Chapter 21: Healing A "Broken Brain"

"Discovery consists of seeing what everybody has seen 

and thinking what nobody has thought."

                               

                                                            Albert Von Szent-Gyorgyi Nagyr

                                                               Nobel Laureate in Physiology and Medicine

                                                                 The scientist who isolated vitamin C

Mark Hyman, M.D., author of, The UltraMind Solution, states on page 7, "Your brain is broken.  You know it.  You feel it.  You hide it.  You fear it.  You have been touched by an epidemic.  It deprives children of their future, the elderly of their past, and adults of their present.

No one is talking about this invisible epidemic.  Yet it's the leading cause of disability, affects 1.1 billion people worldwide---one in six children, one in two elderly---and will cripple one in four people during their lifetime.

I am talking about the epidemic of broken brains.

We refer to our "broken brains" by many names---depression, anxiety, memory loss, brain fog, attention deficit disorder or ADD, autism, and dementia to name a few.

This epidemic of brain breakdown shows up in radically different ways from person to person so that they all seem like separate problems.  But the truth is that they are all manifestations of a few common underlying root causes.

These seemingly different disorders are all really the same problem---imbalances in the seven keys to UltraWellness.

Dr. Mark Hyman on Good Morning America, January 16, 2009

Interviewed by Jeremy Hubbard, abc News

Dr. Hyman has seen many of his patients heal their broken brains by treating their bodies.  He believes brain problems are found in the biology of your whole body.  He has found brain disorders are almost always systemic disorders, and the cure will be found outside the brain and in your body.

Dr. Hyman also believes some people may have a genetic predisposition making it more difficult for their bodies to create neurotransmitters.  This is true even if these people are applying the changes suggested in The Seven Keys to UltraWellness.  I think I am probably one of these people.  The Seven Keys to UltraWellness made so much sense to me I wanted to implement them.  I believed they would contribute to helping me feel better, even if they didn't "heal" my depression.  

On page 387, Dr. Hyman says, "As a former emergency room physician, I recognize that extreme times call for extreme measures.  I use and support the intelligent, appropriate use of medication, including psychotropic medications when needed.  They can often be helpful as a bridge for recovery from all the stresses and toxins that affect our brain and mind.

It may take months or years to heal from damage that has occurred over a lifetime.  In extreme cases, the damage may be so deep that full recovery is not possible using the UltraMind Solution (although most see remarkable results in a few weeks).  In some cases, combining medication with the tools of the UltraMind Solution can give people their lives back."

When I first started reading, The UltraMind Solution, I wondered if Dr. Hyman believed every person could heal their "broken brain" by treating their body systems.  If you choose to read the book and read the first 75 pages you may wonder the same thing.  I included the information above because I didn't want that thought to detract from the brilliance of the book.

I love this book, and in the coming chapters of my blog I am going to share more information of The Seven Keys to UltraWellness and how they have made my life better.

On Monday morning I raised the dose of Effexor XR to 187.5 mg.  After lowering the dose of Luvox when I began 150 mg of Effexor XR, I had some depression symptoms return.  So I went back on 25 mg two times a day.  I am staying on that dosage until I feel Effexor XR improving the depression symptoms.  I did not feel any side effects from Effexor XR until several days into taking 150 mg.

"For the great enemy of truth is very often not the lie---deliberate, contrived, and dishonest---but the myth---persistent, persuasive, and unrealistic.  Too often we hold fast to the cliches of our forbears.  We subject all facts to a prefabricated set of interpretations.  We enjoy the comfort of opinion without the discomfort of thought."

John F. Kennedy

Chapter 20: Acupuncture, Relaxed Wanderer

The needles were thin and I could barely feel them go through my skin.  She used them on many parts of my body and I had some on my face; above my nose and on my forehead.  She was treating my depression symptoms and for pain in my lower back from a herniated disc.  I laid quietly listening to the music and completely relaxed.  It was a restful, rejuvenating experience.  After the half hour quiet time she came in, removed the needles, and rubbed Dragon Balm (an external analgesic) on my skin.  The balm was warm and then cool and the scent was invigorating.  (Dragon Balm can help relieve a headache.  I rub a small amount on my temples and it helps soothe the pain away.)

After my first acupuncture session I felt calm and looked forward to seeing if I would be able to come off antidepressant medication and feel good without it.  I had researched treating depression with acupuncture on the Internet and there were many case histories of it being successful.  I started lowering the dose of my antidepressant and began taking a combination of herbs called Relaxed Wanderer Formulation.

