12 step is totally viable. there are actually MA meetings in Seattle ( marijuana anonymous)
pot is a very different drug today and tends to be addictive to more and more people.
If you are questioning your use and can't stop when you want to chances are you are an addict.
there is so much support out there and people who can relate to your situation.
the recovery Cafe is a great place to get into community and start taking some action.
I've never seen anything change for the better until the individual began taking action for themselves.
You wrote the question, first step.
Next get out and see what goes on in recovery.
See you soon.
Jason

If you have insurance call their customer service line and ask if it's covered and they will do an initial screening to see which therapist in their network best fit your requirements.

You can also call the crisis line at 1-866-427-4747 and they can get you started with any mental health resources in Seattle / King County.

Good Luck!

Bro, you need help. Professional, medical help. It's nothing to be ashamed of, but it's not something you're going to be able to throttle down on your own.

Go see a Doctor. You have a MEDICAL problem, and you need to see a MEDICAL expert.

How much is too much?

I am medium height female and 3 pints of Mac n' Jacks should be the most I need during a night out.

And do you feed yourself a healthy amount of food?

There is this bar that has happy hour long island iced teas. My friends and I went there once, I drank two teas on an empty stomach and got black out drunk and did some regretful things. We went there a second time before which I ate a gryro & french fries and again drank two teas and just got a little tipsy.

DBT has been shown to be extremely successful for many people.

One of the resources we often refer to is the Fremont Community Therapy Project, at 206-633-2405. They offer low cost psychotherapy, including DBT.

You might also be interested in looking into the National Education Alliance for Borderline Personality Disorder, at http://www.borderlinepersonalitydisorder.com/ They will be hosting a DBT conference in Seattle this April.

There's a lot of debate in the recovery community about whether people with out-of-control substance use/behaviours can find control. I'm personally of the opinion it's possible, because I've seen it, but the research is too sparse at the moment to generalize what I've seen.

I don't know you, and I'm not your nurse, so take this all with a grain of salt:

1) Check and see whether there's a substance abuse service in your area that is committed to harm reduction. CAMH here in Toronto has great therapists that do 1:1 work with people to their goals, rather than to the abstinence goal, necessarily (e.g., I once worked with someone who's goal was to stop injecting crack and go back to smoking it, because she was a lot healthier before she started injecting).

2) If there isn't a good agency, I'd still suggest finding a good counselor. The modality probably doesn't matter as much as that s/he's non-judgmental, listens well, and is willing to problem-solve things with you.

3) Since you connect your increase in all of these things with being out of work, I'd consider slowly trying to build a busier life for yourself. Commit to the gym daily, volunteer 2-3x/week, get involved in hobbies that take you out of the house. Don't try all of these things at once! SLOWLY get used to being busier and having less time for pot, booze and self-pleasuring. As you start to slowly have less time to do these things, you'll be able to tell the degree to which your body has become too habituated to them. That will give you and your therapist the feedback you need to slowly make changes.

Sorry that these are sort of general ideas, but hopefully you get the idea, and you and a professional can work out the exact details.

Given the short days and long nights, I think it's natural to be somewhat de-energized here in the winter. On the other hand, perhaps you're running at 110-120% in the summer? I've always viewed it as part of the fun of having 4 seasons, which I never experienced growing up in So Cal, so not necessarily a bad thing.

Don't forget your Vitamin D supplements!

I think it might be because I grew up here, or that I primarily have indoor activities for my recreation, but I've never really experienced SAD.

So...that might mean if you live here long enough you just get used to it. Or it might mean you should become a big ol' indoor nerd like me.

Either way - I think people adjust to it eventually. : )

One of the things I've heard a lot about recently is the possibility of finding out if people are apt to develop the disorder sooner, and providing programs, therapy and treatment to get people BEFORE they become full-blown psychotic. This could be a really great step for those who don't have it yet, because there is some evidence that with each psychotic episode the disease outcome is likely worse. So, preventing the full-blown disease would be fantastic! That is where things like new blood tests and other screening measures come into play, and there is work being done in this area.

