'As-needed' drugs for depression?

Hey everyone.

My question was this...I don't take drugs for my depression. It's cyclical, like I'll be depressed for a month or so then I'm not depressed at all, then anywhere from a week to months later it comes back. I think this is normal for those suffering from depression. Anyway, when I'm not depressed any longer, I feel like I'm the complete opposite of being depressed, and very happy with my life and the things in it (not bipolar though). But I do refuse to take medicine, and I think that's because I never want to be happy and have that happiness feel synthetic. I don't want to think 'Sure, I'm happy, but because I'm taking drugs to make me happy...' I want it to be real and know that it's ME feeling this way, not something ELSE forcing me to feel that way.

The problem is that my depression, as I'm sure most of you know who suffer from it, is...horrible. Last time was absolutely wretched - I think I was very close to doing something veryyyy stupid. I'm not me anymore, and it's the worst thing EVER. I cannot stand it and I fear its only going to get worse.

Ok - to the question: Is there anyway I can go on an anti-depressant when I'm feeling low, and come off it when I'm feeling better? And I mean in a week to month basis, not go on it for 2 years then come off it. I never know how long my episodes will last but I do know they eventually stop (atleast I know that now, when I'm happy). Now I don't have anything against anyone who takes AD's, I have family that does, but I just simply do NOT think they are for me. Any answers, thoughts? Thanks everyone.

(BTW - I've tried the other stuff to try and snap out of it like exercise, eating right, forcing myself out...none of that worked very well. Thanks!)

For a start I would suggest that you reconsider what you are saying ADs actually do.

You say it's 'synthetic' happiness - I disagree that it is just the drug making you 'happy'. If your depression is due to biological imbalance then you probably don't make enough serotonin naturally - the AD helps this issue, it doesn't just make you suddenly feel falsely happy ... It more 'enables' happiness to take place. If you aren't happy ADs aren't just gonna make you feel really happy ...

I am similar to you in that i am pretty anti-meds, in fact I am still in a do-i-don't-i phase myself. But also read the research (you probably have already?) that says if you take the course of ADs properly (I think it is 6-12 months for most people) then you are much less likely to relapse. I think this period fluctuates according to how many major depressive episodes a person has had, etc.

good luck with your decision

Dr unk. (((here))) Taking a medication for what it is prescribed for is a good thing...I think you know this. Some ppl might take, say heroin, for depression because it "takes them away from their problems." An anti-depressant isn't like that, because, as Dr Unksunflower stated... an "AD" replaces something your body isn't making (or using) enough of. People who are not depressed can take an AD with no real effect, I think...(might not be so true with the nifty new ssnri's.. IDK)

I'm not an MD nor pharmacist doctor (nor do I play one on tv )

Noone, imo, "snaps out of " true depression. Not everyone who suffers with depression cycles like you are ... I am wondering if you might be experiencing a hormonal shifting that is depressing your system. Estrogen and progesterone have been known to do that. If you don't wish to see an MD about that either, I would suggest you try natural nutritional supplements like Evening Primrose Oil, and see if, during those depressive events, that it helps smooth out the lows?

Good wishes with this. Mindset is important...to get through, imo. Good CBT has the same effect, btw, as medication for depression (at 6 months ) and better results longer term, I think. TC!

I personally hate when people refer to ADs as "happy pills".

They do not make my "happy"....but they do allow those around me to be "happy" if you get what I mean .

The meds also allow me to like myself........something that with my depression, is the first thing that goes.

I too recommend taking meds for more than a couple of months............I did the on again, off again med rout and when my depression returned (and it always did), it was worse and harder to treat........

It is just my opinon.....but I would really consider a longer period on the ADs.

Good luck and take care..

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Danialla said:



I personally hate when people refer to ADs as "happy pills".

They do not make my "happy"....but they do allow those around me to be "happy" if you get what I mean .

The meds also allow me to like myself........something that with my depression, is the first thing that goes.

I too recommend taking meds for more than a couple of months............I did the on again, off again med rout and when my depression returned (and it always did), it was worse and harder to treat........

It is just my opinon.....but I would really consider a longer period on the ADs.

Good luck and take care..

</div></font></blockquote><font class="post">

Yap as i posted in another thread my dr actually said that the reason he thought mine kept coming back was cos I never gave meds a proper chance.

It is of course different for everyone. And that is just one take on it. It freaks me out more to think about taking something for a long time though. Heh. what hereiam says about 'as needed' would be awesome.

dsf - It's true, I have read the research, but I'm sure you still understand where I'm coming from since you're in the do-i-dont-i phase yourself. It's just hard, ya know? Thanks for the response.

