Hi guys,I'll try posting how I'm doing here for anyone who may find themselves in a similar situation.

I'm having a little trouble focusing so I realize this post may not be the most comprehensible and organized one.

This is the general situation:
I've suffered from MDD most of my life. There have been phases when I felt normal/good, excellent even and some lasted quite a while.
Mostly I just feel incredibly hopeless though and last year has been a major downward slope for me.
At one point, several years ago; I took Prozac for two months and it significantly improved my ability to function. Depression came back when I stopped taking it but it wasn't as severe, self-help was efficient and I was grateful for having felt like I recharged during the two months on the pills.
I'm very worried about how I've become completely unable to function, have no hope, desire or ability to get my life in order and I no longer know how to deal with guilt.
I've gained quite some weight in the past year and a half but since I'm tiny by nature my BMI is still normal. I definitely notice the bad eating habits affecting my health and mood though and am trying to muster up the optimism and will to live healthier. It's kinda hard as I can barely do the regular every day stuff, even my flat looks a mess and I'm usually quite a neat freak. I've been an on-off smoker for about 8 years now and I've been smoking the past 18 months regularly.

Expectations:
I'm hoping Prozac takes away some of the negativity and helps me function again, I'm not even looking to feel great, just good enough to be able to do the necessary life-style and mindset changes myself. Oh, the dosage is 40 mg for now, I took my first today. I've resisted meds so far but I feel like taking them now is the responsible thing to do if I want to function again. Swallowing it I almost felt like I took an illegal drug or something, does everyone feel like a druggie when they start their meds? Perhaps it's because it sort feels like a seal, as in "it's now official you can't do this on your own".

I'm also scheduled for an appointment with a professional. Mostly I haven't had much success with therapists because I feel like their attempts at getting me positive and motivated simply bounce off. As if they don't understand that I lack motivation because I see no point in life. One therapist however was able to help me recognize and work over some dysfunctional patterns from the past and I have successfully gotten over domestic trauma, improved my relationship with my mother and have no resentment towards my family, it's myself I want to be able to live with this time. I'm giving therapy another try, you never know and it can't hurt. Sometimes it helps when someone just gives you a different perspective on things.

Also taking a zinc supplement, I feel I'm less sleepy during the day since I started it.

I desperately want to be able to get hold of myself so it bothers me loads that I've reached this level of inefficiency. I'll let you know if I see any improvement and if anyone has similar experience or a tip it'll be greatly appreciated.

Somehow I don't FEEL like I'll win this, but I THINK I will. Perhaps my heart will catch up to the notion.

Hugs everyone, don't give up, I'm a horrible case and even I have had phases of major improvement, we can do this


P.s. Should this be under some "journal section"? I'm hoping for your insight so I posted here, I hope that's okay.

[ChangingMyMind]

I know what you mean when you say taking the medicine is an official statement of your ability to conquer your depression but I also know that in most things in life we can never do it alone. We need help. I like to think of my depression/anxiety like any other illness, like a broken leg. If I had a broken leg I would use a cast and medicine to allow it to heal. It's the same thing with depression, I am taking medicine to help me heal. I might have to be on medicine for the rest of my life but as long as I have a meaningful life and enjoy the moments I have then it's worth it!

Good luck to you... you sound very strong! You definitely can do this!

[sewerrats]

WHY 40 MG the normal dose is 20mg , why when you felt great did you stop the first trail on prozac that should last a year , now you have rebound

