Are Antidepressants Worth Taking?

Since being diagnosed with clinical depression a few years ago, I’ve been on and off (mostly on) the anti-depressant Fluoxetine.

I’ve taken varying doses between the minimum and, most recently, the maximum.

What beneficial effects did Fluoxetine have for me? What were its side-effects?

Rather than writing about how anti-depressants are supposed to work, in this post I’ll share my subjective experiences, which may be typical, or they may be anomalous.

[Nerdy science warning: Care should be taken before drawing conclusions from a sample size of one with no experimental controls in place.]

Fluoxetine seems to take the edge off the more difficult aspects of life. And by “difficult” I really mean “intensely emotional.”

I experienced less emotion while on the medication. This felt a bit like having a force field, enabling me to more easily endure uncomfortable situations (whether they occurred in the external world, or purely in my internal world of thoughts and feelings).

Fortunately my emotions weren’t numbed completely. I think that would have felt unpleasant for me, though I can understand why someone who’s been through a lot of trauma might want to numb everything and feel nothing.

Often it’s really beneficial to have a force field which prevents you feeling so much emotion. For example, in stressful work environments, it’s easier to keep your cool.

Dull

Along with dulled emotions, I believe my thinking wasn’t as sharp. It’s hard to quantify exactly how dulled my cognition seemed to be. At a rough guess, maybe 10%?

I’m finding it easier to get out of bed now I’m off the antidepressants. And the morning’s mental grogginess fades faster. I concede this is partly because I’m simply enjoying life more, so I have more willingness to engage with the morning rather than trying to hide from it.

Sometimes life is fucking brutal. Our loved ones will die one day, many of them before we die ourselves. That kind of loss can cause immense suffering and pain.

Dr Jordan Peterson rather bleakly proclaims, “Life is tragedy tainted by malevolence.” I have some sympathy with that outlook.

So it’s no wonder people turn to antidepressants to get some temporary relief from the bleakest parts of life.

Was my life ready that bad?

I wasn’t taking Fluoxetine short-term. I’ve been on it for years. So what unbearable trauma happened to me? Why was my life so bad that I didn’t want to live any more?

In short, I simply didn’t like life. I wanted to escape from it. I spent large chunks of my time wishing I wasn’t around.

At the time, my understanding was that if life’s making you depressed, then it’s perfectly natural to take anti-depressants so you can cope with it.

I liked my Fluoxetine-powered force field. I didn’t want to give it up. It didn’t miraculously make me happier, but at least it reduced the intensity of negative emotions.

And that’s the key point: I had decided I didn’t want to deal with everyday life any more. I constantly wanted to escape, through anti-depressants, through videogames and eventually by taking drugs.

And that lead me to addiction and Narcotics Anonymous.

It might seem strange, but I’m incredibly grateful I hit that low point.

Because it was there, as my life teetered on the edge of total destruction, that I learned the last little secret to curing myself of depression.


The root problem wasn’t that I was depressed. My core problem was that I couldn’t cope with everyday life.

And the solution wasn’t to mask or escape from reality (via games, drugs etc). The solution was to learn how to accept life on life’s terms.


I needed to stop running away. I needed to take responsibility for my life.

It’s thanks to Dr Jordan Peterson and to Narcotics Anonymous that I’ve made these astonishing realisations.

It’s taken me literally years to get to this point. Change is often really hard.


It’s been almost 8 weeks since I cold-turkeyed Fluoxetine. I don’t recommend that anyone else does this – it can be very risky to suddenly stop taking antidepressants, in some cases fatal.

Two months ago I couldn’t fully articulate why I wanted to stop taking my medication. But I knew it felt like the right thing to do for me personally.

It’s only now that all of this is becoming increasingly clear to me, almost 5 months clean from drugs and 2 months free from anti-depressants.

Ultimately, I needed to learn how to cope with everyday life again.

I needed to start taking responsibility for myself. And I needed to learn a better way to relate to so-called “negative” emotions.

Without Jordan Peterson and NA, I expect I’d still be on anti-depressants… possibly for the rest of my life.

So, it’s difficult for me to understate how grateful I am to both NA and Dr Peterson (via his YouTube videos).

Who knows where I’d be without their help.


[Caveat: depression is a complex disease. It has many different causes and seems to affect different people in different ways. In this post I talk only about my own experiences. I’m not a doctor or a medical professional. I am not recommending what I did for anyone else.]

Getting the Most from 12-Step Programs

(Photo: Nic McPhee/Flickr)

I have mixed feelings about 12-Step programs like Narcotics Anonymous, which I’ve now been attending for 4 months.

There are plenty of good things about NA. But sadly, there are also several unsettling flaws which drag it down in my estimation.

There’s zero chance that I’m the first person to have recognised NA’s problems, which indicates to me that the organisation is stuck in the past. It struggles to adapt and change, limiting its ability to learn from its mistakes.