Sky - I don't 'snap out' persay, but it does seem like I ween out of it within a few days. I only say it cycles because it continues to come back...that's why I was asking about the 'as-needed' things because I'm not always depressed. Infact when I'm happy, I do very very well in life and school and relationships and things like that. It's a significant difference, even if it does make the depression worse (when you know what you're missing out on).

Danialla - Long term would be better, I suppose. Thing is I haven't even taken them to begin with! I hope things turn out well for you.

Thanks for everyones responses. Sorry if I offended anyone by making AD's sound like 'happy pills' but in reality - that's what they are. That's what they do. If they don't 'make you happy' they make your brain produce the chemicals that do...so, by proxy, they make you happy. Or able to function, or whatever. I don't have anything personally against them because like I said I have many friends/family that do take them, but I just don't feel like they are for me.

Good luck to everyone...

here, it sound like we are quite similar ... but i have had it pointed out to me that 'just because you have good days/good weeks doesn't mean you aren't depressed'.

I dunno ... I have drugs I could take ... but I haven't cos of pretty much the same reasons as you.

Maybe it is worth trying. I guess we will see.

luck to you too hon.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
hereiam said:
dsf - It's true, I have read the research, but I'm sure you still understand where I'm coming from since you're in the do-i-dont-i phase yourself. It's just hard, ya know? Thanks for the response.

Sky - I don't 'snap out' persay, but it does seem like I ween out of it within a few days. I only say it cycles because it continues to come back...that's why I was asking about the 'as-needed' things because I'm not always depressed. Infact when I'm happy, I do very very well in life and school and relationships and things like that. It's a significant difference, even if it does make the depression worse (when you know what you're missing out on).

Danialla - Long term would be better, I suppose. Thing is I haven't even taken them to begin with! I hope things turn out well for you.

Thanks for everyones responses. Sorry if I offended anyone by making AD's sound like 'happy pills' but in reality - that's what they are. That's what they do. If they don't 'make you happy' they make your brain produce the chemicals that do...so, by proxy, they make you happy. Or able to function, or whatever. I don't have anything personally against them because like I said I have many friends/family that do take them, but I just don't feel like they are for me.

Good luck to everyone...

</div></font></blockquote><font class="post">

If you are able to "wean" out of it in a few days or weeks then in my opinion you are not dealing with "Clinical Recurrent Major Depression".......and that is a good thing!!!

Unfortunately, I deal with the Clinical variety, and trust me my pills don't Make me "happy"... They allow me to be "happy". There is a difference.

Maybe a short term anti-anxiety is more what you need.

I do precisely as you inquire about. I go on antidepressants on an "as needed" basis. That's how I manage my illness.

The thing is, you are unique. There is no rule to apply to your individual situation. You can learn about what has worked for other people. You can listen to advice from medical doctors. But nothing anyone can say will ever precisely predict what will or will not work for you.

My experience is my experience. My methods are my methods. I do not advocate them for others.

I, personally, cannot tolerate medication over the long term. I am simply too sensitive to medication. I get side effects that aren't even listed in the medical literature, and I get most of the ones that are listed.

Most of the time, I can maintain a stable mood through nutrition and supplements and intensive self-care. When my mood shifts to a point which I consider to be threatening, where I am at risk of becoming severely depressed, I go straight to my doctor, tell him my truth, and obtain drugs to sledgehammer the impending depressive phase into smithereens. In hindsight, it seldom takes me more than eight weeks to accomplish that. Then, I have to go through the discontinuation symptoms and all of that, and recover from the drug itself.

That is my story. If you are looking for validation, and seeing my words gives you comfort, then that is good. However, what I describe is not consistent with most general medical advice. Medical advice is structured to apply to most people. I have found that I am not typical, and I have had to adapt the general advice to my specific circumstances. I am the expert on me, but only because I have spent a great deal of time, effort, and thought, to become expert.

Lar

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Larry_Hoover said:
I do precisely as you inquire about. I go on antidepressants on an "as needed" basis. That's how I manage my illness.

The thing is, you are unique. There is no rule to apply to your individual situation. You can learn about what has worked for other people. You can listen to advice from medical doctors. But nothing anyone can say will ever precisely predict what will or will not work for you.

My experience is my experience. My methods are my methods. I do not advocate them for others.

I, personally, cannot tolerate medication over the long term. I am simply too sensitive to medication. I get side effects that aren't even listed in the medical literature, and I get most of the ones that are listed.

Most of the time, I can maintain a stable mood through nutrition and supplements and intensive self-care. When my mood shifts to a point which I consider to be threatening, where I am at risk of becoming severely depressed, I go straight to my doctor, tell him my truth, and obtain drugs to sledgehammer the impending depressive phase into smithereens. In hindsight, it seldom takes me more than eight weeks to accomplish that. Then, I have to go through the discontinuation symptoms and all of that, and recover from the drug itself.

