![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 11 to 35 of 79. Go back in thread:
Posted by SLS on July 30, 2011, at 6:14:17
In reply to Re: Cyclothymia: SLS and others. What is it?, posted by mellow on July 30, 2011, at 1:02:31
> I am dx cyclo. Basically it is a sub class of Bipolar some consider "soft" because it does not include full blown mania or full blown episodes of major depression. It is the oscillation between dsthymia (spelling?), a mild yet chronic depression and hypomania.
>
> In my case I cycle between being really dissatisfied with life, sensitive to rejection, fatigued, sad, and often suicidal all the way to being the life of the party, full of energy on four hours sleep, grandiose, etc.
>
> One of the major components of my moodiness is feeling like everything is "crystal clear" when I'm high then losing a lot of my confidence when I crash and feeling dull or shameful for weeks on end.
>
> In contrast to those with Bipolar I who may find months if not years of remission and high function between episodes, people with cyclothymia often feel crummy all the time and experience little remission from what most literature shows. For me the only time I feel really good is when I'm not quite fully cranked up to hypomania. About fifty percent up the scale is when I start actually feeling like a normal person. But it is short lived as I end up being way high and psychotic after a couple of weeks.
>
> There is certainly nothing "soft" about it. I've been feeling sh*tty for two months and keep telling myself I just need to have a better outlook on life. It's really up to me. I have a great doc and good therapist. My wife and family are awesome, but no one is going to live this life for me. I have to make the best of it. I don't think meds or a new therapist is gonna change things. I decided it's up to me.
>
> Best of luck if this is your new Dx. I've done ok (at least I haven't been back to the psych ward) on Lamictal. The stabilizers are worth a shot. Exercise and yoga help a lot too.
>
> mellow
This is better than any description I could come up with.I would just add that cyclothymia is sometimes considered a prodrome of bipolar disorder. If left untreated, cyclothymia evolves into a presentation of MDD or BD mood disorder. It can also be allowed to become worse if acute trauma or chronic psychosocial stress are evident, but not treated.
- Scott
Posted by SLS on July 30, 2011, at 6:24:17
In reply to Re: Cyclothymia: SLS and others. What is it? » mellow, posted by floatingbridge on July 30, 2011, at 1:26:58
You certainly have a convoluted set of facts and theories that you are placing importance on.
Perhaps this would be a good time to describe in detail what you observe and not what you think.
How long do your depressive episodes last for?
I think you are too old to be cyclothymic. Quite often, mood disorders and borderline personality disorder (BPD) exist comorbidly. What would this presentation look like? Let's see if it matches a specific set of symptom clusters.
I might not be around later. I look forward to seeing your observations and having others respond to your descriptions.
- Scott
Posted by sheilac on July 30, 2011, at 7:44:36
In reply to Cyclothymia: SLS and others. What is it?, posted by floatingbridge on July 29, 2011, at 13:36:41
Totally understand your frustration.
About 20 years ago a doc told me I was depressed with anxiety. In recent years, one doc said I was ADHD and didn't say anything about bipolar. Another said I was BPII, another said I was "soft bipolar" with "slight" ADHD issues. What?
All I know is I can remember having crushing, low depression since 4 or 5 years old! My "mania" is of the irritable kind and not the crazy highs. Only times I have experienced super high typical mania is from steroids, cold medicine and too much stimulants.
So, who the heck knows. I just know when you feel really low it sucks and I'm still not exactly sure what I have. I tend to think I do have more BPII - due to the bad depressions I have experienced.
Sometimes I feel like docs are just throwing darts at a board and seeing what sticks with diagnoses and meds.
I hope you feel better. I know with me, "traditional" mood stabilizers - lithium and depakote made me depressed unless the dose is pretty low. Maybe that is because I am prone to depression.
Stimulants, surprisingly have been better for my depression than traditional antidepressants. Odd.
Geodon, so far is working, but is a weird drug in my opinion. Still trying to work out the dosage.
Posted by Dinah on July 30, 2011, at 7:49:26
In reply to Cyclothymia: SLS and others. What is it?, posted by floatingbridge on July 29, 2011, at 13:36:41
That was one of the diagnoses on my insurance receipt over the years. I never took it particularly seriously, since like most other diagnoses it didn't fit particularly well. I figured it was my pdoc's shorthand for "mood instability". I'm definitely on the bipolar spectrum somewhere, but cyclothymia doesn't really fit any better than bipolar II.
My mood instability has seemed to mellow out a bit since menopause. Have you checked with a gynecologist about possible hormonal involvement?
