![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 94 to 118 of 133. Go back in thread:
Posted by SLS on April 6, 2001, at 8:01:39
In reply to Re: treatment resistant depression , posted by sweetmarie on April 6, 2001, at 7:11:34
Anna,
Someone once told me,
"It's not people, places, and things - it's you."
This is, of course, a generality that is certainly not true for everyone all of the time. Sometimes it is people, places, and things. Every now and then I will check myself to see if my current state of mind (happiness vs unhappiness) is truly due to my circumstances, or whether it is due to a psychosocial issue. "It's you" also covers biological mental illness.
I'm almost out the door to go on a trip to Oklahoma City. Maybe I'll see a tornado. I hope so, as long as the only damage done is to a corn field. Maybe it will scare the depression out of me. Anyway, I have no particular reason to write this here, except that I might forget to in the future. It kinda sorta maybe applies here. Actually, I think it applies anywhere, but particularly with depression.
"The measure of achievement lies not in how high the mountain,
but in how hard the climb.The measure of success lies only in how high one feels he must
climb to get there."
See ya' soon. Hopefully, I'll find a computer in O.C.
- Scott
Posted by JahL on April 6, 2001, at 14:38:55
In reply to Re: treatment resistant depression , posted by sweetmarie on April 6, 2001, at 7:11:34
> > [I do apologise for this - I feel like I`ve been writing my memoirs. I totally sympathise with anyone who has fallen asleep/completely had enough of my ramblings.]> > I just wanted to say that for ages and ages, I thought that my depression was simply to do with my circumstances, i.e. situational. I thought I was in the wrong relationship/wrong town/doing the wrong college course/mixing with the wrong people/being in the wrong job etc etc. I didn`t tell any of the GPs that were treating me that it had been a long-term problem (didn`t think it was relevant, due to the above mentioned convictions). I was always advised to `keep going`, `get out more`, `think of all the other people in the world who are in worse situations`, `not spend so much time "looking into my own navel"`. I have to say that this was always my parents` attitude, and I always went along with it, feeling guilty that I was being so selfish. This is the story I gave to those treating me, so they accepted it.
> > I did change things over the years, but it wasn`t until I moved from where I had been living for 6 years since graduating, back to my home town, with the notion that this would `sort it`, that I realised that it was something that wasn`t going away. It was only then that I was referred to a psychiatrist. Everyone - myself included - was then forced to concede that I had an illness. So, basically it`s only been seen as a `proper` illness, not a passing phase (or tendency for negativity) for the past 3 years.
> > The reason that I`m writing this, is mainly for those who feel the same way, i.e. to say that it`s not the product of introspective thinking, tendency to the `glass half empty` way of thinking, or self-indulgence (or even, as one friend put it - `thinking too much`). I thought it was for many years, mistakenly, and have therefore `lost` much time blaming external things and most of all myself for being a failure. I`m not saying that depression isn`t always a biological thing - I know that it is also often reactive. Nonetheless, it is NEVER a `failure`.Hi Anna.
The above pretty much mirrors my own situation & explains my antipathy towards psychotherapists, expressed in various rants elsewhere on this board. I would not like to be the next therapist to tell me "I think a part of you doesn't want to get better" (as if) or "you have a lot of anger" (wouldn't they, if they had severe depression & consequently no life). Fortunately this situation will not arise since I will never see another psychologist as long as I live.
I have come to see through this board that psychotherapy is very useful for some; just not for individuals such as you & I. Like you I found it impeded my treatment, not only in terms of distracting me from getting real (in the context of *my* disorder) help, but in making me think that I was somehow to blame for my predicament. I've lost count of how many times psychotherapists have told me that my lack of response to their mis-prescribed treatment was down to a lack of effort on my part.
Thanks,
Jah.
Posted by sweetmarie on April 6, 2001, at 15:33:35
In reply to Re: treatment resistant depression » sweetmarie, posted by JahL on April 6, 2001, at 14:38:55
>
> Hi Anna.
>
> The above pretty much mirrors my own situation & explains my antipathy towards psychotherapists, expressed in various rants elsewhere on this board. I would not like to be the next therapist to tell me "I think a part of you doesn't want to get better" (as if)Yes - what on earth is all that about? I`ve had about 5 different counsellors/therapists over the years, and they have all asked me different versions of that question - basically asking me to ask myself whether I am gaining some benefit from remaining depressed. You what? It`s total rubbish (or as Bob puts it in `Don`t Look Back` - "lies and rubbish"*), and is an insult to my intelligence.
or "you have a lot of anger" (wouldn't they, if they had severe depression & consequently no life).Another one that I`m familiar with. I feel like saying "of course I`m f***ing angry, what do you think - that I choose to be depressed because I`m angry about some `issue` or other". I have often wondered whether these people actually know what severe depression (and, as you said, no life) is like. I`d say not. It was the classic Freud theory that depression was `anger turned inwards`, and I`m afraid that some therapists still adhere to this. Hopefully, this has been superceded by more modern and realistic thinking (after all, it was Freud who came up with `penis envy` - the biggest load of rubbish I`ve ever heard in my life).
