I've had an account here for 6 years...
 

Since 2004, when I first started to gain weight. I've come and gone from it over that time and have only gotten fatter. I'm sort of at my wits' end and I think I need some kind of support from others. I don't really know what I'm doing, clearly, and never have.

My story, as briefly as I can get it: April 2004, I started to gain weight on antidepressants I desperately needed at the time. I was 18 years old, 5'2" and was around 120 lbs. give or take 5 lbs. all through high school, but like every teenage girl, I always thought I was too fat then and wanted to be 110 or less. Only now do I realize how lucky I was to have been at a healthy weight.

Over that summer, I gained about 30 lbs. I was 145-150 by the end of August, and an appalling 176 lbs. by December, when I turned 19. I still remember my mom exclaiming, "176 pounds?! What have you DONE?" when she went to the doctor with me and I was weighed. I felt absolutely terrible and like everything was my fault, but my GP who had been prescribing the antidepressants had never said much about it, other than 'eat more fruit! Bananas! Eat bananas and oranges. You're probably eating more because you're happy now.' Which wasn't so--I was still miserable a lot of the time and had been on at least 5 different antidepressants that year.

I started college in August 2005 at around 180 lbs. and spent the next four years bouncing up 10-20 lbs. and down again, but never going below 185. I graduated in December 2009 and have been around 200 lbs. over this past year.

I turn 25 on December 18th and I'm now around 209 lbs., still 5'2" and still unhappy. I've been on stable medication for years now and have seen all manner of specialists about my issues. In two weeks I'm actually going to see a Chinese herbalist who helped my sister out with her skin and fatigue issues. I'm seriously not sure what to do. In January 2009, I came back here for New Year's resolution-fulfilling, having bought an AirClimber and diligently used it, tracked my food intake and weight for over a month. I started at 191 lbs. and in February I gave up because I was still at 191 lbs. despite some dipping below that weight.

My weight has given me knee problems--I've had my kneecap fall out of alignment painfully and they crunch when I try to do squats--and no doubt contributes to the oppressive fatigue I feel most of the time. I'm always sore, I sleep a lot and whenever I do attempt to exercise as part of a daily routine, I give up after 2-4 weeks out of fatigue and frustration because NOTHING I DO MAKES AN IMPACT.

I'm thinking about ceasing to eat gluten/wheat to see if that would keep me away from everything I find delicious, but I'm certain that I'll fail again. My mom eats all kinds of crap and doesn't really like fruit but she's always been around 125 lbs. her whole life. My dad is about 270 lbs. at 6'1 and actually got a bunch of fat removed surgically from his abdomen about 3 months before I began gaining weight myself. He claims exercise and dieting 'don't work' for him, but has chided me about my weight since I was a skinny teenager. I've got a lot of issues with him, but that's the one that's important here.

My younger sister who just turned 23 is probably the best influence I have. She's 5'4, 130 lbs., comfortable in her skin and eats well. She's cut out a ton of foods because of allergen problems and cooks a lot with vegetables and stuff. However, because we still live with our parents, their influence on my diet is heavy in my life and we've got a full pantry of all manner of crap that I shouldn't be eating. My sister and I are moving to Portland, Oregon (we currently live in the Midwest, which I hate), in February and I'm hoping that living on our own on a shoestring budget in a very pedestrian-oriented/friendly town (where I live, there's basically no public transport and if you don't drive, you're screwed. There's not a lot of pedestrian-friendly areas and most are downtown and I live in the suburbs) will force me to walk, eat less, cook more and lose all this weight. I'd love to be 140 lbs. again, but my eventual goal that I've failed to meet for nearly 7 years is 125 lbs. I'm scared that I'll never reach it, or that when I do, I'll be so stretched-out and deformed and ill that it won't matter. I've got tons of stretch marks from gaining so much so fast and I actually went to a plastic surgeon earlier this year (a desperate liposuction consult, but I elected against it because I need to save money for the move) who told me I'd need both a tummy tuck and brachioplasty to make my stomach and arms look normal.

