the creepiness of the brain

[RickyGerbail]

I just quit anti-depressant cymbalta after having eating it for about five years. I quit cold turkey two days ago and i've started to experience some side effects like tummy problems (shit movement), a little diziness, involuntary muscle twitching etc. The worst has been the emotional side-effects. Earlier today i felt really intense dread "because" i couldn't be at my best if i could be with the guys at the football field anymore. A couple of hours later i know that it was just part of the side-effect of the medication because it's really not important for my wellbeing to hang out with a bunch of guys at a football field. The creepy part is that the brain always comes up with explenations for feelings. If you're an inherently angry person your brain will come up with reasons for it, be it politics, bigtithobo not understanding the issues of global warming, icehaven giving you negative rep etc. If you're an inherently anxious person your brain will pile up reasons, while an inherently calm person will have a bunch of reasons as well for why they're so calm. At the end of the day, the thoughts and images are all products of the emotions and not the other way around. I'm not saying that our emotions are completely detached from what happens in the outside world but i think a lot of what goes on is just the brain trying to come up with reasons so people can explain why they're angry or whateva.

[Treguard of Dunshelm]

Coming off any antidepressant cold turkey is a bastard. More (perhaps) when I'm less tired and drunk but good luck!

[Small Man Big Horse]

Yeah, it's never a good idea Mr Gerbail. I guess it depends on what dosage you were on, if it was only 10mg the side effects might not be too bad, but any higher and I'd really recommend your doing it more gradually. And try to be aware of the mood swings you'll have over the next few weeks, and that they're directly linked to your decision to do this.

You're right on the creepiness of the brain side of things though. One of the most important things that I learnt during CBT is that it's not your friend, and can work against you if left unsupervised.

[Zetetic]

I quit cold turkey two days ago

Why?

[RickyGerbail]

Why?

this post really pissed me off. i'll see if it makes me as pissed off tomorrow.

[Steve Lampkins]

Why?

Bought a microwave?

[Mark Steels Stockbroker]

Yeah, I drink too much... I tried cold turkey. Didn't work - couldn't keep it down.

[Shoulders?-Stomach!]

Women get hormonal on a fairly reliable regular basis so ought to be able to identify it and catch themselves before being unreasonable mental harridans from hell. You think.

[Buelligan]

You're right on the creepiness of the brain side of things though. One of the most important things that I learnt during CBT is that it's not your friend, and can work against you if left unsupervised.

I love my brain it really is my home and my comfort, I feel like a happy goldfish swimming in my brainfishbowl.  All drugs and emotions are just coloured dye in the water.  Be at ease.

[Replies From View]

My Mum is on a cocktail of anti-depressants and anti-psychotics, and about a year ago she stopped taking them for about six weeks.  As far as I could tell there were no obvious side effects that came as a result, especially compared to what she seems to go through when she's taking them, but my parents had been told she was never to come off them.  It somehow upsets me greatly that my Dad didn't consider the "is it possible for her to stay off them?" route with the GP, but went down there saying "she needs to go back on them, please," which she then was.

I suppose a big issue I have is that there wasn't much evidence that she should go on them in the first place (when she first started in 1998).  She had lost her sense of self because her kids had all grown up (she was no longer "needed" in the same way), and she's never had her own career or hobbies to fill her life out beyond that.  But rather than consider therapeutic options she self-diagnosed herself as clinically depressed and told the GP she wanted to be put on anti-depressants.  Which he did.

[Zetetic]

Was she ever given a diagnosis of 'psychosis' at any point? Not that you need one for keeping someone on anti-psychotics to be a good idea, but certainly if it never reached that point then it might be worth asking for a referral to someone who's in a better position to decide if she should continue with them. I wouldn't expect a GP to be able to make that call.

[Replies From View]

I can't remember when she was put on anti-psychotics in relation to the series of events, but around 2003 there was an attempt to self-harm which made everybody suddenly pay attention (and may have simply been a desperate cry for help), and I know she wasn't on anti-psychotics at that point.  Apparently a lot of people tried to kill themselves whilst taking the anti-depressant she was on back then; a little bit later that was known to be one of the side-effects.

I'd say all of her much stranger behaviour has occurred since she's been on anti-depressants.  Without wanting to get too specific, I think she freaked my Dad out one time by pulling out clumps of her hair and fearing they were creatures, and scratching/scoring the kitchen surfaces and cupboard doors with a sharp knife.  As a result of freaking Dad out, she was taken to hospital for a few months (detained - is that the verb?  The thing where she wasn't allowed to leave of her own free will), but as I say I can't remember when anti-psychotics became part of her routine - it may have been before that.

