need quick advice

[Ales2]

I know I said in previous posts that I would not take anti-d's for several reasons, most of which is I think they dont work, and I dont think they are prescribed very well, they just go by self reporting, and I dont find that to be the kind of exact science I tend to respect with medical professionals. (I know there is a thread on whether anti-d's work  - I read that thanks.)

I have a mutual friend who told me about a study she was involved in for anxiety and I went and got tested and took all the tests. I;m like in the 98thpercentile of depressed and anxious people. I know that the anxiety and depression is killing my job search, but all else (home organization, health, personal hygiene, interest in other activiites) is normal for me. I'm supposed to start tomorrow but I am having my doubts.

What if I get worse on them? I dont have anyone that I see on a regular basis, except checking in with this doctor once a week. What happens if I get worse? No one would notice until my next appointment. I could also get much worse and not be able to look for work at all.

What if I get a job or meet someone I like while on them? I won't be sure they like me for me, since I'll be medicated. And, if I feel better, will I be lulled into a situation that isnt right for me?   If I have a better attitude, will that stay or will I get a job, seem Ok and then crash?

What if they dont work at all or I dont adjust well to feeling better? And, how can I really feel any better if nothing external changes for me? That would almost seem delusional to feel better while everything else in life is a mess.

Anyway, at this moment, I want to email my contact there and say thanks, but no thanks. I am scheduled to start the meds tomorrow, but I am filled with so much doubt and anxiety, I am afraid to start. I just dont think its right for me.

Please post as I dont know what to do. Thanks.

[Hopalong]

Hi Ales,

A quick gut response I have is that your flood of scary questions is the anxiety talking.

I was prescribed anti-Ds when my anxiety was out of control and they helped tremendously. I took them on and off for years. Now, I've been off them for several years. I am older.

You are not static. If you choose to take them, you always have the choice to stop.

The other thing I can say is, remember: You do not have to take them forever. You could choose to take them for now.

Personally, I think you deserve some relief.

I don't think anti-Ds ruin people. When I first took some Rx for mental/emotional illness...I distinctly remember having a "lightbulb" moment about my previous refusal.

I had the thought, "I am tired of being a hero."

(In my own mind, it had been heroic to suffer. To tough it out.)

In a simpler society, with such acute anxiety and pain, a healer would prescribe roots or herbs for you.

These Rx, for all their faults and misuse...are our herbs.

Good luck with this decision, and whichever way you decide...be kind to yourself.

Hops

[sKePTiKal]

We can't know the unknown, Ales -- ahead of time. No one can say for sure how you'll feel, what will be better or what worse, or if you won't notice a difference at all. That's kinda the beauty of the fact that we're all unique. The "you" that you think/feel you are is allowed to change... even for YOU. I had to learn to not be afraid of that. (OK, I'm still learning...)

I relate to your anxiety (have my own flying monkeys) about whether you'll still be and feel like "you", after the drug begins to take effect. That's exactly how I feel about finally quitting smoking. What if I become a flaming bitch and the trade-off for not smoking is that I alienate my small, but growing network of friends and family??

On the other hand - you KNOW exactly how you feel right now, and from your inquiries into the study it would appear that you at least are curious about whether you would be one of those helped by this drug. Knowing what you know about you - now - do you expect improvement to just "happen"? Or, are you willing to dedicate serious effort to change, on your own? I'm talking an all-inclusive obsession with "getting better" and healing. Can you really afford that? What are the cost/benefits of that, versus a short-term run of a drug that would appear to have some possibility of helping?

IF - one of your main goals right now is employment... and you feel your anxiety is what is getting in the way... and you have inquired as to whether you might receive a benefit in this area, from the docs doing the study (I would think you'd want some hope from them, that their drug would help you -- as a condition of participation; not a guarantee... just a probability or liklihood)... then, it's time to ask them whether you have the option to stop at any point in the process.

