The anxiety subsides, the depression rises

The good news is that alprazolam is extremely good for me. The first day I had it, I also refilled my venlafaxine prescription. I had been without venlafaxine for two days, so I was experiencing serotonin withdrawal syndrome. I did not take alprazolam the first day because I only have 30 pills, so I used the positive effects of getting back on venlafaxine to get through that day. The next day, I took 1.5 mg (one-and-one-half pills) and it greatly helped me. The next day, I did not need any alprazolam. Today, I took .25 mg, which is one-eighth of the dose I would normally take when I had good access to all the medicines I need. Despite the low dosages and extreme rationing, the medicine—combined with other coping techniques—is dramatically decreasing my anxiety symptoms and increasing my ability to function even when I feel anxiety.


As my anxiety symptoms become less of an obstacle, my depression symptoms become more obvious. Today, I was able to handle most of my anxiety, but my depression was strong. I have felt soul-crushing sadness for most of the day. I only have weak tools to deal with my depression: caffeine, vitamin B complex, chocolate, and avoidance. I must find a way to better cope with my depression. For the past six years, I have worked with multiple doctors and therapists on my depression. I had to stop talk therapy because I ran out of money. With one psychiatrist, we tried every SSRI anti-depressant available: none of them had positive effects and all but Paxil had horrible side effects—for me. (Other people greatly benefit from these medicines.) When I treated and cured my depression at age 23, Wellbutrin was a miracle medicine for me. This time, it has been useless. I have tried many other medicines but none of them directly help my feelings of depression.

The only medicine that has helped me at all is modafinil. It has some positive effects on my mood, but depression and sadness do not leave. Modafinil is a fantastic medicine for me, however, because it gives me willpower. Even though I still feel horribly sad, when I have modafinil, I am able to use my rational mind to overrule my emotions: I can be productive while feeling profound sadness.

Over the last couple of days, I have had some chance encounters with people and some wonderful conversations. During the conversations, I was much like my healthy self: personable, inquisitive, and funny. I laughed and smiled a lot. It felt amazing. Each time the conversation ended, however, I felt deeply depressed in less than two minutes. It is disheartening how quickly my mood changes and how I have not been able to use these good experiences to gain momentum. The conversations and rapid change prove that a massive part of my problem is strictly medical: my body’s chemistry is inducing overwhelming emotions. If I did not have a chemical problem, then the good feelings from the conversations would last longer. The treatment for this problem is medicine and therapy.

I went to a couple of pharmacies to look at the price of modafinil. The price is US$3.25 per pill—for the generic. I am not sure what I will do next.

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