My first acupuncture appointment was in the month of July.  I was lowering my antidepressant dose extremely slowly because I have experienced withdrawal symptoms from every psychiatric medication I have stopped taking.  My acupuncture sessions were relaxing and enjoyable for about three months.  Then I started to notice my thinking was changing and I wasn't feeling as good.  Two more herbs were added to my regimen and I don't even remember what they were.  I started to write down how I was feeling and what I was thinking.

I no longer looked forward to my appointments.  The half hour quiet time seemed long and I felt anxious for my provider to come back into the room so I could leave.  I was hoping these feelings would pass and the acupuncture itself, and the herbs would begin to work.  I lost the desire to do things I usually enjoyed, things that were important to me lost their value, I felt tired and irritable, and began feeling I had never accomplished anything in my life.  These are depression symptoms for me, and I knew the acupuncture and herbs weren't working.  Soon after, thoughts of suicide plagued my mind and I knew I needed to go back on the antidepressant.  That is what I did the first part of December.

I was disappointed acupuncture did not help my depression symptoms, but I felt fortunate the antidepressant worked for me after going back on.  My doctor had warned me that for some patients the antidepressant doesn't "kick in" after restarting it.  Fortunately, acupuncture did work on the pain in my lower back.  After 4-5 treatments per month, for 5 months, my back was pain free.  It was agile and felt back to normal.  That outcome was welcomed! 

It was fascinating at first to feel the symptoms of depression returning.  I observed my thinking slowly changing.  Other things in my life during this time hadn't changed.  Without the help of the antidepressant the disease gradually took hold again and within five months the disease was in control.  By December the fascination had changed to misery!  The results of this experience did not talk me out of trying the amino acid therapy many years later.  At this point, I believe I will stay on antidepressant medication long term.

Last Friday morning I made the move up to 150 mg of Effexor XR.  The gradual rise of the dosage has seemed slow-paced, but I am still not feeling any side effects that are strong enough to bother me.  I was taking Effexor several years ago and the side effect of nausea never went away.  The medication was effective on my depression symptoms, but the nausea was constant and irritating so my doctor changed my antidepressant to Zoloft.  

My psychiatrist at the Amen Clinic believes I had a problem with nausea because I started on too high of a dose, and increased it too quickly.  I am relieved I have not felt nauseated.  I am taking approximately 19 mg of Luvox twice per day.  The tablets are getting smaller and smaller.

Normal Day, Please Hasten Your Arrival!

  

Chapter 19: Effexor XR, Enlightened Relationships

I Can See a Normal Day in the Distance!

Last Wednesday I raised the dose of Effexor XR to 112.5 mg, and lowered the dose of Luvox to 25 mg two times per day.  I am feeling a shaky optimism. The changes are subtle, but I am feeling a little bit better; less fatigue, more energy, more desire to do things (especially in the late afternoon and evenings).  I'm not telling anyone but you. :)  This would be a gigantic breakthrough for me if I continue to feel more relief from my symptoms!

The disease of depression has taken a huge emotional toll on me.  Having everything in life be an effort is draining.  If you have been reading my blog, you already know I love the books, The Power of Now, and A New Earth, by Eckhart Tolle.  Prayer and the concepts in these books have not only helped me survive, but taught me skills that have helped with my healing.  These skills have helped me feel some happiness and joy, even though I am depressed.  I have talked about these concepts a lot in previous chapters of my blog.

The section on enlightened relationships in, The Power of Now, by Eckhart Tolle was extremely insightful for me, and a relief.  I will explain why.

In Chapter 8, page 159, Tolle says, "Never before have relationships been as problematic and conflict ridden as they are now.  As you may have noticed, they are not here to make you happy or fulfilled.  If you continue to pursue the goal of salvation through a relationship, you will be disillusioned again and again.  But if you accept that the relationship is here to make you conscious instead of happy, then the relationship will offer you salvation, and you will be aligning yourself with the higher consciousness that wants to be born into this world.  For those who hold on to the old patterns, there will be increasing pain, violence, confusion, and madness."

I talked about Tolle's definition of salvation in Chapter 18; here is a quick review.  "True salvation is fulfillment, peace, life in all its fullness.  True salvation is a state of freedom --- from fear, from suffering, from a perceived state of lack and insufficiency and therefore from all wanting, needing, grasping, and clinging."   My definition of salvation used to be having eternal life after I die.  Tolle's definition has broadened my perspective.  I believe eternal life will offer me all of the things mentioned in Tolle's definition of salvation; but I have started to feel a taste of "salvation" here on earth.  I have a strong desire to change my thinking, live in the Now, stay in my inner being or higher self, control my mind --- ego --- and pain-body, and not let the past or future be the focus of my life.  These are my goals as the depression heals.