Fortunately this situation will not arise since I will never see another psychologist as long as I live.
Wise choice. Unfortunately for me, my mother is a counsellor, and still asks things like `how is it for you when ... whatever`. I KNOW my `issues` till they are coming out of my ears - so what? What am I supposed to do with them? No therapist seems to have any suggestions about that. One of my Mother`s friends (a fellow counsellor), once dared to talk to me about medications `masking the real feelings`. I had a lot of trouble not kicking her in the teeth and saying `do you think that catatonia is a preferable state to be in?` I managed not to, though. Another of my Mother`s friends thought that she`d come up with the perfect solution for me - `tell Anna that she should fall in love - I`ve heard that cures depression`. I wouldn`t put myself within 100 miles of another relationship. Far too many of them have suffered through my illness, and I`m determined that it should not happen again.
My Dad`s friend suggested `reality therapy`. I would know what this was, if Dad hadn`t told this guy to shut up and that he really didn`t know what he was talking about. I was really pleased with Dad for that. `Reality therapy` - hello? I don`t like this reality, thank you very much if it`s all the same to you. >
psychotherapy is very useful for some; just not for individuals such as you & I. Like you I found it impeded my treatment, not only in terms of distracting me from getting real (in the context of *my* disorder) help, but in making me think that I was somehow to blame for my predicament. I've lost count of how many times psychotherapists have told me that my lack of response to their mis-prescribed treatment was down to a lack of effort on my part.
Well, knickers to them is all I can say. The only person to really KNOW what`s wrong, and what they know WON`T help, is the sufferer him/herself (even if we are a bit hazy about what will help). I`ve got `issues` all right - no life, no job, no meaningful relationships with my friends, no self-confidence and generally feel as though I should come with a Government Health Warning. But, you`re right - some people do get an awful lot out of psychotherapy (and I have to admit to being just a tiny bit jealous - it would be excellent to go and see a therapist, uncover a complete personal `road to Damascus` revelation, and feel great). Just not me - and you too, so it seems.
>
Sorry if this has been a bit of a rant - I feel quite strongly about psychotherapy. These people seem to pick up on the minutest of irrelevant things. I can remember telling one counsellor that I was anxious, and described it as `buzzing like a fridge` (a lyric from `Karma Police` by Radiohead). All it was was a description, but she went off on one about fridges and stuff. ???Anyway, the good thing is that the correct knowledge has been aquired, i.e. that this is an illness and not some kind of `safety hatch` as counsellors are wont to say. Time spent trying futiley to work out `why` all this happened is, in my opinion, time wasted. What`s needed now, is proper medical help, and to move on from this point, not go over bloody past relationships with family/bad relationships (with men - well, in my case)/any other damn thing they choose to rake up.
Phew.
Cheers,
Anna
*I know quite a few quotes from that film - quite a Bob Dylan saddo, really.
Posted by JahL on April 6, 2001, at 16:11:52
In reply to Re: treatment resistant depression , posted by sweetmarie on April 6, 2001, at 15:33:35
> >. Unfortunately for me, my mother is a counsellor.I'm sorry to hear that ;-)
> > Sorry if this has been a bit of a rant - I feel quite strongly about psychotherapy.
Same; rant on. It makes me feel less isolated on this one!
> >These people seem to pick up on the minutest of irrelevant things.
Tell me about it. I found I had to choose my words very carefully; any kind of negative expression was deemed to be proof that I had 'learned' negative thought processes, which 'obviously' were at the heart of my depression. If only life were that simple. In the end I resorted to using long words which they couldn't understand & so couldn't scrutinise or dissect!
My lifestyle was also under constant attack. As you say, try working or conducting a relationship when you're cataleptic.
> > Anyway, the good thing is that the correct knowledge has been aquired, i.e. that this is an illness and not some kind of `safety hatch` as counsellors are wont to say. Time spent trying futiley to work out `why` all this happened is, in my opinion, time wasted. What`s needed now, is proper medical help, and to move on from this point, not go over bloody past relationships with family/bad relationships.
Exactly. I think we're on the same wavelength here.
Jah.
Posted by sweetmarie on April 7, 2001, at 7:10:56
In reply to Re: treatment resistant depression » sweetmarie, posted by JahL on April 6, 2001, at 16:11:52
>
> > >. Unfortunately for me, my mother is a counsellor.
