Dear Stepan Pavlas:

Escitalopram is a very known SSRI Antidepressant, its brand name in the US is Lexapro. Like other SSRI antidepressants, they are prescribed to be taken daily, either in the morning or in the evening. It does take time to start working, and millions of people feel that SSRI’s are  working for them. These are prescribed short term or long term. Benzodiazepines are often prescribed to take as needed, with a limit of how much you can take per day. These are responsibly prescribed for the short term only. (I took both for about 17 years, and got off these in 2013).

“I didn’t realize that they love me”, you wrote regarding your parents. They must have not expressed to you that they love you, and this is why you didn’t realize that they loved you, didn’t listen to you attentively, didn’t pay attention to you.

It is highly unlikely that a child will not notice that he is loved. It is likely that your parents, like many other parents all over the world,  are often busy, otherwise occupied, focused elsewhere,  distracted, paying attention to other people, other issues, but not to their children.

“I am glad how they raised me, so whatever they did, I am not complaining”- you are a loyal son, and you love your parents. What I am trying to say to you is that you have to connect your anxiety and depression to your early life experience, and see what it really was like for you. Otherwise, you will not see the roots of your anxiety and depression.

With understanding of these roots, learning skills (ex., emotional regulation skills) and with developing and practicing healthy habits, you will be able to heal.

anita

Dear Stepan Pavlas:

“Confusion resulted in a mistake. I have done a horrible thing”- I don’t understand: what mistake and what horrible thing?

Good thing you “started a routine of stretch and positive self-talk for an hour in the morning”, and that it helps a lot.

“it can go back downhill, or up”- you felt depressed before, most recently you feel happy. Your emotions will continue to go up and down- that’s the nature of emotions. Progress is to not go to extremes, not extremely Up, not extremely Down.

Thank you for your good wishes for me, and good to read from you and looking forward to the  next time you post!

anita

Dear Stepan Pavlas:

Welcome back to your thread. Last time you posted was May 4, two months and 18 days ago. Let’s see what you wrote on your other thread today: “this was me: No purpose, no dreams, no desires. Just emptiness and depression. No purpose? Not anymore.. Everything we are doing we do for a good feeling. To feel good. And that is my purpose. No dreams? Well, unfortunately still the same. No desires? .. I long to not have depression, I long to be happy.. I long to find myself.. Know thyself. Just emptiness? Certainly not now! Just depression? Depression is gone.. Maybe it isn’t 100% gone but I can surely say that I feel ten times better. The medication worked, but what helped me a lot was cognitive psychology. And also the support from my friends and family, my trainer, school teachers, total strangers on the internet and the list of kind hearts goes on”.

I appreciate your update, Stepan Pavlas, good to read from you. And it  is  good to read that you are feeling ten times better. Post again anytime for the purposes of  (1)”a good feeling. To feel good”, and (2)”to find myself.. Know thyself”.

anita

Dear Stepan Pavlas:

In April 2020, you shared that you visited a psychologist but talk therapy didn’t make you feel better, so next, you visited a psychiatrist who prescribed you with an SSRI anti-depressant (Escitalopram) to take every day, and a benzodiazepine (an anti-anxiety medication) to take “only if I am feeling horrible (like suicidal)“.

In May 2020, you shared that you were “starting to feel a lot better“, or that “it is a lot easier to have (or to work toward) a positive mindset than it has been in the past“. You wrote that you were not sure if the improvement was due to the medications that you started taking the month before, or that it was due to you telling yourself that “blaming and shaming myself won’t help“, soothing your mind and starting “a routine of stretch and positive self-talk for an hour in the morning“.

In July 2020, you shared: “Depression is gone… Maybe it isn’t 100% gone but I can surely say that I feel ten times better. The medication worked, but what helped me a lot was cognitive psychology. And also, the support from my friends and family“.

Today, March 12, 2022, you shared that you will soon be 18, that in the last few months, you’ve been taking a “new medication pill” and you had “a new therapist session“, progress has been made in your understanding of how you function. But the “biggest concern is that instead of being depressed all the time, there are sudden strikes of suicidal thoughts“.

You closed your update post with: “I do wonder what else should I mention“-

First, welcome back to your thread! In regard to what you should mention, I am interested in you sharing the following:

1) What is the new medication you are taking, and what are all the medications that you currently take every day?

2) What is the situation with your liver, one that you mentioned earlier, were you ever diagnosed with a liver disease?

3) How tired and exhausted are you every day and what is your daily schedule (still attending school… 12th grade?)

4) What did you recently learn in regard to how you function, and did you learn it in the cognitive therapy that you mentioned?

5) Can you put into words two examples of the “sudden strikes of suicidal thoughts“?

anita

Dear Stepan Palvas:

Wow! Thank you for your kind words and appreciation, (as you can see, it made me go Wow!)

