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June 18, 2004


Claude Muncey

No abuse, just a little support from a diabetic who can't sleep this morning.

Along with lightweight blood pressure pills, I take two Metformin every day to regulate my blood sugar. I'm Type II so this is enough, along with diet and such to keep it under control -- my latest HB1AC (90 day average blood sugar) was 6.0 which was very good indeed. Because of this the circulation problems in my left foot, vision problems, and tingling and numbness in my hands either have gone away or at least do not get worse. It may stave off kidney and heart disease or blindness a bit longer. I have no illusions though; my death certificate will most probably read end-stage diabetes. It is strange, and a bit liberating, to know what you will die of, if not exactly when.

The implied comparison between diabetic drugs and such agents as SSRI's is an accurate one, in my opinion. Nothing gets cured, only controlled. You adjust to the side effects as best you can, and life moves on.

The only difference is that both your condition and the remedy involve your mental state, and too many people still think that is completely under ones's own control. You can no more will your way out of a problem with serotonin uptake than I can control my blood sugar by mental effort alone. Skipping pizza does help though, at least on the blood sugar side. (Pizza does, however, help my metal state, especially if pepperoni is involved. But that is one of the reasons I have this problem.)


Testify, sister, testify! I am ready to shout amen! at all the appropriate pauses and stops.

Our knowledge of how to treat chronic mental illness is so far advanced from where it was 40 years ago that it's truly staggering; unfortunately, too many people's understanding of how mental illnesses of various kinds work, and how modern medications control them is from about 70 years ago. I know quite a few people who'd love to see their treatments better than they are, but they would all say they are glad the medications work as well as they do. Without control, diseases like chronic depression, manic-depression, and schizophrenia render life hell for both the victim and those near them. With treatment, these people can lead productive lives with as much chance for happiness and satisfaction as anyone else on the planet. As for the need for further research into how the brain works, and how to correct its chemistry when things aren't right, how about epilepsy, in all its various forms and manifestations? There's another condition that can rob your life away if it's not controlled. Shall we tell epileptics what they're taking, to more or less control their disease, is bad, and that if they just concentrated, they could overcome their seizures? How about all the people who suffer from fibromyalgia, a physical disorder that has connections to mental ones. Feh. Disabling conditions rob people of their lives--both in limiting what they can do on a daily basis, and by shortening them overall. It's unfair to them to make this problem worse, by "disapproving" of their medication, and possibly shaming them out of taking it, when they didn't ask to be sick in the first place. There's also the social cost--a stabilized person is more likely to be a self-supporting, productive member of society. One with an uncontrolled disease [manic-depression, diabetes, epilepsy] is more likely to require long-term financial support and highly expensive treatment to deal with the complications and side effects of their disease. More research means, in the long run, a better understanding of what's happening, with better drugs with less unpleasant side effects. Fewer side effects mean that people will be happier about taking these medications, and this means that more people will be managing their health problems better--both to their own benefit and to society's. If we can do it for high blood pressure and heart disease, for diabetes, and cystic fibrosis, if we can do it for impotence, we should be doing it here as well.


Well said!

And one other interesting connection between treatment of depression and treatment of diabetes: lots of people will tell you that if you eat right and exercise, it will go away. But really, it just won't.

Stef, who has both

Laura Gjovaag

For me, finally becoming willing to take drugs was the step that made me realize just how screwed up my brain was.

For years, after seeing my sister's personality change completely after taking drugs to prevent epileptic seizures, I refused any medication for depression. I thought I could tough it out. I nearly lost that fight a number of times. Eventually I "gave up" and tried anti-depressants. I won't go into the hell I went through with Paxil, but when I finally got on Celexa, everything changed.

It wasn't me that changed, it was like a dark cloth that was over my head all those years was pulled away. Instead of feeling helpless, angry, sad all the time, I could feel everything. Joy that was untainted. Happiness without a tinge of pain. I still felt anger, fear, sadness, but not all the time.

I've managed to reduce my doses quite a bit. A balanced diet actually goes a long way to cutting the edge off. But I will never be able to go completely off the drugs because my brain is simply wired a little wrong. Nothing wrong with that. As long as I take care of myself AND keep taking the drug, I should be fine.

And anyone who has a problem with that obviously is too clueless to be discussing the issue.

Janet Miles

I have depression. My husband has epilepsy. Because we both have screwed up neurochemistry, we understand each other.

And we both understand you.

I'm glad the Effexor works for you. Me, I actually do best on one of the older tricyclics (nortriptyline), but that's in part because brain chemistry is a very individual sort of thing and in part because notriptyline is also good for chronic pain.


I also take my drugs daily so that I don't sit and cry at nothing.

Once, in response to the suicide of someone I knew, I made a post on a mailing list that said, essentially:

"Throughout America, there should be billboards that proclaim: 'Before you kill yourself, why don't you try drugs?'"

About a month later someone sent me private mail saying that post had saved her life.

Part of the damage of the anti-drug crusade is that it talks people out of trying life-saving medication.



thanks for the very clear and forthright post (and thanks also to commenters). At the moment, I am able to live pretty well without medication, for which I am thankful. I am also thankful that I have had medication, and know what neuro normal is, and when I am wandering into the dark forest.

