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I don't wanna work, I just wanna lie in my bed all day
June 3, 2011 9:28 AM   Subscribe

Should I just accept that I need to be on SSRIs? Are there other meds that would help me more effectively?

I have depression and anxiety. Over the past year and a half, this has largely been mitigated by a 20mg dosage of Lexapro, which I finally succumbed to taking after the stress of writing a thesis sunk me into an intolerable depression.

Lexapro has been mostly good, in that I like that I never get so depressed that life seems hopeless and worthless, and my confidence and self esteem maintains itself instead of oscillating between dismal and decent.

However, the end of the school year this year was pretty awful, and for the last month of school I wanted to do nothing but lie in bed and watch internet tv (my go-to depressed activity). So even on the Lexapro I became depressed and useless. I feel like the Lexapro possibly made me MORE apathetic overall, which is frustrating because apathy is one of the most debilitating parts of my depression.

In addition to that, I've always felt uncomfortable being on meds. I don't like feeling like I need them or rely on them, and it seems the longer I'm on them the scarier the prospect of going it on my own seems. I'm in counseling and have done CBT and try to get enough exercise, but all of these things are hard to maintain when your body just wants you to lie in bed and stare at the ceiling/a screen.

Also, the Lex messed with my sex drive, which I really hate. I'm normally a very sexual person and it's an important part of a relationship for me. Feeling little to no desire makes me feel like a robot.

I've wondered if there are other ways to deal with my apathy/depression/lack of motivation. Surprisingly, having a little puff of a joint does wonders. I will be lying in bed feeling despair and zero motivation to do anything, then my roommate will pass me a puff, and suddenly I am up tailoring a dress and making vocabulary cue cards. It also makes me more social, because otherwise I pretty much want to avoid people and social interactions. It also makes me feel sexy/sexual. If it wasn't for the fact that I become a total space cadet and can't go to work or do any real studying, and that it only lasts for so long and then I'm even more of a zombie than before, then I would think it a viable solution. But it's not.

I've also wondered if I have ADD. I watch my roommates be productive and do things all day, and it seems I never get anything done. Little tasks and responsibilities (such as responding to emails, etc.) seem odious and insurmountable. I procrastinate pretty much everything that I can. I've managed to maintain good grades, but it's kind of a miracle borne of last minute all nighters. I can't do school work until it's absolutely necessary (think 3 am the night before it's due). Even then I have to get a large latte and pour a shot of Bailey's in to quell my anxiety.

I hate living like this. I have a dog who I"m sure would appreciate a more stable routine involving predictable exercise, and I would like to not dread having to take him to exercise everyday. I want to have kids some day but feel like I can't if I can't take care of myself.

I don't want to have to depend on meds, but I think I would accept it if they really helped me. THe apathy and sexlessness of Lexapro really discouraged me though.

I've also considered the fact that I'm just plain lazy. Seems like a plausible solution. I don't know what to do about it though...it feels overpowering.

SO...has anyone else experienced this? Especially the lack of motivation to do anything? I have concrete goals that I really want to achieve, just can't seem to make the day-to-day effort towards achieving them. I've been wanting to write this question for weeks...just could never quite bring myself to actually do it.

If you have any insight into my problem and possible solutions I'm antsy to hear it.

Thanks metafilter.
posted by whalebreath to Human Relations (35 answers total) 32 users marked this as a favorite
 
I think everyone who has suffered from depression has gone through the 'meds are a crutch' phase. But there not. As trite as this is going to sound you have a disease which messes with your brain and needing medicine for it does not mean you're weak or lazy.

Sometimes I think its better to think of it like the meds allow you to reach the same baseline as everyone else. If you don't take them you are at a disadvantage which sure you could try to power through with CBT and exercise and sheer will power but you wouldn't be doing yourself any favors.

