![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 157 to 181 of 200. Go back in thread:
Posted by jda1292 on July 12, 2002, at 22:58:16
In reply to Re: no sex drive anymore, posted by OldSchool on February 10, 2002, at 19:53:40
"I dont think you had real depression to begin with...you had what I call "Woody Allen" depression. Self esteem problems, dysthymia, situational depression, etc. "
You are a riot!!!
I had panic disorder so pad 6 years ago I could barely drive to work on back country roads! At that point in time I would have traded me 'John Thomas' for relief!, actually me 'twig and berries' What good is sex if you feel like dying?
I have a loving faithful wife that is not sex crazed and enjoys it a couple times a month. She enjoys it and so do I! It was tough with Paxil, but she loved to watch me suffer for an hour in bed while she got the rock hard weenie. Ejaculation was a problem, but if you keep at it, mine always worked.
I consider this good considering I have an 8 year old and a 5 year old.
I think a lot of people have 'Woody Allen' depression and anxiety, for I would give you my left nut rather than have a bad panic attack. Thank God for the drugs!
> > Well, I don't know your condition or what you're taking but I hear you cuz I been there done that.
> >
> > I will not tolerate sexual side effects with these drugs (it isn't a matter of whether I can or not -- I simply WILL not). I've been down the Paxil and Zoloft roads (forget Prozac) and found that for me the loss of sexual function exacerbated my depression GREATLY, while the drug's "benefit" was simply to flatten out my personality and mood. This is called "Turning Into A Zombie."
>
>
> You must not have real clinical depression then. Id gladly trade my left nut for a drug that blasted me out of clinical depression. I could care less if it caused delayed ejaculation in me, just so long as it actually worked good at achieving remission.
>
> I only care about REAL drug side effects like EPS, TD, neuroleptic induced parkinsons, MAOI hypertensive crises, etc. etc. etc. The typical SSRI side effects like weight gain, headaches, nausea, sexual dysfunction etc. seem like wussy trivial side effects to me after what Ive been thru.
>
> >
> > The loss of sexual function made me more frustrated than I had been, made me isolate because I was ashamed I couldn't "function" anymore, and the damage from those months and years of trying these drugs have taken their toll on my self-esteem.
>
> I dont think you had real depression to begin with...you had what I call "Woody Allen" depression. Self esteem problems, dysthymia, situational depression, etc.
>
> >Today the meds I take are not supposed to have sexual side effects, and yet I still have difficulties -- which are no doubt the aftermath of being put through the ringer with drugs that adversely affect sexual function, along with the original and continuing effects of the depression.
> >
>
> Again...to someone who has had the real deal...severe clinical depression these sorts of side effects mean diddly.
>
> > I know you're joking about the hooker (maybe not), and it's good to see you're trying to make light of the problem through humor, but the long term psychological damage sexual dysfunction can have on you is NOT GOOD.
>
> Neither is having major depression longterm...does weird and bad things to your body and health.
>
> >
> > Advice that was given me and which I pass along is:
> >
> > Talk to your doctor about getting OFF the meds you are on that are robbing you of your sex drive OR see whether you can add a med that makes you more spunky (i.e., the side effects of one drug that offsets the side effects of another drug. Serzone was quoted me as one drug that can offset sexual side effects in other drugs, for example...WB is anot supposed to adversely affect sex drive, etc.
>
> I agree, those with milder depressions would probably be better off trying to fix it without drugs.
>
> >
> > Naturally it depends on what is wrong with you, what you have tried before and what does and doesn't work for your condition (we all respond differently to different drugs and as much as the docs know about the meds they are still in the dark about plenty -- hence we are all our own guinea pigs). If sexual side effects are bothering you even a little you have to take that seriously and demand your pdoc look into and discuss with you every other treatment possibility available for your condition.
> >
> > A lot has to do with diet and exercise, too. Exercise especially. Most of us are sitting on our beee-hinds typing away on this BB when we could be getting a half hour of aerobic exercise (even just fast walking). I know that's a big issue for me, one which definitely also affects my capacity to function sexually. I bet most of us with depression don't exercise nearly enough, and if we did we might be able to take less meds to get enough benefit and deal with less side effects. Just a thought my doc passed along to me.