Hi Sewerrats,
The fist time I took it was about eight years ago. After the initial 20mg dose I wasn't quite feeling the effects so my doc increased the dosage temporarily as I suffered no side effects. After a few weeks on 40mg I really did feel better. Yup, my doc advised a full year but I asked to be taken off the meds because I felt like I was making a lot of progress just working on myself. I don't think the relapse has anything to do with the first time I took meds since that was a long time ago. I don't even know whether I can call it a relapse as I'm nearly always depressed anyway, it's just that this time I can't even force myself to function. My doc intends to lower the dose as soon as it starts to kick in or if I experience really unpleasant side effects. She says it's to help me get a boost so I can squeeze out the maximum benefits from therapy and self-help and has also scheduled me for frequent lab tests so I guess she has a point. I want to be the one to pick myself up rather than rely on a pill or therapist or whoever to do it for me so anything that could help me with the negativity and lethargy sounds like a good idea for starters. While I think maybe I should've continued the drug the first time I was still monitored by a therapist and doing my best myself so it turned out okay, I was able to live quite normally for a long while then, apart from some dysthimia- but I've always had that. I do think it was a mistake trying to be med-free all these years though . Like ChangingMyMind said- it's a disease like any other, pills would've been in place and I probably would have been doing a lot better by now. I guess I've always had the idea that I simply need to try harder, that it's up to me, that I shouldn't rely on anything outside myself...I can see how that was the wrong outlook, we all need some outside help sometimes. I believe I finally did the right thing by agreeing to be medicated and intend to take the meds for as long as my doc and therapist deem it necessary. I do believe that this aversion to meds has something to do with the time I was prescribed paroxetine and it made me feel horrible and suicidal. That was when I asked for a different drug and although I did well with Prozac I guess I'm afraid of how unpredictable these meds can be. It helps with my worries that my doc seems to want to keep a good eye out on the effects of the drug and therapy so I have trust. Just wondering, how does being on it for a year feel? Does the effect change over time or does it sort of stabilize? I didn't feel like a zombie those two months but would I start to feel like a robot over time? Might sound silly but I can't help wondering...

[Altered Moment]

If your car broke down would you feel ashamed of yourself that you had to find a mechanic to fix it. Would you beat yourself up for not being able to fix it yourself.

We have to get outside help in many areas of our lives and think nothing of it. Why should it be any different with mental illness.

I know Zinco, I agree. My closest circle of people have been very good at making me feel like I don't have a reason to seek help but more like I'm just a bad person for failing everything or something like that. I realized later that says more about them than me, I'd never dream of putting someone down for seeking help. I'll go through with the treatment as long as it takes, don't worry. I'm still thinking whether I should tell my family and partner I'm back on the pills, the last thing I want now is someone blaming for feeling like I do. I don't think people get I can't just flip a switch and feel jolly, ugh. But then I don't want to keep secrets and therapy is the most important part of my life now for me so keeping silent about it feels like I'm lying. I guess if they can't understand it they'll just have to deal with it themselves, I need to do this for myself and whoever disrespects my needs can leave. It's intimidating how much I've got on my plate now but the sooner I start cleaning it up the better.

[Altered Moment]

Thats right stick up for yourself. Tell them this is what I am doing and that is the way it is. If they don't like it then they can pack sand.

[sewerrats]

Being on a year to stop rebound , MMMMMM If you like the feeling you had before you gave up because you thought you had beat the monster its just like that ,you feel ok like when your med first worked . Nothing changes, you may eat more because food tastes better when not depressed , well it seems to so watch your burger intake. I should think most have given up there first med because like you they felt your better. More so years ago because the stigma then was 100 time worse than today. Hope IT WORKS WELL FOR YOU.

[FLJ13]

Originally Posted by sewerrats

WHY 40 MG the normal dose is 20mg , why when you felt great did you stop the first trail on prozac that should last a year , now you have rebound

Seems the "normal" dose is 40-60mg in the states.

Hi pipsqueak, I've noticed from people's posts that docs in the States tend to start with higher doses and also that many american patients are prescribed a combo of several meds. I'm not sure about all parts of Europe but around here they're usually very hesitant to medicate you for anything, especially mental illness. It seems they wish you would just go home and get better on tap water, which is ridiculous- we pay a ridiculously high amount into health care monthly and have to practically beg to be treated when treatment is needed. But that's another story altogether. I think the decision about the starting dose also depends on the patients current situation. As I understand, those who have proven sensitive to side effects in the past or are not severely depressed start with the lower dose. When the patient is already so down and exhausted that they have trouble with performing basic tasks even or struggle to concentrate they're usually put on a higher dose so as to ensure serotonin levels are quite stable from the buildup of the drug when they start cognitive or other therapy. They want you to be able to think, focus and perform daily tasks and take responsibility as soon as possible and once you seem to function and do quite well in therapy they lower the dose to twenty mg. I'm also told the dosage for depression is usually lower than when there are some other severe disorders present.