So. All that said... I guess I just wanted any advice or well-wishes anyone would have. Thank you for reading this if you managed to get this far! Apologies that it's exceedingly self-absorbed and self-pitying. I'll respond to all commentary and probably do some reading of other people's stories (I've actually never gone on the forums here--I think I just felt ashamed and like everyone else would actually be succeeding at their goals and I didn't want to be confronted with it in my own private failure).

J.

Hi J., thank you for putting your story out there. It speaks volumes, and not in a self-pitying or self-absorbed way. I think you have really illustrated a lot of things, including how family forces can affect people environmentally and emotionally, how frustrating it is when nothing makes a difference, and how emotions and weight gain go hand in hand. Antidepressants are a real beotch when it comes to weight gain.

It sounds like you are under a good bit of stress right now, so putting a lot of pressure on yourself in this regard could backfire on you. What would you think about just making a commitment to making healthy choices rather than trying to lose X number of pounds? It takes weeks to develop a habit; maybe by the time you head out to the west coast you can kick it into higher gear when you get settled in? Sometimes in difficult situations, the best goal you can set is to just maintain. Also, making one small change at a time is easier than a complete overhaul, a good thing to keep in mind.

That being said, there are all manner of folks here, and we all succeed at some of our goals and fall flat on others. If you read through the forums, you will definitely see that. A goal doesn't have to be a weight...it can be getting the recommended fiber, or eating four veggies a day, or working out for 30 minutes...a choice, not an outcome. Hopefully you won't still feel like you are failing after digging into these forums. There are definitely going to be things you will succeed at!

Do you have insurance or another option to access a dietician to look at your food and exercise and maybe speculate as to why you didn't see any changes in your current plan? I know that can be expensive, but it's an option.

Hang in there, J., and be gentle with yourself. It didn't happen overnight and it won't go away overnight, but bit by bit you can chip away at it. Pace yourself, be mindful, and come back often to read, contribute, or ask for what you need. Again, I am glad you put your story out there because I think it will hit home for a lot of people.

I think what Cassie said makes a lot of sense. Maybe make some small changes, rather than something overwhelming. Maybe just add some vegetables to your meals one week, add some more or drink some more water another.

Also I want to say you do not sound self pitying to me at all. You sound like someone who has had a lot of challenges and is doing the best she can and trying to make positive changes.

Maybe you can also do some PT for your knee. Try to do whatever physical activity you can because it does make a difference in flexibility and also can help with moods and outlook.

You are still so young; you can turn this around; look how many people are turning their lives around at all ages. And I believe you can do this without surgery. One step, even a small one, at a time. We're rooting for you, honey.

Cassie--Thank you so much for your kind words! I know that other people likely have experienced similar things as me as far as antidepressants and environment are concerned. I do take heart in that because they've overcome it and that means there's some hope for me, too.

I've vacillated from wanting to lose weight and 'be pretty' to just wanting to be healthy, whatever that takes or means, so I go from the goal-oriented MUST LOSE 20 POUNDS IN 3 MONTHS mode of thinking to the LET'S JUST EAT MORE VEGGIES way of thinking and back again. I've had to cut out all red meat and too much dairy from my diet already because of IBS, and I feel like for the most part, I probably eat better than I did as a teenager. However, I'm awful at portion-control and easily overeat when I know I should stop well in advance. I need to try harder to 'maintain' as you say. It IS an uphill battle, though, against cravings.

I actually saw a nutritionist once who just told me to drink more water and I did that, and largely cut out caloric drinks from my diet to no avail. I saw another one who gave me a plan to follow that didn't seem rigid until I tried it and found I just couldn't stick with it when I had school and everything going on. I've got a pamphlet from my doctor to go and get a health assessment from the hospital and plan to do that this week. I just keep wondering if anything I do will help or be something I can stick with.

Thanks again for the comments. I do appreciate them and I'll try to keep coming back to see what others have to say/read their stories and to ask for advice. It's good to know I'm not alone, and I will try to be gentle with myself.

J.

Canary--Thank you very much! I agree with Cassie as well. I've been implementing small changes in my diet for a while now but they just don't seem to add up. I still have issues overeating and I've got a massive sweet tooth. I probably try to go to extremes too often, cutting out EVERYTHING I love instead of just cutting back. I decided that for today I am eating no gluten. My sister recommended I try it for a week and I thought that I would focus on it day by day.

