I take Effexor. I was first prescribes Zoloft; that didn't seem to have any effect at all. Then I tried Wellbutrin; I probably could have taken cocaine and been more relaxed, and, as a result, I stopped taking that after less than a week and ended up so leary of anti-depressants that I toughed out my depression for 2 years rather than try any further medication.

Now, I've been taking Effexor for around six months, perhaps a little more, and, so far, it seems to be working pretty well. My general mood has definitely increased, and, although I am still sad quite often, my sadness is not as biting as it once was and is much easier to manage.

The only side effects I have noticed are decreased appetite and a chronic cough, both of which have lessened the longer I have been on the drug.

I know a lot of people have had negative reactions to Effexor; I, obviously, am not one of those people. A healthy lifestyle did not affect my depression. Regular exercise did not affect it. Religion did not help me, and therapy helped me only a little in the short term. Vitamins and supplements seemed nothing more than placebos, and Zoloft and Wellbutrin certainly were not helpful. Effexor is the first thing I have tried that I can honestly say has markedly and consistently decreased my feelings of sadness, and I am very greatful for that.

having been on both paxil and effexor i did find effexor to be the nastier of the two as far as withdrawing from them went---they otherwise caused about the same amount of other uncomfortable symptoms. but I know lots of stories about paxil and effexor that in my mind make both worthy of being called the 2 worst of the antidepressants.

I've stayed away from Effexor and Paxil because of the reports of bad side effects. Even avoiding them, I have my own horror stories about Zoloft and Wellbutrin.

There still is no way of knowing how you will react to a particular medication.

In the years I took Effexor in the late 1990's I had a leg EMG, brain MRI, several "migraine" prescriptions and a dental gizmo to treat tooth grinding... all due to side effects that no one told me about and no one seemed to be aware of.

But the most dangerous thing about this drug, by far, is the intensity of the withdrawal and the speed with which it comes on. I could find myself swamped, despairing and half-suicidal if I was 4 to 6 hours late with the dose. Again, this was something I had to learn for myself, because "withdrawal" from antidepressants was something that did not yet exist.

The most dangerous side effects are the ones that the patient does not KNOW are side effects.

I was on Paxil. No problem except it didn't work after a year. Gained 8 pounds which I've never been able to lose. Then on to Effexor for 8 years. I did well on it. Except that my FMD couldn't understand why my BPressure suddenly was out of control. But when the anxiety & panic returned, I knew instinctively that effexor was the culprit. And getting off was a nightmare because guess what? Antidepressants didn't work for me anymore. My pdoc advised that I had run out of options when both Lamictal & Lexapro gave me terminal anxiety & profound depression. I got smart. (briefly, LOL) I did hours of research & finally found that the vitamin/mineral/amino acid supplements did just fine. Not an easy task nor a quick fix while switching. But I feel much better & I found myself. Not completely well yet, but I'm getting there. The fog is gone & I can feel once more. dfh

Good point Leigh...no telling...since the question wasn't made about Wellbutrin I didn't say anything but for me, by far, Wellbutrin was the nastiest anti-depressant I ever tried. And then Prozac. Both gave me instantaneous horrible, scary side effects. And neither have that reputation in general. For me Effexor was the third worst anti-depressant I've been on. But knowing what I know about anecdotal reports I know that my experience is not typical. At this point I think all anti-depressants are evil and I wouldn't go on one regardless of how depressed I became and that's a sworn statement.

I took Paxil for half a year; gave up because it was impossible to have an orgasm, and I'm a male. I took Effexor for a whole year; gave up because it was horrible. I was always hot, tired, and irritable, and overall more depressed. After I quit I got "electric head" for nearly two months. This where at random times during the day your head seems to have been hit by a lightning bolt, and you completely forget whatever you had been thinking about.

There's a happy ending: when I started on the proper dose of Wellbutrin my depression disappeared. I'm a completely different person.

Yup, anti-depressants have terrifyingly unpredictable results. But on the other hand, there are lots and lots of people they've helped.

I've been on both. I agree with Gianna. Effexor has far far worse withdrawal effects. I've been trying to get off of it for years. It has been the cost of my last two hospitalizations.

I would be interested in the vitamins/supplements solution posted a few posts up. We are about to try orthomolecular psychiatry after several antidepressant and other catastrophes encountered by one with bipolar with great emphasis on the depressive side of the scale.

