Anti-Depressant AMA

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Everything you ever wanted to know. Ask me anything #ama here in comments or a direct message since there’s still a stigma against discussing depression.

I take an anti-depressant medication every day. It’s important for me to be open and honest about this, both to help people, as a health coach, discover the best health care options available, and to end the stigma against discussing mental health.

I’m not ashamed or embarrassed. I don’t feel like I’m cheating life. I love my Wellbutrin and will happily talk about it with anyone. Ask me anything about it.

Here are some answers to frequently asked questions. When I talk about it with others, I’m always greeted with curiosity and people wondering if it could help them too. We don’t talk about it enough!

If you choose to leave a comment, please nothing patronizing or condoling. Questions, discussion, personal experience, or empathy (I relate), please. Thanks in advance!

FAQs

1. What do you take?

Wellbutrin XL 150. I take the generic form, bupropion.

2. Have you tried any others?

Yes. I tried Paxil in 2005 and it worsened my symptoms so I went off it. This drug is not prescribed much anymore and mental health drugs have come a long way in the last 12 years. There are much better medications available now. (As told to me by 2 different psychiatrists).

3. What does it do?

Wellbutrin/bupropion acts as a mild stimulant. It is classified as a norepinephrine-dopamine reuptake inhibitor (NDRI). Many other anti-depressant medications inhibit serotonin reuptake (SSRI’s). “In the brain, dopamine functions as a neurotransmitter — a chemical released by neurons (nerve cells) to send signals to other nerve cells. The brain includes several distinct dopamine pathways, one of which plays a major role in reward-motivated behavior. Most types of rewards increase the level of dopamine in the brain.” (wikipedia)

It treats depression. Due to its stimulating effects, it can increase anxiety so can be paired with an SSRI to decrease anxiety if needed. (As told to me by my psychiatrist).

4. Should I take it?

I cannot tell you that. I can’t even guess. Psychiatrists go through medical school and have hours upon hours… years of medical and mental health training. You cannot tell you that either. If you are wondering if you might want to take something, find a psychiatrist. A really good one.

5. How do I find a good psychiatrist?

The best way is word of mouth. I was referred to an excellent psychiatrist in Texas, considered one of the best in the whole state. I drove nearly an hour each way to see him. You can ask your primary care doctor for a referral. Your therapist (if you are considering taking an anti-depressant you should be seeing a therapist at the same time. A good psychiatrist will require this.) can also refer you. Ask friends you trust if they can refer you to theirs. If you live in Austin, I have a good one. Ask me. If you know a good one in/around Pismo/SLO, please refer me, I’m looking.

Choose one who:

  • Does a full blood work and DNA analysis. Technology is fantastic these days. DNA testing will show which drugs you metabolize well and which ones you don’t. This will take a lot of guesswork out. The bloodwork will tell you if you are Vit D deficient (you probably are) which contributes to depression. A good psychiatrist will prescribe vitamins, good food, and exercise along with a medication. Don’t settle for a psychiatrist who isn’t interested in your total wellness. And/or work with a health coach or holistic primary care doctor at the same time. I discovered my Vit D levels were low despite taking supplements so I increased that. I was also low in B vitamins. I discovered I’m not allergic to ANYTHING (yay!).
  • Doesn’t want you to take meds forever. Someone who will try a few things out, and take you off in a year to see if you’re good. Maybe you’ll take them for life or maybe not. It’s different for every person. You ARE a unique snowflake. What works for me isn’t going to necessarily work for you.
  • Encourages holistic health, nutrition, and fitness.
  • Demands you work with a therapist at the same time (mine did).
  • Is kind, caring, and compassionate. Life is too short to work with assholes. You deserve the best.
  • Has a great reputation (referral will help you know).
  • Communicates well and has an attentive staff. You or your insurance is paying for this service so expect the best.

6. Does your insurance pay for this?

Yes. I had United Health Care. 100% of everything was covered. I now have CenCal Health (California public healthcare) and the meds are covered. Not sure yet about office visits but I’ll bet they are.

7. Does it make you sleepy?

No. Bupropion is a stimulant.

8. Does it lower your sex drive?

No. Bupropion doesn’t have that effect.

9. Did you gain weight?

No. Bupropion caused patients in a clinical trial to lose an average of 5lbs over a period of 6–12 months.

10. Do you feel like you’re cheating your mental health?

No. I did though, so good question. Like most Americans, I too was raised with a “boot strap” mentality that I should be able to do everything myself with no help. Then I had a serious mental health crisis triggered by a specific stressful/traumatic incident and got all kinds of help and realized how crazy I’d been before not to get as much help as possible. Therapists, coaches, doctors, psychiatrists, support groups, women’s groups, book clubs, running groups, yoga classes, long talks on the phone with close friends…I RECEIVE A LOT OF HELP AND I LOVE IT. IT FEELS AMAZING. I don’t want to do this alone, ever.