I'm glad I don't come across as self-pitying. I probably used to be moreso when I'd just gained the weight and wanted to lay all the blame on the antidepressants. I did have poor eating habits at the time as well, though. And now I just want to take responsibility and change my life, but I do need help and guidance.

My knee was injured 4 years ago and I underwent PT for it for 3 months. I should try all the exercises again because I think the weight I've gained since then has made it worse this year. My doctor's been telling me that I just need to take off some weight in order for it to feel better, and the fact that I'm ruining my KNEES by being this overweight is really sinking in and making it clear that I have got to change things. "Being pretty" isn't enough of a motivator, but when my health and everyday well-being are compromised... I guess it should be obvious to me what I need to do and how much I need to turn things around before it gets any worse.

Thanks for reminding me that it isn't too late to change things! I do often feel like I shouldn't have let my weight progress to this point, or that I should have just turned things around instantly in 2004 and lost the 30 pounds I'd gained, but looking back, I really was clueless at the time and felt powerless to change it while it was happening. And I can't change what I did or didn't do in the past, so I want to change what I do NOW instead. And thank you for rooting for me! :)

J.

J., I think what you said about the diet you couldn't stick with is very important. It can be the best, most effective diet in the world, but if it's not something you can stick with, it will do you no good. It takes some experimenting, but if you can find what works for you personally...well, that's more than half the battle. A lot of folks will post what works for them; it's great to read their suggestions, and some of them may be perfect for you. But don't force it if it's not. Keep trying till you find your pattern.

About that portion control...do you have a food scale? They aren't too expensive and are really worth it. Also, little things like serving yourself and then putting the bag or box or plate away could also help. I've even gone so far as to give the food to someone else to hide and divvy things out to me bit by bit if it's something I know I can get carried away on. Or I buy a flavor I like but not love...so I can stop after a serving. After I eat, I chew some gum, brush my teeth, or have a cup of tea or something to signal my brain that eating time is over.

That's what I could think of for now. Glad to see you popping back in. You can probably find a bunch of other threads to chime in on, too. No membership requirements and everyone is very friendly and welcoming. Good luck; you can do this!

I can tell you from personal experience, living in chronic pain will sap your strength and your willpower. I've been dealing with tendonitis and arthritis since my first daughter (now 6) was a year old. I've been through several rounds of physical therapy, more specialists than I can count, antidepressants, and at one point even cut my hair super short because I could not hang on to the brush long enough to care for it long. It wasn't until I started on Celebrex 1 1/2-2 years ago that I could function well enough to have a chance at sticking with this. I've been at this 13 months and though I'm still not at my goal, the scale is still creeping ever so slowly in the right direction, and I haven't gained anything back despite some major stresses in my life. Moving out is a major first step in claiming your life as your own and taking back control. Nothing makes you feel worse than someone criticizing you about things you aren't happy with. Eating because you're depressed, then having someone say stop eating you're too fat... well that just makes you want to say "F it" and eat everything that's not nailed down. Been there, done that. Walking is a wonderful habit to get into. I used to walk for miles and hours, not an option with small kids, I miss it terribly. It's great for clearing your head too. There are things I cannot have in this house, or I will eat the whole package in times of stress. Cheese is a bigtime dangerous item for me. Ice cream tubs are dangerous too, I buy fudgesicles and miniature sized novelties instead. After a year, I'm a heck of a lot better at eyeballing portions, but I still lean heavily on my food scale and measuring cups to keep it accurate. I don't forbid myself anything, because if I "can't" have something I'm going to binge at some point, so I am very strict with portion control on the sweets instead. I used to eat Oreos 8 or more at a time, now 2 is enough, but that sure did not happen overnight.

Long story short, this is a trial and error process for all of us here. Realistically, it will probably take months to figure out what type of person you are and what works for you. But here's the thing, it's not an all-or-nothing situation. Pick one battle at a time, one step at a time, each day just a little different and a little better than it was the day before, and eventually, those little steps add up to a big journey. If you fall, you fall. Doesn't matter how many times you fall, as long as you get up just one more time. You don't have to change it all overnight.

