Posted by Sugardog on July 22, 2014, at 23:17:45
In reply to Re: Best dopamine enhancing selective med » Sugardog, posted by phidippus on July 21, 2014, at 9:52:53
Dear Eric,
Thank you again for your patient help and support.
I'll put my responses to your questions below in caps. I know caps are annoying, but I can't figure out how to do it in italics.> >If you're not a pdoc, you should be!
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> I'm studying neuroscience.
>
YOU ARE SO INSIGHTFUL AND PRECISE. I'M HAPPY THEY HAVE YOU IN THE FIELD!
> > THE NEGATIVE SELF-THOUGHTS ARE PRETTY CONSTANT AND PERSIST THROUGH ANYTHING I'M DOING.
>
> Do they cause you anxiety or depression or both? Have you ever tried to 'agree' with the thoughts? For instance, you have a negative thought and you respond, "That's right, I'm the worst person this side of the Mississippi!". Another thing to try is writing all the negative thoughts down as you have them then later reading what you wrote.HAVEN'T TRIED AGREEING WITH THE NEGATIVE THOUGHTS. THEY SEEM SO DEFINITE, CONVINCING, AND UNDENIABLE WHEN I'M HAVING THEM. HAVE TRIED SAYING, "THIS IS JUST MY CRITICAL VOICE," WITHOUT MUCH SUCCESS. YEARS AGO, TRIED WRITING THEM DOWN AND TALKING BACK TO THEM, BUT DIN'T FOLLOW THROUGH ON THAT TECHNIQUE. I BELIEVE I'M SOMEHOW ATTACHED TO THE SELF-CRITICISM, SELF-HATRED, AND DISAPPOINTMENT IN MYSELF -- AS IF MY WHOLE IDENTITY AND WORLD WILL DISINTEGRATE IF I LET GO OF THIS THINKING. MAY ALSO BE A DEFENSE MECHANISM AGAINST OTHER PEOPLE'S JUDGEMENT, SHAMING, OR ANGER -- IF I BEAT MYSELF UP FIRST, I CAN'T BE TRAUMATIZED BY THEM.
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> >JUST A CONSTANT NEGATIVE VOICE IN MY HEAD.
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> This seems a bit obsessive. Beating yourself up repeatedly. On the medication side of things I'd recommend a higher dose of Lexapro(40 mg) and augmentation with an atypical antipsychotic that agonizes 5ht1a receptors (these receptors improve mood and lessen anxiety when agonized)-Latuda, Geodon(it is also an SNRI) and Abilify all agonize 5ht1a receptors.
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> You could also try Brintellix. On top of being an SSRI,it agonizes 5ht1a receptors and 5ht1b receptors which both effect mood. It also antagonizes 5ht1d receptors which helps lessen anxiety and it antagonizes 5ht7 receptors which helps with mood.THANK YOU FOR YOUR SUGGESTIONS. HAVEN'T TRIED GEODON BUT NERVOUS BECAUSE I HEARD IT CAUSES WEIGHT GAIN (ALREADY GAINED 20 POUNDS IN THE PAST TWO YEARS). IS BRINTELLIX AVAILABLE IN THE US? WILL IT CAUSE A LOT OF WEIGHT GAIN? I'M LITERALLY HAVING TO WEAR MY OLD MATERNITY CLOTHES RIGHT NOW.
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> > MAYBE IT MADE ME FEEL GUILTY BECAUSE I HAD A SECRET FEAR HE NEVER REALLY WANTED TO BE A FATHER.
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> Even when you were young you had a lot of fear.DEFINITELY. I WAS ALWAYS WORRIED ABOUT MY PARENT'S FEELINGS, THINGS FALLING APART, BEING GOOD ENOUGH, ETC.
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> >I PROBABLY FELT VERY ANXIOUS ABOUT THE ABANDONMENT.
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> How did you cope with your anxiety?BRILLIANT QUESTION. I BECAME HYPER AWARE AND SENSITIVE ABOUT OTHER PEOPLE'S FEELINGS AND TONES OF VOICE AND LEARNED HOW TO ADAPT MY BEHAVIOR TO MAKE THEM FEEL HAPPY AND NOT ANGRY OR SAD. BASICALLY HYPER-VIGIL ABOUT MY ENVIRONMENT AND EMOTIONAL CUES. I ALSO THREW MYSELF INTO SUCCEEDING IN SCHOOL, READ A TON OF BOOKS INSTEAD OF PLAYING AFTER SCHOOL, MEMORIZED AND RECITED POETRY BECAUSE I THOUGHT IT WOULD BE GOOD FOR ME, SECRETLY READ THE DICTIONARY INSTEAD OF GOING TO RECESS, THAT KIND OF THING.
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> >IF HE HADN'T BEEN MY FATHER, MAYBE HE WOULDN'T HAVE GOTTEN PARALYZED.
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> There's no logic in that.
I KNOW. IT'S A BIZARRE CHILDISH RESPONSE TO THE SITUATION THAT I HAVEN'T BEEN ABLE TO COMPLETELY SHAKE.
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> > WHEN HE WAS DEPRESSED.
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> How often was this?HE WAS THE MOST LIVELY, FUN PERSON IN THE WORLD (ALTHOUGH A HEAVY DRINKER, A WOMANIZER, AND IRRESPONSIBLE) UNTIL MY MOM THREATENED TO ABANDON HIM. WHEN SHE PUT HER FOOT DOWN ABOUT THE DIVORCE, THAT'S WHEN HE PUT THE GUN TO HIS HEAD.