>
> I'm sorry to hear that ;-)Yes, it`s a bit of a pisser all round. The trouble is that she doesn`t accord me with the same treatment as she does her `clients`. She often tells me that she`s not going to talk to me any further unless I have `something positive to say`. I try to tell her that depression = negativity (no two ways about it), and she should know being a cousellor, but she says that I `haven`t lost my reasoning`. Well, yes actually I frequently do (lose my reasoning, that is). She came to it late in life - took her degree when she was about 58 - and I never understood why she chose to be a counsellor. My own experiences with therapy have been largely (probably about 85%) discussing her, and the problems I`ve always had with her. However, this is a whole other subject. >
It makes me feel less isolated on this one!
You`re certainly not on your own there - during my 12-week `intensive` group psychotherapy course, I met two people - one who I started going out with and subsequently split up with, and another who I am still friends with. Both had nothing but contempt for the whole process (as I did), and it`s completely fair to say that we none of us gained a damn thing. Neal (ex) has a whole history of mental illness (depression/paranoia/self harm), which frankly was not going to be solved by just talking about it, and my other friend was (is) in a similar situation. In fact, we all used to laugh about the sessions afterwards (in so far as one can laugh, being depressed). I know of only one person who has gained anything from counselling. >
> > >These people seem to pick up on the minutest of irrelevant things.
>
> Tell me about it. I found I had to choose my words very carefully; any kind of negative expression was deemed to be proof that I had 'learned' negative thought processes, which 'obviously' were at the heart of my depression.That`s what their textbooks tell them.
If only life were that simple.
Right.
In the end I resorted to using long words which they couldn't understand & so couldn't scrutinise or dissect!
That`s a good idea. Hadn`t thought of that. I`m actually seeing a counsellor at the minute. I started seeing him last November with the specific objective of trying to recover from this (afore mentioned) relationship. I told him that this is what I wanted to do it for, but thus far we`ve hardly even touched on it. You probably think that I`m being completely unassertive by not bringing the subject up, and talking about everything else but that. I`m afraid that it`s just `me` - I`m the same when I go to my 4-weekly appt with my psychiatrist. I may have spent the whole of the previous month lying on my bed contemplating suicide, but when I see her, I`m always `well, it`s been really bad, but ...` and put on my `stoic` mask. I suppose that I feel that I don`t want to `let her down`, which of course is absurd - that`s her job (and one that she gets paid obscene amounts of money for, I don`t doubt). I guess that I don`t want her to see me as some kind of moron; I want her to know that I`m intelligent and self-perceptive etc etc. I know this is silly, but I can`t help it.
I just want to say something that my current counsellor picked up on (I haven`t actually been to see him for the past 2 weeks - too ill). While I was standing outside the building, smoking and waiting for my appt time, I saw a big advertisement for the recent Beatles anthology. It boasted `27 number one hits`, and I was just idly thinking that they didn`t have 27 number ones, or perhaps they did etc. The thought barely took shape in my brain, it was so trivial. He (counsellor) is of the `I`m not going to say anything until you do` school of counsellors (the wisdom of which totally eludes me), so I told him about the poster. He then went on and on about the Beatles, their significance in my life blah blah. For goodness` sake, it was just a passing comment! They don`t have any particular relevance in my life, but I found myself talking about `Sgt Pepper` in great detail. Ludicrous. So why do I continue to go? Answer: I`m too worried about his reaction and hurting his feelings if I stop. As I said, ludicrous.
>
> My lifestyle was also under constant attack. As you say, try working or conducting a relationship when you're cataleptic.It`s completely impossible.
>
Anyway, that`s about it on counsellors/talk therapy for the time being. It`s good to find someone else with the same views, although I`ve probably left you wondering at my paradoxical behaviour. I wonder about it too.Anna.
Posted by sweetmarie on April 7, 2001, at 8:22:35
In reply to Re: treatment resistant depression » JahL, posted by sweetmarie on April 7, 2001, at 7:10:56
Re. Current Research
I belong to Depression Alliance, who publish a quarterly newsletter. The following article was printed in the most recent edition:
DNA code discovery to benefit depression treatments
"Ongoing work to unravel the genetic `book of life` - the DNA code contained in our cells which works as a recipe for every human - will lead to improved treatments for depression, scientists say. New gene-based medication for depression are already being developed using this new information. These developments will benefit the patient by tailoring the diagnosing, treatment and prevention of depression to his or her individual genetic make-up."
This is something that many of you will know about already; I just thought it was worth posting for those of us who haven`t heard about it.
What it doesn`t say is what stage this research is at, and how long it will be until it is at the stage where it can actually be tried out. In this country (UK), it is probably fair to say that it will probably take a long time. Although mental ill health is the second most prevalent illness in this country (I think I`m right in saying), it still ranks right at the bottom of the medical priority list (this is ridiculous, but try telling the government that). In the States, I believe that this is a whole different kettle of fish.
However, it certainly sounds hopeful, especially to those, like myself, whose depression is genetically linked. Lets hope it doesn`t take them too long.