When you write that you like them because "I like that I never get so depressed that life seems hopeless and worthless, and my confidence and self esteem maintains itself instead of oscillating between dismal and decent" you need to realize that this is the way your supposed to feel because thats not normal outside of horrible life circumstances. Its not something you should have to put up with any more than a physical diseases symptoms.

As to the specific problems with Lexapro I think you need to find a doctor you trust who listens to you as those are crappy side effects which you shouldn't have to live with. Their are lots of anti-depressants which all have different effects on different people and its probably worth seeing a psychiatrist to help you find one that gives you the good with less of the bad.

I also think you should talk about you ADD/procrastination with a doctor who can help you decide if its medical.

Er sorry this is so long and good luck.
posted by SpaceWarp13 at 9:42 AM on June 3, 2011 [2 favorites]


Lack of motivation can be a side effect of some SSRIs. You're no longer anxious because you no longer care.
posted by Obscure Reference at 9:43 AM on June 3, 2011


You have a disease which messes with your brain and needing medicine for it does not mean you're weak or lazy. ... If you don't take them you are at a disadvantage which sure you could try to power through with CBT and exercise and sheer will power but you wouldn't be doing yourself any favors.

QFT. Couldn't have said it much better, so I won't try.
posted by mykescipark at 9:44 AM on June 3, 2011 [1 favorite]


I forgot to mention that I'm currently trying to wean myself off the Lexapro and at 10mg am feeling teary, depressed, and worthless. I've been at this dose for at least three weeks now, and I'm guess I'm sad/discouraged that the weaning isn't working and that it looks like I'll have to go back up to 20mg.
posted by whalebreath at 9:50 AM on June 3, 2011


I agree - it's a disease that messes with your brain. I've been there to an extreme degree and more recently to the lack of motivation, lying on the couch watching online TV all the time degree too. You may want to ask your doctor about Wellbutrin (buproprion). It doesn't have the same side effect that some of the SSRIs do (I think it's called a(n) SNRI) and one of the primary things that I like about it is that it's "activating" rather than sedating.
posted by la petite marie at 9:51 AM on June 3, 2011 [1 favorite]


Do you exercise? Try working out on an elliptical or treadmill (or just a jog) for a half hour per day for a week and you'll feel so much more alive.
posted by PSB at 9:51 AM on June 3, 2011


Another forgot to mention: psychiatrist is resistant to putting me on Wellbutrin because of my anxiety. I'd rather be slightly more anxious and productive though than flat and slothy.
posted by whalebreath at 9:52 AM on June 3, 2011


My bad sides sound A LOT like yours. The following have benefited me immensely, each in their own way:

- Bupropion (Wellbutrin), an "atypical antidepressant", not an SSRI but sort of similar - the stuff is a norepinephrine-dopamine reuptake inhibitor. The effect is quite different, and works much better for me.
- Working a 12-step program.
- Exercise.
- Meditation.
posted by krilli at 9:54 AM on June 3, 2011 [2 favorites]


Oh wow, I could have written this question. Actually I almost did this week. I'm having essentially word for word the same issues as you, except with celexa instead of lexapro. I recently started working with a new psychiatrist to try and fix the sexual side effects, and she reassured me it's a big deal to be living like this - as in, don't accept it! - and she's switching me to cymbalta currently.

One thing my psych has done for me that I thought was unusual was prescribe me ritalin for the work day, to keep me energetic. It works, however I really really don't want to be doing that for the long term. I feel unnaturally energetic - like caffeine - on it. my advice is ask about switching meds, and if you need to, possibly ask about ritalin as well.

