long post/reflection on meds ahead...

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almeda24fan said:
I would never judge you for your stance on taking meds. In fact, I have an aunt that swears up and down that my ADD is made up so drug companies can make money.

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I want to be clear that this is not my belief at all. I believe that meds can help many conditions. But just because I think that there are non-pharmaceutical interventions that can help as well, does not mean I believe that the conditions do not exist.

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almeda24fan said:
Actually, I don't disagree with this statement about depression meds being handed out like candy basically.

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I just want to clarify that I never said this, and I do not believe this. My one experience going to a doctor and asking for a psychotropic med (for anxiety, not depression) was not like this. I told her my symptoms, felt she carefully considered them, we discussed them, she suggested several meds, and I chose the one that was most acceptable to me. I never felt like my prescription was handed out like candy, and I guess I expect that other doctors also take similar care with their patients. But maybe you have had a different experience.

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almeda24fan wrote:
Have you told your current T how staunch against meds you are?

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I am not staunchly against meds. For example, I routinely take antibiotics to combat a chronic infection I have. Modern drugs can be amazing. True, I gave birth to two babies with no painkillers or anaesthesia... But seriously, the whole AD med thing with me traces back to my first session with my first counselor, when I was in crisis and devastated in my personal life, had been depressed for at least several years, and was at the point of not functioning. I asked her about anti-depressants, and she was very judgemental and negative about them, and basically didn't want to work with me if I was going to take them. I felt really cowed by her response. It had taken just about all I had to arrange this appointment with her and drag myself to her office, so I was not able to dissent and just agreed to try psychotherapy only. Well, she was pretty much plain vanilla CBT (although I didn't know what that was at the time) and went after the symptoms of my depression rather than the root causes. And dealing with some of my symptoms, by fighting hard to get more sleep, building support systems, and relieving some of the dissonance in my life, did help me feel better, and I am grateful to her for that, but it didn't cure my depression. After 6 months of working with her, following all her advice, and still being depressed, she says to me one day that she thinks I should try anti-depressants. I was very angry about that. She tells me when I really was desperate that she won't work with me if I take ADs, then when I am somewhat better and not in such great need, she says go take them? I felt like, where was this suggestion when I really needed it??? I felt like some lab rat in pain that she had experimented on and only after her CBT-only experiment went awry was she willing to consider meds. I can be very stubborn, and there was no way I was going to take ADs after she said that. I was committed to not using meds because of her, and I did not understand how she could so nonchalantly reverse her strongly held philosophy on this. She gave me the name of a pdoc on a piece of paper, I took the paper and thanked her but never said I would go see this person, and then we never mentioned it again. Eventually I stopped seeing her, took a break from therapy, and then found my current T when I was ready to resume. Within about a month or two of starting to see him, my depression was cured. He was willing to work with the root causes of my depression (for example by using techniques such as EMDR) and so we were able to make rapid progress. (((((hugs))))) for my T. (When I think back on that, I see it is no wonder how strongly attached I am to him since he helped me step out from under this depression cloud that had hovered over me for years. When someone does that for you, you just want to lick their feet. )

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almeda24fan wrote:
doctors should focus on what medical conditions can mirror depression like hypothyroidism, run some blood work perhaps and rule some conditions out. I'll stop here because I don't want to offend anyone for their choice. But I understand what you are saying.

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My own belief is that all of depression is biochemical. I don't understand when people say some depression is situational and some is biochemical. One day I went to see my current T and told him I had been depressed the last week (we all have our relapses), and he asked, did I think it was hormonal, biochemical, or situational? I looked at him, the rational/analytical scientist/biochemist looking at the touchy-feely therapist (probably like how can you say such a dumb thing, lol) and said, "all depression is biochemical." He thought about that for a few moments and said "you're right." (I never understood what was his point in trying to distinguish these 3 "types" of depression anyway.) Hormones are biochemical molecules, so too much or too little of certain ones can certainly affect our mood and cause depression. In our lives we have situations that make us depressed (perhaps a hopeless, failing marriage, the death of a child, anger and grief that has been repressed for years, etc.) but they make us depressed via bio-molecules in our brains. That's how our mood is determined. Sure, we can mess with our neurotransmitter levels by taking drugs, but we can also deal, in therapy, with some of the root causes of those levels of molecules in our brains. This is what I chose to do. So yes, of course, it's all biochemical, but I can and did work on changing my biochemistry through other means besides drugs. I know this doesn't work for everyone. (Now if I had a genetic mutation/variation that made my serotonin transporter extremely efficient, for example, the therapy approach would probably never be sufficient and taking an SSRI would be very, very helpful. Someday in the not too distant future we will all know what genetic variations we carry, and choosing the most effective treatments for many conditions will be a lot easier.)

For those interested in the brain and addiction, there's quite a good article in the July 16 edition of Time Magazine, and it has some great graphics on neurotransmitter action in our brains (focusing on the dopamine neurotransmitter):