Lamictal is some use for me, I think. I take it primarily for migraine prophylaxis, but I think it also has a bit of mood stabilization effects.
Posted by morgan miller on July 30, 2011, at 8:51:03
In reply to Re: The difference between cyclothymia and BPll?, posted by floatingbridge on July 29, 2011, at 23:06:25
> O.K. Maybe I used to have BP ll. What the f*ck do I know? I used to be able to write. It was very difficult with never knowing what f*ck*ng mood I would be in and whether my brain would work that afternoon, that week, that month.
>
> But it was never 'lite'. I just read that in three places. What the heck is 'bipolar lite'? I suppose not having mania. But there is nothing else lite about this. I feel like whatever *this* is is slowly killing me.
>
> It's now like, will my brain work this year? Maybe next? Ever again?
>
> Yeah, I'm a little worked up. I am posting to myself now.
>
> I see my new pdoc in less than two weeks. Do I just beg for lithium? I am really scared :-/
>
> But on the outside, I am o.k.Hey FB...Lithium might not be a bad place to start. I believe you mentioned having an o.k. response to a moderate dose(600mg?) in the fairly recent past. Correct me if I'm wrong.
Some here have suggested lamictal, which might help. Have you tried it? I can't remember. I'm not a huge fan of lamictal, but it does help a lot of people. I just think lithium is a far cleaner substance, with more potential to actually help a brain recover in the long run.
I don't know much about treating cyclothymia, but it sounds like a real pain in the arsh. For you, it may be that starting very simple in the beginning, like a medium dose of lithium, might be the way to go. If you get even some relief, enough to help you feel a little stronger, it would be worth it I think.
The only reason why I'm not crazy about stims and benzos are the potential long term implications. Both of these classes drugs have more potential for neurotoxicity than other ones like lithium and depakote(again, a middle range dose, nothing heavy).
I would be interested to see how you responded to things like holy basil(new chapter supercritical), 4-600 mg magnesium glycinate, uridine plus fish oil(25 mg triacyteluridine and 800 mg combined EPA/DHA), and ayervedic herbs like bacopa and gotu kola. These things would have a more subtle supportive role of course. After a while, they may also help your brain get back to functioning a bit better(this would also improve after you've been stabilized by a medication or two for a while).
Morgan
Posted by floatingbridge on July 30, 2011, at 14:19:34
In reply to Cyclothymia: SLS and others. What is it?, posted by floatingbridge on July 29, 2011, at 13:36:41
I will see my new pdoc and lay it out. Not avoid any bipolar dx nor seek it. Not avoid axis ll comorbidities or seek them.
After some reading this morning, I see that Avoidant Personality really fits. This personality *disorder* dovetails with my persistent (and officially dx'd) social phobia.
Borderline fits only in certain features which are a scary ride unto themselves. They center around a sense of identity disturbance and intensity of emotion. I score off the charts on
MMPI 2 on:Lack of ego mastery
Lack of ego (cognitive)
Lack of ego (conative?)Topping the charts in no order is:
PTSD (*sigh*)
Inversion
Mental dullness
Depression
AnxietyI suspect a bipolar component, esp.given at least one ffirst degree relative with BP l. The cyclothymia may have morphed, but I don't know. Looking back, years ago, I did have hypomania exhibited by increased thoughts clicking together, increased output, lack of sleep (though desperately sought). The grandiose thing didn't happen for me. I think I just suddenly had confidence that I could *perform*, like write, work. If I have BP ll, it expresses itself as agitated or mixed (if that the proper term.). I have been low, very low for years now. I despair about ever is getting back some
functionality.Regarding mania, when I was 18, I left home and went absolutely wild. Not exactly unusual in itself. It makes some sense. But my behavior was wild and very risky, and I had no idea that it was. This stopped pretty abruptly around age
22. If that was manic, then that really was the extent of it. I was in a woman's shelter, was moved out of the area by them to avoid a stalker. I have never hurt anyone or myself
except by avoidance, neglect, and the usual human callousness of ignorance. Being now, as I see, avoidant, I would risk any confrontation possible. I was never combative,
for better or worse. I would though, for some reason, risk putting myself in harm's way for another person. I remember
during my street period of coming upon two young strong men beating an old wino in the gutter. My hair was buzzed and pink. It was three a.m. I walked up to those men and
said, hey, why are you doing to this guy? They looked at me and (in retrospect, thankfully by pure grace) looked very startled and walked away. I can't imagine having the naivety to do something like that again.So, there are times I can put my fears aside for others. The worst symptom of this last break was that I felt myself, my will to be able to protect my son slipping from me. I feel like that urge to care for him is my final anchor.