IF you decide to go ahead and participate, for your own sake - journal each day - specifically about the drug and any changes you notice. The journal can become your "bread crumb" trail... like Hansel and Gretl... it will reflect back to you how you feel, whether you feel "out of control", or better... and the anxiety receding... confidence building... you need that kind of data to feel comfortable, I think -- I know I would!! I think most of these drugs take a week or two to really build up and become effective in one's system... so the journal should capture the slightest change, don't you think?

Or start a thread (or use this one)... to check in with someone every day. I know you want to feel "safe", kiddo. I know I would!! I would think that the folks doing the study would also be interested in protecting your well-being and would need to monitor that on a daily basis to detect (early) any changes... and intervene for your safety, at the earliest point possible if something goes awry. When a system like that is in place... then the decision is simply a personal one:

try it and maybe like it.... or not...
but you'll never know unless you try it...

there are non-drug options to managing anxiety; I've learned a good many of these... but even after years of practice, I still have my meltdown moments... I've simply accepted them and my hubs has learned how to help me and what the warning signs are. Over time, they are less frequent and less intense. But it doesn't seem as if you have the luxury to wait on "slow change". Let us know what you decide to do!

[Lollie]

Hi, Ales.

One more question, and my apologies if this makes you anxious: What if you get the placebo?

It sounds to me like you are a bit more open to taking meds. Would it be out of the realm of possibility to talk to your T, then find a Pdoc, and have your meds prescribed and monitored the "old fashioned way"?

I'm not sure what the value of taking part in a clinical study would be...unless you're feeling pressured by your friend?

Just a thought.

Wishing you some peace,
Lollie.

[Ales2]

Hi Lollie -

To answer your question - there is no placebo. Patients get one of 2 actual FDA approved meds - because they are testing something else. I'm being monitored through blood tests and other objective indicators (for study confidentiality can't say what) but it was the major enticement to me since they are looking at more than mood and self reporting. Cant really talk to my T anymore, I think that door is closed now.

Thanks so much Hops and Phoenix for the thoughts. I agree w/ you Hops, I could use the relief and like Phoenix said, I can try it. I can drop out of the study if it doesnt go well and its only 8 weeks. Maybe not even enough time to see if they will work for me.

Thanks for the responses. I decided to do it and will start today.

[Ales2]

I guess what I am really afraid of is that it wont work and that my problems are insurmountable and I should just accept this as who I am. Some people are meant to live happy and well adjusted lives and I am just not.

[Ales2]

Went to my check up appointment. They do several tests including an interview that was painful. Its hard for me to verbalize my feelings of despair and hopelessness. It makes me feel worse. Its like reopening a wound each time I go there. I wonder how the wound is supposed to heal (I guess thats what the medication is for). I come home feeling drained and its almost like the label of "depressed" makes me feel worse.  I just want to go lay down.

[Hopalong]

it's not a character judgment, really!
Docs don't feel the weight of the label, but just try to think of it the same way you would when a mechanic starts using scary (expensive) words like "transmission">

Years ago, it'd have been called "melancholia".

It's part biochem, and maybe part sanity. You know?

Don't fixate on the word, focus on being opening to the possibility of feeling better.
(And most SSRIs, as I recall, take about 6 weeks to reach effective blood levels...so, patience will help...)

Maybe in about 6 weeks you'll wake up one morning and NOT feel like attacking yourself.

Then you'll know it's helping!

love,
Hops

[sKePTiKal]

Its hard for me to verbalize my feelings of despair and hopelessness. It makes me feel worse. Its like reopening a wound each time I go there.

Well. Of course it makes you feel worse! You are absolutely correct that you are re-opening a wound. This all by itself, does help drain some of the toxic stuff out of the wound. But it's not enough, really. You need the antibiotic; the compassion, the caring about you and how you feel... before the wound starts to heal from the inside out. It's like a nutritional deficiency... like when people crave vitamin-c rich foods... only it's an emotional deficiency. You crave the connection, caring, and ability to rely on another person to care for you...

you need this antidote which has no known physical interactions or side effects in conjunction with whatever chemical cocktail they've given you.... with or without the chemicals, this antidote works -- over time. There is no known "instant gratification" mind-changing substance to (guaranteed) make you "feel better" except maybe laughing gas. You can safely seek this "antidote" at the same time, to help supplement and kick-start the drugs... and perhaps after the study and drug is over, continued seeking and obtaining this emotional nutrition over time will "cure" you.