>
> Exercise can really help mild depression probs.
>
> >
> > For men especially to be robbed of their sexual identity (being relegated to the status of eunuch) is perhaps the most discouraging and underrated liability of taking psychotropic medications which adversely affect sex drive. Whether it's right or wrong, many men equate their intrinsic self worth with their ability to "rise" to various sexual occasions (so to speak). That aspect of man isn't going to change. It is, however, up to each of us to work with our doctors to find solutions to our conditions that do not emasculate us.
> >
> > Sex is one of the easiest things to find in this world if you really want it. There are plenty of people who are willing to have sex for a price, infinitely more who would be willing to do so "recreationally" if approached with respect and honesty. Not isolating and making ourselves available to potential partners is part of the problem also. We can sit on a BB and type away and not be "out there" meeting people. Incidentally, as soon as I finish typing this, I'm outa here to head up to the local watering hole and see if I get lucky. It takes forcing yourself to be social, or else go to a strip club and get a lap dance, or whatever. But don't isolate. Perhaps the worst thing about drugs that rob us of our sexual abilities is that we are even denied the ability to masturbate.
>
> >
> > It's our choice whether we take the drugs prescribed for us and when we find the sexual side effects ruining us, our responsibility to take action. Believe me, I know -- I learned the "hard" way (bad pun).
> >
> > ethan
>
> All the women I meet are super horny and Im not. Its the depression, not the drugs. The drugs dont work good in me, so the best I ever get is about 30%. I used to have a sex drive, it kind of came back some on Wellbutrin. Remeron was good for sex too. It got real strong again for a few days on Amantadine here recently. But overall my sex drive is gone. Women dont want to be involved with a depressed guy with no sex drive. Honestly, I think women are the real sex fiends, not men. LOL I wish I could keep up with them but Im just worn out physically and mentally. Im 33 and feel like 83.
>
> Old School
Posted by Bob on July 13, 2002, at 13:14:51
In reply to Re: Real Depression, posted by cybercafe on July 12, 2002, at 2:39:57
> Actually that was a quote from LostBoy but I'll argue his side on this
>
> ---- my father is psychotic and takes perphenazine (Trilafon) ... he claims his side effects are
>
> Severe chronic sinus infection, congestion
> Rippled Cornea (visual impairment)
> Anal Leakage
> Asthma
> Major weight gain
> Much Sedation
> About 20-30 points off his IQ
>
> ... and a whole host of other symptoms he indicated were permanent ...
>
> .. i'd say that is much worse, ... but in my case there was no question that i would be taking the medication no matter what ... i just don't see how there's any choice involved ...
>There is no question that psychosis and the meds used to treat it are a whole other league of horror. I am truly sorry to hear about what your father goes through. It sounds quite unpleasant.
There is another "choice" for us, and a certain percentage of people eventually take it. I'm not advocating it at all, I'm just saying sometimes it gets to be too much for people.
> .... yep... but isn't the quality of life raised more by the antidepressants themselves?
Yes, in the vast majority of cases. However, it is all relative, and for each person becomes a trade-off between what their life is like off meds, and what it's like on. Sometimes, people's bodies are very intolerant of meds.
> Chronic constipation is easy to deal with... i can recommend several different oil or fibre supplements... one pill you take once or twice a day with other properties (i.e. anti-oxidant, etc)
Are you referring to fish oil?
> .... okay so you're saying that i'm 100% recovered, happy, non-depressed, but i have no libido, or were dizzy and weak? ... well i wouldn't be bothered, if i am happy :)
No, I'm not saying that, because in my personal experience, no such med exists.
> .... on the other hand... if i were always lying in bed ruminating about how horrible the side effects were, totally unproductive, miserable, unable to concentrate, unbearably depressed... well i would postulate that the antidepressant isn't working more than 50% :)
50%? You basically just described my life presently, and I wouldn't place it at 50%.
