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20100625

Client-Centred Therapy and Depression

In my case, I am certain that client-centred therapy plays a role in my recovery from depression, along with cues from the season.

Once I went to my first interview with the psychiatrist (shrink), I gave the 18 yr old diagnosis of borderline personality disorder whilst trying to present most of the sequelae of it.

In response I got the medication (meds) I wanted: mirtazapine.

After that, I decided to stabilize while recovering from shingles, which arose due to stress probably not related to mirtazapine.

After doing research on mirtazapine, the shrink realized with my help that I would be better letting my GP handle my meds after talking with the psychologist.

Currently, therapy is going well, and so's my life.

Yet the main reason is probably because it's summertime, tho it is because I acted to resolve family issues especially social rejection.

Recovery from mental illness does require a lot of work on the client.

What is helpful is not the medication roulette; it's being able to choose the medication and the course of therapy.

This would not have been possible 18 years ago.

The reason why I waited until now was because I felt after my initial years of therapy in the early 1980's, that I wasn't ready for talk therapy and mirtazapine was introduced in 1996.

I do not regret not going in for therapy earlier.

My only wish is that Remeron be more closely examined to be a safer anti-depressant for people whose moods are stabilized and are willing to be compliant with psychotherapy i.e. the older adult patients exhibiting depression without psychoses.

YMMV

1 comment:

Steve said...

Before I placed the prescription authority in my GP, the psychiatrist said things which led me to doubt his authority.

1) He erroneously stated that mirtazapine would affect serotonin levels, and listed the side effects of SSRI use (anxiety, nausea, vomiting).

2) When I related my unrelated bout with shingles, he used phrases which made me feel uncertain about other medication.

In response to my uncertainty, I decided to stick to mirtazapine, because my research shows that it is primarily a sedative with secondary anti-depressant effects.

Careful research of mirtazapine shows that it is not an SSRI, and contrary to what the psychiatrist stated, does not affect serotonin at all.

In fact, it helps relieve the side effects of SSRI medication, as it is primarily a sedative with a strong anti-histamine effect.

In doses over 15 mg, mirtazapine will also have the added effect of reversible memory loss.

Because of its potent sedative effect, this medication should never be taken during the day because, in the worst case scenario, one might end up sleep-walking having auditory and visual hallucinations with the dream-like state of mind interfering with coping with reality.

That is why it is safer to take the recommended 30 mg dose at bedtime.


Sources:

Wikipedia entry on mirtazapine: http://en.wikipedia.org/wiki/Mirtazapine

Mirtazapine: a newer anti-depressant: http://www.aafp.org/afp/990101ap/159.html

Infrapsych - Antidepressants: Mirtazapine: http://www.infrapsych.com/content/medication/Mirtazapine.html -- this websites lists the side effects. In my case, 30 mg is tolerable. If I take more than 30 mg within a 24-hour perioud, even when I go to sleep at 1:30 AM, I don't get up before 10:30 am.

Mirtazapine a potent sedative: http://www.psychotropical.com/Antidepressants_mirtazapine.shtml -- I am going on a limb here to state that mirtazapine is an indirect antidepressant i.e. its hypnotic properties help elicit a strong placebo effect during therapy and in life situations.

YMMV