I feel like I'm constantly lamenting "what I used to be like" - I used to work out constantly and love it, used to love exploring new music and movies, used to not be so tired all the time, used to be more motivated - so personally I'm thinking about bringing up the idea of maybe going off meds entirely, just to see what she says, because so far the cymbalta hasn't really changed my side effects yet. I'll be watching the answers to this question - I want the old me back, but not the depressed, socially-anxious, constantly crying me!
posted by ghostbikes at 9:54 AM on June 3, 2011


I was on SSRI's, and went cold turkey without a doctor's suggestion to do such. (DO NOT DO THIS AT HOME). I find that running and being with my husband does a much better job than meds ever did.
posted by roomthreeseventeen at 9:54 AM on June 3, 2011


You're not lazy. Getting screened for ADHD is important, because depression and anxiety can stem from untreated ADHD and in my admittedly limited experience, it's difficult to treat the depression without treating the cause of it, you know?

I also hear "I'm lazy" from people with ADHD all the time and it makes me sad because it's not true.

There are other SSRIs, and some of them might work better for you than this one. Sometimes Wellbutrin is prescribed because it supposedly helps with ADHD and depression. I haven't done any reading about this independent of what I've heard.

I think it's time to see your psychiatrist and sort this shit out. If s/he doesn't help you, see another psychiatrist. Please also prepare for this visit with your therapist by talking about your fears and desires with regard to your medication.

If you want to go off SSRIs, that's valid too, but don't do it because they're a crutch or because you think you're lazy. Fuck that. Depression is very serious and very real, and so is ADHD (if you have it).
posted by the young rope-rider at 9:56 AM on June 3, 2011 [3 favorites]


Also - my psych tried wellbutrin on me as well, but it made me return to the same effects (anxiety mostly) that led me to therapy and medication in the first place. YMMV.
posted by ghostbikes at 9:56 AM on June 3, 2011


I don't want to have to depend on meds, but I think I would accept it if they really helped me.

Plenty of folks "depend on meds" so they don't, you know, die. Would you be having this ambivalence toward meds if you had high blood pressure? Would you not want to take your high blood pressure medication because it was a moral failing? I really doubt it.

Some folks require the assistance of medication to live the kind of life that makes them happy. There are a ton of anti-depressants out there, maybe another one will work better for you than Lexapro. Why would you write off something that will probably be really helpful to you?
posted by crankylex at 9:57 AM on June 3, 2011 [5 favorites]


Forgot to preview and didn't see the last few replies.

I'll add this: I have anxiety issues, it's on my top-3-killers list. I can take Wellbutrin.

There are prerequisites: I need to manage the anxiety by other means. In other words, bupropion and exercise = very good.

It's hard to tell which is which - is the bupropion supporting the exercise, or is the exercise supporting the bupropion? In the short term, the question doesn't matter for me - The combination works!
posted by krilli at 9:57 AM on June 3, 2011 [2 favorites]


I don't have any answers for what a better med would be, but I did badly on Lexapro and thought it was the depression. It blunted everything. I couldn't make myself care or move much. Withdrawal was pretty bad and lasted a while, but I had more physical symptoms than emotional. I'd taper much more slowly if I could do it again.
posted by moira at 10:25 AM on June 3, 2011


psychiatrist is resistant to putting me on Wellbutrin because of my anxiety

Like krilli, I have strong anxiety and I don't think the Wellbutrin has made it worse, but everybody's body chemistry is different. I agree that I'd rather be a little more anxious than have zero motivation -- maybe he would agree to give it a try and see what happens.
posted by la petite marie at 10:58 AM on June 3, 2011


Some really good answers in this thread.

Like you, I had a hard time accepting it was time for SSRIs. There have been two times in my life where I've taken Prozac, and if I'd known how much it could help I would have taken it in my early twenties as well. However, it's been a last resort for me.

I've been able to manage my chemical predisposition for depression and anxiety by taking amino acids: DLPA and 5-HTP. I'll go ahead and tell you what I know, please ignore if you're not interested.

Both DLPA and 5-HTP can be found in most health food stores, and although they’re not exactly cheap, they’re definitely worth a try. And, unlike chemical anti-depressants, have little to no side effects.

