPosted: Sat Sep 24, 2016 10:08 pm 
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I, too, know nothing about them. And I am not a doctor.

My only advise to anyone, basically, is make sure you are doing everything you can OTHER than taking meds for a condition. Make sure you are living as healthy as possible. Get proper rest. Eat a healthy diet. And get some exercise routinely. I know way too many people who do not do this, and just take a pill thinking everything will be fine. Living well may not cure whatever ails you, and the meds may well be a part of your life, but it sure doesn't hurt. And a lot of people don't realize how unhealthy they are living, as they've become adjusted to it. Eating out for most meals, which I argue is unhealthy unless you are rich and can have someone watching your diet. Not exercising, because they are too tired from work and it's easier to sit and play games or watch TV. And not getting proper rest.

But after all that, I hope you find what helps you get better. And be vigilant. Not all doctors are good or treat each patient with proper attention. So don't assume you are being given advise that is best for your condition, if things don't seem right, say something or find another doctor. I say this as someone who worked in healthcare for many years, and has worked around hundreds or doctors and surgeons from all around the globe. In my area, we have hundreds of doctors, and I could count on both hands the ones that I would go to see if I needed help. Most were not worth their salt, and I would fear to take my pets to them tbh. Especially those G'D ER doctors. 99% of them should be parking cars LOL. Seriously, horrible SOBs that scare the living hell out of me to think people rely on them.


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PostPosted: Wed Sep 28, 2016 5:58 am 
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TheRiov wrote:
Screeling wrote:
- Has been associated with an increased risk of suicide (Black box warning)

At first counterintuitive, this actually makes a lot of sense.

The typical arc of depression involves a number of symptoms, and among the first things to go is motivation; will to action, even before the crippling despair that goes along with it.
Someone may not want to live, but may not have the initiative to commit a suicidal act.

As anti-depressants start restoring the sufferer's facilities, one of the first things to come back is motivation, even if the individual is still despondent. So now you have someone who is far more capable of action but still not wanting to live.


This is a common explanation for the increase in suicide rates, but it's not supported by evidence. Anti-depressants also increase suicide rates and suicidal thoughts in healthy, non-depressed people.

I've never been suicidal or one to ever consider killing myself, but while taking anti-depressants I would get random suicidal thoughts. They weren't enough of a bother to make me stop taking the medicine, but they did seem to be related to it.

Also, the info you gave about depression being caused by a lack of serotonin is also outdated. No professionals really believe that anymore, and depressed brains have just as much serotonin as healthy ones. It is still sometimes used as a convenient explanation to patients for how anti-depressants work, but it's not really accurate. Unfortunately we don't really know why or how anti-depressants work.

Farsky, I'm sorry you're having so much trouble with side effects. I never had much in the way of side effects from wellbutrin, it just didn't do anything for me. Maybe the side-effects are a sign it'll work for you? I donno.


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PostPosted: Wed Sep 28, 2016 2:49 pm 
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Amanar: Thanks! I can definitely tell it's helping, or at least it was. It feels like it's not at its peak helpfulness (at which point it felt almost like a palpable voice would gently tap on my shoulder and encourage me), but it does feel better than before I started the medicine.

To start at the beginning (Wall o' Text, activate! Read if you dare!):

I'd been increasingly experiencing signs that would, ultimately, lead to a diagnosis of mood disorder and possible PTSD. I suppose they started around five or six years ago, but they'd been increasing in both frequency and severity.

Friday, February 13th of last year, I was sitting in my office, and felt an overwhelming pain grip my chest. It was like a vice had been tightened around me and wouldn't stop, terrifyingly tight and increasing. It didn't go away, and my left arm began tingling, I was short of breath, dizzy and lightheaded...all of the classic signs of a heart attack. Now, I'm 32 (well, I was then), get annual checkups that have never shown a problem (even at my heaviest weight), and have no family history of heart disease, so a heart attack seemed unlikely. I did talk with a friend who had a heart attack at a young age (around 30) and described everything to him; he confirmed that it was probably OK. So I decided to just keep an eye on it, and if anything changed, I'd go the ER. It seemed to ebb overnight, but the next day ("Valentine's Day. Bummer."), with my wife at work, I was still feeling it. So my wife took me to the hospital.