[Altered Moment]

I don't understand why in Europe and the UK they don't use combinations. And why it is so hard to see a pdoc. You can go to your GP which is great but as soon as you need a med the GP can't prescribe you need a pdoc but you can't get in to see one. And then they spend more money sending this assessment team out. It would be cheaper to just send you to a pdoc.

[sewerrats]

The GP can script you any med you like, LEXAPRO not hospital but GP yes .The reason we don't go for combos is , if your having side effects which med is it that causing them , on `1 med you no easy. INTERACTIONS is another point. You get 2 meds if bipolar AD and a mood stabilizer. The GP is your front line pdoc in all but name , if depression he goes through ssris till he finds one. Effexor not used much now nor cymbalta do to with drawl . nobody goes to mental hospital till the GP refer you , then you see a shrink nurse to see if you are worthy of going on the waiting list. YOU CAN GO PRIVATE but megga money and same docs .

Many drugs can be prescribed by a gp here and you need a gp to refer you to a psychiatrist if you can't afford a therapist. Combinations are rarely prescribed (because they like to rip us off and deny us the treatment we're paying for because f**k us that's why, ain't that lousy?) but sometimes a gp would get you started with antidepressants and your psychiatrist could suggest additional meds after a thorough evaluation of your condition. A gp will often suggest you also join a support group but I've learned recently that those are not covered by insurance and you have to pay extra for meetings. Healthcare here can be really messy, confusing and very patient un-friendly, ugh.

Originally Posted by zinco14532323

I don't understand why in Europe and the UK they don't use combinations. And why it is so hard to see a pdoc. You can go to your GP which is great but as soon as you need a med the GP can't prescribe you need a pdoc but you can't get in to see one. And then they spend more money sending this assessment team out. It would be cheaper to just send you to a pdoc.

exactly, it makes no sense! Also, the waiting lists are long, you could wait as long as two months before your first appointment with a shrink. It's just criminal.

I'd be in trouble if my pdoc didn't use combinations of meds, including more than one AD at a time. It is those combinations that have helped me the most, and additional side effects have not been my personal experience.

The odd thing is I don't even know people here diagnosed with AD, not even many diagnosed with bipolar, not one with Tourette's for example! I mean, come on, it's not that rare, there have to be people here who have it??! I think most people go undiagnosed and untreated and are left to their own devices which leaves many on the brink of society . Also, you'd think we live in the stone age, it's still literally a taboo to suffer from mental illness! Hardly anyone admits they have it since you're considered an underachiever, lame, dumb, lazy, childish, irresponsible and an attention seeker. Many doctors seem ignorant to me to tell the truth. I'd suffered fibromyalgia for about a decade and the docs here didn't even know what it was. I had to go abroad to get diagnosed and they don't even treat you for it here, just an occasional painkiller. So for a decade they behaved like I was just making things up, looking to justify my "laziness" and some even insinuated I was looking for a diagnosis that would cover up for the fact that I have a mental illness ( well I told them I was depressed myself,how is that covering it up, they seem to think that's hardly an illness. arrrgh). While I believe heavy medication should be avoided when not necessary it's obvious that some things REQUIRE medical treatment and patients can not be expected to go without. If it was cancer they'd put you on a cocktail of all sorts of meds, so how does it make sense to expect patients to sweep mental illness under the rug? Sometimes I wish I could move elsewhere, I get so worked up over this.