Effexor and I go way back. I remember those little peach tombstone shaped pills very well. They caused bladder spasms which in turn caused problems with urine retention. With the higher doses of Effexor the spams got so bad that I ended up having to be cathed. Fun times. While I haven't heard of that side effect from others who have been on it, the urologist I was referred to said it was not uncommon in people taking higher doses of psych meds. I also had the hot flashes and excessive sweating. But by far, the worst part was the withdrawals. I (stupidly) went off 300 mg cold turkey - nobody had ever talked to me about how dangerous that could be. I was so miserable and freaked out from the withdrawals (projectile vomiting which led to dehydration and fever, the uncomfortable electricity type feeling running through my brain, wanting to jump out my skin, sobbing, extreme agitation, and the most intense suicidal feelings I had ever had) that I was soon begging in the ER for my Effexor fix. I did get relief once I got back on effexor. The next time I went off of it I gradually tapered down, but it was still hell. I will never forget that experience, and it's not one I would ever want to repeat. I've taken a lot of different antidepressants. I've also taken mood stabilizers. For me, nothing compared to the hell of coming off of Effexor. That was a bitch.

I will say this about Effexor, it did help my mood somewhat but it wasn't worth the physical/mental price I paid.

Ellen,
My blog is about my journey off meds and talks a lot about alternatives.

If you go to the "About" page there are links to resources for information on natural methods of healing, including support groups that discuss things that have worked for the members.

I learn new things everyday. It's a long process to learn about all the options and figure out what is right for you, but it is entirely possible. It's not just about vitamins but about lifestyle. Many many people who read my blog have freed themselves from psychiatry. I have yet to do that and I am still struggling with uncomfortable side effects of withdrawal, but my blog has brought to my attention many many people who are doing wonderfully well and succeeding in life better than they ever did on drugs.

I hope you visit.

http://bipolarblast.wordpress.com/about/

It's just a place to start...not a final answer.

Effexor was by far the worst antidepressant I tried...it did help me for awhile but the electric jolts in your brain and in your whole body are really disturbing. Getting off of it is just hell--I was SICK for months, really really sick. Never again.

Hi

I have also been on paxil and effexor. I personally found them both to be horrid in terms of side effects and withdrawal. However Effexor was far worse for me - I became psychotic and was put under compulsory detention (whoops I mean cared for in hospital). My story is on my blog http://allotmentjunkies.wordpress.com/

In the UK the National Institute for Clinical Excellence gives a special mention to Effexor in its guidelines for clinical depression. The link is here for anyone who is interested http://guidance.nice.org.uk/CG22/niceguidance/pdf/English.
It states that effexor is more toxic in overdose than other antidepressants and should only be prescribed after other antidepressants have been ineffective.

In terms of which is 'worst' we can talk in generalities, but as someone has mentioned the effect on the individual of either of these drugs can't be predicted. Whilst I would vote for Effexor as being the nastiest, most vile drug ever - other people clearly feel happier for taking it. Therefore informed choice has to be the way forward - not only so people can choose whether to take these drugs but also if it does go wrong users/family are able to see it is a side-effect/withdrawal and not assume they are getting more 'ill'.

My two rambling penneth in a nut shell.
Cheers Keener

Ellen, you might already have been here, but there
are a few good tips (methinks):

http://www.furiousseasons.com/archives/2007/10/meds_or_vitamins_as_cure_for_bipolar_disorder.html

"Why is it that 20 years after the introduction of Prozac we are still at the fingerpainting stage in treating depression?"

In part because nutrition has been ignored.
That's not the only reason, of course, but it
is a bigee. See above link (to Ellen).

"Why do we spend so much money and time on treatments that have very unpredictable results?"

Treatments will probably always have rather
unpredictable results. The brain/mind is too
complex (and highly-individual) for it to be
otherwise. However, that said, we can and should
be getting better results. See above.

Ellen, you might already have been here, but there
are a few good tips (methinks):

http://www.furiousseasons.com/archives/2007/10/meds_or_vitamins_as_cure_for_bipolar_disorder.html

Alan, I don't agree with the idea that bipolar disorder is an illness caused by chemical imbalances in the brain, but it does baffle me that most people who see bipolar disorder this way don't acknowledge that nutrition can effect chemical balances in the body. If "psychiatry" really believes in the chemical imbalance theory, surely diet should be addressed. In the treatment of cancer, diabetes and heart disease, among others, diet is addressed, not enough, but still it's addressed.

It does stand to reason that if you are in distress whatever the cause, eating a good diet can make you feel better....

Hi, Sally.

1) I buy that it is not an "illness" or
"disease". We just covered that one over on
the "vitamins/bipolar" thread:
http://www.furiousseasons.com/archives/2007/10/meds_or_vitamins_as_cure_for_bipolar_disorder.html

I don't buy that "chemical imbalances" have
nothing to do with it (whether or not they are
"the cause"; see, again, the thread above).

It is obvious that mood stabilizing substances
(lithium, valproate, etc.) have at least some
benefit for some bipolars; sometimes great
benefit. Surely these agents have chemical
mechanisms that result in the mood effects
(correct?).