They ran a battery of tests on me, and every single one came back negative. No trace or evidence of a heart attack. Official diagnosis: panic attack.

I didn't think much about it (at least, in terms of placing it into the bigger tapestry of my mental state). I just chalked it up to stress at my job (even though it was a strangely un-stressful day that Friday).

A couple of years ago, I made some major changes in my life, including changes to my diet that led me to drop 70 lbs. and the addition of exercise. That was great...until I got to the point that I hated myself so much that eating at McDonald's was preferable to eating healthy food, specifically because it felt like a slow form of suicide. Speaking of, I've always been someone for whom that act was unthinkable...except I starting thinking about it. A lot. And it started to seem preferable to continuing.

Phe and I talked, and she voiced her concern that I didn't seem like me, and that it had been getting worse over the past few years. It wasn't something that I could see; I knew how terrible and worthless I felt, but that seemed normal to me. I put around 15 lbs. back on, just because I didn't feel like I deserved to do any better. I stopped eating properly. I stopped exercising. I struggled to find a reason to get out of bed in the mornings, and most days I couldn't; I did so more out of habit than anything else. I went between work and home, and that's all I wanted to do. It's all I could do. I started having anxiety in stores or restaurants if there were too many people around.

There's the matter of work as well; there was a particular person (in charge, to boot) who was an abusive, emotional terrorist. He was unceremoniously terminated (mostly), so he's thankfully out of our lives. I hate hate hate to even bring up the term, because I hate the idea of even beginning to compare what I experience to something like a soldier who's experienced war goes through, but several of us here have legitimate PTSD because of him. My heart still freezes when I hear the "ding!" of the elevator, because I'm scared it's him. I have nightmares about him. I struggle to go to sleep at night because I'm certain that he's gotten into our home and is waiting, in the dark.

I would have brief spurts of "good" times, but the "bad" times (and thoughts) were increasingly overtaking my life. I woke up one morning, just like every other, showered, brushed my teeth, sat down on the bed to slip on my socks...and began sobbing. No reason. At least, not one I could (or even now, can) pinpoint. It wasn't an isolated occurrence.

I tried around a year ago to find a mental health care professional to talk to, but what was already an intimidating experience became one that put so many hurdles in the way just to get some help (side note: our attitudes toward mental health care, and insurance coverage for such, absolutely must change) that it felt impossible.

So I made an appointment (which wound up not being for several months, as she's booked solid), but spoke with her about it. I trust her implicitly; she's far and away the best doctor both Phe and I have ever had, and we both think the world of her. I'm normally wary of ulterior motives with doctors, just because there are a host of issues that can present themselves even if one does have nothing but the best intentions. Short version, though, she's one of the good ones, and I trust her judgment. She told me to start on this and scheduled a follow-up for six weeks later (that'll be next Tuesday).

Seeing the urgency, she wanted me to try the Celexa, which spurred this thread. I dunno if it would have worked like gangbusters or not at all; I know there are pitfalls in trying to fix a squishy computer like the brain. But I didn't get to go down that path very far. She switched me to the bupropion (Wellbutrin), which I've been taking ever since, and the difference after a couple of weeks on that has been remarkable. I'm not 100% back to old me, but I'm definitely heading in that direction.

It wasn't until I got turned around that I was able to see the forest for the trees: the panic attack, the depression, the history of it all. And the stigma attached to anything related to mental illness is destructive as hell. The fact that we're still kinda fumbling around in the dark regarding psychological issues (and their physical causes) doesn't help. But treating mental illness as though it's a shameful failure of character is not only wrong morally, but empirically.

When I was growing up, I lived on a farm. My dad was a dirt farmer (still is, to a degree, unfortunately), and I'd help him out when he needed it. I didn't mind the work, but I did mind having to do it outside...not because of discomfort like heat or humidity, but because I'm allergic to pretty much anything green. A triggered allergy attack would pretty much completely sideline me for two to three days. His side of the family used to make me feel like **** for that, like I just wasn't tough enough or if I'd just man up, my allergies wouldn't be a problem. Even knowing factually that it was a matter of biology and not a question of constitution, I still internalized that. Applying it to something intangible like mental illness is a recipe for disaster.