[Altered Moment]

I don't want to say that here in the US it is all roses. It is most often the case you have to wait a month or more to get in to see a pdoc. It is interesting seeing the difference though. I thought I remember one post from the UK where the GP couldn't prescribe a med that he thought the patient needed and reffered her to a pdoc. but she could not get to see a pdoc because the assesment team thought she was not in bad enough shape. It would be cheaper to just let her go to the pdoc then have a whole assessment team come out and evaluate you it would seem to me.

Hi guys, just updating for anyone who may use this as a reference in the future,

side effects:
I took my first dose in the morning and got quite bad side effects despite not being very prone to them- it made me incredibly sleepy, I was also crying all day, dunno whether that was the pill though. Felt like vomiting and I even experienced some belching (wow. embarrasing. I think my boyfriend thinks I'm finally over the "girls shouldn't act like that" belief and he seems to think I'm competing with him to establish dominance ). The very weird thing was EVERYTHING tasted like metal! Everything! I was thirsty all the time and got up at night to refill my water flask and the water even tasted metallic. Had no appetite and struggled with a piece of bread, didn't even feel like smoking (well that's good). Had trouble falling asleep the first night but I guess that's not the pill, my thoughts were racing.
Day two I figured even though you should take them at the same time every day it's still only day2 so I switched to taking them before bedtime to avoid sleepiness during the day and that seems to have eliminated most other side effects as well! Appetite still low but I manage to eat something, especially enjoy juicy fruits and veggies.

feeling:
apart from the horrible day one I started feeling good although I know it can't be due to the pills yet. Perhaps knowing that I'm being monitored and treated and just "in the system" feels like an encouragement so I'm actually starting to believe I will get through this.

other:
people are so annoying. I get understanding and sympathy for feeling bad but they don't acknowledge that is a problem that requires treatment. They don't even know the difference between a bad mood and depression and they say but you're not ill, you look fine. Dang it, it doesn't have to show to be an illness and I've simply learned to not wreak havoc about my feelings precisely because people don't understand what they are but that doesn't mean I'm fine. I just say I'm okay or so-so because I don't want to be preached that I should get a hold of myself already and snap out of it and stuff. It doesn't work like that. i was even told that being this intelligent I shouldn't be resorting to shrinks and crazy pills- as if intelligent people don't get depressed! I especially have trouble getting my feelings to mimic my thoughts so I usually do better with types of therapy different than cognitive-behavioral. Folks nag me that these pills are drugs, no less- folks who know nothing about psychology and farmaceuticals and folks who treat their depression with pot- wow, clever. Idiots. I don't even mention the pills or therapy or depression any more, I just keep popping my meds and can't wait for my first appointment with my psychiatrist. Douches can shove their myopic views up their favorite body opening, I don't care.

I seem to be recovering from burn out. I read an article about Prozac that says the drug forces the adrenals to release more hormone and thus they "pick you up" but the bad part being that it further depletes exhausted, stressed glands. Anyone with info on that?

Anyways, doing well so far, hope others are as well

[Altered Moment]

people are so annoying. I get understanding and sympathy for feeling bad but they don't acknowledge that is a problem that requires treatment. They don't even know the difference between a bad mood and depression and they say but you're not ill, you look fine. Dang it, it doesn't have to show to be an illness and I've simply learned to not wreak havoc about my feelings precisely because people don't understand what they are but that doesn't mean I'm fine. I just say I'm okay or so-so because I don't want to be preached that I should get a hold of myself already and snap out of it and stuff. It doesn't work like that. i was even told that being this intelligent I shouldn't be resorting to shrinks and crazy pills- as if intelligent people don't get depressed! I especially have trouble getting my feelings to mimic my thoughts so I usually do better with types of therapy different than cognitive-behavioral. Folks nag me that these pills are drugs, no less- folks who know nothing about psychology and farmaceuticals and folks who treat their depression with pot- wow, clever. Idiots. I don't even mention the pills or therapy or depression any more, I just keep popping my meds and can't wait for my first appointment with my psychiatrist. Douches can shove their myopic views up their favorite body opening, I don't care.

Good for you for sticking to your guns and taking care of yourself despite all the bs other people say.