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Isn’t esketamine just S-isomer ketamine?
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Mar 26, 2019 17:36
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The Lone Badger posted:I take an antidepressant that exaggerates the effect of stimulants, so even coke will make me feel weird if I drink too much. Oh, you mean cola
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Mar 26, 2019 17:48
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Dr.Caligari posted:Isn’t esketamine just S-isomer ketamine? Yes, but: https://slatestarcodex.com/2019/03/11/ketamine-now-by-prescription/ quote:First, esketamine might not work. Whole thing's worth a read. Phanatic has a new favorite as of 17:52 on Mar 26, 2019 |
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Mar 26, 2019 17:49
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i don't know how to bring up the subject of ketamine to a doctor... i've tried so many ADs that don't work or actively make my life worse. wellbutrin worked for a while until it started giving me huge acne all over that made me even more depressed and unable to look at myself in the mirror. the biggest thing that worked for my depression so far has been top surgery. and now i feel guilty for still being a depressive wreck, like that should have fixed it totally and i should be happy, right?
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Mar 26, 2019 17:54
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Wellbutrin made me sweat like a whore in church. It was so bad I started bringing 2-3 extra shirts to work, and buying undershirts in bulk packs. 3 months of that and I switched to Citalopram which is pretty solid so far. The suicidal ideation never going away fully sucks too. I've had the exact same thoughts as Empty Sea, just driving along and "Hmm, I could just plow into that tree or off into a ravine, it would look like an accident and no one would think less of me...hmmm" and yeah that's scary as hell. Therapy and changing jobs to get away from the soul destroying hateful monster I worked for helped a lot. My wife came out to check on me a couple times when I'd be sitting in the garage psyching myself up for work. It really hit home when she came out in a panic one time because she hadn't heard me open the garage door and I had the car running. That's when I realized how bad I had been and got into therapy and started job hunting. I get it though, the depression and the hopelessness. There's a quote I can't attribute that I'll probably mangle. If anyone knows where it's actually from I'd appreciate knowing. "Only astronomers - and the truly depressive - can grasp how utterly large and dispassionate the universe is, and the full scale of how insignificant we are in it"
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Mar 26, 2019 18:09
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My girlfriend started doing ketamine like a year and a half ago and it's been the only thing that has made her not want to kill herself. It's pretty great and more people should have access to it as needed but 
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Mar 26, 2019 18:25
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Speaking of weird A-D side effects. Paxil made me crave alcohol. I don’t even really like alcohol, but I was drinking at least every other night. I stopped taking it for different reasons and the craving went away, I googled it and sure enough there is a whole lot of reports of it creating a craving where there wasn’t one I think (at the latest) decades from now they will discover that AD are reckless and should have never been prescribed so haphazardly. They benefit some people , for sure, but they shouldn’t be an automatic go-to for everything Maybe ADs/APs will be the lead gasoline of this generation Dr.Caligari has a new favorite as of 19:15 on Mar 26, 2019 |
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Mar 26, 2019 19:12
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I tried Wellbutrin and got a period that didn't stop until I stopped taking it a month later.  The only antidepressant that's worked for me is Zoloft, and when I brought up ketamine to my doctor he looked at me like I'm nuts.
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Mar 26, 2019 19:18
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Dr.Caligari posted:Isn’t esketamine just S-isomer ketamine? it's an enantiomer of ketamine, but more accurately it's $-isomer ketamine $5,000/mo. because drug companies.
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Mar 26, 2019 19:28
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ChickenOfTomorrow posted:it's an enantiomer of ketamine, but more accurately it's $-isomer ketamine Because FDA. Everyone knows ketamine’s good at treating depression but it does so off-label so insurance companies won’t cover it for that purpose even though everyone knows ketamine’s good at treating depression. Nobody’s going to fund a study for a generic drug to get depression on-label. Ketamine itself costs about $10-20/dose.
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Mar 26, 2019 19:32
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Would an unnerving story about a week in a psych ward be too e/n? Because boy howdy do I have stories. (Reading before work. Stories later.)
