It all eases effortlessly within a short time of restarting an SSRI regimen. That effortless thing bothered me at first. I didn't want to take the easy way out because doing so violated some gormless German work ethic notion with which I am genetically afflicted. Unfortunately the hard way doesn't work for me. I tried unrewarded to make it work for 36 years, which should be evidence enough to justify trying something else.

Chronic depression is like chronic pain. It never goes away, but if you're lucky, you can cope with it. The medication helps, but I learned that it didn't clear the symptoms up completely. I cope with twangs of anxiety throughout the day, but I'm able to dismiss them and move on.

Nobody has ever told me this, but my theory, based on my own experience, is that chronic depression is a degenerative condition. The constant drip of stress chemicals that flow through a depressive erodes her ability to concentrate and remember things, and more so than normal aging does. I can see it happening to me and I believe the drugs will help extend my qualilty of life longer than I might otherwise have reason to expect.

Spiraling downI've been perking along on one SSRI or another for a very long time, doing fine and taking the reduction of symptoms for granted. So it came as quite a surprise a couple of weeks ago when I began spiraling down. I found myself without the energy to respond to email messages from friends. I was always on the verge of crying. I over-reacted to things Ted said. A couple of anxiety attacks hit one morning with an intensity that almost knocked me over. I began to feel catatonic.

I hadn't felt this bad in decades. Where was it coming from?

I took my meds the morning of the anxiety attacks and realized the implications of something I noticed when my mail-order pharmacy delivered the last refill. The pills were different. They were round instead of oval. The pharmacy had changed manufacturers before, but it had never caused a problem for me. Apparently the manufacturer of these made them from plaster of Paris and ground eggshells.

An internet search uncovered no complaints about this particular manufacturer, but dozens of people reported a return of symptoms when their pharmacies substituted a generic for the brand name medication, or changed from one generic to another.

Last Friday I doubled up on the dosage to see if it would help and called the pharmacy to complain (yes, I know, you're not supposed to do that, but keep in mind that I've been at this since the late 1980s). Over the weekend, I began to feel dramatically better. Apparently my nervous system needed time to make the new formulation work, just as it would for a drug I had never taken before. The increased dosage seems to be beneficial too.