You shared that every day, you still take the SSRI anti-depressant Escitalopram (also used to reduce anxiety), plus the SARI anti-depressant Trazadone (also used to reduce anxiety and to induce sleep), and that you never took the benzodiazepine you were once prescribed with.

You also shared that you no longer suffer from back pain, stiff shoulders, cramps, or liver problems, all these pains and problems ended when you ended your athletic path.

In regard to your daily schedule, you wake up at 6 am, prepare for high school, attend school, typically until 2:15 pm, go home by public transport, arrive home, watch YouTube a lot or do your homework/ research, play with pets, or “join the typical family debate”, rarely, you chat online for hours, talking about serious topics like faith, problems, meaning, etc., sometimes you do household chores.

My analysis today:

2020: “My parents raised me well…  Generally, we don’t talk much together… I don’t feel that bond like I love them… I don’t have some sort of deep relationship with them” – I now think that the extent of your bonding with your parents, the extent and depth of your communication with your parents- from an early age- is inversely proportional to the extent and depth of your personal thoughts.

Said in other words, there was a gap between you and your parents, an acute gap, an acute literal and figurative silence, a superficiality. In your own head, you made up for that silence and superficiality by having an overly noisy brain that thinks in great depth about anything and everything.

March 2020: “I don’t feel around them like I have that emotional support…  we get along, but it’s not exactly that. Of course, I’m aware that I’m actually lucky for what I have. There are children who are, for example, in divorced families or are beaten at home” – as a younger child you needed much more from your parents than to get along. They didn’t beat you, no violence… but alas, a child needs so much more than the absence of negatives (such as violence). A child needs the presence of the positives, primarily bonding and emotional support.

Previously: “When I am ok, I am optimistic, passionate, confident, and so on. But when things go down the hill…  I can be impatient, impulsive, and feel bad” – when things go well for you, you don’t need emotional support, so you are optimistic, etc. But when things don’t go well, you need emotional support and you become desperate for it, impatient, impulsive. Because you grew up lacking adequate emotional support, you were not able to … store emotional support within you. So now, when things go downhill, you don’t have within you a reservoir of support to draw from.

Previously: “I’m empty. It’s like I’m missing something” – missing a reservoir of emotional support to draw from.

March 13, 2022: “Maybe you can imagine me as a machine that instead of slowing down, keeps searching, thinking, solving, analyzing, moving, shifting, changing, breaking and self-repairing. And If I do slow down, I want to die. Because I know that If I won’t keep the pace, I will start slowing down, bit by bit, questioning why I do this, why not end it” – if you keep the noise in your head going and going (searching, thinking, solving, etc.), you don’t hear that acute silence with which you grew up, that acute absence of bonding and emotional support. That acute silence is so disturbing that you want to get rid of it any which way.

“Every previous experience of depression led to the conclusion, that suicide is the way out. And remembrance is just that. Skipping the being-depressed part, straight to the solution. That’s the switch. I can have a good mood, feeling alright, but then it hits. I find myself wanting to jump under the subway, train, car, from window/cliff, overdose… I am traveling home, reading a book, and then it hits…I am eating, and it hits…  It comes without warning” – you want to get rid of that acute silence immediately, before you hear it for too long.

npr. org/ orphans’ lonely beginnings reveal how parents shape a child’s brain: “Parents do a lot more than make sure a child has food and shelter, researchers say. They play a critical role in brain development. More than a decade of research on children raised in institutions shows that ‘neglect is awful for the brain,’ says Charles Nelson, a professor of pediatrics at Harvard Medical School and Boston Children’s Hospital. Without someone who is a reliable source of attention, affection and stimulation, he says, ‘the wiring of the brain goes awry.’ The result can be long-term mental and emotional problems.

“A lot of what scientists know about parental bonding and the brain comes from studies of children who spent time in Romanian orphanages during the 1980s and 1990s… as a group, neglected or abandoned children tend to have abnormal circuitry in areas of the brain involved in parental bonding“.

But there is hope, because a brain that was shaped without adequate bonding, without the reservoir of emotional support that I mentioned, “has a remarkable ability to rewire itself and compensate for things that go wrong during development, including some problems caused by neglect“, the article says.

In summary, it’s clear to me that you suffered an acute emotional neglect growing up, an absence of enough of that emotional bonding and support that every baby and child needs, and that lack led to your persistent, long-term experience of emptiness and depression.

Please feel free to respond whenever you feel like it, no rush.

anita

Dear Stepan Pavlas:

What you shared in your most recent post fits, in my mind, with my understanding as I expressed it in my recent post of less than 3 hours ago.

What I read in your response is a lot of the noise I mentioned (“an overly noisy brain”, my words in my previous post), a barrage of thoughts, like bullets coming out of an automatic weapon.

When you have a chance, calm down best you can, experience a bit of silence of the non-threatening kind, and re-read what I wrote to you previously, calmly, slowly. Let the words reach the part of your brain that is under than the thought-shooting automatic canon.

anita