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Mar 26, 2019 19:32
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Not an article but I recently watched this old 60 Minutes about an Australian hospital that killed a bunch of people with continuous narcosis therapy that i found pretty unnerving
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Mar 26, 2019 19:39
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queserasera posted:Would an unnerving story about a week in a psych ward be too e/n? Because boy howdy do I have stories. (Reading before work. Stories later.) 
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Mar 26, 2019 19:40
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queserasera posted:Would an unnerving story about a week in a psych ward be too e/n? Because boy howdy do I have stories. (Reading before work. Stories later.) I vote share. Pill talk, I'm on a low dose (10 mg) of Lexapro and it's been good. Talk therapy is making the real difference for me, mostly how to not feel responsible for other people and also how to deal with narcissists.  Also accepting the idea a lot of people are just emotionally dumber than me. Which still feels condescending as gently caress.
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Mar 26, 2019 19:42
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Das Boo posted:Talk therapy is making the real difference for me Yeah, I was on heavy anti-depressants from my mid 20s and didn't get weaned until my late 30s. They did a good to tolerable job of keeping me from curling into a ball and also helped greatly with suicidal ideation. However, talk therapy made the biggest impact. Specifically cognitive behavioral therapy. In the vein of "how can I fix the mind I've got, with the mind I've got". It took a long time, but I learned that *doing* changed my thinking. My thinking at the time was my worst enemy. But changing my actions and reactions to people and situations eventually changed my thinking and internal dialogs with myself.
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Mar 26, 2019 19:49
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Nthing talk therapy, if you're willing to do the work then it goes a long way. Doing the work sucks but you gotta Anyways wanted to chime in that learning about intrusive thoughts made a big difference in my life. I started experiencing them around 11 years old and thought I was completely losing my mind.
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Mar 26, 2019 20:07
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Sorta unerving in the "humans gently caress up poo poo with out really realizing it" way but forest density at least in the southwest is something like 200 - 800% higher than normal and very homogeneous due to a variety of factors like logging and fire supression. It just kinda weirds me out and its also one of the reasons fires have gotten more severe.
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Mar 26, 2019 21:40
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Therapy is good and cognitive behavior therapy helped me a lot 
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Mar 27, 2019 00:41
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Crush Point, an article from the New Yorker about crowd crush fatalities.quote:Later, in a letter sent to the task force assembled to investigate the incident, in which eleven people died, a man in the crowd described what it was like near the doors: “The pounding of the waves was endless. . . . If a wave came and you were being stood upon with your feet pinned to the ground, you would very likely lose your shoes or your balance and fall.” Some people near the doors did go down. “They began to fall, unnoticed by all but those immediately surrounding them. People in the crowd 10 feet back from them didn’t know it was happening. Their cries were impossible to hear above the roar of the crowd. . . . There was a pile of people forming, and all of the people around them were being crushed into the pile, for there was no resistance. If the person in front of you went down, then you would follow for there was no one to lean against.” Then the waves began to carry him toward the pile. “With this realization I began to add to the screaming, ‘They’re going down, they’re going down!’ I yelled repeatedly. . . . A wave swept me to the left and when I regained a stance I felt I was standing on someone. The helplessness and frustration of the moment sent a wave of panic through me. I screamed with all my strength that I was standing on someone. I couldn’t move. I could only scream.”
