Depression

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I've suffered from anxiety most of my life and for as long as I can remember. I had my first major episode of depression when I was 18, right before and after graduating high school. My depression and anxiety were well controlled by Zoloft for about four years but with time it stopped working and I maxed out of the dosage range. I took Viiybrd after that but it only seemed to make my depression worse. After nearly flunking out of graduate school I'm on Effexor now. I like the Effexor. I had minimum side effects and have noticed a steady rate of change in my moods. I'm doing much better in school now. I see a counselor on campus biweekly. My problem is that at night, almost reliably between 9pm and 10pm, my depression suddenly comes back in a very bad way.

In these bouts of depression everything is horrible again. I'm a failure. I'm alone. I feel weighed down, crushed by my own feelings. This happens some nights when I'm still in class. I try to think positively or at least distract myself but sometimes all I can do is lay down in bed and cry. Usually, to get away from the feelings, I just go to bed and am able to make myself fall asleep. From what I've read about depression this is pretty uncommon. Most people are worse in the morning and better at night. I talked to my counselor about it today. He says the same thing that my mom says: I need to get up and get moving. He also urged me to go see my GP which I'm doing at the beginning of next month.

I guess I just wanted to share my story. Its so hard in the midst of these mini-depressions to think of anything good or exciting. Most things seem dull and boring and worthless. Or they're just too much for me to handle, like school work. Has anyone else ever experienced this? Does anyone else take Effexor and have an advise for me? Has anyone else had success with a drug that isn't an SSRI? I know its long but thanks for reading.

I have depression and anxiety and take Risperdal. I guess it's working; hard to say, though. There's a site called SSRI Stories that tells stories of incidents where SSRI's were involved. Here's the link.

http://ssristories.com/

I know your in a low spot right now, but still wanted to say congrats on your success staying to your goals and working on solutions as problems occur.

I have taken Effexor for mainly anxiety and some depression for several years. It definately has helped a lot, made life a lot less stressful, and I like the lack of side effects also.

Could the bad time most evenings have something to do with how and when you take the medication. Is that maybe when it is running out in your system? I take mine split in two doses to try and keep at a certain level rather then all at once.

Also don't be afraid to try something new. One Doc suggested I try Cymbalta, but I have delayed seeing the Effexor is good enough, and I was frankly afraid of possible side effects that are more common with it. Yet two extended family members have gone to it and are quite satisfied and do not experience bad side effects.

I also take mine in two dose, one in the morning and one in the evening. My best friend is a nurse and she suggested to me that it might be an issue of timing. It could be that the first dose is completely out of my system before the second. I looked up the half life of the drug and I take it less than 12 hours apart so I don't think its a timing issue. My doctor will need to verify that but it was something I thought of. The idea of taking something else is prohibitive because I don't have health insurance. Effexor is a cheap generic drug but something like Cymbalta may be too expensive for me. Thanks for the advice though!

You might try to experiment a bit just in case it is timing. I take mine rather irregularly like at 10am and then somewhere between 6-9pm. One possible idea is to stack it up against that bad time. Like a little later in morning and late afternoon so as to be on strongest level at 9pm.

Totally understand the economics. I am not sure about Cymbalta but thought it was not cheap. Its fairly new and may not have a generic yet, but might in time.

Another thought is to try doing zone-out activity (or lack of activity actually) during that time. Something like watch movies that interest you or play a video game. Something to occupy your mind but is sort of sedating if you know what I mean.

I get the most severe depressive spikes in the evening too, any time between 5pm-9pm, although I have bipolar and not straight depression. There are quite a few alternatives to SSRI's, one of meds I'm taking atm is lamotrigine, which is a non-SSRI drug that has been shown to be quite effective against depression without triggering manic swings (although you're not bipolar, it may help with straight depression too). Ive been on risperidole in the past myself, didn't work in my case, but it is thought to be particularly helpful in people with autism.

You might want to try some natural remedies, such as Chamonile tea for the anxiety. Chamonile has natural benzodiazepines, so you got to careful when you drink it, because 30 minutes later, you're fast asleep.

You also might want to try a natural antidepressant also, such as St. John's Wort, or fish oil capsules. I am not a Doctor, so discuss that with your doctor or psychiatrist.

You also might want to try an iPhone app called Relax+. While the app is free, any additional tracks cost $0.99 USD. I've been using it to get to sleep at night, as well as listening to any of the CALM streams on the internet.

I've been pretty much in a funk myself lately, and I think it's because of the holiday's coming up.

I'm with Toy Soldier on this - experiment with your timings. The half life of effexor is really short. Depression comes around 9 - 10 pm. What time is your evening dose? What dose are you on? How long have you been on that dose? What dose did you start on?

And you say: "Most things seem dull and boring and worthless. Or they're just too much for me to handle, like school work." How long have you been on effexor? If over 3 months you should consider changing. Or should certainly be making an informed decision as to whether to increase the dose at both ends of the day.

There's quite a few fora with user experience of effexor - have a look at them.

At night, do you get "brain zaps" and lucid nightmares?

As for alternatives: consider wellbutrin which many like. I'm using mirtazapine which is excellent for me.

If you decide to come off effexor be careful. Because of its short half life it can create a serious dependency. Doctors don't recognise this and will suggest a faster taper than is sensible. The recommended way to get off it is to do a slow taper in conjunction with wellbutrin or an SSRI (NOT Seroxat). Sure, you don't want an SSRI, but using one will help getting off effexor. Then you get off the SSRI.

Advice? First dose when you get up, second dose at 8pm. Give it a week and if no improvement stop. Slowly. Don't increase the dose. When you're curled up on the bed sobbing, try to tell yourself that it is a response to the drug. You say you're not getting side effects but YOU ARE. Depression and suicidal ideation are potential side effects of any AD.

Be careful.

You also might want to go to the Icarus Project's home page and download their Harm Reduction Guide for getting off Psychotropic drugs, show it to your doctor and discuss the guide with him. or her