If it doesn't work, try something new

I might be wrong, but I get the queasy feeling reading these threads that posters in this section are only trying drugs, they are here because their drugs aren't working and yet they are not trying new things. There are so many non-drugs things to try for depression! I have the feeling that some people are waiting for their doctors to figure it out for them.

"DrJohn:
To me, and in this context, it means you've tried multiple treatment options -- whether it be psychotherapy, meds, ECT, TMS, whatever -- over a period of years and despite your (and your professionals') best efforts and multiple tries on different treatments (whether it be with different therapists, therapies, meds, etc.), very little has touched your depression. You are still depressed. It doesn't seem to have responded much to anything."

That's my definition. I'm going to close this thread to encourage you all to start new threads here on the topics of the most interest to you...

I don't think that is the case. At least in my case it is not true.
Here is a copy and paste of one of my posts from this section.

It is often the case that meds are the only help available or offered. Not everyone has access to the full range of treatments and sometimes the lack of motivation, concentration and sheer depth of the depression put self help strategies beyond reach. I do self-help when I'm well enough and have managed 8 years med free up until this episode, but right now all my efforts are directed towards not offing myself and staying physically safe. At the moment I need something that will lift my depression sufficiently for me to be able to benefit from less agressive treatments, that something is most likely chemical but ECT is an option too.

Hi zinco,

My apologies! I'm definitely wrong in your case for sure and it is clear that you are getting major benefits from non-drug practices (not that I'm always against drugs). I'm haven't read back in this section very far and I might well have the wrong general impression too.

We have some overlap of experience. SSRIs didn't really help my depression either. Therapy might have helped a little. Exercise, yoga and getting treated for hypothyroidism definitely helped, but nothing really resolved the whole thing for me until recently. Mine was pretty severe - seriously debilitating, but not really suicidal and not very cyclic.

Even though you're super active, since you asked, I'll attempt to make a list of things you might not have tried.

1. Check for medical problems. There is a book called "the Ultramind Solution" by Mark Hyman that's interesting. He explains that lots of medical problems from hypothyroidism to food allergies to vitamin deficiencies to heavy metal toxicity to infections as well as diet can have major effects on brain function including depression. He had a bad case of this himself.

2. Since your depression is seasonal, have you ever tried light therapy?

3. I'm impressed by this post by butterfly443000
http://forums.psychcentral.com/new-m...-hi-there.html
who had a huge success from brain training.

4. Yoga? (this helps me quite a bit, when I actually do it).

5. "snap club" is what did it for me in a really big way
http://forums.psychcentral.com/depre...n-escaped.html

6. I saw an ad for what looked like "home electroshock therapy" on the front page of this site!? Sounds questionable, but who knows, maybe it works?

Anyone else have ideas? It would actually be interesting to see a complete lists of all things that are claimed to help depression.

First of all, and do whatever you need to to say safe.

I think I know where you're coming from too. Depression FEELS very much like a bad thing happening in your brain that you have no control over. It makes perfect sense when someone tells you that it's a chemical imbalance in your brain and it makes perfect sense that the most direct and reliable treatment would be to directly fix that imbalance. Also, that's what your MDs are recommending and aren't they the experts? The only problem with this is that SSRIs often just really doesn't work:

I'm going to quote Mark Hyman M.D.

"Most patients who take antidepressants either don't respond or have only a partial response. In fact, success is considered a 50 percent improvement in half the symptoms. And this minimal result is achieved in less than half the patients taking these medications." The UltraMind Solution, page 14.

I think you've got an assumption that drugs are the most direct way to treat what you've got and they are the most likely thing to work in a severe case. I am not at all sure that's true. In my case, for instance, SSRIs had next to no beneficial effect and the very simple self-help thing I did (see other post) had a HUGE effect, far more than any drug I ever took.

I know that in the depths of a depression, following some random advice like "meet new people" is just a joke. Still, I believe that there are simple things that you can do, even in the depths of the worst depression that could have a positive effect, maybe more of a positive effect than you are hoping for from your meds.

I feel many people with MI live with a dichotomy of "chemical imbalance, NOT MY FAULT, I can't do nothing for myself, just like nobody can will themselves out of cancer" and "MY FAULT, if you say I can do somethign for myself, it means I am not trying enough, I am horrible person, I am weak, flawed...."

