![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 26 to 50 of 79. Go back in thread:
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).
Posted by Dinah on August 3, 2011, at 0:29:44
In reply to Re: Cyclothymia » floatingbridge, posted by Dinah on August 3, 2011, at 0:19:45
Hmmm... This is darn interesting.
Posted by Dinah on August 3, 2011, at 0:40:25
In reply to Re: Cyclothymia, posted by Dinah on August 3, 2011, at 0:29:44
Sorry, that last one was a bit off topic. I was talking to my therapist about this stuff earlier, and trying to find the articles I was paraphrasing.
Posted by SLS on August 3, 2011, at 7:02:44
In reply to Re: Cyclothymia » floatingbridge, posted by Dinah on August 3, 2011, at 0:19:45
> 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.
Exceptional insight!
- Too much brain cholinergic activity would be expected to produce depression. Too much cholinergic activity in the automomic nervous system can produce a condition where the parasympathic component predominates.
- Dysfunctional autonomic nervous system activity is sometimes the product of a disease known as familial dysautonomia. However, dysautonomia can be a product of depression or the drugs that treat it.
Search the Web for "dysautonomia symptoms" to see how closely it resembles what you are experiencing.
- Scott
Posted by Dinah on August 3, 2011, at 8:19:59
In reply to Re: Cyclothymia » Dinah, posted by SLS on August 3, 2011, at 7:02:44
http://clinicalposters.com/news/2011/0325-dysautonomia-mitochondria-pots.html
This one was interesting, but I by no means have all the symptoms.
What I was reviewing last night was the connection between migraines, IBS, vasomotor rhinitis, mood disorders, and borderline traits relating to affective instability (but not to impulsivity) and the HPA axis - in particular cortisol sensitivity.
http://www.nature.com/npp/journal/v17/n4/pdf/1380582a.pdf
http://onlinelibrary.wiley.com/doi/10.1002/ajmg.1320540412/abstract
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1188657/pdf/jpn00059-0041.pdf
http://www.ncbi.nlm.nih.gov/pubmed/12062878
I think there were other issues I ran across also, though I can't recall them offhand. I originally ran across the idea while researching a very embarrassing manifestation of vasomotor rhinitis. :) I think it's more a question of stress intolerance and sensitivity rather than the more severe dysautonomia. Of course, there's always the question of chicken and egg. Was it caused by long term stress or does it cause an intolerance to stress.
I suppose it's my involvement with dogs that predisposes me to believe there must be an underlying biological component to this.
And that this somehow should be reflected in the DSM. It just irritates me no end that there is clearly this population of people who not only have emotional lability, but often also have physical issues that have been linked to problems in the HPA axis, and yet it's ignored in the bible of the profession.
Granted, I may like this theory in part because it validates my own observations. I also liked the breakdown of borderline personality into two biological groups of characteristics. This explains why the disorder fits so completely in some ways, but not well at all in others. It also explains my very good reaction to Risperdal. There were a couple of studies showing that some AP's but not all AP's were helpful with regard to cortisol sensitivity. Risperdal is helpful.
So maybe I just like the theory because it seems to fit all the pieces for me, and also is in line with my own thoughts on the issue.
I was sorry to hear of what's going on with your friends, Scott. It is truly a difficult situation, and surely you must take that into account when you are thinking about your own health. It doesn't necessarily mean that your medications aren't working as well, just that you're under a strain.
Posted by floatingbridge on August 3, 2011, at 9:03:25
In reply to Re: Cyclothymia » SLS, posted by Dinah on August 3, 2011, at 8:19:59
> http://clinicalposters.com/news/2011/0325-dysautonomia-mitochondria-pots.html
>
> This one was interesting, but I by no means have all the symptoms.
>
> What I was reviewing last night was the connection between migraines, IBS, vasomotor rhinitis, mood disorders, and borderline traits relating to affective instability (but not to impulsivity) and the HPA axis - in particular cortisol sensitivity.