DLPA (DL-phenylalanine) contains two forms of the amino acid phenylalanine. The “L” form is a natural substance found in protein-rich foods; it’s believed to bolster mood-elevating chemicals in the brain, such as dopamine and norepinephrine. The “D” form of phenylalanine is made synthetically in a laboratory and appears to block a nervous system enzyme that amplifies pain signals; in other words, DLPA slows down the enzymes that “eat up” endorphins.

It’s most commonly used to treat chronic pain (like that associated with rheumatoid arthritis), but is also used to treat depression, mood swings, appetite, and PMS. Some people with ADHD also have benefitted from taking it. For relief from the blues, DLPA appears to be most effective when combined with other natural antidepressants, such as St. John’s wort or SAMe (S-adenosylmethionine) or the 5-HTP that I take. (Interesting to note, the combination of DLPA and St. John’s wort performs similarly to Effexor. Like the drug, the supplement/herb combo raises levels of at least two mood-elevating brain chemicals: norepinephrine from the DLPA and serotonin from the St. John’s wort. In addition, like Effexor, DLPA suppresses appetite by promoting the release of a hormone that curbs appetite.)

Dosage: 1,000-1,500 mg of DLPA daily, ideally in the morning. I take another dose in the afternoon, so you may need to play around with the amount that’s right for you.

5-Hydroxytryptophan or 5-HTP is a naturally-occurring amino acid, a precursor to the neurotransmitter serotonin and an intermediate in tryptophan metabolism. Serotonin is an extremely important brain chemical involved in regulating mood, behavior, appetite, impulse control, and sleep.

Serotonin originates in neurons deep in the midline of the brainstem. Because these neurons profile diffusely throughout the brain, serotonin can affect various brain functions. It also interacts with many other neurotransmitters, either directly through neurons that use both serotonin and another neurotransmitter, or by serotonin neurons influencing neurons that primarily use these other transmitters.

The diffuse connections of serotonin allow it to affect many basic psychological functions such as anxiety mechanisms and the regulation of mood, thoughts, aggression, appetite, sex drive and the sleep/wake cycle. Multiple observations suggest that serotonin, one of the most abundant neurotransmitters, plays an important role in the regulation of mood and a key role in the treatment of depression.

Data suggest that serotonin is associated with reduced serotonin function. Studies of cerebrospinal fluid, whole blood, and plasma have shown that serotonin levels are reduced in depressed patients.

Dosage: start out with 50mg two times a day and wait a few weeks to allow your body to adjust. If you need more after that, increase the dosage by 50-100mg.

Amino acids should be taken on an empty stomach to maximize absorption. They should not be taken at the same time, since they can interfere with each other’s absorption. 5-HTP can cause mild nausea for the first few weeks you take it.

Like SSRIs, they can take a few weeks to kick in.

You should not take either DLPA or 5-HTP if you’re still taking other anti-depressants/SSRIs unless your doctor gives you the go ahead. If you have high blood pressure or diabetes, talk to your doctor before taking any amino acid. And of course, if you’ve got a bun in the oven or are breast feeding, you should check with your doctor.

Any questions? Feel free to memail me.

Sorry for the length. They really help me.
posted by Specklet at 11:02 AM on June 3, 2011 [10 favorites]


When you go to your doctor, print this out and read it to him.

If you're anything like me, I'm not at all good at articulating my feelings, emotions, or problems when I'm feeling blue.

Also, talk to your doctor about why it's a bad idea to mess with SSRI doses. The science of dosing antidepressants is incredibly complicated.
posted by schmod at 11:22 AM on June 3, 2011


I struggled with a lot of the same issues with you when I was in college, though with a bit less severity, it sounds like. But the all-nighters, inability to manage little tasks, list of grand goals and little progress...that was all me.

One thing I've discovered, a decade out, is that for people who have trouble maintaining a regular schedule and regular productivity, college and graduate school are terrible, terrible environments. The combination of tons of free time and infrequent but major deadlines just breed a terrible procrastination and cramming cycle. So I think that you may find that once you're out of your current environment, these issues get a bit less burdensome.

