Pain, Depression, and Reflux

Terri Said:

Anyone have experience with ECT?

We Answered:

I have had numerous Major Depressive Episodes in my life, along with chronic refractory depression and PTSD. You are indicating BPD which, while having a genetic component to it, also includes early childhood trauma. My PTSD is both chronic and complex and started with early childhood trauma, the memories of which are, for the most part, repressed (psychogenic amnesia). I found that by dealing with the emotions I felt in relation to the trauma, rather than worrying about trying to remember the traumas, I was able to release the energy that the traumas caused. As a result, my depression lifted. I do not have personal experience with ECT. I have known a number of people with bipolar (mainly depressed) for whom the ECT restored balance and then they were able to deal with other issues. A support system is extremely important. It can include professionals, neighbors, etc. If you enter a residential treatment program you will be assigned a case manager (Social Worker) to help you. You might also want to consider going to www.mentalhealthrecovery.com and use Mary Ellen Copeland's WRAP (Wellness Recovery Action Plan) to help you in your recovery. Contact your local Mental Health Association or Depression and Bipolar Support Alliance chapter for assistance and support, including a Certified Peer Specialist in Mental Health Recovery.

Russell Said:

I recently read an article in which a woman was taking small amounts of opiates to treat depression. It was in

We Answered:

There does appear to be some basis for this in the research, although I admit I am unfamiliar with it myself. Your question sparked me to begin some research on it and I found several links to studies where it appeared to have quite successful outcomes (I was impressed by the dramatically decreased scores on the measures used which were more dramatic than is often seen with typical anti-depressants). If you are considering this as an option, you may wish to print out some of the articles listed below to take to your doc as this is certainly not standard practice, but merits exploration if all other standard treatments have been attempted and failed.

http://opioids.com/antidepressant/opiate…
http://opioids.com/antidepressant/opiate…
http://opioids.com/antidepressant/depres…

The last article was especially interesting in that it suggests a link between cortisol and depression and makes me wonder about the subgroup of non-responders and whether or not they had a trauma history as excessive cortisol is associated with trauma and long-term can produce some very damaging effects. Hopefully it may stimulate further investigation by your doc who may be better able than I to explore the neurobiology.

Added: I would be very interested in the Ultram trials and i will check out your other question. This really sparked my curiosity and I am greatful for having seen the question and begun to research it. Please keep us posted as to how you make out with your doc and what your experience is like if you pursue this course of treatment! I don't post my email here for multiple reasons, but I would be interested in the info on Ultram trials and wondered if perhaps you could post the info in your question details? I will also let you know if I find further info for you in the Psychopharmacology Update which I subscribe to.

Benjamin Said:

is there anyone else out there suffering from treatment resistant major depression?

We Answered:

I too suffer from TRD, since early adolescence, but undiagnosed until my late 30's.
I am now 45 and am considering VNS therapy as a hopeful relief of continual symptoms to improve my quality of life.
I am responding better to tricyclic antidepressants, more so than any of the other dozens of medications I've tried, yet it is certainly not a "cure" for the illness.
I have also sought individual and group therapies, as well as DBT therapy.
Also, hospitalization, and partial hospitalizations, as well as various outpatient services have helped me cope with my ongoing illness.
Having understanding, loving support from friends/ family is also crucial.
I wish you relief soon.

Loretta Said:

Suicide is a permanent solution to a temporary problem?

We Answered:

what was your question again?

Edwin Said:

Who can help me with possibly a deadly situation?

We Answered:

If you are on a regular high dose fentanyl, you might look into the fentanyl patch (brand name duragesic). It is changed every 72 hours. You might be able to use a lower dose of the patch since it is constantly absorbed through the skin (for long term pain), then find a small dose of pain medications that you can take for breakthrough pain as needed.
I would talk to your healthcare providers about the medications you are taking in general. If you are on a medication that caused a grand mal seizure, you might need to find something that would work for you, but not have that side effect. Do you normally have seizures w/o the anti-depressant?
Getting a second or even third opinion might be beneficial to see what other treatment options are available to you as well. One doctor might suggest a medication or treatment you have never heard about, but are willing to try.
Good luck to you.

Jennie Said:

Depersonalization episodes?

We Answered:

I'm on Effexor for treatment resistant depression and Neurontin (gabapentin) for PTSD and anxiety disorder. I also take 50mg of Trazodone at bedtime (it is an antidepressant with the side effect of sleepiness).

Neurontin works well for depersonalization. Zyprexa (Olanzapine) is stronger and works too, also marketed as Zalasta, Zolafren, Olzapin, Rexapin or in combination with fluoxetine = Symbax. These are called a-typical antipsychotics.

Hope that helps. Good luck.

Lillie Said:

Has anybody had any success for treatment resistant depression/anxiety on Lithium Carbonate?

We Answered:

I suffer from major depression and anxiety too, so I know a lot of what you are going through. When lithium carbonate is used for depression, it is usually used to augment the effects of an antidepressant. For example, one might take celexa plus lithium, but not lithium alone. However, as you probably know, we all react to psych meds differently. The only way to know for sure if lithium will help is to try it.

I tried lithium when I was on a bunch of meds, but it made things worse rather than better. So my doctor stopped the lithium in about about 4 to 6 weeks.

We are in a similar boat. I am seriously thinking of stopping all my meds, except for Klonopin. First I am addicted to it and, second, I need it to sleep. So I congratulate you on your success with stopping the meds, especially the benzos.

I also went through brain scans and they couldn't find anything wrong. However, brain scans are mostly useful for detecting major problems like brain tumors.

In the last two years, I have improved a little when I started taking Lamictal (a mood stabilizer) and Abilify (an anti-psychotic). I am not suggesting these exact drugs for you. However, if you decide to go back on drugs, find a shrink who does a lot of research and thinks outside the box. Mood stabilizers and anti-psychotics may help you more than antidepressants.

Someone recently suggested EMPowerplus to me, a vitamin supplement allegedly useful for mood disorders. You are supposed to slowly taper of your meds, while increasing the EMPowerplus. You might look into this: http://www.truehope.com/default.aspx. Also check out EMPowerplus on youtube.com.

Please note: I have only been trying this product for 3 weeks and have not noticed any difference. So I am not recommending this to you, but it is something you might (or might not) consider.

You can email me if you have any comments or questions.

EDIT: My most potent antidepressant is exercise. You might consider starting with a little each day and working your way up. Try to join a health club or go to classes. It is very hard to motivate yourself to exercise when you have to do it alone.

Have you tried therapy and stuff like that?