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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 17 to 41 of 66. Go back in thread:
Posted by ed_uk2010 on March 18, 2018, at 14:10:20
In reply to Re:Current meds and question EDIT title » ed_uk2010, posted by Clearskies on March 18, 2018, at 13:10:12
Hi CS,
It sounds like most of your symptoms are worse in the morning, rather than anything specific. Would you say that's right? Although I'm currently doing OK, I'm very much the same. I am a definite 'evening person'.
I forgot to ask before, how do you sleep at night?
I was also wondering whether it might help to move some of your medication timing around. Just as an example... if you currently take clonazepam at night but sleep OK, it might help to move some of the dose to the morning to help with anxiety.
Posted by Clearskies on March 18, 2018, at 14:19:27
In reply to Re:Current meds and question EDIT title » Clearskies, posted by ed_uk2010 on March 18, 2018, at 14:10:20
> Hi CS,
>
> It sounds like most of your symptoms are worse in the morning, rather than anything specific. Would you say that's right? Although I'm currently doing OK, I'm very much the same. I am a definite 'evening person'.
>
Most definitely.> I forgot to ask before, how do you sleep at night?
>
It is taking me about 2 hours to fall asleep each night after I go to bed.> I was also wondering whether it might help to move some of your medication timing around. Just as an example... if you currently take clonazepam at night but sleep OK, it might help to move some of the dose to the morning to help with anxiety.
>Ive tried moving that dose all over the day - including taking it at bedtime - but theres no relief.
>
>
>Im working with a new pdoc. Im not even certain were on the same page yet. Suicidal thoughts are never far away any more. But I have zero plans to do anything.
I know my thinking is disordered. I dont even want to type the horrible things I think about myself, they are just repetitions of previous depressive dives I have made before.
Posted by ed_uk2010 on March 18, 2018, at 14:45:24
In reply to Re:Current meds and question EDIT title » ed_uk2010, posted by Clearskies on March 18, 2018, at 14:19:27
>I dont even want to type the horrible things I think about myself...
Well I'm thinking it's good to see your familiar name on the board, even though it's sad that you're not doing well lately. Not everyone here will remember your previous posting name, and the one before that. Talking about old times, I successfully got my original posting name 'ed_uk' back... then I realised I couldn't activate Babblemail. I guess I will have to stick with this one, from when I lost my password in 2010.
New psychiatrists can be difficult. It can be really hard to start over and get to know each other. On the other hand, a new doctor can eventually come up with valuable new ideas.
Has s/he suggested any meds changes or 'therapeutic interventions' so far?
Posted by Clearskies on March 18, 2018, at 14:54:04
In reply to Re:Current meds and question EDIT title » Clearskies, posted by ed_uk2010 on March 18, 2018, at 14:45:24
>
> Has s/he suggested any meds changes or 'therapeutic interventions' so far?Putting me on Zoloft and nortriptyline were changes she suggested. Shes kind of flaky- not very organized - but she knows what drug does what. My previous pdoc got to the point where she was switching my meds every week, trying to get me stable but not letting me adjust to anything before changing again. I was in very bad shape and she totally dropped the ball with me. Inexcusable.
Its funny about the user names... the weather has always been unsettled. Ive tried to describe my climate, ha ha, and now the state I want to be in. To be honest, my name right now should be Shitstorm.
Posted by ed_uk2010 on March 18, 2018, at 15:46:15
In reply to Re:Current meds and question EDIT title » ed_uk2010, posted by Clearskies on March 18, 2018, at 14:54:04
>my name right now should be Shitstorm.
Oh no! You need a classy weather name. Wuthering Heights, perhaps :) Definitely not Thunderbird or Shitstorm!
>Putting me on Zoloft and nortriptyline were changes she suggested.
That sounds positive. How long have you been on this combination?
Posted by Clearskies on March 18, 2018, at 16:16:01
In reply to Re:Current meds and question EDIT title » Clearskies, posted by ed_uk2010 on March 18, 2018, at 15:46:15
> >my name right now should be Shitstorm.
>
> Oh no! You need a classy weather name. Wuthering Heights, perhaps :) Definitely not Thunderbird or Shitstorm!
>
> >Putting me on Zoloft and nortriptyline were changes she suggested.
>
> That sounds positive. How long have you been on this combination?
>
>Its been about 2 1/2 months. I have some personal stuff going on thats brought my mood way down, too. I just cant seem to muster any confidence that I can raise myself up out of this quagmire.
