T Nation

Do Antidepressants Work?

Guys,

I’ve been considering trying antidepressants to stop/lessen my depression. I was hoping that HRT would balance my mood. No luck though. I’m running out of ideas. My diet has been cleaned up. No processed food…no man made stuff. I have a balanced diet of protein, carbs (veggies) and fats (fish oils).

I run for 30 minutes 4-5 days a week.

Regarding HRT, I inject T and HCG EOD. I take arimidex for E control. I believe that E is under control due to consistent morning wood. I’ll be giving blood later this week and will post blood results.

Outstanding items are high DHEA and low cholesterol (hdl - 36 and ldl - 87).

I would describe my depression as the constant focus on insecurites and bad memories… which indicates an overactive limbic system. OCD waxes and wanes as well.

Recent articles indicate that antidepressants are only slightly more effective than placebos in mild to moderate depression. What is the forum’s experience?

Please reply with your thoughts or experience.

About 6 years ago my life became over whelmed. Big changes at work, coupled with a wife battling severe depression and adjusting to being a father threw me into a fog that I couldn?t find my way thru. My Doc put me on Celexia. I was on it about 16 months.

My metaphor to describe the experience is cutting the tops off the peaks and filling the depths of the valleys. My weight ballooned 60 lbs over that period to 296. I am 5?10? tall. My libido dropped to zero. HOWEVER given the huge negatives, the antidepressants worked, they calmed the seas for me.

I woke up one day and decided I couldn?t stand the numbness, so I started the protocol to cycle off the meds. I can say it was about 2-1/2 years before I felt completely clear of the effects. If I had been physically active then, maybe the weight gain would have been less.

I would hate to think I would need to take meds like that forever. I am necessarily a proponent for them either. I have to admit they did achieve their chosen effect with me. Whether the side effects are worth it for you is not for me to say.

Have you already looked into cognitive behavior therapy (CBT)? You will in general reduce your chance of relapse, if you combine anti-depressant treatment with CBT.

A very good self-help book that gives you an overview of what CBT is and that may help you feel better very quickly is “Ten Days to Self-Esteem” by David Burns: http://www.amazon.com/Ten-Days-Self-Esteem-David-Burns/dp/0688094554/ref=pd_bxgy_b_img_c

Ive suffered with it my entire life. Its genetic in my case. Or at least theres a link. My Mothers side is riddled with suicide including my Mother. In my case IF I didnt have antidepressants I wouldnt be here.

The problem is that it can be difficult to find the right one for you. As I got older (early 30s) it became unbearable for me. I had to do something. They had to try me on several meds before we fond the right combination. Other than weight gain, I have no side effects.

And its like willy says it levels the field. I havent had a down right “hide the kitchen knives” spell in quite some time, knock wood.
I truly feel for you. And I want you to know Ill be praying for you.

I’ve been dosing hard on prozac since 2002. to summarize a lot of what was said above, anti-depressants without some kind of talk therapy is not going to help. my shrink told me that the first purpose of anti depressants was to take the edge off (chop off the valleys and peaks) so that therapy can be effective. I stopped the therapy after about 5 years, but my shrink said I should stay on the prozac, so I have.

When I first started the prozac, it gave me diarrhea like crazy, so I take a teaspoon of metamucil three times a day, and it went away. I wasn’t getting enough fiber anyhow. No real libido changes.

find a good shrink to talk to, that you feel like you can trust. Most of us can’t really talk about the stuff that bothers us. I used to lose my job every 18 months or so, but the therapy and anti depressants have made a big impact on my work stability (or at least my ability to tolerate a shitty job 8*)

dope harder,
old lardass

Eggman,

I have been on meds since 2002, on and off. lots of personal problems, used alcohol to cope, maritial issues (now divorced thank god), relieved some of the external stressors. Some genetics involved too.

