![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by floatingbridge on November 19, 2010, at 13:10:08
Hi Morgan,
I'm curious what your current regime is right now. Do you have a presiding doc that you see?
I certainly understand being overwhelmed, info-loaded, and for me, a house of cards feeling. Like being fragile. Howeber, you may have more in your
favor than you realize given your current challenges.With so many factoids floating about, it can be pretty difficult to keep perspective, and experiencing mania (hypo? and mixed) can be traumatic. Any perceived loss of control can be
alarming.I'm sorry to hear that you're having somatic symptoms. That is awful. I didn't know :( I feel that makes everything more intense in a not lust-for-life promoting way.
You may not have brain damage from meds. Some people here do, but not everyone. You certainly have been through enough, it sounds, in the past three years to feel uncentered and
exhausted. Do you regret starting
medication? I mean, I can understand
that absolutely. Do you have a way of prioritizing issues and treatment? Are you able to enjoy some things? Please remain hopeful. I don't think it's a done deal for you.I have faith you're finding your way.
fb
Posted by morgan miller on November 19, 2010, at 14:08:18
In reply to Hey Morgan...., posted by floatingbridge on November 19, 2010, at 13:10:08
I think I am experiencing some somatic symptoms, but some of what I am experiencing goes beyond anything that could be somatic. Some of it is related to all the physical trauma I subjected my body to. Some of it, I have to believe is the result of some type of dysfunction, which could be a result of long term chronic anxiety, stress, and depression, but what I would not consider to be directly somatic. I've been horribly depressed for 3 months at a time, and my body felt great, so I have a hard time believing that everything I'm experiencing is a direct result of current depression and anxiety. I do realize symptoms of pain and stiffness can get worse as chronic depression and anxiety continues on.
>You may not have brain damage from meds. Some people here do, but not everyone.
I actually think that most of us have some form or some amount of brain damage, whether it be permanent or not. Heck, even my brother and a few of my friends, none of whom have suffered from chronic mental illness or have been on any medication, admit that something along the way has damaged their brains. Just getting older causes brain damage. Our brains become more and more damaged as we age, as do our bodies. I do think that drugs like Lamictal and Zyprexa, coupled with severe episodes of mental illness, have done some amount of damage. Whether most of this damage can be reversed or not, who knows. I remember when I went to the local private psychiatric hospital for the first time the doctors told me that the severity and duration of my mixed episode may have caused permanent changes in my brain that may not allow me to respond to just taking antidepressants for monotherapy anymore. When I hear "permanent changes" that don't allow my brain to respond to medications the same way that it used to, I hear damage.
>Do you regret starting
medication? I mean, I can understand
that absolutely.I regret trying some medications and trying soooo many. If I had the right guidance and the right doctor, I probably could have saved myself from some unnecessary medication trials.
I really have no problem with taking medication as long as I function properly and feel well. And, as long as I absolutely need medication and there is no other option out there. I'm bipolar, so I figure, at least in the world I was brought into, medication is a necessity. I miss the days of just taking Zoloft, feeling great, sleeping great, and functioning great. Were things perfect? No. Was I a bit on the manic side half the time? Yes. But I felt good and function well, that's all that matters to me. Through maturation and therapy, I could have taken care of the manic thing. I'm sure many would disagree with this. I stopped Zoloft back in June of 2007 thinking everything was great and I didn't need medication anymore. The transition went pretty good. I went through a few days of withdrawal, about 4 or 5 days after cessation. Then I had to adjust a bit to being out in social situations, like going to happy hours. 5 months later, the perfect storm of events and circumstances, including being off Zoloft, sent me into a major mixed episode. Life just has not been the same since.
>I'm curious what your current regime is right now. Do you have a presiding doc that you see?
Currently:
Lithium 600 mg
Depakote 500 mg
St. John's Wort-Serofin-585 mgI think I may have to get back on an SSRI or other antidepressant/antidepressant combo. I was on Prozac. I just felt pretty numb and still felt like sh*t most of the time. I don't feel any worse on SJW, I just don't feel like I should feel.
I don't have a doctor I'm seeing currently, I know I need to find one. I liked my last one but he did not take insurance so I had to stop seeing him.
>Do you have a way of prioritizing issues and treatment? Are you able to enjoy some things?
