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Avatar universal

Ssri effects on cognitive performance and memory

I have saw a topic about it. I’m a 16 years old boy who have generally high IQ. I was studying to programming olympiad until few weeks ago. But, now I can’t.
I’m on prozac for about 2 months(85 ml syrup totally). Since last 4 weeks, I’m very sleepy and numb. I had read some experience about a/d and most of them was saying bad things. I saw an article on dailymail(antidepressant can damage brain permanently) and I’m freaky worried. in this site(lexapro and memory problems?) most of people say, their cognitive ability don’t come back even after months and years. I just saw 1 or 2 people who say, revovery is possible.
I used 10 mg for 2 months(very short time, i know) but im affected already. I can’t imagine as before, and ‘imagination’ is directly affect my intelligence. Also, i can’t feel a ‘muscle’ in my brain that i feel. I’m sure it’s efficient on my deep thinking.
Did i ruined my future?

English is not my native language. Sorry for mistakes.
10 Responses
973741 tn?1342342773
Hello.  Sorry you are in need of help with this matter!  Depression is so hard to deal with.  So, who prescribed the Prozac?  You are on a low dose and that medication has a start up period that goes on when you first start taking it for 6 weeks or so in which the body gets used to it.  Side effects happen then that then peter out and go away!  Being drowsy is one of them.  In the United States, one out of every four adults takes an antidepressant believe it or not.  While some have issues and are quite vocal about it, so many take the medications without issue.  But ANY time you take medicine, it is wise to do so weighing out the risk to benefit.  You need a proper diagnosis and enough of an issue in your life to warrant adding medication in my opinion especially for a teenager.  Most people who taper off correctly from medication do not have lasting issues.  A very rare and unlucky few do.  These medications should be tapered off slowly (meaning taking decreasing doses from 10 mg to 5, etc.)  under doctor supervision and by doing this, it tends to go pretty well for most people.  You've not been on for very long and are taking a low dose.  I'm sure you'll taper fine and will not have 'permanent brain damage'.  :>)  The daily mail is not a scientific journal.  And if you have questions about this, ask your mom to set up an appointment to ask your doctor!  

There ARE other things you can do for depression and if you take medication, you'd want to do them along with that.  Therapy is excellent and, as a mom myself, I'd not allow my child to take medication if he wasn't also doing therapy.  This is where you can learn triggers, strategies, etc. to cope better over all.  Journals are really great to get thoughts out and also record what is happening as a record to look for these triggers and where you can implement a strategy to calm yourself, etc.  You can try some breathing exercises such as deep breathing (breath in for a count of 3, hold, out for a count of 3, hold and repeat), meditation, yoga (boys do yoga too) and overall, exercise is helpful for feeling better emotionally.  You are at a stressful point in life!  So many changing hormones, so much pressure and you are just trying to figure out who you are!!  Can you tell I have a son close to your age.  :>)   I understand how hard it can be.  Do you have friends that you feel safe with?  Safe to talk to?  Do you get along with your parents?  But it is always wise to work on things like depression.  For some, they can handle it on their own because it is more like the 'blues' or melancholy but for others, with clinical depression, it can become quite serious and debilitating.  This is what I'm sure all in your circle are trying to avoid for you.  Know that if Prozac is not the right medication, there are others to try.  Some have more documented information for adolescents.  Some have no information because it is hard to study medication on youth.  No one wants to 'test' something on their own child. But these meds are used successfully and it is a matter of finding the right one.  

So, this side effect and feeling you have very likely will go away. And remember you are not supposed to be numb from feeling.  And would guess that is more of being undertreated than over treated.  good luck
Thank-you because you've also helped me with things I didn't even know!  The breathing, hold in and breathe out while counting to 3 repeatedly is definitely helpful and I'm sure you learned that from therapy, so it's great that you shared because some people don't or can't go to therapy.  I've been paralyzed from the chest-down for 13 years as of December 20, 2019, and with my car accident not only did I lose many physical abilities but I was a first time Mom as well of a 6 month 3-week old son so I couldn't do any of the mother stuff I wanted to do sooo bad.  That pain of not being able to hold or pick up your kid for many years and not take him to his first day of school and sooo much more has always been more painful than any and all my physical pains combined and I was ejected approximately 30 feet according to the police report!  And, still, my loved ones don't think I need mental health help on anything.  And, my soulmate thinks I shouldn't be taking the BS.  I'm not the only person on the planet who's fully dependent on others who think the mental health stuff is all in your head and not real.
