Tag Archives: Depression

Adulting without medication

Since around the time I gave up alcohol back in 2009, I’ve been taking medication for anxiety and depression.

It’s the most recent part of a very long story; I spent years without a proper anxiety or depression diagnosis, self-medicating with alcohol, then to cut a long story short in 2009 I reached a point where I knew I needed to either drastically change my life or prepare for an early alcohol-induced death. Note that this was before I realised I had Asperger’s Syndrome.

I spilled it all out to my family doctor who was very sympathetic, helped me get off the alcohol with a short course of benzodiazepines, prescribed an antidepressant (Seroxat), and recommended a counsellor. I took advantage of all of these things, read the book “Rational Recovery” by Jack Trimpey (highly recommended) and haven’t touched a drop of alcohol since that day. (I ended up continuing the counselling sessions for about three years and they helped me through a break-up and a lot of personal growth.)

Things went well, other than a dramatic loss of libido as a side effect of the Seroxat. So a few months later I went back to my family doctor, explained this, and she switched me to a different antidepressant (Wellbutrin).

Wellbutrin was far kinder to my libido, but it didn’t do much for my anxiety (whereas Seroxat helped with both the anxiety and the depression).

So I returned to my doctor who referred me to a psychologist, and he prescribed Deanxit in addition to the Wellbutrin. This helped quite a bit, and that was my medication regime for several years.

Jump ahead to 2017. I hadn’t had a major depressive episode for over two years, and my general mood was fine too. I had given up smoking, replacing it with vaping, and I felt my anxiety was under control. I decided I wanted to try to reduce (and eventually eliminate, if I could) my dependence on these medications.

I spoke to my (new) family doctor and asked for advice about how to quit Wellbutrin (I decided that was the one I should try and quit first). He wasn’t overly helpful, just said I should take half my dose for a month then stop. I wasn’t convinced by this, so I did some reading, and in the end, because Wellbutrin tablets are very hard to cut into pieces, I came up with this plan:

  1. For 2 weeks, take my dose 2 days out of every 3
  2. For 2 weeks, take my dose 1 day out of every 2
  3. For 2 weeks, take my dose 1 day out of every 3
  4. For 2 weeks, take my dose 1 day out of every 4
  5. Stop

I did this, and it worked amazingly well – I had no depressive episodes, only some minor irritability and sleeplessness. I think the fact that I was still taking the Deanxit probably helped a lot.

So now here I was, free of one of my medications, but quite worried about quitting the other one. The way I saw it was that depressive episodes, while horrible to experience, didn’t actually happen that often, whereas anxiety was my daily companion, so taking the final step of quitting the Deanxit was likely to be much harder. Especially since Deanxit was chemically an antidepressant so likely to affect my mood as well as my anxiety levels.

And in fact for two years I did nothing about it, just kept taking the little pink Deanxit pill each morning.

Jump forward to this year.

In January 2019 my wife and I emigrated from Europe to the Philippines. That’s a big topic that I will touch on in other posts, but its relevance here is that I had no idea whether Deanxit would be available in the Philippines. In the end I decided to take a 9 month supply which would give me enough time to find a substitute if I needed to.

And indeed it turned out that Deanxit is not available in the Philippines. In fact according to its manufacturer’s website it’s only registered in 22 countries worldwide.

So that kind of forced my hand. There were clearly two options:

  1. See a doctor and get advice about switching to a different anti-anxiety medication
  2. Try to quit Deanxit and then see how things went before seeing a doctor if needed

I kept postponing this decision for the first few months in the Philippines, due to the stresses of settling in to our new life. My anxiety levels, even with the Deanxit, were higher than normal, which was perhaps to be expected, and I knew I couldn’t deal with the risk of switching or giving up for a while.

In the end, I waited until we had bought and furnished our house, and dealt with some other problematic family business, before deciding that my life was free enough from anxiety-inducing situations to go with option 2. I would taper down the Deanxit and see how I coped.