In the meantime, one thing that helps is to add as much structure to your day as possible. For exercise, can you join a class that meets at a set time a few times a week? Do you have a part-time job? I found that knowing that a couple of hours each day weren't available for theoretically doing classwork meant that more got done in the hours that were. Can you join - or start! - clubs or groups to support your projects? Can you find a study buddy for each class and meet once a week to work through problem sets or discuss readings?

Your college may also have tons of resources for people in your position. You should make an appointment with whoever is the equivalent of your guidance councilor to discuss your issues - I promise you that many, many, many of your classmates are struggling with these same things to a greater or lesser degree, and there are people who have helped students like you manage these issues successfully.

One book that helped me that I wish I'd read when I was younger is The Now Habit by Neil Fiore. It's about ways you can manage procrastination.

I firmly believe that productivity isn't something you're born with. It's a set of skills that you need to learn, and you can learn. But please don't take any of this to mean that you shouldn't also take everyone's advice for dealing with your medical issues as well. These two things are complementary - when your brain chemistry is out of whack, learning and applying productivity skills will be much more of an uphill battle.
posted by psycheslamp at 11:49 AM on June 3, 2011 [4 favorites]


What a great thread.

Here are a couple of subtle ones I forgot before, and I feel I must mention:
- Stay hydrated! ... !!!!
- Eat well. Many foods do not agree with me at all. The funny thing is that most of the stuff that makes my psoriasis worse also messes up my cognitive ability. (Milk, gluten, sugar, certain fermented things.)
posted by krilli at 11:57 AM on June 3, 2011


Like others here, I could have written your question too. I take Effexor. It's the only antidepressent that has ever worked for me. Wellbutrin made me mean and Celexa hardly touched my depression/anxiety but sure as shit put the lid on my libido.

My partner just switched from Lexapro to Celexa (I guess they are chemically similar in structure) for insurance reasons and found that the switch improved his sexual function (yay for me!)

I'm interested in talking with my doc about ADD meds to keep me focused at work but I haven't gotten up the nerve yet to bring it up. I don't want to seem medication seeking.

There are great suggestions above, but I would caution you to get medical advice about the uses of 5HTP and other over the counter mood enhancers. These things can work unpredictably. 5HTP made me vomit and St Johns Wort makes me mean and irritable.

I'd also like to add that you can forgive yourself for moments of zombification and procrastination. I find that if I consciously forgive myself, it's easier to get up and do something about it than if I stew in my own self disgust. When I start to stew, I tell myself, "Hey! You've already forgiven yourself for that. It's over. You don't need to think about it anymore today."

I have had success with adding fish oil capsules to my regimine. It works like lube for your brain, greasing up the serotonin receptors and making them work better.

Also, consider having a full blood work up. My doc found that I'm seriously lacking in the Vit D department.

Good luck and if you need some internet tv recommendations, watch The League for some laughs.
posted by dchrssyr at 1:36 PM on June 3, 2011


Nthing Wellbutrin.

Possibly worth considering: my psychiatrist strongly discourages using marijuana while depressed. She told me that it can cause mood instability in people with certain kinds of depression because the marijuana high causes an extreme release of "happy" neurotransmitters (dopamine, serotonin, etc.), which can deplete your brain's reserves of those chemicals and result in depression.
posted by Sifleandollie at 2:57 PM on June 3, 2011


Nthing what pretty much everyone else said. My life has gotten infinitely better since going on the medication, and I'd never go off. (FYI: I'm a med student, and left school on a personal leave of absence for depression and anxiety. The medications have allowed me to come back to school, and get through with flying colors. Not to mention that it's a bit interesting that I had to go through some of the same things that my future patients will be going through.)
posted by Ephilation at 5:28 PM on June 3, 2011 [1 favorite]


Specklet makes a good case for supplements. Warning: do not take 5-htp while on an SSRI. If you really want to try it, take a really small dose.