Here's a sample:

((((((((((((((((((((((((((((((((((((((((((((Ales2)))))))))))))))))))))))))))))))))))))))))))))))

It will be OK; it will be alright. Keep breathing!

[Ales2]

Thanks Hops and Phoenix.

I just got back from my check in/interview in the depression study. I'm in week two and I'm pissed.  Here is wh:

I asked about my belief that people have set happiness/depression set points - i.e a genetic factor that makes them what they are. So, I asked if they were doing the genetic testing, would I get to find out my own results. Evidently NOT.  It was explained to me that I am known as a research number and no feedback is given. I'm pissed. I feel EXPLOITED. What is the point of my participating in the study if I can't learn about myself? Oh, yeah, free medication.
Did I say I feel EXPLOITED.

I was frustrated because my interviewer didnt seem to understand that I'm 43 and have a longing to have my own family. Not having a family is basically a life half lived. I'm terrified to go back to work because my life will be out of balance again and it doesn't solve my weekends and holiday loneliness.


Anyway, I doubt this stuff is helping at all and I am ready to quit the study. I feel very much that its my mistake to have my wellbeing and happiness into an outside source again.  I'm going to wait until next wednesday when I have to go back, but will probably quit the study. I dont see how it can possibly help me.

[sKePTiKal]

I was frustrated because my interviewer didnt seem to understand that I'm 43 and have a longing to have my own family. Not having a family is basically a life half lived. I'm terrified to go back to work because my life will be out of balance again and it doesn't solve my weekends and holiday loneliness.

Hi Hon...

Maybe the drug isn't going to effect any of these things you listed. Directly. Maybe indirectly - one thing leading to another - that's still a possibility... it's just impossible to predict the future, so I wouldn't bet the farm on it.

I do see that you have gotten a benefit, though. In that the list above is a real clear statement of "what you want". Damn, girl! You're allowed to want what you want! And knowing what that is, is half the problem solved already. The other half is a lot of work, some luck, and plain old chance.

Be careful tho'. It's kind of a mental trap to say - "I can only be happy IF _________." I could debate the validity of the idea that a family is absolutely necessary to a full life, too. (But, if it's what you want... ask yourself: what's STOPPING you? What are the steps to getting there?) And I admit, I don't understand how working will put your life out of balance. Can you explain that in some more detail? I know from experience, that working has been a great way to develop the kinds of relationships that spill over into off-hour friendships, romances, etc. Both hubs and I have lots of friends from "work" - though we haven't worked for a year or two now - that we still see and enjoy being with. I met my last 2 husbands through jobs I worked... including the current one. Even ex #2 was a long term relationship; it revolved around parenting since we did the "Brady Bunch thing" - his and my kids.

It sounds as if you were expecting help from the study and the researchers. I guess there was some lack of or miscommunication about what to expect for the duration? I can see why you're upset with them. I'd feel that way too if I was allowed to hope that participation would bring me a great benefit very quickly. However, it might be too soon to tell how the drug is/or will affect you... didn't someone say that it could take 6 weeks for it to build up in your body/brain?

Are you having any negative effects from the drug? Or something that you can't explain at all? Like sleeplessness, sleeping too much... etc?

I'm real sorry that you aren't getting any specific info about yourself from being a participant. I hear you and your desire for real help. Maybe you could try to find a therapist to augment and support and help you deal with (any) effects you might have from the drug? To do what being in the study isn't going to provide. And I'll share what I recently read about DNA and emotional/psychological/neuroscience stuff: your DNA (especially brain) itself can adapt and evolve in response to your environment. Genetics is no longer considered a "life sentence" or unchangable. (That said, it takes a long, long time and a lot of work... and being lucky and having other help, doesn't hurt, either!)

I wish there was something else I could do, Ales... other than just play devils advocate here. I'm just trying to feed back some of what I'm hearing you say... and show it from another perspective. Maybe that'll help find the answers you want. (I can only hope so). I am listening... so keep venting! And here's another hug for good measure...