I also have to echo the sentiment that society is way behind the times in understanding the illness and responding appropriately to the problems that people have with this illness. There is simply too much stigma and too little funding and too little community support on top of that. Those are things that can be worked on without a scientific breakthrough, and it is a large part of the problem with helping people to lead better lives.

There are people who are working on uncovering the biochemical dimensions of the disease, but as far as I know, we are still largely in the dark on this one.

However, some of the newer AND older medications can help people to live lives that are worth living. I have heard a lot of good things about Abilify, and actually, I just started on it about a month ago and so far it seems great. I also take Haldol in an injection form and have managed to stay out of the hospital for about 10 years now. I couple those meds with Zoloft and Buspar. I have schizophrenia, btw.

We people with severe mental illness really need other people going to bat for us and being advocates for improving treatment, community support and fighting off stigma though. It is something that anyone can do. You don't need a degree or even to know anyone with illness. It is just kind of hard to be your own advocate sometimes if you are living with the illness, for obvious reasons.

I would say that people with mild depression can go off medications when their symptoms are better, but if you have severe depression, it is better to stay on the medications. You should totally talk to your doctor about the possibility of a different med if this one is killing something that is important to you. They all work on the brain slightly differently. I would say that taking the medication every other day probably isn't that great of an idea though.

There are newer medications that might work better for you. Prozac is kind of an old staple by now. It is good that you are feeling better though, and you could always come back to it if nothing else works. Half the battle for most people is finding one that really works!

Just curious though: why is it uncomfortable for you to think about being on an anti-depressant long term/indefinitely, especially if it makes such a good improvement? Everyone has their reasons for not wanting to be on meds, I was just wondering what yours might be. I know it can feel weird to be on them a long time. As far as I know, there are no long term side effect problems with anti-depressants...nothing like tardive dyskenesia or anything like what might happen with anti-psychotics. You'd probably be at greater risk for developing problems with untreated depression frankly.

Hang in there. Talk to your doctor. Tell her/him about your issues. You are doing great, so pat yourself on the back for getting through everything you have gotten through already!!! :)

First, I'd agree with Basil that you shouldn't necessarily blame yourself for not liking to work. If you find yourself being overly critical of yourself in this regard, you might check out a book called "Soul Without Shame".

Second, and I don't have any direct experience with this, but someone I know what in a similar boat and got a "life coach" to help him figure out what he wanted to do. (He ended up deciding to become a life coach.) I don't know anything about coaching and thought it sounded silly before I met this guy, but it might help you in a more directed way than therapy did.

When I was having some pretty serious depression and stress, my therapist sent me to the Institute for Complimentary Medicine at Swedish Cherry Hill. A naturapath gave me a pee test to measure my neurotransmiter levels (seratonin, gaba, etc). She found that they were pretty seriously out of wack, and started me on some amino acid supplements. I started feeling better within 3 days.

The up side of amino acid supplements is that there are no side affects. The down side is that they are not perscription drugs, so they aren't covered by insurance, and they're around $60 a bottle (I had to take 3 different ones). For me, it was totally worth it, and I was able to stop taking them after a couple months. I go back on them when I start feeling really down, like this winter, but it's not a constant thing. I highly recommend these supplements as an alternative to perscription anti-depressants, which I've also tried with varying results and side effects. Good luck.

One of the ways that we recommend finding a therapist is to attend a support group and seek recommendations. We keep an up to date support group calendar on our website at www.nami-greaterseattle.org/support All of the support groups listed are free.

Two things help me immensely: getting outside every day during daylight for at least a few minutes, and going for at least a short walk every day. Obviously, these are pretty easily combined. For me, it's not the lack of sunshine that kills my moods, it's the lack of daylight. Getting outside, even when it's gray or raining or bitter cold, helps a great deal. Even on a cloudy day, you'll get more light outdoors.