My Mom was paralyzed from the waist down for the last 7 years of her life due to cancer, which killed her.  But in those 7 years she was pretty stable physically, but terribly depressed because she could no longer take care of the family as she was raised to believe was her role.  She didn't talk about it much, she didn't do that, but you could see it on her face.  My Dad changed as well, started drinking, became bitter and bigoted over time.  To the contrary, my wife had a very good friend who was also paralyzed from cancer that eventually killed her who did not get depressed, got around, did things she liked, stayed very nice, and so had a good life until the illness finally took her.  Mental state is really important.  My agoraphobia did not destroy my life.  When reaction to stopping a med killed my mental state all the way, that did destroy my life.  Again, mental state is so important.  Keep your heads up, folks.
Avatar universal
There is research showing taking antidepressants or benzos can damage the brain in a certain way, but not necessarily the way you're mentioning.  Mostly it's the difficulty of the brain in going back to working normally again when someone has been on these meds for a long time., and you haven't been on it for a long time, so I don't think this is really a concern for you right now.  You have enough to worry about and I don't think this is to be added to that.  Prozac is one of the easiest meds to come off of, though you should, as Mom has said, do it on a slow taper to be safe if you want to stop.  Sometimes a particular medication is just not suited to a particular person.  Prozac is particularly known for deadening feelings, which might be what you mean by feeling numb, and most antidepressants are sedating.  Sometimes you get used to it, sometimes you don't.  Prozac is the most stimulating of the ssri types, so it isn't usually as sedating as others in this class, but you're the only you and you're going to feel what you feel.  The fact is, any drug that affects the brain can cause problems -- it's the brain you're playing around with -- and the reason so many Americans take antidepressants isn't because they need them, it's the nature of the US, which doesn't regulate the practice of medicine as much as other countries and is the place drug companies are free to make most of their money -- all other countries regulate the price of drugs, the US doesn't, which makes the incentive to overprescribe quite rewarding.  It's always best to try and resolve issues without taking medication, especially when you're young, but when nothing else works, the downsides of medication don't sound as down, but again, if you can fix whatever is bothering you in therapy or other ways without medication, it will always be a less invasive and safer route.  If you are the kind of person who needs them, and I'm one of the ones who nothing else helped, then you have to find one that suits you and works as well, but you don't say how down the road you are.  As for the Daily Mail not being a scientific journal, most of us don't really look at scientific journals, but newspapers write about what they report in them, but realize that a scientific study doesn't mean a fact, it means an inquiry is being conducted.  With medicine, there are many inquiries and much information, but very few consensus facts so far.  I think it's always good to think about these things, but don't paralyze yourself about it.  Good luck getting better.
Avatar universal
It was about 3,5 week. I just feel little better or same. Oh, thanks for everyone wrote here but i haven't hope now. I already saw someone who can't recovered in this forum. And I saw someone who tried all nutritiens but got worse. He just benefited from l-tyrosine but longterm tyrosine usage harmful to neuroreceptors. I wonder what he did after.
I experience extremely memory zapping and i can't understand unless i read 3-4 times even simple sentences.
I really need to learn about peoples experience about this. But i don't know enough English.
I want to go to doctor, but how can i find a doctor who know information about that.
Avatar universal
First, I'm not sure that's correct that long-term use of tyrosine is harmful to neurotransmitters -- it's going to be a lot less harmful that using medication, because tyrosine is an essential nutrient the body knows not only how to use but how to evacuate.  But that's not to say it can't cause side effects -- sometimes it can make an anxious person more anxious, for example.  But that's a side point, not a suggestion you use that supplement, it isn't.  I'm assuming you have a psychiatrist who prescribed the Prozac to you -- have you brought this up with your psychiatrist?  When you've been taking a medication for awhile and it isn't working or causing side effects, the psychiatrist will generally taper you off of it and try something else.  
I told my psychiatrist i experiencing cognitive problems but she didn’t do anything. Just told me i have to try different a/d. After, i told she i don’t want to use it anymore.
I was going to there for 6 months!  I didn’t have therapy yet.
I don’t matter depression now. I just want my skills back.
