February 08, 2006

• I was on Prozac for 18 months, and it did exactly what it was supposed to do. Every drug has some side affects, and pregnant women have to be especially careful. That isn't Prozac's fault, that's just the way it is. I don't care what Tom Cruise says, clinical depression kills, and the medications available do a good job of treating it.
• Note: this is a question & not a statement, but maybe depressed women shouldn't be having babies? Anyhoo if one gets depressed during the pregnancy then take the meds, the effects described seem pretty minor and short lived when compared to something like alcohol fetal syndrome. I'd reckon that being depressed and not taking the meds would be more of a risk to child.
• maybe depressed women shouldn't be having babies? Maybe you haven't heard, but pregnant women don't have as rigid control over their moods as you seem to believe.
• maybe depressed women shouldn't be having babies? there's a wide range within the category "depression". for the most severe cases i think perhaps the answer is yes. however, i've seen figures indicating that 10% to 25% of women in the u.s. will be diagnosed as "clinically depressed" at some point in their lives. i fear that medication is prescribed too readily in a lot of cases where lifestyle changes might make a more important difference.
• 
• symptoms that include high-pitched crying, tremors and disturbed sleep And I imagine that doesn't do much to help the postpartum depression, either...
• Maybe you haven't heard, but pregnant women don't have as rigid control over their moods as you seem to believe. Well then, obviously the solution is for the menfolk to have the babies!
• I too had a completely positive experience with prozac (except for the allergic reaction!) there are disturbed women out there smoking crack while pregnant, which I can assure you has DIRE consequences for the child. let's try to keep a sense of perspective here.
• and I <3 effexor, except for the withdrawal symptoms when i forget to take them. but what roryk said - my doctor was more than happy to just hand me a prescription and send me on my merry way. they're great and wonderful medications, but you still need someone to keep an eye on you, especially when you don't know how you'll react to them.
• My wife has bipolar disorder (type II) and is on a very effective combination of Zoloft (an SSRI)and Lamictal. For the past two years, you'd never be able to guess that she'd ever had any psychiatric difficulty. At the time she became pregnant in October (our first child) the OB-GYN and the psychiatrist both said that neither medicine would present a problem. Then about a month ago our pharmacist called with information that a new study said Zoloft in the 3rd trimester can cause some respiratory difficulty for the baby at birth. And now this study. So: sucky timing. It's kind of annoying that part-way through the process we get this information. Mrs. Platypus is now slowly tapering off the Zoloft so that it will be out of her system when during the 3rd trimester, and here's hoping that Lamictal alone will be enough to keep her depression managed until the kid is born. If not, we'll have to do the fun calculus of whether a having a depressed mommy is likely to be worse for the baby than the potential side effects of SSRI withdrawal. The tragic irony is that it sounds as though the potential problems aren't too severe, but every time we get news like this, it gives her more things to worry about, which risks sparking another depressive episode. I think we're about to decide that maybe no more TV news or web-surfing would be a good idea until early July.
• My best to Mrs. Platypus. From experience, I can tell her that it is possible to hold one with just the Lamictal. Some days won't be the best and brightest, but Lamictal will keep her steady enough to be able to look ahead to better times--something us type II's don't do well.
• As an obstetrician, I can say with confidence that untreated depression ALSO produces irritable babies. Certain SSRI's are more notorious for this than others, especially Paxil. The key is to go case-by-case, offer treatment to those whose symptoms become severe enough, and counsel them regarding the potential (and at this point still theoretical) risks. Also, people tend to do a lot of bandwagon jumping based on studies published in the popular media, without really having the tools to evaluate those studies' design or validity. I'd need to know more about the study itself before deciding that Lilly Inc. is selling us evil toxins.
• Wow, interesting. You know, I was a long-time 'poo-pooer' of anti-depressants. I said what everyone else did, change your lifestyle, change your eating habits, exercise, yada, yada, yada. Then, after the birth of my second child I found myself completly and totally unable to cope. To the point that I actually started to fear for my children's well-being. Let me tell you, that is a fucking scary place to be. I had post-partum depression in a big way and it was a major eye-opener for me. After some long talks with my doctor he put me on celexa at the smallest dose possible and then on lexapro which was even better. It literally changed my life. In fact, after talking to friends and family they told me that they felt I had been depressed since the birth of my first child but that it was such a slow process I never even noticed it. It took me screaming into a pillow and going into my bedroom to throw things to see there was something very wrong. Anyway, here it is three years later and I find myself on prozac, thanks to insurance not paying for lexapro, and wellbutrin because it seemed that the prozac wasn't doing all that it should. Guess what, I hate it, I am sleepy all the time, I would love nothing more than to go off this stuff NOW but everyone tells me it is dangerous. I don't know what to do. This post prompted me to call my doctor in another state (we just moved to Oregon seven months ago) and discuss it with him. So, thanks!
