Today's Thought 3/18/2011

Subject: Today's Thought 3/18/2011 Fri 18 Mar 2011, 9:08 am

Do I look to others when I'm feeling discouraged, sad, or lonely? Do I want someone to help me feel better?

I hold within myself the ability to be happy. I don't have to put expectations on others to make me feel loved or special. I don't have to look for a new relationship to be happy. I can find it within me. When I try to be happy because of other people, it means they have the power to take my happiness away. When I make myself happy, I'm the one in control of my emotions.

Today I will remember that I'm the one who's responsible for my happiness, not someone else. I don't have to look for someone else to fix my low self-esteem or attitude. Even though I can be upset by some people or feel happy when I'm with others, I'm the one who's creating these feelings because I have the ability to do so.

The only person who makes me feel a certain way is me.

Todays Thought is a reading from the book:
Time to Fly Free by Judith R. Smith

Number of posts : 4 Registration date : 2011-03-18

I am new and have been on subox for 3 months. It saved my life. This topic about us being responsible for our happiness is very true however is extremely hard for me to do. My abusing pain killers began due to one of the nastiest break ups one could ever imagine. The pain of what i was put through was like nothing ive ever experienced. No matter what i tried i could not find happiness from within nor without myself. Even many months later i am still unable to be the happy person i usually am. I hope that in time i will be able to recapture this aspect of myself but for now all i have is the pain of the betrayal and memories of when my yesterdays were filled with the joy of life and the beauty that was in it. I cant imagine ever being happy again.

Subject: Re: Today's Thought 3/18/2011 Mon 21 Mar 2011, 10:37 am

Good Morning motorek and welcome to the forum
I hope that in time your heart will begin to heal. Have you talked to anyone about what your going through?
Sometimes even as much as it hurts to think about loosing someone you've loved it's even harder to talk about that loss. And sometimes it's all we ever think about.
Even though we are responsible for our own happiness, sharing our hurts with others is a part of what helps us to heal.
I want you to remember that we are here for you. If you ever need to talk, let me know. If it's too personal to bring out onto the forum, you can send me a PM.

Number of posts : 4 Registration date : 2011-03-18

Dear Nannamom, i have been away for awhile and just got your e mail. I have spoke to a number of people regarding the horrible break up that started my using. It doesnt help very much. About the only thing that appears to alleviate my anxiety and depression is the suboxone. It stops my racing thougts and helps me to focus on the things that i need to do in the day. Without it i wouldnt be able to leave the house.

Subject: Re: Today's Thought 3/18/2011 Mon 28 Mar 2011, 1:17 pm

motorek
A lot of Suboxone patients have found that Suboxone does help with their anziety and depression.
There have been and still some and still ongoing studies with opiates in helping with depression.

Aims:
Until the 1950s opiates were often used in the treatment of depressive disorders (1). Because of the development of the tricyclic antidepressants, opiates fell into oblivion concerning this indication. However, only 2 of 3 depressive patients respond to newer antidepressants today, and even ECT achieves a remission-rate of only about 70%. Method: 3 patients (2f, 1m; 24, 39, 50y), suffering from major depression, were unresponsive to Tricyclics, SSRIs, Tranylcypromine, Venlafaxin and different combinations. Even ECT up to 14 treatment sessions remained unsuccessful. Subsequently, in an open label study patients were given Buprenorphine 0.8-2mg/d or Oxycodon 20mg/d as monotherapy. Results: In course of the opioid medication, within 1 week the HAMD-score decreased from 24.0 (range 19 to 28) before treatment to 4.3 ( 2 to 8 ) with opiate treatment, the BDI-score decreased from 27.3 (23 to 35) to 10.3 (9 to 12). Temporary appeared nausea, obstipation and dysphoria. Conclusion: Opiates can be a hopeful option in treatment-resistant depression (TRD), even if ECT fails. Our results confirm former studies (2), but a new aspect is that in some cases of TRD opiates can be more effective than ECT. Perhaps, in these cases the endogenous opioid system is more impaired than the monoaminergic systems (3).

Here's another one:
Source: American Journal of Psychiatry
Date: 156:2017, December 1999

Treatment Augmentation With Opiates in Severe and Refractory Major Depression
ANDREW L. STOLL, M.D. and STEPHANIE RUETER, B.A.
Belmont, Mass.
Letter to the Editor

To the Editor:
Substantial evidence supports the antidepressant efficacy of opiates (1). This report summarizes our open-label experience using the µ-opiate agonists oxycodone or oxymorphone in patients with highly refractory and chronic major depression.