Do these drugs correct "the cause" of
bipolar in the cases that they benefit?
Doubtful. But who knows? And more
importantly, who cares? The drugs, and omega-3
fats, and magnesium, and a bunch of other stuff
have value in bipolar. Not fantastic value, but
notable value. So let's go with them -- and
other stuff, too, whether or not we are
addressing the deep dark occult "cause".

I am slightly allergic to what I percieve to
be an obsession, sometimes, with "the cause".
I've seen a LOT of this in the alt med
community, and it can drive me batty. There's
lots of talk about "getting to the root cause",
which is accompanied by a lot of self-deception
and intellectual presumptuousness. WHO KNOWS
what he "root cause" is, anyway? And further,
do you really want to spend your life chasing
after obscure "root causes" that seem to
recede as fast as you move toward them? If
you can get to the "root cause" (or what
passes, for you, as such), for sure, in
a reasonable time, and at reasonable cost, then
great. Do it. Failing that, just treat the
darn symptoms -- which are themselves a large
part of the "disease"/syndrome or whatever
you want to call it. You either feel better,
or you don't, and it is important. A depressed
person's brain cannot recover as long as he/she
is depressed. So relieve the depression, whether
or not the "root cause" is addressed -- assuming
it can be addressed at all. Relieve the damn
depression, by any means that come to hand, and
give the beleageured (sp?) brain a chance to
heal... THEN pursue those foggy occult "root
causes".

Pardon this mini-rant, but I have
personally witnessed a life -- a fantastically
potential-filled life -- be almost completely
destroyed by this obsession with "the cause",
and the failure to get real treatment because
it is not thought to address "the cause".

2) Yes, of course psychiatry should be addressing
diet and nutrition. At least on one level they
"should". But in a more-mature analysis (so I
think), it is just as well that they don't. This
is something that people should be learning
about and doing for themselves. To hell with
the "professionals". (Roughly speaking. I mean,
they have their uses.)

All:

Pardon again that outburst about "the cause".
Seeking after that is often a noble and useful
thing. It is just that it can sometimes get
out of hand, and it can obscure what is right
in front of our eyes. Sometimes the symptoms
ARE "the disease", or whatever you want to
call it.

Alan, I think you make a valid point about obsessing over the cause but there are ways in which it matters and these ways are interelated with the definition of bipolar disorder and mental illness itself.

First, if I showed up in an emergency room bleeding from a gunshot wound, I wouldn't want the doctors to wait to treat me until they police had found the person who shot me, and the same can be said of someone who thinks they suffer from pathological moodiness or someone in an acute psychotic state - this is the first problem - with my gunshot analogy, the treatment has little to do with identifying the specific cause, however, with mental illness, reasonable people can differ on whether someone is too moody, or even psychotic and if it is determined that the subject is pathologically moody or psychotic it is crucial to determine why so we can know how to treat them. If someone on September 11 who was one of the few surviviors of the WTC bombing showed up at an emergency room that day "psychotic" an entirely differently treatment would be in order from the treatment for say Fuller Torrey if in the middle of a TAC board meeting he took off his clothes and started quacking like a duck. The entire field of psychiatry is based on classifying not behavior but the cause of behavior.

Furthermore, if it is, as I believe, and I believe all scientific studies have proven, the environment of the person that causes behavior labeled as mental illness, and particularly the childhood environment, the fact that once labeled mentally ill, one is much more likely to be infantalized and always under the control of the people who created the problem in the first place is not only counterproductive, but cruel, torture to the person labeled mentally ill. It's sort of like legally forcing the survivor of a gunshot wound to become a human target on a firing range or forcing the September 11 survivor to spend all of enternity watching footage of the explosion.

I think that all drugs should be available to all people with honest disclosure of all information available about the efficacy and side effects of these drugs even though I think these drugs cause more problems than they solve - sort of like stuffing a gunshot wound with cotton over and over again, not stopping the bleeding but preventing other folks being made uncomfortable by seeing the bleeding instead of stiching up the wound. And I believe the injured party has a righ to choose which treatment if any they recieve.

I am in complete agreement with you that nutritional supplements like Omega 3 and magnesium, etc can help anyone get better.

I agree you don't have to specify the cause to treat the patient. However, it is biomedical psychiatry's peculiar method to just declare the cause (you're bipolar because your neurotransmitters are out of control) and then consider that question answered. That's not science, just propaganda and wishful thinking.

And, of course, it's important to remember that a sizeable percentage of patients don't get the chance to question the stated causation and refuse dangerous and mind-altering drugs. Forced drugging is a barbaric practice and violates just about every principle of human rights.

What is the thinking behind vitamin theory, anyway? I eat a healthy, balanced diet with as many fresh vegetables as possible. Why should I take vitamins on top of that? What other animal requires vitamin pills in order to thrive?

