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No-drug regimen for depression/mild anxiety relief
July 22, 2014 2:19 PM   Subscribe

I'm sick to death of the prescription drug med-go-'round for MDD and mild anxiety. I'm ready to stop.

Yes. I've tried them all. SSRI, SNRIs, tricyclics, et. al. I'm done. I'm done with the nausea, the fatigue, the spaciness, the fatigue, the loss of apetite, the anorgasmia, the gas, the fatigue, the trips to the psych, the fatigue, the "WTF? How much does that cost?" I want another way. Currently four days into Lexapro. Already on Trazodone.

Situational stuff: Currently in the midst of dealing with a boss who is a micromanger who seems intent or demoralizing me daily.

-- Excellent health. Thyroid's great. Doc says my blood work is "perfect."
-- I've upped the exercise to 5 or 6 days a week. Some days harder than others.
-- Experimenting with amino acids. Can you give me your experiences?
-- See a therapist about twice a month. She works on "family of origin" issues mostly. Should I try a different form?
-- Very rarely drink. Maybe a glass of wine every other month. Caffeine daily.
posted by nubianinthedesert to Health & Fitness (24 answers total) 21 users marked this as a favorite
 
What are you eating? How is your sleep? Providing detail about those two things will keep people from telling you to do things you're already doing. Also, do you meditate or otherwise take time for yourself (journaling, art, etc.?)
posted by stoneweaver at 2:24 PM on July 22 [2 favorites]


Where do you exercise? Some studies suggest being in nature can help with depression.
posted by JackBurden at 2:43 PM on July 22


Mindfulness based stress reduction (MBSR)-- there's an 8 week course, you can do it from a book, it teaches you breathing exercises, body awareness, simple meditation. I highly recommend this!
posted by wyzewoman at 2:44 PM on July 22 [3 favorites]


I tried the amino acid glutamine. I read that you might be short on glutamine if you have excess cortisol, which I figured I probably did since cortisol is a stress hormone. I felt like the glutamine made me sleepy, when what I really need is more energy. I switched to vitamins B and D, and they help.

I'd ask the therapist for help with the situational stuff. When I started off with my therapist, I was dealing with a situation, so we started off talking about how to deal with it. When the situation was doing better, we talked about other things, but whenever the situation started to veer off the rails a little, it became the topic of therapy again.

Regardless of what type of therapy you are doing, I would say to decide on an action plan for either assertively standing up for yourself and your dignity at work, or finding another job. If neither of those seems very possible, then work on that with the therapist: I feel stuck in a bad work situation without a plan to get out of it. You could ask the therapist to put the family-of-origin approach on pause while you work on this. Or you could ask them to help you see the connection between whatever family-of-origin stuff they keep bringing up and your actual situation that you are dealing with now. If you still don't see how it relates after asking a few times for help making that connection, find a different therapist.
posted by Bentobox Humperdinck at 2:48 PM on July 22


Giving up caffeine completely reduced my anxiety significantly. Can you do without?
posted by Hermione Granger at 2:50 PM on July 22 [4 favorites]


If you don't like your therapist, try another one. If she's talking mostly about "family of origin" then she's probably doing a psychodynamic modality. Some people like that, some people don't. There are other types of therapeutic modalities (basically their perspective), maybe one would work better.
posted by radioamy at 2:56 PM on July 22 [1 favorite]


Chamomile tea worked great for me to reduce anxiety.
posted by rabbitrabbit at 2:56 PM on July 22


Four days into Lexapro probably means you are getting slammed with all the ramp-up yucky side effects, and not yet getting any of the benefits. So it must feel like a complete suck-fest. Do you think it might be worthwhile to see it through for a few more weeks, just to give it a fair shot? (If not, I totally respect that choice -- just thought I'd put it out there, since I remember it being helpful to be reminded in the early days of a new-to-me drug that it gets worse before it gets better. It's hard to remember that when you are in the thick of it!)

The silver bullet for me, and for a large number of friendly internet strangers I communicate with on another board, has been a very low carb, high fat, moderate protein diet. This stopped my depression and anxiety dead in its tracks (after a rough few weeks of adapting to eating that way). And when I go back to eating a lot of carbs, the anxiety and depression comes roaring back. It really is that black-and-white for me. YMMV. I've been off Rx meds for years now, and keto was what really gave me my life back.

