No Sleep For the Wicked

Well, the insomnia is kicking up again. I swear it has something to do with hormones and/or depression. Probably both! I didn't sleep at all last night. It's killing me. But, I'm still not tired. It's strange. Very strange. Any suggestions would be helpful. I've tried OTC pills, Ambien, and hot tea - not together obviously! - but nothing seems to help! UGH!

TMR

Today's Word of the Day

Main Entry: an·xi·o·lyt·ic
Pronunciation: "a[ng]-zE-O-'li-tik, "a[ng](k)-sE-
Function: noun
Etymology: anxiety + -o- + -lytic
: a drug that relieves anxiety
- anxiolytic adjective

Exercise and Depression

Exercise may help with hard-to-treat depression

Thu Jul 19, 3:35 PM ET

Regular exercise may improve depression symptoms in people who've failed to get better with antidepressant medication, the results of a small study suggest.

The study found that depressed women who started a supervised exercise regimen had significant improvements in their symptoms over the next 8 months. Those who didn't exercise showed only marginal improvements.

Before the study, all of the women had tried taking antidepressant medication for at least two months but had failed to improve.

A number of studies have found that physically active people are less likely than couch potatoes to suffer depression. Some clinical trials have shown regular exercise can help treat the disorder, and perhaps be as effective as antidepressant drugs in some cases.

The new findings suggest that exercise can even help people whose symptoms have been resistant to medication, according to the study authors.

Dr. Alessandra Pilu of the University of Cagliari in Italy and co-investigators report their findings in the online journal of Clinical Practice and Epidemiology in Mental Health.

The study included 30 women ages 40 to 60 who'd been diagnosed with major depression. The researchers randomly assigned the women to either stick with antidepressants alone or to start an exercise program. All of the patients continued to take their medication.

The exercisers worked out as a group twice a week for 1 hour, using cardio-fitness machines. At the beginning of the study and 8 months later, women in both groups completed standard measures used to assess depression severity.

Pilu's team found that women in the exercise group showed marked improvements in their depression symptoms, while those on medication alone made only modest gains.

The findings suggest that exercise could be an effective additional treatment for depression over the long term, the researchers point out.

There are several theories on why exercise might improve depression. Physical activity seems to affect some key nervous system chemicals -- norepinephrine and serotonin -- that are targets of antidepressant drugs, as well as brain neurotrophins, which help protect nerve cells from injury and transmit signals in brain regions related to mood.

Beyond that, people who take group exercise classes may feel better from simply getting out and being with other people.

SOURCE: Clinical Practice and Epidemiology in Mental Health, online July 9, 2007.

Good times, bad times...

Well, kids, it's been a strange month so far. I seem to be having one good day, then one bad day, and so on...I'm not sure why. One minute I'm fine; the next I'm crying. Depression is a strange thing. After 15 years, I'm still not used to the mood swings, the sleep problems, the fatalistic thoughts, etc. You'd think I would be.

