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Sunday, August 19, 2012

Calm Your Mind Without Drugs

Question: I always feel like a thousand things are running through my mind. I have anxiety severe and have for many years, I have suffered addiction and overcame it twice! I have chronic pain due to lumbar problems, although I can handle most of the pain with nsaids to avoid relapse, I feel a constant need to remove myself from the real world to avoid my problems, I live in VA and know that pot is illegal, although I feel like it would slow me down and bring back my happiness. When I was in high school I had the same feelings and experimented with it and all my previous issues was gone. Now they have returned, and I need help!

Answer: Many people "self-medicate" in an attempt to calm themselves down or in an attempt to "make" their feelings and emotions go away. It is those of us who are unable to self-sooth, those of us who did not learn the art of calming our minds, those of us who have little to no tolerance for uneasiness who often turn to substances to relieve our perceived pain.  It takes much diligence and work to change your thought process. You have the insight, you know your mind is racing with thousands of "worries" and "what ifs."

It is here where I must insert my belief that it is a parent's duty and obligation to teach their children self-soothing and how to calm the mind. If you continuously sooth your child and "rescue" your child...your child may end up like this young man who presents our question today.

And so it is, I recommend cognitive behavioral therapy. You can change your thought process...and when you change your thought process...your feelings will change...and when your feelings change...your behaviors will change.  Find a therapist who specializes in this type of therapy. You will be successful, but you must work at it! It is far easier to smoke a joint and escape the worry for a few hours, than to complete a thought diary and analyze the links between how your negative thoughts create your anxiety. You must train for the marathon of life, there are no short cuts or quick fixes.

Consider reading the book, Buddha's Brain by Rick Hanson. It will guide you through mental practices that may change your reality and bring you peace and wisdom.  Here is a quote from the book that applies to your very situation:
"Only we humans worry about the future, regret the past, and blame ourselves for the present. We get frustrated when we can't have what we want, and disappointed when what we like ends. We suffer that we suffer. We get upset about being in pain, angry about dying, sad about waking up sad yet another day. This kind of suffering-which encompasses most of our unhappiness and dissatisfaction-is constructed by the brain. It is made up. Which is ironic, poignant-and supremely hopeful.   For if the brain is the cause of suffering, it can also be its cure."

Friday, August 17, 2012

Mirtazapine Side Effects

Question: I have been taking mirtazapine 30 mg for about 3 weeks.  I felt that it was helping at first with my depression and anxiety. I have been on many other antidepressants but have not been able to tolerate the side effects, mostly nausea.  I was able to tolerate the mirtazapine for a while and felt it was helping, but for the past week I have been experiencing lightheaded feelings that come and go everyday.  It's like bad sinus pressure in my head.   It is very difficult to function like this.  Is this something that will go away or should I discontinue the med.

Answer: Mirtazapine is an antidepressant. Some people do well on mirtazapine 15mg daily, or 30mg daily, or 45mg daily. The key with mirtazapine is to take your dose in the evening before bed.  Some of the side effects may be mild or very serious. They include: drowsiness, dizziness, anxiety, confusion, weight gain, increased appetite, dry mouth, constipation, nausea, vomiting, flu-like symptoms, chest pain, fast heart beat, seizures. What you are experiencing may be from the medication. It is possible for this symptom to subside, but it is best to discuss it with your prescriber. You will have to review the risks and benefits of this medication and decide, in conjunction with your prescriber, whether to continue taking your current dose, change dose, or discontinue the medication. Good Luck, and don't forget the benefits of therapy!

Wednesday, August 15, 2012

Why Do You Do Drugs?

Question: This is a question about drug interaction.  I've smoked marijuana before with no unexpected problems, just the usual dizziness and mild euphoria.  I have never been a frequent user.  Recently, someone gave me a prescription Marinol pill, and when I took it, I had the most awful experience of my life - a seriously intense high that was in no way pleasurable, hallucinations, a feeling that my mind was continually "spinning," and what felt like electrical pulsing throughout my whole body.  I thought I was going to have a seizure, but I didn't.  The worst of it lasted just over 4 hours, and it took me 24 hours to stop feeling tingly, depersonalized, and altogether weird.  I am currently taking Klonopin at a prescribed dose of 0.5 mg/day as needed (usually 2-3 times per week), and although I didn't take it the same day as I had the Marinol pill, I'd taken it the day before.  My question is:  could my weird trip have been a reaction between Klonopin and Marinol?  And now that it's been over a week (today is August 14th, and I had this reaction on the 6th), is it safe to take my Klonopin again?

Answer: The first order of business is to do some self-reflection regarding why it is necessary for you to do drugs.  Perhaps you use drugs to medicate some emotion or feeling you don't like having or dealing with. I suggest therapy. The second order of business is why in the world you believe what you are buying illegally is actually what the seller says it is!?! What if the seller gave you methadone or some other downer even though they told you it was marinol and it caused you to stop breathing because you took it with your klonopin and then you are accidentally dead. Truth is...that happens all the time!!  Marinol is sort of the synthetic version of marijuana. Marinol's most common adverse reactions are associated with the central nervous system - and can cause anxiety, confusion, depersonalization, dizziness, euphoria, dysphoria, somnolence, and "weird" thinking. It is the synthetic version of a naturally occurring compound known as delta-9-THC.   Honestly, tell your prescriber that you are misusing illegally obtained unknown drugs and if they think it's ok for you to continue on the klonopin.  How about simply asking yourself....Does it seem like the right thing to do...taking your klonopin with unknown illegally obtained substances?  If you didn't need the klonopin for over a week, you probably don't need it at all. Please get some therapy. Your current hobby of experimenting with drugs is high risk and possibly lethal. Time for a new hobby.