NA is stuck in ideology and dogma, seemingly unable to evolve and improve.

The real tragedy about this is that it unnecessarily limits the organisation’s ability to help people.

I wonder how many struggling addicts have been turned off by NA’s negatives, many of which I’ve wrestled with myself. How many of those desperate people relapsed and died as a result of NA’s failings?

A journalist’s conclusions

I enjoyed the following article, which contains many salient points about Narcotics Anonymous (click the link just below)

WHAT I’VE FINALLY CONCLUDED ABOUT 12-STEP PROGRAMS AFTER 25 YEARS WRITING ABOUT DRUGS AND ADDICTION


I don’t want to sound overly negative about NA, so here’s my attempt at a balanced representation of NA’s pros and cons:

What I like about NA

  1. It’s free (other than a small donation each meeting).
  2. I love the social support I receive from other addicts. There are some really lovely, kind, caring people at my local NA meeting. After 4 months of attending meetings, some of them are starting to feel like friends.
  3. For people who diligently follow a 12 Step program, it seems likely that their lives will improve in many different and sometimes unexpected ways.
  4. One vitally important NA catchphrase is, “Take what you like, leave the rest.” You’re not forced to think or believe in a certain way. There is some room for individual differences of opinion.
  5. There’s a lot of overlap between the 12 Steps and some ancient philosophies such as Stoicism and Buddhism. These philosophies are excellent paths to self-mastery and self-improvement. I’m a big fan of both, and for me, much of NA’s ideology fits quite neatly with my existing beliefs and understanding.

What I don’t like about NA

  1. Some members seems to insist that there is only one correct way to recover from addiction (the official NA way), leaving little room for nuance, individual differences or the complexity of life. I strongly resist such a puritanical and ideological approach. Blind faith in dogma is simply stupid – we should always be willing to question what we’re told.
  2. NA’s insistence on the existence of a “Higher Power” is redundant for the treatment of addiction. NA seems wilfully blind to the fact there are plenty of secular, effective, evidence-based drug treatment programs.
  3. NA lumps all attendees together and treats us as if we’re all the same: sick addicts who are fundamentally broken. Personally, I don’t find this approach helpful. NA literature is full of unhelpful narratives about the lives of addicts – I can’t relate to much of it and I have to force myself to ignore it. The organisation could avoid this problem if it was more inclusive and better recognised the large variations in the experiences of different people.
  4. In its very first step (Step 1), NA insists I admit I am powerless over my addiction. That’s a huge turn-off for me. I’m absolutely NOT powerless. (See the article I mentioned earlier for more on this.)
  5. NA insists that anonymity is essential and non-negotiable. But some people (like me) find it helpful to be open and honest about my drug problems. I believe that silence and stigma around mental illness and addiction just makes things worse.
    (NOTE: I don’t recklessly over-disclose, I’m careful about who I share with. And for this blog I keep my true identity hidden behind a pseudonym.)

How I reconcile all these problems

For me, it all comes back to that idea I mentioned earlier:

“Take what’s useful for you, ignore the rest”

And there are plenty of things I find beneficial about Narcotics Anonymous.

It would be churlish of me to throw the baby out with the bath water – to stop attending simply because there are certain aspects I don’t like.

Perhaps NA is simply a microcosm of society… everyone is different and if we want society to function well, we must be tolerant of each other’s differences…

… that’s unless you want to live in a totalitarian state like Communist China.

The Big S

My brain keeps coming up with amusing ways to begin this post. It’s bizarre, the subject I want to talk about isn’t funny at all.

Suicide

There, I’ve said it. I’m sorry if I’ve just ruined your day.

Last week, an old friend took her own life.

She was recently married and had a young baby. But depression and other mental illnesses don’t particularly care about your life circumstances. It doesn’t matter how successful and happy you might seem on social media.

She wasn’t the first person in my social circle to do this. It’s distressing that I’ve actually lost count of the number of friends and family who have died by their own hand.

And even worse, I’m not particularly unusual. By the time most of us reach our forties (like me), we’ll know at least one person who killed themselves.

Suicide is the biggest killer of men under 45 in the UK. I’m sure the rest of the Western world has similar stats.

Just stop and think about that for a second…

Not cancer, not heart disease, not even car crashes. Suicide.

And yet many of us are still too scared or feel awkward talking about it. And that stigma contributes to the problem.

I feel strongly about this issue – before my blog’s recent redesign, this post aimed at preventing suicide was permanently featured on my home page.

Impotence

I’ve had my fair share of mental health problems: depression which brought me close to suicide several times, panic attacks and addiction in recent years.

I’m incredibly grateful for these difficult experiences. They’ve taught me useful skills, for helping both myself and others. I’m better able to empathise with people going through similar experiences.