Meanwhile, some UK statistics:
* 19 million prescriptions for anti-depressants were issued in Britain over the last year.
* About half a million people are undergoing psychological therapy at any one time.
* Depression is set to become the second biggest cause of death and disability worldwide after heart disease, according to the World Health Organisation.
* 19% of people working more than 48 hours a week experience symptoms of depression, a new survey suggests.
This is all very depressing I know, but kind of helpful too in a way (or at least I found it so). It means that we are certainly not alone in our struggle (19 million people can`t be wrong!), and also hopefully it will mean that it (depressive illness) will be taken far more seriously.
Anna.
Posted by dove on April 7, 2001, at 11:15:59
In reply to Re: treatment resistant depression » sweetmarie, posted by sweetmarie on April 7, 2001, at 8:22:35
This entire thread has been very comforting to me. I haven't added much of anything to the conversation but I have really listened, and a number of us seem to have the same 'symptoms' that make us 'atypical' in the eyes of many mental healthcare professionals.
The meds we are taking, or have tried seem to either: make things worse, make things a *little* bit better, or make things better temporarily, proceeding in a float back down to where we started or lower. I wish the best for all of us and am very buoyed by the fact that there are others in the same boat (although I wish there was no boat to begin with--or no raging sea for that matter!)!
Thank you all for sharing the dialogue thus far, I'm sure there are many others benefitting from it also!
dove
Posted by Shar on April 8, 2001, at 23:56:05
In reply to Re: treatment resistant depression--ditto » Shar, posted by sweetmarie on April 3, 2001, at 6:14:16
Sweet -- just saw your post.
The combo (listed below) is still better than anything has been in years. I do not feel depression free, I am probably what some people would call "blue" most of the time. However, compared to where I've been and the various combos I've tried, and the hassles of getting off and on, side effects etc. - this is very good.
Years--I've been depressed since I was about 12-13, maybe 14 years old. That is 35 years of fairly unremitting plain old chronic depression (more than just blue) with episodes of severe, breathtakingly horrible depression.
Always lots of suicidal ideation. Even now; however I am squared away with the suicide issue, it's not an option.
Hope you are well-
Shar> > My pdoc recently added .5 mg Risperdal to my cocktail of wellbutrin sr and effexor xr, and klnonpin at night. It worked (I felt relief from depression) within a few days. We upped it to .75 because I was having the "feeling ok then the bottom falls out" plus "rage reactions" and doc said increase could help me stay feeling better for 24 hours, plus rage reaction could be a rx to withdrawal when .50 couldn't get me thru 24 hours.
> >
> > BTW, I have not felt this good in years. Years! It is incredible. Zoloft also worked well for me, but pooped out. I am praying this will not poop out.
> >
>
> Shar,
>
> Haven`t heard from you in awhile. I was wondering whether the combination you went onto (the Ritalin, Welbutrin, Efexor and Klonpin) has continues to work, i.e. has it managed to sustain you? Also, How long is `years`? That probably sounds a bit of a stupid question, but I hope you know what I mean.
>
> Anyway, I hope it`s still doing the trick; let me know,
>
> Anna.
Posted by sweetmarie on April 9, 2001, at 4:46:56
In reply to Re: treatment resistant depression--ditto » sweetmarie, posted by Shar on April 8, 2001, at 23:56:05
> Sweet -- just saw your post.
>
> The combo (listed below) is still better than anything has been in years. I do not feel depression free, I am probably what some people would call "blue" most of the time. However, compared to where I've been and the various combos I've tried, and the hassles of getting off and on, side effects etc. - this is very good.
>
> Years--I've been depressed since I was about 12-13, maybe 14 years old. That is 35 years of fairly unremitting plain old chronic depression (more than just blue) with episodes of severe, breathtakingly horrible depression.
>
> Always lots of suicidal ideation. Even now; however I am squared away with the suicide issue, it's not an option.
>
Shar,Thanks for the reply. I`m glad that your meds are still working (or, at least working better than others have).
It sounds to me like you have Dysthymia - a fancy name for `pretty much always had a tendency for low mood`. The reason I say this is that I have had a very similar experience, with the depression beginning at an early age, and never really going away. I`ve had periods of very severe depression too, including the current one which has been raging for about 3 years now(`officially`, although I know that it started way before that).
Anyway, labels are only really any use up to a point. Depression is depression, and it`s a complete and utter nightmare, full-stop.
It must be a releif to be back to just plain old feeling `down`. I know that this sounds ridiculous, but I really look back fondly on the days when I was kind of mildly depressed. I didn`t even know the half of it back then. So, I imagine it must be a huge relief. It`s tragic that it should be so, but `small mercies` and all that.