A ketogenic diet isn't for everyone, but if you do a little research on it re: depression and anxiety, you'll find some medical wonks touting it (as well as lots of personal anecdotes).
posted by nacho fries at 2:59 PM on July 22 [3 favorites]


Here's what's worked for me - consistently over the last 5 years - to keep my mild depression under control and at bay:
- aerobic/cardio exercise first thing in the morning, preferably outdoors (for sunshine & Vitamin D production) - say 20 minutes or so of running or biking. My exercise motto is "break a sweat every day."
- Multi-vitamin and Amino acid regimen, again every day, taken in the morning with a big glass of water say 16 oz of so. Consisting of:
----a women's-daily general multi-vitamin
----C with Rose Hips 1000mg
----B-complex 100mg
----P5P (form of Vit. B6) 50 mg
----D-3 6000 iu (more in winter)
----Omega 3-6-9
----Amino Acids: L-Arginine 500 mg
----L-Phenylalanine 500 mg
----L-Tyrosine 500 mg
----5-HTP (a precursor to L-Tryptophan) 50 mg
The above Vitamin & Amino acid regimen is largely cobbed from Dr. Priscilla Slagle's book The Way Up From Down. Her book is available as a free .pdf on that website - be aware that the website looks like it was built in 1994. A few excellent reviews & testimonials on Amazon. The book is well written and understandable; part of what convinced me to give Dr. Slagle's regimen a try is that her book explained why the Wellbutrin worked for me, for about a year, and then suddenly stopped working and started causing huge sugar cravings.

Smart shopping for vitamins brings my cost for this regimen to about a dollar a day - I'm a big fan of VitaminShoppe.com's annual April buy-one-get-one-50%-off sale - that's when I stock up.

Other things that have helped to a lesser degree:
-Taking a yoga class regularly (especially good during times of work & job stress)
-Adhering to a low-carb diet (Atkins or similar)
-lowering intake of sugar
-Sam-e, taken independently of above regimen

Things that didn't work:
-St. John's Wort
-Valerian

There is a lot of alternative therapies out there, so I suggest you do some research, and then simply try things out and see what works with your system, and what doesn't.

Good luck, the black dog is hard to walk with.
posted by Ardea alba at 2:59 PM on July 22 [1 favorite]


The stuff in The Mood Cure helped someone I know, though it was an awful lot of pills to take.
posted by bink at 3:54 PM on July 22


Vitamin D and a B-complex plus extra B12 helped me a lot. I have also had success with reciting lists of things I am grateful for during my evening meditation.

This may be an out-of-left-field solution, but two years ago I actually went to Peru for 4 months to take ayahuasca in the hopes of getting a handle on my chronic depression and anxiety. It worked wonders for me. Not a solution for everyone, I'm sure, but it taught me skills that no amount of therapy ever has. I am happy to report that I have had very few slip-ups in my newfound stability, and when I start to falter, I have tools and mental tricks to snap me out of the darkness instead of succumbing to it.

Best of luck to you, feel free to memail me for more details if you would like.
posted by ananci at 4:23 PM on July 22 [3 favorites]


Personally (also have had depression & anxiety, but my d&a isn't your d&a, necessarily), I've derived the most pronounced and clear benefits from making changes / addressing the problems I face in life. I'm all about a change of scene, whether that's changing jobs, locations -- even a holiday can help -- or people, if it comes to that. Or of course, changing coping strategies. I just find it helps to place myself in situations where the sights and sounds and scripts are different, where people's expectations aren't reinforcing, like they might be in some relationships, or where there's maybe more room for me to approach a situation differently.

(Yes, there's a fundamental neuroticism, a baseline inclination for worrying and rumination that makes any hiccup maybe more of a challenge. Consistent self-care is the thing I know I need to work on, all the time, to help with that, and to buffer against challenges.)

You can of course go the other way around, like with CBT, which takes it from the angle of the self-fulfilling prophecy that results from the cognitive styles associated with depression and anxiety. (Though moving/switching jobs is faster, imo.) MBSR and acceptance techniques are helpful any time, and especially when your scope for action is limited.
posted by cotton dress sock at 4:35 PM on July 22 [2 favorites]


I'm still experimenting on myself with supplements for similar issues, but the two things that really stood out so far are: Sam-E, which did the most good prior to my being put on needed thyroid meds; and especially a really good omega-3-stuffed fish oil (this can augment all kinds of stuff!) A psych doc recommended Nordic Naturals brand, DHA 'extra' or 'ultra.' That's helped me a great deal in the past few months. It's kinda pricey, but it has been worth it to me, and it sounds like you're a veteran shopper- just stay vigilant for sales. Good luck- and please bear in mind, you deserve to be happy & motivated, so keep looking!
posted by JulesER at 4:54 PM on July 22


Spent decades treating depression & anxiety before bipolar diagnosis and more appropriate drugs. Seen many talk therapists.

The first effective therapist was psychodynamic. After the initial, crucial understanding that my upbringing wasn't great (and it was OK to take care of myself), repeated examinations of my family dynamic was counterproductive. Remembering and recalling those insults would reinforce my negative self-concept and retraumatize me. Now working with cognitive behavioral therapist: we work on scripts to use in shitty situations like your work. Changing therapists made a huge difference for me.

