Am I just stupid or is it the meds?

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Sorry this is kind of long and rambling.....I've had depression since a kid, been on various different meds since about 14 yrs. old (I'm 31 now) and its changed since a teen, like before it was a very harsh debilitating 'I wish I was dead' kind of depression but now I guess it's more anxiety and restlessness than feeling really low. I got really depressed a few years ago due to stress from work, and since then decided to change careers and go back to uni. Luckily, my parents are really supportive and have helped me with uni costs etc. I just feel mentally handicapped most of the time. And it's not a self-confidence thing of me thinking I’m stupid, if that makes sense, but an actual physical problem with recalling words, getting things mixed up, poor memory. I just feel like, in comparison to my 20's when I did my first degree, my IQ has seriously declined since then. I recently completed a PGDip course in psychology, a conversion course, and I really struggled to recall things. Like we could do a lecture on something and two weeks later people might talk about it and I would be sat there feeling confused, adamant that we hadn't been taught something, then go home and review my notes only to see the stuff I had written with no memory of it. But sometimes they would talk about stuff from two weeks ago and I would remember it. It's like selective memory or something. But I've been finding that during my studies, when I talk socially, I struggle to place words, like I would begin a sentence only to stop whilst my brain is searching for the word, like it's on the tip of my tongue but I just can't verbalise it? Which of course then makes me really nervous about talking to people because they probably think I’m an idiot. I've tried like rehearsing sentences in my head before starting/joining a conversation, but obviously, when things go off on tangents my brain really struggles to improvise? Anyway, when I did my first degree I took an SSRI, I’d been on seroxat since my teens and was still on it at uni. I can remember having lots of energy, clarity of thought, almost hyper points where I would sometimes not sleep at all. I was also an exercise enthusiast and went running/cycling and gym daily. My concentration and thought/speech was fine, and I can remember almost like having a tuning fork type of concentration and really good memory recall. As I entered the workforce once finishing my degree things started to get worse again as I did an office job and spent more time sat and getting mentally tired an so into a bad habit of just going home, having dinner and going to bed. Because of this I put on a lot of weight, which I admit gets me down but, at the same time, I can be optimistic that it's something within my control to change. I'm still overweight now which I guess I can attribute some of my fatigue too. I'm also not on seroxat anymore as it stopped working for me. I went through a handful of different meds, different addons, different combinations etc and finally my psychD put me on lofepramine which is a tricyclic. That med seemed to calm the anxiety I got about work and pressures of deadlines but at the same time I felt a bit like it took away my concern for things in general. The change from work to uni with everyone being on the ball  all the time and being able to remember things all the time made me realise how much I struggle with memory and word recall. My head feels foggy, but not in a depressed fatigue kind of way? I dunno how to explain it, it's like the feeling you get when you first wake up? That kind of half-awake not there feeling that disappears after a coffee, only with me it doesn't feel like it disappears. The lofepramine dosage my psychd put me on was upped to 280mg, and I recently realised that one of the reasons I over sleep and feel fatigued is partly due to the sedating quality of the drug, since then I've decided and have reduced my dosage to 210mg then 140mg to see if it would make a difference to the fatigue, foggy headed bad memory etc.

(Please, no lectures on how I shouldn't be changing my meds or how I’m not a qualified to alter my dosage. I'm been on various different AD all my life, and I'm fully aware of the interactions and also repercussions to changing my dosage. However if I can monitor my 'happiness' level and I'm in a relatively stress free environment atm to do this, then I feel it is within my purview to ‘experiment’. I’m chasing a better quality of life, and the meds are one factor which I am trying to consider as being partially responsible for that quality. Again I’m fully aware that meds take weeks/months to build up in the body to reach maximum therapeutic levels and so in reverse logic lowering a dosage may not immediately display any changes until some weeks or months may have passed. Again, I could consult my psychD,  but I would have to be referred again to them, and after a year had gone by of me waiting for the stupid referral for me to explain all of this for them to nod and say ‘Yes, let’s try and reduce down and see how it goes’, I’m skipping the inevitable GP visit where they say ‘Oh we can’t deal with that dosage, we have to refer you to X NHS department which should take X amount of months.’ And I’m skipping the nodding head from the psychD and the forewarned conversation about how I might only be managing because I’m in a stress free environment and that could change depending on said environment –just…no lecture please, I’m fully informed.) 

