My Last Post Here...

I will be leaving this site up, but I am moving over to a new blog. Coming off the Celexa and onto the St. John's Wort ended up being a horrific experience, but I don't regret it because it's lead me to a new line of treatment. I don't believe depression has really been my problem anymore, but rather a symptom of a problem. Read about it at by new blog, The Pure O. Hope to see you there.

St. John's Wort...

For a number of reasons I have decided to try coming off of the Celexa and moving over to St. John's Wort. This is an idea I've been kicking around in my head for some time now.

The most fundamental reason is that St. John's Wort is an MAOI, or Monoamine Oxidase Inihibitor, which have shown themselves to be better at treating depression that SSRI's, or Selective Serotonin Reuptake Inhibitor, which Celexa is classified as. It's also easier and much cheaper to get St. John's Wort. I generally prefer "natural" cures to drugs (though drugs are necessary), and also would like to not be dependant on medical insurance and having a doctor, as mine has not always been reliable.

The real problem is that SSRI's and MAOI's do not get along and can have lethal results if mixed. This means I will have to be off of Celexa for about three weeks before I can begin taking the St. John's Wort. This has already led to a false start, as I knew the two could not be mixed but did not know the length between the two was quite that long. I began taking very small doses of St. John's Wort only one week after discontinuing the Celexa and had mixed results. I believe I began having some symptom's of Serotonin Syndrome, though not most, and discontinued use to give my body more time to clear out the Celexa. Mainly I was beginning to feel "mental confusion" and racing thoughts, which may or may not have been symtoms, as it could also have been stress that I was under. Either way, better safe than sorry. There are also a number of foods it is recommended I stay away from.

This will no doubt be a difficult transition for me, and there is a lot of emotional baggage I am dealing with right now. Playing around with medication is always nerve racking for me, as I'm uncomfortable with the fact that our minds are basically created by a series of chemicals and changing those chemicals, in a good or bad way, can alter our thinking. This thought has bothered me ever since my encounter with marijuana, and haunts me to this day. I have realized in the last couple of days that the real psychological effects I felt after my unfortunate encounter had less to do with the pharmicological effects of THC as the psychological effects, the knowledge that our brain is a tool and can malfunction. It made me question reality itself, for what is reality to us other than our perception of it, and what happens when that perception is played with.

My early experience with St. John's Wort was a mixed one. As I said I think I was getting elevated levels of serotonin, which I did not enjoy, but on the other hand I found it much easier to feel emotion and to emote in general than I had with the Celexa (which had helped but I don't think as much). This was another mixed bag as I enjoyed being able to feel, but am also a little at a loss as to how to navigate the flood of emotions. One thing I realized is how scary depression itself is, as it's caused mainly by faulty brain chemistry to begin with. In other words, while trying a medication is hard enough, not taking medication is just as bad, as my chemistry isn't right to begin with. It's not as though I can reset to gain my bearings.

This last week I've had a flood of guilt, as with the St. John's Wort it seemed more than ever I could see how much my depression caused me to keep people out, to resist being loved. It's a terrifying thought for me that all these years help and understanding were there but I simply could not see it. That is as scary to me as when I was in the hospital, because both were a degree, albiet a small one, of psychosis. I feel almost like Neo awakening from the Matrix. All these years the truth was out there but I've been unable to see it or use it because my depression kept negative thoughts in front of me and disallowed positive ones. We all have our difficulties to deal with, but I've spent most of my life not being able to enjoy, or even know the existance of, the positive things we all have in our lives that makes life bearable. I feel as though I have been robbed of my joy, or worse, even my chance for joy then. As painful as that is, it's easier to deal with that pain and know that it can be healed than it is to just be depressed and not know it. It's easier to feel pain than to repress it and not know of it's existance. Whatever pain I feel now, at least I am aware of it and can act.

In the end, the St. John's Wort may be a failure, or it may be a success. I am hoping it is a success but will assume nothing and rely on my own observations as well as that of others to ascertain its effects.

Breaking the Mold...

Habits are good and bad things. We forget that sometimes. We usually only talk about bad ones, but we probably have more good ones than bad. We take showers or baths every day, usually without thinking about it, or why we're doing it. We're used to bathing. That's a good habit. A lot of habits we've had for so long we can get to a point were we don't even know how it started. When you put your shoes on do you put one on and tie them and then put the other on, or do you put both shoes on at the same time and then tie them? Whichever you do, you probably don't know why you do it that particular way, you just always have.