TMR

New Antidepressant/Suicide Study

Antidepressants lower the risk of suicide attempt in adults with depression

Medical Studies/Trials

Published: Monday, 9-Jul-2007

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Antidepressants lower the risk of suicide attempt in adults with depression, according to a study published in the July issue of the American Journal of Psychiatry. The researchers also found that the lower risk held true for young adults ages 18 to 25. "The risk of suicide attempt among depressed patients treated with SSRI drugs was about one-third that of patients who were not treated with an SSRI," said the lead author Robert Gibbons, director of the Center for Health Statistics and professor of biostatistics and psychiatry at the University of Illinois at Chicago. "We would not expect a lower risk in this patient population because patients treated with SSRIs are generally more severely depressed and would have a higher risk of suicide attempt." The researchers analyzed medical data of 226,866 patients newly diagnosed with depression in 2003 or 2004 at the Veterans Administration healthcare system. They compared risk of suicide in four age groups (ages 18 to 25; 26 to 45; 46 to 65; and older than 65) before and after treatment with selective serotonin reuptake inhibitor medications, also known as SSRI drugs. All age groups of depressed patients who received selective serotonin reuptake inhibitors -- the most commonly prescribed antidepressant medication -- showed a significantly lower risk of suicide attempt when compared to those who did not receive antidepressant treatment. Among 82,828 patients, there were 183 suicide attempts before treatment with SSRI drugs and 102 suicide attempts after treatment with SSRI drugs (a rate that fell from 221 to 123 per 100,000 after treatment). In 2004, the Food and Drug Administration issued a black box warning suggesting that SSRI drugs increase the risk of suicidal behavior in children and adolescents. An FDA advisory committee recently recommended extending this black box warning to young adults. Gibbons cautions that extending this warning to young adults may further decrease antidepressant treatment of depression and contribute to higher rates of suicide. In previous research, Gibbons reported an inverse relationship between antidepressant prescriptions and the rates of suicide in children and adolescents. Co-authors of the study include Kwan Hur and Dulal Bhaumik, UIC Center for Health Statistics; C. Hendricks Brown, University of South Florida; Sue Marcus, Mount Sinai School of Medicine; and J. John Mann, Columbia University. Funding for the study was provided by the National Institute of Mental Health. UIC ranks among the nation's top 50 universities in federal research funding and is Chicago's largest university with 25,000 students, 12,000 faculty and staff, 15 colleges and the state's major public medical center. A hallmark of the campus is the Great Cities Commitment, through which UIC faculty, students and staff engage with community, corporate, foundation and government partners in hundreds of programs to improve the quality of life in metropolitan areas around the world. http://www.uic.edu

Back by popular demand...

As of July 4th, TAR is open once again to submissions of all kinds. The current submission period will run through September 1st. All submissions received during this time period will be eligible for publication in the Fall 2007 issue. Please read our submission guidelines for more details.

Thanks and take care,
Tracy

Ah, antidepressants...

Well, changed antidepressants again...The bupropion made me too anxious - so much so that I dreaded changing and procrastinated. I'm now taking Effexor, and after two weeks I already feel tons better. It even seems to be helping with my PMDD this month, and my social anxiety problems.

YAY!
TMR

An interesting article on social isolation...

Americans' circle of close friends shrinking

By Amanda BeckFri Jun 23, 3:04 PM ET

Americans are more socially isolated than they were 20 years ago, separated by work, commuting and the single life, researchers reported on Friday.

Nearly a quarter of people surveyed said they had "zero" close friends with whom to discuss personal matters. More than 50 percent named two or fewer confidants, most often immediate family members, the researchers said.

"This is a big social change, and it indicates something that's not good for our society," said Duke University Professor Lynn Smith-Lovin, lead author on the study to be published in the American Sociological Review.

Smith-Lovin's group used data from a national survey of 1,500 American adults that has been ongoing since 1972.

She said it indicated people had a surprising drop in the number of close friends since 1985. At that time, Americans most commonly said they had three close friends whom they had known for a long time, saw often, and with whom they shared a number of interests.

They were almost as likely to name four or five friends, and the relationships often sprang from their neighborhoods or communities.

Ties to a close network of friends create a social safety net that is good for society, and for the individual. Research has linked social support and civic participation to a longer life, Smith-Lovin said.

People were not asked why they had fewer intimate ties, but Smith-Lovin said that part of the cause could be that Americans are working more, marrying later, having fewer children, and commuting longer distances.

The data also show the social isolation trend mirrors other class divides: Non-whites and people with less education tend to have smaller social networks than white Americans and the highly educated.

That means that in daily life, personal emergencies and national disasters like Hurricane Katrina, those with the fewest resources also have the fewest personal friends to call for advice and assistance.

"It's one thing to know someone and exchange e-mails with them. It's another thing to say, 'Will you give me a ride out of town with all of my possessions and pets? And can I stay with you for a couple or three months?" Smith-Lovin said.

"Worrying about social isolation is not a matter of nostalgia for a warm and cuddly past. Real things are strongly connected with that," added Harvard University Public Policy Professor Robert Putnam, author of "Bowling Alone," a book on the decline of American community.