The only thing you can do if you don't feel your psychiatrist is right for you is to find another one, but if she recommended a different antidepressant, that is doing something.  But you do have to make the decision, she isn't going to force you to switch.  And therapy is important to try even if you're on a medication that works great unless you desire to take medication the rest of your life.  I don't know what else to tell you except that it is your decision but make sure you taper off the drug if you decide to stop, don't do it abruptly.  You don't need more problems.  
Avatar universal
I found some useful article.
and Dr. Peter Breggin giving importance to ad's.
But those writings is too much for me. I hope someone could explain me basically. Can i recovery?
Also i think it got worse. My short-term memory really garbage now. Is this withdrawal?
I don't understand -- if you're still taking the Prozac you can't be in withdrawal.  You didn't say you stopped, you say this all started while you were taking it.  That makes it sound like a side effect that will go away most likely if you taper slowly off the med.  Now you're talking about withdrawal problems, which come when you stop a med, and usually when you've been on one for a long time and it worked.  The article you read is probably something about people who take these meds for a long time.  I would be a lie to say medications are not dangerous -- all of them can be dangerous.  All should be used by balancing the costs vs. the benefits.  You should only take them if they are necessary, not just because they exist and might be nice to try.  I know most doctors hand them out like candy, but that doesn't mean anyone is being forced to take them.  In your case, you had symptoms that drove you to see a doctor who basically dispenses medication.  You could have seen a therapist to see if you could fix your original problem without medication.  But when we need to take medication, it does come with some risk.  Most people do fine.  Some don't.  But you're not in any of these categories, because you've only been on the med for a short while, it's not one of the most problematic ones to stop taking because of the long time it stays in the body, but it can come with a host of side effects.  When these drugs work and nothing else did, you don't mind the side effects much.  In your case, you're obsessing over a drug you've been told to taper off of and try something else. but you haven't said you've done that.  So have you stopped taking it?
I maybe made an grammar mistakes. I stopped them 24 days ago.
Avatar universal
I was forced to take sertraline with a dose of 50mg/day during 8 months. Since I stopped this 2 months ago, I don't feel normal and can't achieve any thinking.
I saw this thread and wanted to ask @Cipro to know if he finally succeeded to recover... I REALLY NEED HELP.
If anybody else can help me, please do... I don't want to live anymore.
Did you stop abruptly or taper off slowly?  Look, if you're having bad withdrawal effects, assuming this is what it is, that are as bad as you describe, you probably stopped the drug too quickly for you.  You can go back on it at the last dose at which you felt fine and if that works, taper off of it as slowly as you need to because this can last a long time in some people.  That's only if this is withdrawal you're talking about, you don't say.
I reduced my dose to 25mg during 5 days, then I totally stopped the medication.
It was 2 months ago, and I hate this medication because I was forced to take this and it made me feel bad. I don't understand how my brain can improve the symptoms if I start taking it again now... please explain me why it can be useful to continue so many time later...
You stopped way too quickly.  The slowest recommended taper off one of these meds is 6 weeks, and for a particular individual that can be way too fast.  We differ in how we're affected by stopping these meds, some have no problems at all and others have huge problems.  We don't find out until we try to stop.  Some meds we take are hard to do this and others we take are really easy, so it even differs by the drug.  Here's the explanation:  first, it doesn't matter why you took the drug, you did, and you can't undo that, so leave that part alone.  Second, these drugs alter the way the brain naturally works.  When you stop, the brain has to relearn how to function naturally again.  Some of us do this easily and some don't.  You apparently aren't.  That's why when we stop we take our time and take as long as we need to because everyone will have a different experience.  What going back on it does is stop what you're going through, hopefully, by putting your brain back to working unnaturally so you can then taper off of it much more slowly so your brain has the time to adapt.  Now, you don't have to do this, it's just a suggestion.  You might in time get past this.  But some just don't, and so that's a risk, because the longer time passes since you stopped the less likely it is you'll be able to easily go back on the med and have it do just what it did when you were on it.  Again, this is just a suggestion, because it might very well go away with time.  But it's been 2 months, which means, if it is in fact withdrawal, and I'm only guessing that's what it is, you know better if this only started when you stopped taking the drug, you already have what's called a protracted withdrawal, and they're no fun and can last a very long time for some people.  Up to you what you decide to do about it, but being safe is the best thing with these meds.  Peace.