I've had fewer problems since I bought a convertible, too. Any day that it isn't likely to rain, I commute with the top down (and a hat and mittens if need be) - it's astonishing what a difference just a half hour in daylight can make.

It sounds like you need to find the right medication, or combination. For clinical depression taking medication is a way to help the brain hard-reset the chemicals it produces. At the end of a year, tappering off of the medication will allow your body to produce like-chemicals. You should not need to be on a life-long regimen if done correctly, and working with a good psychiatrist in combination with counseling.

This goes hand-in hand with taking the medication daily, and finding the right mix for you. Typically clinical depression requires a consistent treatment to be able to recover (no skipping doses).

In terms of alternatives, there are some options such as testing your vitamin D levels (studies show a direct link between depression and insufficient vitamin D levels), Omega 3- fatty acid suplements, and such. These are more on the homeopathic side, but most people respond best to using these in combination of clinical depression medications.

Keep in mind this is not a permanent condition, you can take control and recover from this.

Yes, it'll get better. I think it's important to pay attention to your natural rythyms, which is to say, maybe 90% of your summer "normal" IS winter "normal." It may be healthy to embrace a time of turning in, allowing yourself to be more quiet. I'm not advocating hibernation or letting your sadness/lack of motivation get out of control, but it sounds like you are doing good things for your brain chemistry, so perhaps you are expecting too much of yourself right now.

First off- remember that many, many of us have the same problem. Take a walk down the street and look at people's faces. Lots of SAD going on.

I've lived here almost 20 years, and find that each year is different. Sometimes it rains and rains and I feel fine. Sometimes it's relatively mild and I'll get hit with that heaviness and can't shake it. You just have to ride the wave sometimes.

Speaking of shaking it, I highly recommend music and dancing. I tend to forget how happy music can make me feel, and if you're at al inclined to dance, it's such great exercise for free.

Good luck. I hope you feel better soon. (And you will.)

After all the good advice below from many of the other posters, I only have one thing to add.

Have you registered for accommodations from your school? Public schools tend to have better and clearer policies, but all schools have to make reasonable accommodations around disabilities, including chronic depression. This could involve deadline extensions (though those can be worse, if they just pile up), or can mean your grades don't get docked because of bad attendance (again, try not to skip class, but you don't want to fail a class you've done good work in because your illness has caused you to miss too many days). Talk with your school's office of disability support (or whatever they call it). They'll be able to help you register for accommodations, explain what sort of accommodations are considered reasonable, and point you towards on-campus support groups and other resources. And in most schools, registering for accommodations doesn't mean you actually have to take them, but registering your disability now, instead of at the end of the term, will make it easier to make a request if it turns out you do need it. And for me at least, sometimes the knowledge that I could get accommodations if necessary lifted the anxiety enough to do the work without them.

Dr. Kathreen Gimbrere used to work with UW students who have ADHD, and now works for either Harborview (unless she has since moved on-- my info is about two years out of date). Since a lot of people don't get treatment for ADHD until college or grad school, she's had a lot of experience assessing people. Much like the other poster's doctor, she's trustworthy, experienced, and attentive to your concerns. If she's taking new patients, I highly recommend her.

For more general advice, since I've been through three intakes now (thanks to embarrassment over the issue combined with moving cross-country multiple times and needing new doctors):

Technically, a diagnosis of ADHD is supposed to involve a very expensive (several thousand dollars!) test, one which isn't covered by most insurance plans. However, unless you're applying for social security or accommodations from somewhere really strict, a formal diagnosis from a psychiatrist will usually do the trick, as far as getting medication and accommodations from school or work. So don't stress over that test.

