Depression the invisible hell - Politics Forum.org | PoFo

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#14875144
My wife is a good person who suffers from serious depression. It is incurable but it is possible to have periods of stability. She has tried various chemical combinations. Effexor being a primary one. Periods of stability end sooner or later and other methods must be tried. She is presently experiencing a period of instability. We have tried many things but, this time, we seem to have run out of options.

Depression is not all that rare. Many struggle with it. If you do, please use this thread to comment on any methods you have used to deal with this invisible hell.
#14875154
What about medical marijuana?

I actually have an older cousin who has possibly had a somewhat similar experience. These days, she tokes a lot, says it does her good. There are so many strans nowadays, with so many effects.
#14875296
I look at orthomolecular options, because medical doctors almost always overlook them. Depression can be caused by a depletion of key nutrients. For example, hypomagnesemia (magnesium depletion or deficiency) can cause all sorts of problems. Magnesium is important for 325 different enzymes in the human body. All kinase enzymes require magnesium as a prosthetic in order to make them biochemically active. There are 103 kinase enzymes in the human body, so that's almost 1/3 of the enzymes requiring magnesium.

One important reaction is pyridoxal kinase. You should get reasonable amounts of pyridoxine or pyridoxamine in your diet--i.e., vitamin B6. However, it is metabolically inactive in that form. It gets oxidized in the liver to pyridoxal. Then, it gets phosphorylated into pyridoxal-5'-phosphate (P5P)--the metabolically active form. The pyridoxal kinase enzyme, of course, requires magnesium. Additionally, Adenosine Triphosphate (ATP) also requires magnesium. So in that reaction, ATP gives up a phosphate group to pyridoxal and becomes Adenosine Diphosphate (ADP), the added phosphate group to pyridoxal binds to the 5-prime end of the carbon atom giving you pyridoxal-5'-phosphate. ATP is important because it's the energy regulator in the human body. If ATP isn't working properly, you'll be pretty lethargic/apathetic.

Why pyridoxal kinase, pyridoxal, ATP and magnesium are so important in depression is that three key neurotransmitters are dependent on P5P:

1. GABA: Gamma amino butyric acid (GABA) is the primary inhibitory neurotransmitter in the human central nervous system. Ironically, it is synthesized in vivo from glutamic acid (or glutamate) which is the primary excitatory neurotransmitter. So if you don't have enough P5P for the glutamic acid decarboxylase enzyme, you end up with a build up of glutamate and a dearth of GABA which makes people excitable and agitated. Doctors will ignore that and prescribe drugs like benzodiazepines to counteract anxiety. Longer term, they will prescribe drugs like gabapentin to block the effects of glutamate. I've talked to doctors who were knowlegable about the GABA/glutamate balance/imbalance, but none of them knew that glutamate was the substrate for GABA.

2. 5-HT: 5-hydroxy-tryptamine (or serotonin) is a key neurotransmitter for regulating the nervous system. People with a dearth of it tend to get depressed, anxious, etc. Many anti-depressants are serotonin selective reuptake inhibitors (SSRIs). The metabolic path for serotonin can get shut down because of a lack of L-tryptophan in the diet. It also gets disrupted in women in another case: PMS. When estrogen spikes, it can bind to tryptophan hydroxylase, which breaks L-tryptopan down in to 5-hydroxytryptophan (5-HTP, which you can get at most vitamin stores). 5-HTP gets decarboxylated into serotonin with, you guessed it, P5P/B6 as a co-factor. There is another case where that gets blocked too. Some people with bi-polar disorder cycle with high degrees of dopamine, which can bond to and deactivate tryptophan hydroxylase too, just like estrogen. However, the mania from too much dopamine is followed by irritability and depression; hence, so-called "bi-polar" disorder.

3. Dopamine: Dopamine is key to what makes you feel good. The pleasure from sex, the satisfaction after a good meal, the "aha" when you learn something new generally comes from dopamine. The "keep doing this" aspect of addiction is also generally dopamine related. It uses exactly the same enzyme as 5-HTP in decarboxylating 5-HTP into serotonin; however, it decarboxylates L-Dopa into dopamine. Just like that reaction, it requires P5P, phosphorylated vitamin B6, to be metabolically active.

So I like to look at magnesium, zinc, potassium and b-vitamins as a baseline before looking at drugs.