5-htp can also be troublesome if you quit taking it. It causes me to have a massive, foul moodswing.

In the alternative, make sure you eat plenty of protein.

Wellbutrin: Lower "everyday" anxiety for me, but it amplifies the occasional "stagefright" style anxiety. I'm able to power through it, but be prepared for unexpected flopsweat. Also, when I started it, the doctor was very particular in mentioning that it might amp me up, make it hard to sleep for a couple of days. He was shocked when I returned a month later and told him that it *helped* me sleep. I can dream again!
posted by gjc at 6:45 PM on June 3, 2011 [1 favorite]


I've also wondered if I have ADD. I watch my roommates be productive and do things all day, and it seems I never get anything done. Little tasks and responsibilities (such as responding to emails, etc.) seem odious and insurmountable. I procrastinate pretty much everything that I can. I've managed to maintain good grades, but it's kind of a miracle borne of last minute all nighters. I can't do school work until it's absolutely necessary (think 3 am the night before it's due). Even then I have to get a large latte and pour a shot of Bailey's in to quell my anxiety.

One thing I would definitely recommend is getting screened for ADD/ADHD, by a doctor who specializes in adult ADHD if you can manage it. I've had life-long issues with procrastionation, anxiety, motivation, and depression. I always just thought I was depressed, that that was my main problem, and everything else I was experiencing (feeling lost and overwhelmed, impulse control issues, terribly money management, and so so so much more) was just a symptom of the depression, or a result of not dealing with my depression properly. But about six weeks ago some things happened in my professional life that led me to seek a solution to my procrastination issues. One of the books I picked up on procrastination mentioned undiagnosed ADD as a problem that many procrastinators have. I took a couple of online adult ADD assessments and my results pretty much said, "Palomar, is that you? Your score broke me. Go to a doctor, for pete's sake."

Long story short, I went to my regular doc (who happens to be an adult ADHD specialist, as well as having it herself), I had an assessment with her, got the diagnosis, and since then things have been so much better. I'm on low doses of various meds right now while we figure out which one is going to work best and in what strength, but I don't even feel "medicated" -- I just feel more able to focus and prioritize. I'm actually able to get things done, and done quickly, instead of dithering over something small all day while ignoring the huge honking, flashing tasks I'm trying to avoid. The weird urge to avoid things that I know need to be done is much less strong -- I still have to work on that, but considering I only got diagnosed and started treatment about two weeks ago, I'd say I'm doing pretty damn well.

Since getting diagnosed, my anxiety and depression have decreased considerably -- I've read that for many people with ADD, the diagnosis is a huge part of the "cure". Finally having a name to put to this thing that has haunted every corner of my life has been so amazing. I know now that I'm not lazy, dumb, defective, or any of the other negative self-talk I've gotten used to spewing at myself. My brain just functions in a different way from the norm, and I have to make adjustments for that. I'm still learning what those adjustments are going to be for me, and it's something I'll likely have to mess with over the years, but that's okay.

I am not a doctor, and I am especially not YOUR doctor. So I'm not saying this is definitely the problem. But I do think it's something you should look into, because if you do have ADD (or ADHD, I forget the current nomenclature), getting a diagnosis and starting some kind of treatment (whether it involves meds or not) will probably have a major impact on your depression.