So this is what I did, and have just finished doing. Luckily Deanxit tablets are much easier to cut with a knife.

  1. For 2 weeks, take two thirds of a tablet
  2. For 2 weeks, take half a tablet
  3. For 2 weeks, take a third of a tablet
  4. Stop

I’ve now been without any Deanxit for about two weeks, and so far I’m coping. I’ve tried to examine my state of mind and have found that my mood has been, on average, a bit lower than before. I’ve felt, on and off, a bit ‘fed up’ without necessarily being able to pinpoint a cause – in other words, the dysthymia that I experienced for many years is creeping back. I’ve also experienced one stressful situation since stopping the Deanxit and I did experience something approaching a panic attack before forcing myself to calm down and examine the situation. My appetite is also a little reduced, and I’m not sleeping as well as normal. It seems that while the Wellbutrin helped protect me from major depressive episodes, it was the Deanxit that was a significant contributor to general mood elevation.

So, now I need to decide whether I should put up with these issues and see if they go away, or decide that I’m not willing to do that, and talk to a doctor about some replacement medication that is available here in the Philippines.

I think that to be fair I need to give it a few weeks and see how things develop. It’s possible that I will acclimatise given the fact that I’m so much more self-aware these days (thanks to the counselling) than I used to be when I was using alcohol, but it’s hard to be sure. In principle I would like a medication-free life but not at the expense of enjoyment and emotional stability.

UPDATE 6TH SEPTEMBER: I’m still battling some mild unsteadiness and slight feelings of nausea at times, and although it could just be the heat, I think it’s still Deanxit withdrawal. My sleep is gradually getting a little better, and my appetite comes and goes.

UPDATE 31ST OCTOBER I couldn’t do it. There are some things not worth going through hell for. I’ve seen a psychiatrist and after a long and cathartic discussion she’s selected some locally-available medication for me which will hopefully get my mental well-being to where it needs to be for me to function normally without distress. I’m currently battling some side effects but it’s only been a week, so I will persevere.

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Are we the last generations of humans on planet Earth?

Catchy title, no? And no it’s not clickbait – look around you.

In Brazil, huge areas of the Amazon rainforest are burning out of control. The Brazilian president Jair “Captain Chainsaw” Bolsonaro has waited until today to ask the military to step in to assist, when Brazil’s National Institute for Space Research announced that it has detected more than 75,000 wildfires in the Amazon rainforest since January.

And the cause of these wildfires? Possibly farming companies looking to clear land to make a profit. Land that for millennia has acted as the lungs of the planet, absorbing carbon dioxide and generating oxygen – for humanity, not just Brazilians. And it seems to me that it’s Bolsonaro’s influence on politics and culture in Brazil that has empowered these people to feel they can act with impunity – or dare I say it, maybe his government is sponsoring them behind the scenes, as a way of speeding up the deforestation Bolsonaro seems hell-bent on. Were there wildfires in the Amazon on this scale 20 years ago? 50 years ago? There were not.

Slightly further north, in Iceland, scientists have put up a memorial to a glacier that has ceased to exist due to the climate crisis. There’s no doubt whatsoever that human activity is responsible for the change in temperatures that caused this to happen.

And a little further northwest, in Greenland, scientists are finding that coastal glaciers are more affected by deeper, warmer water than previously thought. If the Greenland ice cap were to melt entirely, the world’s sea level would rise by over 24 feet. It’s not hard to imagine what that would do to London, or New York, or Sydney, or Jakarta.

And all the while temperatures rise and in turn humans install more power-hungry air conditioners and contribute further to the temperature change.

And what is humanity doing? Not very much.

In Nepal, proposed construction of a new airport will destroy large areas of forest, including rare animal habitats.

In Malta, construction is out of control due to political corruption and the Maltese islands are rapidly becoming a dustbowl.

In China, construction of new coal power plants continues.

In the US, energy consumption continues to increase and hits a new record almost every year, with 80% still provided by fossil fuels in 2018.

Everywhere, traffic increases as car ownership rises and the transport of commodities increases to support a growing global population.

