Medication-free depression?

[SoMuchKombucha]

I'm struggling quite a lot with moderate depression (with some very dark days in the mix). I have other mental health issues, too (anxiety and complex trauma, for example), but the depression seems to be what's sucking the life out of me most these days. I've had "all" the meds (not literally all, but enough), and getting off them has been a nightmare, and going back on is not an option I will ever entertain (some of the side effects haven't ever even gone away, I'm not willing to risk more).

I feel like I'm already trying so hard. It sometimes feels like my whole life is nothing but endless mental health maintenance! Currently I try to manage things by:

• Having a set routine and mostly forcing myself to stick to it.


• Eating well and in a healthy way.


• Exercising six days a week, including daily time outside in nature.


• Trying my best to sleep well, but I have chronic insomnia, and sleep hygiene and sleep restriction haven't helped me very much, so it's a hit and miss.


• Having talking therapy.


• Forcing myself to go out to do a hobby every week with people, even though I really don't enjoy it.


• Trying to do some very basic mindfulness, although honestly I hate it.

But am I missing something else that anyone could throw in as a suggestion to try?

I feel like I'm having to hide how bad I feel from my GP, therapist, DH and other people because everyone will just tell me to take medications. And when I don't want to take them, the attitude is often a shrug and a "well, I guess you'll just have to suffer then - upto you!" - even though these are the same people who were around when I've been on all the various meds, and was depressed despite them, with added side effects. I do understand that no one likes a moaner, but it gets hard to hide and try to pretend. Sorry if this comes across as moaning! It just gets tiring to constantly try to force myself to do things I should somehow enjoy, while my brain is just moaning at me about how much it wants to die.

But not wanting to try more medication is a symptom of your problem, so you’re just going round and round in circles.
And you’re doing things you don’t want to do - hobby and mindfulness - so stop doing them.

I think you have to persevere with medication and find the right one. There's no cure for depression, (well there probably is but its years and years of therapy with highly skilled and specific professionals).

Have a read of Lost Connections by Johann Hari. It's an amazing book and there's a Ted Talk if you want a taster of his book.

thelostconnections.com/

www.ted.com/talks/johann_hari_this_could_be_why_you_re_depressed_or_anxious?language=en

Yes, there are cures for depression and no, they do not take years and years of therapy, etc. Where did you get this information from?

I wasn't aware that there were cures for depression @Eyesopenwideawake - would you care to share them with us? Many many mumsnetters plus millions of other people suffer with depression so it would be great if you could let us know what the cure is please.

Have you tried an SNRI like Venlafaxine?
I'm on a very high dose, 337.5mg MR a day. Probably for life.
I just feel down occasionally then I can feel the med lifting my mood again within an hour literally.
I had major depressive disorder but now that's an old diagnosis thanks to the Venlafaxine working well.
I do get some side effects but it's worth it not to feel suicidal and miserable every day.
I do find if I have even one glass of wine it affects the Venlafaxine so I don't drink alcohol at all.

Also I find that taking the contraceptive Pill to stop my periods has really helped with the bad PMT I used to get.

I needed the right type & dose of anti depressants in order to even function & to start doing the things like therapy & exercise that help with depression.
At one point I couldn't even pour out a glass of water, I was so low.

(My other more recent mental health diagnosis is Schizoaffective bipolar type after a psychotic breakdown; which I take anti psychotics for and I tend to get hypomanic with the bipolar type rather than low in mood. I see a psychiatrist 3 monthly).

@Eyesopenwideawake - Thanks for the links - I'll have a look.

As to all the comments about persevering with meds, I persevered for 20 years. Several different SSRIs, a tricyclic, mirtazapine, (no SNRIs as venlafaxine is a no go due to some drug interactions that I can't recall) benzoes, z-drugs, two antipsychotics, all at various doses for various time. I'm utterly done playing the game of neurotransmitter guinea pig. Honestly, I have no faith left in me towards the mental health services in general, so I even get my therapy elsewhere these days.

I'm not looking for a "cure", just ways to function, and to hopefully enjoy something at some point, I suppose.

The mindfulness is somewhat helpful despite me hating it, which is why I keep it up. And the hobby is my main way to socialise outside home, and I feel it's important to keep up some connections, even if it's not currently bringing me any joy.

I get evil side effects from all of them too. But persevered with Ven and have got there in the end.

Could you try Ketamine therapy at Oxford NHS? I think you pay for cost of infusion, but part of it is on the NJS.

@DenholmElliot1

There are many cures for depression, it's a matter of finding the right one, or combinations of several, that work for the individual. We are not born with depression, it is a construct of the mind. You can't see depression on a brain scan.