I usually do not feel well enough to prioritize things the way I should right now. I need more financial and moral support and I'm just not getting it. Everyone in my family has grown tired of dealing with me. First it was my bipolar acting up, now it's all the physical/physiological issues(some that I had when I experienced the major episode 3 years ago, which was one of the stressors that pushed me over the edge). My father has been very generous, but now he just watches me suffer and doesn't seem to want to get involved. It's complicated. I need to have a conversation with him. I don't think he realized that I feel as old as he does when I get out of bed in the morning. I know he doesn't know that my hands and feet are extremely stiff and ache upon waking.
I'm really not able to enjoy much. I can't even feel music right now. I would say that I enjoy life about 25 percent of what I enjoyed it a little over 3 years ago.
I would never kill myself(well maybe if I'm 70 and feeling awful knowing that things are just going to get worse fast) but just going through the motions of life and existing is not living or worth living. I'm not a simple person, and simple life never really worked for me. I come from an urban/suburban area where it is common to go out and socialize, go to concerts, go to nightclubs and dance, have parties and go to parties-this is living to me. Hope I don't offend anyone that lives a more simple life in the countryside. I actually am friends with a babbler that lives in a more remote country location. I don't think there is anything wrong with a simple more secluded life, it's just not for me and never will be. I live a secluded life right now. I never really get out at all, I just don't feel well enough to be able to enjoy it. I actually look forward to going to work(I work 3 to 4 days a week at an organic market), even on the days week I feel bad(most days it seems lately), as being at work is really my only social outlet right now. Ugh, seriously, F U C K life!
Posted by morgan miller on November 19, 2010, at 14:17:51
In reply to Re: Hey Morgan...., posted by morgan miller on November 19, 2010, at 14:08:18
Let me make a correction: F U C K MY Life!
Sorry if I offended anyone with my us of the F word. I just find that it is sometimes THE best way to express frustration. There was actually a study done finding that using swearing to express frustration was actually healthy. I think it has something to do with letting things out and not internalizing.
Posted by morgan miller on November 19, 2010, at 14:42:43
In reply to Hey Morgan...., posted by floatingbridge on November 19, 2010, at 13:10:08
FB, how are you doing today? Did the symptoms you were feeling the other day go away?
Posted by Free on November 19, 2010, at 15:03:40
In reply to Re: Hey Morgan...., posted by morgan miller on November 19, 2010, at 14:17:51
> Sorry if I offended anyone with my us of the F word. I just find that it is sometimes THE best way to express frustration. There was actually a study done finding that using swearing to express frustration was actually healthy. I think it has something to do with letting things out and not internalizing.I agree, sometimes it's the only word that hits the spot. And I'm not offended in the least.
I'm just sorry I don't have any words of wisdom to make things better for you, Morgan. Your candid posts brought tears to my eyes.
Oh, life...
Hang in there and keep trying when you can. That's really all any of us can do.
I'm not into virtual hugs, but here you go...
(Morgan) :)
Posted by floatingbridge on November 19, 2010, at 16:39:21
In reply to Re: Hey Morgan...., posted by morgan miller on November 19, 2010, at 14:08:18
> I think I am experiencing some somatic symptoms, but some of what I am experiencing goes beyond anything that could be somatic. Some of it is related to all the physical trauma I subjected my body to. Some of it, I have to believe is the result of some type of dysfunction, which could be a result of long term chronic anxiety, stress, and depression, but what I would not consider to be
directly somatic. I've been horribly depressed for 3 months at a time, and my body felt great, so I have a hard time believing that everything I'm experiencing is a direct result of current depression and anxiety. I do realize symptoms of pain and stiffness can get worse as chronic depression and anxiety
continues on.Depending on your insurance allowances, some blood tests sound very reasonable. If that's your intuition. A primary care type can order them, but you know that. I went to a few doctors for tests. What work to do when depressed and not feeling well. I tried to balance between every test and turning over every rock, to being a somewhat informed personal advocate. I empathize that the process can be daunting and overwhelming even for those not depressed.
>
> >You may not have brain damage from meds. Some people here do, but not everyone.
>
> I actually think that most of us have some form or some amount of brain damage,Yes, I'm afraid you're right about that. That is distressing. I try to focus on what I can do to heal, and be who I am now. (Which is what you seem to do.) I said 'try'. That's not always what I do. And it is really easy for me to creep myself out and get paranoid. I figure, even if I have a crummy MI I don't need to scare myself. But you've been told worse than I have--so point blank. That's tough to hear, Morgan.