CS
Posted by ed_uk2010 on March 18, 2018, at 16:48:38
In reply to Re:Current meds and question EDIT title » ed_uk2010, posted by Clearskies on March 18, 2018, at 16:16:01
But you've always been able to raise yourself up before, right? Eventually.
Posted by Clearskies on March 18, 2018, at 16:58:54
In reply to Re:Current meds and question EDIT title » Clearskies, posted by ed_uk2010 on March 18, 2018, at 16:48:38
> But you've always been able to raise yourself up before, right? Eventually.
Not to be fully operational. I have to budget my time and energy carefully or Im easily overwhelmed. Depression is always breathing down my neck.
Posted by ed_uk2010 on March 18, 2018, at 17:10:20
In reply to Re:Current meds and question EDIT title » ed_uk2010, posted by Clearskies on March 18, 2018, at 16:58:54
Not to be fully operational perhaps. But you got through, and that is something to be proud of.
When do you next see this new psychiatrist?
Posted by Clearskies on March 18, 2018, at 17:41:09
In reply to Re:Current meds and question EDIT title » Clearskies, posted by ed_uk2010 on March 18, 2018, at 17:10:20
> Not to be fully operational perhaps. But you got through, and that is something to be proud of.
>
> When do you next see this new psychiatrist?
>She had to cancel my appointment with her yesterday, and will call back to reschedule. I can feel the depression deepening.
Posted by ed_uk2010 on March 19, 2018, at 5:46:57
In reply to Re:Current meds and question EDIT title » ed_uk2010, posted by Clearskies on March 18, 2018, at 17:41:09
>She had to cancel my appointment with her yesterday, and will call back to reschedule.
Ugh. I find waiting for callback a bit stressful. People don't always call back. Call her secretary if she doesn't get back to you soon.
Posted by bleauberry on March 22, 2018, at 6:33:06
In reply to **TRIGGER** Current meds and question, posted by Clearskies on March 14, 2018, at 4:00:17
This is going to sound completely bizarre but it is profoundly true. If you want to truly experience improvements in your mood issues, consider seeing an L.L.M.D. at least as often, or more often, than you see the psychiatrist or the regular doctor.
LLMD = Lyme Literate Medical Doctor. Each state has 6 to 20 of these experts. Find one. Add him/her to your team. I am not exaggerating when I claim the LLMD is likely to take you much further into success territory, and much faster, than any other type of doctor out there. Let them decide if you have Lyme or not. It doesn't. matter if you do or don't - their input, suggestions, medicines and herbs, actually get psych patients a lot better.
That's because they focus on the areas that actually cause psychiatric symptoms - systemic inflammation, microbial insults, and environmental insults. They also know some tricks on dosing psychiatric meds that I never saw any psychiatrist do.
I was a 20 year basket case of treatment resistant major depression, failed so many meds, failed ECT, suffered so long and wasted so much money. When I got hooked up with an LLMD, all that changed. Three years later I was in remission with no meds.
Posted by ed_uk2010 on March 22, 2018, at 12:40:59
In reply to Re: **TRIGGER** Current meds and question, posted by bleauberry on March 22, 2018, at 6:33:06
That sounds very much like seeing a complementary therapist. Like a medical herbalist.
Posted by Clearskies on March 22, 2018, at 14:49:11
In reply to Re: **TRIGGER** Current meds and question, posted by ed_uk2010 on March 22, 2018, at 12:40:59
> That sounds very much like seeing a complementary therapist. Like a medical herbalist.
>
>Im rather at a loss. My current pdoc is also a naturopath. Shes who told me to take a bunch of different supplements. Honestly, my depression cant handle yet another search for a competent doctor again. Its difficult to find good ones where I live; the nearest big city is a five hour drive away.
At the moment my concern is that my hair is falling out in a diffuse pattern. Ive started to use minoxidil foam. This sucks.
Posted by SLS on March 22, 2018, at 15:09:57
In reply to Re: **TRIGGER** Current meds and question, posted by Clearskies on March 22, 2018, at 14:49:11
> > That sounds very much like seeing a complementary therapist. Like a medical herbalist.
> >
> >
>
> Im rather at a loss. My current pdoc is also a naturopath. Shes who told me to take a bunch of different supplements. Honestly, my depression cant handle yet another search for a competent doctor again. Its difficult to find good ones where I live; the nearest big city is a five hour drive away.