I am better than that now. I didn't really fail my son as I had feared, and feel even more sensitive to his needs than before. So recovery of some sort is possible. I am just so tired of suffering and failing.
I will just lay this all out to the good doctor. I start personal
therapy with a new therapist. I remember now that more that DBT, MBCT helped me more, and I just need to reconnect
with my good guides here.Much of this break was precipitated by a failure in my therapeutic relationship. I had seen a psychiatrist for
medication and therapy. It really fell apart and left me without any support and a head full of unhelpful cr*p. It also provoked the emergence of the worst reactivation of PTSD to date.Thank you for reading my frantic posts last night. I checked today, and don't think I broke the board's guideline of three posts in a row. Is that the guideline?
You all are so kind for being here. Thanks. Sorry I getbso worked up. (But I really don't fit histrionic. I just looked that up, too.)
Retiring back towards a more lurking stance,
fb
Posted by floatingbridge on July 30, 2011, at 15:52:41
In reply to Re: The difference between cyclothymia and BPll?, posted by morgan miller on July 30, 2011, at 8:51:03
Lithium is what I will suggest. I took 300mg with no sides. Given my sometimes sensitivity, maybe subtheraputic doses will make enough difference.
I did try holy basil (I read you and, I think BB), but with so much going on, I felt zip.
I have added lemon balm to GABA. There is some new souped-up lemon balm from New Chapter set to hit the shelves. You know how the vitamin aisle is in markets. There
is always that next big cure coming. Still, I am giving the lemon balm GABA a good run. Was told the combo was key.Gotu kola. Is that a stimulant? Bacopa? It's a liitle ironic that I can be very sensitive to herbs. I had to discontinue
cucurim-something or other because I swear it kept me awake.Mag and fish oil (krill) but when I feel bad, it's hardvto choke the supplements down. I'm not sure why.
I'm not gonna restart dex. I'm going with the Emsam for now. Xanax xr, well what can I say....? It's on board and I take it gratefully like I used to take the communion wafer.
Thanks Morgan. I can move these questions over to the alt board. I lurk there :-)
fb
Posted by Phillipa on July 30, 2011, at 21:59:35
In reply to Thanks Morgan » morgan miller, posted by floatingbridge on July 30, 2011, at 15:52:41
FB just googled it now and seems it's less than full bipolar but as Scott said it can turn into bipolar . It was Scott? Love Phillipa
Posted by Phillipa on July 30, 2011, at 22:01:01
In reply to Re: Thanks Morgan » floatingbridge, posted by Phillipa on July 30, 2011, at 21:59:35
Scott you said you might not be here are you leaving babble? Phillipa
Posted by floatingbridge on July 30, 2011, at 22:32:54
In reply to Re: Scott, posted by Phillipa on July 30, 2011, at 22:01:01
> Scott you said you might not be here are you leaving babble? Phillipa
What? If so, on to better things....
Posted by floatingbridge on July 30, 2011, at 22:38:20
In reply to Re: Thanks Morgan » floatingbridge, posted by Phillipa on July 30, 2011, at 21:59:35
>
> http://www.angelfire.com/home/bphoenix1/cyclo.htmlThis is helpful. Everything else I read led me to believe cyclothymia was no longer a valid dx after a major depressive episode. I get confused.
Thanks Phillipa.
Posted by Phillipa on July 30, 2011, at 22:53:16
In reply to Thanks Phillipa » Phillipa, posted by floatingbridge on July 30, 2011, at 22:38:20
Sounds like don't treat and may turn into bipolar but not sure I agree. I do see a biological component to bipolar as well as scizophrenia and with my family history of anxiety anxiety as well. So then depression must also be the same. Phillipa
Posted by SLS on July 31, 2011, at 6:30:56
In reply to Re: Scott, posted by Phillipa on July 30, 2011, at 22:01:01
> Scott you said you might not be here are you leaving babble? Phillipa
I'm not going anywhere just yet.
I have been spending a great deal of time helping a friend and her mother, both of whom are fighting cancer. The mother has decided to allow herself to expire rather than undergo more surgery and radiation treatments. It is a difficult time for all.
I have not felt very well over this past week. I fear that I may be stuck, with no further recovery to be expected.
I have restarted taking fish oil. After three days, I have not felt any different, although this might be a good thing. That I don't feel worse is encouraging.