Francesca:
"I eat a healthy, balanced diet with as many
fresh vegetables as possible. Why should I take
vitamins on top of that? What other animal
requires vitamin pills in order to thrive?"

What other animal has strayed so very far from
their evolutionary experience? By that I mean
that homo agriculturus (that's us) are living
and eating in a way that departs radically
from our historical, evolutionary experience.
The agricultural revolution (circa 10,000
years ago) changed everything -- and not for
the better. Humans promptly began to degenerate
while eating the new foods: grains, especially.
Chronic diseases like heart disease, arthritis,
dental disease, and others, which theretofore
did not exist, became common.

I agree that if you eat a healthy, balanced
diet OF THE SORT CONSUMED BY HUMANS AND
PRE-HUMANS IN THE ERA OF EVOLUTIONARY
ADAPTATION (some hundreds of thousands of
years), almost all of it in the raw state
(including the meat, fish and eggs), while
living outdoors and in the sunshine, naked
or near-naked most of the time,
getting lots and lots of exercise every day,
and living completely free of all the
pathogenic influences of urban-industrial
modernity (air pollution, light pollution,
noise, etc., etc.), THEN you ought not need any
nutritional supplements whatsoever. Does that
describe your diet and your life? Didn't
think so.

Some 22 years ago a team of authors (Eaton and
Konner) wrote a ground-breaking article in the
New England Journal, titled "Paleolithic
Nutrition". In it, they calculated the
probable nutrient and micronutrient intakes
of paleolithic man. Surprise! Paleo man was
continually exposed to very high
(almost orthomolecular-high, for some stuff)
levels of micronutrients, including all the
goodies that are now known to be related to
mental health: omega-3s, magnesium, ascorbic
acid, zinc, and many more.

The bottom line should be obvious.

But let me give one example, not covered by
Eaton and Konner. They looked at all the
"conventional" micronutrients. But there is
a lot of stuff in whole natural "paleo"
foods besides conventional micronutrients.
Glutathione, for instance. Glutathione is
a key tripeptide antioxidant, vital for the
liver, brain and immune system. You might
have seen the item recently on the use of
the glutatione precursor NAC (N-acetylcysteine)
in the treatment of bipolar. It looks real
good, though further trials are needed. But
here's the kicker: what is the best natural
source of glutathione? Raw foods, especially
raw meat, and especially raw liver and brains.
Fantastically high in glutathione. These were
foods that paleo man ate, routinely.

Meat is also a great source of carnitine,
creatine, carnosine, and other substances
for which there is increasing evidence of
value for the brain and mind. Creatine, for
example, is a cognitive enhancer, and is
being studied for therapeutic or preventive
activity in Parkinson's and Alzheimer's.
Paleo man ate liberal quantities of flesh
foods, and almost no grains.

There's lots more that could be said on this
subject, but I will exit with just one more
point: early vitamin researchers
(e.g. Tom Spies) found that when people are
deprived of a nutrient for a time, like
people with pellagra (niacin deficiency),
they thereafter require quite high doses
(almost orthomolecular-high doses) of
that nutrient for maintenance. Apparently
being deficient for a time permanently
alters something -- either absorption, or
utilization, incorporation into enzymes,
whatever -- such that high doses are
required for optimal health. This is in my
view a striking fact, with great potential
relevance in a lot of clinical situations.
True, we don't have people with pellagra
anymore, but we DO have people (like, try
about 100% of the population, less the
routine vitamin-takers) who are consistently
getting much less of the micronutrients than
our paleo ancestors did. Could chronically
low(er) intakes cause the same kind of damage
(maybe to a lesser extent, but some)
that Spies et al observed in pellagra and
other gross deficiencies? I don't know, but
I'll bet the answer is Yes.

Alan, My cause rant was a little convoluted but what I was getting at, typing as I thought, probably a mistake (sorry) is this - all people agree that most behavior that takes people to psychiatrists can be sane if there is a justifiable cause, for example, a child who screams and runs and throws fits when left alone with a certain adult will be labeled adhd or bipolar unless it's determined that that adult was sexually abusing the child and thus the behavior that appeared insane was sane, a man who tells everyone he thinks his phone is taped and becomes obsessed with proving it is a paranoid schizophrenic until it is determined that his phone is taped, and then there's the opposite situation, a man who goes to therapy to work out his issues with his wife and then it turns out he's never been married. In other words, in order to determine if the "patient" is crazy or not, you have to know whether their self reports about their environment are true. This doesn't mean the man who saw the world trade center collapse can't benefit from couseling and maybe even meds for a time, but it means he needs a different kind of help from the man who shows up at an emergency room in shock because he saw the Empire State Building collapse - a good clinician before addressing this man's needs would look out the window to make sure the Empire State Building was still standing before deciding how to treat. Most psychaitrists don't bother to take even a cursory look out the window and hence blame biology for what is really the purview of sociology and social psychology and thus the problem is never solved. No matter how much speed you give a child who is acting out because he's being sexually abused, if the sexual abuse doesn't stop, he's not going to get any better.