I believe I am the only person that has the power to make me happy.  There is not a relationship in my life that can do it for me!  My relationships give me the opportunity to learn and practice the skills I mentioned above.  Tolle's teaching of these ideas was enlightening to me and a big relief. 

In Chapter 8, pages 147-148, Tolle explains, "Unless and until you access the consciousness frequency of presence, all relationships, and particularly intimate relationships, are deeply flawed and ultimately dysfunctional.  They may seem perfect for a while, such as when you are "in love", but invariably that apparent perfection gets disrupted as arguments, conflicts, dissatisfaction, and emotional or even physical violence occur with increasing frequency.  It seems that most 'love relationships' become love/hate relationships before long.  Love can then turn into savage attack, feelings of hostility, or complete withdrawal of affection at the flick of a switch.  This is considered normal.

The relationship then oscillates for a while, a few months or a few years, between the polarities of 'love' and hate, and it gives you as much pleasure as it gives you pain.  It is not uncommon for couples to become addicted to those cycles.  Their drama makes them feel alive.  When a balance between the positive/negative polarities is lost and the negative, destructive cycles occur with increasing frequency and intensity, which tends to happen sooner or later, then it will not be long before the relationship finally collapses."

Page 152, . . . "Intimate relationships do not cause pain and unhappiness.  They bring out the pain and unhappiness that is already in you.  Every addiction does that.  Every addiction reaches a point where it does not work for you anymore, and then you feel the pain more intensely than ever."

Page 153-154, . . . "You can change an addictive relationship into a true one by being present and intensifying your presence by taking your attention ever more deeply into the Now:  Whether you are living alone or with a partner, this remains the key.  For love to flourish, the light of your presence needs to be strong enough so that you no longer get taken over by the thinker or the pain-body and mistake them for who you are.  To know yourself as the Being underneath the thinker, the stillness underneath the mental noise, the love and joy underneath the pain, is freedom, salvation, enlightenment.  To disidentify from the pain-body is to bring presence into the pain and thus transmute it.  To disidentify from thinking is to be the silent watcher of your thoughts and behavior, especially the repetitive patterns of your mind and the roles played by the ego."

Page 160-161, "If you both agree that the relationship will be your spiritual practice, so much the better.  You can then express your thoughts and feelings to each other as soon as they occur, or as soon as a reaction comes up, so that you do not create a time gap in which an unexpressed or unacknowledged emotion or grievance can fester and grow.  Learn to give expression to what you feel without blaming.  Learn to listen to your partner in an open, nondefensive way.  Give your partner space for expressing himself or herself.  Be present.  Accusing, defending, attacking --- all those patterns that are designed to strengthen or protect the ego or to get its needs met will then become redundant.

Giving space to others --- and to yourself --- is vital.  Love cannot flourish without it.  When you have removed the two factors that are destructive to relationships --- when the pain-body has been transmuted and you are no longer identified with mind and mental positions --- and if your partner has done the same, you will experience the bliss of the flowering of relationship.  Instead of mirroring to each other your pain and your unconsciousness, instead of satisfying your mutual addictive ego needs, you will reflect back to each other the love that you feel deep within, the love that comes with the realization of your oneness with all that is.  This is the love that has no opposite."

What a challenge for me!

Chapter 18: "Fulfillment, Peace, Life in all its Fullness."

Sixteen days on Effexor XR, seven of them on the higher dose of 75 mg in the morning.  I decided to not lower Luvox quite so quickly.  I am taking 25 mg in the morning and 37.5 mg in the afternoon.  In three more days I will increase Effexor XR to 112.5 mg and lower Luvox to 25 mg on both doses.  I have had short periods of time where I feel the depression symptoms are lifting.  I am still not feeling side effects or withdrawal, which is a huge positive!

I am still hopeful.  I am trying to take life a day at a time.  Prayer and faith in my Higher Power to give me direction are sustaining me.  Listening to Eckhart Tolle every day helps me stay focused on the Now, not spending much time in the past or making up a possible future.  Chapter 8 in, The Power of Now, A Guide to Spiritual Enlightenment, Tolle explains what he believes salvation is.  