> ... sorry if i come off a bit harsh, ... i just hear from so many people claiming they suffer more than everyone else when their behaviour totally does not seem to support this....
Actually, I agree. When physical dysfunctionality comes into play it becomes a whole other ballgame.
> .. and if i can back up lostboy's trivial statement... i refer you again to the top of my mail listing what my father tells me were his side effects... hell why not throw in movement disorders like TD and diabetes... these things don't go away ...
No question, there are a host of horrific possible effects out there.
> .. i also wish people would stop using recreational drugs and screwing up their heads...Uh-huh. I never touched a rec drug in my life. My brain and autonomic nervous system got totally wacked all by itself. Lucky me.
> ... as for the public expectation being higher.. yes you're right.... i just wrote a letter to a university professor of psychiatry who had all of these noble claims about pdocs and continuing education ... pleeeeeeeeease! how can people have such distorted views...
> ... hell i would be happy if a doctor would ADMITT a patient is beyond his ability and refer or consult another doc...I think it comes from people not seeing the reality of the big picture. There are many people out there suffering unimaginably, and there are many drugs out there with many problems. We are not currently at a point where we can sit back and say that we have "excellent" tools to fight this problem. If you cold measure our progress towards a cure for mental illness in terms of sailing across the Atlantic, I think we'd still be well within sight of the port from which we'd disembarked.
> take care ;)
you as well.
Posted by cybercafe on July 15, 2002, at 0:13:44
In reply to Re: Real Depression » cybercafe, posted by Bob on July 13, 2002, at 13:14:51
> There is no question that psychosis and the meds used to treat it are a whole other league of horror. I am truly sorry to hear about what your father goes through. It sounds quite unpleasant.
... well it did at first -- then i said to myself "this has been ill for 45 years and never once attempted suicide -- he must be reasonably happy" ... and later i discussed taking a different med with him, and he has zero desire to change meds so.... i am convinced you can have quite a few miserable side effects and still be a happy fellow
> There is another "choice" for us, and a certain percentage of people eventually take it. I'm not advocating it at all, I'm just saying sometimes it gets to be too much for people.
.. yeah... but the thing that bothers me is there are so many treatments available that people havn't had the chance to explore... i'd like to think imparting knowledge can greatly improve upon this
> Are you referring to fish oil?
actually i tried flax seed oil for constipation i think.. but i only used it once or twice and the problem went away (damn it)...
... if only i had known about it during those years of paxil and metamucillibido, or were dizzy and weak? ... well i wouldn't be bothered, if i am happy :)
>
> No, I'm not saying that, because in my personal experience, no such med exists.oh... how many meds have you tried and if you have communicated your feelings to your doctor, does he consider you a 100% success or otherwise?
> 50%? You basically just described my life presently, and I wouldn't place it at 50%.
... hmmm... i always thought if you tried all the stimulants, opiods, augmentation strategies and so fourth there was always ECT ...
> Uh-huh. I never touched a rec drug in my life. My brain and autonomic nervous system got totally wacked all by itself. Lucky me.
.. same here... but i am expecting a 100% recovery sooner or later... most likely through an augmentation strategy ...
... i'm actually pretty much 100% when i'm around people, but feel like crap otherwise...
.. why are you doing worse than 50%, .. are you waiting for the current med to kick in?
> I think it comes from people not seeing the reality of the big picture. There are many people out there suffering unimaginably, and there are many drugs out there with many problems. We are not currently at a point wherehmmm... besides antidepressants taking so long to work (possibly managable with pindolol?) and permanent movement disorders what do you see as major problems with current drugs?
>we can sit back and say that we have "excellent" tools to fight this problem. If you cold measure
... i think excellent tools can be misused and turned into horrible tools.....
>our progress towards a cure for mental illness in terms of sailing across the Atlantic, I think we'd still be well within sight of the port from which we'd disembarked.
cure? .... i'll get back to you on that when i finish reading up on gene expression ;)
> > take care ;)
>
> you as well.are you doing any better?
what steps would you have to take to improve your condition?
