A separate thread?

Metaschima, I respect that you treat the issue with respect.

What you stated above is what I've been told by doctors before.

However... When I first sought treatment, I had an initial consultation with a psychotherapist, and was given a 566 question test, and then in the first session with a psychiatrist was put on three different medications.

According the drug makers and doctors, it can take up to six weeks for medication to get the full effect.

I had no prior history of suicide attempts.

Now, during this time, I was working. I owned a car. I drove. I was rational enough to do these things.

I've used myself for an example because it's relevant for other people. We can agree that some people who are struggling are still taking care of themselves, even to the extent of having their own apartment and working at a full-time job?

In situations like this, I think considering medication is fine, keeping that option on the table. But because of the unknowns of the brain, and psych meds, more emphasis should be put on non-pharmacological treatment.

Another key point to consider, meds can take up to six weeks to work, so even prescribing them to a patient who is far closer to the point of suicide can do little to actually prevent a suicide. That's when the close monitoring should be done.

Speaking of close monitoring, once a week appointments is the standard. Any problems, call the doctors office. After hours, a message usually instructs someone to dial 911 in the case of an emergency. And usually there's no help available unless one actually has a plan. It's not enough to simply feel hopeless and desparate, if they determine you're not an immediate threat to yourself or others... nothing 911 can do, except give you the number for a suicide hotline.

So then you talk to an operator who's never met you before and you have no rapport with. Their job is apparently to help you feel better so you can... cope until your next appointment with your doctor or therapist?

Going directly back to close monitoring... family and friends? I believe it's commonly known that many people with mental illness are more likely to voluntarily isolate themselves, or simply not have a good connection to family and friends. So... the reality is, close monitoring is not realistic. One could argue it's irrational to expect it of a patient, or treat someone with psychoactive drugs unless there is a method to closely monitor them.

Or irrational to expect someone to feel happy and content when they know every week they have to pay someone to talk to them

It seems almost irrational that in some cases it's cheaper to see a prostitute rather than a therapist. But prostitutes don't take insurance, so, no, I'm not advocating that if one has to pick one or the other to feel better in the short-term.

Once in a session I was feeling particularly down, and spoke more of thinking about suicide. He usually just let me vent, but this time he said, "Well, if you're going to commit suicide, there's really nothing I can do about it."

See, if there's no immediate plan, then legally they really can't.

In fact, if someone is put on a 72-hour hold because of a suicide attempt or because he was deemed to be in immediate danger, he is released if deemed no longer an immediate danger. Where to then? Back in the same situation he was in before the attempt. For me, it was like a little vacation, I met some nice people who I could relate to, so yes, I did feel better afterward and able to cope.

I learned about Depressive Realism when I read Lincoln's Melancholy a few years ago.

Some research shows that depressed people are more realistic than non-depressed people. The problem is the balance isn't there, which leads to depression caused by negative thoughts and feelings. Too much focus on the negative, not enough on the positive. But it's a big topic and I won't attempt to summarize further. And I'm not suggesting depressive realism applies to all cases of depression.

Well, as I sometimes do, I addressed more than one topic in a post. I do apologize for being long-winded. I did my best to stay on topic and be relevant.

I realize my personal experience will be different from that of other people.

But when I keep seeing messages about getting help, call this number... I get a bit frustrated because I have been asking for help, off and on for thirty years. For the last 6 I haven't been on medication. I've been meditating and practicing CBT. I feel more stable generally, and I feel more like myself off the meds, but I still struggle with depression. But not more than when I was receiving treatment. The things that help me the most? Socializing with family and friends. Escaping into discussions on message boards... playing piano, which I started for the first time almost three years ago. It's the first instrument I ever learned. I've had more personal growth in the last six years than in the entire time of treatment.

Oh, by the way, the only suicide attempts I've had were when I was getting treatment, when I was getting treatment. None before, none since. Coincidence? I honestly don't know. I'm just glad to be myself. Meds can cause anxiety, depression, suicidal thoughts, insomnia... well, I'm grateful that now I can narrow down the list of things that might be affecting me, and not wondering how a drug is interacting with me.

