Depression, medication and expectations
December 17, 2017 8:03 PM   Subscribe

I've been on antidepressants for a long time. When will I get beyond basic depression to actual happiness?

I'm on welbutrin and zoloft right now, and have been on welbutrin and prozac in the past. Tried lexapro and it didn't really work.

The drugs definitely help. Without them, I am totally irritable, I snap and have a bad temper and zero patience for anyone. I also have typical depression, though the meds keep this in check for the most part.

But I'm in a funk right now, and it's lasting a bit longer than normal. I am unmotivated, to say the least. Sleeping too much, not doing basic tasks if I can avoid them, being more snappish than usual.

So my question is: Is there a drug out there that will not only mitigate the depression/anxiety symptoms, but also elevate my mood and/or motivate me to get shit done? I'm so grateful that the drugs do the job they do, but now I'd like to see if there's MORE that could be done.

I am only interested in answers involving prescription medications available in the US. Therapy is already happening.
posted by wwartorff to Health & Fitness (11 answers total) 9 users marked this as a favorite
Cymbalta did so for me, but only at a fairly high dose; my psychiatrist said the norepinephrine effects were only noticeable at higher dosages, and that norephinephrine helped with motivation/decreasing anxiety. (My anxiety tends to manifest in decision-paralysis/avoidance.)

That said, I think the work I did in therapy was more important than the medications. My therapist said that if recovering from depression was thought of as having to get from San Francisco to New York, medications would get me to Denver; I had to do the rest of the work myself.
posted by lazuli at 8:09 PM on December 17, 2017 [2 favorites]

Do you have ADHD? You might try switching out the Wellbutrin for Adderall or Ritalin. Or adding a small dose of the latter two as an adjunct to the Wellbutrin.
posted by elsietheeel at 8:48 PM on December 17, 2017

Cymbalta 40mg and Wellbutrin 150mg here. Exercise helps, even just walking for a bit.
posted by Johnny Wallflower at 9:31 PM on December 17, 2017 [1 favorite]

Hi. I'm a fellow long time sufferer of major depression and I've tried all the meds. Elavil, Prozac, Celexa, Cymbalta, Wellbutrin, Zoloft, Paxil, Effexor, etc. etc. Of all of them, I found Wellbutrin to be the most activating/motivating, but none of them ever made me happy, per se.
posted by xyzzy at 1:02 AM on December 18, 2017 [1 favorite]

If you've been on an SSRI for more than a year, and you're finding that it feels less effective than it once was, talk to your doctor about adjusting your dosages. Because this is definitely a thing that SSRIs are known to do.
posted by flabdablet at 1:10 AM on December 18, 2017 [3 favorites]

It's December. If you're in the northern hemisphere, this might be seasonal depression, which a lot of people have on top of ordinary depression.

You can probably get a light therapy box for cheap-ish on Craigslist — they're like exercise gear, lots of people buy them and then never make time to use them, so there's a steady supply of used ones out there. Especially if you've had this kind of winter funk in other years, you might as well give it a try.

Either way, seconding the suggestions to ask your doctor about dosage/med changes. Unfortunately, finding the right med is really, really frustrating, and involves a lot of trial and error. Two people can have exactly the same symptoms and react in totally opposite ways to the same med. So, like, we can share our experiences on specific meds, but ultimately the way to find something that works is going to be to try lots of stuff yourself.
posted by nebulawindphone at 4:38 AM on December 18, 2017 [1 favorite]

I don't think that SSRIs or SNRIs or any other prescription medicine available in the USA is supposed to get you to happiness, just to relieve depression. Though I also don't think that happiness is anything other than an elusive exceptional state. Maybe that's because I'm depressed. Maybe your definition of happiness is different than mine.

Your question seems to be too narrowly defined to get effective answers.

Based on previous questions, you seem to have fairly recently relocated into a new city without a support system and with a couple of preteens while you are having trouble getting into shape. That's more than enough to make many people pretty depressed!

I hope that you find the answers that you seek.
posted by GregorWill at 6:05 AM on December 18, 2017 [1 favorite]

though I also don't think that happiness is anything other than an elusive exceptional state

This is a point worth making very strongly.

Happiness is in no way a permanent condition. Not for anybody. It comes, it goes, like every other emotion. If you're starting from the commercially approved presumption that happiness is mandatory, and that failure to feel it all the time means that there is something fundamentally broken in you, then it's time to kick commercial approval to the kerb.