You really should see a psychiatrist, and one who specializes in ADHD and learning disorders. The most a psychologist can do is say, "You probably have ADHD" and give you a referral. That's useful if you have a therapist you already know and trust, but if you want a medical diagnosis, you will need to see a psychiatrist. Your current psychologist should be willing to give you a referral. A good psychiatrist will be able to make a diagnosis fairly quickly, and if needed, refer you to a therapist with experience supporting people with ADHD.

A psychiatrist will probably need an initial 1-2 hour intake session, where they will ask you about everything from family history to your life story, and maybe make you take a little quiz. Just answer everything honestly, without worrying about what your answers mean-- my diagnosis was based partly on some things that I had thought totally unconnected.

Some doctors will be ready to prescribe at the end of that, others will want to schedule one more appointment. This will depend both on their treatment style and on your own concerns. If they think you have ADHD, you'll probably need a couple of followups over the next month or two to get the medication levels right, then a monthly appointment for a few months to see how you're handling everything, and then every two months, and then maybe once every three. All this is going to vary by doctor, but regardless, it shouldn't take months to get your yes/no. Seeing a therapist who understands ADHD-related issues may be a good idea, too, given all the guilt and anxiety issues that can afflict people who don't get a diagnosis until adulthood.

You may want to read up on medications before your appointment, to have an idea of your treatment options should you be diagnosed with ADHD. The main kind of medication for ADHD is stimulant medication (ritalin or dexedrine), which is highly controlled, so filling prescriptions is a little bit of a hassle. Some people take certain kinds of anti-depressants instead, like Wellbutrin. There are also some experimental sound-based treatments, but I don't know if any of them have been proven effective yet.

Anyway, good luck!

To your second question, no. Our beloved Governor vetoed increased mental health funding for UW students not long after the VA Tech shootings. I doubt this tragedy will be in any different.

As for promising treatments, some of the newer anti-psychotics are a lot better, according to my friends who are on them for schizophrenia and/or bipolar. They're still heavy meds with nasty side effects, but they don't zombify you the way thorazine used to, and the weight gain is apparently less severe. But meds aren't much use without community and institutional support-- friends and family to make sure you're taking your meds and to take care of you when you're having an episode, a doctor who remembers your individual treatment needs and can be responsive, and a job/school that can work around the times when you're having a minor episode and ease off the pressure until you're more stable. And the combination of stigma, budget cuts, a bad economy, and a general lack of compassion make it hard for even the most exciting new treatment advances to have much impact.

Which is really sad-- mental illness is not curable, but people with mental illness, even the extreme kind, can led largely happy lives in a variety of careers. I have a schizophrenic friend who's a nurse, a bipolar friend who's a lawyer, a friend with really serious PTSD who's a published author, and my own depression and ADHD haven't stopped me from becoming a graduate student. None of these are a death sentence! But all of us had access to extensive community support that a lot of people with mental illness don't have-- we had family who could pay for private schools, or help us fill out the paperwork to get social security and/or vocational rehab funding, or spouses/partners who could take care of us during bad times. And good doctors who could help with accommodations, and with careful medication adjustments. I really think that changing institutional and cultural support for people with mental illness is as important as (or more than!) better drugs. And, like I said above, that doesn't seem to be happening, and even national tragedies don't seem to persuade people.

(sorry for the super-long answer)

Meditation could be extremely helpful if you're willing to commit time each day - 20 to 30 minutes. It will teach you to calm your mind and body and help you take charge of your thoughts. It's not a quick fix, but you'll notice benefits after a few weeks.

Find a meditation teacher. It's very difficult to learn and develop the discipline just through reading.

Also, find a therapist who's aware of mind/body connection and can support you in this,as well as working on other issues. Reach out for support - you don't have to go it alone.

A minor addition to the great answers above: Someone told me she takes short winter trips east of the mountains. It's not far but it's sunnier there, and a reminder that the gray crap just sits over Seattle and not over the whole world.

BTW, be prepared for the different winters around here. My first one was gray and shitty through June, and because of that and other factors I felt awful. This one has had a lot of intermittent blue sky, for which I'm quite grateful.