I would also suggest that you read Driven To Distraction for more information about ADD. I cannot recommend that book enough.
posted by palomar at 7:06 PM on June 3, 2011


Have you ever tried psychotherapy? I spent a bunch of years on and off of SSRIs in my late teens and early twenties with recurrent depression. I found that a few years of therapy really did help, and I have not been on an antidepressant in five years. My depressive tendencies are still there, I just think I have become better at noticing when that ball starts rolling, and what to do about it, e.g. get out of bed, work in my garden, talk to my boyfriend/friends about how I'm feeling. It has also helped to have some insight into the reasons why I feel the way I do from my familial culture, e.g. shaming parenting style, anger not allowed, etc. I don't know if it'll work for you, but it's worth a shot if you've never done it.
posted by amileighs at 7:48 PM on June 3, 2011


Another forgot to mention: psychiatrist is resistant to putting me on Wellbutrin because of my anxiety. I'd rather be slightly more anxious and productive though than flat and slothy.
This might be obvious, but in case it isn't: you should tell your doctor this.
posted by nebulawindphone at 8:05 PM on June 3, 2011


Should I just accept that I need to be on SSRIs?

No. In fact I would suggest researching the effectiveness of SSRIs. There are countless articles which and much research done which conclude that they are not much more than a high priced placebo with rather unpleasant, perhaps even, at least in my experience, downright depressing side effects.

Here is just one article referencing a study which concludes the following...

Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.

But I am not your doctor, or a doctor at all. I don't get free 5 star lunches or all expense paid 'educational' excursions to places like Vegas or Hawaii courtesy of drug company reps.

I am some one who has beaten 'depression' through the will to focus on the good in my life, little as there may seemed to have been at times.
posted by anonop at 11:21 PM on June 3, 2011 [1 favorite]


It sounds like you could use a reminder of what depression and anxiety do to you. I know I do from time to time, and when I catch myself feeling really anxious with the horrible secret thought that there is some kind of shameful flaw in me and that there is no help for it, I know it's the depression. If you haven't read The Noonday Demon, please do. It's a beautiful, really interesting and wise book, and will give you that reminder you need.

What I really came in to add here is that SSRIs aren't the only antidepressants out there, although doctors prescribe them the most often. I was feeling pretty dissatisfied with the way I had been feeling on my SSRI (celexa) for the last couple of years and finally worked up the courage to talk to my doctor about trying something else (change is scary). Her first thought was wellbutrin, but we had tried wellbutrin in the past - specifically to deal with the low-libido, apathy blah of the SSRI - and it made me feel like an anxious zombie. Then, she became enthusiastic about trying an MAOI. (*she knows they work for my mom, and that's a big reason she thought of it in the first place). She explained that they're out of fashion, but it's not because they don't work well. It's mainly because most of them interact with a lot of foods and OTC drugs, which makes them a pain in the ass and I suppose dangerous for people who can't comply with those kinds of restrictions. They're said to be for 'atypical depression' - whatever the hell that is - and a 'last resort' (WTF? It's just an older class of meds. Electroconvulsive therapy is a last resort!). Anyhow, those freaky but semantically null descriptions shouldn't factor into yours or a doctor's willingness to try them, if it seems appropriate.

I went off my celexa and simultaneously started taking moclobemide 7 days ago and my libido's come back already. I feel good and am keeping my fingers crossed as we up the dosage, yadda yadda. Moclobemide is awesome because you don't have to restrict your diet at all while you are on it, however, I looked it up here on metafilter and discovered that it's not available in the US (if you search for moclobemide, you'll find the mefite who's said a few things about taking it. There are other MAOIs, though, and maybe things have changed since that mefite wrote about his/her experience with the drug.

I should say, too, that while I kind of ranted about MAOIs just now, my doctor although considered 5-HTP before settling on this route.

My advice in a nutshell: don't doubt yourself, and make a meds change, probably from SSRIs to something else.
posted by kitcat at 12:02 AM on June 4, 2011


And here's an article that talks about how that study linked by anonop is flawed.

OP, please consult with your doctor (who has undergone medical training and is already treating you, unlike anyone commenting here) before discontinuing any meds that you're currently taking, or adding in any supplements.

It might be helpful to print out this thread and take it to your next doctor appointment so you can ask specific questions about some of the things people have suggested.
posted by palomar at 12:03 AM on June 4, 2011


5HTP gave me a lift without the apathy. You could also try taking tryptophan - take it with some carb or fat, away from protein meals. This is so other amino acids don't reduce the effect.