And in fact out-of-control population growth is another huge factor in the unsustainability of what is being done to the planet. The catholic church is of course one of the biggest causes with their intransigent backward policies on reproductive health, indirectly supported by the USA with their global gag rule.

I don’t think there has been a period in history when more politicians and religious leaders were enabling more damage to the planet than today. And I can’t understand why these people are in power. Is humanity really becoming collectively so stupid that they vote into power people like Donald Trump, Jair Bolsonaro and Boris Johnson? Is humanity really becoming collectively so selfish that as long as their own personal interests are served, the rest of the world can go fuck itself? Is humanity really so blinkered from reality that they continue to support and fund damaging religious organisations like the catholic church?

If it was possible to graphically represent all the things I’ve been talking about in a graph that measures ‘damage to planet earth’ against time, I’m pretty sure the result would be an upward curve increasing in gradient, not even an upward straight line.

A day is going to come when that curve passes a certain critical point, the oceans rise, crops fail, water supplies dry up and temperatures are too high for humanity to survive. The question is, when will that day be?

I actually think there are people alive today who will see the start of the extinction of humanity.

And people wonder why I get depressed.

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Did Lariam cause or worsen my depression?

Today I came across an article on the BBC News website, discussing the vivid hallucinatory dreams that one person experienced while taking Lariam tablets as a prevention against Malaria during a trip in Africa.

This got me thinking back to an African road trip I had done through Botswana and Zimbabwe way back in 1994. Like the article’s author, I took Lariam (the brand name for the drug Mefloquine) for a few weeks before, during and after my trip.

I didn’t (to the best of my memory) experience any vivid dreams, but I do remember a 2 day period during the trip when I felt extremely depressed and nervous. At the time I put it down to a bit of homesickness and after it had passed I forgot about it.

But the BBC article author’s experience with depression, paranoia and anxiety after his trip piqued my interest, and so I did a little googling. Guess what I found:

All these sources are agreed on two things:

  1. Lariam is proven to be a cause of depression and anxiety (among other equally serious issues such as psychosis and suicide ideation)
  2. The effects of Lariam can persist for months and even years after the patient stops taking it and may in some cases be permanent.

My own experiences of depression (apart from the brief episode while on my trip) started a year or two later, as far as I can recall. It wasn’t as if I woke up one day and suddenly found I was depressed – it crept up on me slowly and insidiously until there came a point where I realized that something was wrong.

My family doctor was not particularly helpful and simply prescribed a few weeks worth of tricyclic antidepressants, which had the effect of numbing my feelings, both positive and negative, and in the end I discontinued them, figuring that I would get over it in my own good time.

During the next few years I didn’t connect my state of mind with depression, though my drinking steadily increased and if I look back there’s absolutely no doubt that I was depressed. In 2005 I sought help from a counsellor at my family doctor’s clinic, and they suggested I attend some cognitive behavioural therapy sessions. I attended a few but wasn’t convinced by their conclusion – that I was suffering from low self-esteem.

In the end I had to stop the sessions due to my plans to emigrate to Malta finally bearing fruit.

And to cut a long story short, it wasn’t until 2009, in Malta, that I discussed my depression and alcohol abuse with an understanding doctor, got medication that actually helped, gave up drinking, and started 3 years of weekly counselling sessions that were ultimately my salvation.

Now, looking back on the various stages of my life, the places I was educated, the places I’ve worked, the towns I’ve lived in, and the state of mind that prevailed during each of those stages, I can see that before using Lariam I had some minor anxiety issues and the occasional brief bout of depression, whereas after that period my depression gradually grew until it effectively controlled my life for many years before I finally got the right kind of assistance and support.

Now, I will never be able to prove that taking that course of Lariam was directly responsible for my depression and anxiety over the last 20 years, but it certainly seems possible that taking Lariam could have been a factor in worsening my symptoms, even if it wasn’t the sole cause.