As for the medication cocktail, well, I have tried many combinations at different doses for different lengths of time. I don't think it's rational for treatment to consist of casually prescribing drugs that can cause a multitude of side effects. If they take six weeks to build up, how long does it take to leave your system? If a person has a severe adverse reaction... is it the med? Is it the patient? Up the dose, decrease the dose...

I'm not anti-med, but their efficacy is hyped up, and the dangers are... minimized.

I know some people have been helped, at least that's what I've heard. I think there's people who feel just as strongly about the opposite point of view I have. So, no, I'm not anti-med. I would simply like the information about the various aspects of mental illness and treatment to be honest and complete by all involved.

I'd be remiss if I didn't mention this info I recently found. A genetic test that can determine how a med will metabolize.
Medication Sensitivity: It’s In Your Genes
I do appreciate the kind and supportive messages that people posted in the RIP Robin Williams thread. It is helpful to know that there are understanding, non-judgmental people that are willing to talk about the issue. Thank you. Many people, I believe, will appreciate it.

I didn't vote because I never had treatment for my depressions nor taken medications.

Don't get me wrong, I had my share of depressions in life but they weren't in the severe situations. I did had a health related depression but I never consider suicide as a means to resolve the depression. Many of my depressions got resolved through time.

A peculiarity about anti-depressants that isn't mentioned too often (to patients) is that they give you energy (2 weeks) BEFORE they improve your mood (6 weeks). This means that when starting anti-depressants you must be very closely monitored, because if you didn't have the energy to act on your suicide plan, now you do. Once your mood is improved (6 weeks), things should get better. However, not everyone responds to the medication, so treatments can be changed to try and obtain an effect (I guess in the future they may be able to know using genetic tests which meds are best beforehand).

Monitoring is a real problem, and many solutions aren't realistic like you said. However, the more support you have from everyone in your life, the better.

Hello...I'm back after a sudden freakout.....


After a few months hiatus...I'm not dead even though months ago I did have ideations....thanks to xanax

After lurking these months and recent freak out at the beginning of this year, I guess I will post my For me it started with a severe panic attack due to the sudden onset of tinnitus, which turned into a vicious cycle of depression and anxiety.. Im taking benzos and z-drugs just to sleep and stay asleep, which cycled into chronic fatigue, depression, , wash - rinse - repeat. Went to a psych, prescribed some weird sublingual med "zephryss" or whatever it was, and I ended up at the ER because of it. I can't sleep normally now because of the tinnitus causing anxiety , turning to insomnia, which leads to depression.... btw xanax(alprolazam) is a benzo ... I am currently on lorazepam though, unlike xanax, it stays with you longer so you don't crash like xanax does. And to add a Z-drug into the mix as well, zolpidem for sleep. Its the only way I can sleep now, it sucks but what else can I do?

Also I have lost considerable amount of weight... 215lbs to 165lbs within a month

Oh and its not just having tinnitus , what makes it worse is that I have hperacusis. Been to many audiologists which confounds them even more, because my audiograms are within range no loss. MRI confirmed a cyst in the occipital lobe, but shouldn't have anything to do with my tinnitus due to that portion is visual. Nothing else, no acoustic neuroma or anything. No TMJ...Which also added to my depression... "sorry just deal with it.'


Oh, benzos and z-drugs are 'short term' and doc isn't going to keep giving me these presc. So I will have to figure out how to sleep without them but at this point in time I still need them. Which is probably also bad because I've been on these meds for months already , but when I don't sleep I feel I want to

I'm glad to see discussion on this. This is a place where a lot of people will see it.

(Sigh ... Rest in Peace, Robin, and know that you raised great public awareness of the demon that assaulted you.)

To quote part from another thread comment I just made, to increase the chance that someone ... you, yes, I am talking to you, whoever you are ... will encounter it.