That is my story. If you are looking for validation, and seeing my words gives you comfort, then that is good. However, what I describe is not consistent with most general medical advice. Medical advice is structured to apply to most people. I have found that I am not typical, and I have had to adapt the general advice to my specific circumstances. I am the expert on me, but only because I have spent a great deal of time, effort, and thought, to become expert.

Lar

</div></font></blockquote><font class="post">

Larry, I just have a few questions.......

What medications does your Dr. perscribe that have the ability to smash or sledgehammer the impending depressive phase into smithereens.

How far into an impending depressive phase do you get before getting to the Dr (ie 2 weeks, a month, etc.)?
Or is it the "quality" of the depression you are feeling that sends up your own red flags?

Are you able to use the same medication each time?

I have tried your approach in the past........not due to the side effects of the meds (I am blessed with being very medication tolerant), but due to feeling better and my own fear of the stigma attached to taking psych meds.

I have found that starting and stopping meds for the past 20 yrs has contributed to my treatment resistant depression w/pschotic features........and the fact that my suicidal thoughts can go from 0 to 60 in nothing flat....

After doing that for twenty years, I have been medication compliant for the past 6 years!!! Yes, I will be on meds for life...........but damn, I wish I would have done it sooner.........for me and for those around me that suffered as much as I did...

But, as you stated Larry, each person is different and needs to follow the plan that works for them.............just DON'T call them "HAPPY PILLS"!

Take care everyone!!!

So far, it hasn't been any particular kind of medication.....tricyclic, SSRI, others like Effexor that work on multiple paths.....it may not even be the drug effect, per se, as I don't generally stay on anything long enough to stabilize on it. It could be that I am so clearly attending to the feeling that my depression could take over my life, and that my doctor's act is so blatantly supportive, that the drug effect is not even relevant (placebo response ?). I don't even care what it is that reverses the trend. I don't need to know that, and maybe it's better that I don't (or the putative placebo might not work). It is a state of mind that leads me to the doctor's office, not a calendar thing. I know I need help, I go and get it, and somehow I get out of the hole. I often start feeling better within days, but then again, I also disagree with the assumption that it takes weeks for these drugs to affect the mind. There are immediate psychological effects, and that may be all I need, to get the trend going the other way.

If I could easily tolerate medication, I may well have stayed on an antidepressant long-term. However, I do not consider side effects such as sexual dysfunction or insomnia to be trivial. I do not like even calling them side effects. They are, plain and simple, effects of the drug(s). I'd rather risk the return of depression, while maintaining a normal sex life, thanks. Others do make different decisions, no doubt.

Lar

Thank you for your reply Larry........... I, unfortunately, have trouble asking for help or maybe recognizing the signs of impending doom. Consequently, I ended up way over my head when the depression struck again!

The medication for me ,allows me the time to recgonize that things are going down again.....and gives me the added confidence to ask for help........and know I deserve it!

Depression is a funny thing (in a sad way ).........it is different in everybody, but ultimately I think we all want the same thing.....peace and happiness in our own lives and those around us.

Thank you again for everyone's insight.

I am truly sorry if I seemed to have hijacked the thread.

Hmmmm this has made me rethink ...

Larry so you start something as soon as you notice signs? and your dr is happy for you to do that?

that sounds like such a good way to do it ...

.....not when I notice signs. Instead, when I begin to feel threatened by the signs. There are always signs. I can choose to monitor them, or not. I choose to monitor.

My doctor has learned to trust my judgment. He has also learned that therapeutic responses to meds can occur at what appear to be very small, even trivial, doses. I respond to about 0.05 mg clonazepam, as one example. That is not a typo. He raises his eyebrows, once in a while. Gives me "that look". But if I say I don't need a clonazepam renewal because I only take a fragment of a pill, once in a while, he's not about to argue.

I'm the gatekeeper to my mouth, and nothing passes that threshold but on my consent.

Lar

Do you feel you are an individual case, or could other people manage their conditions in a similar way that you do?

I certainly think that my philosophy of care is transferable to others. Not universally so, but it could work for you. Why do I say that? Because my intuition tells me that you are responding positively to my suggestions, based on your own intuition. Just as you did with the Prozac when you travelled. You used a very similar process of self-assessment, and you went with your intuition.

It's not a foolproof method, by any means. But what's the worst case? For me, it's being one day late asking my doctor for help. The monitoring that I do has become so automatic that it is almost innate. In fact, I can tell how well I'm doing by what I'm doing.

Lar

i respond well to ADs. but i do feel that i don't need them all the time. i would rather try and treat something then let it go and if it comes again later, treat that.

against that i guess i hear from dr that if i stay on it for 9-12 months it could be totally gone. but then again it might not. Length of treatment might not result in best treatment.