Mr. A was a 44-year-old man with severe and chronic depression. Numerous trials of antidepressants produced only limited benefit. Mr. A also had an extensive history of opiate abuse, and he noted that the only times he ever felt normal and not depressed was during opiate use. Because of the refractory nature of his depressive symptoms and his apparent self-medication with opiates, Mr. A was given a trial of oxycodone under strict supervision. After 18 months of oxycodone treatment (10 mg/day), Mr. A remained in his longest remission from depression without the emergence of opiate tolerance or abuse.
Ms. B was a 45-year-old woman with bipolar disorder and opiate abuse (in remission for 2 years). A trial with standard mood stabilizers had failed, and she had experienced mania with several standard antidepressant drugs. As with Mr. A, Ms. B reported feeling well only when taking opiates, particularly oxymorphone. Oxymorphone (8 mg/day) was thus cautiously added to ongoing lamotrigine therapy (as a mood stabilizer), and she remained well for a minimum of 20 months without drug tolerance or abuse.

Mr. C was a 43-year-old man with chronic major depression that was unresponsive to numerous antidepressants with and without augmentation. Detailed questioning revealed that he once experienced marked antidepressant effects from opiates that he received after a dental procedure. There was no history of opiate abuse, and a cautious trial of oxycodone was initiated. Mr. C experienced a dramatic and gratifying antidepressant response from oxycodone (10 mg t.i.d. for 9 months) without opiate tolerance or abuse.

This report describes three patients with chronic and refractory major depression who were treated with the µ-opiate agonists oxycodone or oxymorphone. All three patients experienced a sustained moderate to marked antidepressant effect from the opiates. The patients described a reduction in psychic pain and distress, much as they would describe the analgesic effects of opiates in treating nocioceptive pain.
Two of the three patients described in this report were previous abusers of opiates. Although the clinical use of opiates in patients with a history of opiate addiction is usually contraindicated, in these cases there was a strong indication that they were self-medicating their mood disorders (2) with illicit opiates. None of the patients abused the opiates, developed tolerance, or started using other illicit substances.

We used oxycodone in three additional patients without histories of opiate abuse. In two of these three patients, oxycodone produced a similar sustained antidepressant effect. Two of these patients experienced mild-to-moderate constipation, and one experienced daytime drowsiness from the opiates. Opiates should be considered a reasonable option in carefully selected patients who are desperately ill with major depression that is refractory to standard therapies.

REFERENCES

Bodkin JA, Zornberg GL, Lukas SE, Cole JO: Buprenorphine treatment of refractory depression. J Clin Psychopharmacol 1994; 15:49–57

Khantzian EJ: Self-regulation and self-medication factors in alcoholism and the addictions: similarities and differences. Recent Dev Alcohol 1990; 8:255–271

I know that in my case, I feel better when I take opiates. Not becuase of the addiction but because it helps with anxiety, memory, energy and all around mood.

Number of posts : 4 Registration date : 2011-03-18

Nannamom, thank you for the information. That is exactly how i have felt, normal. My anxiety has been reduced aswell as my depression. My current doctor will not listen to me. He wants me off suboxone but is more than happy to provide me with any number of antidepresants that never work. It is so frustrating.

Subject: Re: Today's Thought 3/18/2011 Tue 29 Mar 2011, 8:12 pm

motorek,
If that is the case and your current provider wants you to stop taking Suboxone before you are ready it might be time to look for another provider. Certified Suboxone Providers are supposed to work with their patients.
No two people are alike and their treatment are different as well. If you need help let me know. I would be happy to help you look around.
Taking someone off of Suboxone before they are ready causes great risk at relapse.
I am here if you need anything.'

Number of posts : 4 Registration date : 2011-03-18

Thank you Nannamom. I have already done so through 'Here To Help'. My new physician is more than understanding however is a little bit of a kook in my opinion as he diagnosed me as bipolar with in 10 minutes. A rather hasty exam to make such a diagnosis i believe. I have never had any problems with depression or anxiety prior to the horrible ordeal that struck my life. The vicodin,especially at the amounts i was taking,amplified my emotions to an uncontrollable level thus causing me to experience the degree of mental pain that i have been having. No doubt my chemistry is still compromised and will be for some time. This didnt happen to me in a day and will no doubt take time to correct. The suboxone is helping i believe. I am currently taking 8mg once a day.

Subject: Re: Today's Thought 3/18/2011 Tue 29 Mar 2011, 10:53 pm

Glad to hear that you do have another provider. A ten minute diagnosis for Bi-polar.
I guess modern medicine is more advanced that I thought.

Probably diagnosed you due to mood swings, depression etc. But with everything that you have been through, I'd think he'd expect that.
Take care. As always I am here.
We have a new member who is starting Suboxone tomorrow afternoon, her post is over at the "Introductions" area of the forum. Her post is titled "Starting Suboxone"
If your up to it, see if you can pop over and tell her hello and share your induction experience with her, I'm sure she could use some encouragement right about now.
I will check back in later,

Subject: Re: Today's Thought 3/18/2011

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