• Darshon, I know that if your doc is willing to battle for you, lots of insurance companies will pay for something "off formulary" if your doctor will tell them that you've tried what's on their formulary and can't take it or it doesn't work. My mom's doctor has done this twice for her when it turned out she was allergic to an inactive ingredient in a generic. In both cases, the insurance has coughed up the money for a name brand. So it's worth asking. Good luck.
• Prozac does exactly what its supposed to, blocks serotonin reuptake in the brain. Drugs don't make ethical decisions about rightness, goodness or honesty. In a complex framework of what is best for a child, a living in the womb of a depressed mother (which is not without fetal consequences) or exposure to antidepressants in the womb (which is not without fetal consequences), who should make that decision? The doctor, the mother or the state? As far as I know, there aren't any other actors, and I am certainly not entitled to tell somebody what is best for their child.
• Darshon, my mom works for a doc, and they have done for patients what Lara describes. It doesn't always work, but it does often enough to make it worth a shot! Also, depending on your income some pharmaceutical companies will give you a discount or free drugs.
• Depression is a completely benign, harmless, and rightly condition that would never do anything untoward to you. Honest. Orococo...looking at some of your other posts about the evils of pyschiatric drugs, may I offer a suggestion? Maybe you shouldn't take them. Crazy, I know...must be the deadly Prozac running through my veins. Those of us who do benefit from psychiatric drugs will manage to survive quite nicely, thanks.
• OTOH--It's always interesting to see where everyone lines up with their agenda. But OTOH--MJ, it's good to know there's someone keeping an eye on these things. If it weren't for psych drugs, I wouldn't be here talkin' to you, but it's always nice to know what new and potentially damaging side effects are. Even the "old" drugs haven't gone through a generation of experimentation yet. And let's face it, the FDA isn't exactally on OUR side.
• Thanks for tha linky, moneyjane...that's precisely what I was trying to say.
• But are not now simply medicating the normal range of human emotion and personality? Treating hyperactive kids medically rather looking at environmental factors first. It's so very easy and profitable to simply provide a script rather addressing other issues. I've know people taking meds just for exam periods, to help with nerves. It's a personal impression, but that seems silly. Then again: With the world the way it is the eternal optimists are the ones who really need the meds. And of course it's easier to treat depression then make the world a nicer place. It's not so much that the world has gotten crap, it's that we can't escape the fact of it. On a personal note: take my venlafaxine from me, then you'd better get the coroner out of bed.
• But OTOH--MJ, it's good to know there's someone keeping an eye on these things. True. But I think there are folks out there that buy into the 'drugged sheep in thrall to the evil pharmaceutical empire' bullshit and assume that someone on those medications have some kind of "la-la-la, I can't hear you" reaction to anything negative about these drugs. Which is bullshit. I, and most people I know are very well informed about what psychiatric drugs they're taking, and their side effects. Prozac is a completely honest, good, and rightly drug that would never do anything untoward to you. Honest. The above does not lead me to think orococo is keeping an eye on these things in a way that is particularily helpful to those who are actually on these drugs.
• Orococo I've no problem with you posting stuff you find interesting, or having an opinion on things. You can editorialize all you want as far as I'm concerned. It kicked off a discussion so it's all good. Though that could just be the pills talking.
• I have realized that I am now officially old, because I start my day each morning with a handful of prescription and otc medicine...ugh!
• I've been on and off antidepressants most of my adult life. Some work for me; some don't. Zoloft was the best, but it started to lose its efficacy after two years. Are they overprescribed? Mmmm...quite probably. Do a lot of doctors not watch their patients who take them closely enough...the same. But I'd rather see that than have them not be available when we need them. There must be some sort of happy medium between blindly taking too much medicine during preganancy and just as blindly swearing off everything. I've heard of women refusing antibiotics for pneumonia becauss they're afraid of the effects to the fetus.