I've talked to you about my friend before. She had a migraine from Christmas Eve until Wednesday evening. Where 800mg of Ibuprofen multiple times a day did nothing; where her migraine drug (a barbiturate + acetaminophen + caffeine) didn't help much, I found that as little as 250mg of magnesium began to clear the head pounding symptoms almost immediately. It took me awhile to realize that magnesium might help, but once I did the relief was almost instant. So I've got her taking about 750mg of it a day, which is almost 2x the RDA. So I added zinc and potassium to that mix, just to get some basic metabolites going.

Effexor is a NET and SERT drug. It binds to neurotransmitter transporters.

NET is the norepinephrine transporter. It makes me wonder if that binding is what was effective.

I have what I call the "motherfucker" gene, because its initials are MTHFR, or methylfolate reducatase. If I start getting down, turning it around for me is as simple as taking vitamin b9 (methylfolate) and vitamin b12 (methylcobalamin).

Some people have a COMT (catechol-o-methyltransferase) gene that makes them agitated and depressed too. The supplement SAM-e helps with that.

How is her diet?

Also, Swanson Vitamins has combinations for B9/B12 for the MTHFR gene. It also has a nice one called GABAplex, which contains GABA, Tyrosine (a precursor to dopamine) and a bunch of the soothing aminos like Taurine and L-Theanine.
#14875358
While images of love and joy fill storefronts, TV screens and magazine pages, for many people, the reality of the holidays isn’t so cheerful. Between stressful end-of-year deadlines, family dysfunction and loss, poor eating and drinking habits, and increasingly cold and dark winter days, it’s easy for the holiday season to feel not-so-merry and bright.

Constant reminders of others’ happy seasons can additionally serve as a painful reminder of the happiness and love that’s lacking in our own lives. For this reason, the month of December can be a particularly difficult time of year for those dealing with family conflict, loss, break ups, divorce, loneliness and mental health issues.

Feelings of depression and negative mood affect many people at the holidays, and not just those who have been diagnosed with clinical depression. While there hasn’t been data to suggest an actual rise in depression rates and suicides in December ― research has found that depression and suicide actually peak in the spring ― some experts say that the holiday blues are a very real phenomenon. And of course, there’s plenty of anecdotal evidence to suggest that this is the case.

https://www.huffingtonpost.com/entry/ho ... 789f6941c0


I think it's a Christman thing which will pass after the Christmas season. From TV commercials and programs, you are constantly reminded of how happy you're supposed to be around Christmas time, which may worsen mental depression. Opting out of any information related to Christmas may help her calm down, such as special Christmas programs on TV or gaudy Christmas decorations.
#14875475
jimjam wrote:My wife is a good person who suffers from serious depression. It is incurable but it is possible to have periods of stability. She has tried various chemical combinations. Effexor being a primary one. Periods of stability end sooner or later and other methods must be tried. She is presently experiencing a period of instability. We have tried many things but, this time, we seem to have run out of options.

Depression is not all that rare. Many struggle with it. If you do, please use this thread to comment on any methods you have used to deal with this invisible hell.


Hoping your wife and you may find respite some day from what you know so well.

Has she been prescribed Wellbutrin, by any chance? Also, has she worked with any cognitive-behavioral therapy?

I've dealt with depression for some years now, and to be honest, the meds I received didn't help me a lot, although Wellbutrin helped a little.

Interestingly, I got the most relief for my depression from the mild anti-anxiety medication Atarax (hydroxyzine). According to my doctor, Atarax is an allergy drug that was found to cross the blood-brain barrier and provide some relief for anxiety. It has few mild side effects and is considered non-habit forming, unlike other anxiety meds.

So: short and sweet:

Two things have helped me:

Atarax

My own formulation of CBT that I refer to as "fake it 'til you make it." A consistent daily structure is key to this. It's willing yourself (and I very much understand what it means to say that when life seems like wading through quicksand, exhausted from the effort of going nowhere) to go through the motions of a daily routine, focusing on others instead of inward (thinking of the needs and concerns of family and friends), focusing on the idea of "do the next thing." If the "next thing" means walking out to the mailbox: so be it.

Ultimately, each person's journey is their own. I wouldn't presume to say what you 'should do' or 'shouldn't do,' only offering what you asked for, which is what's worked for others. So this is mine, with the caveat that it works 'for today,' and tomorrow may be different.