Sally:

> if I showed up in an emergency room bleeding from a
> gunshot wound, I wouldn't want the doctors to wait to
> treat me until they police had found the person who shot
> me

Precisely my point, and not a bad analogy. At that moment,
who cares about "the cause"? Treat the symptoms! Now!

And to extend the analogy for a moment: you wouldn't want
to ruminate and speculate and do research on the subject
of the social/cultural pathology that led to there being
people who are predisposed to shooting other people,
either. All the murky, obscure "root cause" stuff is
completely irrelevant, at that moment. You can get to that
stuff, if you wish, later, after the symptoms abate.

> and the same can be said of someone who thinks they
> suffer from pathological moodiness or someone in an acute
> psychotic state - this is the first problem - with my
> gunshot analogy, the treatment has little to do with
> identifying the specific cause, however, with mental
> illness, reasonable people can differ on whether someone
> is too moody, or even psychotic and if it is determined
> that the subject is pathologically moody or psychotic it
> is crucial to determine why so we can know how to treat
> them.

Why is someone other than the subject him/herself making
this determination? On this point I agree with the
anti-psychiatry guys. The person to make the determination
is YOU. You are the doc. Others are your assistants.

> If someone on September 11 who was one of the few
> surviviors of the WTC bombing showed up at an emergency
> room that day "psychotic" an entirely differently
> treatment would be in order from the treatment for say
> Fuller Torrey if in the middle of a TAC board meeting he
> took off his clothes and started quacking like a duck. The
> entire field of psychiatry is based on classifying not
> behavior but the cause of behavior.

I do not agree that "the entire field of psychiatry is
based on classifying not behavior but the cause of
behavior." It is MOSTLY based on classifying behavior.
Just read the DSM.

But I also see what you are saying, having to do with
whether or not the behavior has some immediate situational
precipitator -- like a terrible catastrophe. This is the
difference between "exogenous" and "endogenous". Yes,
psychiatrists make that distinction.

> Furthermore, if it is, as I believe, and I believe all
> scientific studies have proven, the environment of the
> person that causes behavior labeled as mental illness, and
> particularly the childhood environment,

Could you refer me to key review articles or books on this
subject? I am not arguing; I just would like to be exposed
to the information you've been exposed to.

> the fact that once
> labeled mentally ill, one is much more likely to be
> infantalized and always under the control of the people
> who created the problem in the first place is not only
> counterproductive, but cruel, torture to the person
> labeled mentally ill. It's sort of like legally forcing
> the survivor of a gunshot wound to become a human target
> on a firing range or forcing the September 11 survivor to
> spend all of enternity watching footage of the explosion.

Yes, and it is shameful. I am very sympathetic to all that,
and to the ideas/orientation of "radical mental health";
see stuff on the icarus project, here (end of page):
http://www.furiousseasons.com/archives/2007/10/meds_or_vitamins_as_cure_for_bipolar_disorder.html

> I think that all drugs should be available to all people
> with honest disclosure of all information available about
> the efficacy and side effects of these drugs even though I
> think these drugs cause more problems than they solve -
> sort of like stuffing a gunshot wound with cotton over and
> over again, not stopping the bleeding but preventing other
> folks being made uncomfortable by seeing the bleeding
> instead of stiching up the wound. And I believe the
> injured party has a right to choose which treatment if any
> they recieve.

I agree unreservedly about "right to choose". I don't
agree that the drugs always cause more problems than they
solve. Sometimes they do, sometimes they don't. Used in the
present (bad) context, they often do.

Francesca:

> I agree you don't have to specify the cause to treat the
> patient. However, it is biomedical psychiatry's peculiar
> method to just declare the cause (you're bipolar because
> your neurotransmitters are out of control) and then
> consider that question answered. That's not science, just
> propaganda and wishful thinking.

It is a reductionistic point of view, stated with
excessive (undue) confidence, and with the ultimate purpose
of strengthening and defending class interest (the
professional class, and the ruling class generally). But
that does not make it completely wrong, or unscientific.
Your neurotransmitters (or better, your cell membranes;
see below) very likely ARE out of control if you're
bipolar.