(((((((((((((((((((((((((Ales2)))))))))))))))))))))))))))))

[Ales2]

I'm going to quit the study. It wont help. Thanks for the advice, Phoenix.

[Hopalong]

Hi Ales,
I thought I posted this but mebbe I goofed.

I am sorry to hear you're quitting so quickly, before blood levels have a chance to change and affect your depression.

Your thought is a pre-determination that you cannot be helped... If so, you might be right.

On the other hand, your thought might be the depression talking (the voice or thought patterns of depression itself can sabotage new paths, or healing).
Your thought, "It cannot help me" -- especially so early in -- could possibly be incorrect.

I don't know.

It's hard to think of a "thought pattern" as an actual symptom (rather than ideas me-myself am rationally generating).
That realization was a revelation to me in reading about alcoholism.

Later, I realized the exact same thing is true for some thought cycles in depression. Some thoughts are more symptom than reasoning.
In clinically real depression -- I found that my own ruminating negative thinking was often not helpful -- or, as it turned out, accurate. (Not that ALL my thoughts made no sense, but that the symptomatic ones that actually impeded/blocked/irrationally ruled out possibility--were mixed in with the "smart stuff".)

Perhaps the SSRIs (with or without data you have decided you must have to receive benefit from participating) could -- might still -- be a way of detouring your depressive symptoms to some relief.

The objective thing I'm thinking about is that quitting before there's a biological chance for them to affect you means you choose not to give your body/brain a chance to find out.

It is certainly a free choice. I might make the same choice if I were you. But I wonder if you'd like to analyse that thought (It cannot help me) one level further. Simple as the thought sounds, it does have more than one meaning. Perhaps, it might help you to look at that specific thought more closely:

I am choosing to quit. It is my free choice.
This choice is also reflecting, in addition to freedom, the fact that I am not willing to give the SSRI time to affect me.

versus...
It -- the study, an external thing -- I will think about as another example of something letting me down, crushing hopes, proving to me the accuracy of my (depressive) belief that I cannot be helped.

In the "I choose to quit" example above, freedom is critical.
What I propose is that you invite yourself to own (without any self-criticism) the second half of what it is. It's fine to choose not to give it time. You absolutely can decide that. But not wanting to give it time (or endure the waiting) is a different reason than, "I already know what the outcome is."

I already know what the outcome is the thought that sounds to me like depression talking.

Do you think there is a possibility that you have closed the door on something for yourself?

Sending strength,
Hops

[Ales2]

the only good thing so far is that i have absolutely lost my appetite and any interest in food at all. it makes my existing insomnia worse. not sure how long  can stand that.

hops - i will answer your post next ....

[Meh]

Ales2:

My opinion is that one has to take research studies with a grain of salt. Typically they are collecting data eventually into aggregate form (no faces, no names). Research is very statistical and impersonal. The published results of the study will inform future treatment methods, the goal is to collect data not to cure you. I'm sorry for saying this, it just sounds as if you have put a large amount of hope in the results of this study on your personal situation when usually they are trying to extract something very statistical and broad in nature, it's probably not a substitute for individual treatment.   IMO

They do entice people because it's how they get compensated. People need to think there is a reward.
Some people get involved in research because they want to further knowledge and that is probably the most reasonable expectation to get out of a study is to know that you have contributed to an increased knowledge base on a subject.

PS:

You stated that the medication has been researched and now they are looking at a different aspect (not the efficacy of the meds) with the particular study your in.

I guess you just determine how long you are willing to try out the medication and then decide if it is working for you or not.

I tried Prozac long time ago, Paxil, Wellbutrin, Zoloft.
Now I am not on anything because I'm pissed off! But that's just me. The Wellbutrin worked the best for me so I did take that for a number of years and it helped me through my workaholic years. The main result that I noticed was that I got more tasks accomplished but it didn't make me "happy" just more productive or focused.

Trying to find help and figuring out what the "right" help is has been very frustrating for me also. Wish you better luck.