Psychological side-effects of anti-depressants worse than thought

[peggy-sue]

Thank-you so much for your lovely post, @taniaaust1
I'm sorry to have caused you difficulty in replying so kindly.

I do feel really detatched from it all, it is just a practical sort of working things out for the worst case scenario.

I'm aware that the antidepressant combination would be horrible and not neccessarily successful. I just happen to have them. I don't want to use them at all, even if I ever did really want to use something, which is why I've been looking at other methods.

I have strong feelings about the right to die with dignity at the time of our own choosing. I don't ever want to be stuck in a "care" home.

@Hip, I'm so sorry you've been through total anhedonia. Nobody who hasn't been there can possibly imagine how bad it is. Thanks for the empathy and advice.

 

[A.B.]

@peggy-sue

Persons taking Celexa (citalopram) may be more likely to think about killing themselves or actually try to do so, especially when Celexa is first started or he dose is changed. People close to persons taking Celexa can help by paying attention to changes in user’s moods or actions. Contact your healthcare professional right away if someone using Celexa talks about or shows signs of killing him or herself. If you are taking Celexa yourself and you start thinking about killing yourself, tell your healthcare professional about this side effect right away.

http://forums.psychcentral.com/meds/celexa.html

 

[peggy-sue]

Perhaps this is just me, but I don't really see what the fuss about suicide is.
If somebody would rather not live any more, surely that is their right?
Forcing somebody to endure a life with anhedonia is utterly inhumane.

Folk just can't put themselves in other's shoes for a wee while, they judge using thier own sets of beliefs, not those of the person suffering.

I'm not planning to do anything now or in the near or far future, I have Michael to consider...
I would have to be suffering far more than the grief he would have in order to do it seriously.

Mentioning it to my gp is not on the cards. I may need him to prescribe something I might need in the future.

 

[Hip]

From my own experiences of having constant suicidal ideation every hour for several years, caused by severe anhedonia, I got the impression that suicidal ideation is a kind of build in mental behavior or instinct, not a reasoned thought process. Just as the cells in our body have a built-in suicide program (called apoptosis) that gets activated in certain circumstances, I distinctly got the impression that the mind also has a built-in suicide program that gets automatically activated when you suffer from severe anhedonia (severe anhedonia = loss of all pleasure and reward in life, which is a void-like state of existence).

I was able to notice that my anhedonia-driven suicidal ideation did not appear out of a reasoned decision process, but rather appeared as a deep instinct. Just as a healthy mind may feel erotic instincts naturally arising in the right circumstances, it seemed to me that an unhealthy, anhedonic mind may automatically and instinctively feel suicidal ideation. In other words, suicidal ideation may be a built-in mental program of the mind, just as apoptosis is a built-in program of the cell.

Freud coined the term "death drive" (Thanatos) to describe these suicidal ideations, and contrasted it to the life instinct (Eros).

When you actually feel this intense suicidal ideation, none of this intellectualizing of the situation really helps much. It does not change the dire state of anhedonia. And it does not change the overriding instinct of suicidal ideation, which as I say does not appear to be a product of the intellect, but seems to be an instinctual response built into the brain. No amount of intellectualizing will remove any of the sheer hell of anhedonia and the suicidal ideation that is frequently precipitated by it; though intellectualizing and reasoning may give you enough perspective to override your suicidal ideation instincts.

Fortunately the several years I had of intense constant suicidal ideation are over (as a result of very low dose amisulpride and I believe the anti-neuroinflammation supplements I take); but this horrible experience left me with certain insights into the mental processes of suicidal ideation. It made me realize that every human being is critically dependent on the little pleasures and rewards they get from their ordinary daily activities. Little pleasures that mentally healthy people are not even aware they are experiencing on a moment to moment basis. You only become aware of these ordinary daily pleasures if they are taken away from you.

But once those ordinary little pleasures are taken away as a result of anhedonia (which is where your brain's pleasure circuits are dead), it seems that a suicidal ideation can automatically appear.

 

[peggy-sue]

I don't really feel any need to intellectualise it,
I do understand why folk want to do it; I don't understand "society's" revulsion to it.

I don't have very much respect for Freud, I'm not a dualist, so do not dissociate the "intellect" from emotion.
Emotions drive everything, including the reasoning of the so-called "mind" or intellect or whatever you want to call the conscious wordy sorts of thoughts you have.