Navy guy, been deployed several times, and can tell you that going on and going off meds is not a good thing. Every time I have been stable for a long time, I think I can handle it and go off, only to find myself in a fetal position and trying to choose which shotgun model I would like to off myself with.
from my experience, this is what worked and didnt work:

prozac 60mg daily worked, but lost libido
prozac 60mg, wellbutrin extended release 100mg worked well and countered some of the SSRI stuff. the XL is extended release and better for less jitters than the regular one.
Prozac is an SSRI, works on serotonin. Wellbutrin works on nor-epinephrine.
Prozac stopped working after going off it and back on so then went on…
Zoloft, SSRI felt like a zombie and killed libido, gave me a taste of ED :slight_smile: so got off it.
Effexor SNRI does both, relatively cheap generic and Navy tried to give it to me instead of cymbalta but didnt work as good.
Cybalta, SNRI does both serotonin and nor- is what I am on now 60mg day, is enough for stability without robbing of emotions and feeling the highs and lows of everyday life and no side effects.

Have a friend that is a neurologist and he gave his mom a prescription for prozac and told her it wasnt for her but for everyone else because she was so miserable!

Been to counseling, and shit is going to happen to you no matter what. Cognitive behavior therapy can help you reframe your outlook to some extent. Meds help keep my frustration tolerance high, so I dont lose it when stuff happens.

Additionally, I only recently started HRT, and tried Testim and was a non-responder so now take 100ml/week of Tcypionate, and have noticed more aggression and anger/shorter fuze creep back into the equation, but man did it help energy levels and libido! no HCG yet, but only started 3mos ago trying to dial it in still.

Best of luck to you and all I can offer is my own experience. From that I am a lifelong advocate for anti-depressants for myself. Others respond differently and have different needs, some temporary to get them through. I remember once coming back from deployment and wanted to stop meds and the doc said, “Why do you want to run without a net under you after all the turmoil involved with coming back after 8 months?” and you know what… he was right. I know I cant come off the meds, have tried too many times with bad results so I treat it like taking protein shakes or vitamins, just part of the routine.

Can also tell you that a good therapist is good to have. I have had several through the navy and every time I deploy, I get a different one when I come back, get tired of having to baseline and give history, etc, so found a civilian I went to when going through divorce, and finally just stopped going because I felt they were merely hand-holding instead of using a pro-active goal oriented approach which is what you will eventually need.

You can’t tell a depressed person to pull themselves up by their own bootstraps, they can’t, they are depressed!

Check out a book called Mind Over Mood, it has worksheets in it to help you keep records of your emotions, kind of like a good workout log, and once you have the data, you can make changes based on frequency, severity, recurrence of issues, etc. It helps you master things and get you back into things you enjoy.

Best of luck to you and hope this post helps anyone out there with similar problems. BTW I am 40yrs old for gp.

I agree with most of the above, they basically numb you. I was first diagnosed at 19 now 37 years old. My life has been a struggle to say the least so i feel for everyone posting. My first anti-d was prozac and it worked fairly well, like others have said if you start going off and on they tend to not work well. i went through several years where i didn’t take anything but then had a severe breakdown about 4 years ago.

Tried several drugs and ended up on Cymbalta. Have been on it for 2 years+ was good at first but in the last six months i have noticed some cognitive issues such as memory loss and severe apathy. The specialist i now see says he is seeing alot of problems with the snri’s namely Cymbalta and Effexor and we are now in process of weaning off of it. This is a hellish process, i fully expect there to be a class action suit against Lilly on Cymbalta, way too many weird side effects.

I won’t ramble too much about my situation but let me just say i have had many close calls with just wanting to be done thanks to Cymbalta. The biggest problem is they can be fairly certain there is some chemical imbalance but there is no way to know what it is. For instance lets say you are completely apathetic and have no “reward sense” or joy. Quite likely you could have a Dopamine deficicency, so when they throw an SSRi at it guess what happens? You get worse, much worse.

A qualified psychiatrist is the only person that should ever be allowed to dispense anti-depressants, and even they, if they are honest, will tell you its pretty much a guessing game. They roll the dice with your mental health, sometimes they win which can be great, sometimes they lose and you end up suffering in horrible ways. In all it is just incredibly sad to know people that suffer with this disease because i am all too familiar with its pain. So in short i guess my advice would be

  1. Talk to a real Psychiatrist NO GP’s
  2. If you decide to try something use a drug that has a long track record.
  3. Research protocols for withdrawal and clinical trial data before starting. There were actually several suicides during the clinical trials of Cymbalta at the damn Lilly complex (of course this had nothing to do with Cymbalta, geez)
  4. I truly wish you the best

You may want to read about sam-e. Also, there is a lot of good research (particularly out of Richard Davidson of University of Wisconsin-Madison) in regard to meditation helping with depression. I bought the first level of tapes from perfectmeditation.com to help speed up the process of learning how to meditate better more quickly. I wish you well.