Currently:
Nardil 90mg
nortriptyline 150mg
Lamictal 200mg
Abilify 10mg
Carlson's fish oil: EPA/DHA = 8/5I am thinking of switching to the Omegabrite brand fish oil formulation suggested by Harvard University. It contains 100 percent EPA, the omega-3 fatty acid claimed to be the active component when treating mood disorders.
- Scott
Posted by polarbear206 on July 31, 2011, at 8:54:47
In reply to Re: Cyclothymia: SLS and others. What is it?, posted by SLS on July 30, 2011, at 6:14:17
Psycheducation.org is an excellent resourse for Bipolar. I think your on the right track.
Posted by morgan miller on July 31, 2011, at 9:46:06
In reply to Re: Cyclothymia: SLS and others. Floatingbridge, posted by polarbear206 on July 31, 2011, at 8:54:47
FB, I enjoyed hearing about your story. It's interesting to picture the younger you living on the edge. It sounds like you were almost punk rock back then. Anyway, thanks for sharing.
As far as the fears go that you are experiencing, they are likely, at least in part, manifestations of deeply rooted stuff that just happened to start impacting you and coming to the surface later in life. These types of fears, as with things like OCD and anxiety, are coping mechanisms we use to protect ourself and manage our emotions. In a sick and twisted way, we end up making ourselves suffer, sort of punishing ourselves, so we cannot feel good and fully experience life. This way of coping is a result of the hurt that left us with deep pain and sadness. If we feel anxiety, develop great debilitating fears, and develope crippling OCD, we prevent ourselves from being vulnerable to truly feeling things in life, from being exposed to the world around us. We do this out of fear of being hurt the way we have been hurt in the past. If we remain in a state of suffering and torture, we never are able to feel good enough to be vulnerable to getting crushed and dissappointed by life as we had before. These are deep emotions in our psyche/subconscious that drive these self destructive coping mechanisms. So, I would understand why most would have a very difficult time understanding how we could do something like this. These things that drive us are intangible, they are not concrete like neurotransmitters and such. They are likely a result of the extremely complex system as a whole. It's just not one of those things scientists can pinpoint and draw pictures of.
I hope some of this made sense. I'm sure you already have a good grasp on these concepts. I also hope you don't think I am pinning everything you experience on our very flawed psychological coping mechanisms. I am a beliver that genetic predispositions and maldeveloped biology play a major role. I just believe that things are far more complex than most people want to even begin to try to understand.
Morgan
Posted by floatingbridge on July 31, 2011, at 11:51:17
In reply to Re: Cyclothymia: SLS and others. Floatingbridge, posted by morgan miller on July 31, 2011, at 9:46:06
Hi Morgan, I enjoy talking with you. You are right, about the psychological underpinings. By my age, they're very deep, I always had extreme sensitivity, then there is that damn bipolarity thread that runs through my family. What's one to do? Keep slowly opening to life good therapy, healthy people (people with mental illness can be very healthy--they often have excellent B.S. detectors.)
I was very fringe in my glory days. Wish I had enjoyed being a wild child. I enjoyed dressing up, my nose was pierced,
and my hair was always a new color. There was a club called the Mabuhi Gardens (sp?) in SF I used to go pogo in, mosh pit and all. I never could abide performers spitting on the audience though and too much vulgarity. Nor the fist fits.
Seems what passes for rebellion is often reactionary, pointlessly scatological and (IMO) misogynistic. *sigh*I saw Jane's Addiction back in the late 80's. That guy, I happily forget his name started spitting on the audience. Wtf.
It's the 80's dude. I just walked. The Pixies were always awesome live. The Replacements, too, though sadly, they thought it was cool to go off stage to vomit, then come back and perform. Sonic Youth was awesome, too.Funny thing about aging is that people think I've always been
old or ill with fibromyalgia or very conservative because the only freak flag I fly these days is with my weird jokes that startle most folks except my husband. When I had tomtell him recently I honestly didn't know if life was worth it and I was so sorry to admit it, he said I could not live without your jokes. Isn't that a beautiful thing to say?One thing I am sad about right now and another motivator too wellness is seeing live music. Gillian Welch started here new album tour in my town the first week of July. That coincided with my massive withdrawal and stuttering.
Oh well. Heck yeah. Going forward. Thanks for talking Morgan. How are things your way?
fb
> FB, I enjoyed hearing about your story. It's interesting to picture the younger you living on the edge. It sounds like you were almost punk rock back then. Anyway, thanks for sharing.