I can also relate to the chronic pain because I have fibormylgia which makes exercise extremely difficult. Light activity that used to be like nothing for me can now force me to be bedridden for days. But if I don't do some movement, my back and knee go into spasm. I also have IBS so I can relate to that too, J. I know my advice was nothing you haven't heard a million times but I would also like to say just don't go to extremes and choose a plan that will be too hard to follow. I agree with Lizzy: it is trial and error and it will have its ups and downs. But don't give up! Where there's a will there's a way and I know you will find your way, which may not, as Cassie says, be the same as others but which will work for you. I really believe it will happen for you.

And Lizzie I am so sorry to hear of your struggles as well.

Cassie--Your suggestions are excellent! I will look into getting a food scale. I've resisted one until now, thinking I could do it on my own, but I'm far too permissive and guesswork just doesn't lend itself to accurate portions! And thank you again for the encouragement--I've opened several threads to read to see how others are coping with their struggles. :)

Lizzy--Thanks for chiming in! I'm sorry to hear of your chronic pain issues. :\ I'm actually taking Celebrex for my knee right now, but it's not helping a lot. I think taking weight off the knee will be my only recourse. Congratulations on how much progress you've made! You're quite right on the temptation front, and also on the self-esteem front. I feel like moving out WILL help me a great deal, but I'm going to try and make some stabs at progress in the meantime. I feel you on the pints of ice cream--I know not to buy them because I'll eat them in one or two sittings rather than four or more. And I eat far too many Oreos at once, too. Portion control and stopping when I've really had enough is probably my biggest issue.

Canary--My mom suffers from fibromyalgia, too, and she thinks I have it, but I feel like my problems run towards CFS. I've been worn-out since I was a teenager and easily sleep anywhere from 10-18 hours at once. Working up the energy to exercise is really difficult. And I appreciate your advice! Thank you very much for your belief that I'll find success. I'm understanding now that it's far more trial-and-error than I thought. I sort of figured if I couldn't stick with something, it was *my* fault because X or Y method was clearly working for other people! But I'll find my own path.

Thanks again, everyone, for your support & kind words! It does mean a lot to me. I've kept up a gluten-free regimen for two days now and seem to have lost a little weight on it. I'm going to try to make it through the week with no wheat to see how that goes. I think focusing on exactly one task/limitation at a time is the most I can handle right now and this is easier than I thought it would be--but only because my sister's been doing it for years and has all the right foods sorted out! :)

J.

Hey! I've just skimmed this thread - but are you still on antidepressants?

I was on Paxil for 5 years. In which time I went from 150 (5'7) to 199 lbs. Was also living with parents at the time, and in my twenties. I decided not to carry on taking it.

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Digression on that:
This might be controversial, but frankly, I'm anti anti-depressants now. In my case, I found it flattened all the good aspects of my sensitivity, and left me numb, but with the same life problems. Except I didn't care about them any more. I was a trained singer, and I stopped caring about music. I used to be very attuned to people's feelings. That stopped - I'd just blurt things out, without any censorship. Made for awkwardness that I could recognize, but not feel. I lost my intellectual drive, which was a defining trait, all my life. Good news: most of these qualities, as I'll call them crudely, have come back.

I found my experience confirmed by many, many people. Since then (five years on), there's been an increasing volume of scholarship showing anti-depressants are no better than placebo. (Studies that showed this had not been published by the FDA or by professional journals.) Anti-depressants are worse than placebo, because you get the noxious side effects (some of which include depression, anxiety, and insomnia - what's the point?) If you want links to more information, let me know.

My view now is that you can manage mood with exercise. You can get better at living in the world by doing it. Small steps always. Meaning is always a problem. Journalling helps me a lot (google 'expressive writing'). Reading does too. Curtailing ruminating behaviours is important. I really believe in old-school occupational therapy. Keeping busy with some silly and not so silly hobbies is a kind of magic. Also, these things enrich your life, and make you better...

If I'm totally honest, my life took some dark turns after what I'd thought was my bottom. I can't discount that. Now, I'm grateful for every minute. I feel more positive about life in general, and am *finally* focussed on what I need to do.

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A big move was part of all this. I left my parents' (also suburban) house for a big city. I did this after discontinuing my Paxil use - that, by the way, took a year. (Don't even try it without research, if it's something you want to do. )

I lost 50 lbs in 6 months. I didn't particularly change my diet or exercise - it was just walking every day, and working. (Had been a terrible student for too long.)