> I remember when I went to the local private psychiatric hospital forthe first time the doctors told me that the severity and duration of my mixed
>
> I regret trying some medications and trying soooo many. If I had the right guidance and the right doctor, I probably could have saved myself from some unnecessary medication trials.
>Regret. Yeah. I wish you had what you needed earlier, too. Regret can really sap energy, and I hope you know I don't say that lightly as a supermarket tabloid headlining top ten stress-busters.
> I really have no problem with taking medication as long as I function properly and feel well. And, as long as I absolutely need medication and there is no other option out there. I'm bipolar, so I figure, at least in the world I was brought into, medication is a necessity. I miss the days of just taking Zoloft, feeling great, sleeping great, and functioning great. Were things perfect? No. Was I a bit on the manic side half the time? Yes. But I felt good and function well, that's all that matters to me. Through maturation and therapy, I could have taken care of the manic thing. I'm sure many would disagree with this. I stopped Zoloft back in June of 2007 thinking everything was great and I didn't need medication anymore. The transition went pretty good. I went through a few days of withdrawal, about 4 or 5 days after cessation. Then I had to adjust a bit to being out in social situations, like going to happy hours. 5
months later, the perfect storm of events and circumstances, including being off Zoloft, sent me into a major mixed episode. Life just has not been the same since.
>I've always been an introvert. Still, even I liked to go out and listen to music, stay
out late, drive to the city, make plans... It's really a loss right now.> >I'm curious what your current regime is right now. Do you have a presiding doc that you see?
That makes everything so much more difficult :(
>
> Currently:
> Lithium 600 mg
> Depakote 500 mg
> St. John's Wort-Serofin-585 mg
>Wow. That's so simple. I like it. Yet you're looking at ssri's? Snri's? How careful do you need to be about cycling? What looks interesting? Personally, prozac didn't seem to work. I couldn't feel it worsen or better anything. I suppose it was doing something, hopefully nothing insidious.
>
> I usually do not feel well enough to prioritize things the way I should right now. I need more financial and moral
support and I'm just not getting it.
Everyone in my family has grown tired of dealing with me. First it was my bipolar acting up, now it's all the physical/physiological issues(some that I had
when I experienced the major episode 3
years ago, which was one of the
stressors that pushed me over the edge).
My father has been very generous, but now he just watches me suffer and doesn't seem to want to get involved. It's complicated. I need to have a conversation with him. I don't think he realized that I feel as old as he does
Lwhen I get out of bed in the morning. I
know he doesn't know that my hands
and feet are extremely stiff and ache upon waking.
>
Oh. I'm sorry you have that morning
pain. (Hug.) A conversation sounds good. Depression. (MI) burns out the family, doesn't it? With
love, which it sounds like, people come
back and the family reknits--don't you think? My brother is BPI, and it was very
rocky before he sought treatment and
bottomed out. Very dramatic, though
not his intention. He was deeply
mortified. I really felt for him. And at the same time, our family's collective
adrenaline skyrocketed. He is highly sensitive yet robust. He works out like a maniac--I've seen him at Gold's Gym. I
think that's his glue. I used to run and
do Iyngaer (sp) yoga. Good glue, but I
have a back injury. I could walk more....You know, come to think of it, he does very well on Wellbutrin. Not too
stimulating for him, but boosts him out of depressive brooding (runs in our family). Have you tried it?> I'm really not able to enjoy much. I
can't even feel music right now. I would
say that I enjoy life about 25 percent of what I enjoyed it a little over 3 years ago.