However,I cannot agree with you more on this point.
"It made me realize that every human being is critically dependent on the little pleasures and rewards they get from their ordinary daily activities. Little pleasures that mentally healthy people are not even aware they are experiencing on a moment to moment basis. You only become aware of these ordinary daily pleasures if they are taken away from you."

Exactly!
It's the teeny-tiny everyday things that make life worthwhile.
Somebody smiles at you, you get a lift.
Somebody scowls, you feel a tiny bit of apprehension.
Normal folk are up and down like a yo-yo, all day long, every day.
And they don't even notice.

 

[Snowdrop]

@Hip

I agree with your post #24.
But in a perverse way.

I think of it as an extreme response either way. What I mean is as A.B. pointed out how can people who have been given a drug and respond with what seems to be depressive symptoms say they feel better? The drug gives them relief from their feelings. The withdrawal and numbness are a relief from intense feelings that are causing pain.
If you feel too much and are too attached too negative feelings it can in the extreme cause suicidal thoughts but also the reverse. If a drug is too effective at blocking out feelings so that one is left in a profound void it goes beyond relief to a new state of loss. The void of which you speak.

Or so is my opinion.

 

[peggy-sue]

The antidepressants get you out of the void of anhedonia. You do get feelings again.

Anhedonia, the utter deepest pit of depression is no feelings at all. Not even bad ones.

And we have to remember that symptoms (just like laws) are arbitrary, human constructs.
Depression is depression. Those who have had it know what it is.
Those who haven't had it, haven't a clue, they are the ones who need words and "symptoms" to try to understand it.

 

[Hip]

@Snowdrop

You are mixing up depression and anhedonia. Anhedonia is often a sub-symptom of depression (and anhedonia is also often a sub-symptom of schizophrenia); but depression is not the same as anhedonia. I have had both clinical depression (without anhedonia), and anhedonia, at different times, and I can tell you that there is world of difference.

My clinical depression involved terribly strong emotions of sadness, and huge loss of self esteem. I went through 2 years of such clinical depression (and I avoided taking antidepressants, because my depression was precipitated by life events, not some aberrant biochemistry, so I felt that in some sense, my sadness and loss of self esteem were appropriate responses).

By contrast, anhedonia (= loss of pleasure) and the phenomenon of blunted affect (= loss of emotions) that often comes with anhedonia, makes (non-anhedonic) clinical depression seem like a luxury!

I would swap my anhedonia for clinical depression anytime! At least in (non-anhedonic) clinical depression you can still feel things, you can still feel emotion and pleasure. You feel intense sadness and loss of self esteem when you have depression, but feeling anything, even negative emotions, is infinitely better than feeling nothing, the void of total nothing, which is what you get in anhedonia.

Anhedonia is just one of those things which you have to experience yourself before you can understand it.

 

[peggy-sue]

Absolutely. There are no words to describe it, nothing could convey the absolute agony that that nothing is, no imagination could ever come close to it. It really does make suicide a very reasonable, logical and humane option.

 

[robinsonsb]

@Hip, I was reading an old post by you (2012) about the efficacy of small doses (12.5 mg) of Amisulpride helping with depression and irritability. I have been suffering severely for so long with both of these. At the time, this drug was only available in Europe, I believe. I have two questions for you:
1. Do you still feel it is efficacious for improving mood and motivation?
2. If so, do you know how one might go about acquiring this medication? (I believe the old post said something about getting it from "the usual sources" in Europe, but that means nothing to me.)

Thank you very much for all of your informative posts.

 

[robinsonsb]

@Hip, never mind. I just noticed your "treatment protocol" link, and I went to it. Thanks for sharing your knowledge and experience.

 

[Hip]

@robinsonsb
To answer your question anyway: (1) yes, I still take 12.5 mg of amisulpride each day, and it still helps my depression, irritability, and many other symptoms. See this thread for amisulpride info. For the various potential causes of irritability, see this thread. (2) You can buy amisulpride from the pharmacies here and here.

 

[Martial]

@robinsonsb
To answer your question anyway: (1) yes, I still take 12.5 mg of amisulpride each day, and it still helps my depression, irritability, and many other symptoms. See this thread for amisulpride info. For the various potential causes of irritability, see this thread. (2) You can buy amisulpride from the pharmacies here and here.

hip I can relate so much to everything you said lol, I also went through a clinical depression, severe anxiety with 6 hour long panic attacks a day, and severe anehondia with suicidal impulses and ideation.. The severe emotional blunting of anehondia along with the severe de personalization and hallucinations was really fricken brutal, the depression was from inflammation of lyme disease and the anehondia and hallucinations were from a later stage of it.. Definitely one of those things only people that go through it understand.

