Posted by andrewb on January 16, 2000, at 21:55:39
In reply to Dysthymia, posted by Janet on January 16, 2000, at 16:10:47
Janet,
First of all let me say that you have my sympathies. As a fellow dythymic, I understand the frustrations that accompany this condition. Unlike many depressions, dysthymia does not go away. For many of us, we have had it since an early age, it is all we have known, it is part of our temperment, it is who we are. I believe this is why many dysthymics go undiagnosed, they have never known anything else and thus don’t think they have a disorder or that something can be done for them.
You however have a diagnosis and that is a start. And chances are, though you haven’t found it yet, there is medication out there that will help you. In fact it is estimated that 70% of dythymic patients show improvement with medication. A Dr. Akiskal has claimed even greater results, stating that only those with physical brain damage are truely treatment resistant. Listen to this somewhat typical statement of someone helped by antidepressants, “I thought I was a sad person, now I feel different, it is as if life is a rich experience I had never felt before.” Please note that the source of the preceding information was a book entitled, “Dysthymia and the Spectrum of Chronic Depressions” (H. S. Akiskal, editor). Though somewhat technical you may want to check it out, it is a good introduction to dysthymia and the treatment options.
You are probably thinking now that while its fine other dysthymics have been helped by medicines, you’ve already tried so many so what could help you. Let me say, without knowing what you’ve tried already, that there is probably a lot of strategies left to explore. For example, have you tried mood stabilizers. Dr. Akiskal has stated that up to 50% of patients diagnosed as having dysthymia are, in fact, suffering from a ‘soft bipolar’ disorder and would thus benifit from treatment with mood stabilizers. Another possibility, is the same treatments that have helped those with Chronic Fatigue Syndrome (CFS) may help you. It has been speculated that a significant number people with dysthymia also have CFS.
One mistake doctors often make is to treat dysthymics like other depressives. They are different. For example it has been noted that those with dysthymia tend to repsond more slowly to antidepressants than those with major depression and that they often need high doses to achieve full recovery. Also, it is understandable for doctors to apply the most common treatments for depression, a variety of Selective Seretonin Reuptake Inhibitors (SSRIs) such as Prozac, for dysthymics. But, again, dysthymics are different. In fact, whereas platelet serotonin levels are reduced in people who are depressed or under great stress, they are actually increased in dysthymics.
I’m a perfect example of a dysthymic who wasn’t helped by the standard medications for depression. I was first given Sezone, which basically increases seretonin. It didn’t help my mood at all. It only made me feel more lethargic and foggy headed. The doctor then increased my dose, that only made things worse. I was like a zombie. Then he had me try Wellbutrin. (Wellbutrin is perhaps the most commonly prescribed antidepressant in the US that is not an SSRI.) Wellbutrin did not help my mood either and I had to discontinue it after 2 months because of increasing side effects like headaches. I found something that really worked for me, however, when I started taking the antidepressant amisulpride that my doctor prescribed from overseas. Amisulpride works in a novel way, it doesn’t effect seretonin at all, rather it works on another neurotransmitter, dopamine. Specifically, it increases the dopamine in the synaptic cleft of the D2-D3 receptors in the limbic system and to a lesser extent the striatum. What it did for me was improve my mood, concentration, energy and sense of pleasure while decreasing my social anxieties. (For more information on amisulpride and ordering it you can email me at andrewb@seanet.com.) After about 4 months though some of my symptoms returned, I again felt tired and unmotivated. So just recently I have started taking reboxetine, Reboxetine increases the amount of yet another neurotransmitter in the brain, norepinephrine, the brain’s version of adreniline. Its too early to tell what the full effect of reboxetine will be on me, but already it has provided me with a great increase in energy and I am more motivated. There have been almost no side effects. I feel very lucky to have found amisulpride and reboxetine, they have made such a difference in my life. It wasn’t easy though. For your sake and your daughters’ sakes, be willing to turn over quite a few stones before you find what helps you.
One final piece of advice. If you aren’t already doing it , supplement your diet with a qualtiy multi-vitamin, mineral and antioxidant formula. Shortages of magnesium, iron, and the B vitamins have been associated fatigue.Best Wishes,
Andrew
poster:andrewb
thread:19054
URL: http://www.dr-bob.org/babble/20000112/msgs/19069.html