Mary Kay

I thank everyone for their insightful and supportive comments. Y'all are awesome. As another person pointed out in email, there are people for whom diet and exercise and talk therapy will work. It's true and I didn't mean to be dismissive of that regimen. Nothing works for everyone. Amazing how something as simple and obvious as that gets overlooked by huge numbers of people.


Jill Smith

I think you have obliquely pointed to the solution to the boneheadedness problem: talking about it - "it" being the neurochemistry, the pharmacological solutions, all of it.

I think there are a lot of people who are privately sighing in relief that they have these meds and are therefore leading a life they want to live, as opposed to a life they are barely enduring. I'm all for privacy, but there is such a stigma about neuropharmaceuticals that what might normally be an instinct to be private about a personal medical condition turns into fear that others will "find out."

So, as a result, people who don't *know* their boss or their friend or their neighbor or their coworker are taking these medications assume that they aren't. They assume that these sorts of lives are led by "other" people - out there, somewhere. But not here, near me. Unthinking comments by these oblivious people often end up reinforcing the stigma that urges people to be hyper-private about their condition, and the oblivious ones get to continue to live in a bubble where just about everyone they know is well-adjusted - naturally, of course.

So, that's a long way around to saying, "Bravo for shedding some sunlight on something that is unfairly stigmatized. The more light, the less bigotry."

Mary Kay

Jill: That's one of the reasons I tend to go on and on about this Just ask people who've known me for a while. I do this every 6 months or so.

The other reason is that I finally went to my doctor and asked after hearing someone else talk about it. If I can shorten on person's misery I've done more than most people can imagine.


Kim Wolford

I took effexor for my brain, too. I would not be alive today if not for effoxor. I suffered from clinical depression since the age of 14. I had no idea that there was any other way to live or any other kind of life. Emotionless is what I was. When my therapist asked me to describe a time when I felt good, I just looked at her as if she were speaking a foreign language. "For example, think about sitting outside in the sunshine, and the warmth of the sun on your face..." . She just stopped in mid-sentence, because the look on my face--total lack of understanding. I could no longer even appreciate a simple thing as sunshine on my skin. Long story short, at the age of 36 I feel as though I have finally beaten depression. Today, I am effexor free, but I shared my medication use with everyone(when you have to take 5 pills a day, people tend to notice). Usually, I got the same response, "You, take anti-depressants?!" Yep!!!
AND THEY SAVED MY LIFE!! Just as I had no idea there was another way to live life, society, in general, has no idea about anti-depressant medication and it's vital role in so many people's lives. Because the medication changed my life, I felt I had to tell everyone about it and still do. Good luck and don't EVER be ashamed!

Morgaine Swann

Excellent post. I often use the diabetes analogy as well. A chemical imbalance is real, whether it affects the pancreas or the brain. I get so furstrated with trying to explain to people that I don't need to "just cheer up" and that no amount of positive thinking is going to make a difference. Medicines can make all the difference in life and no life at all.


Good for you. This is one area where I take it very, very badly when people presume to have strong opinions about the morality of treating a physical malfunction.

It's not a panacea, and should not be given casually or as a substitute for adult attention to children, and you have to do the work the same as you would if you were stretching the muscles on a once-broken leg, but if your medicine cabinet has aspirin in it, I really don't want to hear what you think about how I treat my medical problems.


Seriously! The best comment I've heard on this is from the book, "Undercurrents" by Mary Martha Manning.

After someone questioned her treatment for depression: "Shut UP! Shut UP! Unless you've been lost in this particular corner of hell yourself, don't try giving me directions!"

She is also a psychologist, btw.

Mary Kay

More wonderful comments! I've been hideously busy elsewhere or I would have answered sooner. JM: Yeah, your psychologist pretty much sums it up. Of course, there is still the problem that people think they have experienced depression when they've felt grief or loss or any of a number of other unpleasant things. Depression, especially the biochemical kind, is different. If you haven't actually experienced it that may be difficult to understand. I'm still not entirely sure my family and friends really understand that I have a MEDICAL condition which manifests psychologically. I suspect some of them still think I wouldn't need the drugs if I'd just..... whatever. They're wrong of course, but decades of conditioning against drugs, especially psychotropic ones, and distrust of doctors of all sorts runs deep.

I'm so glad for all of you who've posted that you haven't let these things keep you from getting what you need. Keep talking!



Thank you for your insight--and your website! I've been on SSRIs alternately, am now trying Effexor. Here's what I'm wondering: I am tired of having no sexual drive. I want to be as sexual as I am when I'm not taking drugs. Has anybody any experience with taking Effexor, say every other day or every two days? I'm thinking maybe I can sustain mental health and still keep up my libido. Or maybe I'll try taking them for three months on and three or four months off.

Certainly, this kind of non-prescribed regimen only goes to show you that our knowledge in brain response is limited, and that meds prescribed are certainly not a perfect solution.

Best wishes to everyone who is trying to live with depression!



Dear Mary Kay I am happy about your success with Effexor. I am starting a treatment.

I wonder how you managed to quit taking the drug. How long was your treatment?. Do you think it corrected your brain chemistry?. I thought in most cases you had to continue taking it.


James Kronefield

I don't know if these medications can correct your brain chemistry for good, but they definitely help to overcome depression while you are taking them.


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