Also, there is of course the question of family history. Normally I'll rattle off the things my parents or grandparents experienced, like diabetes, hypertension, etc., but no one's ever told me about any mental illness in my family (the closest anyone comes to talking about that was my maternal great-grandmother, who suffered from Alzheimer's in her waning years). Only pressing the issue results in potential relevance coming to light. Like my mother being on antidepressants since my grandfather passed away, and going to therapy when I was in middle school. Or her mother contemplating suicide (decades ago), and her obsessive cleaning compulsions (still going on) being viewed as just family joke fodder. Or her father, who did commit suicide a few years before I was born.

Because those things aren't "mental illnesses". They're viewed as just isolated incidents, completely unrelated and not discussed because they're "embarrassing". Taken together, though, it's a helluva pattern; one that might have helped me identify this earlier. Dad asked me why I didn't look for help sooner; the simple answer is because I didn't even realize I needed it. And how do you say "I feel suicidal" without causing friends and family to panic? It's difficult to modulate the difference between "Do you think I need to find some help?" and "Holy **** WTF is going on emergency emergency stop everything". Everything's relative to the experiencer. Plus, it just felt like whining to me.

Which brings us to today. I'm on the Wellbutrin (generic), and I, along with Phe and my friends and family, have seen a big, big difference. The Wellbutrin has had some bumps (like the spazzy muscle/thought thing, and the tinnitus exacerbation), but it's definitely helping. And the muscle/thought issues seem to have abated; only the tinnitus remains, so I just want to check on that.

Aaaaaand incredibly long text is over! *tap dances away*



Edit: Skipped a word. Fixed now.


Last edited by FarSky on Thu Sep 29, 2016 3:56 pm, edited 1 time in total.

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PostPosted: Wed Sep 28, 2016 4:39 pm 
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Whoa. I'm glad you're seeking assistance and have been steered onto something that seems to be helping.

I've got some history with throwing medications at my brain to see what sticks; if you want to talk about stuff with a sympathetic ear, you nkow how to get in touch.

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PostPosted: Wed Sep 28, 2016 6:29 pm 
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FarSky if you can tap dance away you aren't as bad off as you think! /wink

I want to thank you for your "wall of text". I know now that you are more like my son than I thought...

Eight years ago my stepson flew out here. He and my son loaded my son's car up with all it could hold and drove back to Murfreesboro, TN. The first Christmas he was out there my son wanted to fly home. He didn't make it because he had an anxiety attack and couldn't get on the plane.

A couple years later he thought he was having a heart attack. He went to the clinic where they ran all sorts of tests. The result was he was having an anxiety attack.

My son told me a couple of days ago that he is looking into some therapy. I hope it works out for him and I hope it continues to help you FarSky!

/hugs and good thoughts :)

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PostPosted: Wed Sep 28, 2016 8:03 pm 
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Don't catch this!

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PostPosted: Wed Sep 28, 2016 8:56 pm 
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Amanar wrote:
TheRiov wrote:
Screeling wrote:
- Has been associated with an increased risk of suicide (Black box warning)

At first counterintuitive, this actually makes a lot of sense.

The typical arc of depression involves a number of symptoms, and among the first things to go is motivation; will to action, even before the crippling despair that goes along with it.
Someone may not want to live, but may not have the initiative to commit a suicidal act.

As anti-depressants start restoring the sufferer's facilities, one of the first things to come back is motivation, even if the individual is still despondent. So now you have someone who is far more capable of action but still not wanting to live.


This is a common explanation for the increase in suicide rates, but it's not supported by evidence. Anti-depressants also increase suicide rates and suicidal thoughts in healthy, non-depressed people.

I've never been suicidal or one to ever consider killing myself, but while taking anti-depressants I would get random suicidal thoughts. They weren't enough of a bother to make me stop taking the medicine, but they did seem to be related to it.

Also, the info you gave about depression being caused by a lack of serotonin is also outdated. No professionals really believe that anymore, and depressed brains have just as much serotonin as healthy ones. It is still sometimes used as a convenient explanation to patients for how anti-depressants work, but it's not really accurate. Unfortunately we don't really know why or how anti-depressants work.




Interesting. Do you have any articles on this you can point me to?


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