If you are still feeling a bit down, you might want to augment your light box therapy and exercise with a tiny bit of anti-depressant during the winter months. Of course, you would have to speak to a doctor about that.

You might also try one of the herbal/natural mood boosters like 5-HTP, St. John's Wort or SAM-e. Just a word if you try the natural substances, they will all have different concentrations and percentages of the ingredients that you might want, so make sure to read up about how much to take and all the dosing and percentages and stuff. I actually did try St. John's Wort once, and it seemed to have a positive effect.

Make sure you are paying attention to your sleep, caffeine use, other drug/alcohol use (if any), food intake and all that jazz too.

Some people experience SAD every year. I think that some others might adjust to it...it all depends on the person.

Good luck and try not to forget: Spring is just around the corner!!! :)

You ask does it get easier, does it stay the same, or even get harder?

The answer, of course, is Yes, which is a flip way of saying it depends on the individual.

It sounds as though you are being proactive using a bright light box. The basic recommendations are to expose yourself to at least 10,000 lux light source starting at 15-20 minutes and increasing that time up to an hour depending on the effects (morning is the typical routine). The actual light rating of a box will specify at what distance from the box is the 10,000 lux brightness. Light intensity decreases by the the inverse square of the distance. So if the lux rating is for 10,000 at 12 inches and you sit two feet away from it you are only being exposed to 1/4th of that level or 2,500 lux, so pay attention to the specifications and your position relative to the box.

You may also want to obtain an artificial dawn simulator that causes a room light to slowly brighten in the morning to give your brain a normal wake up sequence of brightening light instead of the jarring alarm and waking up in the dark.

Having grown up in the South I didn't pay much attention to the light situation but soon it became apparent that it was paramount to be outside when the light is bright (sans sunglasses). Also work at creating a well lit interior to your home (in addition to whatever light box time you have).

What you eat affects your mood and energy cycles (better eating low-fat) as does the use of caffeine and alcohol (not recommended). Getting a regular exercise period helps keep your body out of the depressive cycle. If you can schedule it and afford it make a trip to a sunnier place during December (even for a few days) to recharge and celebrate the return of the ever lengthening daylight. I used to watch the calendar and it helped me to realize that the situation was only getting better everyday after the winter solstice passed.

I work with numerous people with mental illness that are getting back into the work force.
Most have case workers and get involved with DVR, Department of Vocational Rehabilitation. People come to the Recovery Cafe and get a scheduled volunteer position and begin working with us. They are evaluated by their case worker or other appointed professional. They help with resumes, interviews and transportation.
Farestart is another excellent program that offers intensive training and job placement in the restaurant business. Try a volunteer schedule and see how it works for you. People at the Cafe can help with finding other placements.

I recommend Dr. Lohman (spelling? I'm on the road-sorry) at downtown group health mental health. She is experienced, trustworthy and makes you feel like you're not crazy just because you have ADD/ADHD symptoms. It took me years to follow through with a referral and she made a world of difference.

Sadly, no.

It's very difficult, legally and practically, to force an unwilling patient to stick with any of the treatments that work for schizophrenia. Even if it were easier to medicate a schizophrenic person who refuses treatment, the GOP is unlikely to allow any funding at all for a new health care program.

I don't know much about how money is distributed for medical research, so it's possible that more grant money will be flowing towards promising treatments for schizophrenia in the wake of this tragedy. But making a meaningful change would involve a lot of government money and a lot of legal wrangling, and I seriously doubt anything will change in the near future.

I doubt that there are any "promising" treatments for schizophrenia. Powerful drugs that dull the impulses of the afflicted seem to be the most common treatment. I do know one individual whose diagnosed schizophrenia has been treated with only low dose navane and it has worked for her. It is a terrible disease that has never received the money or attention it deserves.
No. I doubt that any more money will be made available to treat it.
It is one of the most heart breaking conditions humanity is afflicted with.