Posted by Gabbi on July 16, 2002, at 20:09:44
In reply to Re: Real Depression, posted by Geezer on July 10, 2002, at 15:48:39
Posted by Gabbi on July 16, 2002, at 20:16:58
In reply to Re: Real Depression » LostBoyinNC1, posted by Bob on July 11, 2002, at 0:12:57
In no way, no way did I mean to infer that it is the patients fault that they quit their treatment and get worse. I finally learned my lesson after 10 years. It is humiliating to feel that you are not in control, and a minor point its just a huge nuisance to get refills, remember to bring them, and also a huge societal pressure as well as our own self-doubt wondering "am I just lazy" "Am I being melodramatic?" And though its fortunate that depression is finally being given legitimate recognition, its also a double edged sword. Because now that many of us have discovered what has been wrong for many years, we're accused of jumping on the bandwagon..as in "What'll it be next week chronic fatigue"
Posted by Gabbi on July 16, 2002, at 20:31:03
In reply to Re: Real Depression, posted by Geezer on July 11, 2002, at 10:56:27
I completely agree... that "issues" stuff is a bad day, maybe a bad week. Its true that continued trauma can eventually alter brain chemistry enough too create "organic" major depression. But depression to me is frightening because there is no "tangible problem" if there was an "issue" I could work on it. As it is One morning I'll wake up in another dimension of terror, hopelessness and fear, and be told to "relax"
I'm sorry to mention his name again but much of the reason I appreciated Andrew Solomons book so much was that he came as close as anyone I've ever heard to be able to describe depression to people who have never suffered it.
Being a sufferer himself, and a "success" before his first breakdown he managed to have many people listen. Its unfortunate that to get through to people you have to be "successful" in societal terms, but it did get people who think its laziness or weekness or lack of will to listen. He still admits that though he is "managing now" he can't say that he will never take his own life if the suffering outweighs the joy.
Posted by Gabbi on July 16, 2002, at 21:06:17
In reply to Re: quitting meds » Bob, posted by Gabbi on July 16, 2002, at 20:16:58
First off, I should never have said "Atlas of depression is the Ultimate book" I know better than to make those kind of "factual statements" on something that is an opinion. And I'm a little embarassed.
Additionally don't think this is anything other than a sincere enquiry of your opinion.
If you read the book and didn't really appreciate it I'm not going to write back telling you why you should. (its a personal pet peeve)
I consider myself a real cynic when it comes to books on depression,or most things actually.
Did you read Andrew Solomons book and still
remain unimpressed.
After a slew of "inner child, heal your mood, eat your way to mental health, toxic psychiatry, books or readable but reductive anecdotal books. I thought this one was truly remarkable, and I really apreciated that the author states first off that "no book can span the suffering of people with depression". If the book left you cold it at least its acknowledged!.I found his personal,historical,scientific, and cultural references and vivid descriptions stunning. But was most impressed by his scrupulous investigation of sources and balanced approach.
I'm just curious, not saying YOU HAVE TO READ IT It will change your life. Because we know, (well I should speak for myself) I know that external "things" don't make a dent when I'm in that indescribable(SP?) horror.
And God knows most of us have tried everything money allows.
I swear if I hear one more person recommend more Vitamin B or spew another version of
"I saw this guy on Oprah with no arms no legs skin cancer and cerebral palsy and he's happier than you are....I will become homicidal rather than suicidal. Gabbi
Posted by Geezer on July 16, 2002, at 21:24:32
In reply to Re: Oh ya!, posted by Gabbi on July 16, 2002, at 20:31:03
> I completely agree... that "issues" stuff is a bad day, maybe a bad week. Its true that continued trauma can eventually alter brain chemistry enough too create "organic" major depression. But depression to me is frightening because there is no "tangible problem" if there was an "issue" I could work on it. As it is One morning I'll wake up in another dimension of terror, hopelessness and fear, and be told to "relax"
>
> I'm sorry to mention his name again but much of the reason I appreciated Andrew Solomons book so much was that he came as close as anyone I've ever heard to be able to describe depression to people who have never suffered it.