"True salvation is fulfillment, peace, life in all its fullness.  It is to be who you are, to feel within you the good that has no opposite, the joy of Being that depends on nothing outside itself.  It is felt not as a passing experience but as an abiding presence.  In theistic language, it is to 'know God' --- not as something outside you but as your own innermost essence.  (I believe this is my spirit, which Tolle calls the inner being.  I believe my spirit is a literal offspring of my Higher Power.)  True salvation is to know yourself as an inseparable part of the timeless and formless One Life from which all that exists derives its being.

True salvation is a state of freedom --- from fear, from suffering, from a perceived state of lack and insufficiency and therefore from all wanting, needing, grasping, and clinging.  It is freedom from compulsive thinking, from negativity, and above all from past and future as a psychological need.  Your mind is telling you that you cannot get there from here.  Something needs to happen, or you need to become this or that before you can be free and fulfilled.  It is saying, in fact, that you need time --- that you need to find, sort out, do, achieve, acquire, become, or understand something before you can be free or complete.  

You see time as the means to salvation, whereas in truth it is the greatest obstacle to salvation.  You think that you can't get there from where and who you are at this moment because you are not yet complete or good enough, but the truth is that here and now is the only point from where you can get there.  You 'get' there by realizing that you are there already.  You find God the moment you realize that you don't need to seek God.  So there is no only way to salvation:  Any condition can be used, but no particular condition is needed.  However, there is only one point of access: the Now.  There can be no salvation away from this moment.

There is nothing you can ever do or attain that will get you closer to salvation than it is at this moment.  This may be hard to grasp for a mind accustomed to thinking that everything worthwhile is in the future.  Nor can anything that you ever did or that was done to you in the past prevent you from saying yes to what is and taking your attention deeply into the Now.  You cannot do this in the future.  You do it now or not at all."

Fulfillment, peace, life in all its fullness ... a state of freedom --- from fear, from suffering, from a perceived state of lack and insufficiency, wanting, needing, grasping, and clinging ... freedom from compulsive thinking, from negativity, and above all from past and future as a psychological need.  This is what I want.  I am getting better at Living in the Now everyday.

Chapter 17: Effexor XR, ADHD & Viral Meningitis

I have been on 37.5 mg of Effexor XR for 9 days and I feel the same.  This is a good thing!  I have not felt any side effects or withdrawal symptoms from lowering the dose of Luvox.  (Or at least not enough to notice.)  I will go up to 75 mg of Effexor XR tomorrow morning, and lower the dose of Luvox to 25 mg in the morning and 25 mg in the afternoon.  I am hopeful!

I think it was my last post I mentioned the new psychiatrist in my city that supports my trip to the Amen Clinic.  I think I told you how AWESOME he is.  :)  He discussed an interesting possibility with me.  I was diagnosed with ADHD from the results of my brain scans at the Amen Clinic.  I feel I have had ADHD for the past 2 1/2 years, but not my whole life.  My doctor was a teacher and researcher at a university before he recently went into private practice.  The research he was involved with indicated there is usually something that precipitates the onset of ADHD later in someone's life.

He asked me if I had a brain injury, or a major illness such as encephalitis or meningitis.  I said no, but then I said wait a minute, I may have had meningitis.  In February of 2003 I went in to the emergency room on a Friday night with a severe head and neck ache.  They gave me morphine in an IV for the pain and said it could be meningitis, but I didn't seem sick enough to warrant a spinal tap (lumbar puncture).

By Sunday morning the pain in my head and neck was excruciating; I had never felt anything like it before.  I may have passed out more than once as my husband drove me to the hospital.  I was in such bad shape I was admitted immediately into the emergency room, no waiting!  :)  The fluid in the spinal tap was negative for bacterial meningitis.  My white blood count was extremely high, but they couldn't find a specific cause of the infection.  I was given morphine through an IV that whole day and sent home Sunday night.  The possibility of viral meningitis was never mentioned.

The next four days I took a combination of prescription pain killers.  I could barely get out of bed and had no appetite because of nausea.  I could not tolerate any light and had to keep my room dimly lit.  By Wednesday of that week I could no longer tolerate the pain.  The pleading with my Higher Power changed in content from asking for help, to asking if this was the time for me to die.  I had never been so sick and I asked my Higher Power if death was going to be the outcome, "Could we do it now?"  If I had a choice I wanted to stay to finish raising my sons, but if that wasn't part of the plan I was ready to "move on".  I remember feeling surprised at how simple the decision was.