Another option is to up the poundages. my shrink told me that working out was usually as good as anti-depressants, at least in clinical studies. I have found that even though I’ve been on 60mg prozac/day for 6 years, if I don’t train real heavy at least twice per week, the drugs are not as effective.

Oh, yeah, because these types of drugs are modulated by the liver, it can take 3-6 weeks before you see a difference, so if you go that route, understand that it takes some time to work. Once it starts to work, expect to spend 3-6 more months dialing in the dose.

stay strong

I have to third or fourth the cognitive behavior therapy. I had a therapist who never let me whine or complain no matter how much I wanted, she made me work on solving my problems, or overcome fears. Looking forward not backward.

Mind over Mood is a great book too with lots of practical advice and help re-training our brains to treat obstacles like opportunities.

Still when I feel stress I use some of the exercises in that book to help analyze what’s going on and put it in perspective, and develop plans and prepare myself. Also I have to have goals and be working towards those goals in order to feel good. And dreams too.

Sometimes drugs helped. I didn’t have problems with side effects but i was 25-33 so maybe my hormone levels were high enough … but as people said make sure to learn the side effects and above all take them exactly as prescribed don’t take too many and don’t just stop taking them, some bad things can happen when you suddenly stop depending on the drug.

I read a book once called Potatoes not Prozac which pointed out the relationship between sugar and beta-endorphins which is often overlooked. The therapist who wrote it counseled to cut out sugar and refined carbs to stop beta-endorphine swings (especially for recovering alcoholics who often develop sweet tooths). While working on increasing insulin sensitivity to lose fat I also got rid of sugars and the highs and lows, and I think that’s helped a lot. Everything we eat and exercise we get affects our brain chemistry just like it affects our bodies.

I can say yes they work, once you find the one (or two) for you. It took several years for us (me and the Dr.) to hit on effexor + wellbutrin for me. Xoloft was horrible for me.

Once we started TRT, I had to back off on the wellbutrin.

I will repeat the above advice: Go to a psychiatrist, not a GP. Maybe try out 2 or 3. This is a long term relationship, not a trip in to get antibiotics. Find someone that you get along with and vibe with.

Most of us are hardwired for how we behave, act, and so on. My father grew up in the Great Depression, landed at Omaha, lost most of his friends in the battle across Europe, watched my mother die of cancer, and lost his left arm when hit by a bus. Yet he was happy most of the time. Go figure.

I hope you find the right meds.

Maybe looking at my avatar might make you feel better too!
:slight_smile:

That, and pussy.

Everyone,

Thanks for the advise. I appreciate the thoughts and prayers. This depression is strange. I’ll go a year or two just fine, then bam…6 weeks to 3 months of hell. However, the last year has been consistently bad. More than anything, it’s the fear of another depressive bout that bothers me.

Glad to read that you guys experience some relief.

Thanks again.

[quote]Eggman wrote:
Everyone,

Thanks for the advise. I appreciate the thoughts and prayers. This depression is strange. I’ll go a year or two just fine, then bam…6 weeks to 3 months of hell. However, the last year has been consistently bad. More than anything, it’s the fear of another depressive bout that bothers me.

Glad to read that you guys experience some relief.

Thanks again.[/quote]

Eggman, from my experience that fear will lay in the back of your mind forever. After a while the specter lessens, but the devil dog is always there. I think alot of the guys are right. Find a shrink, you can develop a rapport with, get some meds, play close attention to the side effects, and document them. be prepared to change meds often and it will become controlable.

Winston Churchill referred to his depression as his “black dog” that patiently pads around just outside the door waiting for an opportunity to come in…pretty accurate for us all. That fear can become overwhelming and that is why depression has a tendency to feed on itself. It skews your reality to a point where all you can think about is the depression and how to get out of it. But the more you think about it the worse it becomes…yeah I think we can all relate unfortunately.