No more Dexamfetamine – let’s try bupropion

Bupropion is an anti-depressant, but not an SSRI which increases availability of Seratonin and conversely decreases the amount of Dopamine. Low Dopamine is thought to be related to symptoms of ADD/ADHD. Bupropion is an NDRI which means it acts on Noradrenaline and Dopamine, increasing their availability.

I had high hopes for this medication. When I first discovered of it’s existence I thought this was going to be the perfect medication for me. I suffer from extreme and chronic depression and appear to have ADD. Unfortunately it’s not licensed in the UK for use as an anti-depressant so I was unable to get it. Fortunately my ex-wife’s health insurance allowed me to get a private consultation with a psychiatrist who was then able to presribe it (again off-label) for my ADD symptoms as well as my depression.

But my surety that this was the exact medication that I needed and that I’d be miraculously cured was, of course, foolish. If there’s any improvement in my concentration it is minimal. Sometimes I feel like I am slightly better, but I honestly feel these perceived slight improvements are well within the realms of normal variation, particularly when I’m attempting to measure and quantify changes so closely. It’s very easy to want to think “yes, I think I do feel a little better today”, but … well, I’m not sure.

Life is complicated again. I’ve just read over an old post from when I was on the amfetamine and when the effects from it were much reduced from when I began taking it, but even the difference there was stark. I am now back to being in a nightmare world of confusion, of sadness, of helplessness. An empty head. No ability to plan or think beyond just right this second. The world is again a sinister place where nobody wants to help.

An example of my perception

An example. Yesterday I had an assessment for Medical Psychotherapy with a liaison psychiatrist I think they’re called. My understanding of this term, liaison, is that they are not just specialised in one area but have a decent general overview of many disciplines within psychiatry. So I had my assessment where I went over my entire life and all the trauma, neglect and misery that contained. I laid it all out, my entire life very candidly and matter-of-fact. It made me feel quite exposed. Naked. Vulnerable. These were all sensitive and emotive subjects that I shared in order to get some help. Not a single one of the things I mentioned is something I generally want to share with anyone – to go through 40 years of continued struggles was extremely exposing.

So at the end, after opening up everything about me and feeling metaphorically like I was now spreadeagled, naked and hoping for some sort of reassurance I was told, “I don’t think this is right for you.”

Fair enough. Some things aren’t going to be right. He said he thought it might do more harm than good, which is very possible. My emotions are unstable, I despair very easily, so I don’t have a problem with that judgement. But now I’m just cast out again.

If this were a private, paid-for assessment I am 99% sure that if the assessment ended with it not being suitable, you would be signposted to something else. Maybe a recommendation of what other field to look at that could help or a referral to someone. Or just some advice. But this was “This isn’t for you. Goodbye”. Not as short as that of course, but not very far from it. After talking for probably an hour about my life, the wrap up of being told I wasn’t going to receive this therapy and being escorted to the exit was probably 2-3 minutes, including the time it took to walk to the exit. No advice, no idea of what to do next or what could happen next. Just abandoned.

End of example

So my perception of yesterday was that again nobody cares. This person was sinister and uncaring. He had no desire to help me and wanted rid of me. He made no effort to reassure me or guide me, despite knowing the struggles I was having and my history which of course will be having a bearing on my struggles and views of life.

So either I am seeing clearly and this world is populated, to quite a significant percentage, of uncaring, selfish and sinister people who will quite easily let you come to harm as long as it doesn’t affect them, or I am unwell – my ADD is confusing me and all I can feel is helpless and then angry at my being helpless and that those put in charge of helping me don’t help me, which ties into my longstanding problems with abandonment and neglect.

If I can see this and I’m an idiot, how come trained mental health practitioners consistently don’t and indeed consistently make it worse?

These posts are indeed rambling aren’t they? Still better out than in as my dad used to always say when he farted. I used to hate that, but in all honesty I think that hatred came from me unconsciously picking up that my mum hated him. You learn how to act and feel from your parents. My mum taught me to treat my dad with disdain.

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