Thursday night as I went to sleep I was planning on asking my husband to admit me to the hospital the next morning. Friday morning I woke up slowly and realized the fever had broken and food sounded good.  I believed recovery was possible and I felt blessed.  Full recovery took another week.  Now I believe I had viral meningitis.  This inflammation in the membranes around my spinal cord and brain may have made me more vulnerable to ADHD.  Interesting!  Here are the symptoms and the differences in meningitis and encephalitis if you would like more information.  

Taken from:

http://www.ehow.com/facts_6186800_difference-between-meningitis-_amp_-encephalitis.html

Difference Between Meningitis & Encephalitis

By Anjus Chiedozie, eHow Contributing Writer

I want to do this! What's This?

Meningitis and encephalitis are two medical conditions that involve inflammation, thus the suffix "itis." Despite their similarities, meningitis and encephalitis are not quite the same.

Description

1. Meningitis is an inflammation of meninges, which are membranes that envelop the nervous system, particularly the brain and spinal cord. Encephalitis is an inflammation of the brain itself.

 

Causes

2. Meningitis usually results from either viral or bacterial infection. Encephalitis is usually caused by viral infection.

 

Symptoms

3. Symptoms of meningitis and encephalitis include high fever, seizures and headache. Additional symptoms of meningitis include stiff neck, vomiting or nausea with the headache, and sensitivity to light. Encephalitis-specific symptoms include hallucinations, tremors and loss of consciousness.

 

Treatment

4. Bacterial meningitis is usually combated with intravenous antibiotics. People infected with viral meningitis or encephalitis usually require substantial fluid intake, over-the-counter pain medications and lots of rest for treatment.

 

Prevention

5. Bacterial meningitis can be prevented by maintaining a healthy lifestyle and avoiding instances that can put you in contact with bacteria. Viral meningitis and encephalitis can be avoided by immunization, and preventative measures include keeping away from major viral agents such as mosquitoes.

Read more: Difference Between Meningitis & Encephalitis | eHow.com http://www.ehow.com/facts_6186800_difference-between-meningitis-_amp_-encephalitis.html#ixzz0u5llOx3N

Chapter 16: Effexor XR, Live My Life In The Now

A NORMAL DAY FOR ME, I BELIEVE YOU ARE ON YOUR WAY!

I started taking 37.5 mg of Effexor XR this morning.  I cut my 50 mg Luvox tablet down to 37.5 mg for both doses.  I will continue on these amounts for 7-10 days.  If I do not experience side effects, I will increase the Effexor XR to 75 mg and lower Luvox to 25 mg per dose next.  I will continue to increase Effexor XR until I feel improvement in my anxiety and depression symptoms.  My psychiatrist at the Amen Clinic has recommended I raise the dosage to 225 mg, if I don't feel better at a lower dose.  I will talk to him again the first week in August.  He is positive and supportive and keeps me motivated.  He reminds me what an accomplishment it is to have been off the beast (Klonopin) for 9 weeks!

I had an appointment with a psychiatrist here in my own city that supports my visit to the Amen Clinic.  AWESOME!  I learned a lot at my appointment with him, it was intellectually stimulating, and he was helpful.  AWESOME!  Thank you for being a doctor who thinks progressively and is so comfortable in his own skin that my visit to the Amen Clinic is not threatening to him.  Did I tell you how AWESOME I think this is! :)

I have been listening to, The Power of Now, on CD by Eckhart Tolle every day.  His words keep me focused on recovery and not stuck in the misery of not feeling well.  Every night in my prayers I ask for help in understanding and integrating these concepts in my life.  I believe these concepts are teachings my Higher Power wants me to understand.  They correlate with scriptures I have read for many years.

I love these words by Tolle, "Have you ever experienced, done, thought, or felt anything outside the Now?  Do you think you ever will?  Is it possible for anything to happen or be outside the Now?  The answer is obvious, is it not?

Nothing ever happened in the past; it happened in the Now.

Nothing will ever happen in the future; it will happen in the Now.

What you think of as the past is a memory trace, stored in the mind, of a former Now.  When you remember the past, you reactivate a memory trace--and you do so now.  The future is an imagined Now, a projection of the mind.  When the future comes, it comes as the Now.  When you think about the future, you do it now.  Past and future obviously have no reality of their own.  Just as the moon has no light of its own, but can only reflect the light of the sun, so are past and future only pale reflections of the light, power, and reality of the eternal present.  Their reality is 'borrowed' from the Now.

The essence of what I am saying here cannot be understood by the mind.  The moment you grasp it, there is a shift in consciousness from mind to Being, from time to presence.  Suddenly, everything feels alive, radiates energy, emanates Being.