During World War II the US Army was faced with many problems, one of which was they were having a difficult time raising llamas in New Jersey. This was because Germany had cut off American supply routes to South America, where the Army used to getting their llamas or, more accurately, their llama dung. Since Jersey llamas weren't working, someone asked the obvious question of why they needed the dung in the first place. And investigation was conducted, and what they found was that during the days of the cavalry , back in the 1800's, the Army was having a terrible time with horses wearing new saddles throwing their new riders in training. It was found that the smell of new leather was making the horses jumpy, and if the leather was treated with llama dung first the smell no longer bothered the horses and they, in turn, stopped breaking the arms and necks of young cadets. Of course by WWII the Army had phased out the cavalry, but not their need for leather. In WWII there was no Air Force as it is now, there was the Army Air Corp, and it was still part of the Army. The army planes used leather seats, and Army specifications for obtaining leather still carried the same requirement for treating the leather with llama dung. Since airplanes are not known to be made jumpy by the smell of new leather the specifications were then changed, but it just goes to show how you can get used to a way of doing things and eventually forget why you were doing it in the first place.

I am still in the process of trying to unearth old habits that no longer make any sense. It isn't very easy. For one I still find myself to be a terrible procrastinator. This stems from more depressed times when I was saturated with the notion that nothing would ever get better and that there was no point in trying. I don't live in those times anymore, and I don't feel that way anymore (much), and yet I find myself, I think purely out of habit, discouraged from taking actions that I know will help. This happens a lot when I need to clean house. Cleaning seemed unbearably difficult as a child, and while it's fairly easy for me to do now I still get feelings that it is a hopeless endeavor. Instead of using tools that I have acquired I revert back to giving up. Then the mess gets worse which adds to the feeling that it's a lost cause.

I face a similar problem at work. When I feel discouraged or upset about something I want to withdraw, to sulk. I know this won't work. I know I have many better tools to use. Yet my impulse is to do just that. This is irritating to me. I have to fight to use these other tools, even though I know using them is easier than shooting myself in the foot. I have no reason to sulk other than it is what I'm used to. I don't even like to sulk, but again, it is what I'm used to.

Watching TV, or mindlessly surfing the internet, is another form of avoidance I'm battling against. I don't think I'm really even avoiding anything in particular half of the time I do it, I think it's just a learned behavior. After so many years of depression it's like I have to remind myself there are other choices. I am free to do things that I like. I just need to keep reminding myself of that.

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Old Dog, New Tricks...

My therapist once told me that the hardest thing in the world to do is to change. It's so difficult, most of us literally have to have a heart attack before we change... at least our diet and exercise. This I have found to be true. In fact, many people don't even change their lifestyle after a heart attack.

I've spent a lot of time trying to catalogue and understand the roots of my behavior. This has been helpful for a certain part of coping with depression. Unfortunately, it doesn't account for all behavior. I've come to find that some behavior exists merely out of habit. Even once the initial reason for the behavior is gone, the synaptic pathways are loathe to change. I find myself slipping into depressive behavior now sometimes out of habit, not out of cause. I'm simply used to moping around so I do it. I am finding this is difficult to change. Because it's a habit it's hard to notice that I'm even doing it.

I am finding more and more that I have to rethink behavior modification. I'm used to looking for causes and circumventing them, or finding more mature responses to them. That is increasingly not working. So I'm working on a new strategy to deal with this next layer of problem. Fortunately, in terms of depression, these are problems I don't mind having, given the alternative. I'll be writing another article soon on more specific behavior modeling.

"The butter melts out of habit,
You know that toast isn't even warm"
-Ani Difranco, Out of Habit

New Look...

I decided to ditch the all black page, a little too depressing for a depression page. Plus I just realized I can change the code on the page, and therefore change the color. Enjoy!

Headaches and Withdrawal: Addendum...

A quick note in regards to the last post, the other night I began to get a headache after I began drinking a caffeine soft-drink. I hadn't had caffeine in a couple of days. So now I'm wondering if the headaches aren't just withdrawal, but re-introduction of caffeine to blood stream as well.

Headaches and Withdrawal...