Now, whether or not you will benefit from one of
biological psychiatry's (and Big Pharma's) latest sexy
miracle pills is another matter. You might, though you
probably won't. You stand more chance of benefitting from
Big Pharma's neglected step-children, like lithium --
cheap, unpatented, practically no profit in it. Or
valproate, which is close to that status. Lithium is in
fact a nutrient, a wonderful neuronutrient with exciting
brain-protective and even brain-building properties
(documented: 3% growth of grey matter in 6 weeks!). It is
just that it has to be used right, which is to say in
conjunction with liberal omega-3 fats, in order to protect
the kidneys, and (likely) to reduce the required lithium
dose, and (likely) to support *healthy* brain growth. And
of course liberal supplies of other neuronutrients.
Lithium is like an "anabolic steroid" for the brain, and
when you give anabolic steroids, you should 1) keep the
doses low, reasonable, and 2) supplement liberally with
protein, fatty acids and micronutrients to support healthy
tissue growth. Same with lithium. But that's too
sophisticated for the biological psychiatry
"professionals"; you'll have to do it yourself.

The use of lithium in very high doses is an example of
using one nutritional tool as though it were the entire
toolbox. They think that if they just keep hammering away
on the lithium (1200 mgs, 1500 mgs, 1800 mgs, more...)
that that will solve the problem. And sometimes they are
right; sometimes that solves the problem -- but at the
price of kidney damage, thyroid damage, and other side
effects. (And, I suspect, inferior long-term results with
respect to the brain and behavior because they've
stimulated growth without the full pattern of
neuronutrients essential for *healthy* growth,
particularly but not exclusively omega-3s.) They have
perverted lithium, using it in ridiculous doses just below
the level of acute toxicity, and utterly denuded of the
appropriate nutritional context. It is, shall we say,
*insane*, and ought to be a DSM entry: Contextual
Neuronutrition Awareness Deficit Disorder (CNADD).

Idiots.

Recommended:

http://www.thorne.com/altmedrev/.fulltext/9/2/107.pdf

Alternative Medicine Review, Volume 9, Number 2, 2004
Page 107

Review

Bipolar Disorder as Cell Membrane Dysfunction. Progress
Toward Integrative Management

Parris Kidd, PhD - University of California, Berkeley, PhD in
cell biology; contributing editor, Alternative Medicine
Review; health educator; biomedical consultant to the
dietary supplement industry.

Correspondence address: 847 Elm Street, El Cerrito, CA
94530

Abstract

Bipolar disorder (BD) is characterized by periods of
abnormally elevated mood (mania) that cycle with
abnormally lowered mood (depression). Multiple structural,
metabolic, and biochemical abnormalities are evident in
the brain's cortex, subcortex, and deeper regions. This
disorder is highly genetically conditioned but also highly
susceptible to environmental stressors: prenatal or
perinatal insults, childhood sexual or physical abuse,
challenging life events, substance abuse, and other toxic
chemical exposures. Its high morbidity, lost productivity,
and suicide risk place a great toll on society. Since
World War II, BD has been steadily worsening with earlier
age of onset, greater intensity of symptoms, and
development of drug resistance. Incidence in children is
rising and misdiagnosis is common. Disciplined management
of the many risk factors is essential, including cognitive
psychotherapy and support from family and community.
Lithium has been the foundational treatment, followed by
valproate and other mood stabilizers, antidepressants, and
anticonvulsants. Several single-nutrient and multinutrient
supplements have also proven beneficial. Controlled,
double-blind trials show multinutrient combinations of
vitamins, minerals, orthomolecules, herbals, and the
omega-3 fatty acids EPA and DHA to be effective
monotherapy. The molecular action of lithium and valproate
converge with nutrients on the level of the cell membrane
and its molecular signal transduction systems. This
emergent, unified rationale presages effective integrative
management of bipolar disorder. (Altern Med Rev
2004;9(2):107-135)

Alan, I'd really appreciate it if you would stop presuming how I live my life. In point of fact, I do spend most of my time outdoors (that firewood doesn't chop itself) and my lifestyle is radically different from the typical urban office worker that I used to be. I don't see any benefit in either eating a prehistoric diet or stuffing my body with expensive and irrelevant vitamin supplements. Sometimes the vitamin people have the same disturbing zeal that Big Pharma does.

"what is the best natural
source of glutathione? Raw foods, especially
raw meat, and especially raw liver and brains.
Fantastically high in glutathione. These were
foods that paleo man ate, routinely."

And need I add that they are fantastically
rich in omega-3s (including DHA), zinc, heme
iron (vital!), B12, choline (in the superior
form of of phosphatides), taurine, glutamine,
arachidonic acid, vitamin A, and many others,
all with neurological benefits. And the
nakedness (and sunshine) to which I referred
makes for vitamin D levels perhaps an order
of magnitude higher than those of the typical
urban clothes-wearer and building-dweller. The
vitamin D story that has unfolded over the past
10 years is very exciting (google for), and
indicates that this nutrient is UNIVERSALLY
insufficient for optimal health of the entire
body, not least the brain. Vitamin D actually
promotes neurogenesis and hippocampal
regeneration -- like the SSRIs and
other "miracle" (?) pills.

