I know that I am still suffering quite heavily from Major Depressive Disorder because mornings continue to be very difficult. This morning was certainly no exception. I wake up severely depressed and have to fight simply to get out of bed and function. As the day wears on the depression lifts, and by the time that I am about to go to sleep, I feel just about depression-free. I brought this to my physician assistant, Matt’s, attention. So he has increased the dose of Effexor that I would take in the morning.
I am now supposed to take 225mg of Effexor in the morning and an additional 75mg in the afternoon. I hope that this will bring about the desired result although I am not certain how it will as I don’t understand the psychopharmacology behind it. I am trusting Matt’s instincts on this one. He did say we have to be careful about a dopamine flood when on the higher doses of Effexor and I am a bit frightened by this because the last thing I need as a potential “high” from a medication.
I kind of proposed increasing the night-time dosage of Remeron which I am on to 45mg from 30mg but Matt wasn’t as receptive to this change just yet as this could have an activating effect versus sedating. I thought the purpose of Remeron in the Effexor/Remeron combination was supposed to help make mornings easier. As of yet it has not done so and the medication that I am on for PTSD, Clonodine, may actually be an antagonist (decreasing the efficacy) of Remeron. Well, I know we will reevaluate in 4 week’s time.
I understand the need to make small changes because too many at once can cause problems that would be difficult, if not impossible, to pinpoint. So I just need to be patient. In the mean time, I hope that the increased dose of Effexor will help with concentration because I am still having lots of trouble with it and I have goals and things I want to accomplish but unable to do so. Oh well, I guess I just need to take things one day at a time.
For now, I will just need to push myself a little bit harder to do what I want to do to reach my goals. It’s easier to write this than it is to actually do. I this morning I utterly lacked the motivation. Now some of this could also simply be that I am not sleeping because the heat is really on and summer has hit hard.