I have recently been suffering from a number of headaches. Some of it is probably because I'm cutting back on coffee. At first I didn't notice any physical signs of withdrawal, just a disgustingly rabid desire for more coffee, I suppose my first inclinations of what coming off an addiction is like, though I'm aware this is nothing in comparison to other forms of addiction. Why would I decide to curtail the drinking of such a wonderful beverage? Heartburn. I'm not sure now how I linked to two together, but a couple of weeks ago it occured to me that my awful bouts of heartburn (which I had never had before in my life) where being caused by the coffee. It was around the time I started actively treating heartburn with vinegar (it really does work, and clears up acne and cuts down on dandruff, believe it or not) that I made the connection. It made sense once I thought of it too, since I did start getting heartburn around the time I went into the hospital, annnnnnd... that was not long after I started working at Pfizer where the coffee was given away free and I became an active coffee drinker, unleashing an orgy of caffiene on my body.

I now have another problem (funny how these things seem to domino) which is that I've yet to completely cut off my coffee intake as working third shift two days a week I find it helpful in keeping me awake. But I'm afraid if I'm only drinking it twice a week I may be setting myself for a state of perpetual withdrawal, which would be undesirable. Sigh.

The other kind of headache I'm having I'm wondering if is from the Celexa. It seems that if I miss so much as a day I get the "depression headache" I can only describe as feeling like my brain has been scratched up with sandpaper. It's not so much painful, but it makes me feel like crap. I used to get this more when I wasn't on medication, now I tend to get it if I stop taking it. This I know moreso from the last time I came off the medication. Now I get it once in awhile if I miss so much as a day, which does happen now and then. This worries me because I'm worried I may one day build up a tolerance to the medication and have to make more, or who knows what. It's not a scenario I like. It's also making me consider more the thought of switching over to Saint John's Wort.

Pro's and Con's

Pro's - St. John's Wort (SJW, my own abbreviation) is an MAOI. "MAOIs act by inhibiting the activity of monoamine oxidase preventing the breakdown of monoamine neurotransmitters and so increasing the available stores. There are two isoforms, MAO-A and MAO-B. MAO-A preferentially deaminates serotonin, melatonin, adrenaline and noradrenaline. MAO-B preferentially deaminates phenylethylamine and trace amines. Dopamine is equally deaminated by both types." - Wikipedia.

What I take now is an SSRI. "Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants. They act within the brain to increase the amount of the neurotransmitter, serotonin (5-hydroxytryptamine or 5-HT), in the synaptic gap by inhibiting its reuptake." - Wikipedia
I can buy SJW pretty cheaply, and while the Celexa is now free through my insurance, that may not always be the case. So there's a financial incentive. SJW is also not a drug, and I am coming to like drugs less and less. I also wouldn't need a prescription for SJW. Lastly, from everything I have read, MAOI's work better than SSRI's. So, why aren't MAOI's presribed more? That brings us to the con's.
Con's - "When ingested orally, MAOIs inhibit the catabolism of dietary amines. Sufficient intestinal MAO-A inhibition can lead to hypertensive crises when foods containing tyramine are consumed, or hyperserotonemia if foods containing tryptophan are consumed. Hypertensive crises can sometimes result in stroke or cardiac arrythmia if not treated. This risk is not present with RIMAs. Both kinds of intestinal MAO-inhbition can cause hyperpyrexia if levodopa-containing foods are consumed.

Examples of foods with high levels of tyramine include liver, Chianti and other aged wines, aged cheeses, meat extracts (e.g. Bovril) and yeast extracts (e.g. Marmite, Vegemite). A separate list of foods containing tyramine has been established. Examples of levodopa-containing foods include broad beans.

Although the "MAOI diet" is not necessary for those taking selective MAO-A inhibitors, the same drugs should still be avoided. Since the selective MAOIs are not 100% selective, taking a drug metabolized by MAO-B will still be dangerous while taking a selective MAO-A inhibitor.

Combined use of non-selective MAO inhibitors or MAO-A inhibitors and serotonergic drugs (such as MDMA) is likely to lead to serotonin syndrome."

So there lies the problem. Sigh, again.

I am also trying to modify learned behavior, realizing that a lot of what leads to depression now for me are simply learned behavior problems I've yet to change. I'll talk on that more later.