Anxiety can be the architect of depression - closing off every avenue of light with fear and dread - or it can be situational from trauma or loss. No matter what the cause, depression is the loss of hope. But hope can be found in the knowledge that these feelings are not permanent and that they can and will change. It sounds trite but anything the mind can learn, the mine can unlearn.

Whether it be diet, exercise, therapy, a change of circumstances, an acceptance of altered circumstances following a loss or trauma, medication or a combination of all of the above - depression is NOT permanent and IS curable in the vast majority of cases.

I thought it could be viewed on a scan, The amoglyda or whatever gets smaller?

We are not born with depression, it is a construct of the mind but it can be genetic, and you could be born into conditions that promote it.

I’ve had it all my life and it became chronic about 28 years ago. So no, mine isn’t curable.

With moderate depression I couldn’t have managed without medication. I also did CBT, got outside each day and took gentle exercise. Focused on self care and making myself fo the things I used to enjoy.

Mumsnet is very pro medication, so you'll get alot of replies saying try more meds, despite you saying you don't want to risk it.

What kind of therapy have you tried? I notice you mention complex trauma. Is that still ongoing? Have you tried EMDR?

Your post really resonates with me. Sounds like you're really doing a lot and trying to get rid of the black dog. Perhaps a different therapist? I found someone a few years ago that really helped me, more so than anyone else I'd previously seen. I recommend The compassionate mind - Paul Gilbert, it's helped me in the past. Is there anything you get any pleasure from? Maybe a change in your exercise routine, try something new, maybe a new class or intensive course. It's really hard and living with repeated bouts of depression is exhausting.

@flashbac - Yes, so I see. The mental health chat often looks like it might as well be called medication chat. Oh well.

I did have a course of EMDR on the NHS (a miracle, I hear), but I actually think the chemistry with the therapist was really wrong to the point that it sabotaged the actual treatment. I've also CBT, of course, and a long stint of psychodynamic when I was much younger. The private one I see now works a lot with complex trauma, and we have good rapport, and I have found her very helpful. The trauma doesn't affect me as much now as it has in the past, although I feel like chronic sleep issues, anxiety and trust issues will always be with me. I don't get uncontrollable flashbacks and stuff like that anymore.

@alwaysorange - Thanks for the book recommendation. I'll mark that down. I have no focus for reading, but I've been listening to a lot of Matt Haig lately on audio books, even the fiction, and those have often resonated. More books to try is always welcome. Talking of a change in exercise, I'm forced to do that right now due to some minor injuries, so I've been doing more nature walks over gym sessions, and it's not a bad change so far. I have been very very set on my routine, so maybe mixing things up more often is an idea.

Yes, you're right that untraceable/unexplainable depression can be genetic or due brain damage in very small number of cases and yes, there is some evidence that there are differences in the brain with someone with a "major depressive disorder" - www.healthline.com/health-news/mri-detects-abnormalities-in-brain-depression#Welcome-to-the-connectome

What happened to you 28 years ago, if you don't mind me asking?

Interesting @Eyesopenwideawake that there can be differences in the brain in people that suffer serious depression etc.... I've also got epilepsy and my birth was traumatic so possibly the epilepsy was caused by that.. my mental health illnesses have seemed to be caused by chemical or brain differences rather than genetics or past lived trauma.

For me personally I abstain from alcohol completely, even a small amount puts my mind in a very very dark place, abstaining completely has been life changing for me and I've seen a huge improvement in mental health.

Secondly reading gives me an escape so I do it as often as I can. Not self help books but actual stories, usually a good thriller with a twist that keeps me guessing and provides my mind a temporary escape.

Hot baths with various nice smelling oils pr a long hot shower help me and I usually light an insence in the bathroom as well

Listening to good music while cleaning, its hard for me to get started but once its done i always feel great (this one I don't do often enough)

These are all just random little things that I find help me day to day with my mental health.

I’m cautious on threads like these because I think it can be dangerous to encourage people not to take meds. But I’ve had problems too and I’d rather stay off the medications if I can - with the proviso that I will reconsider if my problems are impacting my dc.

I do put a lot of effort into my MH - I can relate to that word endless. But what I’m doing differently from you, I think, is seeking pleasure and self awareness. I’m finding the things that support my well being, and leaning in to small joys.

It absolutely is an effort to get outdoors on a bad day. And it’s tough to get a workout started but both feel worth it once I get moving. If you’re not getting that, drop the hobby and mindfulness and search out your thing.

Rapport is vital in therapy - I’m glad you’ve found someone good.

I’ve discovered that hormones play a significant part in my moods. That’s something to watch if you’re on contraception, or getting into peri. And I discovered I had ADHD in the last year which had presented as anxiety and depression. Learning how to move with my rhythms and impulses, and to work with my neurology has been a game changer.

