Hello

[alc]

I am a retired biology teacher (high school & community college) w/ husband afflicted by Parkinson's and 2 wonderful grown sons. Have had pretty rotten year due to major depression. Been taking Wellutrin since 95. Recently found relief from suicidal thoughts thanks to therapist suggesting to my psychiatrist an addition of mood-stabilizer Lamictal. Seem to have my life back now. Why does it take so long for mental health "experts" to come up with right prescription(s)?

 

[David Baxter PhD]

The answer is partly collaborative (you must be an active participant in your own treatment) and partly the nature of psychotropic medications which are often a matter of trial and error until you find the best one for you.

That said, Wellbutrin is rarely the best choice for a stand-alone antidepressant.

 

[forgetmenot]

Hi alc glad your doctor was able to help you with the add on. Sometimes the experts need more information from us then we give them so they can change things a bit. I am glad you finally got help you needed.

 

[alc]

The answer is partly collaborative (you must be an active participant in your own treatment) and partly the nature of psychotropic medications which are often a matter of trial and error until you find the best one for you.

That said, Wellbutrin is rarely the best choice for a stand-alone antidepressant.

Back in early 90s psychiatrist in CA tried all different forms of SSRIs to no avail. When moved to TX, it was a GP that suggested Wellbutrin. It worked most of the time. Last winter even 450 mg/d didn't help. New psychiatrist tried all kinds of antidepressants and augmenters. Quit her and next shrink pushed ECT at me after 20 min. inteview. After that didn't work he gave me Adderall and Depren as dopamine enhancers. At the point where I was suicidal I went to psychologist and she was the one who suggested the life-saving Lamictal. Am not impressed w/ psychiatry.

---------- Post added at 09:10 PM ---------- Previous post was at 09:05 PM ----------

Psychiatry has failed me several times. It was a GP who finally prescribed Wellbutrin. It was a psychologist who came up w/ the idea of mood stabilizer.

 

[Daniel E.]

:welcome:

During all of that time, were you getting much therapy? Did your therapists give you "homework" to do?

You seem to be saying that only the Lamictal is "life saving," not the therapy (CBT?) you have been working on? Is there a particular reason your therapist suggested a mood stabilizer, besides the apparent fact you did not try one before?

Am not impressed w/ psychiatry.

Some people, like me, are more impressed with psychology than psychiatry. My brother is the exact opposite since his bipolar disorder is relatively well managed with Abilify. My pet peeve with psychiatrists is that they don't usually write prescriptions for exercise.

 

[alc]

:welcome:

During all of that time, were you getting much therapy? Did your therapists give you "homework" to do?

You seem to be saying that only the Lamictal is "life saving," not the therapy (CBT?) you have been working on? Is there a particular reason your therapist suggested a mood stabilizer, besides the apparent fact you did not try one before?

Some people, like me, are more impressed with psychology than psychiatry. My brother is the exact opposite since his bipolar disorder is relatively well managed with Abilify. My pet peeve with psychiatrists is that they don't usually write prescriptions for exercise.

Never been given "homework" by therapist. Therapists have never found much to work with in terms of what I call "stinkin' thinkin'. They seem eager to turn me over to pharmacology after they hear my family history of alcoholism and mental illness. Wellbutrin got me back to living once and for a long time, I was a mess this year until 4 weeks after starting Lamictal. I believe strongly in correct diet and exercise. Of course at bottom of depression can't manage either.

 

[Daniel E.]

Therapists have never found much to work with in terms of what I call "stinkin' thinkin'.

But don't you think your suicidal thoughts were distorted thinking? e.g. all-or-nothing (dichotomous) thinking:

Depression and Negative Thinking: A Cognitive Approach to Hamlet
Morin, Gertrude. Mosaic 25.1 (1992): 1-12.

Using the cognitive-behavior approach, this essay hopes to demonstrate that "Hamlet is, essentially, a portrayal of a tortured, depressed young man who loses his way in the labyrinth of his negative thoughts". Rather than agree with Freud's assessment of Hamlet as a victim of the unconscious, this article presents the protagonist as the responsible party of a "common occurrence" - depression. Hamlet reacts to the loss of his father and his mother's hasty remarriage "by employing negative schematic processes" - learned responses. His soliloquies reveal examples of "cognitive logic error that leads to and reinforces the depressive's negative view": Hamlet's fascination with death reflects "selective abstraction," in which the positive aspects of life are overlooked, in favor of "absolutist, dichotomous thinking," which views death as the "principal reality"; he suffers from the cognitive error of "overgeneralization" when he concludes that Gertrude's flaws extend to all women; his poor prediction for the marriage of Claudius and Gertrude (and thus the creation of a self-fulfilling prophesy) demonstrates "arbitrary inference"; Hamlet's various methods of self-criticism include "magnification and minimization", "inexact labeling", as well as "self-coercive" thoughts. According to this approach, the depressed person "thinks him/herself into an impaired mood". While literary studies may benefit from the new insights of cognitive-behavioral research, the simultaneous hope is that psychologists, researchers, and patients may benefit from reading Hamlet.

http://forum.psychlinks.ca/cognitiv...s-ten-forms-of-twisted-thinking.html#post4999

 

[alc]

Back in early 90s psychiatrist in CA tried all different forms of SSRIs to no avail. When moved to TX, it was a GP that suggested Wellbutrin. It worked most of the time. Last winter even 450 mg/d didn't help. New psychiatrist tried all kinds of antidepressants and augmenters. Quit her and next shrink pushed ECT at me after 20 min. inteview. After that didn't work he gave me Adderall and Depren as dopamine enhancers. At the point where I was suicidal I went to psychologist and she was the one who suggested the life-saving Lamictal. Am not impressed w/ psychiatry.

---------- Post added at 09:10 PM ---------- Previous post was at 09:05 PM ----------

Psychiatry has failed me several times. It was a GP who finally prescribed Wellbutrin. It was a psychologist who came up w/ the idea of mood stabilizer.

Undoubtably suicidal thoughts are very "stinky". What I'm talking about are habits of mind that lead one downward into depression. I don't tend to negative thinking, perfectionism, insecurity, etc. I start my slides w/o a detectable trigger...it just gets harder and harder to get through a normal day, I don't want to interact w/ family/friends, and don't enjoy things that usually make me happy. It gets to the point I can't get out of bed. Sometimes I can still pull up after a couple days of disfunction but couldn't seem to do that this year. Spent months depressed despite going to professionals when I realized I wasn't going to get better on my own.

 

[Daniel E.]

I don't want to interact w/ family/friends...It gets to the point I can't get out of bed.

Such avoidance/withdrawal is partly treated by behavioral activation and cognitive therapy -- in other words, CBT.

and don't enjoy things that usually make me happy.

So what usually happens is people with depression stop doing those activities, which keeps the cycle going.