> At the moment my concern is that my hair is falling out in a diffuse pattern. Ive started to use minoxidil foam. This sucks.Any thyroid stuff going on?
- Scott
Posted by Clearskies on March 22, 2018, at 15:16:51
In reply to Re: **TRIGGER** Current meds and question » Clearskies, posted by SLS on March 22, 2018, at 15:09:57
> > > That sounds very much like seeing a complementary therapist. Like a medical herbalist.
> > >
> > >
> >
> > Im rather at a loss. My current pdoc is also a naturopath. Shes who told me to take a bunch of different supplements. Honestly, my depression cant handle yet another search for a competent doctor again. Its difficult to find good ones where I live; the nearest big city is a five hour drive away.
> > At the moment my concern is that my hair is falling out in a diffuse pattern. Ive started to use minoxidil foam. This sucks.
>
> Any thyroid stuff going on?
>
>
> - ScottI wish. A complete panel was done at my wellness appointment not 2 weeks ago. Im going to have it repeated in a couple of weeks, but so far my thyroid is performing as it should. Not under or over functioning.
I believe the hairloss is due to a very poor diet. For months I have struggled to eat more than a meal a day. Proper food, but not enough of it. My depression has led me to not bother caring for my physical self for quite a while now. Being on my own, theres no incentive to look good for anyone; I sure dont care to look good for myself.
Oh, dear. Tears again.
Posted by SLS on March 23, 2018, at 0:07:11
In reply to Re: **TRIGGER** Current meds and question » SLS, posted by Clearskies on March 22, 2018, at 15:16:51
> > Any thyroid stuff going on?
> I wish. A complete panel was done at my wellness appointment not 2 weeks ago. Im going to have it repeated in a couple of weeks, but so far my thyroid is performing as it should. Not under or over functioning.
>
> I believe the hairloss is due to a very poor diet. For months I have struggled to eat more than a meal a day. Proper food, but not enough of it. My depression has led me to not bother caring for my physical self for quite a while now. Being on my own, theres no incentive to look good for anyone; I sure dont care to look good for myself.
> Oh, dear. Tears again.I'm sorry...
- Scott
Posted by ed_uk2010 on March 26, 2018, at 19:02:30
In reply to Re: **TRIGGER** Current meds and question » SLS, posted by Clearskies on March 22, 2018, at 15:16:51
Hi CS,
How are things? Did you get a new appointment with your pdoc?
Hope minoxidil helps. They say some people get some addition loss at first before it works.
Posted by Clearskies on March 26, 2018, at 20:14:32
In reply to Re: **TRIGGER** Current meds and question » Clearskies, posted by ed_uk2010 on March 26, 2018, at 19:02:30
> Hi CS,
>
> How are things? Did you get a new appointment with your pdoc?
>The pdoc assured me that the Zoloft is not responsible for the hair loss; that she hasnt seen any such side effect in the 23 years shes been prescribing it. (= she wont budge) She suggested that the increased dosage to 150mg hasnt had a chance to work yet, and that my initial response was a brightening effects. (If you think I am rolling my eyes, they are just about stuck that way.) Still, shes the doctor, and I know full well that the internet is not. So I will remain compliant.
> Hope minoxidil helps. They say some people get some addition loss at first before it works.
>
>
I believe it is going to help, yes. The hair loss has slowed down substantially.Thanks, Ed!
cs
>
>
Posted by ed_uk2010 on March 26, 2018, at 20:54:28
In reply to Re: **TRIGGER** Current meds and question » ed_uk2010, posted by Clearskies on March 26, 2018, at 20:14:32
Hi,
So, did the hair loss start suddenly after you began taking sertraline? Or not clearly related to sertraline in time? There are a few case reports of hair loss from sertraline, and fluoxetine too. But that doesn't prove it was the cause. So who knows.
Minoxidil sounds highly promising if it's helping already. Perhaps I should try it myself.
>If you think I am rolling my eyes, they are just about stuck that way.Haha :) I know just what you mean.
I suppose.... Some people do feel suddenly different after a dose increase, and then the long-term effects take a while to occur. When did you increase? I hope your doctor is listening to what you are saying.
Posted by Clearskies on March 26, 2018, at 20:59:00
In reply to Re: **TRIGGER** Current meds and question » Clearskies, posted by ed_uk2010 on March 26, 2018, at 20:54:28
> Hi,
>
> So, did the hair loss start suddenly after you began taking sertraline? Or not clearly related to sertraline in time? There are a few case reports of hair loss from sertraline, and fluoxetine too. But that doesn't prove it was the cause. So who knows.