So. Get naked, hunt animals in the sunshine,
kill them and eat their organs and drink
their blood, raw, on the spot. Also eat 2-3
pounds of foraged fresh young greens and
shoots, and other raw vegetation, (rich in
protective phytochemicals, antioxidants and
vegetable omega-3s), daily, in the sunshine.
Quit all artificial lighting; sleep when it
is dark out; get tons of fresh air and
sunshine when it is light out. TV, radio,
computers, automobiles, etc., are of course
out of the question.

Or take supplements and drugs.

Your choice. "A" or "B".

:-)

Also wanted to pointed out to you that mythically blissful prehistoric lifestyle where people ate what they "should" be eating used to last a very few years. I don't know what the average life span was for proto-man but it sure as hell wasn't 80ish.

Wrong, Alan, it's not A or B. I choose C. I'm going to continue to live a healthy life and refuse to be harangued by you.

Alan,

I think you can pretty safely say most folks would consider me one of the "antipsychiatry guys," though I'm not sure that is the case:

"Why is someone other than the subject him/herself making
this determination? On this point I agree with the
anti-psychiatry guys. The person to make the determination
is YOU. You are the doc. Others are your assistants."

Your question, why is someone other than the subject making this determination, is one that is a valid one. Ideally you are right, but when you go to a psychiatrist and ask them what is wrong, you are asking them to make a determination.

As for documents regarding mental illness being caused by environment, Phillip posted a link to this about Nemeroff backing off the idea the neurobiological defects underlie depression:

http://clinpsyc.blogspot.com/2007/09/key-opinion-leader-contradicts-himself.html

And the Carlat report posted a link to a study indicating therapy works better than drugs for PTSD

http://www.thecarlatreport.com/index.asp?page=wp530200711859

And then there's the recent lastpsychiatrist post about the nature of borderline and bipolar disorder.

As for the DSM and cause, well I posted about that before I saw your comments.

Francesca:
"Also wanted to pointed out to you that
mythically blissful prehistoric lifestyle where
people ate what they "should" be eating used to
last a very few years. I don't know what the
average life span was for proto-man but it sure
as hell wasn't 80ish."

It was not mythically blissful. In many ways it
was a hard life. In some ways better than
ours, in some ways worse.

Life expectancy at birth was very low in those
times -- perhaps 25 years -- due to childhood
infections, accidents, (untreatable), etc. But
life expectancy of people of age was nearly
the same as now. Further, they were much
stronger and healthier than we are. No dental
caries, no artery disease, no arthritis.
People were tall, with massive muscles and
bones, and terrific strength and endurance.
And I suspect very little if any "mental
disease", mood disorder, etc.

For the full defense of primitivism and the
case against agriculture and civilization,
go here:
http://anthropik.com/thirty
http://anthropik.com/series/essential

Francesca:
"I'm going to continue to live a healthy life and refuse to be harangued by you."

Whatever. Do as you please. Good luck.

NOTE: this message is NOT for Francesca. It is for other
readers who might be interested.

.....................

Correction to previous:

"He only said
what he said -- that it is clearly disordered and deficient in
many if not most people with depression. And he is right.
There's overwhelming evidence for that."

There is, in my view (and in Nemeroff's),
overwhelming evidence for that -- but it is
of necessity circumstantial evidence, because
of the aforementioned impossibility of
measuring serotonin and its actions in the
living human brain. The evidence comes from
many sources and it all points to the same
thing, constituting (in my view, and in
Nemeroff's) an overwhelming, compelling mass.

If you know for a fact that you did not shoot
the victim, and if the butler was the only
other person in the house at the time of the
shooting, and if the butler had clear motive
(an intense animosity toward the victim), and
if the butler's fingerprints are all over the
murder weapon, then you can conclude with
reasonable certainty that the butler DID shoot
the victim, even though you did not witness it,
and do not have a videotape of it. So it is
with serotonin and (many, maybe most)
depressions.

It is unfortunate that posts do not get posted
IN THE ORDER that they are posted. Webmaster:
could you do something about this? In this case,
my "correction to previous" post is confusing
because the post that it was supposed to correct
has not been put up yet! Sorry about that, folks.
Webmaster? Can you help?

NOTE: this message is NOT for Francesca. It is for other
readers who might be interested.

.....................