A good psychiatrist will find the right meds just for you at the right dose and for the right amount of time. It’s meant to help support you, not to take anything away.

11. What is a psychiatrist, anyway? How is that different from a therapist?

“A psychiatrist is a physician who specializes in psychiatry, the branch of medicine devoted to the diagnosis, prevention, study, and treatment of mental disorders. Psychiatrists are medical doctors, unlike psychologists, and must evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments, or strictly psychiatric.

As part of the clinical assessment process, psychiatrists may employ a mental status examination; a physical examination; brain imaging such as a computerized tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) scan; and blood testing. Psychiatrists prescribe medicine, and may also use psychotherapy, although the vast majority do medical management and refer to a psychologist or other specialized therapist for weekly to bi-monthly psychotherapy.” (wikipedia)

A psychiatrist has attended medical school and has had a medical residency.

A licensed family and marriage therapist (LFMT) has a bachelor degree in some field and a master’s degree in counseling from an accredited program. California requires 3,000 hours of supervised practice and passing exams to become licensed.

Then, there’s psychologists (omg, there’s a lot, right?). A psychologist with a PhD completed a Master’s degree research project as well as their doctoral dissertation, while PsyD graduates focused on clinical training.

To read more about the difference between a psychiatrist and a psychologist, read this: http://www.efpa.be/psychologist-psychiatrist.htm. I know I’m missing the nuance here. Do more research. This is a quick summary. It’s confusing.

12. How do I find a good therapist?

It’s pretty easy to become a therapist so be careful. Not all of them are good. I saw a couple different LMFT’s before choosing the one who worked best for me.

My criteria:

  • Had to be covered by my health insurance, saving me hundreds of $$ each month
  • Had to specialize in attachment disorders. Modern research is showing that who we are is almost wholly dependent upon the environment we absorbed while our brain was developing as a child. Humans cannot fit through the birthing canal with a fully-formed brain, so ours develops and grows during childhood rather than coming out ready-to-go. There are a lot of things that can go wrong in the early years and there’s no such thing as a perfect parent or society. Luckily, therapy exists so we can correct the imperfect care we received. Yay adulting! Because I was raised by a parent who was raised by an alcoholic parent, and because my parents divorced, I needed therapy around attachment-related issues. This is common. Google ACE (adverse childhood experiences). The more ACE’s you had as a child, the more healing work you will most likely need as an adult.
  • Had to have worked on their own stuff and be familiar with the written works of Alice Miller (author of The Drama of the Gifted Child). I interviewed my therapist and asked her about her own healing work before agreeing to work with her. Again, *anyone* can be a therapist and it doesn’t mean they’re good and it doesn’t mean they’ve done their own healing work. Ask them about emotional healing, emotion coaching, and healing emotional neglect. I have yet to meet a human being who got the full emotional nurturance that scientific research is now saying helps us be well-adjusted adults. Chances are, your emotions need work too. That’s a cool thing. Doing the work is awesome and no one has to blame anyone for failing them. The more of us who do the work, the healthier of a society we are co-creating.

13. Is taking anti-depressants an excuse to not heal?

It certainly can be! But don’t let it. They have been a helpful tool for me to show up even better in my life and do healing work.

My healthiest, best self has both an internal and external practice for regulating my mental wellness.

Internal:

  • Working with a therapist on emotional health.
  • Developing my inner mothering voice of self-love and nurturance.
  • Labeling my emotions and feeling them in my body.
  • Prayer (even secular) and some sort of meaning-making.

External:

  • Daily practice that includes eating well, meditation, yoga, running/exercise, gratitude, working hard/being productive, etc.
  • Writing every day is a great daily practice. Check out The Artist’s Way by Julia Cameron. Doing something creative every day.
  • Community and intimacy with others. Read Man’s Search for Meaning by Viktor Frankl. Changed my whole way of seeing my relationships with others and the meaning of life. This includes being vulnerable and honest with others. Check out Brene Brown’s TED talk on vulnerability.
  • Doing fulfilling work.
  • Physical touch with other humans.

Have other things in your daily practice I haven’t mentioned? Please add them to the comments!

14. Does taking anti-depressants make your highs lower? Does it make your life boring?

I have a pretty exciting life so, no. I show up big, try new things, push my comfort zones, challenge myself…if my highs feel lower I haven’t noticed one bit.

15. [Your question here] Seriously, ask me anything. Let’s talk about mental health.

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