>
> Minoxidil sounds highly promising if it's helping already. Perhaps I should try it myself.
>
>
> >If you think I am rolling my eyes, they are just about stuck that way.
>
> Haha :) I know just what you mean.
>
> I suppose.... Some people do feel suddenly different after a dose increase, and then the long-term effects take a while to occur. When did you increase? I hope your doctor is listening to what you are saying.
>
>
>The hair loss coincided with me starting the sertraline, so I see a direct correlation. The pdoc was pretty huffy and haughty about it, and spoke condescendingly to me. I asked at one point if she meant to argue with me as I was presenting my symptoms to her! That shut her up.
But I think shes a dud.
Back to the drawing board. At this rate I am going to end up unmedicated.
Posted by ed_uk2010 on March 26, 2018, at 21:24:45
In reply to Re: **TRIGGER** Current meds and question » ed_uk2010, posted by Clearskies on March 26, 2018, at 20:59:00
Hi,
>The hair loss coincided with me starting the sertraline, so I see a direct correlation.
That definitely makes sense to me, but I had a thought. I wondered whether the hair loss was caused by the extreme anxiety and stress which you've gone through over the last few months. Apparently, there is often a delay between the period of stress and the hair loss. This could make it look like sertraline was the cause. What do you think?
I also thought, if sertraline was the cause - which you're now taking more of, it seems unlikely that minoxidil would help so much.
So perhaps your pdoc is right about the sertraline? Although wrong to be so condescending.
Posted by Clearskies on March 26, 2018, at 21:35:58
In reply to Re: **TRIGGER** Current meds and question » Clearskies, posted by ed_uk2010 on March 26, 2018, at 21:24:45
> Hi,
>
> >The hair loss coincided with me starting the sertraline, so I see a direct correlation.
>
> That definitely makes sense to me, but I had a thought. I wondered whether the hair loss was caused by the extreme anxiety and stress which you've gone through over the last few months. Apparently, there is often a delay between the period of stress and the hair loss. This could make it look like sertraline was the cause. What do you think?
>
> I also thought, if sertraline was the cause - which you're now taking more of, it seems unlikely that minoxidil would help so much.
>
> So perhaps your pdoc is right about the sertraline? Although wrong to be so condescending.
>
>
Clearly she has much more experience than I with the med and its side effects, so for now Im giving her the benefit of a doubt, and the sertraline a good go.
My stress and anxiety have been severe recently. Im having a tough time keeping my façade of a functioning human going. So much of how Im feelng relates to the political and cultural climate here in the US. I live in an extremely right wing part of the country. Many white supremacist groups are headquartered nearby. I dont feel I can safely express my opinions. The repression is killing me... but I cannot imagine being able to move to yet another part of the country and starting all over.
Last Saturdays march by the students was bracing and powerful. I do sense a sea change.
Posted by ed_uk2010 on March 27, 2018, at 8:03:02
In reply to Re: **TRIGGER** Current meds and question » ed_uk2010, posted by Clearskies on March 26, 2018, at 21:35:58
>So much of how Im feelng relates to the political and cultural climate here in the US. I live in an extremely right wing part of the country.
What's it like CS? For every person here with one opinion, someone else disagrees.
Posted by Clearskies on March 27, 2018, at 11:30:06
In reply to Re: **TRIGGER** Current meds and question » Clearskies, posted by ed_uk2010 on March 27, 2018, at 8:03:02
> >So much of how Im feelng relates to the political and cultural climate here in the US. I live in an extremely right wing part of the country.
>
> What's it like CS? For every person here with one opinion, someone else disagrees.Well, even the state I reside in is deeply divided (Washington). On the Pacific coast, generally the population is for gun control and increased legislation. Its a region heavy with business and industry. Where I am, however, in the east of the state, is far more rural. Families have been hunting for necessity and pleasure for generations. Distrust of the government is deep. Theres not much siversity here, so not much knowledge or experience of other cultures. Its ripe for seeds of distrust and paranoia to be sown. Theres no understanding of the world at large among the people that I know.
Just a fierce determination to hang on to their guns, no matter what. Kids here grew up around them, safely. Its presumed that the mass killings are due to mental illness, religious fervour, and nothing can legislate these elements away.This is, you understand, my point of view and experience. I dont want to paint the region with my brush.
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