 

It’s only been a month on the different dosage and I honestly can't say I feel any better energy/memory wise. I mean I assumed it was the meds, because I tried taking 2 tabs at night before bed and two in the morning, and although I woke up easier, I found once I'd taken the morning 2 I got really tired and drowsy, so I know the tablets have played some role in the fatigue feeling. I exercise now more than I used to as well, and I admit the decline in that was partly due to a hip injury that would flare up if I attempted to run or cycle. That is healed now, so I've been doing more exercise, my thinking being maybe that was also partly helping my memory or something, increase blood flow etc. But, I find it really difficult to maintain, like I might start going to the gym 3x a week and running in the evening 1-2 times, and I'm fine for the first week or two but after a while the fatigue thing gets really bad, like I feel like I’m coming down with the flu or something, my throat gets sore etc. That’s another annoying thing, since being at uni again I don't think there has been a month when I haven't been sick. As in with a cold /chest infection. December 2014 and January I was really ill, at one point I was convinced I had pneumonia it was that bad. But I just pushed through and used day nurse and it kinda got better. And no I didn’t go to the dr and get antibiotics. I’ve had some really bad chest infections and been once to see a dr only to be told that I didn’t need antibiotics, I’d rather not face that condescending judgement again. Anyway, exercise wise I know it takes some time for the body to adapt, I also know I'm not a spring chicken anymore and yes I was careful to monitor diet, protein etc. I've tried different things, like cycling the exercise to have tough weeks and easy weeks etc to give my body a break but also build up some tolerance but again I get periods where I have to stop. Sometimes I get really low periods again, like very sudden no warning everything goes flat and pointless and slows down, and if I sleep the day away, then I feel better again, so I'm kind of attributing that to fatigue rather than depression. I dunno if any of that makes sense. But I guess I'm tinkering with things (meds/diet/exercise/sleep) to try and get back onto an optimal way of living. It's hard, especially when I can remember (haha remember) all the things I used to do when I was 20. The joys of getting older?

 

I guess out of all of that what I’m trying to ask is, does anyone feel like their IQ over the years has declined? And not due to inactivity, but due to the meds? I mean I know intelligence is something you partially acquire, and doing nothing will not improve it. But I’ve been two years in an environment where all I do is learn new things etc, and I don’t feel like my head has progressed or as I say ‘woken up’ to being back on track like before. Maybe I will never get that way again, but it’s hard to accept. It’s hard to accept that having memory problems and recall problems to the point where sentences seem to tale off into some fluffy vagueness that leaves me wondering what I was talking about, is normal? Part of me has a suspicion that the meds may have altered my brain in some way that has caused some permanent change, and now this is just ‘normal’ for me. Can anyone relate to this? Any thoughts?

 

(Once again, I don’t condone the changing of meds without some kind of professional intervention per se, but individual cases warrant individual choices. In this case I’m fully aware of the repercussions of med changing with no professional consultation, and anyone reading this who is new to meds or unsure, please do not stop taking your meds or change the dosage without talking to a dr or psychiatrist just because you’d read that I did this. And for those of you out there thinking ‘31 is just a baby you don’t know what you are doing’ please restrain yourself. I could go fully into my personal circumstances and life history and you’d have a better understanding that for me, 31 is just a number not an indication of my maturity, but I’ve already info dumped enough for today.)

 

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  • Posted

    Hi Sunny

    I waitwd 4 months to see my med team and I'm having my dosage reduced. All the symptoms you refer to I can associate. I suffered tiredness weight gain and others. Since my dosage has altered I think better and have more motivation. My depression will alwaya hang over me but the trigger has gone from my life and I now accept what the problem was. I don't know your circumstances but maybe you need to re examine your medication as that could be the cause and through your exercise you no longer need the medication you are on.... Just a thought good luck x