I'm working my way through these Dinah. The reading is tough going :P. I did find references to HPA disorder and PTSD in the sidebar.... Affective instability. That's a very useful term.> I think there were other issues I ran across also, though I can't recall them offhand. I originally ran across the idea while researching a very embarrassing manifestation of vasomotor rhinitis. :) I think it's more a question of stress intolerance and sensitivity rather than the more severe dysautonomia.
Dysautonomia seems a slightly different bird. Maybe in it's severity of manifestation.
>
>
> And that this somehow should be reflected in the DSM. It just irritates me no end that there is clearly this population of people who not only have emotional lability, but often also have physical issues that have been linked to problems in the HPA axis, and yet it's ignored in the bible of the profession.
Thank you for saying this. It's difficult just being neurotic on it's own without that being the sum cause for everything, like just having one's nerves shot and looping back in painful or at least annoying ways just out of one's control.>
> Granted, I may like this theory in part because it validates
my own observations. I also liked the breakdown of borderline personality into two biological groups of characteristics. This explains why the disorder fits so completely in some ways, but not well at all in others. It also explains my very good reaction to Risperdal. There were a couple of studies showing that some AP's but not all AP's were helpful with regard to
cortisol sensitivity. Risperdal is helpful.
>Well, I do find this helpful because a number of posters with some 'similar feeling' symptom clusters use risperdal. I have notice it drop in and out of their treatment as needed, something that fascinates me. I know it somehow works.
> So maybe I just like the theory because it seems to fit all
the pieces for me, and also is in line with my own thoughts on the issue.
>
Oh well. Wouldn't be the first :-). But you have as good
evidence here as anyone.> I was sorry to hear of what's going on with your friends, Scott. It is truly a difficult situation, and surely you must take that into account when you are thinking about your own health. It doesn't necessarily mean that your medications
aren't working as well, just that you're under a strain.
>Yes Scott. I second that, if I may.
Thanks for sharing the links and you thoughts, Dinah.
Posted by SLS on August 3, 2011, at 9:04:01
In reply to Re: Cyclothymia » SLS, posted by Dinah on August 3, 2011, at 8:19:59
> I was sorry to hear of what's going on with your friends, Scott. It is truly a difficult situation, and surely you must take that into account when you are thinking about your own health. It doesn't necessarily mean that your medications aren't working as well, just that you're under a strain.
Thank you, Dinah. I will take your suggestion and not look too closely at my mental state as being completely biological at this juncture.Regarding dysautonomia, symptoms can appear paradoxical and very changeable. For instance, one would expect bradycardia when tachycardia is evident. I am not looking to explain your conditions by suggesting that they be a product of idiopathic or familial dysautonomia. I look to offer a model of autonomic instability that might help conceptionalize the phenomenology of your symptom cluster.
- Scott
Posted by SLS on August 3, 2011, at 9:07:16
In reply to Re: Cyclothymia » Dinah, posted by floatingbridge on August 3, 2011, at 9:03:25
> I was sorry to hear of what's going on with your friends, Scott. It is truly a difficult situation, and surely you must take that into account when you are thinking about your own health. It doesn't necessarily mean that your medications
aren't working as well, just that you're under a strain.Yes Scott. I second that, if I may.
Thanks, FB.
:-)
- Scott> > http://clinicalposters.com/news/2011/0325-dysautonomia-mitochondria-pots.html
> >
> > This one was interesting, but I by no means have all the symptoms.
> >
> > What I was reviewing last night was the connection between migraines, IBS, vasomotor rhinitis, mood disorders, and borderline traits relating to affective instability (but not to impulsivity) and the HPA axis - in particular cortisol sensitivity.
>
>
> I'm working my way through these Dinah. The reading is tough going :P. I did find references to HPA disorder and PTSD in the sidebar.... Affective instability. That's a very useful term.
>
> > I think there were other issues I ran across also, though I can't recall them offhand. I originally ran across the idea while researching a very embarrassing manifestation of vasomotor rhinitis. :) I think it's more a question of stress intolerance and sensitivity rather than the more severe dysautonomia.