>You'er a guitarist? Recently I have begun
to listen to music again. It's been a long
time. My husband is a musician.> I would never kill myself
I'm glad to here it. You do sound like too much of an optimist despite your current
state :)I don't think I would either, though given the duration of this depression (10+ years?) I see how it has eroded my husband's life and affects my son, and I wonder how they'd be w/o me. Today is
not one of those days :)> I come from an urban/suburban area where it is common to go out and socialize, go to concerts, go to nightclubs and dance, have parties and go to parties-this is living to me. Hope I don't
offend anyone that lives a more simple
life in the countryside. I actually am friends with a babbler that lives in a
more remote country location. I don't think there is anything wrong with a simple more secluded life, it's just not for me and never will be. I live a
secluded life right now. I never really get out at all, I just don't feel well enough to
be able to enjoy it. I actually look forward to going to work(I work 3 to 4
days a week at an organic market), even on the days week I feel bad(most days it
seems lately), as being at work is really my only social outlet right now. Ugh, seriously, F U C K life!Who's offended? There are city mice and country mice. You stated where your
from, what you like, and what you miss. For you, that social and cultural stimulation seems keenly missed. And as far as being unhappy, even angry with life, sometimes a person just needs to shout out. Somehow I didn't take you to mean all life in general. I think of you as quite a positive person. You have a right to your anger.Morgan, thanks for telling me some of your story. I really do experience you at PB and upbeat (well I did admit to not keeping up on threads) and kind--so willing to consider posters' feeling and pov. It good to get to know you better.
((Hugs if I may))
fb
Oh, today is a good day despite an earlier trigger at home. The cymbalta might actually work(!!!!!)! Pain is down, energy up, mood brighter. I suspect it could be too stimulating somehow for some. GI issues seem to have subsided. I don't know how it might fit in to BP treatment. Maxime here used it. I don't think it caused cycling for her....
Posted by Phillipa on November 19, 2010, at 17:05:22
In reply to Re: Hey Morgan...., posted by morgan miller on November 19, 2010, at 14:17:51
Morgan not offended and had no idea you were feeling this horrible. I was under the impression that your job was helping with socialization. So sorry to hear you are having such a rough time. Love Phillipa
Posted by morgan miller on November 19, 2010, at 17:36:17
In reply to Re: Hey Morgan.... » morgan miller, posted by floatingbridge on November 19, 2010, at 16:39:21
Thanks for the response and interest FB, I appreciate it : )
>He works out like a maniac--I've seen him at Gold's Gym. I
think that's his glue. I used to run and
do Iyngaer (sp) yoga. Good glue, but I
have a back injury. I could walk more....Man, working out was my glue for years. I still needed a med to be working at the same time though. The condition of my body, musculoskeletal and physiological, keeps me from getting that benefit at the gym that I experienced just a few years ago. The fact that my brain is not quite operating in a way currently that allows me to feel the full effects for pleasure is another reason why I would not benefit from workouts as much as I should right now. I had the same problem ten years ago before I got on Zoloft. The main reason for getting on Zoloft was that I did not feel things the way I should, not necessarily that I was experiencing depression. I think this was due to a long mixed episode and some antidepressant trials. It wast he first time in my life I had experienced this inability to feel things. I was lively and full of emotion at the time, so it had nothing to do with anhedonia or major depression.
Do you think you could do a recombint stationery bike or eliptical machine? I'm trying to think of other things you could do than walking, things that would allow you to get a better more intense sweat inducing workout. I bet you would feel pretty good if you could.
>Yet you're looking at ssri's? Snri's? How careful do you need to be about cycling? What looks interesting?
I never had a problem with cycling on SSRIs. I'm one of the few people with bipolar that has done very well taking just an antidepressant. The first time I had a mixed episode(I did not know that is what it was at the time) I took Prozac and it was a miracle in a pill. About three weeks into Prozac, I woke up, took the little pill, and within an hour i felt better than I had in a long long time, I was a brand new person. All anxiety, obsessive thoughts, sleep issues, depression, and inability to focus was obliterated. I loved Prozac the first time I took it. I will always miss my good days on Prozac and Zoloft. I felt good, slept good, and was able to fully enjoy life. I was also younger and did not have all the physical issues, so that does play a major role.
What looks interesting? Hmm..Zoloft plus Nortriptyline, an MAOI(I hate the 2 and 3 time a day dosing), a TCA by itself-Amitriptyline or Nortriptyline or other, maybe Luvox-hated it over ten years ago, but things may have changed, and low dose Lexapro-this may be my first try.
>You know, come to think of it, he does very well on Wellbutrin. Not too
stimulating for him, but boosts him out of depressive brooding (runs in our family). Have you tried it?I did try Wellbutrin, it increased my anxiety and gave me the shakes. I only gave it a 3 week trial, which is rare since I usually stick something out for at least 4 weeks even with side effects. My doctor just didn't think it was a good idea to continue WB with some of the side effects I was experiencing.
>You're a guitarist?