• So you finally kick your depression with the help of drugs, and now you can see yourself starting a family. What then? Do you stop and hope you make it through 9 months without a relapse? Or is depression something that means you should never have children. What if you get 3 months in and start considering suicide? Or do you take the drugs and risk a heart valve defect in your child that might or might not have happened otherwise. The human condition sucks and mother nature is an absolute bitch.
• And let's face it, the FDA isn't exactally on OUR side. BlueHorse, whose side do you think the FDA is on? I ask this question in all honesty, as I work in the quality compliance arm of a major pharmaceutical manufacturer, and I can assure you that the FDA is not on our side, either. They actually do a pretty good job of ensuring that we comply to all Good Manufacturing Practices, which is federal law. They actually do a lot better than most of the foreign ministries of health that I deal with (our sales are global), except for maybe Japan. As a consumer, I can appreciate the level of scrutiny that the FDA affords pharm companies.* *Disclaimer: I work with critical care drugs/ therapeutic proteins that have nothing to do with anti-depressants.
• K-Gopher, I believe there are good people that work in the FDA, and the are good people who work in the BigPharm industry--I'm even going out on a limb to state there may be a few honest people in Washington. BUT, I strongly believe when the no-good-niks in BigPharm start lobbying, the FDA tends to take a roll-over, and what may be good for public health takes a back seat to the good of BigPharm's pocketbook.
• BUT, I strongly believe when the no-good-niks in BigPharm start lobbying, the FDA tends to take a roll-over, and what may be good for public health takes a back seat to the good of BigPharm's pocketbook. ... that's why Plan B is an OTC drug now, right? =/ On another tack - w/r/t the advisability of certain people having kids. It shouldn't be dumped just in the women's lap... it's an issue that involves men, too. If you have an illness that causes severely erratic behavior (this includes certain forms of depression) or that can be passed through the genetic line, we know enough now that it's a risk that I would personally hesistate to take. The former is a parenting issue, but the latter has to do with what kind of life a kid will have regardless of whether a parent's illness is managed or not. taking randomaction's question at face value - assuming we're talking about a woman with a lengthy history of major depressive disorder - I would say "maybe not," particularly if one of her parents had the same problem. I would say the same thing about a man with a similar family history. I would not say it about a person with a mild dysthymic disorder. I would say "absolutely not" about a schizophrenic person. But it's up to them to make that decision for themselves. And many people never even realize that their partner's genetic material is going to combine with theirs to produce a kid who's frequently going to be miserable; people who know they have a hereditary condition just have a heads-up about it.
• Without going into detail, the genetics of depression is multifactorial, unlike single gene diseases (sickle cell anemia, huntington's, etc..). To my knowledge, there is almost no way to predict whether your children will also be depressed, unless your family is extraordinarily afflicted. There are large environmental components as well. I would be interested in knowing if anyone had references that said otherwise. I guess individuals draw the line for their families, but nobody is without flaws, and they will all eventually kill you. Avoid passing depression onto the child and he or she will get premature colon cancer, or heart disease, or something worse. By this reasoning, nobody should have kids because noone's genes are good enough to inflict on a new person. You also throw away all the good traits you carry trying to expunge the bad through self-eugenics. I can understand with Huntington's, but with Uncle Bob being an alcoholic, I don't know. I think the question of whether you go off the drugs when your depression is in remission for pregnancy is a bigger one. At worst, paxil and the like raise the risk of a birth defect by 0.1% (going by memory, and the background rate is about 1% to begin with).
• Also, rates of mental illness are so high and go undiagnosed in most cases, that it seems odd that people sane enough to decide that they shouldn't have kids are the ones that wouldn't be having them. The really crazy people won't make that distinction.
• it seems odd that people sane enough to decide that they shouldn't have kids are the ones that wouldn't be having them. Interesting idea...although there are different levels of function in mental illnesses; and different intellectual levels in people, independent of mental illness. Therefore, I would hypothesize thusly; Butt stupid + nuts = frequent multi-generational family appearances on COPS.
• Maybe you shouldn't take them. Crazy, I know...must be the deadly Prozac running through my veins. Those of us who do benefit from psychiatric drugs will manage to survive quite nicely, thanks. Hah, I knew someone would say that. I tried prozac. Yuck. Wierd kind of sonambulent feeling, kinda halfway to asleep, halfway to bored. Fergettid.
