Depression Management or Solutions

[Buster Highmen]

A long time friend (40+ years) ate some bad food a year ago which completely blew out her GI system and since has been suffering from constant nausea and insomnia. She's a super tough girl, PhD, professor, smart as a whip, but has succumbed to some pretty serious depression where she's pretty much constantly shaking and crying.

Everything tried so far has failed to either help with the GI issue or the depression and she's beginning to turn dark in ways I would never have guessed. Her husband, also among the few longtime friends I have, is at wits end. She just got kicked out of an outpatient program.

So, this is a long shot in a crowd, but does anyone know of alternative programs to deal with serious depression, preferably west coast?

I've read of a number of research programs that use psychedelics to help with addiction and depression, but can't find one that would admit her. Any refs would be much appreciated.

[iceman]

Has she looked on clinicaltrials.gov? There's a ton on there for depression, including this one with psychedelics (and it's recruiting currently): https://clinicaltrials.gov/ct2/show/...&draw=2&rank=7

Has she looked into fecal implants for the GI issues? They got some bad press because of the death of a patient, but there are many stories of literally life-saving success as well. Doctors don't like to talk about them much but they're a thing for sure.

[Buster Highmen]

She's not really capable at this point, but yeah, man, thanks a million, that's the kind of thing that might work.

I know that her anxiety has gotten so bad, she might not get into a plane under her own power, so West coast is a priority but maybe someone can get her to Texas.

I know they're aware of fecal implants, but I don't know if that's been attempted.

[natty dread]

Just sent you an email B.

[Sweetbippy]

This group is doing a lot of great clinical research with psychedelics. Might be worth checking out:

Maps.org

[Buster Highmen]

awesome people, thanks, really.

[The AD]

A long time friend (40+ years) ate some bad food a year ago which completely blew out her GI system and since has been suffering from constant nausea and insomnia.

Unfortunately I've got no help to offer, but--Jesus--this is awful. Hard to believe something you ate could fuck you up permanently.

In any event, vibes to your friends. Sounds tragic.

[Dantheman]

x2 on fecal transplant. Sounds a lot like Cdiff.

There are a few sites out there that can help you connect with psych-friendly therapists
https://psychedelic.support/
https://integration.maps.org/

In Michael Pollan's book he says there's a lot more communication between underground guides and university researchers conducting FDA approved trials than you would expect.

[uglymoney]

Maybe you could be her guide on a trip to somewhere better, assuming you can't get her into an official program. The logic and the track they take them down seems pretty easy to follow. Seems so promising to me, circular thoughts - albiet thankfully usually not dark ones, being my specialty.

[bagtagley]

I never hit the deep end of despair, but things got pretty dark. I can completely relate to the negative effects GI issues can have on your psyche. Has she tweaked her diet? I’m guessing yes, but it’s insanely difficult and just adds to the mounting stress. Low FODMAPs has been a life changer for me. Shorter term, Pepogest is miraculous in its ability to calm things down in the gut and help with a reset.

Hope she’s able to find some balance.

[stuckathuntermtn]

I have had a similar thing happen to me, though not nearly as severe.
Ate some Burger King and the fry oil was shit. Gave me diarrhea and you could even hear my dog's stomach growling (he loves french fries). Got kinda depressed afterwards. I think there have even been a few studies that might show a link between gut flora and mental health. Kind of a new not very established area of research.
A probiotic helped. I don't know if she's tried that yet. I'm also on SSRIs and those help a bit.
When it comes to depression, sometimes you just need a day/week/month/more to let it wash over you, wallow in it, and then move on. Unfortunately, most people don't have that luxury. Many don't even have the luxury of 1 sick day, but if you broke your leg badly, you might be in traction for weeks, right?
One of the best things for her might just be to chill. Maybe eat some yogurt. She sounds very type A. Maybe burnt out. Needs a reset.
How long had this been going on? Are you really scared she might hurt herself?

[Cono Este]

I’ll state the obvious. Get a good counselor. Take time off from stress if she has a chaotic job/life. Stress is a killer. Time cures all, and life always goes on.

I had a terrible chain of a events about a yr ago, and looking back, everyone gave the wrong advice. Everyone was worried about the business, or the kids etc, and that’s where the stress came from. It’s been going on for 12 yrs. toxic environment. My instincts where to go to the most awesome place I could think of and do shit for a month, and that’s what I will do, if, god forbid I ever feel that poorly again.

Vibes.




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[4matic]

Some LSD and a forest hike with a friend


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[Toadman]

Not so much for the gut issue but in terms of anxiety and insomnia I saw this on 60 minutes a while back. Might be worth looking into.

https://www.militarytimes.com/off-du...ment-for-ptsd/

[altachic]

I went through some pretty tough panic and anxiety issues this past spring. I've always had gut issues, though not this severe.
Anxiety, depression, worry, stress can be such a vicious cycle and trap us in our own heads.

Buster, I highly recommend having her seek out someone who can help guide her in a phsychedlic journey, this sounds so sever this could definitely help. I took my first trip with Dan in July and it was mentally and emotionally life changing, especially for my anxiety/depression/worry/stress.
Natty Dread knows A TON about this, you should reach out to him ASAP.

