Posted by MarkinBoston on October 20, 2000, at 17:51:02
In reply to SOME OBSERVATIONS ABOUT US ALL, posted by GLYN on October 19, 2000, at 18:52:29
Interesting observations, here's my feedback. I too am "treatment resistant" like most here. I've been through lots of meds which eventually resolve my major unipolar melancholic episodes, help some with dysthymia, but not much in comparison to the side effects, and nothing for underlying anhedonia. My enjoyment of things and motivation are definately subnormal during major episodes and enjoyment always subnormal. Memory and cognitive skills return to suprnormal after major episodes (normal for me).
> We are all morbidly fascinated with our problems so much so that they appear to be as much a hobby as they are a burden - no offence intended as I am the worst for this.
Well, I've spent less time here as I'm starting to feel pretty good on 20mg Ritalin AM, 5g 1% Androgel bid, 50mg. Serzone bid. The first two I think make the biggesst difference for me and the subtheraputic level of Serzone helps and more of it increased memory problems (morning fog turning to panic while trying to remember where my keys or whatever are).
Some people may be here for the sense of community or shared common cause. I have a number of hobbies, but lose interest in them during episodes and priority shifts to health. When healthy, there are many things I'd rather do than spend personal time on a computer.
> We are all extremely intelligent, articulate, informed and, I would guess, fairly high achievers or gross under achievers.
I fall into that last catagory, and upon just turning 40 got really pissed off about the time I've wasted, fettered by this disease. I've had accounts and email addresses on "the net" for 25 years, started working for DEC at 16 fixing operating system bugs, dropped out of college, interviewed at Microsoft in 1982 with Steve Ballmer and Bill Gates, and turned down the job offer because the job wasn't interesting enough; they didn't have an ARPAnet connection, and DOS on an 8080 PC was a pathetic excuse for a computer compared to what I had been using. I am mad at myself for not having more motivation and in hindsight see it as component of long standing dysthymia. Same with a mostly single status resulting from long term anhedonia. Oh, and while I may be bright, I don't spell well.
> Almost all of you (I dont include myself in this just yet) are more informed about our meds than most docs are.
This is a current problem for me. The last three doctors I've seen in 6 months have not liked it. My pdoc of 8 years is supportive, and unlike the others appears to listen well and exchange knowledge. It seems to bruse their ego that I want to work with them on a course of treatment instead of just accepting their standard treatment for whatever issue. Spending more time on pubmed then they do, when its their job, irritates them too. I wish more doctors were as open-minded and unthreatened as my pdoc. This week's friction was splitting up my dose of Androgel to bedtime and waketime to decrease aromatization to estridiol, which elvates my already high levels, which twice resulted in panic attacks. The manufacturer advocates once a day use following the morning shower without much explination, but I infer its to reduce undesireable transfer to a female partner, but that is not a factor for me now. He turned down my request for very low dose Arimidex to reduce T- >E2 conversion, and didn't appreciate me suggesting giving Clomid to men to more quickly restore endogenous testosterone production when going off gel, patch, or shots. Both he termed as for research use, not clinical use, though anabolic steroid using athletes routinely do both. I'm sure he thinks I'm crazy (psyc history, you know), and though I was relieved to find that in men too, increased estradiol levels result in heightened stress response like I've felt, reading the study abstracts from PubMed won't change his opionion of my mental state.
Like JohnL, I've been frustrated at the lack of protocol for treating depression. I'm also frustrated by the trouble I've had finding a MD with expertise in both endocrinology and depression, despite the interrelationship in my case. Sometimes a pdoc will screen for hypothyroidism, but I don't know many wanting a full endocrine workup. Even endocrinologists seldom use the extended assays requiring numerous samples because hormone levels can have cycles, spurts, an/or dramatic 15-minute level changes. There's also the link between endocrinology (hypercortisolism) and hypertension, and newer types of anti-hypertensives are also antiaxiolytic.
> An alarming number of us confess to have taken some kind of illegal drug in the past (Cannabis, LSD etc). The old causation correlation debate applies here though and because there appears to be a relationship it is not easy to say if one caused the other.
I'd love to feel as good as the average person and illegal drugs must have some positive attributes if the government goes through the hassle of creating legislation. I don't know of any laws banning ingestion of purely toxic substances like gasoline, bleach, Draino etc.. Other factors at work here are that psyc meds stigmatize, but the value of sharing information outweighs that fear; we're shameless! Since HIV, having to talk openly about sex became a life or death issue, and a little embarassment was nothing compared to the pain of losing a loved one. Also more open is discussion of schedule I drug use to the degree that even our elected officials have talked about their own use.
As for having tried some schedule I drugs, well, I've tried far more antidepressants. No stigma in that. Even if I were a person adverse to trying new things (foods, activities, positions, travel), a pdoc would encourage trying a new drug or dosage if it might work (better). So some of us may have been more experimental to begin with or encouraged to be by Russian Roulette of psyc drug choice leading to more drugs experienced than if there were a more scientific approach to narrow down treatment candidates.
As to causation correlation debate, I think making a drug illegal causes more research funding to support the political decision. A drug I would like to see made illegal is the heartburn drug Tagamet (citimidine) which is now off patent and over the counter and can cause depression and hypogonadism besides having many drug interactions. But without "abuse potential", and large sales -its not likely to be made illegal despite newer, safer drugs.
So, being bright, more free-thinking, and post Vietnam and Watergate, I don't assume the FDA/DEA, drug companies, and AMA have my health and interests as their top priority and know what's best for me.
> Despite all of our travailing, very few of us seem to have been "cured" or feel satisified by the meds we are taking.
I'm fairly satisfied with the progress I'm making and how I feel now. When I'm "cured" or health treatment is no longer an acute concern, I'll spend my time other than here.
Concerning your hypothesis about disillusion, I don't find it true. All my major episodes have resulted from prolonged exogenous stress. I've tried thinking "happy thoughts" without success and still try, having done some cognative therapy work in the mid 80's. Acceptance of nature and what I can't control is important. The times I feel hopeless is when I have trouble finding a good doctor who can listen, keeps current, is willing to spend time with a patient, doesn't feel threatened, and has expertise and experience in treating my seemingly simple, interrelated symptoms. I also feel hopeless when treatment isn't working and I feel most avenues have been exhausted. Then I stumble upon this site and hope returns as I find others in similar situations and reporting benefit from many atypical combinations I had not considered.
One footnote on panic. One paper I came across on a small study sample subjected to 5 days of public speaking showed two thirds adapted to the stressor during that period with lowering HPA stimulation (cortisol levels), while one third maintained high cortisol levels throughout. So, many are predisposed to having panic.
poster:MarkinBoston
thread:46800
URL: http://www.dr-bob.org/babble/20001012/msgs/46904.html