Avatar universal
The choice is hard... two months with symptoms were really hard to live with... and I overcame despear by thinking that my abilities would be back fast, and that the ill-being was just a short period.
Take it again would be definitively a horrendous thing, and I don't know if I would survive to this...
I have some exams in about 1 month, and I know that taking it back would toggle me totally off for at least 2 months in the best case.
What would you suggest me ? Is there any chance to fully recover ? Would my inability to memorize things be resolved by taking the medication again ? Did you already take some SSRI, and experienced difficulties with it ?
My experience won't match yours, but yes, I've had a horrible time stopping an antidepressant.  Had to learn a lot I didn't really want to learn about because docs often just don't pay attention to this kind of thing.  As to you, I have no idea, nobody does, how long this will last, if it will go away, etc.  I also don't know the experiences you had while on the medication that makes you hate it so much -- I never had a memory problem on one.  But you're you and I'm me and nobody really has the exact same experience with this stuff.  It's why it's so hard to know what to do.  All I can tell you is you stopped more quickly than is recommended and you're suffering, apparently, because of it, though I can only go by what you've said.  It's always your choice what to do.  I always advice doing things safely.  Others like to jump.  We're all different.  You're suffering and I offered one way to possibly end that.  Waiting it out can work.  But you won't know until it either does or doesn't.  You can't predict.  Whatever you choose to do, I hope it works out for you.  All I can say is, having gone through what I've gone through and reading what others have gone through, results are all over the place and so I always suggest not waiting it out only to find it never goes away and it's too late to go back and do it the right way.  Nor is there a guarantee that doing it the right way will end up any better, but it does give you a chance for a do-over.  Peace.
Avatar universal
I have a question which can seem crazy, but I would like to ask it.
I read that insomnias allow the brain to keep a high level of serotonin, which is habitually used during the sleeping.
Could à bad sleep help my brain to get used to a level which isn't as high as the level it got when I took Zoloft, but which can maybe be sufficient to resolve my problem.
What do you think about it ? I guess you find it completely wrong, but I would like to verify what is other people's point of view on it.
Thank you for all your advices. It helps me more than you can imagine.
You are misunderstanding how SSRIs work.  They don't change the amount of serotonin that is in your brain or your body --- most serotonin is actually in your digestive system and blood vessels, not the brain -- they change how your brain uses it.  The drugs block the action of the enzyme that breaks down serotonin for evacuation from the body and targets certain receptor sites, it doesn't increase the amount of serotonin.  This allows serotonin to be used intensively and for longer by those selected sites.  Other sites stop working, since they're no longer needed, and part of withdrawal is thought to be those other sites trying to wake up and work again when the drug is stopped.  Serotonin is made by the body when you consume tryptophan, an amino acid, combined with B6, Vitamin C, and other co-factors.  That's what makes serotonin, not SSRIS.  They use what's already there.  As for sleeping, the key hormone there is melatonin, which the body makes from serotonin.  That's the main sleep hormone.    
Avatar universal
I forgot : do you know if a SSRI's withdrawal can affect some other neurotransmitters than those which use serotonin ?
Yes.  Choline, for one, which is involved in memory.  Some drugs are more intensive in affecting choline than others.  Paxil is very high, for example.  And yes too, substances in the body are in balance with one another.  Get one out of whack and it can affect the others.  For example, very high dosages of serotonin affecting drugs can affect dopamine adversely.  So yeah.  But that doesn't probably affect what's going on with you.
Do you mean acetylcholine, the neurotransmitter involved for reasoning ?...
So has my I.Q. been significantly affected in reasoning, as I thought ?