This is of course a fallacy. Maybe many hear the "not your fault" when first diagnosis and cling to it. Maybe some doctors encourage them in "only me and my meds can help". I mean, I seen bloggers spewing this ****, about how healthy eating and living, friends and spiritual things don't matter, because it's all chemical imbalance, only fixable by a pill.

Also, the efficiancy of drugs is overstated, hence if the drug fails a patient, they feel they must be so flawed even the sciency drugs don't help them, when it fact the fault is in the drug. Maybe one kinda integrates that into their view of themselves and their problems. Psychiatrists are known to blame side effects of drugs on the illness, underestimate the dangers, scoff of patient's concerns... This might be difficult to challenge for people who tend to overly respect authorities (and... who of "crazies" doesn't have self-confidence issues?).

So I think this should be also looked at.

Thanks Venusss. I just notice this article too:

"Why Antidepressants Don't Work for Treating Depression"

Why Antidepressants Don't Work for Treating Depression | Mark Hyman, MD

- v

Maybe someone could explain my recent experience to me because i really don't know.

My aunt bought a condo. So I went out of town for a week to help her move. I remodeled the bathroom, built some shelves, moved all her stuff and so on. We went golfing, went to the casino, went to dinner with friends and family, went to watch my nephew play hockey. Had a great week and enjoyed it very much. Got lots of exercise, ate good, social activity with friends and family, purpose, got paid, felt really good. This has pretty much been true since last April, living this lifestyle.

Then I go home and got slammed with major depression. In a matter of two days I had all the symptoms. No energy, no motivation, have not showered in a week, don't want to get out of bed, didn't get out of bed until 6pm today. Starting to get suicidal thoughts. I had things planned. I have things I need to do. I can barely brush my teeth. I have said this many times and I swear it is true. It is like I can feel a switch going off in my brain. This has happened to me many many times in my life just like I have described. Durations vary. the switch may turn back on next week.

So how do I go from doing everything right, in therapy, all the right life style choices, to bam, brick wall depression??? Am I just on the pity pot? Is it my fault? I am just not trying hard enough? It is not really a disease? Please someone explain to me how this happens.

And my thyroid has been checked many times. that is the first thing any competent doctor should do.

Take Vitamin D, Fish oil, and Melotonin every day.
Took L Methylfolate for a long time.
B vitamins

I suppose I could have heavy metal toxicity but seems like a stretch.

I don't know anyone who would argue against diet, exercise, meditation, social activity, CBT, brain training, increasing self esteem, spiritual practices and so on. Every pdoc and therapist I have ever had has strongly encouraged those things. The problem is they often don't prevent depression and don't bring us out of it once in it. That is just a fact for many of us.

Hi zinco, I *might* be able to explain this. You don't completely spell it out, but it sounds like when these things start, at some point you notice that "the switch has gone off" in your brain, but then it takes about two days to develop into a full blown episode. I suspect that at the moment you notice the switch going off, you just have a bad feeling, possibly with some specific thoughts, but possibly just arising as if out of nowhere. Right?

Now even though you're doing lots of great things in your life and having a lot of success, the process of slipping into the depressed mode is really an unconscious involuntary thing. Once "the switch goes off," I suspect that you start to have some negative thoughts and feelings. Although nothing drastic has happened yet, it might be that this builds on itself rapidly, just because you have subconsciously learned what happens next. You may be subconsciously afraid of what happens next and this fear may actually cause what happens next.

Now, I know I sound like a broken record, but when you do SNAP CLUB for a while, you will find that you can actually decide not to think some thoughts if you find them unpleasant and you can do the same with feelings. When I have some negative thought and/or feelings that would before have caused a whole debilitating cycle, I just notice them and decide "Eh, I don't want to feel angry(say) right now." SNAP! And it's gone. Once your subconscious brain get's used to this, the spell is broken. You are not afraid of your own thoughts and feelings anymore and you escape the negative spiral.

Anyway, it's not as if it's hard to try. Try it!