Tryptophan is the safer option, because tryptophan is an unmodified form of the amino acid, whereas 5HTP can cross into the brain. Some people think it may have problems.

Having said that 5HTP had a stronger effect for me, and it's not like there are clear cut dangers.
posted by Not Supplied at 12:23 AM on June 4, 2011


As another person who could have written this AskMe, although I have already been diagnosed with ADHD as well as anxiety and depression, I'd like to add that the single most important factor for me was getting the correct (adhd) diagnosis. Because of that my therapist and I were able to find the right combination of medications. Treating the adhd decreased the anxiety so much that I could actually function well enough to work on the depression. It has taken a combination of meds to make me actually want to live, and I know that I'll never be able to stop taking them but I think it is better to take a few pills every day than to retreat into painful paranoid agoraphobia. If one SSRI doesn't work for you, try another. If the one you like doesn't work all the way, see if your doctor will let you try adding bupropion (Wellbutrin). Or if you have a good case for ADHD or treatment-resistant depression, a stimulant would be a reasonable next step. For me it takes a Prozac-Wellbutrin-Adderall trifecta just so that I can leave the house.

Anyway, learn as much as you can about medications and find a doctor who will work with you and not make you take or stay on meds that don't work or make you miserable. On the other hand, you may have to decide what you can and can't live with as far as side effects go.

Whatever you decide, don't give up hope and try to be open to possibilities. It took years for me to finally get the right combination because I was afraid to try a lower dose of a different form of a medication that I took for 4 days at one point before my anxiety was under control. And I am trying very hard to be glad for the feeling better, not mad at myself for stubborn headedness, so I hope that someone will learn from my mistake so that there might be some meaning in it.
posted by monopas at 2:15 AM on June 4, 2011


You sound like me when I was in college, though I didn't have benefit of any medications.

Go to a doctor specializing in adult ADHD. This is a specialist job. Dr Joe Bloggs down the street isn't up to it.

Do this right away, don't waste another minute of your life being miserable. Even if you don't have ADHD a specialist can rule it out and point you in the right direction.

You are a special snowflake. You deserve specialist attention.
posted by tel3path at 4:19 PM on June 4, 2011


I'm very sorry to learn of your depression. I also suffer from this illness, so -- in that vague way that is the best we can do when the all-too-common experiences of being human are also excruciatingly singular and unique -- I offer my empathy.

And this advice: Ask your psychiatrist about lamotrigine (Lamictal is the brand-name). It is not an SSRI, but functions by altering the behavior of charged calcium and sodium channels in the brain. It is clinically effective in treating both depression and anxiety, so it would be worth exploring with a qualified professional whether this drug would be right for you.

It has made a huge difference in the quality of my life. Last fall I was so depressed that I couldn't even feel beauty of any kind, a strange and terrifying plight for a creative artist! I became easily overwhelmed, anxious and hopeless about my life and career, and barely functional. Since beginning treatment, all of these symptoms have lifted, with no discernible side-effects, and a much better energy level and outlook on things. "Dependence" on medicine is nothing to avoid, given the alternatives. A smart diabetic would not eschew his/her insulin, after all....

I wish you well in your path to recovery, and offer you the hope that treatment can help.
posted by longing4thewayIN at 12:23 PM on June 9, 2011 [2 favorites]


During my diagnosis phase, i went through pretty much every SSRI out there and nothing really worked right. Either i had side effects (Wellbutrin) or it just wasn't effective enough (Lexapro).

After switching doctors a couple times (insurance changes), one doctor suggested that I switch to a bipolar medication (lamotrigine / lamictal) and that's worked very well for me for around 5 years now. If your depression is cyclical, you should talk to your doctor about this possibility.
posted by escher at 8:47 AM on July 6, 2011


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