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    • Posted

      Hi Phil, thank you for the reply. Unfortunately, I've had my meds 'examined' so many times that I am now at the point of being done with the medical profession. Every time I pick up my repeat from the pharmacy I get a lecture from the pharmacist about my dosage and I can't be bothered to keep explaining that 'yes dear it's fine, no my gp didn't prescribe that level, yes I've been referred'.  I've had some very condescending and ignorant remarks made by GP's who seem to think 'depression' equates to 'making up side effects / symptoms because depression = a head case/attention seeker/time waster' pick your choice. Because I have nothing better to do with my time than sit in surgery waiting room for an hour before seeing a GP who doesn't care what is wrong with me and who specialises in family practises or some other non-related area. I've tried to exist on no medication when I've been in a 'good phase' haha, and convinced myself I've grown out of depression, only to have a rude awakening. I revert to my former glorious depressed self, it's an existence much the same as my teens i.e. things as in feelings, energy levels and general way of being, (despite my best attempts otherwise), start to deteriorate to a point where I spend the majority of day in bed. And when that isn't possibly, my thoughts become consumed by 'ending it all' and I have no clue why I revert to being like this, I don't have some traumatic childhood memory, or any kind of adult life event which has made me this way. I've always been a very consciencious perfectionist, always asking 'why' things works etc. I go through manic phases when I'm in an up (I'm referring to teens) but it never lasts and usually crashes into a low. Whilst I was on the ssri's my gp (before i was referred) watched for manic reactions to the meds. My first psychd referral when I was about 18? I think, he told me I had bipolar, I think, he said if he confirmed his diagnosis my driving license would be taken away. I don't know if that was a test, but after that I told him that he wasn't taking it away and to not confirm anything. I never saw him again.  Anyway, I've come to accept that I have a chemical imbalance in my brain and I need the medication unfortunately to function like a 'normal' person, whatever that may be smile. I have tried various ssri's first (seroxat, citolopram, fluroxetine etc) and I've been on ssnri's- venlafaxine (Effexor XR) with dosages up to 275mg, duloxetine (Cymbalta) upto 120mg when these alone didn't work it was combined with olanzepine then when that didn't work quetiapine. I've tried arizapriole (sp?) (altho I can't remember now what that was for) and mirtazepine when I had problems sleeping on the cymbalta/venlafaxine. The final visit, my psychd said she wanted to try cymblta and lithium either that or lofepramine, and I really didn't like the sound of lithium (this was when I told her I was suicidal) so I was a bit skeptical of lithium given she had told me it was easy to overdose on. (I mean come on, I've just said I'm having thoughts about suicide and she tells me the lithium can be dangerous if overdosed, shakes head) so I went with the tricyclic to which I'm still currently on.

      I've seen one GP that said I have been on the meds too long and I should try yoga/meditating, she obviously has no idea whatsoever what depression can do to a person, does she not think that if meditating and yoga could cure depression I wouldn't be doing it? Another GP said that (from a 15 minute visit) she couldn't see why I would have some symptoms (vertigo/nausea, I was tapering off the seroxat I think) and said it must therefore be in my head if she couldn't account for physical symptoms. Seriously, I just give up with these ignorant fools. And it's why I am on here. I think that people in general have got a better idea about what is going on with me than a GP will ever have. And I don't necessarily blame the GP because our government sure isn't making their job any easier. But...oh well, I dunno. Thank you for the reply tho, it's hard to differentiate the tiredness and weight gain from life choices/depression or the meds. But ultimately I know that at least on the meds, even with the fatigue and weight gain, I can function and at least do things. Without..well I seriously doubt I would be here, sadly.

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  • Posted

    This all sounds very familiar. I don't think it's the meds, sorry (because that would easy to fix). It's not age either. I'm really sorry to say that I think you may have chronic fatigue syndrome. It all fits, the exhaustion, the sore throats, the constant infections. I've just been diagnosed with it after 25 yrs of what you're describing. It's a hard diagnosis to accept because there's no real treatment for it (although someone in Norway may have just discovered one). 

    However, the good news is that there are things that helped me. I found that Venlafaxine gave me back my mental acuity so by all means try that. I did find I had side effects for 6 months, and I now can't come off it, but it's worth it. A combination of a broad spectrum probiotic (eg prescript assist) and healthy eating esp oily fish and green veg help my energy and mood. (The probiotic is important because the bacteria are what breaks the healthy food down into vitamins and amino acids and you're likely to be deficient. Healthy eating on its own isn't enough). Try a Google search for CFS microbiome.  Vitamin D3 2000iu a day is good for mood and immune system. Get your iron levels checked too.

    The other thing is to know your limits. Get a feel for what you can do without triggering a collapse. Start off with less exercise and work up slowly. People with CFS tend to get so frustrated with being tired that when they feel ok they do loads which then triggers a collapse. It's called boom and bust. This also runs you down and makes you more susceptible to infections. 

    You don't mention whether you have gut problems, sensitivity to strong chemical smells, eg perfume and petrol, muscle aches, a feeling that your body doesn't adjust well to the ambient  temperature, say if you go from cold outside to a hot room. These can all also be associated with CFS.

    Im sorry, it's not what you wanted to hear, and I might be wrong. So I don't have as much energy as other people, and that can get me down sometimes, but I've managed to get the constant infections under control and THANK GOODNESS I've ditched the brain fog. 

    I hope that's been helpful. Do let me know if you have any other questions.