My best wishes to you both.
#14875637
Third Term wrote:I think it's a Christman thing which will pass after the Christmas season.

Well, clinically, it could also be seasonal affective disorder. I think they prescribe Wellbutrin for that during the holidays. That's incidentally why Northern Europeans have light festivals at Christmas time. It's basically to combat the darkness. The further North you go, the longer it is darker during the Winter. Vitamin D and Nitric Oxide may be waning during those times.


https://www.psychologytoday.com/blog/re ... depression

SAD, Seasonal Affective Disorder, research is interesting as well. The National Institute of Health cites several studies where sunlight markedly improves mood. Of course even though we know sunlight increases vitamin D levels this doesn’t prove that the increase in vitamin D is what is responsible. It also doesn’t prove that sunlight will work in those that are depressed and do not have SAD.

The other thing sunlight does with the skin is increase Nitric Oxide. For you boys out there, that is the neurotransmitter that gives you a boner. Choline is the transporter (vitamin B0), and arginine is a precursor. However, if you are relying on Viagra/Cialis, etc. you may need nitric oxide, as that is essential for circulatory system health.
#14875670
I am so sorry that you and your wife have to go through that. My sister has had depression issues for most of her life and I know how hard it is for everyone around her. She takes lithium, ativan and some other ones whose name I forgot. We make sure she has things to do each day and each week. When she has places to go and people to see, she comes home too tired to do much except sleep. Ugh and when she sleeps, everyone can rest and she won't mumble or cry in her sleep.

She tried Depacote and Wellbutrin but those didn't work for her, the dosage would make her so drowsy and she would lie down on the sofa and not be able to get up.

Regular exercise helps her to stay cheerful too. She likes to walk and swim. She used to go all manic during Halloween and Christmas but she has been so much better in recent years.
#14875721
Stormsmith wrote:Has she tried St John's Wort?



To expand a liitle: SJW is a common herb that the Germans experimented and tested. Properly. The concensus is, it's very effective in treating moderate depression with no side effects. Now, it may be the case that Ms Jimjams case is too severe, but because its sold for very little cost, and available in any health care shop, I'd give it a shot.
#14875727
I'm still shocked that people are shallow enough to blame "depression" like it's a disease (very few if any people have a physical problem in their brains that makes them sad but has no other negative side effects) instead of the things that cause depression.

Lately I've got a motorcycle, a new hobby etc. People need to make changes in their lives, not blame things like "depression" for everything. Even sadness has turned into a scapegoat for people's ire, it's crazy.
#14875788
Hong Wu wrote:Ok, that was probably more than a little inconsiderate. Let me apologize. I just get frustrated with these sentiments I have trouble relating to.

You have trouble relating to clinical depression most likely because you have neither experienced it or lived with it over a long run. Depression is caused by an inbalance of chemicals and causes symptoms ranging from a "blank" feeling/outlook up to and including suicide. Hardly someone depressed for awhile because, for example, they lost money or love. As I said, it is invisible.
#14875789
I have to kind of agree with Hong Wu. Western doctors will tell you depression is a chemical imbalance in the brain and maybe so (I don't know - I'm not well-educated) but in my experience, depression is a problem of perception and emotional reaction. I strongly suspect these chemical imbalances are a physical component of negative emotional reactions - chronic, negative patterns of being, of thinking. I would personally highly recommend mindfulness and meditation. Mindfulness is essentially waking meditation - staying in the moment, experiencing whatever happens and letting it go, without analysis, regret or fear: truly living. I'd be lying if I said I had mastered it but mindfulness and meditation have undoubtedly saved my life and slowly changed it for the better.

Don't mean to bore you with my own sob story but I was diagnosed back in 2009 with Dysthymia (chronic depression), Body Dysmorphic Disorder and PTSD. I believe the BDD to have had several causes: self-esteem issues, acne problems and ethnic identity issues, etc. I think the depression stemmed from my negative self-image and the PTSD a result of the previous couple of years of struggling with BDD being so psychologically brutal. Not that I've had a corner on the misery market (everyone has their own cross to bear) but that was my personal hell; a particularly nasty trifecta of mental health issues.

