Posted by Sugardog on July 20, 2014, at 21:42:35
In reply to Re: Best dopamine enhancing selective med » Sugardog, posted by phidippus on July 19, 2014, at 11:07:09
>
> Eric
>Dear Eric,
I can't thank you enough for being so caring and thorough! If you're not a pdoc, you should be! You ask all the right questions. I've pasted your response below along with answers to your great questions in caps for clarity.
> > The anxiety is complex. I think I was born with some natural anxiety
>
> Do you have a free floating anxiety? The kind that makes you nervous and worried about all sorts of things?
>
> > My anxiety consists mostly of negative self thoughts.
>
> Are these thoughts intrusive and recurrent? Do you try to suppress the thoughts?THE NEGATIVE SELF-THOUGHTS ARE PRETTY CONSTANT AND PERSIST THROUGH ANYTHING I'M DOING. THEY RANGE FROM GLOBAL NEGATIVE THOUGHTS TO COMPLETELY SPECIFIC THINGS: "I'M A BAD PERSON," "I CAN'T DO ANYTHING RIGHT," "I'M A TERRIBLE WIFE," "I'M A TERRIBLE MOM," "I'M A TERRIBLE WRITER," "I'LL NEVER ACCOMPLISH ANYTHING," "I'M GOING TO DISAPPOINT EVERYONE," "THEY'LL HATE ME," "THEY'LL BE ANGRY AT ME," "I'LL MESS IT UP," "I SUCK. I DIDN'T EMPTY THE COFFEE FILTER BEFORE POURING IN THE WATER," "I WAS SUPPOSED TO BRING THREE THINGS DOWN FROM UPSTAIRS, AND I ONLY REMEMBERED TWO. I SUCK." THAT KIND OF THING. JUST A CONSTANT NEGATIVE VOICE IN MY HEAD.
>
> > When I was about six years old, my parents started having very violent fights (glass thrown, blood).
>
> > Then when I was seven, my dad put a gun to his head and threatened suicide.
>
> These events may well have caused you some PTSD.
>
> >All I wanted to do was save him because I loved him the most.
>
> You may very well have saved him.
>
>
> I thought it was my fault because I bugged him about building the dollhouse he promised to build for Christmas but hadn't done yet. He came up with the gun to his head after working on the dollhouse in the basement.
>
> >It happened on Father's Day, so of course I felt guilty.
>
> Why would that make you feel guilty?MAYBE IT MADE ME FEEL GUILTY BECAUSE I HAD A SECRET FEAR HE NEVER REALLY WANTED TO BE A FATHER.
HE MOVED TO PUERTO RICO AFTER THE DIVORCE, AND I PROBABLY FELT VERY ANXIOUS ABOUT THE ABANDONMENT. I'M NOT SURE. I JUST KNOW I FELT IT WAS SOMEHOW MY FAULT. IF HE HADN'T BEEN MY FATHER, MAYBE HE WOULDN'T HAVE GOTTEN PARALYZED. I ALWAYS FELT RESPONSIBLE FOR ANYTHING BAD THAT HAPPENED TO HIM AS WELL AS FEELING RESPONSIBLE FOR IMPRESSING HIM AND MAKING HIM FEEL BETTER WHEN HE WAS DEPRESSED.
>
> > Sorry to lay all this crap on you.
>
> I'm happy to lend an ear.
>
THANK YOU FOR BEING SO KIND!> >So in terms of my anxiety, I'm not sure if it comes from genetics, past trauma, or an extreme perfectionism
>
> It comes from genetics and the past, but I think your perfectionism stems from the anxiety.I AGREE!
>
> >If I'm in situations where I face judgement or a possibility of not preforming to my or others' standards, I go into avoidance/obsessive mode.
>
> I think you may have OCD with some PTSD thrown in for good measure.VERY LIKELY.
>
> > I also have a lot of anxiety about heights and driving on bridges or around high, curvy roads. I'm afraid of falling off.
>
> Have you ever tried exposure therapy for your phobias?THE HEIGHTS THING HAS DEFINITELY IMPROVED SINCE I MOVED TO A HILLY AREA. UNINTENDED EXPOSURE THERAPY!
>
> > I don't remember all the meds I've been on, but here's an incomplete list:
>
> >clonazepam, ativan
>
> How was your experience with those?BOTH HELPFUL FOR ANXIETY. DOESN'T DO MUCH FOR OBSESSIVENESS, NEGATIVE THOUGHTS, OR DEPRESSION.
>
> >depekote
>
> You don't need Depakote.
> AGREE. THAT DIDN'T WORK.
> >effexor, prozac, paxil, celexa, lexapro, cymbalta, vybrid,
>
> Did any of these impact your anxiety?LEXAPRO (WHICH I'M ON NOW 20MGS) AND PAXIL BOTH HELPED WITH ANXIETY. NEGATIVE SELF-TALK QUELLED SLIGHTLY BUT STILL VERY PRESENT. HAVE A PROBLEM WITH WEIGHT GAIN ON PAXIL AND LACK OF MOTIVATION ON LEXAPRO.