     

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    • Posted

      Hi Claudia, thank you for the reply. I must admit, that I have occasionaly considered CFS, both my dad and my aunt have both been diagnosed with it. I have a cousin with MS as well and another aunt and uncle (one with CFS) who is also diabetic, they are also on antidepressants for depression and PTSD. And as you say, it's a diagnosis I have been really hesitatant to approach because there is no cure. Like depression, there is also a lot of ignorance surrounding CFS, and gp's and other professionals usually refer to it as 'yuppie flu'. I know about it because I have done some research for my dad. I have tried to get him to try cymbalta or venlafaxine because it's supposed to be an energising AD and I've read on some websites how it's recommended for M.E. -CFS. I'm sorry, my dad has said ME and CFS aren't the same, but I think cymbalta or venlafaxine is still recommended for the fatigue element in both? I guess I went down the med route because whilst doing some research for my dad I read about how tricyclics cause cognitive problems such as poor memory and co-ordination in people who already have to deal with those issues, and my dads gp has prescribed ametriptyline (sp) for back ache which I didn't think was a good idea considering how sedating it is, and he struggles so badly with energy and motivation as it is. But..I fight a battle in that department because if anyone has any letters after their name, PHD etc, he believes everything they promote, and if  a gp prescribes him something he will take it. I guess I struggle with the idea of CFS for me also because well, if get really tired, so tired that my face feels like it's gonna fall off. But...it never does, and I always push through. I've always worked full-time, and although my evenings were spent in bed and my weekends also, I was still able to force myself to get up monday morning, even if I felt like I was on the verge of collapsing. Part of me says that, well if I had CFS I wouldn't be able to do those things? Granted the full-time work and pushing myself issue seems to last around 2 years before I get to the point where I feel like I can't handle it anymore, where I feel like I could sleep for a month. The problem I find is that because I feel tired all the time I'm very irritable and quick to anger. I hate that about myself, but my time is so precious these days that I just hate things that drag or when people faff with things. I'm quite socially secluded now due to these issues and having problems with noise irritation, high pitch noises or banging or paper ruffling noises, I really don't know why but it's like nails on a chalk board. 

      You're right in that I get fed up, i do bits of exercise, and feel good for like an hour after, but then I start to get really tired and laden. I always try to pace myself but end up getting so angry because I feel like I'm living half a life and what's the point in living if I can't even do simple things like go for a 3 mile walk without having problems with my calf muscles locking up. The same with running. One of the reasons I had a hip injury is that I started running long distances and ignored my calf issues/pain, it got to the point where I couldn't walk very far without pain. And the hip issue was due to a fall when it was icy. Even now when I go to the gym if I am in pain, so prior, I take pain meds, at least I can get some enjoyment out of the exercise even if I know I will pay for it later.

      I've read about choline cdp and l-carnitine and ...another one I can't remember sad but they are supposed to help with brain fog and memory. I think there was a brand actually called Brain CDP or something like that. I take these supplements along with a whey protein supplement powder which has the whole BCAA profile before and after exercise to help bolster my energy as well as help repair damage.

      The vit D is interesting as my dad also had a blood test? done for that and he was advised to get a high strength vit d tincture at holland and barrets. But...I've never considered it for myself.

      I have problems in winter with the cold, and usually have thermal trousers, hat, top, socks etc with my two quilts, and in summer I sweat like anything which makes social situations a no go and when I was working it made me feel really awkward.  I have problems staying warm in the cold and over heating in the warm. I don't know if that is a CFS thing, I just put it down to being over-weight/meds.

      I don't think I have gut problems? Maybe sometimes constipation but again I've attributed that to the meds. And cheap perfume makes me sneeze and my nose run, bleach makes my chest hurt, but I think again that's normal?

      I have some bad memories of when my dad was first diagnosed, and it was something new that no-one had heard of. I know I went with him once to the gp and they told him he was just making things up. He had chronic pain in his back and in his legs but the tests didn't show anything causing it. He has IBS atm and is taking kefir?sp? live thing which he keeps in the fridge which, if I'm honest, doesn't look very appetising. He's also bought some very expensive prebiotic liquid drink stuff off the internet which is stored in the fridge and it's like £25 a month, but he tried this for 3 months and said he felt really great, but he then relapsed so gave up on it.

      The only time I really am able to ditch the brain fog as you call it, is if I drink redbull. And I know that stuff is reallllly bad for you, but something in it perks me up for a little while I can think and I can talk normally and I can put together sentences coherently.