- vital

But I have been trying it for twenty years. CBT and the 12 steps of AA are all about intervening on your thinking and changing it. Processing your emotions in a healthy way. Changing behavior that doesn't lead to good results. If it was just a matter of applying my CBT skills as I feel myself slipping I would have solved it years ago.

Here is the thing. The negative thinking does not precede the depression. In this case when I say the switch goes off it is then that I am in the severe depression. That is often how fast it happens. There is no negative thinking or emotion to intervene on. The negative thinking and feeling comes as a result of the depression not the cause of it. When I am deep in it I start feeling ashamed because of how it effects me and that can cause a cascade of negativity. It is much more physical for me. The switch goes off and I notice I am very fatigued. I don't want to get out of bed. I have no motivation to do what I had planned on doing. No energy. Emotionally numb. Flat affect. Don't care. No interest. The negative thinking comes because these symptoms cause me not to be able to function normally. There were no triggers or negative thinking or emotions that preceded this that I am aware of and I am a highly aware person. It just happens. I am not afraid of my thoughts and feelings. I have been journaling, processing, talking about them, changing them, for years and years. It is like everything is great and SNAP now your depressed.

When I experience mild to moderate depression I can keep fighting and often snap myself out of it. This is much more on the theory of "act as if" or "fake it till you make it". Forcing myself to do things I don't really want to do is a form of changing thinking as I am choosing. Sometimes it works sometimes it doesn't. I have been living with mild to moderate my whole life mostly. It is my norm. I am used to functioning that way with periods of doing really really good thrown in. The severe ones that hit in regular cycles are the problem. If a severe one hits me the first hot week of spring every year is that because I just have negative thinking in that week. Is it self fulfilled prophesy because it happens every year. I don't think so.

Sorry if I sound defensive. I appreciate the input. I am really frustrated right now. It is always hard when this happens after a period of doing good. I have a number of things that need doing before winter and it is stressing me out how I am going to be able to do them.

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If you view the whole thing in disease/my fault dichotomy, than what should I be explaining? Zinco, no offense I done it before and got lectured as a stupid person, called ignorant psychopath...

Anything me or anybody else will say will be refuted by some sciencey schmiency links.

I don't know what is going on with you. I don't know what is missing. You must know. So mainstream therapy didn't help. Meds work, you claim.... until they don't. One has to be resourceful. It took me a while to use my IQ to my advatage not to self-sabotage. One thing I know it came from within......... and from random good omens. Look elsewhere than doctors and self-help books aim particulary at mental health. Don't do things with "I am doing this to help myself", just do them.

I posted this long time ago

http://forums.psychcentral.com/bipol...ng-better.html

I read your post and I agree with it. I don't think I have ever called you ignorant, stupid or a psychopath. Actually a huge part of AA philosophy is getting out of yourself and helping others and I agree with it.

Here is my issue in a nutshell without sciency links and debate.

To me it does not matter whether I view it as a disease a characteristic a label as part of my nature as whatever. It does not matter what is at fault, whether I blame genetics, the guy who beat me up in sixth grade, my parents or whatever. I am long since past that in my mind. Of course if there are answers as to why this happens to me I would want to know them. And of course if there are solutions I would want to know them. That is natural. I have tried many things besides doctors and therapists and I don't think I am self sabotaging.

I am just telling you what happens and what I have done. Really I have accepted it as a part of my life that I have to live with and deal with. If it is just me, myself and my depression I can be very content and at peace even at the same time as having suicidal thoughts. Paradoxical but true. I do the best I can when in it and ride it out as long as my immediate needs are met.

That last sentence is key. It is not living with depression and totally focusing on it and obsessing about how to get well that is the problem. It is how it affects my ability to function and how it affects those around me. If it is so severe and debilitating that I cannot get out of the house and go earn money to pay my car insurance and buy food and pay my mortgage than I have a problem. If I happen to be on unemployment cause I just got laid off and I can pay my bills I don't stress. I can just do the best I can and let life unfold. When I cannot meet my immediate needs under my own power and am a burden to others then I have a problem.

So for me the bottom line is how it in very real terms effects my life and my ability to function that causes me problems. Two years ago I was very close to being homeless. If it wasn't for family I would be inspite of having very high skills and the ability to earn lots of money. How do I manage my life given that I have these cycles of severe depression. That is my current dilemma and what I have to figure out.