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Mar 27, 2019 00:42
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I bounced around like four different anti depressants in as many years with varying degrees of efficacy and while escitalopram seemed to be doing ok for me I did realise something was up when I decided one evening it would be super to stand in the kitchen staring at the wall just eating tablespoons of sugar straight out of the bag
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Mar 27, 2019 00:51
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That might have been the teleporter, dr brundle
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Mar 27, 2019 00:56
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Well to add to the unnerving stories I have a recent one of my own. I figure I might share in case it helps anyone here. It might just bring you down, so if hearing stuff about depression, drugs, rape and suicide might make you feel worse don't read this. My fiance and I have an early-20's friend that has always been a very awesome person. She's a photographer, does really nice work, has always been an incredibly intelligent gal, and besides some depression that she was always really forward about she was doing pretty good. We got busy with life and didn't get to hang out with her for a few months. A couple days ago we got a call that she was getting out if the hospital. Apparently her mom had to sign her into mental health care for a few weeks-- her depression had taken a sudden lovely turn and led her to doing giant amounts of opiates. She almost died and wound up going from the ER to a behavioral health center. We invited her over the other night on a promise that she'd been clean for 22 days. She's been living out of her car and we wanted to see how she was doing and if we could help in any way. I'd given her the number for several LGBT-friendly places but she hadn't gotten ahold of them. Our friend has apparently decided that prescription drugs for her anxiety/depression and appparently bipolar disorder are bad for her. She told us how terrible it was to be in a behavioral health institution (I can't imagine it's less than terrifying) and claimed that treatment made her condition worse. She's doing essential oils now and from what it looked like switched from opiates to meth on top of throwing away her meds. We spent maybe an hour chatting, she asked for some cash for gas (we understand it may not have gone to gas but what the gently caress do you do? I was probably going to use it for beer or something stupid anyway) and then she went on her way. We rent from my in-laws and don't have a place for her to sleep, and in all honesty I don't think I'd trust her to live with us right now. It's really terrible knowing that we've probably lost her, and it's awful to know that there isn't really a solid support system for people in her situation. The stories she told us about her other friends included rape, having one friend try to kill her and the others ("It wasn't really his fault") and how she lost another friend to an opiate overdose. She couchsurfs and can't get away from the same group, and she won't live with her mom because she thinks her mom is trying to harm her. It's clear that the drugs aren't the cause of the problem, but that mental illness is the reason she became a person with an additiction in the first place. It's also absolutely loving horrifying that there's this huge community online telling her that her doctor-prescribed meds are the issue and that natural cures will fix her. My fiance suffers with bouts of depression and the whole thing prompted him to see a doctor to see if he could do better for himself. Anyway I had to get that out because gently caress, it's frightening. My friend isn't the only person I've lost to mental illness. Two of my closest friends have killed themselves, one while the girl he was about to propose to was in the shower and the other when his daughter was two. I've had a ton of my friends with obvious depression turn to meth and destroy themselves because feeling better for just a moment is better than nothing. Go to your doctors if you need to, get the proper medication, and don't lose hope. Ignore all the "friends" out there telling you that street drugs or essential oils will fix you, because they won't. Your doctor might not be perfect but they'll try. E: I got really lucky. I had a poo poo childhood and escaped with some light PTSD and anxiety. It doesn't bother me and is manageable enough without meds. The worst I get is some jitters when thinking about being behind the wheel of a car. I worry about my fiance though. Depression sounds loving horrible. Scathach has a new favorite as of 01:35 on Mar 27, 2019 |
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Mar 27, 2019 01:29
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Kitfox88 posted:Therapy is good and cognitive behavior therapy helped me a lot Gonna add another voice to this. I resisted doing talk therapy for a long time and CBT, or more specifically the DBT version of it, has been a literal life-saver.
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Mar 27, 2019 01:31
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Proteus Jones posted:Yeah, I was on heavy anti-depressants from my mid 20s and didn't get weaned until my late 30s. They did a good to tolerable job of keeping me from curling into a ball and also helped greatly with suicidal ideation. When I finally learned I have depression, the hardest thing for me was getting treatment. At the time I'd heard nothing but bad stories about therapists and the friendbase I had at the time insisted that even if I found a good therapist, I'd end up on meds and that was the worst thing to be on as according to them meds would completely change me that I wouldn't have the same interests anymore, I'd be a zoned out zombie..etc.. It took a deep heart to heart with my boyfriend that he admitted my depressive moments terrified him because he wanted to help me, but didn't know what to do and he'd long been dreading coming home and finding me dead. I went through what options I had at school and the first therapist I met with recommended me to another that after a few talks wanted to try cognitive behavioral therapy. It's made a dramatic difference for me. I still have depressive moments but they're nowhere near as severe as they were. It's still a work in progress but worlds better than what it was.