I played bass for 5 years. I am a huge lover of music. I can't play my bass anymore due to progressive carpal tunnel syndrome. I just don't think my hands and wrists were made for the bass. I loved playing and miss it so much, but I don't see how I will ever play again. I would just love to get back to turning up some of my favorite music in my car and really feeling it. It's good for the brain to listen to loud pleasurable music, just not for too long because of hearing loss of course.
>Still, even I liked to go out and listen to music, stay
out late, drive to the city, make plans... It's really a loss right now.Ya know, I can't deal with that loss. I want to be going out and being social into my 70s.
>I think of you as quite a positive person.
Thank you. I really am innately positive. At work, my customers and most of my co-workers would never guess that I'm going through this right now. Even the most positive people can start to have a negative outlook if they are beat down hard enough for long enough.
>Wow. That's so simple. I like it.
I like to keep it simple. I have a very high tolerance for discomfort so I'm able to stay away from adding on too much until I find the few meds at the right doses that will work for me. I also fear taking too many things, possible making it harder for me later to respond to the more simple solution. I'm also not a believer in 100 percent remission through medications. I think anyone who believes they are going to get that after years of suffering and medication trials is kidding themselves. I do believe it is possible to get 70 and maybe even 80 percent remission. And honestly, should that be enough? I mean, if you get that much better, you should be able to enrich your life in ways that help you achieve the other 20 or 30 percent, at least some of the time.
FB, thanks again, you are very thoughtful and kind. I really hope Cymbalta works out for you. So far it sounds like it has potential.
Morgan
Posted by morgan miller on November 19, 2010, at 18:03:45
In reply to Re: Hey Morgan.... » morgan miller, posted by Phillipa on November 19, 2010, at 17:05:22
Being at work helps a lot, since I really like the people I work with. Unfortunately, I do not feel well enough to go out and consistently enjoy a healthy social life. Today I have not left the house. 2 years ago when I was horribly depressed, I still made it out of the house to go work out. Things are different now, a whole lot of discomfort and dysfunction going on here.
Thanks for your thoughts and supports Phillipa.
Posted by Phillipa on November 19, 2010, at 21:28:02
In reply to Re: Hey Morgan.... » Phillipa, posted by morgan miller on November 19, 2010, at 18:03:45
Morgan I simply had no idea. You've always sounded to me so in charge so to speak of your condition. I didn't know you'd played guitar. Like I had to stop nursing what I loved you had to stop playing so I totally relate. And ran all the time no more. Lots of losses. My pdoc said the other day that we all have kind of a point at which we function and can accept and deal with losses and I've reached my threshold. The glass is empty so to speak. Love Phillipa
Posted by Hombre on November 21, 2010, at 21:54:59
In reply to Re: Hey Morgan...., posted by morgan miller on November 19, 2010, at 17:36:17
^ I think it's funny to address a post called "Hey Morgan" to Morgan :)
You seem to be in a low place these days, brother. It's tough to watch you suffer. I think I know what you mean about not feeling or having that lust for life. I am still trying to light a spark under my *ss. Lots of other things seem to be making recovery harder. Stress, worrying, family stuff. I also know what it's like to have a father that just watches and doesn't seem to do anything.
Part of me has a hunch that you may need some long-term herbal therapy for kidneys and liver. These two are the ones that tend to get exhausted from the stresses of life, or sometimes too much of a good thing. Deep fatigue, anxiety, and lack of drive are kidney related. Liver has to do with free flow of energy, thoughts, ideas, and also the tendons/ligaments. Healthy muscles are spleen related, and sometimes I wonder if too many raw foods might be sapping energy from an already weakened system.
My guess, without having more to go on, would be to supplement kidney yin and liver yin. This would also require a pretty quiet life, going to bed early, etc. at least until your reserves get replenished. I know that sounds like living death, but we all have to play by the rules of physics-energy and matter cannot just be spontaneously created.
On the upside, I think your hunch about something else going on to be right on. I also have the hunch that SSRIs and other psyche drugs can only act on what you've got, and if you are deficient in energy reserves, especially kidney, the drugs don't work so well. We see it all the time actually, people developing apathy after long term med use. That's at least partially kidney yang deficiency, but without healthy kidney yin to support yang, the fire eventually goes out.
Hope that makes sense. I hope you can meet with a doctor that can help you choose a good med that will help you get back to doing what you love.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.