Nobody has any way to measure IQ.  It's not a real measurement.  IQ is the measure of the potential of a person to learn.  An IQ test is a measure of certain things the authors believe everyone should know, which is a measure of how much you've learned, not of how much you're able to learn assuming you have the motivation to learn.  Reasoning isn't equivalent to IQ.  So nobody has any idea if anything significantly affects IQ.  What is usually referred to when that term is used is performance, which, again, isn't related to capability but to what you're able to feed back in, say, an exam.  It's highly unlikely your reasoning ability is in any way affected.  What might have been affected, and again notice I always am using waffle words like might or maybe because I don't personally know if you are in fact suffering from withdrawal.  I'm assuming it from your post, but you haven't given enough detail for anyone to know for sure.  I'm just saying "if" you are suffering from a protracted withdrawal, which it sounds like you are but I can't know.  You've never said, for example, whether this stuff you're complaining about only started after your stopped your med, and by the fact the schedule you used to stop it was really really fast, pretty much cold turkey.  And yes, acetyl-choline is a part of the choline system.  As you say accurately, it is involved in reasoning and memory and other brain function but so are a lot of other things working together in harmony, a harmony that can be thrown off by using drugs of all kinds but that doesn't mean that has happened.  I mentioned Paxil, and you weren't taking Paxil.  I'm not as familiar with how strong the affect is with Zoloft, though I'm sure there is some.  So no, your IQ whatever it is, something we're not currently able to measure, is fine.  What apparently isn't fine is your focus and concentration because you're not feeling well, and if that's because of withdrawal, again, if, that's what you need to address.  If it's something else, you need to address the something else.
And yes, everyone, I know there are IQ tests and if we score high we feel great and if we score low we are labeled slow.  What I'm saying is, research shows all IQ tests are biased because the only thing we can ask on any test is something we personally know, meaning we learned it.  There is no reliable way to measure the true learning potential of anyone compared to anyone else, so these tests are more fun to talk about than they are informative.  Much better to judge folks by what they know, say and do.  That is something we can see.
Thank you.
I just noticed your name... it is again more discouraging, because it shows that yourself suffers of what you took, so I'll probably experience the same difficulty lifelong, what will push me to always consider that I've been "Zolofted", to take your words, like if I was "lobotomized"...
No, no, no.  Wrong.  First, while Zoloft users do have a very high rate of withdrawal symptoms, Zoloft is nothing like Paxil.  For whatever reason, Paxil and Effexor are way harder for most people to stop taking than any other antidepressant.  So there's that.  Second, different people react differently.  Third, what happened to me is rare.  Most people have a few bad weeks and then are fine.  Some have protracted withdrawals like the one you're apparently suffering, though again you still haven't answered the question of whether this only started after you stopped the Zoloft.  Nobody on this website over the years since I came on here like you looking for answers has ever had the depth of problem I had.  You do find them on other websites devoted to the problem.  But not here or most places.  Most psychiatrists have never seen someone like me and so it's very hard for me to find help.  You haven't been suffering all that long and you're not suffering nearly as badly as I am.  I know it feels awful, but from your description you're having one main problem, and that's concentrating.  I won't go into what happened to me, I seldom do, because it just isn't going to happen to people on here.  Some of us just get dealt a really bad hand in life with something that doesn't happen to many people.  That's me, not you.  And if this is withdrawal, I didn't have anyone to tell me what had happened -- none of the docs I had seen over the years had ever told me these meds are very hard to stop taking so I had no idea what I might be in for.  You know now, if you didn't before.  I've said something you can do if you want to try to help you, but if you want to wait it out you're a lot younger than I was but if you just complain about it you will make it worse.  But don't for a minute assume because something happened to me it will happen to you, I stayed on here to try to make sure that doesn't happen.  Peace.
Looking to your writting, you don't seem to be weaker than anybody else (completely the opposite), but I understand what you write.
All my problems started just after the beginning of my taking, and were developped through months. I think that the holidays and the laziness didn't help at all...

I saw a pratician today, and was finally prescribed 25 mg of Zoloft, to take each day during a week, 1/2 day during 1 other, and 1/3 during the last (the sirup isn't sold in my country).
I hope it will help... in all cases, I would have remorse during all my life if I don't do anything possible to undo the medication's effect.
I'm gonna stay alone while taking the drug, and will go back to a normal behavior with others about 1 week after my withdrawal.
Do you think that 25mg isn't too high ?
Okay, more info.  Good.  If this started when you started taking the drug and it didn't start only after stopping it, then if I understand you correctly you're experiencing the same things now you experienced all the time you were on the drug?  And it only started once you started the drug?  Because if that's true, it's not withdrawal, it's a continuation of the same old same old.  If you had side effects that were debilitating from the time you started, why did you stay on the drug?  Seems like your doc should have tapered you off and tried something else, assuming you ever needed an antidepressant in the first place, which it sounds like you've not all that sure about.  But if it is withdrawal there is no set amount to go back to.  The advice is, go back to the last dose at which you felt fine and then taper off as slowly as you need to, not a general schedule the doc uses for everyone.  Now, all docs use the same taper for everyone, they're quite lazy about it, but that's not what's recommended by those who study the issue.  They say to do what suits you, not what suits someone else.  Without a complete description of what exactly happened and when, nobody, including a psychiatrist, can really help you.  You need to say, whether here or in your doc's office, exactly what's going on and when it started so they can respond.  A lot of people simply don't tell their psychiatrists how the drug or stopping the drug is changing them, so the docs don't know.  Hope whatever you do works for you.
