![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by manduh on June 12, 2011, at 23:29:09
It's been awhile since I've posted anything on here. I started cymbalta back in January. By all accounts it seemed like to be the drug for me.
Things were working out good for awhile. Things at work started getting better, people started saying things like "the old manda is back".
After this period, I would be pretty good except the week around my menstrual period.
Then the good days started getting fewer and far between.
Just in this past week I was sent home from work because I couldn't control my crying. I was okay again for a few days, but friday I went to work feeling really anxious, and dissociated from myself. I took a half a klonopin that day before work. Around my lunchtime I started to break down badly. I called the on-call doctor at my gp's office. He told me to go home and try to relax.
I came home shortly later, and spent the next 3 hours just generally breaking down.
My mom was home at the time. She sees things in a very black and white way. She was doing nothing but sending me deeper into my freak out.
I finally made the decision to get into the ER to see someone immediately. The doctors there pretty much told me that they were pretty confident I wouldn't kill myself, so I was given a prescription for ativan and sent home.
I spent saturday in a some-what haze from being exhausted from all the crying, and the ativan.
Tonight it seems as though I'm back to where I was, or quite possibly worse.
I tried to talk to my parents about taking a short leave of absence from work. My mom decided that this was a bad idea, because according to her "all I'd do was sit around or sleep". Also that I was "using depression as a crutch, since I just didn't want to go to work".
Trust me, nobody likes work....sometimes I have a great time there, sometimes it sucks and I feel like having a good cry when I get home.
It's really hard to explain to a parent who has no history of mental illness exactly what I'm talking about.
So that's where you guys come in. I'm really having a tough time. I feel as though I'm barely hanging on, and I'm going to totally lose it any moment. I just want to cry, and I'm physically uncomfortable. I find myself pacing a lot.
Finally, I had a cutting problem for quite a few years. Which I was able to stop doing for quite some time now. But the urge to do so again has been back lately, and at the moment it is SO strong.
Posted by Phillipa on June 12, 2011, at 23:43:15
In reply to need advice ASAP!, posted by manduh on June 12, 2011, at 23:29:09
I'd say stay home call your doc or if can't get doc go to ER again as now you feel like cutting and that is reason. Please be safe. Phillipa
Posted by jono_in_adelaide on June 13, 2011, at 1:35:35
In reply to need advice ASAP!, posted by manduh on June 12, 2011, at 23:29:09
I'd take one of your benzos (ativan or klonopin) and call your doctor right away.
Posted by jms600 on June 13, 2011, at 16:23:34
In reply to need advice ASAP!, posted by manduh on June 12, 2011, at 23:29:09
> It's been awhile since I've posted anything on here. I started cymbalta back in January. By all accounts it seemed like to be the drug for me.
> Things were working out good for awhile. Things at work started getting better, people started saying things like "the old manda is back".
> After this period, I would be pretty good except the week around my menstrual period.
> Then the good days started getting fewer and far between.
> Just in this past week I was sent home from work because I couldn't control my crying. I was okay again for a few days, but friday I went to work feeling really anxious, and dissociated from myself. I took a half a klonopin that day before work. Around my lunchtime I started to break down badly. I called the on-call doctor at my gp's office. He told me to go home and try to relax.
> I came home shortly later, and spent the next 3 hours just generally breaking down.
> My mom was home at the time. She sees things in a very black and white way. She was doing nothing but sending me deeper into my freak out.
> I finally made the decision to get into the ER to see someone immediately. The doctors there pretty much told me that they were pretty confident I wouldn't kill myself, so I was given a prescription for ativan and sent home.
> I spent saturday in a some-what haze from being exhausted from all the crying, and the ativan.
> Tonight it seems as though I'm back to where I was, or quite possibly worse.
> I tried to talk to my parents about taking a short leave of absence from work. My mom decided that this was a bad idea, because according to her "all I'd do was sit around or sleep". Also that I was "using depression as a crutch, since I just didn't want to go to work".
> Trust me, nobody likes work....sometimes I have a great time there, sometimes it sucks and I feel like having a good cry when I get home.
> It's really hard to explain to a parent who has no history of mental illness exactly what I'm talking about.
> So that's where you guys come in. I'm really having a tough time. I feel as though I'm barely hanging on, and I'm going to totally lose it any moment. I just want to cry, and I'm physically uncomfortable. I find myself pacing a lot.
> Finally, I had a cutting problem for quite a few years. Which I was able to stop doing for quite some time now. But the urge to do so again has been back lately, and at the moment it is SO strong.
>
>
Firstly, how often are you taking the Klonopin? I tried Klonopin some time back (1mg twice per day) and had a terrible time with it. It really increased my depression to the point where I was crying and feeling so low. Some people do really well on it. However, following my experiences with it I really wouldn't recommend it if you're suffering from depression along with the anxiety. I did far better on Valium (albeit at a high dose). It's a longer acting benzo than Ativan, but there again if Ativan is working for you then stick with it.I'm wondering if Cymbalta is really right for you?? If you're taking it and still suffering from depression then you either need to get your doc to change the med or add something to it. It could be that the drug is simply no longer working for you - the dreaded 'poop out'.