[dunfree]

Mushrooms, psy

Cultures (yogurt, kimchi, etc for the GI)

[rideit]

Glad to hear you came out of the brighter end of the tunnel, AC.

[Buster Highmen]

I went through some pretty tough panic and anxiety issues this past spring. I've always had gut issues, though not this severe.
Anxiety, depression, worry, stress can be such a vicious cycle and trap us in our own heads.

Buster, I highly recommend having her seek out someone who can help guide her in a phsychedlic journey, this sounds so sever this could definitely help. I took my first trip with Dan in July and it was mentally and emotionally life changing, especially for my anxiety/depression/worry/stress.
Natty Dread knows A TON about this, you should reach out to him ASAP.

Right now, she's pretty much refusing to deal with anyone except her husband and sisters.
She won't respond to me anymore.
She's in a super bad way. All conventional mechanisms have been exhausted, psychologists just give her drugs that don't really work. This is way more than just taking some time out.

All the usual GI therapy (yogurt, oatmeal, drugs, etc) have failed. Don't know if the fecal implant has been tried.

I've forwarded some of the links to them. Natty did ping me and we're queued to chat about this in detail.

Thanks again, such good heart here. So glad you've pulled through.

[char_]

I don't know of any facilities/professionals, but know from personal experience that people who have chronic physical conditions can get into very challenging and dark head spaces and become completely different people. If the physical symptom are real, resolving them is as important as any help for the depression/anxiety in my experience.

Good luck. This is really challenging stuff and very difficult to influence from the outside.

[2FUNKY]

Super sorry to hear this Buster. Nothing else to add other than the best of luck to your friend in getting the psychological and physical help she needs.
Fecal transplant is probably her best bet if she hasn’t already looked into it.

[SkiLyft]

Woah, some real off the wall stuff is being recommended in here. I’m all for alternative treatments but make sure she covers her bases with evidenced based medicine first. I’ll admit, as a primary care provider in allopathic medicine my bias is pretty obvious — but it’s what I know and I’ve had great results helping patients in her exact position!

#1 - establish with a quality primary care provider. They will be the central hub for all her health care and will be used in the initial triage/crisis management.
- they can refer to a good psychologist for counseling and a psychiatrist for medication management.

#2 Fill out FMLA for her job and STOP WORKING, the PCP can facilitate this. She then can focus on getting healthy. You mentioned getting kicked out of an outpatient program, I suspect that might due to the continued challenges at work (if she still is).

#3 complete GI and nausea work up, not going to go into specific detail here but any provider worth his/her salt can do this. Rule out infections, inflammatory, autoimmune. Once this is done we can settle on the fact that her anxiety/behavioral health is likely contributing to her nausea/IBS.

#4 medications: Start with evidence here! SSRI’s are powerful but only if the correct one at the correct dose is chosen. Again start at the lowest dose and titrate up to max tolerable dose and stay there for at least 4 weeks (that’s how long it takes to effect the serotonin receptors). If that medication is intolerable go to the next.

The list:
- sertraline
- escitalopram
- fluoxetine
- citalopram
- paroxetine

Failed all - try Viibryd!

Then SNRIs -> then NDRIs -> then TCADs -> mood stabilizers?-> atypicals? These should be chosen cautiously based on her symptoms — again a good medication manager can guide treatment here.

All this should be done WHILE building a relationship with a good psychologist who can teach coping skills, mindfulness, and equip with tools.

All the above should be done while eating a good diet full things that don’t trigger her. Start basic with 3-4 things (rice, chicken, broth) and add a new food every 5-7 days. Or start with a low fodmap and go from there.

After all the above then begin to experiment with compound pharmacy/ alternative medicine — micro dosing ketamine has been successful with a few of my patients.

My heart breaks hearing this, they are not alone, and it’s not too late!

PM me if you have more questions


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[iceman]

Why do you assume that she has not had competent medical and psychiatric care? To me it sounds as though she has done that and is still suffering. In fact I thought that was pretty clear.

[SkiLyft]

Why do you assume that she has not had competent medical and psychiatric care? To me it sounds as though she has done that and is still suffering. In fact I thought that was pretty clear.

No assumptions were made, if they have tried all the above things then excellent. Was trying to offer suggestions.


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[iceman]

10-4. It's a good set of guidelines no doubt.

[Buster Highmen]

Both are highly paid professionals, she is a chemistry professor, Columbia PhD, kickass girl. They have medical coverage.

Virtually all conventional medical and psychological pathways have been exhausted to my knowledge. This has gone on for a year.

The diagnosis is clinical psychological depression, she just got kicked out of an outpatient program and told there's nothing they can do for her. She is contemplating suicide.

She can't really eat, she forces herself to drink Pedialyte and Ensure, but is constantly nauseated and can't sleep.

I appreciate the suggestions, but evidently I haven't conveyed the severity very well. That's why I'm trying to help them find some alternative stuff.