>
>
> Dysautonomia seems a slightly different bird. Maybe in it's severity of manifestation.
>
>
> >
> >
> > And that this somehow should be reflected in the DSM. It just irritates me no end that there is clearly this population of people who not only have emotional lability, but often also have physical issues that have been linked to problems in the HPA axis, and yet it's ignored in the bible of the profession.
>
>
> Thank you for saying this. It's difficult just being neurotic on it's own without that being the sum cause for everything, like just having one's nerves shot and looping back in painful or at least annoying ways just out of one's control.
>
> >
> > Granted, I may like this theory in part because it validates
> my own observations. I also liked the breakdown of borderline personality into two biological groups of characteristics. This explains why the disorder fits so completely in some ways, but not well at all in others. It also explains my very good reaction to Risperdal. There were a couple of studies showing that some AP's but not all AP's were helpful with regard to
> cortisol sensitivity. Risperdal is helpful.
> >
>
> Well, I do find this helpful because a number of posters with some 'similar feeling' symptom clusters use risperdal. I have notice it drop in and out of their treatment as needed, something that fascinates me. I know it somehow works.
>
> > So maybe I just like the theory because it seems to fit all
> the pieces for me, and also is in line with my own thoughts on the issue.
> >
>
>
> Oh well. Wouldn't be the first :-). But you have as good
> evidence here as anyone.
>
> > I was sorry to hear of what's going on with your friends, Scott. It is truly a difficult situation, and surely you must take that into account when you are thinking about your own health. It doesn't necessarily mean that your medications
> aren't working as well, just that you're under a strain.
> >
>
> Yes Scott. I second that, if I may.
>
>
> Thanks for sharing the links and you thoughts, Dinah.
>
>
Posted by Dinah on August 3, 2011, at 10:29:08
In reply to Re: Cyclothymia » Dinah, posted by floatingbridge on August 3, 2011, at 9:03:25
Blood glucose and insulin resistance. My endocrinologist says I have a *very* extreme glucose response to stress.
Even hypoglycemic unawareness, which I also seem to have. Although if I understand correctly, that should be a symptom of the opposite cortisol problem.
Posted by Dinah on August 3, 2011, at 10:37:39
In reply to Re: Cyclothymia » Dinah, posted by floatingbridge on August 3, 2011, at 9:03:25
I'm not sure I understand it either.
It's just that it keeps popping up over and over again in the most unexpected ways. I feel like I should find that significant. And perhaps that my health practitioners should also find it significant.
Though again, chicken and egg. Hard to say.
Posted by floatingbridge on August 3, 2011, at 11:35:27
In reply to And how can I forget, posted by Dinah on August 3, 2011, at 10:29:08
> Blood glucose and insulin resistance. My endocrinologist says I have a *very* extreme glucose response to stress.
>
> Even hypoglycemic unawareness, which I also seem to have. Although if I understand correctly, that should be a symptom of the opposite cortisol problem.This is something I don't understand.. Though you have mentioned your issues, and so many medications affect glucose response ( if that is a working term.). Diabetes is on
both sides of my family.....But there is the opposite, isn't there? My friend does not make enough insulin. Stress exacerbates this and underlies
her particular form of presenting depression....Sometime I feel like I am working on some sort of medical degree.... The endocrine system is very, umm, complicated and under-understood. At least in practical medicine.
Posted by Dinah on August 3, 2011, at 12:25:17
In reply to Re: And how can I forget, posted by floatingbridge on August 3, 2011, at 11:35:27
It's all very confusing.
And I just realized I am obsessing about this today because I want to get my mind off my gall bladder surgery. :)
I'd better go do something productive instead. Or spend time with my dog. There's nothing like a faceful of sheepdog hair for what ails me.
There's no hurry, I suppose.
Posted by floatingbridge on August 3, 2011, at 13:38:28
In reply to Re: And how can I forget » floatingbridge, posted by Dinah on August 3, 2011, at 12:25:17
> It's all very confusing.