>
> As far as the fears go that you are experiencing, they are likely, at least in part, manifestations of deeply rooted stuff that just happened to start impacting you and coming to the surface later in life. These types of fears, as with things like OCD and anxiety, are coping mechanisms we use to protect ourself and manage our emotions. In a sick and twisted way, we end up making ourselves suffer, sort of punishing ourselves, so we cannot feel good and fully experience life. This way of coping is a result of the hurt that left us with deep pain and sadness. If we feel anxiety, develop great debilitating fears, and develope crippling OCD, we prevent ourselves from being vulnerable to truly feeling things in life, from being exposed to the world around us. We do this out of fear of being hurt the way we have been hurt in the past. If we remain in a state of suffering and torture, we never are able to feel good enough to be vulnerable to getting crushed and dissappointed by life as we had before. These are deep emotions in our psyche/subconscious that drive these self destructive coping mechanisms. So, I would understand why most would have a very difficult time understanding how we could do something like this. These things that drive us are intangible, they are not concrete like neurotransmitters and such. They are likely a result of the extremely complex system as a whole. It's just not one of those things scientists can pinpoint and draw pictures of.
>
> I hope some of this made sense. I'm sure you already have a good grasp on these concepts. I also hope you don't think I am pinning everything you experience on our very flawed psychological coping mechanisms. I am a beliver that genetic predispositions and maldeveloped biology play a major role. I just believe that things are far more complex than most people want to even begin to try to understand.
>
> Morgan
Posted by floatingbridge on July 31, 2011, at 12:11:02
In reply to Re: Scott » Phillipa, posted by SLS on July 31, 2011, at 6:30:56
> I'm not going anywhere just yet.
Oh, good :-). (purely selfish, shamelessly so :-/ .)
>> I have been spending a great deal of time helping a friend and her mother, both of whom are fighting cancer. The mother has decided to allow herself to expire rather than undergo more surgery and radiation treatments. It is a difficult time for all.
>
> I have not felt very well over this past week. I fear that I may be stuck, with no further recovery to be expected.
>Darn. I am sorry you are currently feeling poorly, Scott. Acceptance of a stall or a wall is important. You still don't
know completely what is in the future. You helped show me that. If you are providing support for a family in crisis, you are
having a profound effect on others' lives. I admire that greatly.> I have restarted taking fish oil. After three days, I have not felt any different, although this might be a good thing. That I don't feel worse is encouraging.
>Did you catch Larry Hoover's post about adding some fresh
fish? Something about it being different. I'm not saying stop the supplementation. I'm suggesting yes to both.> Currently:
>
> Nardil 90mg
> nortriptyline 150mg
> Lamictal 200mg
You tolerate the lamictal o.k.? I guess you do, or you wouldn't take it. No more lithium?
> Abilify 10mg
> Carlson's fish oil: EPA/DHA = 8/5
>
> I am thinking of switching to the Omegabrite brand fish oil
formulation suggested by Harvard University. It contains 100 percent EPA, the omega-3 fatty acid claimed to be the active
component when treating mood disorders.
>
>
> - Scott
>
You know my support for you is ongoing. May God bless you. I know I'm not the only one here to appreciate this update from you.fb
Posted by floatingbridge on July 31, 2011, at 12:14:51
In reply to Re: Cyclothymia: SLS and others. Floatingbridge, posted by polarbear206 on July 31, 2011, at 8:54:47
> Psycheducation.org is an excellent resourse for Bipolar. I think your on the right track.
Posted by morgan miller on July 31, 2011, at 13:09:20
In reply to Re: Cyclothymia: SLS and others. Floatingbridge » morgan miller, posted by floatingbridge on July 31, 2011, at 11:51:17
The Pixies are one of my all time favorites! I saw them twice during their reunion tour about 6 years ago. I've always really like the others you mentioned as well. I hope one day you are feeling really good and able to lose yourself in some Pixies or any other music you once enjoyed.
It doesn't surprise me that you were more into the grunge/punk seen in the late 80s and early nineties, or that you changed your hair color often. I went through a phase of changing my hair color fairly often, especially when I worked as a hairstylist apprentice-one of a few things I never followed through with. I wish I had pics of me and the hair color and hair style changes, but sadly I don't.
Your a very cool lady FB, you should feel proud that you are, or at least appear to me to be, such a well rounded person with a wealth of experience. I really do hope you get things worked out and recover well enough soon to start truly getting back to living. I would love to hear you are able to get back to writiing as you had in the past, and feeling good about it. I do believe these are attainable goals FB.