He suggested flexible work schedules would allow Americans to tend both personal and professional lives.

I feel crazy...

Well, I've spent the past week contemplating how my brain functions. I cannot seem to handle crowds. I just get overwhelmed with noise and anxiety, and usually it ends with a great deal of embarassment on my part. I'm not sure why. It's like some sort of sensory overload. I really think I may be dealing with a social phobia at this point. I keep thinking it will get better, but it never does. I can handle conversations with one person - even in public - but I cannot do groups. I feel slightly deranged. I really do. It's not a comfortable feeling. I don't know. I guess I'm just not a people person. Or maybe it has to do with the hearing loss I experienced when I was small (from chronic ear infections and music played too loud). I jsut have to step back and take a few deep breaths and try again. Sometimes it works, sometimes it doesn't. It makes me feel like maybe I have more serious mental illness than I realize. And, that is not a comfortable feeling for me. But, when I'm with Mom or someone else close to me, I have no problems. Even family gatherings are not a problem. I dont' know. Maybe L's right. Maybe I am nuts. Or maybe I'm just a person out of time - like I should have been one of the early feminists or something in a time when things moved slower and people didn't think multi-tasking was the only way to go!

Sigh...
TMR

Porn and social phobias...

Another lunch with Shannon Friday. Apparently, the guys have been looking at porn with her on the web...from work!!! I thought all that shit was blocked out. Besides, isn't that sexual harassment or something. Then, she proceeds to tell the story of what they saw in front of the customers! I do not like Mom's work environment at all right now. I kinda feel like whatever people are into is cool with me, but if I wanted to be exposed to weird shit and lewd shit I'd be looking it up on the web myself. I'm sure the customer's feel the same way. I'm not a prude. People can do what they want. But, I don't want to talk about that anymore than they want to talk about what I am interested in.

And, I seem to have inherited Mom and Papa's propensity for not hearing details or distinct voices when there's a lot of noise. It's like my ears or my brain short circuit. I also have either paranoia or delusions because I can always swear that people are talking to me and then they aren't. It's partly the cell phone craze I think. I'll be talking to someone and then they'll pick up their cell and start talking to whomever. Or people have five different conversations at once or something. But, also, I kinda feel like I don't speak the same language as anyone I know in person right now. And, it's making my anxiety level go through the roof! I feel twitchy and shit all the time. But, when I'm at home and not thinking about social settings, I'm fine. Maybe I'm becoming social phobic. Maybe I'm just psyching myself out. I don't know.

TMR

Conversation is a dying art form...

Has anyone else noticed that conversation is dying art form? Everything is so fast paced and hectic. I've had people suddenly answer their cell phones in the middle of what I'm saying. I've had people have conversations with me and someone else at the same time. What is up with that? I don't know if it's something in my brain or just that I spend most of my time at home in front of this computer, but I can't keep up. (Oy, can that lead to embarassing moments!) I don't know you guys. I never really liked the whole go for an all-day visit thing my grandparents used to do, but at least they listened and didn't try to have five conversations at once. Maybe I'm old-fashioned. Maybe I'm too slow and not as smart as I think I am. Maybe I just hate groups. I don't know.

In other news, it's been a bad day. I think I have a stomach virus or food poisoning or something. Major stomach cramps and dizziness. Actually, the dizziness has been going on for a week. I don't know if it's the new meds or anxiety or what. I seem to suffer a lot of confusion lately. I can't figure out if it's that I have a lot going on in my mind and I space out or if there's a bigger problem. Actually, when I'm having a one-to-one conversation I'm good. It's that whole group thing again. I never know who's talking to me when. Very strange. Maybe I just need to get out more? I don't know. I really don't. But, I feel very stupid and embarassed when it happens.

TMR

Coughing and chipper

Since I can no longer take decongestants, my throat is killing me. By the same token, my mood is very chipper indeed. Not sure what to do. I can't seem to feel 100ver! And, all decongestants seem to come with those warnings about anxiety and crap. So, I'm coughing and chipper - a lovely combination. I'm trying a nasal spray, but those usually don't dry up everything. Any suggestions?