I`ve been told by my specialist that, whilst they can almost certainly do something about the severe depression, the underlying low mood (the Dysthymia, which is a kind of genetic thing) is not so easy to eradicate. I was quite dismayed when I heard this, but I was speaking to my sister about this, and she said that she reckoned that I`d feel so relieved that I wasn`t suicidal any more (well, not suicidal as such - more wanting to die all the time, which is different I know), that I`d be able to tackle `problem areas` in my life, and thus go some way to alleviating the low mood tendency. What I mean, for example, is not going into another stressful job. I`ve always had stressful jobs, but I realise now that I can`t cope with stress at all. So, I suppose what I`m saying is that there are certain things I can put into place to help redirect any potential recurrence of this hideous pit I`ve been in for so long.
That`s the theory, anyway. Whether it will work out like that, is another story entirely. First and foremost, I need to be in a position to actually be able to see the outside of my flat now and again, instead of lying in bed all the time, feeling completely crap and unable to do anything. That in itself will be a major achievement.
Anyway, I`m really glad that you are still doing O.K.
Cheers,
Anna.
> >
Posted by sweetmarie on April 9, 2001, at 6:25:54
In reply to Re: treatment resistant depression , posted by SLS on April 6, 2001, at 8:01:39
Every now and then I will check myself to see if my current state of mind (happiness vs unhappiness) is truly due to my circumstances, or whether it is due to a psychosocial issue. "It's you" also covers biological mental illness.
Which, of course is no small matter, although it`s sometimes hard to comprehend that it`s your brain that is creating all this havoc (just doesn`t seem possible). >
> I'm almost out the door to go on a trip to Oklahoma City. Maybe I'll see a tornado.
Did you see one? Did you end up the other side of the rainbow like Dorothy? (You know, the place where `skies are blue` and `troubles melt like lemon drops` etc.) >
> "The measure of achievement lies not in how high the mountain,
> but in how hard the climb.
>
> The measure of success lies only in how high one feels he must
> climb to get there."
>
That`s good, I like that one. >Still no response to the Lamictal - 2 and a half weeks, and counting ...
Anna.
Posted by Shar on April 10, 2001, at 20:00:11
In reply to Re: treatment resistant depression--ditto, posted by sweetmarie on April 9, 2001, at 4:46:56
Sweet:
> It sounds to me like you have Dysthymia
..........Dysthymia is my dx-> It must be a releif to be back to just plain old feeling `down`. ........It is indeed. I think what I have noticed most is that I am not devoid of energy. That's made the most day-to-day difference. So going to the post office isn't this agonizing routine; I just go.
the underlying low mood (the Dysthymia, which is a kind of genetic thing) is not so easy to eradicate.........This is what I have been told also. I have accepted the idea that I may always be blue, and stopped yearning for complete relief; that has helped. I am trying to learn to be here now (a tip of the hat to Ram) more often than not, and not spend a lot of time in the past or future. I do still dissociate some in more stressful situations.
>
> Anyway, I`m really glad that you are still doing O.K........I appreciate your encouragement. I hope you will find some relief soon. Blue beats the hell out of the Pit.Shar
Posted by sweetmarie on April 11, 2001, at 15:34:16
In reply to Re: treatment resistant depression-- » sweetmarie, posted by Shar on April 10, 2001, at 20:00:11
Shar,
> It must be a relief to be back to just plain old feeling `down`. ........It is indeed. I think what I have noticed most is that I am not devoid of energy. That's made the most day-to-day difference. So going to the post office isn't this agonizing routine; I just go.
I can`t remember when I last felt like that (although there must have been a time when it was the case).
I have accepted the idea that I may always be blue, and stopped yearning for complete relief; that has helped. I am trying to learn to be here now (a tip of the hat to Ram)
who/what is RAM? and I thought that `be here now` was an album by Oasis (joke).
more often than not, and not spend a lot of time in the past or future. I do still dissociate some in more stressful situations.
What does dissociate mean? Well, I know what it means, but not in emotional terms.
> > Anyway, I`m really glad that you are still doing O.K........I appreciate your encouragement. I hope you will find some relief soon. Blue beats the hell out of the Pit.
I`m sure it does. I look forward to the day (hopefully it won`t be too long)when I`ll find out.
When you say `blue`, do you mean `sad` or `mildly depressed`?
One more thing about Dysthymia: the professor that will be treating me, wants me to do a course of CBT when I am well enough to do it. I`ve heard this is an effective way of helping Dysthymia, on the basis of `learned` behaviour over a prolonged time caused by this underlying depression.
Cheers,
Anna
p.s. Had you been `looking` for a long time before you found this combo?
Posted by sweetmarie on April 12, 2001, at 15:13:33
In reply to Re: treatment resistant depression-- » sweetmarie, posted by Shar on April 10, 2001, at 20:00:11
To everyone who has been so helpful to me on this thread:
I`ve had my hospital admission date, and it`s next Tuesday. I don`t think that there is Internet access there, so apart from the odd posting before Tues, I won`t be around for the support that everyone has so kindly given me.