Since ancient times, spiritual masters of all traditions have pointed to the Now as the key to the spiritual dimension.  Despite this, it seems to have remained a secret.  It is certainly not taught in churches and temples.  If you go to a church, you may hear reading from the Gospels such as 'Take no thought for the morrow; for the morrow shall take thought for the things of itself,' or 'Nobody who puts his hands to the plow and looks back is fit for the kingdom of God.'  Or you might hear the passage about the beautiful flowers that are not anxious about tomorrow but live with ease in the timeless Now and are provided for abundantly by God.  The depth and radical nature of these teachings are not recognized.  No one seems to realize that they are meant to be lived and so bring about a profound inner transformation."

I want this inner transformation.  Is it really possible for me to be so completely present that no problem or suffering; nothing that is not who I am in my essence, can survive in me?  In the Now, in the absence of time, can all my problems dissolve?  I want to find out!

Chapter 15: Clonazepam The Beast, Effexor XR

During the past month since I posted on my blog I have been trying to eliminate the withdrawal symptoms from clonazepam (generic for Klonopin).  I have not made much progress!  The main symptom being extreme anxiety. Starting Wellbutrin also increased anxiety.  On the fourth day the anxiety was so extreme I did not take anymore.  I took regular Wellbutrin, instead of SR or XL which was what my psychiatrist at the Amen Clinic recommended.  I think that was a mistake!  I was disappointed, but I didn't want to try Wellbutrin again!  The anxiety makes my body feel like it is going to explode from the inside.  This feeling is a new one to me, very uncomfortable, and I am weary!

I was first prescribed clonazepam for the anxiety caused by the antidepressant Zoloft.  I did not feel anxious until I started on the medication, and the anxiety was mild.  There was evidence at this time of clonazepam causing scalloping on the brain and of it being highly addictive.  There was also evidence the anticonvulsive class of drugs helped with anxiety.  My psychiatrist at the time didn't know this information about clonazepam (or maybe he didn't agree with it), but he helped me recover from a major depression more than once.  Now I want to come back to the "present" and not spend any more time in the past.

One bright spot in the past month was talking to my psychiatrist at the Amen Clinic by phone on June 16.  He was happy to hear I had been off clonazepam for over 5 weeks.  He was positive and supportive and boosted my spirits.  He reminded me what an accomplishment it is to be off this drug!  He said I had been on clonazepam for so long it could be causing depression!  He recommended I wait until my body had been free of the drug for 8 weeks before we decide to change or add medications to my treatment.  I did add 5-HTP, also known as oxitriptan (INN), a naturally-occurring amino acid, chemical precursor and a metabolic intermediate in the biosynthesis of the neurotransmitters serotonin and melatonin from tryptophan.  I will talk to my psychiatrist again on July 7 after being off the beast (clonazepam) for over 8 weeks.

I have not noticed any difference in how I feel after adding 5-HTP, except maybe a little nausea.  I am ready to take the next step in my treatment plan, adding Effexor XR.  This is what my treatment plan from the Amen Clinic says about Effexor XR:  "At low dosages, Effexor XR will help anxiety, depression and obsessive thinking, and at high dosages will help ADHD symptoms.  An antidepressant with action at multiple receptor sites, Effexor XR will enhance prefrontal cortex function and decrease anterior cingulate and limbic hyperactivity.  Effexor XR has a starting dosage of 37.5 mg daily, increasing by one every 7 days as tolerated, to the therapeutic target dose of 75 mg to 350 mg.  It should be taken with food to avoid upset stomach.  Effexor should not be stopped abruptly because it has been associated with a discontinuation syndrome in some patients.  At higher dosages, blood pressure should be monitored.  If Effexor XR causes more irritability, I would increase the anticonvulsant to stabilize the temporal lobes, enhance mood stability, and decrease anxiety or irritability."

I was on Effexor (not Effexor XR) about 10 years ago.  The nausea it caused didn't stop, so I changed to Zoloft.  The problem with nausea could have been caused by going on the medication too quickly.  This time I will increase the dosage more slowly.  I experienced the discontinuation syndrome mentioned above when coming off Effexor.  At this point, I expect to be on an antidepressant for the rest of my life so I am not concerned about discontinuing the drug.  I will need to lower the dose of Luvox as I add Effexor XR.  I have a positive attitude and will discuss the treatment plan with my psychiatrist next week.

I am ready to have a normal day not based on surviving!  "Normal day, let me be aware of the treasure you are." (by Mary Jean Iron)