Moving to Portland will do you a WORLD of good. Glad you have your sister. Hopefully that's a solid relationship! Suggest working hard to do your own thing when you get there, so as to avoid strain - you guys'll have all kinds of stresses just from the move.

Sorry for ramming my opinions down your throat. I know things are hard for you right now. You wouldn't be taking ADs if you felt you had another choice, if things weren't as bad as they've been. I had a similar experience, and came out the other end.

I don't have fibromyalgia, so can't speak to that - but all my life have had various aches and pains, and a sluggish energy. I thought I'd be that way forever. Exercise has really, really helped all this. Moving out helped more! I mean I'm not the Energizer bunny or anything, but I can get a lot more done in a day than before. Still have problems with organization, and am working on sleep (could fill another page on that, with more advice), but it's improving.

Your life can change dramatically. You're doing the right things :)

Oh yeah, want to share a fantastic website. Free yoga videos. Found the yogini on youtube on a search for 'beginning yoga'. She does short sequences, and has kookily useful ones, like 'yoga for a bad day', 'yoga for a hangover', among others. The lady's got a very calming energy - I swear my blood pressure goes down a couple of notches just hearing her voice. Check her out at
Yoga Videos and Yoga Poses at Yogatic with Esther Ekhart

Pinenutcasserole--first, what an interesting username! LOL. I called myself after a song by a band I love, but realized belatedly it fits my appetite. I really am the insatiable one sometimes! :X

I am still on antidepressants and I DON'T want to be. This entire year, I've felt lows as bad as before I was ever on them, which makes me think that they're doing me more ill than good. I know how dangerous it is to quit them cold-turkey--I tried that once in early 2008 and ended up crying in class and having terrible nightmares and just feeling like life wasn't worth it. I actually began to taper off my dosage in October by snapping one of my two pills in half and have felt better since then. I'm going to try and get myself down to one pill. I've been on Zoloft for years now--I tried Cymbalta again at my erstwhile drug therapist's advice, and even though I TOLD her I knew it'd make me a little ball of anger and hatred, she made me try it anyway, and when I was right, she concurred and put me back on the Zoloft. It's the only one that hasn't caused massive weight gain and the only one on which I've been stable. And I know that being stable on an AD is kind of a crapshoot since NO ONE KNOWS HOW THEY WORK, which has ALWAYS bothered me.

The GP who prescribed me them was an idiot. I no longer see him because of how much his happy-go-lucky Rxing screwed me up. I saw dedicated mental health specialists for a couple of years to get me where I am today. I take 200mg of Zoloft a day, or did--I've been at 150mg for 2 months now. Like I said, for many reasons, I want to taper myself off them. I'm hoping when I get more exercise in my regime (walking around a gorgeous city!) and am away from the toxic influence of my parents, I won't NEED them anymore, but I also don't want to rush myself off them. It took you a year and may take me as long or longer--I've been taking them for 6 years, nearly 7 now. :\

I thank you so much for your advice! My relationship with my sister IS a strong one, you're right. I think she's probably the best influence I have in my life currently, although a couple of my long-distance friends are into exercise and when I visited them, I was more into it myself. I really think environment and influence is everything when it comes to lifestyle changes, given my experience and the experiences of others, like yourself.

Oh, your commentary on blunted affect strikes home with me, too. I feel I've become such a disaster on medication. I take a lot of pills for a 24-year-old (singulair, celebrex, zoloft, zyrtec, levothyroxine all daily, Xanax when I need it and naproxen several times a week) and I want so much to whittle that down. My sister takes no prescription drugs now that she's gone to her herbalist and while I'm not sure I'm down with the hippie thing, I'm going to see what he says about me on the 17th. My sister said he's a really good listener and has a Western medical degree in addition to his Eastern studies and will draw on both for a diagnosis. he focuses on lifestyle changes, too.

I don't feel like you've rammed your opinions down my throat at all! You have good suggestions, many of which I've considered myself. Thanks so much for your advice! I'm definitely heartened by your experiences since you were in a very similar place to me at one time. Thanks again. :)

J.