Other than that, things are good. Still a bit of anxiety at times, but that's normal for me, to say the least. Mostly I've been working, writing, and trying to make sure nothing falls through the cracks.

TMR

Weird CNS issues...

Well, my friend J has issues with bupropion, and I have issues with pseudoephedrine. I have felt jittery off and on since starting this anti-depressant cycle. Turns out those things have a lot to do with whether or not I'm taking an expectorant/decongestant called Entex. You see, Entex has pseudoephedrine in it, as does Drixoral an antihistamine/decongestant that Mom no longer lets me take since I'm totally whacked when I'm on it - angry one minute, crying the next, totally paranoid all the way through. So, I'm calling the pharmacy and the MD tomorrow to have them put on their records that they have to notify me if it has PSE in it. This is why I haven't been able to hold a thought in my head for the majority of the past week! And, the sad part is that now I know that I thought of it several times, but the thought escaped before I could really do anything about it. So, I just kept getting up every morning and taking my pills. I feel like a total goof. It actually came out today when I went to Mom's office to have a little closed-door meeting with her (since she's always strung out by the time she gets home). She's like, "Are you still taking the chlortrimeton?" I'm like, "Yeah, but I've never had a problem with it. It doesn't even make me sleepy." And, that's when it occured to me that I'd gone back on the Entex because I felt another sinus episode coming on. Oy vey! So basically I've been a bitch and a half all week for like no apparent reason other than my own stupidity.

TMR

Fighting the power...

You know, as educated as I am about depression and anxiety disorders, I still fall into the trap of thinking "God, I should be able to do better, I should be able to focus more, etc." I've gone through some major changes over the past few weeks - our flood, throwing out Dad's stuff, realizing that I'm in love with someone who will never love me back, Uncle Chester dying, etc. And, really, maybe I am too trapped in my own head, but isn't that just part of the disease? I really find it strange that after 15 years I still buy into the stigma on some level. Strange.

TMR

The continuing saga of tmr...

Well, I am no longer allowed to call him at work, and since he doesn't return any of my calls to his cell after work I guess we're pretty much not friends anymore. And, hey, that kinda sucks! He was very sweet about it, but it's still a rejection of sorts. I know he has to work and such, but I pretty much don't exist in his life otherwise. I've never quite understood why. We used to talk on the phone and stuff, but he quit taking my calls for whatever reason. I guess that should have been my first hint. But, then, he still wants to talk to me at times. So, I don't know. Everything must be by his terms or his idea (even though I had pretty much called him the night before and said the same thing), and I'm too much of a pushy broad to let him get away with that. Also, he plays way too many games for me. Why do we always fall in love with the wrong people? The ones who don't want us around and have no interest in anything having to do with us? The ones who are total mismatches? I don't know. I don't think anyone will ever love me - not the way I need/want to be loved. I somehow wonder if sometimes I don't think love can exist without massive amounts of pain. And, I feel really like I'm clinging desperately to any and everyone I can just so that I'm not totally lost at sea. And, hey, the PMS isn't helping.

Anyhow, it's just been a rough week. My great uncle's funeral is today, and of course I'm not going. I don't do funerals anymore. Too many have come my way over the years. And, really, the man was a dead ringer for my grandma (his sister). I just know I'd lose it if I had to see him, and I really don't want to subject my family to that. They have major issues with any display of emotion - which is probably why I'm such an unholy mess most of the time. But, the truth is that I feel like I'm losing my grandma again. He was the last one of her siblings, and everytime I saw him he looked and sounded and acted so much like her. He and her younger sister were the only two people in the world - at least that I'd ever met - who had the same blue eyes as my grandma. None of their kids inherited them. It was just exclusive to that generation apparently. Strange.

And, to top things off, my confidante, Steve, is out of pocket at Twangfest. When it rains, it pours. I know I should learn to deal with all of this on my own, but I'm used to having a sounding board. It fucking sucks when all that falls through and you're alone with your own thoughts and time to stew.