And I think you are right. In the big picture it just doesn't matter. I have very strong spiritual beliefs and it just doesn't matter. We do the best we can. But I have to live in this world as it exists and meeting my needs under my own power is very important to me. Independence is very ingrained in me and causes huge conflict when I cannot be.

You seem to see it as something must be missing. That there is some spiritual void that must be filled and that intuitively deep inside I know what it is. All solutions come from within. These problems are existential ones.

If this is true I have not found what is missing and filled it in such a way as to cure depression. I have filled those voids in many ways but not when it comes to depression. In general I am a very content at peace person with a strong desire to help others in anyway I can, and I do. I love the simple things in life and get great satisfaction from them. I will not say I am happy joyous and free but I can use the words content, at peace, empathetic, compassionate, satisfied, loved, worthy of love, etc. When I am depressed all that is still there but might be buried and hard to get in touch with.

I am not cured either. It just gotten easier when one is at peace.

I whole heartedly agree with that. And it is easier. the immediate needs thing and bills and independence will work out somehow I just don't know how yet.

Thanks zinco. That's totally OK and I hope your Fall is productive and happy.

- vital

Thanks. I upped my dose of Fetzima and it is working. Some side effects I will get over. Off to work tomorrow to take care of some of the things I was stressing about. Thank God I feel able.

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Please feel free to ignore this or even shoot me down in flames, I don't want to be alarmist, but it doesn't sound completely fanciful to me. Some people are more senstive than others.You work as a plumber, so you must have been exposed to a fair amount of lead in old pipework and solder? Also you have lived in California where the air pollution can be bad and you are of an age where petrol (gas) used to have lead added to make the engines run smoother. I think I've read about toxic waste in the woods in Michigan too, so you could have had a pretty high lifetime exposure to lead. Symptoms of lead poisoning can include depression and mood disturbances. Lead Poisoning | Doctor | Patient.co.uk

Another possible source is the mecury amalgam used in some tooth fillings, what is your dental work like? I once read about tooth fillings causing all sorts of long term health problems. The only reliable science I could find was inconclusive, so I think my level of concern on that one is more about my own personal anxieties.

Slightly off topic, I'm interested in the subject of heavy metal toxicity as it has been used as a theory to explain the long term decline in serious crime in the developed world. Particularly linking the drop in delinquency to the switch to unleaded petrol in the 1990s.

To me, heavy metal toxicity in someone with known exposure and already predisposed to mental illness seems like a theory worth investigating if only to rule it out as an aggravating factor.

Actually I did think about all that.

I grew up when lead was still in fuel.
Half my career as a plumber was with 50/50 lead based solder. Not really any exposure to old piping, lead, and asbestos because it was all new construction. I know I have had high levels of copper in my system from running copper pipe for days on end. I think that leaves your system though whereas lead and mercury don't.

Not sure about California pollution as they don't have any coal fired power plants. The main source was smog from the bay area from autos, and lots of dust, pollens, and allergens where I lived. In the summer the central valley would have a high pressure dome sitting over it all summer so there was no air exchange. Bay area smog would filter over. I don't think heavy metals are high though.

Growing up in Northern Michigan is anyones guess. Less likely because it is rural northern but I did spend tons of time in the woods. It all depends on if Dow Chemical and the like bothered to drive this far to illegally dump their toxic waste in the woods. There is plenty of woods in Southern Michigan for them to dump. Hard to know but I think the area I grew up in had pretty clean air and water even back then. Mercury and acid rain were problems then.

I don't know how to get it checked out. It would certainly be worth the test. I will look into it. My pdoc will probably poo poo it.

The depression definitely started before the plumbing. The most likely sources then would have been mercury and lead in the air. Oh and I forgot......In 7th grade science class after school we played with mercury like it was a toy. It is a very cool and bizarre element. The fact it has such a high density and is a liquid.

I am sure I have fillings with mercury in them if they haven't fallen out. A lot of the old ones fell out. I could have swallowed them.

Maybe I will print this post and give it to my docs.

Thanks for your concern.