I also know exactly what you are talking about with suicide being a kind of programming and here is a video from a friend who explains all of this perfectly actually!

 

[robinsonsb]

@robinsonsb
To answer your question anyway: (1) yes, I still take 12.5 mg of amisulpride each day, and it still helps my depression, irritability, and many other symptoms. See this thread for amisulpride info. For the various potential causes of irritability, see this thread. (2) You can buy amisulpride from the pharmacies here and here.

Oh, @Hip, I am nearly weeping with gratitude for your incredibly helpful information. I will order some amisulpride today and start with a very low dose. I'm also going to try the trifecta of NAG, tumeric and flax seed oil that has helped you. At the moment I'm just trying the simplified methylation protocol that Rich Van Konynenburg had recommended in 2011 because I learned that I do have a homozygotic mutation for the MTHFR gene (or SNP). (I dont' know squat about gene language.) I'm very late trying this because I took a sabbatical from trying new treatments for 2 or 3 years. Just so tired of searching, searching, searching and paying, paying, paying for new protocols.

I'll read the threads you gave me links for and hope to find out if amisulpride causes people to gain weight. I have been helped by 10mg of amitriptyline in the past, but, man, I gained 10 pounds in a month when I tried taking it daily. So now I only take it when I'm absolutely desperate for sleep and can afford to be dopey the next day.

Again, thank you SO much!

 

[robinsonsb]

hip I can relate so much to everything you said lol, I also went through a clinical depression, severe anxiety with 6 hour long panic attacks a day, and severe anehondia with suicidal impulses and ideation.. The severe emotional blunting of anehondia along with the severe de personalization and hallucinations was really fricken brutal, the depression was from inflammation of lyme disease and the anehondia and hallucinations were from a later stage of it.. Definitely one of those things only people that go through it understand.

I also know exactly what you are talking about with suicide being a kind of programming and here is a video from a friend who explains all of this perfectly actually!

Thanks for your post, @Martial. I'm encouraged that you can lol after such a dark journey. I'm glad you mentioned hallucinations. Yes, it's brutal. And life-sapping. I've been tested twice and apparently don't have Lyme, but I do have fribromyalgia and ME/CFS. And none of the SSRIs or SNRIs seem to help me now. Thanks too for posting Mystic Girl's video. I'm going to share it with a friend of mine. I think my own spiritual journey is the reason I'm still here. And I have received many gifts from being disabled--things like compassion, humility, the ability to receive, the ability to be present for life as it is. Big gifts I would never have received when I thought I was running the world. I'm not lol, but I am smiling at the thought that I ever thought I was running the world!

 

[Martial]

Thanks for your post, @Martial. I'm encouraged that you can lol after such a dark journey. I'm glad you mentioned hallucinations. Yes, it's brutal. And life-sapping. I've been tested twice and apparently don't have Lyme, but I do have fribromyalgia and ME/CFS. And none of the SSRIs or SNRIs seem to help me now. Thanks too for posting Mystic Girl's video. I'm going to share it with a friend of mine. I think my own spiritual journey is the reason I'm still here. And I have received many gifts from being disabled--things like compassion, humility, the ability to receive, the ability to be present for life as it is. Big gifts I would never have received when I thought I was running the world. I'm not lol, but I am smiling at the thought that I ever thought I was running the world!

I have had a pretty dark life in some aspects of time but also plenty of good and fun times as well, though to be honest I am not that person anymore.. I don't even really have an internal processing or an "inner world" or "me" so to speak.. I am not even trying to sound spiritual or mystical lol, I even went to a psychologist who stated that he could even tell I was in a dark night of the soul, or in the state of the "unborn" similar to someone before birth, where the body is alive and moving but inside there is no "you".. Its literally walking in emptiness really interesting stuff but incredibly painful so to speak. My time with lyme disease pretty much wiped out the remaining pieces of the old ego state. I was very heavily into spirituality before coming quite ill with lyme disease and actually believe that the illness was also grace, a form of fierce loving grace.. To really eradicate any chance of a sense of self trying to rebuild or put itself back together.. Definitely Truth has also been my highest priority and I think for a lot of people that are chronically sick it is a wake up call to come back home and into reality ..

If your interested I'll link a really great E book called Way of Liberation by Adyashanti.. I think you would definitely enjoy it!

Wishing you well!