Antidepressants are a tool, one of many, to combat depression. The degree to which people tolerate them and benefit from them varies enormously.

I think, that with respect to psychotropic medications, it's truly a case by case basis, the same as it is with dieting. People can tout low-carb and show me study after study about how healthy and effective it is, but it does not work for me and I doubt it ever will.

Some folks need antidepressants to give them the energy and the motivation to make other changes in their lives. Some people respond very well to them, and some depressions are largely biochemical in nature. Some folks, including a close relative of mine, don't react well to them at all, and find that none of them works for them. In the interest of full disclosure, I'm a psychologist. I don't prescribe; I would rather people do the grunt work of therapy and lifestyle changes as opposed to just running to the prescription pad, but there are times when it is optimal to have both.

I am not disagreeing with anyone's opinion, but I know that a lot of folks on these boards are on such medications and I wanted to point out that there is another side to the coin than the one pinenutcasserole eloquently presented.

One thing you will find me saying again and again on these boards is that if it works for you, do it. If it doesn't work for you, don't do it. Within reason, there is no "right" and "wrong." Another thing I say quite frequently is that you can find anything to support any position on the internet or in the library; you can quite easily find a study contradicting something you just read. So really, there is no ultimate answer for a lot of this.

If you are on the medication route, listen to your doctor, be open and thorough with your doctor...and if you don't completely trust your doctor, find a new one.

And as always, keep sharing your thoughts and experiences, because you never know when one will be an "ah-ha" moment for somebody!

Hi both,

Stepping on a soap-box, with respect:

I share your concern, J, that SSRIs were put to market without robust investigation of, or consensus on, their underlying mechanisms and effects. In the 90s, the serotonin hypothesis was seductive - and certainly, initial outcomes appeared to prove its validity. It's now being revisited. The knock-on effects of serotonin reuptake inhibitors on other neurotransmitters remain unknown and continue to be largely unstudied. It took over a decade for wildly confused patients, who'd previously suffered in isolation, to organize the critical mass of lawsuits it took to get GSK to admit that suicidal ideation, weight gain, and discontinuation syndrome were linked with paroxetine (my drug... I don't know much about Zoloft, but they're in the same class of drugs). Obviously, part of the problem was bias - patient experiences were discounted, since their initial diagnoses cast doubt on the cause of the symptoms.

I find it unacceptable - to put it very mildly - that all this had to emerge in a clinical context, in the open market. Trials for paroxetine have been no longer than 12 weeks at 40 mg. I don't know much about Zoloft, but it's the same class of drug, and imagine the protocol was similar. As we've experienced, J, clinicians prescribe it for *years* at much higher doses. The 'empirical' tack. "Hey, it could work, let's see what happens." And patients like us are often in no position to be critical healthcare consumers when we first approach practitioners. Most of us just 'want it to stop', whatever it is.

I'm not suggesting there's a conspiracy. Doctors (and we're usually talking about overwhelmed GPs, who then refer to psychiatrists) want to treat patients as much as patients want to be treated. Their mutual desire to believe in drugs' efficacy converged with pharma companies' interest in selling to a (sadly increasing) market, and was expedited by the unbelievable practice of advertising the stuff on television, creating a demand-led prescribing culture. The economics of health care (even in Canada, where I'm now based) often mean that in practice, too many patients are handed out drugs in the first instance ("cheap", even if it isn't) and in lieu of, rather than in conjuction with talk therapy (expensive). I'm really pleased to hear you've found solid support.

Cassie: you're right to encourage people to be critical of studies. There's a fair amount of sensationalism in science journalism, and too many studies are less rigorous than we'd all like. (Including, I might add, some of the ones that established SSRIs as the 'gold standard' drug treatment for affective disorders.) Also, few academic journals - and this extends to disciplines outside of psychology - were/are interested in publishing the null hypothesis. This is, I think, more a question of sociology and economics than anything nefarious ( 'x didn't happen' is less sexy than 'y did', to both editors and readers). (Though in the case of the FDA, it's hard not to think of it as being a question of influence.)