It`s an `open-ended` stay of at least a month, and I reckon I`ll be there longer.
Anyway the point of this was just to say thank you very much to everyone who has been so kind to me, during this very bad period in my life. I expect that I`ll be back here as soon as I`m `out`, but till then,
bye,
Anna.
Posted by Shar on April 12, 2001, at 23:26:16
In reply to Re: treatment resistant depression-- » Shar, posted by sweetmarie on April 11, 2001, at 15:34:16
Sweet--
> who/what is RAM? and I thought that `be here now` was an album by Oasis (joke).
........hehehe.....Ram is Ram Dass who wrote a book called "Be Here Now." I know his approach is not western; I believe he is a guru or yogi or something similar.
> What does dissociate mean? Well, I know what it means, but not in emotional terms.
.......to me dissociate means that I am not in my body. It is more like a trance-like state, or staring a lot; definitely not in the moment. But not a complete loss of function. One instance is arriving at work and remembering nothing about the drive into the city. And crossing my fingers that all the lights I went through were green.....
>
> When you say `blue`, do you mean `sad` or `mildly depressed`?.......I use blue as "mildly depressed." I use colors to describe my depression, from black to clear. Clear is the absence of depression. I felt clear on Zoloft until it pooped out (much to my great dismay). 'And what color are we today?' a former pdoc of mine used to ask.
>
> One more thing about Dysthymia: the professor that will be treating me, wants me to do a course of CBT when I am well enough to do it........What does CBT look like in action?
>
> p.s. Had you been `looking` for a long time before you found this combo?.......I had been looking for quite a while. Probably total time was 7 years before now. During that time I had used some meds with limited success, but kept trying for more relief. Thank god(s) for Risperdal, the last thing that was added to my cocktail.
......I read your post about going in to the hospital and would like to encourage you for stepping toward some potentially very helpful stuff. If you are scared, my thoughts are with you. On this board we have many people that have been in the hospital and come out just fine. I'm holding your hand.
Take care,
Shar
Posted by sweetmarie on April 13, 2001, at 11:58:48
In reply to Re: treatment resistant depression-- » sweetmarie, posted by Shar on April 12, 2001, at 23:26:16
Ram is Ram Dass who wrote a book called "Be Here Now."
They bloody nicked it (Oasis)! I knew they were too stupid to think up such a profound title.
I know his approach is not western; I believe he is a guru or yogi or something similar.
I have heard of him, but never read his stuff. In general I don`t read `self-help` or philosophical stuff, which is probably fairly silly. I imagine that I am missing out on quite a lot. >
> .......to me dissociate means that I am not in my body. It is more like a trance-like state, or staring a lot; definitely not in the moment. But not a complete loss of function. One instance is arriving at work and remembering nothing about the drive into the city. And crossing my fingers that all the lights I went through were green.....
I know that one. I frighten myself sometimes when I am driving (on the very rare occasions that I am well enough to leave the house), as I find that my eyes are sort of `glazed over` and that I am staring at the adverts on the side of the road, or at the car next to me, or the car behind me through the rear view mirror. I kind of drive on autopilot, and constantly miss things, e.g. cars stopping in front of me etc. It`s not such a good idea to drive when you`re poorly.
Is this kind of what you mean?
> > When you say `blue`, do you mean `sad` or `mildly depressed`?
>
> .......I use blue as "mildly depressed." I use colors to describe my depression, from black to clear. Clear is the absence of depression. I felt clear on Zoloft until it pooped out (much to my great dismay). 'And what color are we today?' a former pdoc of mine used to ask.You use the expression `pooped out` - can this happen with all meds? The colour thing is a good guide; my psychiatrist used to get me to draw a graph, but I gave up as it looked like I was constantly flatlining at zero! Not very encouraging.
> > One more thing about Dysthymia: the professor that will be treating me, wants me to do a course of CBT when I am well enough to do it.
> .......What does CBT look like in action?
CBT (Cognitive Behavioural Therapy) is about changing ways of looking at things.situations etc. The theory is that people who have long-term problems with depression, have learned negative trains of thought (or, from another angle, negative trains of thought have produced depression). My understanding of CBT is that it is a way of intercepting negative thoughts/feelings simultaneously they enter the mind, and replacing them with positive thoughts/feelings. It certainly SOUNDS good, but I am very skeptical of it`s effectiveness. Basically, I wonder if those walls that we have been surrounding ourselves with (well, me anyway) for so long (34 years in my case), are actually open to that kind of change. I mean, they feel pretty inpenetrable to me. I`m cynical though - I`ve had lots of therapy over the years, and can`t be bothered really. I MUST go into this with an open mind, though (repeat 100 times!) So that`s it basically.
> > p.s. Had you been `looking` for a long time before you found this combo?