It is. And of course, quite justifiable to obsess over. Then, we (the royal we) know that obsessing serves it's purpose for only so long. Sheep dog hair will do, hopefully quite nicely. Dogs don't obsess on what might ail them, but what they want to do: eat, play, spend time with owners, smell (o,k, I do have a scent hound.). But smell is just an unfathomable (to us) language for dogs. When we walk the dogs in public, there are always the favored sniffing (and marking) spots. I
figure they are somehow checking their inbox.I didn't know about the surgery. My friend (the one with low insulin) had it, and it was an o.k. experience for her w/o any real repercussions on her life (like diet). She had stones :-/
and her gall bladder was removed. She has not missed it.Best with this, Dinah. Don't stay offline too long (cause you'd be missed!)
>
> And I just realized I am obsessing about this today because I want to get my mind off my gall bladder surgery. :)
>
> I'd better go do something productive instead. Or spend time with my dog. There's nothing like a faceful of sheepdog hair for what ails me.
>
> There's no hurry, I suppose.
Posted by Phillipa on August 3, 2011, at 20:34:05
In reply to Re: And how can I forget » Dinah, posted by floatingbridge on August 3, 2011, at 13:38:28
Dinah I didn't realize you were having your gallbladder out. Endoscopic or cut open and remove? Right shoulder pain? Phillipa
Posted by floatingbridge on August 3, 2011, at 22:20:29
In reply to Re: Cyclothymia » floatingbridge, posted by Dinah on August 3, 2011, at 10:37:39
Well, I see my new pdoc tomorrow. I'm glad he has requested to see me so often. Like Mellow said above, sometimes things feel 'crystal'. That is now in the mornings despite early awakenings. It used to be reversed. I woke in dread.
Now the afternoons and evenings are terrible. I swear I don't know what to do other than be very observant.
Some of you might recall I have seen lots of specialists in the past few years. Fact is, I am miserable with the same symptoms, but like the article Dinah posted on pots, doctors have given up. My endocrinologist has only ever tested my tsh. I get tired of asking for tests because it makes me look absolutely nuts. I know it does. How does one even get a cortisol test? When I first met this endocrinologist, I said I might have some HPA dysfunction. He looked at me. Not mean or anything. Then said why would you think that. Well, because of chronic PTSD. So he asks if I have a therapist.
He's an o.k. guy. I don't need every test run in the book. Frankly I am too tired to endure it. But to not want to test my hormone levels other than tsh I find so disheartening.
I have told three practioners explicitly that I have difficulty standing up. I can sit down and I feel better. Standing, just standing can increase my fatigue. Then I see that link about pots and dyautonomia.
I'm not self-dxing. But heck. I figured out that somehow standing is fatiguing. I don't just sit around and dream this up. I don't like this. I also don't feel competent to figure this stuff out.
Anyone can see from my posts how my mood goes up and down.
Even as a pre-adolescent, I looked at other people and actually thought, their body works. It just works right. They get up, go to bed, have stress, miss sleep, but something is always resetting them. I feel like I am missing something.
Pdoc tomorrow. Thanks for all this discussion. I need to read threads a few times to really get them. I haven't even finished the links Dinah posted.
Over and out.
fb
Posted by floatingbridge on August 4, 2011, at 18:58:11
In reply to Re: Cyclothymia, posted by floatingbridge on August 3, 2011, at 22:20:29
Yes. 1/8mg per night. The new doc says I should know fairly quickly if it will help with PTSD and 'affective instability'. Amazing the value of accurate terminology. Communicated to me clearly that if I feel 'weird' in the way abilify and seroquel felt to stop immeadiately and call.
Bipolar spectrum, too. He suggests (pending reaction to the risperdone) low dose lithium. Needs my bun and creatine levels tested first, even to start at 300mg. That's fine with me. The last doc never checked that.
Bumped Emsam to 9mg. Told me to get a bracelet and reread the food stuff, but not to worry about it.
I am greatly relieved this guy can use low doses. He suggested the splitting of the risperdone. What do I know about dose? He says it can be very strong.
We'll see.
Thanks again for the support.
fb
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