I'm not sure I buy the distinction between biochemically based depression and any other kind. (Former medical anthropology/philosophy of mind student.) I'm not trying to be glib or rude, or bring up the tiresome (and outworn) nature/nurture debate... but aren't all experiences biochemical, at bottom? I mean obviously there are many kinds and causes of depression... but even fMRIs can't offer insight into causation. The brain of someone whose depression is exogamous bears the impact of social causes. As you know, researchers are finding that we are neuroplastic - for others, change in response to experience - well into and through adulthood. To a greater or lesser extent (we still don't know enough to know how much), it seems our brains reflect our lives, as they are lived. Which is hopeful news for us both, J!

I haven't meant to be argumentative or disrespectful to you, Cassie, and I'm not against all pharmacological treatment. It's true that many people are helped by drugs. It's just that we don't yet have robust enough research to make better guesses about who will, and who won't - and in the meantime, the unlucky ones suffer. And this new suffering is compounded by more familiar pains. It's unjust, and theoretically preventable.
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J: Bit winded after all that, but briefly now, I truly empathize with your struggles. Your post has called me to remember the long road I've travelled, but if it helps, that time (and the feeling of that time) is very far away from me now. It's true you've got some tough days ahead, but you're an equally tough cookie. You've already been a strong advocate for yourself, through the avenues available to you so far. It'll be something to see what you will do when you're in your new situation!

I'm glad to hear you're taking it all as slowly as you need to, and hope as others do that you stay kind to yourself. You sound tremendously frustrated right now. Lean on those helpers, lean on your sister. I absolutely agree that situation, proximity, & modelling have a tremendous influence, for good or ill. I can imagine it will be hard to generate the wherewithal to get going on much, if there's not much activity or healthy eating happening at home, and your sleeping and sense of well being are where you've said they're at. I'd like to take the liberty of recommending a few very practical things:

- Get a dawn simulating alarm clock. Magic, if you do your best to practice sleep hygiene. First time ever I've woken up painlessly. I have this one, it rocks.
- January = a new semester. I've suggested to someone else on this board something that really helped me, which is taking a night class in something fun. (You're a precise and moving writer... maybe something like short story writing? Which I'm guessing you might have already tried... Or maybe something you don't have a history with but have wanted to try. )

I'll repeat my argument for it: it's a weekly appointment that will *make* you get out of the house. It'll be in the evening, so perhaps less of a challenge in terms of time management. It's a class and therefore structured, which in your case (my case, of old, and still) may be a good thing. And in the days after a class, if you're like me, you might find yourself 'kick-started', just sort of feeling intuitively that you want to do more of other things ...

- Something physical that doesn't make you feel like a failure. I'd suggest walking, but in the suburbs, where only the most intrepid cats and maybe the elderly dare venture out, it might feel a bit daunting. (Did me anyway.) Personally, I find DVDs hugely helpful. Easy to do at home, low investment, little gear or hassle involved. Sometimes I just do em in my pjs. There are some that are aimed at rehabbing folk, which might better accommodate your fibromyalgia issues.

I hope your meeting with the herbalist goes well! And am glad I was able to be helpful, thank you for letting me know :)

Crikey, I've written a novel. And most definitely thrown some opinions around.

nx

ps - pinenutcasserole is just me being literal and stubborn. I was actually looking at a pine nut when I registered, but the name was already taken.

pps - i don't mean to encourage people who are happy with their drugs to leave them, but, j, for you (in the absence of a discernible pm'ing function): I found this site helpful in terms of information on tapering. It's to do with paxil, but many on there are on other SSRIs.

Well, I wrote a huge post, and FitDay ate it, which sometimes happens. Basically, the high points are as follows:

I personally don't have experience with antidepressants, or any other psychotropics. My conclusions come just from my profession and what I've seen over 15 years in practice. I've seen antidepressants work. I've seen them not, and I've seen them come with wicked side effects.

That being said, my Ph.D. is a research-based degree, but I have a clinical practice. I do therapy, not research. I have the background of the science, but I'm not in the pocket of any drug company and never have been. I never, ever, advocate using medication without therapy, and often do therapy with folks who do not need and/or do not want medication. Most of my patients are not on medication.

I always advocate starting with therapy and lifestyle factors. However, in the case of vegetative depression, suicidal depression, or intractible depression, medication can be helpful. I have seen patients who don't have the will or energy to get out the bed, let alone process their issues using insight-oriented therapy, and if an antidepressant can get them to where I can work with them, then I'm truly okay with that.