Volunteering as a listener for a suicide prevention charity was one of the most fulfilling roles of my life.

And yet, I feel like I should be doing more. More to help others, more to reduce the number of deaths by suicide.

Suicide isn’t inevitable. Severe depression can be treated. Maybe not for 100% of people, but certainly for some, maybe even most.

There’s more I could be doing to help.

Recently I’ve been looking for a clearer purpose for my blog, a tighter focus. Again and again The Universe keeps prompting me to do something about mental health issues and specifically suicide.

I guess it’s about time I did something.


That’s A Sign! (No, That’s Psychosis)

I’ve written before about my obsession with the numbers 444 and 11 during the peak of my drug-induced psychosis. But I don’t think I’ve told many people about another strange occurrence which happened at about the same time.

My work colleague was describing to me a picture which her 4 year old daughter had drawn. The picture featured three people: my colleague, myself and another colleague. In my mind, the 3 stick figures were arranged in a triangle.

Instantly, I knew – this was a sign. There was some special significance in this drawing. It was telling me (or us) something important… we just had to decipher the correct meaning.

That was over two months ago. I’m pretty sure any last traces of psychosis have left me now… which is a shame because there were so many benefits!

For a while my colleague joked that “the [alien] mothership is talking to you!”

I still haven’t worked out what that picture means. For a while I thought it was predicting the order in which me and my two colleagues were going to leave the company. But we’re all still there, happily employed.

And so, with some sadness I’ve had to accept… there was probably zero special meaning or significance in my colleague’s drawing.

Instead, the rational scientific explanation is that psychosis had ramped up my brain’s inherent pattern-spotting ability to the point where it was seeing patterns and significance where there were none. It was magical thinking.

Of course, I remain open-minded. Every now and then I’ll be sure to think back to that picture and see if any new events have transpired which explain its significance. I may well do that for the rest of my life.

My real life is pretty boring now. On my low days I often experience suicidal ideation. The peak of my psychosis wasn’t like that – life felt exciting and new and motivating. I was uncovering mysteries (real or imagined) continuously.

I suspect that a psychological phenomenon known as “motivated reasoning” was a factor in my psychosis. In other words, we believe certain things because we want them to be true. I was believing in fantasy because I was desperate to escape reality… and the after-effects of a pretty hardcore drug trip made it easier to make that leap.

In a couple of weeks I’ll hit 90 days clean. Right now I feel more sad about that than happy. If I stay clean for the rest of my life, I’ll never get to experience those feelings again. I’ll never explore alternate universes inside my own mind… except when dreaming.

It’s no wonder I can quite happily stay in bed 12 hours per day at the moment.

It’s also no wonder that some people choose to believe in God, despite a lack of hard evidence. Their faith gives them hope and keeps them alive. There’s tremendous power in that.

The Unexpectedly Comforting Thing My Psychiatrist Told Me

I saw a psychiatrist for the first time in my life last week. I have depression and problems with substance abuse.

She was lovely. She listened attentively to my experiences and genuinely seemed to want the best for me. Her insight was razor-sharp, but she delivered her advice with kindness and compassion. That combination is rare and takes real skill!

[Caveat: She wasn’t perfect… some of her advice seemed… a little misjudged.]

Embarrassing

In mid-August 2019, I experienced a Spiritual Awakening… AKA drug-induced psychosis, depending on your preferred way of looking at the world.

Last week, I explained to the psychiatrist with some embarrassment that I often felt as though God was with me. I didn’t mean purely metaphorically either… In the last couple of months I’ve often experienced physical sensations which I interpreted as God being alive and present.

I felt a kind of echo in my breathing, which I interpreted as me being filled with the Holy Spirit, or the Breath of God. And I felt a wonderful sense of joy in my chest, which I interpreted as God’s love inhabiting my heart.

I still get those sensations at times now, over 2 months later. They’re pleasant and calming. They give me a sense of peace.

More rational and scientific thinkers may dismiss those sensations as merely symptoms of psychosis caused by drug abuse. But that doesn’t mean they didn’t feel real to me, or diminish the spiritual significance I derived from them.

Maybe it’s all just the placebo effect. But again, don’t dismiss placebo effects as meaningless or worthless. They can be extremely powerful.

Missing

Anyway, I explained to the psychiatrist that I felt these sensations far less often now, compared to during the peak of the psychosis. I admitted that I missed those feelings because they let me know that God was with me.

But God is always with us, isn’t He, whether we feel Him or not.” she gently explained, her voice full of kindness and wisdom.

I was stunned… I had not expected that!

I thought that as a highly qualified medical professional, she would probably be atheist or agnostic. What a dangerous assumption for me to make!

Peace

What a wonderful thought… God is always with us. How reassuring!