• In my personal experience the people that recognize their own depression are the ones with insight, on or off medications. To me these are exactly the people who would make great parents. Those many that simply ignore/deny or are just totally unaware of their own emotional state are missing something. Now, I'm not saying people who are depressed are great, or that the easily distracted are fun, or that the irrepressible optimist is annoying. What I am saying, is that people that can take enough time out from being themselves to actually see how they feel or who they are, or what effect they have, are the best kinda people. orococo. For me this was the 2nd best thread on monkeyfilter. Don't stop posting because people feel defensive or whatever.
• Uh, thanks randomaction. I gotta ask (no competition feelings implied) what was your favorite post? Ennyway, back to the subject at hand: earlier there was a post from someone who said "18 months on prozac. did exactly what it was supposed to do." As a disillusioned former pharmaceutical professional ("drug discovery" was my field), I just cringe when I read something like that. Prozac does one thing and one thing only (according to pharmacetutical orthodoxy): inhibits re-uptake of serotonin. Now, I gotta wonder, how much of a factor is that single neurotransmitter action over 18 months? Would the depression have gone away on its own by then? Is the psychological placebo-encouraging act of taking a pill every day for many months to combat a supposed disease a huge factor in how much a drug "works". The pharmaceutical industry itself admits that something like 50% of the control group (no drug) gets better anyway, compared to something like 60% of the drug-taking group. Numbers like that strike me as being very much like a statistical anomaly, not a "cure". And with all the stories rising back up the pipe about problems with the anti-depressants, I am willing to go out on what I consider a very short limb and say: "serotonin re-uptake inhibitors with respect to depression treatment are bunk".
• Sorry Orococo, I'd love to be off the damn things*, and I keep trying to dump them. Supposedly, they're not all that great for Bipolar II. Lamictal doesn't seem to be enough. Unfortunately, everytime I do get off 'em, I start heading down that black tunnel. I'm not going there, ever again. It's the choice between the drug or the gun. *Prozac didn't do much. We're not talking 18 months depression--we're talking 30 years.
• orococo I think this is the best FPP ever.
• I dont know. I did 5 months on prozac last year, my first time on psych meds. it was AWESOME. I loved it. It made me alert and focused and productive. but I was allergic to it. in short order I also tried celexa & zoloft. I was allergic to both, but I can definitely say that my reactions to each (before getting spotty) were different from prozac and different from each other, and they are all ssri's. now I am on 150mg of effexor and 10mg of prozac. the effexor alone was ok, but not entirely positive. the two together make me functional :) there is a huge area between 'bunk' and 'miracle cure'. orococo, I completely respect your professional experience. my husband is a chemist doing drug discovery in biotech. we have each, in the past, been very skeptical re my trying meds, but the difference in our lives is undeniable! (the matching his-n-her ativan scrips help too!) Its a complicated issue, which I don't believe we fully understand. But if there are some people out there getting relief, that's a step in the right direction.
• When I was reading Lacan in school, he said that the role of psychiatry is to "reduce or eliminate suffering." Kristeva's book _The Black Sun_ adds psych meds to that project. Anything that reduces suffering is ok by me, is my viewpoint.
• "serotonin re-uptake inhibitors with respect to depression treatment are bunk The mechanism by which anti-depressants work is not well understood. As your initial post indicates, information about how these medications work and their effects on patients is still coming in fast and furious. So how is it with the jury still out - and liable to be so for a long time yet - you're claiming a verdict? Is the psychological placebo-encouraging act of taking a pill every day for many months to combat a supposed disease a huge factor in how much a drug "works" (bolding mine) Do you not consider depression to be a disease? If so, please tell me what I have that has made dying a preferred option to living for the last thirty years. Yellow fever? Dislocated shoulder? The boogie woogie blues? Because if I've been having only a supposed disease all this time, it would be great to have you diagnose me with a real disease so I can scamper off for some real medicine. Do you think that your interpretation of data is a more important concept than depressed individuals being deterred by statements like yours from taking SSRIs when even the most pessimistic studies and interpretations do allow that SSRIs are more effective than active placebos? What happens if you're 'wrong'? Not much. The consequences for someone with clinical depression deciding not to take an SSRI based on statements like yours are likely to be more serious. I don't know if or how SSRIs work for everyone. But then again, neither do you. Because at this point in time, nobody does. So what, exactly, is your point in discouraging use of SSRIs? How do you think depression should be treated instead, if in fact, you even consider it to be a real condition?