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Mar 27, 2019 02:11
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As a supplement, meditation was a big helper for me. My problems were anxiety and depression, but I found being able to set with myself and slow down thoughts for even just 10 minutes was harder than you would think, but also rewarding. It’s not a cure all, and not even for everyone, but if you think it might help I recommend finding instruction (or even use YT videos. I recommend Ajahn Brahm. He’s a Buddhist monk, but also does secular meditation)
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Mar 27, 2019 02:21
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This is pretty personal as I was friends with, shared a b hut with, and went to college with this guy who was killed in a green on blue attack 10 years ago tomorrow. https://www.nytimes.com/interactive/2018/09/23/magazine/those-who-cant-forget-toner.html I was running with the group of 4 others, but had moved ahead by the time of the shooting. Frankie was one of those completely decent people who always did the right thing and never had a bad thing to say.
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Mar 27, 2019 02:51
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My only real criticism of CBT is that it makes my balls ache.
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Mar 27, 2019 03:05
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What I'm sure is an unnerving thing for some people is that there are those, like me, who really can't be helped. We bounce off of talk therapy hard because while we understand the methodology and what its supposed to do, there's just such apathy about it that isn't even a depressive 'why bother?'. It's just a 'no thanks, that doesn't sound interesting'. People have to want to be helped, and unfortunately sometimes the ability or desire to form enough of a connection with people to care just isn't there  .Like I'm sure it's not a psychopathy for me cause I definitely feel and all (probably the 'tism or mild schizo) Pvt.Scott posted:My only real criticism of CBT is that it makes my balls ache. ... Isn't that the point? Watermelon Daiquiri has a new favorite as of 03:16 on Mar 27, 2019 |
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Mar 27, 2019 03:14
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talk therapy works a little for me but decades of abuse have made me intensely suspicious of anyone trying to gently caress with my head. i've been in and out of psych wards and hospitals, i can't begin to describe the loss of humanity, especially when you're trans and not a voluntary patient
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Mar 27, 2019 05:26
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I wanted to add a small thing to the anti-depressant discussion. This isn't unnerving at all, though; sorry. I sympathize so much with the terrible side-effects, or just no effect, a lot of the posters here have seen, and I think it's brave and self-aware and helpful to share them. Certainly side-effects are relatively common, and often bad enough to outweigh improvement in mental health. But - and this is not in any way a contradiction of the stories above - loads of people, indeed the majority of people, don't have any, or serious side-effects from psychiatric medication. I felt compelled to pop that in, not as a counter-narrative, but as a footnote for the benefit of anyone who's thinking of trying them, or trying a change. These stories can be genuinely scary and deter exploring the medication option. I used to fall down the hole of review sites like this: https://www.drugs.com/comments/bupropion/wellbutrin.html. I've had friends with side-effects that were traumatic just to witness. But I also have my own lucky example - I've been on various SSRIs and SNRIs, and never a single side-effect. Not even on the tiny scale (speaking only for myself) of skin breakouts or digestive issues or slight tremors. The worst that ever happened was that some of them worked much better than others. And mostly, even though my diagnosed problems are preeeeetty gnarly, they worked like magic. In any single case this is pure chance of course, but it's heartening to remember that the chances, in the aggregate, are in your favor.
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Mar 27, 2019 06:55
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It's nice if you've found an anti-depressant that works for you, but the side effects are bad for most people. You can tell because they're prescribed off-label for the purpose of those side effects. SSRIs are prescribed to delay orgasm, because almost everybody experiences that (and in fact, it may cause permanent sexual dysfunction.) Tricyclic antidepressants are prescribed off-label to Crohn's patients because it will give you constipation. MAOIs aren't prescribed off-label for anything, because if you eat a grapefruit it will kill you. Medicine can be helpful for people, but you will probably need to try many kinds in many dosages, and the end result will still probably have bad side effects. But not always, so good for you! xtal has a new favorite as of 07:14 on Mar 27, 2019 |
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Mar 27, 2019 07:11
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I mean isn't a large part of the problem with anti-depressants that depression isn't a single disease but instead a collection of symptoms that can often have differing causes; so you have to feel out which medication works on any given person?