Todd


http://www.adyashanti.org/library/The_Way_of_Liberation_Ebook.pdf

 

[robinsonsb]

I have had a pretty dark life in some aspects of time but also plenty of good and fun times as well, though to be honest I am not that person anymore.. I don't even really have an internal processing or an "inner world" or "me" so to speak.. I am not even trying to sound spiritual or mystical lol, I even went to a psychologist who stated that he could even tell I was in a dark night of the soul, or in the state of the "unborn" similar to someone before birth, where the body is alive and moving but inside there is no "you".. Its literally walking in emptiness really interesting stuff but incredibly painful so to speak. My time with lyme disease pretty much wiped out the remaining pieces of the old ego state. I was very heavily into spirituality before coming quite ill with lyme disease and actually believe that the illness was also grace, a form of fierce loving grace.. To really eradicate any chance of a sense of self trying to rebuild or put itself back together.. Definitely Truth has also been my highest priority and I think for a lot of people that are chronically sick it is a wake up call to come back home and into reality ..

If your interested I'll link a really great E book called Way of Liberation by Adyashanti.. I think you would definitely enjoy it!

Wishing you well!

Todd

http://www.adyashanti.org/library/The_Way_of_Liberation_Ebook.pdf

Thanks, Todd!

 

[Hip]

I am nearly weeping with gratitude for your incredibly helpful information. I will order some amisulpride today and start with a very low dose. I'm also going to try the trifecta of NAG, tumeric and flax seed oil that has helped you.

Well that is a lot of gratitude!

Regarding the amisulpride dosage: you need to keep to the very low dose regimen, because very low dose amisulpride acts differently to higher dose amisulpride. I myself normally take just 12.5 mg a day (a ¼ of 50 mg tablet), and have never taken more that 25 mg a day. I would suggest that you don't go higher than 50 mg a day. This study on amisulpride for depression used 50 mg a day.

This is because at very low doses, amisulpride effectively activates dopamine receptors, but at higher doses, amisulpride has the opposite effect, and blocks dopamine receptors. This is why amisulpride is actually a different drug at very low doses compared to high doses.

I use the lowest dose amisulpride possible because amisulpride increases levels of prolactin, and you don't want to increase prolactin too much if you can help it.

 

[MeSci]

Perhaps this is just me, but I don't really see what the fuss about suicide is.
If somebody would rather not live any more, surely that is their right?
Forcing somebody to endure a life with anhedonia is utterly inhumane.

I don't have a fundamental objection to suicide and am very much in favour of voluntary euthanasia with appropriate safeguards.

But it is sad when someone takes his/her life, or causes him/herself permanent damage, when there is potential for him/her to get through the mental agony and come out the other side, as people often do.

I took a massive overdose in the early days of ME when my world was collapsing around me, I had complete anhedonia and was vomiting every day. I couldn't see any light at the end of the tunnel, and really wanted to die. It seemed very desirable - to end the pain. I don't know how I survived and didn't suffer permanent damage.

I spent a month in hospital with liver and kidney failure, at first aghast that I had survived. But gradually I regained my will to live - something I thought would never happen.

Oh - and I had resisted the suicidal urges until I took Prozac/fluoxetine - just for a few days before I could no longer bear the side effects and had to stop. It made me horribly wired, and even more unable to sleep than before. Even after stopping it seemed as though my willpower to resist suicide was reduced.

 

[robinsonsb]

Well that is a lot of gratitude!

Regarding the amisulpride dosage: you need to keep to the very low dose regimen, because very low dose amisulpride acts differently to higher dose amisulpride. I myself normally take just 12.5 mg a day (a ¼ of 50 mg tablet), and have never taken more that 25 mg a day. I would suggest that you don't go higher than 50 mg a day. This study on amisulpride for depression used 50 mg a day.

This is because at very low doses, amisulpride effectively activates dopamine receptors, but at higher doses, amisulpride has the opposite effect, and blocks dopamine receptors. This is why amisulpride is actually a different drug at very low doses compared to high doses.

I use the lowest dose amisulpride possible because amisulpride increases levels of prolactin, and you don't want to increase prolactin too much if you can help it.

@Hip, when I set about ordering amisulpride from United Pharmacies, the only type of payment they wil accept is an international money transfer from my bank or an international money order. No credit cards, PayPal, etc. I find that a little bit weird and just wanted to check with you to make sure this is legit. Have you done business with them this way? Thanks again! (I would ask this in a private message, but I don't know how to do that in this context.)