I am doing better, thank you for asking. Still making progress, but far from where I should be in several areas. I think it's pretty crazy that I am probably more grounded than ever, but my mind and body are far from functioning as well when I was not so grounded. Maybe its a trade-off??? I hope not. I think with supplements, the right medication at the right dose, diet, exercise, and as you mentioned the always crucial positive support system, I will continue to make progress, just maybe not quite as much as I would like. Who knows, we will see what the future holds!
There are some crazy things happening in my personal life, I'm not quite sure what to make of them. They are good things, though someone is going to get hurt here. I'm speaking of romance. I've never been in this situation before. Maybe I can babble mail you and tell you all about it.
You're great FB. I think if I knew you in person we could be great friends. Maybe one day I will have the pleasure of meeting you.
Take care sweetie,
Morgan
Posted by floatingbridge on July 31, 2011, at 15:39:52
In reply to Re: Cyclothymia: SLS and others. Floatingbridge » floatingbridge, posted by morgan miller on July 31, 2011, at 13:09:20
The Pixies are one of those real deals :-)
Arctic Monkies are pretty good, too.
My babbllemail is always on.
Really, I predate grunge :-/. I am of a certain age. I remember the Sex Pistols being pretty good despite their manufactured prefab start. I think some of that stuff started with The Who. I just always love music. It's another language.
I missed out big on ever seeing Sly Stone. That's what I'd use a time machine for. I was too young for Sly.
Somehow, I almost understand the mind being more grounded than the body.. I know Chinese medicine has a way to explain it. But I don't think it's a tradeoff. I think the relationship is as you said, more complex and subtle. I don't know everything about your situation, but I think you might just be healing your bodyna little more slowly.
In osteopathy, there is one of the very first adjustments dome to a new patient. It involves subtle manipulation of the soft tissue adjacent to the 'atlas' in the neck/head. They call it setting one's house in order.
Wishing you ongoing steady healing, Morgan.
The Clash :-)
> The Pixies are one of my all time favorites! I saw them twice during their reunion tour about 6 years ago. I've always really like the others you mentioned as well. I hope one day you are feeling really good and able to lose yourself in some Pixies or any other music you once enjoyed.
>
> It doesn't surprise me that you were more into the grunge/punk seen in the late 80s and early nineties, or that you changed your hair color often. I went through a phase of changing my hair color fairly often, especially when I worked as a hairstylist apprentice-one of a few things I never followed through with. I wish I had pics of me and the hair color and hair style changes, but sadly I don't.
>
> Your a very cool lady FB, you should feel proud that you are, or at least appear to me to be, such a well rounded person with a wealth of experience. I really do hope you get things worked out and recover well enough soon to start truly getting back to living. I would love to hear you are able to get back to writiing as you had in the past, and feeling good about it. I do believe these are attainable goals FB.
>
> I am doing better, thank you for asking. Still making progress, but far from where I should be in several areas. I think it's pretty crazy that I am probably more grounded than ever, but my mind and body are far from functioning as well when I was not so grounded. Maybe its a trade-off??? I hope not. I think with supplements, the right medication at the right dose, diet, exercise, and as you mentioned the always crucial positive support system, I will continue to make progress, just maybe not quite as much as I would like. Who knows, we will see what the future holds!
>
> There are some crazy things happening in my personal life, I'm not quite sure what to make of them. They are good things, though someone is going to get hurt here. I'm speaking of romance. I've never been in this situation before. Maybe I can babble mail you and tell you all about it.
>
> You're great FB. I think if I knew you in person we could be great friends. Maybe one day I will have the pleasure of meeting you.
>
> Take care sweetie,
>
> Morgan
Posted by SLS on July 31, 2011, at 17:49:13
In reply to Re: Scott » SLS, posted by floatingbridge on July 31, 2011, at 12:11:02
> You tolerate the lamictal o.k.? I guess you do, or you wouldn't take it. No more lithium?
Oops. I forgot to list lithium. Lamictal at 200mg does not impair my cognition too much. 300mg really screws-up my memory.
- Scott
Posted by Phillipa on July 31, 2011, at 21:18:11
In reply to Re: Scott » floatingbridge, posted by SLS on July 31, 2011, at 17:49:13
Scott what you are doing now for your friend and family is truly courageous and I bet you are doing better than you think or you could not handle this so hard!!! Phillipa
Posted by Dinah on August 1, 2011, at 11:22:53
In reply to Thanks Phillipa » Phillipa, posted by floatingbridge on July 30, 2011, at 22:38:20
I wonder if it really matters, diagnosis. I mean, it's helpful to have a framework for the problem or ideas for treatment.