My main concern was that, given that this is a newcomers' thread, that no one feel isolated or criticized because he or she happened to choose medication as an option for him- or herself. A lot of folks on here have done just that, and I would hate for someone to read this thread and think that they would not be accepted because of a personal choice that is their right to make. Consequently, I simply presented the other side of the argument.

I am not saying that your post was dogmatic at all. However, we sometimes have some individuals who post with the attitude that their way is the only way (search for Zorba's posts if you want an example), and it is quite polarizing; I tend to be very hyprvigilant for that. It is wonderful to be passionate about one's point of view, and I don't disagree with the basic premise of yours, but in the long run, there are two sides to every issue, shades of gray for every black and white, and exceptions to rules, and I felt that it was important to state them for others who may be reading through, if only to illustrate that everyone needs to do what's right for them, provided they're being honest about what that is.

My own personal soapbox on the whole herbal/holistic market in a nutshell is this: Herbs are untested, unregulated drugs. Cocaine is an herbal product if you want to be technical about it. As with everything else in life, buyer beware. Herbal therapies do help some people, but there are a lot of claims out there with nothing but anecdotal evidence to support them. My personal opinion is a combined approach is best. My persoal background is in traditonal/western medicine, but the whole person treatment approach and the mind/body connection that eastern/holistic medicine addresses does have merit. You cannot treat one symptom without affecting many other bodily processes, and how a person feels emotionally does have a physiological effect.

In my case, I am no longer on antidepressants. I weaned myself off of them because I wanted a second child, and because physical therapy got me to a place where I could get relief without them. I started taking them because of nerve pain that was keeping me from sleeping, the lack of sleep was causing me to be depressed, and I was very close to a major breakdown. My depression was physicological. The particuar one I was prescribed eases nerve pain as well as depression, and I was on it for about 2 years. I agree with Cassie that antidepressants can be a useful tool in conjunction with therapy. I don't think simply throwing pills at a problem can make it go away, but medication can be the crutch needed to get a person to a place where the problem can be addressed. Once the person is well enough to stand on his/her own, then the crutch can be set aside.

Sorry, InsatiableOne, for so diverting this thread... would just like to briefly respond to Cassie.

I was unclear above, in mixing comments to InsatiableOne and yourself - when I spoke of 'we', I meant to refer to IO, as we're both consumers of care.

In no way did I mean to suggest that you personally were a 'pill-pusher', or prone to 'big pharma' manipulations... in fact I wish more care providers (GPs & psychiatrists in particular) were as conscientious as you evidently (by your care in balancing the picture here) are. I would guess that your patients/clients are among the lucky ones.

My gripe is with pharmaceutical companies that I feel didn't do due diligence in their research; insurance companies, which place constraints on length of treatment, and bias or even force some practitioners towards drug-heavy treatment plans; and finally, with pharma-minded doctors.

As you well know, there are many cultures among psychological carers. GPs, psychiatrists, psychologists, social workers, and counsellors each have a different scope of practice, and different orientations. I think the GPs struggle to deal with affective issues because they're not specialists, they're dealing with shingles and bronchitis and god knows what else - I suspect that many find it easier to view - and manage - depression as a strictly physical disease, given their orientation. And much of the continuing professional education that's most easily accessible is sponsored by drug companies. I even think more of them would probably like to offer insight based therapies, but are overwhelmed. I think that culturally, because of limited time, non-specialists take older research for granted. And I think many patients are familiar enough with psychology - through advertisements, and other popular media - to present themselves as worst case scenarios, therefore needing drugs; to perhaps exaggerate some symptoms, in the belief that only a drug can cope with their depression. I don't see this whole exchange as malicious, just - very often - misguided. I feel it's a structural and systemic problem. I'm sorry if I in any way suggested otherwise.

I'm sure there are many who have found balance too. Personally, I found community and help among people who did not have that experience. Probably those who are pleased with their treatments are unlikely to go on about them in online forums and elsewhere - they just get on with their lives.

Lizzie: agree that herbal treatments should also be standardized (in their production) and vigorously tested.

I hope everyone here who is struggling with sadness or depression finds what they need, where they need it.