It had been a gradual descent to near-madness and as I was hitting bottom, it occurred to me that maybe it wasn't just that life sucked but that maybe I wasn't right in the head - not a comforting thought when you're at your breaking point. But I knew I wasn't going to make it if I didn't get some help so I started seeing a psychologist and hence the diagnoses. In addition to "Cognitive Behavioral Therapy", she promptly sent me to the doctor to get anti-depressants.

Anti-depressants didn't work well for me in the long run. I was on a low dosage of Zoloft first and at that point, any relief was welcome. But pretty soon that wasn't cutting it and the dosage was upped, eventually to the maximum. After that, I was switched to Cymbalta. Same story with it. At max dosages, anti-depressants began to have opposite the intended effect. I had never been that fucked up before - alternating between near-suicidal to feeling empty, dead inside and lethargic, everything in a haze. Not that medications don't have their place - it probably kept me off the ledge long enough to start getting my head on straight but in the long-term it just wasn't for me.

Same with psychotherapy. It was basically an expensive exercise in being told to suck it up, take my meds and put on a happy face. Not that she was totally wrong but it's easier said than done when you're that deep in the hole. Luckily my psychologist turned me on to some books about spirituality and the rest is history. Ironically, I had born and partially raised in a town that is a mecca of transcendental meditation and yet I knew nothing about it.

Long story short, I know from experience that depression can't be fixed by living in the past or worrying about the future. It can only be alleviated right now - so simple and yet so difficult. I'm sounding like Wayne fucking Dyer here and don't know if it makes any sense or not. Jimjam, I suspect that only your wife truly knows what's troubling her and ultimately it's up to her to get herself right. Nobody can do it for her. But it is very much possible and I wish you both the best of luck, whatever route you take!
#14875883
Jethro Bodine wrote:depression can't be fixed by living in the past or worrying about the future. It can only be alleviated right now - so simple and yet so difficult.


An old good friend who is hardly a psychiatrist or a meditation guru (he was an organizer for the Teamsters union) said something to me years ago that I thought rang true ...... "The past is gone and tomorrow ain't here yet. All you got is today."

Isn't it ironic that complex problems frequently have simple solutions.

Thank you for your story Jethro.
#14875916
I think that worrying about tomorrow and feeling hopeless is insecurity and should not be confused with depression.

Depression is caused by chemical imbalances in the brain. With the case of my sister, it is more complex because she has at least 2 psychological disorders: bipolar and schizophrenia. She hears voices like the man featured in A Beautiful Mind. Her medication can calm the voices but they never fully go away. She seems to be happier now around her caretaker so we're not as worried about her. There are still little incidents now and then, but we know how to calm her down now. Mostly she just needs someone to talk to. Medication is a bandaid and she really needs comfort and to know that she's going to be okay.
#14875941
jimjam wrote:An old good friend who is hardly a psychiatrist or a meditation guru (he was an organizer for the Teamsters union) said something to me years ago that I thought rang true......"The past is gone and tomorrow ain't here yet. All you got is today."

Isn't it ironic that complex problems frequently have simple solutions.

Thank you for your story Jethro.


Very true. And yet knowing that, it's appalling how much time is wasted not even being present in our own lives. I'm sure it's that way with most people. Life is truly what we make of it.

Honestly, I'm a bit embarrassed having shared so much information (I tell very, very few people about it in real life) but my "advice" probably sounds like bullshit without some of the backstory. Or maybe my girlfriend's TMI, diarrhea-of-the-mouth is rubbing off on me....

@MistyTiger - I don't have experience with bipolar disorder or schizophrenia but depression and I are old friends. I don't presume to understand anyone else's situation but my problems seemed to have been a result of decades of being wrapped up in the negativity of my own mind. Just sharing what got me through it and I believe mindfulness and meditation could be beneficial to anyone, even in combination with medications, therapy, etc.
#14916147
The latest study focused on psilocybin, the psychoactive compound found in magic mushrooms, in the treatment of chronic depression. The results suggest that when taken in therapeutic doses, the drug “resets” brain areas associated with depression and reduces symptoms for weeks after the initial dose.
https://www.forbes.com/sites/daviddisal ... d969118763
#14916148
Best solution....

Read about Jesus, after all he had a pretty average Friday afternoon once... Nothing like reading about other people with worse problems to cheer you up. Watch The Passion again. At least you're not being Crucified alive.

But other than the obvious Religious or reading about some other person with shittier problems solution, CBT(Cognitive Behavioral Therapy) works well enough.

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