Oh, and again, my problems aren't the same as your problems.  These drugs are very weird and everyone has a different experience both when taking them and when stopping them.  
Since this morning, I experience the same symptoms as before... I have difficulties to concentrate, to stay sitten down and to think, globally.
It is scary, and I don't know what to do... by stopping the reinstatement now, I condemn myself to always live with the culpability to have not do the right thing, which would save me...
At the beginning of my taking, about 1 year ago, I always complained about my inability to think, which I linked to the neuroleptic I was taking.
I was really bad, experiencing the hell... all my skills were lost.
The pratician introduced Zoloft at the same time. I don't know how it modified my behavior, because I always considered it gone.
I only remember that, following my first taking, I started dancing in my room, thinking that it was helping me to destress.
I did not noticed immediately a total change in my social relations. I spoke more, but was still the shy guy, who stuttered.

To conclude, I think that Zoloft had an immediate effect on me, which really changed my relation to the world few months after I started taking Zoloft, so following my developing of new capacities to interact and my debilitating.

It is absolutely disgusting. My previous state was a so complex way of thinking and communicating, that I can't reproduce it... I was just a machine in reflexion.

Please send me hope... I really need it in this trouble's period, to keep my will and my dreams up.

- I apologize for my writing. If you notice any difference with the other messages, please note that it is due to the altered consciousness induced by Zoloft.
Don't know about the neuroleptic -- you haven't mentioned that.  Hopefully, you will do the taper off the Zoloft properly, and then face what comes next.  Meds can have profoundly good and profoundly bad effects on people.  When they are bad at the beginning and don't improve, that's not a drug to take.  Can't redo that.  Some take statins for cholesterol and destroy their livers or joints.  Some take Tylenol and destroy their livers.  Some take aspirin or ibuprofen and destroy their stomachs.  For others these same meds are life savers.  Life isn't easy.  When you do properly quit the Zoloft, it will be time to consider what to do next.  For now, have patience, but you do need to develop the ability to speak up for yourself with medical professionals.  When you know a drug isn't right for you, you have to tell your doc, and if you don't get a good response, find a different doc.  This is a hard lesson to learn, one I learned too late.  Peace.
Avatar universal
Are you really sure that it is the safest way to recovery ? I'm gonna take the pill away, only according to your advices, and I would like to be verify before... I don't know if taking back the treatment could weak my mind by tiring it, and I would like to avoid the problems that could result of this...
No, I'm not sure about anything.  Honestly, I'm not.  Since you're in school I'm assuming you're still fairly young, and the younger you are the more adaptable you are.  Now, if you're really young, being on an antidepressant can cause brain development problems, just as can any drug or substance that profoundly affects brain neurotransmitters, such as pot or opiates or speed or alcohol or all the drugs advertised on TV that aren't even for treating mental illness but do affect neurotransmitters.  When I say safest, remember, it's only if you are indeed suffering from a withdrawal that is so severe it's interfering with your life and not getting better or going away.  What you describe isn't as severe as a whole lot of people suffer, but my concern is the length of time it has been going on and the fact it's so concerning to you it brought you here.  So when I say the safest, I mean it's the only -- read that right, only -- way anyone knows to respond to a protracted withdrawal.  There's very little research on it.  Nobody is sure why it happens to some and not everyone.  Nobody is sure about anything.  So when I say safest, I mean it's the only thing you can do as far as a medical intervention.  But again, it might very well alleviate on its own in time.  There's just no way to know.  Why don't you find the best psychiatrist any0ne knows, one who isn't devoted to mainstream thought but who actually cares about his or her patients, and use them as a sounding board?  But as far as this one person knows who has been through this but much much worse than what you're going through, I've never found any other way to deal with this, and I've been looking for a very long time.  That's why I say it's the safest, but not the only.  Do some research on your own, talk to a great professional, see what you think.
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