>
> .......I had been looking for quite a while. Probably total time was 7 years before now. During that time I had used some meds with limited success, but kept trying for more relief. Thank god(s) for Risperdal, the last thing that was added to my cocktail.What a relief. I`ve been on different meds for nearly 11 years now, and all but the first one have totally failed to work. I myself haven`t worked (done a job) for 3 years now. Even ECT didn`t shift it. Hopefully, my `time` is not far away. >
> ......I read your post about going in to the hospital and would like to encourage you for stepping toward some potentially very helpful stuff. If you are scared, my thoughts are with you. On this board we have many people that have been in the hospital and come out just fine. I'm holding your hand.
Thanks, Shar - just what I needed to hear. >
Cheers,
Anna.
Posted by Noa on April 14, 2001, at 12:21:55
In reply to Re: treatment resistant depression-- » Shar, posted by sweetmarie on April 13, 2001, at 11:58:48
Sweetmarie--good luck in hospital.
Posted by sweetmarie on April 14, 2001, at 13:46:47
In reply to Re: treatment resistant depression--, posted by Noa on April 14, 2001, at 12:21:55
> Sweetmarie--good luck in hospital.
Thanks very much (much appreciated),Anna.
Posted by sweetmarie on April 15, 2001, at 11:32:37
In reply to Re: going into hospital » Shar, posted by sweetmarie on April 12, 2001, at 15:13:33
This is it - final posting.
Thank you VERY VERY VERY much to everyone who has responded to me.
So now I`m off to hospital, and
in the words of Morrissey:
`please please please let me get what I want ... this time`
and in the words of Arnie:
`I`ll be back`
and to everyone:
keep on keeping on
Thanks once again - this board has been a tremendous help, and I wish everyone the very best of health.
And thanks to Dr Bob for being a diamond geezer.
Anna.
Posted by Dr. Bob on April 15, 2001, at 14:51:25
In reply to FINALLY GOING » sweetmarie, posted by sweetmarie on April 15, 2001, at 11:32:37
> And thanks to Dr Bob for being a diamond geezer.
Come again? :-)
Bob
PS: Good luck!
Posted by sweetmarie on April 15, 2001, at 15:41:04
In reply to Re: a what? » sweetmarie, posted by Dr. Bob on April 15, 2001, at 14:51:25
> > And thanks to Dr Bob for being a diamond geezer.
It`s a cockney expression for a jolly good chap.
> PS: Good luck!
Thanks,
Anna.
Posted by ShelliR on April 15, 2001, at 18:02:18
In reply to FINALLY GOING » sweetmarie, posted by sweetmarie on April 15, 2001, at 11:32:37
> `please please please let me get what I want ... this time`
Anna, we're all wishing that for you.Looking forward to hearing from you when you return to the world at large.
Shelli
Posted by dove on April 16, 2001, at 11:19:24
In reply to Re: FINALLY GOING » sweetmarie, posted by ShelliR on April 15, 2001, at 18:02:18
Dearest Anna,
My prayers, thoughts, and hopes are with you. Please know that we will all be here when and if you need us. You have given so much to this board, you've shared so much of yourself, your struggles that I just want to say "Thank You" one more time :-)
Please come back and update us all!!! I will be watching for you! My best wishes, my best 'get something good outta this' vibes, and my prayers send I to you! And a BIG hug (((Anna)))
~dove
Posted by sweetmarie on June 17, 2001, at 8:38:02
In reply to Re: FINALLY GOING, posted by dove on April 16, 2001, at 11:19:24
> Dearest Anna,
>
> My prayers, thoughts, and hopes are with you. Please know that we will all be here when and if you need us. You have given so much to this board, you've shared so much of yourself, your struggles that I just want to say "Thank You" one more time :-)
>
> Please come back and update us all!!! I will be watching for you! My best wishes, my best 'get something good outta this' vibes, and my prayers send I to you! And a BIG hug (((Anna)))
>
> ~dove
Dear Dove (and everyone),Well, I`ve been at the hospital (specialist treatment resistant affective disorder unit) for 8 weeks now. It`s a really nice place, and completely unlike any other NHS hospital I`ve ever been in. The best thing is that there are only 10 patients there, and we all get a lot of individual attention from the nurses (who are all - with the exception of one - really nice).
The bad news is that I haven`t experienced a lift in mood (well, maybe a very small one). I`m very frustrated about this obviously, although I`m still told it`s `early days`.
I have a question regarding Venlafaxine/Mirtazapine (Efexor/Remeron - `Zispin` in this country). I have now been on Venlafaxine for 6 weeks, and Mirtazapine for 5 weeks. The Mirtazapine has remained steady at 30 mg, and the Venlafaxine has been gradually increased to 375 mg. I`ve been on this dose for a week now. This could be an impossible question to answer, but here goes -
Does anyone know whether length of time spent on a medication is `counted` from the highest dose, or from when the medication is first taken (at the lowest dose)? I have asked the nurses this question, but frankly they didn`t make all that much sense. I`d be really grateful for any info on this subject ...
