"Process" addictions....

Does giving them a name make them any easier to deal with? If I had had the same problems with drinking as I do with Internet p*n-surfing, I'd be drunk in a gutter and hoping for death right now. Being lonely, bored, fearful, anxious or whatever does NOT help.. and acting out just makes all of that worse.

Has anything changed in 11 years?

SUNSET DRIFTING

The sunset this evening
Was like the one I saw
In Jacksboro eleven years ago.
Where have all those years gone?
Treading water?
I haven’t even done that, economically.
I have done that, and more, career-wise.
I have higher levels of confidence, dedication and skills
Than in Jacksboro.
All in the name of a career
In an apparently dying industry.
A non-Jungian symbol for my life?
I’m not quite dead yet, though.
And neither is my current job,
Nor my career hopes.
The sunset is long faded into night now,
As I try to reflect on what emotions it stimulated
Besides a bit of nostalgia
And a full measure of semi-poignant reflection.
No, my past eleven years don’t feel “wasted,”
But, whatever “better” means for me,
I wish I were “better” off than I am.
Whoever I am.

— March 18, 2009

Seeking entry to Middle-Earth

My senior year in high school, I was surely battling some unrecognized depression. My dad was in graduate school; his divinity school had those “mushroom lights” around most of the sidewalks on campus.

Anyway, I had already read “Lord of the Rings” once, and was re-reading it. It prompted me to try to call out to Earendil one night while walking by the mushroom lights, as described by this extended-haiku poem.

A ELBERETH GITHONIEL

Earendil, hear;
A Elbereth Githoniel;
Elrond, set me free.

So said a young teen,
Depressed and seeking escape —
Frodo’s Middle Earth.

But nothing happened;
No transmogrification;
Mushroom lights stayed fixed.

Homeward back I trudged
Depressed and distressed yet more
With no one to hear.

Is this all Fourth Age?
Elbereth availed me not —
I still lack magic.

Want to quit drinking? Address quitting smoking, too

New studies show a synergistic effect between the two addictions. They also show that cigarette-smoking alcoholics smoke more than non-alcoholic smokers. And, while I'm not in Big Pharma's pocket, and don't normally tout particular products, it appears Chantix can help on the smoking side.

Drug court – the saner alternative

The saner alternative to locking up mild drug offenders, that is. And, drug courts work in at least some instances.

The biggest issue, it seems, is how knowledgeable a drug court judge is about addiction in general, and about the different behavioral specifics of alcoholics vs. crack cocaine users vs. powder snorters vs. meth users, etc.

Sex addiction about addiction, not beauty or sex

Married to the beautiful Tea Leoni, who seems personally, not just physically, beautiful? Check.

Married for 10 years, with two children? Check.

Self-proclaimed sex addict needing help? Check.

Actress David Duchovny announce he is a sex addict and is entering a treatment program.

Good luck, David.

Mother’s day, no mom

Two open eyesores
Pouring buckets of water
Which she called weeping.

Emotions flowing
Without consciousness behind.
A mom self-detached.

No apologies,
Whether her fault or more mine.
This IS what I felt.

Child abuse changes the brain

Specifically, it changes RNA in an epigenetic process known as methylation.

Ketamine good for depression?

Scientists aren’t horsing around when they claim the notorious horse drug and human drug of abuse ketamine can help depression.

It doesn’t work on levels of neutransmitters like norepinephrine, serotonin or dopamine, either. Instead, in some other way, it’s supposed to “reshape” the orbifrontal cortex of the brain, an area where dread and shame can arise.

AND, it starts to work in just 24 hours, far earlier than the month or so Prozac and other SSRIs can take.

Plus, in what is surely a disappointment for Big Pharma, ketamine is already generic. No high-priced gouging by the Eli Lillys of the world.

Prozac: No better than placebo?

A major new meta-analysis, as reported in The Guardian, makes exactly that claim. The full study, published in the Public Library of Science, is here. And, it’s not just Prozac; another major selective serotonin reuptake inhibitor antidepressant, Paxil, get the same critical nyet, as do two serotonin-norepinephrine reuptake inhibitor antidepressant:

The review breaks new ground because Kirsch and his colleagues have obtained for the first time what they believe is a full set of trial data for four antidepressants.

They requested the full data under freedom of information rules from the Food and Drug Administration, which licenses medicines in the US and requires all data when it makes a decision.

The pattern they saw from the trial results of fluoxetine (Prozac), paroxetine (Seroxat) [Paxil in the U.S.], venlafaxine (Effexor) and nefazodone (Serzone) was consistent.

“Using complete data sets (including unpublished data) and a substantially larger data set of this type than has been previously reported, we find the overall effect of new-generation antidepressant medication is below recommended criteria for clinical significance,” they write.

I think the conclusion is somewhat overstated, and meta-analysis research in general is sometimes overhyped; nonetheless, is this anywhere near bogus? I think the research probably is pretty solid.

In any case, Big Pharma is HUGELY worried and wasted no time to attack.

In adults, however, the depression-beating benefits were thought to outweigh the risks. Since its launch in the US in 1988, some 40 million people have taken Prozac, earning tens of billions of dollars for the manufacturer, Eli Lilly. Although the patent lapsed in 2001, fluoxetine continues to make the company money — it is now the active ingredient in Sarafem, a pill sold by Lilly for premenstrual syndrome.

Eli Lilly was defiant last night. “Extensive scientific and medical experience has demonstrated that fluoxetine is an effective antidepressant,” it said in a statement. “Since its discovery in 1972, fluoxetine has become one of the world's most-studied medicines. Lilly is proud of the difference fluoxetine has made to millions of people living with depression.”

A spokesman for GlaxoSmithKline, which makes Seroxat, said the authors had failed to acknowledge the “very positive” benefits of the treatment and their conclusions were “at odds with what has been seen in actual clinical practice.”

Hey, if you can remarket an antidepressant as another drug, as Lilly did by rebranding Prozac as a pre-menstrual issues drug after its patent expired, you’re going to be dollar-sensitive.

That said, as someone currently on citalopram (generic Celexa), and having run through comments on a post on this on Political Animal, I have a few thoughts.

First, if antidepressants did work BECAUSE they were placebos, why wouldn’t the placebo effect work with the first antidepressant? Why do so many people, unfortunately, try three or four before finding the right one for them?

Second, claiming a “spontaneous remission” for depression, saying that means we can and should go back to pre-drug days, is not just naïve but dangerous. Like a physical illness such as MS that goes into “remission” but then flares up again, depression can do the same.

Finally, we know too little, still, about brain chemistry to know exactly how antidepressants work. Therefore, claiming we know they don’t work is premature, even if that does prove to be the case 20-30 years from now.