But mental health diagnosis is nebulous at best and often seems to be more of a descriptor than a definition of cause. Even major depression is unlikely to be one illness.
It's not as if you could find a mechanism that causes "cyclothymia" as opposed to "bipolar II". Or that once there is a definition there is a cure. Psychiatry/neurology just isn't there yet. They just treat symptoms at this point, in a rather hit or miss way.
Cyclothymia indicates more rapid mood swings than bipolar II. Which is helpful to know. But surely it's even more helpful to find a descriptor that more closely fits *you* rather than try to fit your symptoms into a diagnostic framework.
For example, while I don't have enough behaviors to meet the diagnosis for borderline personality disorder, I find the theory behind it *fits* very well. So I adopt some of the terminology for myself, even though the whole diagnosis doesn't fit. I say I have OCD, but in some ways it doesn't precisely fit. I'm likely somewhere on the borderline spectrum, but none of the diagnostic criteria fit me all that well. I even have some attention problems. I guess what fits best is old fashioned "neurosis" but that seriously downplays the physiological causes.
So I say I have easy arousal with slow return to baseline, a *lot* of anxiety and obsessive thinking, and difficulty in mentally switching gears. Under some circumstances, lack of sleep or certain medications or even extreme stress, I can get hypomanic, though never manic. At times I can become depressed, though that is by no means the major issue. I have health issues associated with the same chemicals that cause emotional/mental issues. IBS, migraines, etc. There's probably some problems caused by excessive stress hormones over an extended length of time.
Personally, I think whatever is wrong with me isn't all that much different from what's wrong with an overexcitable dog. There may be childhood factors, but if I weren't wired like an overly inbred cocker spaniel, my childhood factors would not have caused serious problems.
I treat symptoms, which is all anyone can do at this point, until they understand more about underlying causes. I think they've finally figured out that correlation does not equal causality. Through trial and error I've found that SSRI's give surface relief but overall just increase my agitation. Mood stabilizers are somewhat helpful. Tranquilizers can be occasionally helpful. Antipsychotics, or major tranquilizers, are very helpful on an as needed basis though I can't tolerate them on a continual basis.
I've grown to be aware of my body and what's going on, and to treat as needed. I know what situations cause problems and I try to avoid those situations.
I've given up on the psychiatric holy grail, the perfect medication or the "correct" diagnosis. I've given up thinking that the experts are all that expert at all, in comparison with most fields of medicine. Maybe in my lifetime they'll figure it out. But in the meantime, I'm not going to identify with any diagnosis. They're going to have to treat *me*.
Does cyclothymic or bipolar II or any other diagnosis really matter, if treatment doesn't change? Can't you just think of yourself as somewhere on the bipolar spectrum?
Posted by floatingbridge on August 2, 2011, at 7:37:55
In reply to Re: Cyclothymia » floatingbridge, posted by Dinah on August 1, 2011, at 11:22:53
Dinah, thanks for typing out this reply. It seems very sober, and after about three years of casting about for a single dx, I am ready to take this in.
> I wonder if it really matters, diagnosis. I mean, it's helpful to have a framework for the problem or ideas for treatment.
>Yes, the proper framewrk. Certainly having the 'wrong' one can be at the very least, psychologically defeating.
> But mental health diagnosis is nebulous at best and often seems to be more of a descriptor than a definition of cause. Even major depression is unlikely to be one illness.
>
> It's not as if you could find a mechanism that causes "cyclothymia" as opposed to "bipolar II". Or that once there is
a definition there is a cure. Psychiatry/neurology just isn't there yet. They just treat symptoms at this point, in a rather hit or miss way.
>Very true I think. The more I have read, I understand even depression, something I have increasingly severe bouts, to remain diffuse at the core. There's the old sense of 'I know it when I see/feel it', but beyond that, the varities and paths to it
seem infinite.> Cyclothymia indicates more rapid mood swings than bipolar II. Which is helpful to know. But surely it's even more helpful to find a descriptor that more closely fits *you* rather than try to fit your symptoms into a diagnostic framework.
After reading about these two conditions, wwho knows? Dx is often based on patient report tona subjective practioner. Somewhere along the line, BP ll seems more likely now then when younger. But recommended treatments largely remain the same. Self knowledge, as you point out, is important. If one rarely, *sigh*, even feels the old hypomania during which I could be at least productive, I'm not even sure there is an apt treatment. Though plenty of treatments to avoid.
