Saturday, September 06, 2014

California Rocket Fuel

I had a post in 2008 about the all-or-nothing antidepressant combo nicknamed California Rocket Fuel.  It has been in my top ten posts most months ever since, though it has only attracted a few comments. A new one came in tonight, quite excellent, which prompted me to reprint it.

Depression is miserably hard, lying to you and telling you it is the normal state of affairs and will go on forever, when in fact is more usually has a beginning, a middle, and an end.  One of the extra discouragements is that people use the term "depression" in everyday conversation for far less painful conditions, such as grieving, feeling sad, or having low energy.  Depression does not even always include sadness, though it frequently does.  A few times a year my mood drops enough that I qualify for a diagnosis of Mild Depression, and a few times in my life that has become Moderate Depression.  Even Mild Depression, according to clinical standards, is hellish.  When I float back up out of it, I am enormously grateful that I don't have depression at the level I see at work.  Severe Depression can mean having such low energy that you soil yourself in bed because you cannot muster the energy to get up and cross the hall to the bathroom, and don't really care that much that other people are horrified to be with you.

Bear that in mind when you are tempted to describe your blue funk as "depression." You could be kicking someone one more time while they are down.  BTW, let me put in a plug for ECT's here.  They don't work on personality disorder/PTSD-style depression all that often, and only slightly more frequently on Schizoaffective Disorders.  But they can be absolutely magic for some patients. And for pregnant women who don't want medications on board while they are carrying a child, electrical treatments can be a godsend.


james said...

I know they sometimes work (though it left behind some self-reported fuzziness), but ECT always seemed like banging the side of the computer when the system doesn't boot. (BTW, if the problem is drive "stiction" that can actually work.)
Frustration mostly drives that analogy, I guess. Something radical that has no good reason to work works anyhow. Sometimes.

Assistant Village Idiot said...

I've actually used the analogy of rebooting the computer for ECT's

Texan99 said...

I had a friend in high school whose younger brother was born with severe physical deformities, basically no arms or legs. The father fell apart and left; the mother was absolutely prostrated. They used ECT on her, with apparently good results. This was in the 60s, I guess. She wasn't depressed, as far as I know; she always seemed like an unusually healthy, strong woman to me in the years after, while she raised her son to have a remarkable level of independence. But ECT sure looked like it enabled her to climb out of a total collapse.

Anonymous said...

None of your blog posts are impressive to me. Why?

Aren't you in the BGI study?

And depression. GMAFB!

It's 100% pure IDEOLOGY unless it's due to drug withdrawal.

There are good reasons to be depressed, but the locus of pathology is always "found" in the individual rather than in the mismatch of individual and society or anything else. That's ideology at its finest.

Read the unabomber and check out this chart

My SATs would've done it too, but I couldn't find them.

My bona fides:

Assistant Village Idiot said...

Simplest answer: I do this for a living, and you simply have no idea what you are talking about.

I did venture over to your site a few months ago, BTW. If you observed yourself half as well as you observe others you would begin to see.

Texan99 said...

Wait, that was a real comment? I thought it was A.I. spam, though with a few refreshing bits of quirkiness compared to the usual "Hi, I was reading your blog" posts.

It's not often people appeal to their SAT scores to win an argument.

Assistant Village Idiot said...

It's real.

Anonymous said...

recent research with PTSD folks in the military indicates repetitive transcranial magnetic stimulation (rTMS) reduces suicidal thoughts & depression
i'm no conspiracy theorist, but it seems odd that rTMS can only be used after all drug treatments have failed. i.e., do drug companies try to squelch non-drug treatment? hmm.

i worked on psych wards in IL back in the 80s & many of our folks swore by ECT - it worked well for them.

Assistant Village Idiot said...

rTMS is expensive and insurers don't normally approve it until cheaper stuff has been tried.

I have also heard good things on that front, but other reports seem to indicate it's no better than standard treatment.

Anonymous said...


Then why do so many like yourself agree with me.

I quote a PhD clinical psychologists:

"I have never had a patient where I couldn't say that I would also be depressed in their situation."

I think maybe the senility is setting in old boy.

Anonymous said...

My site?

I don't have one?

What are you talking about?

Assistant Village Idiot said...

A. Then your PhD clinical psychologist only treats outpatients. I have had many patients who don't have a particular reason to be depressed, yet are from time to time. The research isn't particularly ambiguous on this.

B. I clicked on your name months ago and it brought up the google record of many places you had commented around the net. I read a fair number of them. Granted, that's not the same thing as a site. I remembered wrongly, as I did get a fair sampling of your opinions, and thought it must come from a site of yours.

Terribly wrong, I'm sure. Such things shouldn't be allowed.

Anonymous said...

My clinical psychologist?

He has a fucking website. His name is Phil Hickey. Here are two others Thomas Saetz, Jay Joseph.

Get a fucking grip. Or at least start on the Aricept.

The research?

OMG. You have no background in natsci. Do you?

That's the problem.

All commissars are eventually victims of the system to which they belong.

Assistant Village Idiot said... further evidence, just insult.

Game over.

GraniteDad said...

Oh papa! A real troll, of our very own! Please, papa, may we keep him? We haven't had one in ages, and mother won't object!