Now, thankfully, Lariam is hardly ever prescribed for malaria prevention – there are far better drugs available. But as far as I know it still isn’t actually banned worldwide. And if you’re ever advised to take it, I would seriously recommend that you refuse. It could change your life, permanently, in ways that you really, really don’t want.

And where does this leave me? Well, where I was before, I guess. I suffer from depression and anxiety, that’s a fact of my life that I can’t change. I keep both controlled reasonably well, most of the time, using medication and ways of coping learned during my counselling sessions.

Does the thought that my depression may have been prevented or lessened if I hadn’t taken Lariam make me angry? Well, yes, up to a point, but what’s the point in being angry at something in the past that you can’t go back and change? Being angry at things has always been one of my depressive symptoms and I can do without even more of it.

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Depression is not the same as being sad

It’s time to try and increase the frequency with which I post to this blog. Today’s post fits more into the “life” theme than religious or political comment…

I have a chemical imbalance in my brain. Not enough of one particular chemical is produced, and as a result my positive moods and feelings don’t last as long as they should (and would, in a “normal” person), whereas negative moods and feelings persist far longer and their intensity is magnified completely out of proportion to their significance.

I’m not absolutely certain, but I think I can say with some confidence that in my case this is an inherited condition, from which both my father and paternal grandmother suffered. That’s not true for everyone, and there can be many different causes.

This condition is, of course, called clinical depression. And it’s no joke.

Brain activity in a depressed person

Right now I’m slowly recovering from a short period of severe depression, and in the interests of science (and because it’s good to get it off my chest), I’m going to try and describe how the worst days felt.

One of the most intense feelings was one of isolation. And I mean total isolation. Though I was in a social situation, I felt that I was looking at the people around me through frosted glass – I could see them but they couldn’t affect me. I could hear what they were saying but none of it made any real sense to me. Someone could ask me to do something, and I might say yes, but I would have no real comprehension of what they were asking or what I should do. A fellow sufferer said to me recently that felt like what was going on around them wasn’t real, but instead was a foreign film with no subtitles.

Another feeling was the loss of any sense of past and future. All hopes, dreams, plans and achievements disappear from my consciousness and anything that happened more than a few minutes ago is blurred in my mind. Any present fears, however, remain.

Then there is the short term memory loss and mental impairment. I lose the ability to count (so that gym workouts, which are always helpful in general when I’m depressed, become a bit chaotic because I can’t remember how many of each exercise I’ve done). I forget what someone said to me within a few seconds, unless I reply straight away.

And finally there is the complete and overwhelming sadness – I mean the kind of sadness where you know you’re crying, you don’t really know why, but you simply can’t stop it. And it’s accompanied by a feeling of such wretchedness, guilt and worthlessness that it leaves you literally gasping for breath. This comes and goes for hours at a time over a period of several days.

As well as these core symptoms, for me there are also secondary symptoms. For a period of 4 or 5 days leading up to a severe depressive episode, my mood becomes gradually more and more irritable and irrationally intolerant, causing me to react harshly to other people and “act out” recklessly. Each depressive episode normally costs me €100+ in driving offences. I can do nothing about this, because by this time my brain is treating this mood as “normal” and won’t let me understand that I’m changing. It’s only once the anger gives way to the despair that something “clicks” and I suddenly realise I’m in the middle of another episode.

And all the while there is a constant headache and mild dizzyness or disorientation, which makes me slightly nauseated all the time. A bit like a migraine though not as intense. My appetite comes and goes, and although I sleep at night, I wake up either very early or miss the alarm completely.

I have no idea whether any of this will make sense to someone who does not suffer from depression, but I’m hoping that you can see how different it is from just “feeling down” or “getting the blues”.

The next time you encounter someone who tells you that they’re depressed and you’re tempted to say something like “cheer up” or “pull yourself together”, please try to understand that this is just about the worst thing you can do. A far more sympathetic option is just to say that you’re sorry to hear that, ask them whether they want company or to be left alone, and take it from there.

Originally posted on my blog ‘Reasoned Rants’

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