In any case I think the medication has done my Mum nothing but harm.

[Ronnie the Raincoat]

Sometimes they put people on low doses of antipsychotics for impulsivity or sleep issues.  Personally, I think doctors that do so need a fucking kick up the hole.  I've been on them for five years and every time I try to get off them I get rebound symptoms which knock me for months- combined with being a zombie for most of the time, I wish I had never been prescribed them.

[Zetetic]

Sometimes they put people on low doses of antipsychotics for impulsivity or sleep issues.

Huge numbers of elderly people are also put on anti-psychotics (and benzos and z-drugs) for behavioural problems. (Edit: Sorry, that's not really going anywhere - it's just another abhorrent use of them that detracts from their actual utility elsewhere.)

[Replies From View]

It's fucking horrible, basically.

[Zetetic]

Well. Noting that I obviously don't know the specifics of your mother's case, so I hope that any possible offence is nullified by the acknowledgement that I really might have no idea what I'm talking about.

there was an attempt to self-harm .... (and may have simply been a desperate cry for help)

This is really an side: I'm not sure if you're trying to minimise that attempt to yourself, but I don't think that it being a cry for help makes it any less of an attempt to self-harm.

Apparently a lot of people tried to kill themselves whilst taking the anti-depressant she was on back then; a little bit later that was known to be one of the side-effects.

I fear that this is inherent in anti-depressants. You're taking someone who is both miserable and who has ended up believing that they are powerless to change this. Anti-depressants are pretty good at jump-starting the latter - enabling agency and a greater sense of control again - but do essentially nothing, certainly not directly, to ameliorate the former. Without concurrent therapy, I think that poor outcomes (to say the least) are horribly understandable and anyone prescribing anti-depressants without also then continuing to push a behavioural or other intervention isn't doing their job properly.

Similarly, anti-psychotics are an incredibly useful tool at taking someone who's losing their grip on reality and their reaction to it and at least getting them to shut up, sit down[nb]Might not actually be a quote from the NICE guidelines.[/nb] and stop trying to do anything unpleasant to themselves or someone for a bit, so that you can start with behavioural and social intervention and eventually begin the fun process of trying to balance the side-effects and the risk of another episode of psychosis. For all their bluntness (and terrible mis-prescription), anti-psychotics have helped a great many people.

In any case I think the medication has done my Mum nothing but harm.

I know it's trivial to say this: It's very difficult to know what is occurring despite the medication, rather than because of it, and what would have occurred without it. That's not to detract from your point that perhaps more consideration should have been given to seeing if keeping her on those pills was a good idea, particularly if the side-effects aren't tolerable.

[rudi]

Sometimes they put people on low doses of antipsychotics for impulsivity or sleep issues.  Personally, I think doctors that do so need a fucking kick up the hole.  I've been on them for five years and every time I try to get off them I get rebound symptoms which knock me for months- combined with being a zombie for most of the time, I wish I had never been prescribed them.

But then you may be dead if you hadn't been. Same for me, really; the ones I'm on (and will be for the forseeable) are almost impossible to kick but, at the time, it was that or who the fuck knows what.

[Zetetic]

The creepy part is that the brain always comes up with explenations for feelings. If you're an inherently angry person your brain will come up with reasons for it,... If you're an inherently anxious person your brain will pile up reasons, while an inherently calm person will have a bunch of reasons as well for why they're so calm.

At the end of the day, the thoughts and images are all products of the emotions and not the other way around. I'm not saying that our emotions are completely detached from what happens in the outside world but i think a lot of what goes on is just the brain trying to come up with reasons so people can explain why they're angry or whateva.

I think that if you're going to think of it in those terms, you almost need to step back further than "anger", "anxious" and "calm".

Those three words, and I'd argue anything that's "an emotion", are already about tying your behaviour and your "feelings" (in the perfectly simple sense of what you feel bodily and so on) to the outside world. They're already not only describing how you're acting but supplying some vague reason (or motivation[nb]AAAAAH[/nb]) behind why you're acting in that way.

All of which supports the thrust what you're saying - we certainly don't tend to talk about "physical arousal" or whatever separate from emotions in normal conversation. (Although that sometimes we don't know why we're feeling this way or that way and have to consciously cast around for an explanation.)

[Buelligan]

I know it's trivial to say this: It's very difficult to know what is occurring despite the medication, rather than because of it, and what would have occurred without it.

Surely, if this is the case, then one could reasonably ask why any improvements are attributed medication when they may also have occurred anyway?

[Zetetic]

Yep. It's particularly difficult with anything that's vaguely periodic (like lots of people's depression and psychosis), since you'll tend to seek out (or come to the attention of Health Service) and get prescribed medication at the worst points and so you're likely to see an improvement anyway.