On the other hand, there is also nothing wrong with a simple desire to feel happy more often than one does. Melancholy is not mandatory either.
posted by flabdablet at 7:20 AM on December 18, 2017 [5 favorites]

Just anecdata, but what elsietheeel said. My doctor recently added a very low dose of Ritalin to my antidepressant. I don't have ADHD—the intention was to help me cope with fibromyalgia fatigue—but as a bonus I've found it does make me feel significantly "brighter" than the antidepressant alone.

Like others have said, no antidepressant I've taken has made me feel outright happy. It's more like the difference between a cloudy day and a sunny day; when the happiness does come, it's not hard to be happy. I think that's maybe what you're hoping for, and it's definitely achievable if you find the right drugs. Best of luck!
posted by fire, water, earth, air at 1:42 PM on December 19, 2017 [2 favorites]

Right, I'm going to elaborate a bit (okay, a LOT) more on my initial comment since I've had some additional insight after the last few days of my life. I should probably put this in a MeMail, but I'm going to post it here in the hopes that it maybe will help someone else who is dealing with the same crap I've gone through.

So. I've been suffering from a debilitating depression for more than two years now. My old GP put me on SSRIs, but around the same time I lost my health insurance and my ADHD meds (Adderall, which I've been taking for almost 10 years) were prohibitively expensive - although the antidepressants were affordable and so I kept taking them.

But ultimately, due to that medication failure, the serotonin in my brain outpaced the dopamine and my neurotransmitters have been completely imbalanced for ages. For most of 2016 I couldn't get out of bed. I was barely able to keep myself alive and there were days when I really didn't want to be alive at all. The only reason I'm still here is because I didn't trust that my cat would be cared for if I died AND because I couldn't find a reliable and painless way to end it all, heh. And in my mind I kept saying to myself, "hey you're on antidepressants, so what the hell is wrong with you? Stop being sad and get up and do shit!" Note: that narrative never works.

At some point I stopped taking the antidepressants (Prozac, then Zoloft, then Prozac again) and the depression lifted just enough to stop me from wishing I were dead, but I still had no motivation, no interest in life, and no joy or satisfaction in ANYTHING. And I've long been the sort of person who loves hobbies and projects and the like. Cleaning and reorganizing my garage/woodshop was something I looked forward to. But I've spent the past six-eight months watching TV and sitting on my couch...and that's about it. That's all I've been capable of. And I figured it was better than lying in bed and watching TV because at least I was upright.

I haven't been able to work in nearly two years. I haven't been paying my bills. I'm facing bankruptcy. Shit fucking sucks. But I haven't been able to find the drive to do anything about it and that compounded the depression and stress and the feeling of gloom over my head. (This is called executive dysfunction and it is the ABSOLUTE WORST for lots of reasons but mostly because it is a real thing that no one, save for the people who have experienced it and some mental health professionals, seems to think is actually real.)

Anyway, last Friday I finally got in to see a doctor at the local reservation (I am lucky enough to qualify for Medicaid *and* the IHS) and she really understood how much ADHD affects my life and her first priority was getting me back on my ADHD meds. She was also worried about the depression and executive dysfunction, but the first prescription she wrote was for Adderall. I've been back on my meds since Saturday morning and it's truly been like night and day. As of today I don't feel empty. I vacuumed my house for the first time since I moved in (in August). My living room is spotless. My bedroom is tidy. The bathrooms are clean. I worked ALL day organizing and I'm FINALLY starting to unpack the boxes that have been sitting around for four months. And I was happy while I did it. I LOVED IT!

It's not begrudgingly doing something that you know you should do because it's good for you. A lot of people can do that and then feel satisfied. Rather it's being physically and mentally unable to do tasks that absolutely must be done to continue your existence and then sitting there and beating yourself up for not doing them. But then three days after being back on my medication, it's such a goddamn relief finding joy in those things -- knowing that I'm once again able to take care of myself, being able to get off the couch and start a task and then follow it through to completion.

And finally, lest you think I'm suggesting otherwise, the drugs won't make you happy, but when you hit on the right combination of them, they allow you to find happiness in the everyday stuff. It's been more than two years since I've felt satisfaction and joy in my life and there's something extra special about finding those feelings in the simplest and smallest of things.

Feel free to MeMail me if you want to talk. And good luck. <3
posted by elsietheeel at 9:05 PM on December 19, 2017 [3 favorites]

Google "microdosing".

I haven't tried it. It is definitely something you would want to talk to your doctor about. Lots of potential dangers.

But from all I've read, it is the only thing that shows promise for curing depression instead of merely making life bearable.
posted by LauraJ at 3:35 PM on January 16, 2018

« Older Winter on Chincoteague and Assateague   |   NTSC color bars via Pantone? Newer »
This thread is closed to new comments.