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Mar 27, 2019 07:18
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Yes, as far as I know. What I mean to say is that you may need to try dozens of medications and dosages before you find something that works for you, and it will still probably be bad for you. Cognitive behavioral therapy is much more effective and much less painful. Even reading books about CBT has been shown to be therapeutic.
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Mar 27, 2019 07:24
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xtal posted:Yes, as far as I know. What I mean to say is that you may need to try dozens of medications and dosages before you find something that works for you, and it will still probably be bad for you. Cognitive behavioral therapy is much more effective and much less painful. Even reading books about CBT has been shown to be therapeutic. I don't mean to argue against you at all, but I think we might be talking slightly past each other on the key question of proportion. One issue of proportion is partly subjective: how bad is this side effect, and how do I, the patient, weigh it against the intended effects. The second issue of proportions is mixed up with the first one: what proportion of people have side-effects - and how does that play into my 'weighing'. You're probably right that most people have side-effects, though I couldn't back that up. Having said that, you used 'most' and 'probably' pretty emphatically - as in, most people will probably have side effects. And you more or less say they'll be awful. I should have written it out loud, but when I said the opposite, that most people don't have side-effects, I also meant 'much too serious' side-effects. Which is an inescapably subjective category, but not entirely. Serotonin syndrome that wrenches your shoulders out of joint (Jesus, I'm so sorry for that poster), and ears getting hot at odd times, can be placed at opposite sides of the spectrum pretty confidently. PLUS we both do have to qualify the whole discussion with matching the right medication, or combination of them, to your condition. I'm totally with you, that is probably a long hard road for most people. So anyway... talk therapy, CBT, DBT, and Lacanian analysis if you like, are all great. They're GREAT. But becoming suspicious of chemical intervention can deepen into a cultural skepticism about the brain as a physical-chemical thing, altogether. Note I don't mean the poster I'm replying to, who has totally earned the authority to be as skeptical as they like. But for anyone who's beginning to think about getting professional help. I might not be saying any of these things well, but what the hey, I'll add that as someone raised in the Mysterious Orient, Hindu and (which is very rare) Buddhist, it gives me cramp and the squirms when youtube videos of monks etc. appear alongside therapy recommendations. No disrespect, I swear, but a Western adherent should at least lay out the massive theoretical problem here. If you're trying ancestor worship and tantric meditation and DBT, those are... those are not tools that can be disaggregated, really. People who offer them in easily transferable, enclosed capsules that can be mixed and matched are not reliable sources, and if 'meditation' works for you that's because of some basic and simple, universal, and therefore medical-isable factor. Any such praxis is based on an entire worldview, and not a static one but a complex of evolutions and offshoots and reformations and Great Synods over thousands of years. It's like taking catholic sacraments when you feel poorly, and sacrificing horses when you want a promotion - that's not coherent. To the point of seeming surreal to me. Is the 'mind' an after-construction of humors fighting against the soul's governance? Is the world a series of concentric circles separated by oceans of milk and honey and soma? Is your brain a scientifically knowable thing which is the site of your 'self'? Are there 'chakras' and 'energies' in your body, or nodes of animal-being, or echoes of your past births? Those are not the same universes. I may be just failing in imagination or sympathy here, but I can't get my head around how the mishmash is even supposed to work by believers. 'Exotic' or 'Alternative' solutions should be respected in their difference, if you like, or escaped without a backward look, if you're me... or you go the whole hog and take one up as a comprehensive system.
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Mar 27, 2019 08:08
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Since this was published there was the 2015 Hajj stampede which, according to some estimates, had more fatalities than every other incident mentioned in the article put together.
Whiz Palace has a new favorite as of 13:11 on Mar 27, 2019 |
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Mar 27, 2019 13:04
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Great article.