Thanks also to Dove for the lovely sentiments - I really appreciate them.
Let me know.
Regards,
Anna.
Posted by Cam W. on June 17, 2001, at 9:10:10
In reply to Re: FINALLY GOING » dove, posted by sweetmarie on June 17, 2001, at 8:38:02
Marie - When mentioned in clinical reviews, the time one should remain taking an antidepressant is 6 months. This means that one should take an antidepressant for "at least" 6 months after remission is attained. It can take 4 to 12 weeks (or longer) to enter antidepressant-induced remission.
OTOH, in clinical trials, the time when starting an antidepressant is used as the starting date. Rarely, are these studies followed through to remission and recovery, but when they are, the studies still use the time when starting the drug, as a start date.
I think this is where the confusion comes in. Really, the date of remission should be judged the start of the antidepressant working, but this date is sort of fuzzy as entering remission is gradual. Therefore, many docs use the rule of thumb that, the first date that they see their patient is recovering (4 - 12 weeks into treatment), they will try to maintain that patient for at least another six months. Most docs nowadays just keep a person on an antidepressant for at least a year from the start date, and then evaluate the person at that time; using their clinical judgement to determine whether that person should remain on an antidepressant or whether it is time to try to take the person off of the antidepressant.
I suppose that it was this sort of wishy-washy answer that the nurses gave you, isn't it? None of these rules are written in stone, and it is really up to the judgement of the doctor. Research has bourne out though, that if people stop taking an antidepressant within 6 months of remission, there is approximately a 60% to 80% chance of relapsing. These figures are for first-time treatment-responsive depressions.
This is probably not the "rule of thumb" in treatment-resistant cases like yours, where long-term therapy, after (if) remission is achieved. So, to answer your question in the context of your treatment-resistant depression: it depends on how you do eventually respond to the medication.
I hope that this mess is of some help. - Cam
Posted by sweetmarie on June 18, 2001, at 5:52:26
In reply to Re: FINALLY GOING » sweetmarie, posted by Cam W. on June 17, 2001, at 9:10:10
> Marie - When mentioned in clinical reviews, the time one should remain taking an antidepressant is 6 months. This means that one should take an antidepressant for "at least" 6 months after remission is attained. It can take 4 to 12 weeks (or longer) to enter antidepressant-induced remission.
>
> OTOH, in clinical trials, the time when starting an antidepressant is used as the starting date. Rarely, are these studies followed through to remission and recovery, but when they are, the studies still use the time when starting the drug, as a start date.
>
> I think this is where the confusion comes in. Really, the date of remission should be judged the start of the antidepressant working, but this date is sort of fuzzy as entering remission is gradual. Therefore, many docs use the rule of thumb that, the first date that they see their patient is recovering (4 - 12 weeks into treatment), they will try to maintain that patient for at least another six months. Most docs nowadays just keep a person on an antidepressant for at least a year from the start date, and then evaluate the person at that time; using their clinical judgement to determine whether that person should remain on an antidepressant or whether it is time to try to take the person off of the antidepressant.
>
> I suppose that it was this sort of wishy-washy answer that the nurses gave you, isn't it? None of these rules are written in stone, and it is really up to the judgement of the doctor. Research has bourne out though, that if people stop taking an antidepressant within 6 months of remission, there is approximately a 60% to 80% chance of relapsing. These figures are for first-time treatment-responsive depressions.
>
> This is probably not the "rule of thumb" in treatment-resistant cases like yours, where long-term therapy, after (if) remission is achieved. So, to answer your question in the context of your treatment-resistant depression: it depends on how you do eventually respond to the medication.
>
> I hope that this mess is of some help. - CamHi Cam,
Thanks for your reply - it WAS of some help.
I think that the idea is that I remain on the successful combination (whether this is the combination I am currently on, or another - if any), long-term. I`ve suffered from moderate - severe depression for most of my life (I`m 34), and the current severe episode has lasted for over 3 years now. I have discontinued meds twice over the past 10 years with disastrous results, so I`m in no hurry to stop taking them any time soon.
The `4 - 12 weeks` you mention is useful; I`ve always been told that the time-span is 3 - 6 weeks. Having said that, I know that the longer the depressive episode has lasted, the longer it takes the meds to have an effect. What I was really after was when the `4 - 12 weeks` (or whatever) is measured from - i.e. is it measured from the onset of taking the med(s), or the beginning of taking the highest dose. In other words, is the period before (hopeful) efficacy measured from the beginning (when a patient begins taking the meds, at a low dose), or from when the meds have been `boosted` to the highest doseage.
Does this make sense? I hope you can get the gist of what I`m asking.
Any `light` on this gratefully appreciated.
Cheers,
Anna.
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