Hmmm any advice ... would be appreciated.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Danialla said:

Depression is a funny thing (in a sad way ).........it is different in everybody, but ultimately I think we all want the same thing.....peace and happiness in our own lives and those around us.

</div></font></blockquote><font class="post">



It is interesting to see the various ways we each approach our respective depressive disorders. (I read something that I really like and will have to scour through my library to find what book it came out of. The author said he doesn't use the term "mental illness" because nothing is wrong with our minds. It is a chemical imbalance in the brain.)

Anyway...to throw my 2 cents and experience in....

hereiam - I also cycled like you do...my diagnosis was Major Depression - Recurrent. I was initially put on an AD for about 6 months or so and when the cycling was getting so close together that it interfered with my job, etc., then my pdoc put me on a mood stabilizer...in my case Depakote.

I'm fortunate in that I have had absolutely no side effects from the AD/Depakote combo, including sexual. In fact, they have become so much my routine that I really don't even think about it. I have taken them for 15 years and just feel...like me...with the normal ups and downs of life, but I know the difference between "situational depression" and when it's the chemicals in my brain starting to break through the meds.

In those 15 years I have only had 3 major episodes that necessitated my pdoc either upping the dosage on my meds and/or adding others to zap whatever is going on. For me, the episodes are caused by an overload of stress (as in my recent episode).

I understand the desire to not be on meds. Although I've never had a problem with my AD/mood stabilizer combo, I *did* have some hideous side effects from a couple of the meds my pdoc put me on to zap me out of my last major episode. (Which have now all subsided.) It's funny, I'm content taking two, but I really didn't like taking 6 different ones. My pdoc is now taking me off the added meds so I will be back to my "regular 2" but thank goodness for the others that I needed at the time.

I have no issues with stigma. To me, it's like a diabetic having to take insulin to control a physical problem.

So...as Larry said...everyone is so different in how they respond to meds and their personal preferences/beliefs about taking meds.

This is just my story for whatever it's worth.

P.S. Oh yes...please don't call them "Happy Pills." I think people confuse ADs with "uppers" (which having never taken any I don't know what the names are). I'm a fairly serious person overall, so ADs definitely don't make me happy - they keep me stable.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Azalysa said:
I'm a fairly serious person overall, so ADs definitely don't make me happy - they keep me stable.

</div></font></blockquote><font class="post">

My feeling exactly........

Thank you all so much for your responses, they've really helped me see all different sides of the issue.

Danialla - You said... "Maybe a short term anti-anxiety is more what you need. " And that you didn't think what I was suffering from was major recurrent clinical depression. But, however, I've seen 2 seperate T's who recommend AD's because of the nature of my depression - and in that depression, while there is anxiety, it's not the main factor. And considering it lasts for around a month or so, I would think that's more than 'short term'. Now, I'm positive what I go through is depression because...hell, you just know. Maybe at the time you aren't sure or you think your tricking yourself into it but when you're out of it you look back and you just know. In my case, the last time I was depressed, I knew but I didn't care. I got, by far, the worst I'd ever been. You don't think about giving up when you have some short term anxiety.

I don't mean to try and knock what you are saying, I just want you to understand my situation and why I'm searching for the answer to this question. While my depression may not mirror yours, it is certainly depression because of that I'm sure...which completey sucks, but what can ya do?

Larry Hover - I see you've found a way to do it. Maybe I can figure out a way as well, although I doubt anyone would be willing to take that risk with me.

I know AD's aren't uppers, I know what they do and how they work, I just know I'm not comfortable taking them. And that's my issue, I know, but I just figured I'd ask and see if there was anyway people could take them on as as-needed basis. Thanks all!

Just wondering if you realize you can be depressed without feeling sad?
(BTW Larry, this is most common in men.)

I suspect that the depression itself, per se isn't cyclic, but the sad feelings you can't handle are.

I still wish to counter the idea of an antidepressant being a happy pill. If your brain was producing, or utilizing what it would normally (serotonin) then the AD would not have such an effect. It's the fact that the normal "happy" chemical is NOT available to you, that you need the AD, imo.

Some ppl might have quick responses to ADs as part of a sensitivity, and thus can feel like they can take them on and off as needed. Personally, I would consider this rather dangerous, realizing how succinct some of the newer meds are and how they manipulate the brain chemicals, the areas of activity. Until we know more about it all, imo, it's not a good ploy. I liken it to someone who is allergic to a particular medication, takes only enough for a basic reaction they like, but not enough for any long term response.

Yes, you are correct in that anxiety is part of depression. It appears to me that you are dealing with that, it's just when the sadness comes around that you want better relief? Again, I think you may have a type of depression that is ongoing, and not really cyclic like we tend to use that word.

I hope you will find something you feel safe taking, and that you will find relief from the terribleness of depression.

I got the answer to my question. Thanks for the responses.

Ummm sorry but where did you read that into our comments????