Illicit drugs, evidence of depression

[Strategery]

Doctor,

A little bit of background. I have experienced anxiety and depression to varying degrees for the majority of my life. It got really bad when I graduated from college and entered the "real world" (although I also experienced Dep./anx. in high school and college) I was prescribed Effexor and it worked at about 225 mg. After a couple of years I felt that it had "pooped out," so my doctor put me on Paxil. It didn't work very well. After about a year on Paxil, I was put on Lexapro. That didn't work very well either. I am currently very depressed and anxious and am considering getting back on Effexor, however the withdrawal aspect of Effexor is disconcerting. In summary, SNRI's 1, SSRI's 0.

Anyways, I think a lot of us who struggle with depression wish we could isolate it as a disease or disorder once and for all. I wish I could understand my neurochemistry a bit better. It's been a long and sometimes confusing rollercoaster ride of depression, drugs, doubt that I am truly clinically depressed, no drugs, more drugs, to feeling 100% confident that I have "messed up" brain chemistry. I wish I could also better understand how environment and stress affect production and reuptake of neurotransmitters, and vice versa. Which came first, the chicken or the egg? My feeling right now is that I have an underlying condition which becomes severely aggravated when environmental stress increases. I simply cannot cope with what life throws at me at times. Circumstances can send me spiralling into a deep pit of depression. Everybody has problems, but most people are able to cope with them without becoming severely depressed.

On a few occasions, few and far between, I've taken Ecstasy or Cocaine (won't do that stuff anymore). The following days were miserable. I had very intense feelings of guilt, anxiety, and depression for days after having taken these drugs. It would literally take me about a week to recover and feel "normal" again. But other people with whom I took these drugs seemed to be fine. They just slept it off the next day (eventually), and then were just peachy. Meanwhile, I was a nervous wreck. I construe this as "evidence" that I indeed have very real neurotransmitter issues. What do you think? Is the fact that I get very depressed/anxious after using these drugs a signal that I am truly clincally depressed? I know cocaine works more on dopamine and MDMA works on serotonin. Can you surmise anything from my drug hangovers or am I just over-analyzing this?

[blondee046]

So strange...I did ecstacy for 3 years with my friendson and off and the same thing happened to me. We would all smoke some pot and then later they would go to SLEEP. Me, I would literally be up for 3 days afterward every time and would get REAALLY depressed for about a week.I finally stopped when I realized I was addicted to painlikkers I would use to help bring myself down but Honestly it has really done a number on my seratonine!The afterneffect of ex~ is not worth it for me, but 3 years later my friends are still doin the saaaame ****...I just have a different chemical makeup and can not put myself in that position without paying some SERIOUS consiquences.I am now FINALLY on Zoloft and trying to help get a peice of ME back.

[drunksunflower]

I would too ... there are some correlations that I wonder about, for example when I look at my friends who have been 'diagnosed with depression' they are generally all really bright people who have done awesomely at uni/careerwise - so I wonder if it is intelligent people who tend to think more and overanalyse things and do the repetitive thinking thing - what's it called again?

I suppose it's a big generalisation like bipolar and creativity ;)  but i guess it is natural to try and find common elements of people who suffer something.

i have a phd in psychology (not clinical though, research- criminal justice) so have studied a bit along the way ... still don't really understand though.  i think it comes down to the fundamental 'how can i have so many things going well and still feel like **** and be thrown by silly small things?'

just the other weekend, as i said, i rediscovered going out and taking some recreational drugs - at least it creates a good happy for a while :)

hope you are doin ok.

[Roger Gould, M.D.]

Yes, you are over analyzing this.  The brain chemistry is even more complex and mysterious than the simplified version available to the public re serotonin and dopamine.  You probably have a great tendency to be self critical and anxious.  those are things that give you a base negative reaction, and those are things you can change on your own, or through experience or through psychotherapy.  Work on that, not your chemistry.

[Strategery]

drunksunflower,

You're not interrupting at all. In fact, I'm really glad you posted that. I think we're probably pretty similar in that respect.  

I agree with the doc that I "have a great tendency to be self critical and anxious. those are things that give you a base negative reaction..." That makes sense, but I still get the overwhelming feeling that there's something else to it.

I also agree 100% that "The brain chemistry is even more complex and mysterious than the simplified version available to the public re serotonin and dopamine." If I try to do any research on the subject, all I get is the same regurgitated ****. I would really like to be able to understand it better.

[drunksunflower]

It's funny, I used to take a *lot* of e and coke and ket and all sorts, probably more to make myself happy than anything else.  I never wanted to take proper drugs for depression.

But I notice I take so much longer to recover from a night out than most of my friends, their comedown is a couple of days and mine is ages.  

So perhaps I have a similar sort of *&%$ed up neurotransmittery mess as you do?  I have been so much better, stopped taking Celepram/Celexa, been good for a few months and after a big weekend when i dropped an e for the first time in a long time am back in a muddle ... i wouldn't have thought just one pill would do it but it kinda has ... meh don't really know what to do.

Anyway not to interrupt yo thread, but i thought it was a similar sort of thing ... maybe ... in a way.

[Strategery]

Hi,

I actually have an appointment set for Tuesday and I am hoping to start taking Effexor again. I am currently working and actually, my job/career is something that has been causing me quite a bit of anxiety, but that's a long story. My social relationships are OK for the most part, but I have been kind of isolating myself from people because I don't want this episode to damage any relationships, and I don't feel much like being around people a whole lot lately.

I don't think I'm really conflicted anymore about my depression/anxiety. I have pretty much accepted it. But my question was more out of curiosity. On a scientific level, doesn't it stand to reason that if I feel more depressed after taking a serotonergic drug than others around me, could you conclude that my brain is more deficient in serotonin?

[ckg]

Hey there,

I'm sorry that you're feeling quite conflicted on the inside.

Ecstacy & Cocaine can cause lasting damage to the brain.  However, in most, the body is able to recover from the damage (remember in high school biology class how the teacher always discussed homeostasis).  However often people, such as yourself, need a little help to get to that point and beyond.

First -- are you working? do you have hobbies? what are your social relationships like?

If you have that much time to analyze back to your high school days, it leads me to wonder whether you are obcessing over something that you now have no control over.

As a practioner, I'd consider getting back on the EffexorXR - if it worked for you.  I'd also consider talking to your physician about adding something for anxiety, as needed, in a low dose as well as a referral off to a psychologist to maybe talk through some of the problems that you're encountering in your everyday life?