Above paragraph (re the paleo lifestyle) amended/extended,
somewhat:

So. Get naked, hunt animals (great exercise!) in the sunshine,
kill them and eat their organs and drink their blood, raw, on
the spot. Also eat 2-3 pounds of foraged (great exercise!)
fresh young organically-grown greens and shoots, and other
raw vegetation -- rich in protective phytochemicals, soluble
fiber, antioxidants and vegetable omega-3s -- daily, in the
sunshine. Quit all artificial lighting. Sleep (outdoors, in
the fresh air) when it is dark out; get tons of sunshine when
it is light out. TV, radio, computers, automobiles, etc., are
of course out of the question. All industrial and most
agricultural food is of course out of the question; little if
any grain, zero sugar, zero processed food, zero junk fat. All
this should be done, optimally, on seashores, lakeshores or
estuaries, where a great abundance of fish, seafood and sea
vegetation is available -- fantastically rich in the
above-mentioned nutrients PLUS iodine, lithium, boron (all key
brain nutrients) and other elements available only poorly from
terrestrial sources.

There! Better.

Someone I know became extremely hostile, easily agitated, as well as severe short term memory loss; after being prescribed Effexor by a PCP.

NOTE: this message is NOT for Francesca. It is for other
readers who might be interested.

.....................

Friend Charles writes:

> Before reading this last e-mail of yours I was about to
> write that I had a very positive experience with Lithium
> at one time. I was on the verge of a nervous breakdown.
> I thought my head was going to explode or that I was
> going to jump off something very high. I was given the
> lithium to take for a couple months. I took it for only
> a couple weeks and it made me very happy and put things in
> perspective for me until I was able to handle things in my
> physical world and get back on my feet.

Congratulations! Looks like you stumbled on a key
neuronutrient for you. Lithium is great stuff. Everyone
should take some of it (low doses) for prevention of
neurodegenerative disease. Perhaps you would do well on
somewhat higher doses, for mood enhancement/stability. By
"higher doses" I do NOT mean the ridiculous overkill
anti-manic doses that shrinks use -- upwards of 1200 mgs
per day. Those doses can hurt the kidneys and thyroid. No,
I mean something like a couple hundred mgs per day. High
relative to potential background exposure (lithium in
water and food), but low relative to the toxic anti-manic
doses. Plus some omega-3s (fatty fish or fish oil) and a
good multiple. You might find that it continues to make
you "very happy", and assists in "putting things in
perspective". In any case you'll be doing your brain a
favor, long-term.

Details:

: http://intelegen.com/nutrients/lithium.htm
: Lithium's Potential Role in Preventing Alzheimer's Disease
: Mineral Benefits Other Conditions Besides Bipolar Disorder
: Linda Fugate, PhD
:
: http://www.findarticles.com/p/articles/mi_m0ISW/is_247-248/ai_113807015
: Lithium, Part 1: Protect and Renew Your Brain
: Townsend Letter for Doctors and Patients, Feb-March, 2004 by
: Jonathan V. Wright

> The native American sorcerers called us sleepwalkers
> because we are constantly swimming around in our heads
> constantly assigning thoughts to things and making things
> more of a big deal than they are instead of paying
> attention to the here and now. Maybe taking something
> like Lithium brings us back out of our painful thoughts
> and makes us realize everything is going to be ok anyway.

Maybe!

Alan

Okay, Alan, I'll bite. How does listening to the radio and/or using my computer interfere with my nutrition and/or healthy lifestyle?

My diet is already centred around no processed food and zero junk fat. And we're lucky to live close to superb oyster and clam beaches. Organically grown fresh vegetables are easy to come by here.

I do tend to sleep more in the winter (saves stored solar energy for daytime activities). Artificial light is not "bad," just expensive, energy-wise.

Life changes. People adapt. Sure, I'm cheating with my wood stove and comfy quilt but, on the other hand, no adjoining cave dweller is likely to beat me over the head with his club.

Don't you think it's possible to blend the best of both worlds? I get lots of vitamins but I call them "food." There's a whiff of sanctimony in your posts and it's not helped by your "Hey, Francesca, don't read this!" disclaimers.

As an aside, please consider formatting your posts so they read across the page.

I wanted to make a comment on the drug Effexor. I was diagnosed with Bipolar disorder about 8 years ago. Prior to this diagnosis, I was diagnosed with major depression at 13 years old. After finding out I was Bipolar the first medication the doctor's put me on was Depakote, and when that didn't work they tried the dreaded Effexor. At first I noticed nothing. I received no warning signs about this drug from my doctor's either. After about a month I started getting even more depressed, and my mood swings were unbelievable. I couldn't take it any more so I decided to take myself off. Little did I know that the withdrawals from this medication could make someone want to die. I heard voices, which I have never heard before, I had horrific "brain shocks", (please google that and Effexor), and lastly I had horribly psychosis. I didn't know what was worse, being on the drug or off. The point of my comment was doctor's shouldn't just hand this kind of stuff out to people. It's awful.