I’m learning about the medications for adhd before I make up my mind about whether I want to try them and one thing I learned is that it’s not unusual for ADs to be ineffective in people with adhd because the problem is with dopamine rather than serotonin.

I’m not saying you must have adhd of course, but just that getting to know yourself with kindness and curiosity, may reveal something else that hasn’t been obvious yet.

I’m very low right now, because I’m dealing with post covid fatigue and the speed of my my inner and outer worlds aren’t matching. It’s probably the worst I’ve felt in a long time, and some of my normal MH strategies are out of reach, but it’s a tiny bit easier because I feel I understand where the issues are coming from, and I have faith it will pass.

28 years ago l turned 40. I think it was the perimenopause. I’ve had it since then. Can’t take HRT. I’d had it off and on since then, the longest period being 5 years.

l just couldn’t cope without medication. I hate to say this, it sounds awful, but l think people who choose not to use medication can’t be that bad. I couldn’t function.

I hate my tablets, they all give me evil side effects. But I’m not sure I’d be here without them.

@ArseInTheCoOpWindow People chose whatever they feel works for them, be it medication, therapy, mindfulness, etc. I guess the intensity of the condition is very subjective but I can't agree that the choice not to take medication means that it's not that bad; it's a choice. Thank you for sharing your story.

@Justkeepon - Oh yes, I also don't drink at all. I quit because of some physical health issues, but it has had a minor help with mental health, too. I used to get very deep despair in the early hours if I couldn't sleep after drinking, and those are gone without the alcohol.
Glad to hear reading, baths and music help. Those are all things I keep trying, because even if a lot of the time they don't seem to do anything, there's always chance! Audio books while doing chores are my go to right now.

@Trivester - I probably should've been worded things in line of what things other than meds people in general find helpful, rather than "medication-free", since I don't have any opinions on other people taking them. They must obviously help some people, and that's great. I'm sorry you're dealing with a bad period right now, but glad you're able to see better times ahead.
I would actually say that I, too, try to seek pleasure and self-awareness. The pleasure part I find incredibly hard to find, though. The only thing that semi-reliably gives me a small sense of pleasure are post-exercise endorphins, and there's only so much you can lean in to that, before it starts becoming a problem in itself. Very occasionally being alone in nature, or catching a funny podcast, or feeling a fleeting moment of human connection with someone, will give me a happy feeling, so I keep at trying those, and plenty of others. Mostly the "pleasure" things in my life seem more like distractions from the bad, rather than actively good.
As to self-awareness, I'm better at it theoretically than emotionally, but years of therapy, reading, talking, journalling, thinking etc does bring some of it. The journalling is yet another thing I do because I can see and feel how beneficial it is, yet actively dislike actually doing it! (I've tried to replace it with apps and other things, but those were never the same. Something about hand-writing a journal seems to do it for me better.)
I'm getting into the peri territory probably, so that is a thing I'm looking out for. So far no obvious signs of hormonal changes. Fingers crossed for not too many spanners in the works.

@ArseInTheCoOpWindow - The idea that "l think people who choose not to use medication can’t be that bad" makes the completely incorrect assumption that medications actually help everyone who takes them. Even the drug makers' own research has never tried to claim success anywhere like that. I've been on psych wards, I've spent years absolutely not functioning (although never have I been worse than on a coctail of unsuitable meds). Of course misery top trumps is a game where everyone loses, and there are definitely people worse off than I am, but your assumption is a bit insulting.

What about trying crafts - making something does give you a feeling of achievement.
Work your way through the options - knitting, sewing, painting, etc
You won't be a master craftswoman in a couple of months. If you do get into something you then have an interest in the subject and learning more is rewarding.
Can't you think of any treats - lying on the sofa once a week watching a great movie? What did you like as a child?

@CherryReid - Thanks, I could definitely try out some more crafts. I do some occasionally, but haven't done a lot lately.
I can't seem to think what would really count as a treat for me, to be honest. DH and I try to sit down with a film or a program, but there's not much I find myself enjoying. (I managed to both focus and enjoy an entire film four weeks ago, and it was a very rare but lovely thing!)
Now that you mention it, I do actually have two special interests that I've had since childhood, and when I have the focus, I like watching documentaries, Youtube videos or online lectures around those, or even reading when I can. It's very hard to get into that on days when I'm very sleep deprived, brain foggy or more low in mood, but maybe I should make more of an effort. The best thing about them is that they can take me out of my own head, out of thinking about my own life and things around me, and into thinking about the world in general.

Apologies for my writing this morning, by the way! I must be really tired and losing track of my sentences in the middle of actually writing them!

Do you have a pet? My dog brings me happiness because they are so loving and loyal.
Also, do you have a faith? I do and I read my bible when times are tough. A lot of MN doesn’t like God but I do and He brings me great comfort.