• SPNAK
• *******YOU GO, MONEYJANE!!!******** (Just another idiot stayin' alive on placebos)
• (What's a SPNAK, Mr. Tool?)
• SPNAK
• Good discussion. Please keep it up. I am considering asking my doctor for help. But in my circles, nothing is secret and there is a stigma for being on "meds." I want to know peoples' experience, even though a "prozac baby" is not the issue for me. Babies are not the problem. It's all about functioning at this point. Sorry if I derailed.
• Not a derail at all, cynnbad...it all boils down to helping folks function. I'll look up some sites for you.
• That's not to say that the drugs themselves never cause suffering. When I was taking Remeron, I had alternate bouts of insomnia and hypersomnia, weight gain (who doesn't find THAT depressing?), dehydration, dizziness, and a complete inability to focus on my surroundings. The abyss just got deeper. If I hadn't had an exceptionally good doctor who knew when to take me off it and try something else, I would have ended up a lot worse off. I haven't tried Prozac myself yet, but I've known enough friends and family with adverse reactions to be wary. I guess it's a relatively new field, and there are bound to be problems as well as miracles.
• Try; http://anxietyhelp.org/directory/depression/ for different flavours of crazy, and; http://www.mcmanweb.com/medications.htm for different flavours of meds. These two sites should give you a good start figuring out a game plan. As for the stigma of mental illness, I think about it this way; if you know I'm on meds, you know I'm doing something about problems I may have. Some of the scariest people I know are the ones who refuse to even consider medication regardless of how screwed up they are, thinking they can do it all on their own; that they'll just tough it out. All I'm going to say is this; a lot of times, that really doesn't end well.
• Thanks -- I value all the opinions of those here. They can get incredibly silly and goofy and make me laugh and then get serious about issues; that's why I consider you all the measure of sanity. Please don't go to undue trouble, MJ. But thanks. I am worried because my paternal grandpa was hospitalized for "nerves," he was a young father and a Mormon missionary. My maternal grandpa died in a Kansas snowstorm because he passed out from alcohol. It's the unspoken burden of our family, that now, generationally, we have a problem. So please understand that there are some of us looking through that pretty bright and clear window, known as "treatment," who have to decide whether or not we can manage the storm. Because we stand to lose our families if we declare ourselves "sick."
• That's not to say that the drugs themselves never cause suffering. Absolutely. Effexor sent my blood pressure so high they worried I might stroke out. Because there is not enough known about how they work, even less is known about how these drugs work on any particular individual. It can take a while to find what drug or combination of drugs work, and there are individuals who they do not help at all. Oh yeah; and Elavil made me hallucinate occasionally...which brings me to this; given the side effects of psychiatric drugs are serious and very, very personal - weight gain, loss of libido, etc. - I'm surprised anybody would stay on them...unless the mood improvement was worth it. I mean, seriously, who the hell is going to take these drugs if they don't work for them in some appreciable way?
• That sucks cynnbad. It's all awful prejudice that hurts a lot of people. You're the only person who can find your way, and however you do it, I wish you the best. Incidently, my family's like that too. All the women are nuts as hell. Oh well. At least there's always the creativity bonus pack :)
• Best of luck to you, cynnbad. I don't envy you that journey, but I bet you're up to the challenge. The fact that you realize there's a problem is one huge hurdle overcome.
• Thanks, ma'am. I'll pull through because I have no choice. I like to think I change the odds. If I can buck the system, what's next?
• Cynnbad: I'm not sure why you have to take on the "sick" label. Non-functioning/non-coping people are "sick" someone who is doing what they can to stay well is in good shape. I also don't understand why you need to even discuss it with your family or see your usual physician. It's your life, and they're your medical records. Go to another doctor in another town, if need be. Take care of yourself. You're worth it.
• Butt stupid + nuts = frequent multi-generational family appearances on COPS. LOL! Moneyjane, re: the loss of libido, this is where I found Lexapro to be really, really good. It brought that back up to normal, much to my and my husband's relief. Cynnbad, I had been tentative about admitting that I was taking medication because of the stigma that is often attached. Imagine my surprise when I found out that most of the people I knew were actually taking something and had never said anything for the same reasons I hadn't.