No caffeine helps my anxiety a lot. But caffeine is very attractive when you have the drug-induced fatigue.
posted by Jesse the K at 6:50 PM on July 22 [4 favorites]


Exercise, meditation, low carb diet here as well. Caffeine doesn't help but I enjoy having ONE vice!

Good luck! I think it's really empowering to decide to live with your brain and make it work for you instead of the other way around. It's basically changed my lifestyle completely but I'm a much happier person now.
posted by jeweled accumulation at 7:47 PM on July 22


What were the symptoms that prompted you and your doctor to decide on antidepressants? How severe were those symptoms? Are those symptoms still present? How severe are they now? What coping mechanisms for dealing with those symptoms do you possess now that you did not possess when you started the medication? What social support do you possess now that you did not possess when you started the medication? How is your thinking different now than from when you started the medication? What situational stressors are different now from when you started the medication? What plan do you have in place in case you stop the medication and things get bad again?

In my opinion, if someone can answer those questions in pretty progress-evincing ways, they can make a good case for stopping medication.

If you haven't gotten to a point where you have seen progress in those areas, talk to your therapist about how to get there, or get a new therapist. Twice a month is great if you're doing well, but not often enough if you haven't already made a great deal of progress.
posted by jaguar at 7:48 PM on July 22


No idea why no one mentions light deficiency any more, but...Get outside as much as possible, and as early as possible. Walk, take off your glasses and look at the sky. Ahh....lumens!
posted by serena15221 at 8:51 PM on July 22


Get your vitamin D and B-12 levels checked if you haven't already.

About a year ago, I was mired in one of the worst depressions I've ever had when the doctor just happened (seemingly to satisfy his own curiosity, as it is not a common test for them to order) to check my vitamin D levels. They were in the gutter, like, less than a third of what is considered deficient (30 ng/ml is deficient, mine was at 9 ng/ml). The doctor gave me a supplement (50,000 IU/wk for 12 weeks iirc) and, no joke, it was like a goddamned miracle happened. It alleviated my depression so quickly and so abruptly that I almost didn't trust it. I felt so good after three weeks that I thought I had dreamed the whole two year depressive, unable-to-get-out-of-bed, ready-to-end-it-all cycle.

Vitamin B supplements (and B12 in particular) have also been very, very helpful in reducing my anxiety and disordered/negative thinking. I know that I've been slacking off on B vitamin supplements when I start to feel like I'm losing control of my thoughts. A B supplement and 4 or 5 sublingual B12 tabs in a single day will straighten me right out.

Along with the vitamins, I've found that making time for some creative endeavors every single day (either painting, journaling, sketching) and starting a small meditation practice (Susan Piver's Open Heart Project will email you a link to a weekly approximately 10-minute guided meditation that is not hokey at all) have helped tremendously.

Good luck to you. Depression is a tough foe, but you have what it takes to triumph over it.
posted by GoLikeHellMachine at 10:06 PM on July 22 [1 favorite]


Undoing Depression by Richard O'Connor was helpful to me in developing lifestyle changes that help keep my depression in check. It's not a cure, but it's something.
posted by metasarah at 7:13 AM on July 23


My depression has been HUGELY improved by following a ketogenic diet. Totally unexpected and very surprising effect, but very much enjoyed.
posted by PuppetMcSockerson at 7:59 AM on July 23 [2 favorites]


I had a major panic attack last years, and blood work revealed that I was seriously deficient in potassium. I started taking a potassium/magnesium supplement and it helped me a lot. I later read that magnesium supplements can be very helpful for depression.
posted by vibrotronica at 9:57 AM on July 23 [1 favorite]


I can't mark a best answer. I appreciate all the tips (including those to give this last med a real go) and more importantly, the compassion.
posted by nubianinthedesert at 11:47 AM on July 23 [5 favorites]


It also occurs to me that, if you decide to continue on the Lexapro, that it might be really helpful to up the frequency of your therapist visits, if at all possible. Those first weeks are such a delicate time...having someone to help keep an eye on the process and progress (or lack thereof) will lift a burden from your shoulders. You're worth the investment of time, money, inconvenience...no need to tough it out solo if you are at all able to get more support for the short-term.

Keeping a journal of how you feel during this time will be helpful too to keep perspective, and keep an eye on the passage of time and side effects. This is true whether you stay on the meds, or opt to taper off.
posted by nacho fries at 1:20 PM on July 23 [2 favorites]


Magnesium for anxiety. Also Tension Tamer herbal tea by Celestial Seasonings.

Books: The Chemistry of Joy and The Chemistry of Calm, both by Dr. Henry Emmons, a psychiatrist. He is sympathetic to the desire to avoid medication, though he sometimes prescribes it.
posted by Comet Bug at 3:41 PM on July 23


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