Hence why you have to try to establish efficacy in large, controlled studies (and preferably by establishing a plausible mechanism).

[rudi]

Surely, if this is the case, then one could reasonably ask why any improvements are attributed medication when they may also have occurred anyway?

Isn't that an accepted view anyway when it comes to anti-depression meds?

[Zetetic]

No. Certainly not for the severely depressed. (Backed up with stuff like hippocampal neuroprotection.)

[Buelligan]

Isn't that an accepted view anyway when it comes to anti-depression meds?

I have no idea, I'm just asking because I'm curious.

[RickyGerbail]

[RickyGerbail]

http://jech.bmj.com/content/62/5/448.full

[RickyGerbail]

when i had a lecture in one of my biomed classes at university the psychiatrist who was having that particular lecture talked a bit about the time before the discovery of anti-psychotics etc. it was pretty grim.

[Zetetic]

The problem is that shutting down the asylums - as enormously enabled by anti-psychotics - hasn't really made the problems go away, it's just made it easier to ignore. Pills are (relatively) cheap, the integration people back into their 'communities' through years of psychosocial interventions (for them and those close to them) isn't.

That Danish study does look interesting (particularly noting that clearly either other interventions or perhaps even social changes[nb]Or perhaps it's even in part down to make access to the tools of suicide more difficult. I haven't read beyond the abstract.[/nb]) seem to be responsible for the biggest drop in suicide rates). You might want to change that graph into a link though...

[RickyGerbail]

I think that if you're going to think of it in those terms, you almost need to step back further than "anger", "anxious" and "calm".

Those three words, and I'd argue anything that's "an emotion", are already about tying your behaviour and your "feelings" (in the perfectly simple sense of what you feel bodily and so on) to the outside world.

i don't think you can say that they are "about" something. it's like saying that the word "car" is about driving. doesn't make any sense.

All of which supports the thrust what you're saying - we certainly don't tend to talk about "physical arousal" or whatever separate from emotions in normal conversation. (Although that sometimes we don't know why we're feeling this way or that way and have to consciously cast around for an explanation.)

not sure what you mean.

[RickyGerbail]

The problem is that shutting down the asylums - as enormously enabled by anti-psychotics - hasn't really made the problems go away, it's just made it easier to ignore. Pills are (relatively) cheap, the integration people back into their 'communities' through years of psychosocial interventions (for them and those close to them) isn't.

That Danish study does look interesting (particularly noting that clearly either other interventions or perhaps even social changes[nb]Or perhaps it's even in part down to make access to the tools of suicide more difficult. I haven't read beyond the abstract.[/nb]) seem to be responsible for the biggest drop in suicide rates). You might want to change that graph into a link though...

Obviously a combination of different treatment methods is the best way to go in most cases. The reason i posted that link is because there's often a lot of anti-anti-depressant sentiments being aired in threads like these, people with experiences of not feeling like the've gotten better when they've been prescribed medications or having seen relatives not being helped etc. I think it's important to remember that there are reasons why so much money is allowed to be spent on these medications, and no it's not all down to a conspiracy between doctors and pharmaceutical companies.

ed: the effectiveness of anti-depressants cannot alone be measured by looking at suicide rates, since far from all people who get depressed kill themselves if they don't get anti-depressants. I just thought this is the most blatant way of showing that they do make a difference.

[Zetetic]

I wasn't trying to detract from that, although I'm not sure it's the best study on its own to make strong conclusions about the efficacy of anti-depressants. I just thought that the extent of the drop not associated with the use of anti-depressants was interesting as well.

i don't think you can say that they are "about" something. it's like saying that the word "car" is about driving. doesn't make any sense.

Fair enough; I mean that their use involves both a description of the behaviour of an individual (and perhaps bodily feelings that we associate with such behaviour in ourselves) and a description of - or at least a guess at- the situation that surrounds them.

I think that it becomes clearer when you try to contrast words that pick out emotions. What is the difference between "anger" and "frustration"? What's the difference between "excitement" and "nervousness"? To what extent does the bodily feeling associated with these emotions differ?

While you've got to be careful about taking etymology to mean too much (particularly given other languages), thinking about how the word "emotion" has come about is useful here. How would you translate emotion into your mother tongue?

not sure what you mean.

I'm hoping that this has been brought out a bit better above: that the bodily feelings we associate with emotions aren't the same as the emotions, and that we generally talk about how we "feel" in terms that also convey the situation we are in - for example I'd say that "I feel jealous" and "I feel irritated" both make references to causes of our current state to different degrees of vagueness.