Posted by Abby on February 9, 2000, at 19:09:23
Noa's right. I never described my symptoms. Here's a brief history. I always struggled some and may have been dysthymic all my life, but I also had a terrible time as a child, because my mother is really crazy, paranoid etc., and I could not keep her chaos away from me.
When I was 19 and a sophomore in college (fall of 94) I slipped into a ‘moderate' depression. I was rotten company, but I felt a little bit safer when I read in the room of one of my old roommates. Friends were worried, and I sought help in late October. I got a couple of counseling sessions with a social worker, but I couldn't really get them to take me seriously. I was clear that I needed help (I don't think they really believed me) but couldn't afford outside help. I was clear about my mother and the fact that my Dad's mother was manic-depressive. I first went in in late October; it wasn't until mid to late December, just a day before Christmas break that they finally referred me for a 20 minute psychiatric consult. I was prescribed Zoloft, written out always as sertraline, starting at 25 mg and then up to 50 mg. For a while it was great, and then I felt ‘normal' though slightly better than I had been in the past.
I stayed at 50 mg for 4 years. I noticed that I felt worse in winter and tried some light therapy. The psychiatrist said I might try it out, but he never bothered to supervise the light therapy. I felt more comfortable sitting in front of the bright light while I did my work, but I still felt worn down by winter. In general, I feel off and awful during most of the winter---tired, slow, stupid and sleepy. October and November are somewhat worse than January, when I usually feel really good for about a week. I always tried to get things taken care of--summer plans and fellowships during good weather, but of course the applications were never ready. I also notice that my visual acuity is reduced in winter.
Early spring and summer is the most comfortable for me, but high heat and humidity really wipes me out.
In the summer of 1998, I weaned myself off of the Zoloft without medical advice. I had no objection to being on the drug; it's just that I didn't have a prescription. Following graduation in 1997 I was very aggressive about looking for jobs, but I never fit or I didn't have the right resume to work in business. Nor was my resume appropriately tailored etc. In desperation I had gone for some advice from a firm in Cambridge, MA called Interim. Their main business was helping high school students plan a year off. They waved all kinds off possibilities from various contacts, including an international business experience in Germany. In the end, they referred me to some people in England who said they could set up an internship and teach me finance. That was a disaster; they never did get me a proper internship; they had no connections, and the tutor they found was interested in marketing. On the life front, I'm applying to law school for next year, but I need a real job w/ benefits now. So, I need to get better fast and would prefer drugs which don't require expensive blood tests.
I had tapered the medication, figuring that I could hold out until I was in England where I could get National Health benefits. As it turned out, I wasn't really a student, and I hunted around for a private psychiatrist; there were only two in Oxford. The one who agreed to see me seemed to think that I just had the common cold of mental health--depression and upped the dose to 100mg of Zoloft. I was better. I tried to talk to him about cyclothymia, but he didn't believe me. (My mother had beeen briefly committed in January 98, and thought to be atypical bipolar rather than schizophrenic.)
One of the things I noticed was that in April and May in England when spring came, there was an exacerbation of certain unpleasant symptoms associated with spring. I think that this may have to do with the fact that England is further north than the U.S., and once the days got longer. Overall I feel better in spring, but I was starting to feel a bit antsy, couldn't sit still or had to be doing something---even if that was reading. Sometimes, though I felt so activated that I had to listen to very regular classical music; this usually helped after a few hours. Sometimes I had to lie down in a dark room for up to 45 minutes.
More recently, I've been experiencing these energized states along with periods when I break into tears after almost nothing. Twice in the past two weeks, but it only lasts one day; I think it would be too exhausting otherwise. After an awful time Friday, I was really productive for two days, then sort of normal, then I had an unpleasant ‘hypomanic state' again. Sometimes driving--more even than walking calms me a bit---but while I am actually driving. I also think that taking a long hot bath might help, but this really terrifies me, because my mother used to take endless baths.
I've also noticed a kind of depression where the weight of it is so oppressive that I have to walk. Exercise helps I know, but for me this is partial symptom relief if I pace in a room, not behavior most people appreciate.
Right now I'm taking 150mg Zoloft in the AM and 300mg of lithium at night; I've been on this regimen since mid-October. I'm wondering whether I ought to add an anti-convulsant mood stabilizer, one which might be more appropriate to ‘rapid-cycling'. I'm a little wary of Depakote, because we got my mother into treatment briefly, and depakote just zonked her out.
So I'm wondering about Lamictal and Neurontin. The predominant problem is depression, but there is considerable mood lability.
So, any advice is much appreciated.
poster:Abby
thread:20928
URL: http://www.dr-bob.org/babble/20000209/msgs/20928.html