I’ve been taking my meds on schedule but for some reason I can’t get my body to calm down. I fall asleep for a few minutes and then jerk awake in a struggle to get free of imaginary restraints. This happens over and over.

I’ve had about enough of it.

Or just reassure me that there IS useful and valid information on the web for consumers to find, if we know how to look for it. My depression and PTSD make it easy for me to be suspicious and critical of everything. I value rational skepticism, but I don’t want to let myself slide into that bitter and faithless state of mind… you know the place. It’s so dark and boring down there, and there’s never anything to giggle about. There’s no joy.

It’s nice to know there are so many options… or is it? It strikes me that these conditions are all quite different from one another. The ruminations and compulsive rituals of OCD don’t look much at all like the flashbacks, nightmares, and existential despair of PTSD. (Note: some people do suffer from both OCD and PTSD. However, OCD often begins in childhood and seems to have a strong genetic component; in contrast, PTSD is not inherited and its diagnosis relies on a history of psychological trauma). The symptoms of SAD sometimes overlap with those of PD, GAD, and/or PTSD, but it also has interesting associations with avoidant personality disorder and body dysmorphic disorder… sheesh, I think my brain’s gonna explode.

Anyway. The point is, I’m not sure it makes much sense to group these disorders together. However, the SSRI antidepressants have had good results with all of them, so what do I know.

Other classes of medications commonly used to treat anxiety disorders include the benzodiazepines (short-acting tranquilizers, also called anxiolytics or sedative-hypnotics), BuSpar (an anxiolytic), Anafranil (a tricyclic antidepressant shown to be effective for OCD), newer atypical antidepressants like Effexor and Cymbalta, beta blockers Catapres and Tenex, and the anticonvulsant/mood stabilizer Topamax for PTSD.

The chart (cool as it is) doesn’t mention Topamax as an effective treatment for PTSD symptoms. I have taken Topamax on and off since I was diagnosed with PTSD in (um… I suck at remembering dates…) 2004. (Ok so I pulled that date out of my a$$, but I know I have had the diagnosis for at least four years.) It definitely helps with my nightmares and flashbacks, but hasn’t made so much as a dent in my fatalistic outlook or my sarcastic conversation style. Look how shocked I am. How dare that drug fail to erase my past and make everything all shiny-happy forever and ever.

Don’t expect to find detailed information here. I checked out the “Patient Information” page for Effexor, one of the medications I take, and most of it was a reiteration of the safety alert from 2006 regarding serotonin syndrome.

Speaking of Effexor, here are some things I’ve learned about it as a consumer. Painfully obvious disclaimer: the following should not be taken as fact, and it won’t be true for everyone who takes this medication.

I take the short-acting form of Effexor. For a brief time I tried switching to the sustained-release form (Effexor XR), but it didn’t work as well so I switched back. My dose is 150 mg twice a day, which is on the high side. I’ve been on this dose for several years with excellent results; it’s the first antidepressant that has not stopped working after a couple of months.

When I miss a dose of Effexor I feel really awful, both physically and emotionally. This withdrawal effect sets in about 6 hours after I fail to take the regularly scheduled dose. It’s quite intense and unpleasant, more so than the withdrawal from any of the other antidepressants I have tried previously (these include Prozac, Zoloft, Paxil, Celexa, and Wellbutrin). On occasion I have been so disoriented from the withdrawal that I’ve forgotten the following dose too… not good.

Other side effects I have had from Effexor are nausea, insomnia, and severe sensitivity to caffeine. The nausea went away quickly after my body adjusted to the drug, and the only time I experience it now is when I don’t drink enough water. Insomnia is a chronic problem for me, so it’s hard to know how much (if at all) the Effexor contributes to that. The caffeine sensitivity has persisted, so I only drink decaf or half-decaf coffee now.

Consumers of psychiatric drug treatment are generally advised not to drink at all, but I have to wonder how many of us disregard this recommendation.  Food and wine are pleasurable for me, and I’m one to take pleasure wherever I can get it (as long as it isn’t harmful to me or anyone else).

Do you drink?  Please share your thoughts and experiences on mixing alcohol with psych meds.

First, here’s an article addressing the stigma of psychosis. Dr. Tony Benning describes a more progressive, spectrum-oriented view of psychosis that acknowledges the commonality of hallucinations and delusions among people who do not meet diagnostic criteria for a psychotic disorder. In other words, many sane people have experienced occasional psychotic symptoms. If we are willing to recognize that the experience of hallucinations and delusions is not limited to individuals diagnosed with psychotic disorders such as schizophrenia, perhaps we can start to bridge the gap between “normal” and “crazy.”

And now that I’ve given an entire paragraph to a doctor, it’s time to honor the consumers. Anyone who hasn’t yet visited the National Mental Health Consumers’ Self-Help Clearinghouse should take a few minutes to check it out (if you’re like me, you’ll end up browsing for hours… whoops, so much for doing the laundry). This site has a lot to offer and I am very much in support of its mission.

More links and commentary to come. At the moment, it really is time for me to do some laundry.