Sometimes mental-illness treatment requires kick-ass drugs with serious side effects, and-d-d-d sometimes it doesn't. The brain is a profoundly delicate thing that is also, of course, tapped-in to the lion's share of the body's blood supply. It's impossible to "characterize" what strategies will work with any individual, and which will not. Therefore ( ... Gentle Reader who may be reading this now ...) don't let this thing persuade you not to treat it. If you're in the middle of this morass, to any degree at all, you need to talk to someone.

And as I have said before: a suicide-prevention hotline is manned 24 hours a day; there are also internet equivalents, but in this case I think it's really, really important to talk. (Yeah, you can skype some of 'em.) You don't have to actually be contemplating suicide. All that you need is the realization that you need help ... of some kind and with some urgency that is "yet to be determined." Mental illness is a physiological syndrome. Regrard it as soberly as you would any other disease process that has no right to be attacking you, and that can be driven away.

Welcome back, glad to see you're still with us. Sorry to see that you can't find a good solution to your problems. I've found that eventually a solution is found to virtually every problem, so don't give up.

I'm glad you and others are posting.

It's a drag not being able to sleep or not being able to predict when one will be tired enough to fall asleep.

I'm curious—have you (or anyone else) ever heard of melatonin supplement use to help regulate sleep and circadian rhythm?

Unrelated to the quote above:

sundialsvcs mentioned working at a hotline (Thanks for that). Correct me if I'm wrong, but does it seem like hotlines are far more well-known than warm lines? I was given a number to a local warmline several years ago; I'd never heard of it before.

I just looked up to see about national warmlines. Here's one link:
www.warmline.org/
I wonder how updated their site is or if there's other directories that people should be aware of. Anyone know?

I wasn't familiar with "warmlines."

For a person who is locked in a crisis disease-syndrome and is basically coming to grips for the first time that something is "happening to him or her" that s/he can't deal with directly (despite earnest attempts to do so ...), I think that a hotline would be the first call. You need that trained, interventive point-of-view, and you need those resources. Going forward, I can see that a warmline would be helpful in showing you that "you are not alone."

I have taken melatonin too on this seemingly un-ending hell of a ride that I'm still on. 5mg tabs of melatonin, but I would be taking 2x of it, along with the benzo and zolpidem, AND valerian root (400mg) along with all that at one point. Sometimes I would still wake in the middle of the night and thats the worst, because I wouldn't be able to go back to sleep. Then I found myself taking yet another zolpidem to knock me out. Oh yea, and thats a class iv drug! great....

Bedtime for me has turned into a nightmare, thats where the benzos come in to keep me calm. I have to go back to the doc soon, for an alternatives. I've tried trazodone but didn't make me sleep... I know I can't stay on z-drugs and benzos, problem is now I've been with them long enough that I probably can't just quit without withdrawls -- This from researching. Another possible alternative is amitriptyline for sleep. I dunno.... Sorry for hijacking the thread if I did.

@Jeebizz:

No, I don't think you hijacked the thread. The topic is mental health and suicide prevention, and I don't see any reason this thread should be about any one individual.

I hope I'm not out of line if I suggest: try not to worry about the withdrawal. Not everyone experiences it, and those who do seem to be affected to different degrees. If you get to the point of talking to your doctor about weaning off, withdrawal may be a problem, but there are ways to manage that if it is (hint, doctor suggested ways to manager, and if you also prefer, various web sites and blogs by people who have gone through it). In the meantime, I just wanted to remind people that discontinuation syndrome doesn't affect everyone. What I don't know is how common or rare it is, or even if it's documented when it happens to a... consumer such as you or I .

To tell you the truth, I don't have much first-hand experience with it. I've had problems getting off SNRI meds, but nothing severe. I can't recall right now if I've ever been on any benzos. If I was, it wasn't for very long.