If you decide to stick with the Cymbalta you could try augmenting it with another med(s). I don't know what you have tried before or what other meds you're on now, but you could consider adding an atypical antipsychotic such as Seroquel or Zyprexa to the Cymbalta. Not only can they help with anxiety but they also have an antidepressant effect. Some people say that their usage is controversial due to tardive dyskinesia, but if the drug works for you (and you keep an eye out for TD) then they are definitely worth considering in my opinion. They don't work for everyone (me being an example) and they both tend to cause weight gain - especially Zyprexa - so be mindful.
You could also consider adding low-dose lithium to your med regime to augment your antidepressant. You could even take an antidepressant, atypical antipsychotic and low dose lithium - but to start with just try one or the other and then build up if no response.
Finally, I read on here time and time again about people's dramatic responses to MAOIs. People seem to do just so well on Nardil or Parnate. Nardil would be the drug of choice where anxiety is present, however, you must weigh up the benefits with the unpleasant side effects and dietary restrictions. Also some doctors don't like prescribing them (mine included).
Hope you're feeling better soon.
Posted by torrid on June 13, 2011, at 17:24:40
In reply to need advice ASAP!, posted by manduh on June 12, 2011, at 23:29:09
Have you been on AD's before? many people suffer poop out at about 6-9 months of drug treatment.
Posted by floatingbridge on June 13, 2011, at 18:10:42
In reply to need advice ASAP!, posted by manduh on June 12, 2011, at 23:29:09
Manduh,
The following is 100% subjective advice. I will use as many "I" statements as possible.
First of all, I personally did not like cymbalta as an AD. It worsened my depression and this could be a big part of worsening my depression, muffled my cognitive abilities. However, you reported doing well on it.
You mention disassociating. May I ask you what your dx is? And who is treating you, psych or a gp, or...?
I think that sometimed parents can make things 1000x worse just when they are needed most. Sad, but true in my
experience. Do you have a therapist. I think you need to have support from outside your family as well as from inside.Any, any hunch what is triggering this wave of pain? You don't need to tell me. But maybe you can break it down into smaller pieces. Do you journal?
Non-depressives DO NOT get it. Today
my shrink told me about a study that said as much and also said what a non-depressed person can do, a person undergoing depression simply cannot. It has nothing to do with will-power or wishing. Depression is a real illness and not everyone understands that. Who would rather stay home and feel crummy and crying rather than work. I don't personally know anyone who would choose that.It could be your parents are scared, frustrated, angry at your illness. I am sorry to hear that you are being blamed in any way. I'd love to take that load of blame off your shoulders.
If you are not in therapy, I feel it would serve you well in many ways (a good fit and appropriate therapy).
Many here have self injured and have and do deal with it successfully.
Some find risperdal or zyprexa helpful,
but I am not suggesting them, only pointing to what others here have found helpful.You are not suicidal, are you?
If you have the urge to self-injure, do
you have someone to call? Even a hotline. And please post here. Sometimes the response may not be immediate, but be persistent, please.Let us know how you are doing, and keep working towards solutions. You can diminish your pain greatly.
There is something to be said about keeping a job, but I don't think for the same reasons your mom said. Mind you, I'm not advising not to take a leave, esp if it does not endanger your
employment.Take very good care of yourself, please.
fb
Posted by desolationrower on June 13, 2011, at 18:15:51
In reply to Re: need advice ASAP! » manduh, posted by torrid on June 13, 2011, at 17:24:40
Agree that if you are having mostly dysphoria, as opposed to mainly panic, benzo may make things worse.
antipsychotics mostly suck, but some olanzapine does seem to work well if you are having a really bad couple of days.
You may just need to increase the dose, if the medication is mostly working and just seems to be dropping out. I think there is some evidence for taking an sri just once week a month or so - see:premenstrual dysphoric disorder. perhaps that is what is going on?
Also, it sounds like you benefit from some practice relaxing yourself. I am always banging on about mindfulness meditation. Just taking some time and focusing on breathing slowly is helpful.
-d/r
Posted by alchemy on June 14, 2011, at 20:20:26
In reply to need advice ASAP!, posted by manduh on June 12, 2011, at 23:29:09
When you write: "I went to work feeling really anxious, and dissociated from myself"
Dissociation is a relative of anxiety
"I feel as though I'm barely hanging on, and I'm going to totally lose it any moment. I just want to cry, and I'm physically uncomfortable. I find myself pacing a lot."
Feeling physically uncomfortable and pacing sound like agitation and/or anxiety. At least short term, I would want a benzo. I know they prescribe Zyprexa a lot for agitation and it works pretty fast (although it wasn't a success for me).
I am so sorry for your pain and especially that your mom just makes it worse. And if you live at home, that is really hard. Damn! I wish we could make people understand. Would she go to your dr. with you?
If you need short-term disability - take it (sounds like you need it from your post). Screw people if they talk. You need to get healthy. I took it once and had some ect. I was scared to go back, but it worked out.
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.