TMR

Headache City, Baby!

Having massive migraines these days. Things are stressful here - not only because of death in the family, but also I'm in over my head on a few things. I didn't intend to get in over my head - I just didn't realize that I was until it was too late. Not a good feeling. And, of course, my first response was to ignore meals and go to bed. My shoulders have been achy too - not sure if that's the meds (which supposedly can cause flu-like symptoms) or all the time I spend at the comp for work purposes. Things are looking up on the paying gig front. I have a few more tryouts. But, this jeopardizes my non-paying gigs a lot because I've got tons of work from them, but MUST make the paying gigs my priority for obvious reasons. That's where I got in over my head. I didn't realize how much I'd agreed to take on until after the fact. It's so easy for work to pile up, it seems. Then, I get overwhelmed and shut down. Okay, I'm talking in circles again! LOL. Anyhow, the migraines could be stress or the summer storms which creep up on us so suddenly in June. Or it could be my meds. I'm hoping it's not the latter, as I actually do have more energy when I'm not PMSing (which I unfortunately am right now!). Sigh.

TMR

RIP Uncle Chester

Well, it's rainy and stormy here today, and when I phoned Mom this morning she said her uncle Chester - my gramma's little bro - died yesterday afternoon very suddenly. I'm so sad. We had been meaning to go show him grandma's pics for a while now, and it just never happened. He always looked like my gramma too. You'd think they were twins or something - same blue eyes, same face shape, same everything except he was about a foot taller. LOL. He had heart problems, so that's what happened. At least, he didn't linger in pain. Somehow that's always worse. YOu can get over the shock, but the images of someone you love suffering stay with you forever.

In other news, the bupropion is making me very up for the most part. I feel better, but my sense of humor is a bit out there - not that that's new or anything!

TMR

Even keel

Well, I think my meds may have finally kicked in...Unfortunately, I now have PMS. But, I had a much happier day today. Joking and such actually happened. So, maybe it's all gonna be okay. I just have to learn to ride it out when the bad times hit. Exhaustion still hits unexpectedly, and the sleep patterns aren't so great at times. One step at a time...

TMR

Man/friend/man-friend trouble...

How do you know when it's time to give up? How do you know how much of it is your perception and how much is the other person? How do you know you're not just being paranoid when you think the other person is trying to get rid of you? These are the questions I've been grappling with. Because part of me hates that cowardice that allows people to reject without having to appear unkind or hateful. Somehow, giving people the brush off non-verbally or by avoidance seems too easy and even more annoying. I just mentally go into Sam Kenison mode, mentally screaming "Say it! Just fucking say it!" I don't know how unfair this is to the other person - still grappling with that - but probably not anymore unfair than getting the brush-off after a year or so of friendship (or longer in some cases in the past). I don't know. I really am beginning to think I'm too generous with some people, but I don't know how to turn off my caring nature for some and not for all. Unfortunately, I'm a misanthropic caregiver. Plus, I see the worst and accept it, but I do expect people to cut me the same slack. Very rarely happens, folks! The world is lacking love, kindness and a generosity of spirit. That's why I always argue with people who say the internet is a bad thing because, if not for my friends here and over on yahoo groups, I don't think I'd be alive at this point. Anyhow, only two more doses of my antibiotics, thank god! I think they're making me a bit crazy. But, hey, it separates out the people who can hang from those who can't, even if that is painful.

TMR
Currently listening to Springtime Can Kill You whilst watching the visuals on her updated Windows media player. Is that a pathetic way to spend a Friday night?

Constant PMS? Oy vey!

Um, okay, I feel like I have constant PMS right now, even though it's totally the wrong time of month. I'm hoping it's just the antibiotics and not the Wellbutrin. I don't know if I can handle another antidepressant change this quickly. Sigh. Anyhow, too much caffeine tonight to try not to keel over, now I'm wide awake. Sigh.

TMR

NP - Elvis Costello & Allen Toussaint - The River in Reverse