      The only other thing I get is tinnitus, which again I've been to the dr before and again they've told me I'm making things up. I think if I went to the gp and asked whether they could refer me to be tested for CFS I would get laughed our the surgery.  sad

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    • Posted

      By that last paragraph I mean the gp has this ..disposition, that 'well you've been diagnosed with depression what more do you want?' I'm not sure even if I was diagnosed whether I would change or whether it would change anything? I mean I could pre-empt the fatigue more, and explain the memory issues but would I stop exercising? I'm not patient at the best of times, and pacing myself....well it would be hard to learn. sad Again I guess it depends on what quality of life I want....

      Did your gp help with your CFS diagnosis? How did it get diagnosed? Why does the vit D issue have to be addressed?

      My dad read some recent research also on how the mitochrondria in people with ME don't recover as fast as people without. Also something to do with ITP? which is to do with energy conversion and muscle fatigue. What supplements do you take?

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    • Posted

      Well, I was first offered the diagnosis about 6 yrs ago at Kings Hospital, and I burst into tears and said I didn't want that label. Then more recently I moved house and went to a new GP who gently talked me round to considering it. There's no test, and the only treatment is anti-depressants, graded exercise, and CBT to help you to pace yourself, so there's no huge advantage to accepting you have it, except that I've been able to do a lot of my own research. If your doctor isn't sympathetic, find one who is, even if it's just going to a different one at the same practice.

      Venlafaxine doesn't give me energy, I was put on it a long time ago because I was having trouble with SSRIs, and it had the completely unexpected effect of making me mentally alert. Oh! And seeing colours properly - everything looked muted before.

      I've been doing the same as you, working full time, then going to bed early. I chose to ditch my social life so that I can carry on working, and it's very isolating. I'm trying to change that now, but with limited success so far. I'll find a way.

      Red Bull is horrible stuff. I use Sudafed tablets if I need more stamina for something (pseudoephedrine hydrochloride) - it's also in Day Nurse. That's really just for unusual circumstances though, say if I'm under the weather.

      The Vitamin D was prescribed for me by a consultant endocrinologist when I was trying to find out if I was hypothyroid. He gave me a blood test and said I was at the low end of normal and my immune system might improve if I raised it - and it has.

      I only really take supplements when I start to feel rubbish, which is the wrong way to do it! But Iron (because I'm always low), Vit D when I get run down, a probiotic. It's been trial and error (and I've tried A LOT over the years) but those and the venkafaxine have been the only ones that have a noticeable effect. Having said that, ive only just started researching CFS specifically rather than fatigue so I may find other things too.

      Sorry to hear about your Dad, I'm grateful that my CFS is relatively mild. If you don't want to depress yourself by thinking you have it, don't. It took me 6 years to be ready to accept it. Just make sure you don't push yourself too hard, and hopefully the infections won't come so often.

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    • Posted

      Ah yes, I used to use actifed but then actifed was pulled off the shelves, then i tried sudafed, I'm not sure if you are in the UK? but sudafed has phenylephedrine in it now? Or maybe you still have some old boxes with the original formula. But phenylephedrine is like a weak version of pseudoephedrine, which is why I use day nurse as pseudoephedrine lasts longer. I try to be careful with it because it's easy to grow a tollerance for it, and if you use it too much it can fatigue your adrenal glands which in turn can be hard to recover from. I try to stick to using it when I get a really bad cold/sinus/chest infection as it's great for clearing the airways. It also has the side effect? or benefit of making me feel really good and motivated and I get some mental acuity with it sometimes too (I've mentioned this to my psychD before he retired, he'd never heard of it being used as a mood elivator). I first heard about it when I was into fitness at uni, I used to take hydroxycut, the original diet formula which had ma huang in it, which is the chinese herbal name for pseudoephedrine or ephedra. (I guess the same can be said for caffeine, too much stresses out your adrenal glands.) Then i think someone abused hydroxycut (and died from an overdose) and so the fda banned it. Actifed was originally abused I think by people cutting drugs (wikipedia), so again it was pulled off the shelves. Anyway long story short, ha, people started trying to find products that had pseudoephedrine in it to try and make up the original hydroxycut formula which was a really successful diet tablet. (Researched some fitness body building websites) but I think I also read that it's not recommended for people who have ME/CFS exactly because it can fatigue the adrenals, but I guess that may be only if you take it constantly? But I know that people (me included) use it for energy boost when flagging. I will research the vit D thing, I've tried multivitamins which don't see to do anything, but body volt energise which is an effervescent vitamin tab perks me up. Can we post links in here? Or is that banned?
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