• Sorry, moneyjane, the bad-outcome to good-outcome ratio among people I'm aqcuainted with with respect to SSRI treatment is running very heavily to the bad side. This is probably excaberated by the fact that doctors now hand out SSRI's for treatment of everything under the sun including pain treatment, which SSRI's are most decidedly not useful for. Perhaps the problem here is that we're talking from different experiences. You were helped by SSRI's. So was ONE of my friends. However at least two other friends had severe negative reactions to these drugs and practically needed "interventions" to get back to the land of the functioning. A few others simply had no effect from the SSRI's and stopped taking them. I tend to see this as sloppy medicine. Multiplied by millions of people and then billions of dollars when we are talking about profits to the pharm corporations. True, no one *really* knows how well the SSRI's work in the very long run, as SSRI's haven't been around long enough. But initial anecdotal data suggests that the SSRI's are far from the miracle claimed by the pharm propaganda agencies. (The glossy newsmagazines for one.)
• A few others simply had no effect from the SSRI's and stopped taking them. How long did they take them before stopping?
• orococo, your points are all valid, and its obvious that you are coming from a place of concern, and not having some random axe to grind. however, based on my observations this past year and more with several friends, I think the prob is that finding the drug that will help someone is still very much a trial and error operation. what if a doctor hears from a colleague that drug a alleviated symptom x in a patient? they might try that drug on their own patient, but as so many elements of diagnosis are subjective, and individual metabolism/chemistry etc., are going to vary greatly, its a crap shoot. the 'science' of behavioral and mood disorders is stumbling in the dark, trying to figure out healthy minimal interventions that give relief to those who need it. do the drug companies want to make a profit? of course, but I assume that you, at least, understand the astronomical expense involved in developing one of these drugs. I too have had friends with VERY unfortunately experiences re SSRIs. Is is crass to say you can't make a cake without breaking some eggs if those eggs are willing to try whatever is available to improve a very difficult situation?
• This is probably excaberated by the fact that doctors now hand out SSRI's for treatment of everything under the sun including pain treatment, which SSRI's are most decidedly not useful for. As Medusa points out, again, our understanding of both the drugs used for treating depression, and the disease itself is primitive at best, which is why I think it important to not make sweeping statements about either the drugs or the ailments they treat. Which brings me to your statement indicating SSRIs are "most decidedly not useful for" pain treatment. SSRIs are thought to affect our perception of pain, and are prescribed to treat it from that angle. Reducing your perception of pain is very useful for those being treated for chronic pain. While TCAs are more effective in reducing pain perception than SSRIs, the side effects of TCAs are not as well tolerated by many people as are the side effects of SSRIs. What is your basis, then, for declaring SSRIs as 'most decidely not useful for' pain treatment? I get the feeling that what you've been trying to say all along is; But initial anecdotal data suggests that the SSRI's are far from the miracle claimed by the pharm propaganda agencies. I totally agree with you. However, attempting to bolster that argument with unsupported sweeping statements that invalidate the very real experience of many, many people is condescending and not helpful to your argument. Also, you did not address a central question about this statement; Is the psychological placebo-encouraging act of taking a pill every day for many months to combat a supposed disease a huge factor in how much a drug "works" (bolding mine) Again, do you not consider depression to be a disease? I am very interested in your answer.
• Actually, I was prescribed an SSRI for pain treatment. I take Celexa in combination with Neurontin to deal with some really bad spinal nerve damage that has left a big part of my leg with no feeling and other parts feeling like they're being dipped in acid. A neurosurgeon with a very good reputation and a lot of miracle cases under his belt explained to me that "we don't know exactly how it works, but those two drugs in conjunction help the brain filter out pain signals". So not a case of him just trying to send me away and hope "happy pills" make me deal with the pain or forget about it. And it's been very successful. I probably wouldn't be walking or functioning without it. If I miss a day, or a couple days, I feel like my skin is being peeled back and hot sauce is being poured under it, as well as more loss of sensation in the rest of the leg. It goes without saying that this much pain can also be depressing, and I can't help but think the Celexa has helped with that, too. So I don't believe it's fair to say SSRI's aren't useful for pain management.
• Chronic depression IS a disease. It runs in my family. The question for us has always been whether one can channel it appropriately, or whether one succumbs and exhibits socially inappropriate behavior.
• And Lara, I'm glad you found a regime that helps you. I am thankful that I'm not in actual physical pain. Hope you stay well.
• Maybe you haven't heard, but pregnant women don't have as rigid control over their moods as you seem to believe. Mr Knickerbocker you assume too much, and then move smoothly on to missing the point.