>
> For example, while I don't have enough behaviors to meet the diagnosis for borderline personality disorder, I find the theory behind it *fits* very well. So I adopt some of the terminology for myself, even though the whole diagnosis doesn't fit. I say I have OCD, but in some ways it doesn't
precisely fit. I'm likely somewhere on the borderline spectrum, but none of the diagnostic criteria fit me all that well. I even have some attention problems. I guess what fits best is old fashioned "neurosis" but that seriously downplays the physiological causes.
>
> So I say I have easy arousal with slow return to baseline, a *lot* of anxiety and obsessive thinking, and difficulty in mentally switching gears. Under some circumstances, lack of sleep or certain medications or even extreme stress, I can get hypomanic, though never manic. At times I can become
depressed, though that is by no means the major issue. I have health issues associated with the same chemicals that cause emotional/mental issues. IBS, migraines, etc. There's probably some problems caused by excessive stress hormones over an extended length of time.
>This is very helpful for me to read, Dinah. I have those odd health pieces that arevjust beginning to be recognized as running the similar pathways of depression and stress. I, too have borderline features, but as I reread the personality disorders again, wondered if anyone, anywhere, was a pure type. I self-administered the short MMPI2, and finally felt enlightened by (laboriously) studying the generated response charts. It provided not a dx, but rather clusters of difficult or symptom areas that I listed above. To my interest, after trying to fit myself into a borderline spectrum (which fits well enough, mind you) Avoidant had much to 'offer'. It makes complete sense, given sensitive to stimulation and hurt, who wouldn't at least become Avoidant. But rather than take on that particular dx over another, it's just now on a symptom awareness list.
> Personally, I think whatever is wrong with me isn't all that much different from what's wrong with an overexcitable dog. There may be childhood factors, but if I weren't wired like an overly inbred cocker spaniel, my childhood factors would not have caused serious problems.
You might imagine I love the dog analogy. And right now, my new one year old is an English Springer Spaniel. She is overexcitable. If anything, she helps remind myself to practice remaining calm, poor girl. She can get a bit worked up.
>
> I treat symptoms, which is all anyone can do at this point, until they understand more about underlying causes. I think they've finally figured out that correlation does not equal causality. Through trial and error I've found that SSRI's give
surface relief but overall just increase my agitation.This has been the biggest discovery for me to date. I am hoping that Emsam does not recreate this agitation in the long run. I'm not sure yet.
>
> Mood stabilizers are somewhat helpful. Tranquilizers can be occasionally helpful. Antipsychotics, or major tranquilizers, are very helpful on an as needed basis though I can't tolerate
them on a continual basis.
>
> I've grown to be aware of my body and what's going on, and to treat as needed. I know what situations cause
problems and I try to avoid those situations.This sounds very sane. I imagine it took some time to gather this awareness for yourself. I'm glad you have it--and are sharing it with me. Thank you.
>
> I've given up on the psychiatric holy grail, the perfect medication or the "correct" diagnosis. I've given up thinking that the experts are all that expert at all, in comparison with most fields of medicine. Maybe in my lifetime they'll figure it
out. But in the meantime, I'm not going to identify with any diagnosis. They're going to have to treat *me*.:-). I like this.
>
> Does cyclothymic or bipolar II or any other diagnosis really matter, if treatment doesn't change? Can't you just think of yourself as somewhere on the bipolar spectrum?Yes. After reading and reading in my hysterically driven way, I came to a big shrug of my shoulders. What was once perhaps cyclothymic is perhaps BP ll ish because of the greater ratio spent in depression. So yes, the bipolar spectrum. Whatever that is, bipolar. What real mysteries these conditions are. This last fit of reading was good. I keep trying to place all these symptoms into order. The best I came up with were constellations. That's o.k. now for some reason. And what seemed important this time around was taking the MMPI 2 and sitting w/ it myself without the professional interpretation. There would just be, thankfully, few spikes on the charts, but the spikes all seemed to go together upon a little meditation. A term you used earlier, I guess that is just a sketch of *me*.
There is still practice out there to parse out the *merely* psychological from the *merely* physical. I feel that for now, I can't pull myself apart any longer, and to do so, or be expected to or looked at that way would be non-helpful and even cruel.
Posted by Dinah on August 3, 2011, at 0:19:45
In reply to Re: Cyclothymia » Dinah, posted by floatingbridge on August 2, 2011, at 7:37:55
I loved my MMPI! I felt like my MMPI scores fit me better than any diagnosis. I'm a 2-7-8.
Right now I'm looking at autonomic nervous system dysfunction and cholinergic sensitivity. It's interesting to me because it's also linked to other health issues I have. (Plus, it fits quite nicely with my overly inbred cocker spaniel diagnosis).
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