Even if you’re not religious, I hope you can see that such a belief can provide great comfort to people…

… And not just in an infantile “comfort blanket” kind of way…

Believing in God and feeling His love can be the difference between life and death to some people. It can be the deciding factor which makes someone decide not to commit suicide.

What a tremendous difference a belief in God can make to the way we feel! How much lighter our burden becomes!

Even if you’re staunchly atheistic, I believe it’s worth believing in God just for the benefits such a belief provides.

Perhaps God is the ultimate placebo… but as studies have shown, placebos can be effective even when the patient knows they’re taking a placebo!

I’m certainly going to continue believing God is with me, whether I can feel Him physically or not.


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Metacognitive Therapy Holds Promise for Treating Depression

NORWEGIAN UNIVERSITY OF SCIENCE AND TECHNOLOGY

Depression is one of the most common mental disorders worldwide. It affects both individuals and society as a whole, in the form of lost work productivity, high mortality and lower quality of life.

Unfortunately, it is typical for patients with depression to experience relapses. Research findings show that one and a half years after the end of treatment, only about 30 per cent of patients are still healthy.

Fortunately, there is hope. A recent study shows that metacognitive therapy significantly reduces the risk of relapse.

“We found that about 67 to 73 per cent of patients, depending on how you measure it, were still classified recovered one year after the end of treatment. This is good news,” says Professor Odin Hjemdal at the Norwegian University of Science and Technology’s (NTNU) Department of Psychology. Hjemdal is also head of the university’s Resilience Centre.

Hjemdal collaborated with Stian Solem, Roger Hagen, Leif Edward Ottesen Kennair, Hans M. Nordahl and Adrian Wells on a recent article in the journal Frontiers in Psychology.

The researchers reported that participants in the study had a lower rate of relapse than what is found with other treatment methods.

Simply put, metacognitive therapy involves teaching patients not to respond to perseverative thoughts, which means learning to not continuously focus on negative thoughts.

When a patient begins to ruminate on a negative thought, the patient is taught that they can make a choice whether to think about the negative thought or just register that the thought is there and move on. By becoming aware of what happens when they start ruminating, patients learn to recognize when it is happening and then choose other alternatives.

The method is not about analysing a patient’s worries. Blocking thoughts saps energy and solves nothing. Patients need to let the concerns arise, but train themselves to become a passive observer, to meet their thoughts with more detached attention. They practise seeing their thoughts as just thoughts, and not as a reflection of reality.

[Rock’s note: Metacognitive therapy sounds very similar to mindfulness]

“Most of us have negative thoughts, we think we’re not good enough or we don’t accomplish what we want to. But only few people get clinically depressed, because most of us can put aside our repeating thoughts, rather than getting stuck in them.

“What perpetuates depression is that you get stuck in a thought pattern and ruminate about the same thing over and over,” says Hjemdal.

The patients who participated in the study received ten sessions of metacognitive therapy.

After six months, 77 per cent of them had recovered completely from their depression diagnosis. Between 67 and 73 per cent were still healthy one year following treatment, according to patient questionnaire responses. The remaining patients had seen an improvement, while for about 15 per cent their depression remained unchanged.

Anxiety and depression are often linked, and the study shows a marked reduction in both.

“Metacognitive therapy can work better than other therapies to reduce thinking processes such as rumination, worry and inappropriate coping strategies,” says Hjemdal. “But there’s still more we need to know.”

So far, medication or cognitive behavioural therapy (CBT) have been the most common approaches for treating depression and anxiety. CBT involves having patients probe their thoughts and analyse them.

Hjemdal thinks many patients find it difficult to revisit earlier depressive episodes. His impression is that metacognitive therapy is a less demanding form of treatment.

“The feedback from patients is that some of them are very satisfied, and many have experienced very quick positive effects.

The researcher admits that he is surprised by the results of the new study.

“We’re a little surprised, but we’re really happy that it’s turned out this way. To us, it seems that when patients crack the code and manage to change their thinking styles and patterns, they stay healthy,” he said.

But a lot of research still remains, especially on the long-term effects of treatment. Hjemdal thinks it’s odd that less money is spent on mental health research than physical illnesses, even though the social costs of depression are of the same magnitude.

“As a society, we could save a lot of money and spare people a lot of personal suffering, if we provide metacognitive therapy treatment to help individuals with depression,” says Hjemdal.

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Reference: A Randomized Controlled Trial of Metacognitive Therapy for Depression: Analysis of 1-Year Follow-Up. Odin Hjemdal, Stian Solem, Roger Hagen, Leif Edward Ottesen Kennair, Hans M. Nordahl and Adrian Wells. Frontiers in Psychology. 8 August 2019.

Source: https://norwegianscitechnews.com/2019/10/breaking-thought-patterns-increases-chances-of-recovering-from-depression/