>
> >lithium, lamictal,
>
> Did they think you were bipolar? Are you bipolar?THEY THOUGHT FOR A WHILE I MIGHT BE A SOFT BIPOLAR II WITH VERY RAPID CYCLING SINCE MY MOODS SHIFT OFTEN DURING THE DAY DEPENDING ON MY ANXIETY LEVEL AND SENSE OF SELF-WORTH (DID I ACCOMPLISH ANYTHING? DID SOMEONE MAKE ME FEEL BAD? HAVE I BEEN SHAMED? WAS I A GOOD PERSON TODAY?") ALSO, WHEN I'M AT A PDOC, I'M EXTREMELY TALKATIVE AND ENERGETIC, WHICH COULD BE INTERPRETED AS BEING HYPO-MANIC. I SEE IT MORE AS TRYING TO BE EFFICIENT WITH MY PDOC TIME AND BEING EXCITED THAT SOMEONE WILL LISTEN TO ME AND SEEMS TO CARE. ALSO, I GET VERY ELEVATED BY HAVING INTELLECTUAL CONNECTIONS WITH PEOPLE. NEW PDOC THOUGHT IT WAS SOFT BIPOLAR AND NOW THINKS I'M ADD.
>
> >abilify,
>
> This combined with a high dose of SSRI may have helped.HOW HIGH A DOSE? I WAS ON A THERAPEUTIC DOSE OF ZOLOFT WHEN I TOOK THE ABILIFY, AND I HAD SUCH A STRANGE REACTION TO THE DRUG. I WAS TOTALLY ZONED OUT, THEN VERY TEARY, THEN FOCUSED, CALM, AND HAPPY FOR A FEW HOURS, THEN TEARY AND DEPRESSED AGAIN. FOR SOME REASON IT WAS A BIZARRE ROLLER COASTER RIDE FOR ME. KIND OF LIKE LSD LIGHT.
>
> >naltrexone,
>
> To ween you off your heroin addiction?DID VERY LOW DOSE NALTREXONE TO TRY TO BOOST MY ENDORPHIN LEVEL AND CURB MY ALCOHOL INTAKE. HAD BEEN DIAGNOSED WITH RHEUMATOID ARTHRITIS AT THAT POINT (RHUEMY AND I BOTH NOW DOUBT THE DX) AND THOUGHT IT ALSO MIGHT HELP MY IMMUNE SYSTEM).
>
> >topamax,
>
> What for?
>
DX'ED WITH MIGRAINE-INDUCED VERTIGO BY A NUERO TWO YEARS AGO. HAVE HAD ON AND OFF INSTANCES OF TOTAL DISEQUILIBRIUM FOR A NUMBER OF YEARS, MOSTLY TRIGGERED BY BOUNCING LIGHT, BOUNCING SOUNDS, OR A FLOOR VIBRATING (LIKE NEAR AN ELEVATOR). WHEN GIVEN TOPA, IT WAS AFTER TWO WEEKS OF BARELY BEING ABLE TO STAND BECAUSE I COULDN'T BALANCE. I HAD TO CRAWL TO GO TO THE BATHROOM. STILL GET SPELLS OCCASIONALLY, BUT IT HASN'T BEEN REALLY BAD FOR TWO YEARS. QUIT TOPA AFTER A MONTH BECAUSE I COULDN'T THINK CLEARLY ON IT.> >gababentin
>
> Did this help with your anxiety?YES!! UNFORTUNATELY, I CAN ONLY TAKE IT IN THE EVENING BECAUSE IT MAKES ME TOO MELLOW AND UNMOTIVATED DURING THE DAY.
>
> >adderall, dexadrine
>
> Do you have ADHD. Stuffs also good for OCD.NEW PDOC THOUGHT A LOT OF MY ANXIETY MIGHT BE FROM UNDIAGNOSED ADHD.
DEX MADE ME CATATONIC, EVEN AT A VERY LOW DOSE. 10MGS ADDERALL XR HELPED WITH INTRUSIVE THOUGHTS, BUT I BOUNCED FROM BEING CALM AND HYPER-FOCUSED TO COMPLETELY NERVOUS, AND I WAS FOCUSING ON THINGS LIKE CLEANING CLOSETS INSTEAD OF DOING MY WRITING. WAS VERY ANXIOUS ABOUT AMPHETAMINES GIVEN A COCAINE ADDICTION IN MY 20'S. WENT OFF AFTER TWO AND A HALF WEEKS.
>
> >amitripaline
>
> You were on the wrong TCA. You need Clomipramine.I'LL TAKE TO MY PDOC ABOUT THAT.
>
> >wellbutrin
>
> How did you respond to this?DEFINITELY HELPED WITH DEPRESSION AND ENERGY. HOWEVER, MORE IRRITABLE, JITTERY AT TIMES, AND PRONE TO IMPULSIVELY LASHING OUT AT PEOPLE. NO HELP WITH CIGARETTE SMOKING, WHICH WAS ONE OF THE BENEFITS I WAS HOPING TO GET.
>
> >Would welcome any advice!
>
> Let's figure out if you have OCD.YOU ROCK!!!!
poster:Sugardog
thread:1067983
URL: http://www.dr-bob.org/babble/20140717/msgs/1068609.html