Thought I'd contribute to the thread due to this being the time of the year that usually strikes me, as I have a cyclical depression, or perhaps even a mild form of cyclothymia (an atypical form of bi-polar) - which leads me to have periods of major depression and periods (albeit it much shorter unfortunately) of hypomania. So at these times I can read excessive amounts compared to normal; have extremely good recollection (on top of having a usually photographic memory anyway) and insomnia. But yes, I'm now at the start of my cycle that usually leads to 3-4 months of hell. And to top it off, I've had stuff to deal with this week that has set me back quite a way (separate from the market).
From between the ages of 18 and 21, I spent most of my time in and out of psych wards. Was very close to death on many occassions. Was nearly effectively braindead twice apparently. A side effect from medication also almost killed me, as a bout of tardive dyskinesia put my throat muscles into spasm and nearly crushed my wind pipe. I also had a temporary psychotic side effect from a drug called reboxetine, over powering 5 security guards during this. Apparently, it was "a miracle drug", but it just happens to randomly effect people's heart rates, randomly stimulate adrenaline production and crash and spike blood sugar levels. They are still prescribing it I believe...
Basically we had tried everything, and by the end of all this, I was totally unable to function in really any practical capacity. Although I managed to maintain good grades at UNI
. I had tried 15-20 anti-depressants. They either had no effect or the side effects outweighed the benefits. I remember having a panic attack after just one beer when on escitalopram. When I asked my doctor about this, his response was, "Oh no, you can't drink when on these." But this was at a time when I was trying to socialise to shake it, which I needed to do. So as a total last resort, I was put on dexamphetamine. It worked. I could actually function at last! And that's all that people with serious mental illness want, to be able to function. And I resent the fact that a large part of my life was wasted by trying the same things again and again.
Geez... this is getting long winded, lol! Anyway, 6 months later with a new psychiatrist, I explained that I wanted to be able to socialise and drink moderately whilst being on an anti-depressant. He gave me one. I didn't know there was one; I was never told. So I came off the speed and have made continual progress while on the oldest of all anti-depressants, Prozac/ Lovan/ Fluoxetine (same thing). And throughout this time I've recognised that when I crash, or just before, I stop reading, and when I'm recovering, I begin again. So, personally that has been the biggest help to me to recognise, being that I need to continually read. Even sitting on the grass at uni is all the social interaction I need to get my brain on the straight and narrow at times.
Julia, I know you wanted opinions on various treatments. I think I can offer some opinions.
In terms of therapy styles, DBT is far more effective than CBT. Long term impacts of CBT are totally negligible. It's just a method to get people out of wards quicker. 90% of people 3 months later are no better off after CBT.
In terms of medications (in order of success rates), Effexor has the best success rate (but the majority of people can't tolerate it, I was allergic to it), followed by the very first AD, Prozac or more commonly Lovan. It's also non reactive so you can drink and have fun on it without a problem. Escitalopram from what I know is next, although you cannot drink on it because it can kill you, and Avanza. I wouldn't recommend this one because of the weight gains, which in my mind is more likely to increase depression. Ciprimal is also OK, but the Escitalopram is a better version of it. These are the only meds I know of that have success above the placebo rate.
Zoloft is commonly prescribed but I've never seen it help anyone. I used to describe it as having a "zoning out" effect, but someone here called it zombie like, which is apt.
Julia,
I'm not sure if you realise but prolonged levels of anxiety will destroy your thyroid... the doctor's diagnosis and the physical hormone levels in my mind support each other.
I'm also a big believer in physical therapies, both exercise and body work to overcome depression and mental illness. Certainly since I began having regular work done, my rounded and hunched shoulders have been largely corrected, which is how a depressed person presents. I'm not sure if you can rid the internal problems without also aiding in relief from the external presentation and vice versa.
In fact I've spoken to some people about the above point, and it led to me being told that in some european countries one of the standard treatments for schizophrenia is massage. Because they have massive problems in being able to draw their own bodies, and situate themselves in space/ or have a total lack of spatial awareness, it helps them to gain this control and to be able to centralise thoughts and feelings more readily.
And even in my own work, it's quite obvious to see that people hold emotional problems in their body. This is no more evident than in myofascial release sessions.
Cheers,
Chops