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Mar 27, 2019 14:17
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Whiz Palace posted:Since this was published there was the 2015 Hajj stampede which, according to some estimates, had more fatalities than every other incident mentioned in the article put together. quote:Saudi Arabia's head of the central Hajj committee, Prince Khalid bin Faisal Al Saud, blamed the crush outside the holy city on "some pilgrims with African nationalities" 🙄🙄🙄
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Mar 27, 2019 15:02
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Oh, naturally. Of course millions of people squeezing their way into undersized public spaces is only dangerous if some Africans get in there.
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Mar 27, 2019 15:28
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Whiz Palace posted:Since this was published there was the 2015 Hajj stampede which, according to some estimates, had more fatalities than every other incident mentioned in the article put together. Osama wasn't even the most deadly Bin Laden. IIRC the Saudi Bin Laden Group has had an exclusive contract with the Suadi government for development in Mecca since the 50s they got in exchange for a big loan to the royal family, and since then they've killed more people than 9/11 through accidents, mainly through that stampede and a bridge collapse in 1990 that killed a similar number of people.
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Mar 28, 2019 07:51
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Unnerving fact: we had comprehensive laws to protect animal welfare before we had them to protect child welfare. (CW for descriptions of child abuse) Mary Ellen Wilson was a child under foster care of Francis and Mary Connolly who abused her greatly, she was so rarely even allowed out of the apartment they lived in that many of the neighbors didn't even know the Conollys had a child. The few times she was seen, bruises from the whippings she received were plainly visible, and she wore tattered clothes with no shoes or stockings, even in the cold New York winters. Her condition eventually came to the knowledge of a Methodist missionary named Etta Angell Wheeler who first tried to help the girl by going to the police. While there were some laws about child welfare at the time, but they weren't particularly strong and the authorities were reluctant to act upon them. Wheeler was then recommended to Henry Bergh, founder of the American Society for the Prevention of Cruelty to Animals, which gave rise to the popular misconception that she was actually protected under animal cruelty laws, though this is not the case. Wheeler did not come to him because she thought animal cruelty laws would make a case to save the child, but because he had a reputation as a compassionate man who was likely to be sympathetic to her cause. He was. Working together, Bergh and Wheeler were able to get neighbor testimony, remove Mary Ellen Wilson from the home, and take Mary Connolly to trial. At the trial, she was represented by Elbridge Thomas Gerry, (who was also affiliated with the ASPCA) and Mary Ellen gave the following testimony: quote:My father and mother are both dead. I don’t know how old I am. I have no recollection of a time when I did not live with the Connollys. Mamma has been in the habit of whipping and beating me almost every day. She used to whip me with a twisted whip—a rawhide. The whip always left a black and blue mark on my body. I have now the black and blue marks on my head which were made by mamma, and also a cut on the left side of my forehead which was made by a pair of scissors. She struck me with the scissors and cut me; I have no recollection of ever having been kissed by any one—have never been kissed by mamma. I have never been taken on my mamma's lap and caressed or petted. I never dared to speak to anybody, because if I did I would get whipped. I do not know for what I was whipped—mamma never said anything to me when she whipped me. I do not want to go back to live with mamma, because she beats me so. I have no recollection ever being on the street in my life. Mary Connolly was convicted and sentenced to one year (!) in prison, but the case led to the creation of the New York Society for the Prevention of Cruelty to Children, considered the world's first child protective agency. The Society quickly became an influential part of the New York legal system, and the entire foundation of modern child protective laws can be found in bills actively advocated for by the NYSPCC. In later years, the organization began to lose its progressive credentials, as their focus was on law enforcement and responding directly to cases of child abuse, even while other organizations began to focus more on family support and cruelty prevention. As for Mary Ellen Wilson, the rest of her story is a pleasant one. She was adopted by Etta Wheeler and later named her first daughter Etta in honor of her. She had two children with her husband, and adopted a third. Mary Ellen passed away peacefully at the age of 92 and was remembered by her children as a kind and caring mother, and "not much of a disciplinarian." Acute Grill has a new favorite as of 23:47 on Mar 28, 2019 |
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Mar 28, 2019 23:40
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