HE ALWAYS CARRIED A LOT OF GUILT AND SHAME ABOUT HIS DAD'S DEATH BECAUSE WHEN HIS DAD DIED OF CANCER WHEN MY DAD WAS 13, IT WAS KEPT SECRET FROM MY DAD. MY DAD FELT TERRIBLE LATER ABOUT BEING DEEPLY ASHAMED OF HIS DAD WHEN HE HAD DIARRHEA ON A BOAT, NOT UNDERSTANDING HIS DAD WAS DYING OF CANCER AT THE TIME. HE NEVER GOT TO SAY A PROPER GOODBYE AND HAD A VERY RIGID, EXTREMELY CRITICAL MOM. SO I THINK HE WAS AVOIDING ALL THESE FEELINGS BY BEING HEDONISTIC WHEN HE WAS YOUNG. AFTER HE GOT IN THE WHEELCHAIR (AGE 33, I THINK), HIS DEPRESSION WAS VERY PRONOUNCED AT FIRST, THEN WENT UP AND DOWN. HE WAS ALSO DRINKING A LOT AND ON TONS OF MUSCLES RELAXANTS AND PAIN KILLERS.
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> > LEXAPRO (WHICH I'M ON NOW 20MGS)
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> This negative self talk may be recurrent and intrusive, which would indicate you have OCD. OCD is often treated with higher doses of SSRI. Usually the highest recommended dose is doubled-in your case you would take 40 mg of Lexapro.I WAS ON 40MGS LEXAPRO FOR A NUMBER OF YEARS, WHICH DID HELP ME BE MORE PRODUCTIVE. MY ONLY CONCERN ABOUT GOING BACK TO THAT DOSE IS I WAS ALSO QUITE IMPULSIVE, MORE ADVENTURE SEEKING, AND MADE SOME BAD DECISIONS (HAVING SEX WITH THE WRONG PEOPLE, ETC.).
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> > HOW HIGH A DOSE? I WAS ON A THERAPEUTIC DOSE OF ZOLOFT WHEN I TOOK THE ABILIFY
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> A normal therapeutic dose of Zoloft is about 100 mg, whereas a dose for OCD would be 200 mg. Then add Abilify at a low dose and adjust upward until you feel results.I CAN'T REMEMBER WHAT DOSE I WAS ON. I GAIN A LOT OF WEIGHT ON THE HIGHER DOSES OF ZOLOFT. THINK IT MESSES WITH MY BLOOD SUGAR AND MAKES ME WANT TO DRINK MORE.
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> >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.
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> Abilify can cause mood shifts which usually pass after a few doses.MAYBE I SHOULD TRY ABILIFY AGAIN. I WAS ON IT FOR AT LEAST A WEEK AN WAS AN EMOTIONAL WRECK. HOW MANY DAYS DOES IT USUALLY TAKE TO STABILIZE?
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> > DX'ED WITH MIGRAINE-INDUCED VERTIGO BY A NUERO TWO YEARS AGO.
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> Yuck. I have chronic daily headache.
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> > YES!! UNFORTUNATELY, I CAN ONLY TAKE IT IN THE EVENING BECAUSE IT MAKES ME TOO MELLOW AND UNMOTIVATED DURING THE DAY.
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> Have you tried Gabitril for the anxiety?NO. IS THAT AVAILABLE IN THE US?
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> > NEW PDOC THOUGHT A LOT OF MY ANXIETY MIGHT BE FROM UNDIAGNOSED ADHD.
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> I doubt it.ME TOO. WAS A RELIEF TO GET OFF THE AMPHETAMINES.
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> > Clomipramine.
> >
> > I'LL TAKE TO MY PDOC ABOUT THAT.
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> Gold standard for depression and ocd.CLOMIPRAMINE MAY BE A GREAT SOLUTION. THANKS SO MUCH FOR SUGGESTING IT!
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> > > Let's figure out if you have OCD.
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> > YOU ROCK!!!!
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> you're intrusive thoughts seem to center around negative self-talk and these thoughts are recurrent causing you anxiety. How does your depression figure in? I think it comes after the negative thoughts.SPOT ON. I DEFINITELY THINK THE ANXIETY COMES BEFORE THE DEPRESSION. I START THE DAY FULL OF HOPE, THEN COMES THE ANXIETY/NEGATIVE THOUGHTS, THEN I SPIRAL INTO DEPRESSION. OR I GO INTO A DEPRESSION IF I'M FACING AN ANXIOUS SITUATION I'M SURE I CAN'T HANDLE.
I don't think medication is going to help you all the way with the negative thoughts. I think you need to see a therapist who specializes in anxiety disorders, like OCD, to help you train your brain to more effectively deal with the thoughts. Go to psychologytoday.com and you can find a therapist by specialty.
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THANKS! I'LL CHECK IT OUT. MY PDOC WANTS TO TRY EMDR THERAPY WITH ME BECAUSE OF PAST TRAUMA. ANY THOUGHTS ON THAT?> How does your anxiety affect your mood?
AGAIN, GREAT QUESTION. A LOW LEVEL OF ANXIETY IS OFTEN MOTIVATING AND FEELS TOLERABLE AND, UNFORTUNATELY, NATURAL. A MEDIUM LEVEL OF ANXIETY CAUSES ME TO BE AGITATED, BECOME MORE OBSESSIVE, AND START TO HAVE MOOD SWINGS. A HIGH LEVEL OF ANXIETY CAUSES ME TO BECOME VERY UNCOMFORTABLE, VERY OBSESSIVE, AVOID THINGS I NEED TO DO REALLY DO, AND SPIRAL HEAVILY INTO SELF-HATRED AND DEPRESSION.
THANKS AGAIN!!!!
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> Eric
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poster:Sugardog
thread:1067983
URL: http://www.dr-bob.org/babble/20140717/msgs/1068695.html