Lindsay Lohan

[jannieC]

Originally Posted by Nikolaj

I like you, and I believe you, Jannie, but that is my diagnosis, 'low grade clinical depression'- it's a term I have heard for almost 9 years, and my doctor, who is an MD with a masters and phD, told me that the 'usual' anti-depressants (such as Prozac) will have absolutely no results when taken by someone with defective opitate receptors, which I imagine can be caused by a number of things, but in my case, was caused by this chronic 'low grade' depression. "It's just how you are and have always been" was part of her explanation, "and there's no cure, and that's why the anti-depressants don't work for you."
From your description, it sounds like that it's possible she meant 'Dysthymia' but didn't use the term with me. She said for certain I had malfunctioning opiate receptors, which is why we had success with opiate drugs- if you have the damaged opiate receptors, the Prozac, Zoloft and Effexor can't work, and I believe that, because I was on them all. Sure, everyone is different, I agree. My sweeping generalization was an uninformed, ignorant thing to assume, that 'my' case would apply to all others, but I thought, surely, to some others.
I'm surprised that you, a therapist, would say there is no such thing as 'low grade clinical depression' when I was told I have it, that I have likely had it since I was 8 years old, that there is no cure, but the opiate drugs were found to be of use in managing depression in many patients who'd had no success with the standard route of anti-depressants because of damaged opiate receptors. I'm surprised, but not angry or even saying you're incorrect. Maybe my doctor was 'talking down' to me and purposely didn't use 'Dysthymia' --but from your description, it's either that, or the 'mild' form of clinical depression that I have, for which she says there is no cure.
It'd be so 'like her' to say 'low grade' instead of 'mild'.
For almost 10 years, she's written me multiple prescriptions, and invariably, on 1 or 2 of them, she'll properly spell my name, and on the other 1 or 2 scripts, she misspells my first name, Nikolaj, which isn't that hard to spell. I think she has some ADD, herself. In my early years going to her, it wasn't unusual for me to have to return to her office when the pharmacist would note she hadn't included her DEA number on the top of the prescription, or had a cross-out on a controlled substance, which is not allowed, and she had to have known. She's 58 years old.
So, there have been bumps along the way, and red flags for sure, though the past 5 to 7 years have gone smoothly until about a week or so ago.
I'd like to hear more from you, whenever you have time, but don't expect free medical advice, and I do have resources, thankfully. So, whatever you decide or don't is kewl, I know you come from a good place.
My dad swears that it is time I change doctors, and with the reaction I had from the Suboxone, I am considering it, because I think I would have died- the next day- if I'd taken it again, and she wanted me to continue, and I found strength I should have known I had, and listened to myself and the 2 pharmacists good enough to tell me the truth, that the real danger was in continuing the drug, especially with my severe, violently ill physical reaction to it ("that just means it's working", my doctor told me) and a psychotic reaction I'd never before had with any medication.
This is not a comfortable subject for me to discuss, though I've done ok these past 2 days here, and there are medical forums where I've been helped a lot and that's really where I prefer to get into this. The Lindsay Lohan jail sentence really hit me, though, and the lack of compassion for her generally (not specifically here on The Ledge) got me thinking 'there but for the grace of God go I", but then, I was never an in-demand starlet, and knew when the hell to stay home when I was feeling worst-- or, when, rarely, I was feeling too good.

What I meant was, there is no such thing as a clinical diagnosis of "low grade clinical depression." The phrase itself is not accurate but I could see how a provider may describe it that way. I tend to be very blunt and open with clients and tell them as much as they want to know about their diagnosis. so, if I had a client with Dysthymia, I would say the world "Dysthymia" and then explain what that meant. Your defective opiate receptors and your depression are two different issues. I work with many clients who are either recovering from addiction or struggling with Dysthymia (or both) and are doing wonderfully on a combo of anti-depressants and therapy.

I don't want to contradict your physician, but the statement, "It's just how you are and have always been" was part of her explanation, "and there's no cure, and that's why the anti-depressants don't work for you." makes me uncomfortable. I have never heard a peer make this type of statement. What is that telling you? That you are doomed to a life of mild depression and because you damaged your opiate receptors by abusing drugs, you're doomed to a joyless life? I simply do not agree with that. There *are* clients with very severe and recurrent depression who do not seem to respond to medication. I am working with a client like that now. She is considering ECT at the suggestion of her physician. That does happen.

I am not a substance abuse "expert" but it is my understanding that opiate receptors don't become damaged, but rather depleted. Over time, you will "heal" and begin to feel pleasure again, but it is a slow process.

I'm sharing this publicly right now, rather than via PM because I wanted to clear up a misconception. Feel free to PM me if you want to have a private discussion.

[Nikolaj]

Thanks for your reply, Jannie.
First, I've never abused illegal drugs*. My opiate abuse began in the past few years, after I'd been on them for at least four years. It was many years ago when I'd been informed of my 'defective' opiate receptors, long before I had any dependency of any kind, on anything.
I had been told that my effed up opiate receptors are due to depression of about 30 years that hadn't been treated, not because I had used heroin- I never once tried it even, or any hard drug. This was told to me close to 8 years ago, after my doctor saw improvement after I initially began the Percocet. I was lead to believe it was not 2 separate issues, the depression and the opiate receptors, in my case, as the receptors were preventing drugs she expected to work from being of use at all. If it weren't for the Adderall, which I got in my first visit and helped right away, the first year would have been a total disaster, as we tried 5 different (or 6?) anti-depressant drugs, all for a few months each. Eventually, we found the opiates worked. Yay! But they get very hard to take as directed!
*I loved pot in my 20s, technically illegal, but she never said to me the pot smoking caused my whacked-out opiate receptors and I'm not certain I abused pot, but I liked it, greatly!!
('Shoulda just become a full-on pot head' has entered my mind tons during the past decade of hit or miss legal drugs.)
I quit smoking pot because I didnt want to do anything illegal and figured maybe I could stop self-medicating and get 'well' and, perhaps, yes, get an alternative legal buzz.
And yes, I had a similar reaction to yours with her comment 'Its just the way you always have been and there's no cure"- I was 'great. good to know that.' I don't know what I thought about all that, really. The opiates were helping, at the time I wasn't taking them long and wasn't taking too many, and thought 'I feel better than I did'.
Lastly, I thank you, because from you was the first time that I have ever heard that the opiate receptors do have a chance of repairing or regenerating, even if slowly, and I had never been told that before. I feel actually a little bit hopeful, useful tonight.
Thanks very much. I think I'm going to listen to my dad and get a new doctor.
PS- I've never had shock treatment, which you said happens sometimes, near the end of your message, and it hasn't been recommended.

[jannieC]

Quick clarification: NOT a doctor, here. I diagnosis mental illness all day, every day, and treat with therapy. I do NOT prescribe medication and don't advise on medication. I have a working knowledge of what does what, but that's it.