Here's a list of the meds I've been prescribed over the last twenty years (may not be complete):

Prozac
Stelazine
Cogentin
Wellbutrin
Paxil/Seroxat
Effexor
Celexa
Buspar
Trazadone
Amytriptylene
Nortryptiline
Alprazalam

I have been prescribed paroxetine aka 'paxil' , tried it for a week and quit - it is an SSRI , problem sideffects are insomnia which I already have. amitriptyline/trazodone are also antidepressents but can be used for sleep - so thats what I am looking for now as alternatives.

Alprazalam (xanax) also a benzo. Usually 1mg tab, but thats where I had problems. It WILL calm you down, but it acts too quickly and leaves too quickly, so its like a hand that catches you, but then lets you go too quickly. Lorazepam aka 'ativan' is slower to act, which is better, because it leaves your sys. a lot slower, so there is no 'shock', at least not to me, which is why xanax caused me to feel the way I did when this shit started..

Fsck, its no secret that I am still pretty much depressed, not on the lines of where Robin Williams was , but still I am pretty low right now .

SSRI/SNRI/etc all sounds good 'in theory' , but also the unfortunate side effect is that it can amplify suicidal ideations as well...ironic.


Oh yea, I have also tried triptophan 500mg too. So I have been combining natural supplements and prescriptions at one point... *sigh*

As someone who have suffered from depression, anxiety and OCD, I have also had my fair share of bad times and have been medicated for about 16 years as well. I'm not depressed anymore, but a subtle anxiety remains (it's bearable to be honest). Currently taking a very low dose of an antipsychotic to help control my anxiety, but my doctor said I can stop taking it in a few months (which is completely fine by me).

Anyway, hope things get better for you guys.

Cheers!

I don't think you need to complete the list .... I'm aghast that you have been on all that... Its great that you are off , meanwhile I still don't know where I stand. Its near bedtime again, and this time I don't have the help of zolpidem (ran out, pharmacy won't prescribe anymore)... I figured it was THAT or temazepam which I never touched... I also forgot I was prescribed 'quetiapine' or whatever the hell it is, but reading side effects of that also made me not touch it. FSCK it, I'll go and say it I was always averse to taking any kind of meds, even when I was little, especially cough syrup (then again what kid LIKED cough syrup...)...still probably bad example sorry.

I'm forced to weigh options of sleep vs. other side effects... Kinda makes me look that one song now from Huey Lewis & The News 'New Drug'. in a different way now(not intending to make light of any of this - I just feel it is an apt comparison)

I'm glad that you've overcome it. Months have nothing against YEARS.....

@odiseo77, thanks for sharing. Every story is important, especially success stories.

@Jeebizz: Oh, yeah, I forgot about Paxil. The wonders of "zapping." That was my first experience with discontinuation syndrome from an SSRI.

Anyone else think manufacturers should have a comprehensive, official guide to tapering off psych meds (for the times it's applicable to patients)? Last I heard—and my info on this may very well be outdated—doctors have to guess at it, or experiment, whatever term one prefers. But doesn't it seem that in a rational world such as ours, when drug manufacturers include warnings not to stop medications suddenly, they should provide information to doctors about what to do when a patient needs to taper off?

Good luck with sleep. I know it can be a real nightmare sometimes. I remember when the Huey Lewis song came out. It's great.

I couldn't tell you how many long nights I heard this song come on: "I'm so Tired" by the Beatles (primarily written and sung by John Lennon. It's great.

Yer Blues (White Album), another of his songs. "Yes, I'm lonely.... wanna die." How's that for a cry for help? He told the whole world. Glad he conquered his depression. From what I know about his life and what I've heard in interviews, he seemed to find genuine happiness, contentment, and inner peace near the end.

@Andy Alkaline thank you for your encouraging words, trying not to dwell also.

Yes I do think manufacturers need to have a comprehensive guide to tapering off....But I look at them as the problem...Remember the show Scrubs? I don't recall what episode/season it was, but I distinctly remember an episode where a drug manufacturer was visiting the hospital essentially 'hocking' their new product......The younger doctors I think obviously tried to do everything they could to deny the manufacturer, but if I recall the senior doc was convinced otherwise...Why? $$$$$$$$$$$