> Being a sufferer himself, and a "success" before his first breakdown he managed to have many people listen. Its unfortunate that to get through to people you have to be "successful" in societal terms, but it did get people who think its laziness or weekness or lack of will to listen. He still admits that though he is "managing now" he can't say that he will never take his own life if the suffering outweighs the joy.Thanks Gabbi,
There are issues and then there are ISSUES. Lets take an example: On December 30, 1943 my father was a first leut. in a B-24 bomber flying missions against Hitlers war machine. On that date he was shot down by enemy fighters and made it safely to the ground by parachute. Until June of 1944 he was active with the French Maque (French resistance fighters), arrested by the Gestapo in June and was brutally treated by his interagoters. It was his good luck to have enough of his Air Force uniform left to avoid being classified a spy and facing almost certain death in a Natzi death camp (you didn't have to be Jewish). When he came home he had what we now call Post Tramatic Stress Syndrom - not major depression. I was 15 months old when he came home. Now THAT IS AN ISSUE but has nothing to do with my Bipolar II. That I got by way of genetics from my mother.
I do pretty well on Depakote, Lamictal, and just added Prozac (again). We have come a long way from the hair shirts and fire hoses of the old asylums....but we have a long,long way to go and we are not going to get there with some tdoc blubbering about issues, relationships, etc.
I am hopeful about gentic research and post mortum studies on suicide patients with REAL DEPRESSION.....heaven knows we need EMPIRICAL STUDIES.
Thanks for your post,
Geezer
Posted by Gabbi on July 16, 2002, at 21:37:40
In reply to Re: Oh ya!, posted by Geezer on July 16, 2002, at 21:24:32
Agreed absolutely, as with the issues referring from a spending problem to a Concentration camp, no wonder we ourselves on this particular board probably miscommunicate unintentionally all the time. There is hardly a word available to describe anything in a significant way. Awesome terrible horrifying amazing, they sound so trite.
Just a little rant,
and a Thank-you
and for all its worth.. I wish you the best of luck but mostly understanding and some useful treatment thrown in.I'm a cyclical refractory major unipolor depressive myself,its hard even write that seriously, but thats it. I've not completed the 'final act' because of what it would do to those left behind, but my only real hope to have my Own reason to live is waiting for that successful research.
Thanks
Gabbi
Posted by Gabbi on July 16, 2002, at 22:21:34
In reply to question for Lostboynci and forgive my punctuation, posted by Gabbi on July 16, 2002, at 21:06:17
Belongs on the Book board Sorry
Posted by Geezer on July 17, 2002, at 10:09:15
In reply to Re: Oh ya!, posted by Gabbi on July 16, 2002, at 21:37:40
Hey Gabbi,
Nope the "final act" is just not permitted. Pdoc told me the same thing...."If you kill yourself no amount of treatment will help your children".
You may have noted in one of my earlier posts, I have seen 4 different pdocs in the past year, 2 vote Major/Recurrent/Unipolar the other 2 vote Bipolar II/Depressed. According to Akiskal's "sliding scale continuum" we all fit somewhere between pure Unipolar Major Depression and full blown Bipolar I. At this point I don't give a damn.....just give me some relief.
Have you had experience with any trial study meds. through University research programs? I haven't read all of your posts - could you give your major symptoms and drugs you have tried?
Best regards,
Geezer
Posted by mist on July 17, 2002, at 13:06:13
In reply to Re: Oh ya!, posted by Gabbi on July 16, 2002, at 20:31:03
I think psychological issues can produce symptoms of depression in some people. Depression is simply a condition, there is not one cause for it. Nature/nurture is a two way street.
I also don't agree with the idea that people who think their depression has psychological causes are "not really depressed," or "not as depressed as those with 'biological' depression (again, that's a false dichotomy anyway—it's not either/or). In my case, I believe psychological factors were significant in my becoming depressed. Last year when I was severely depressed not only was I unable to work, but when I was at my worst, I couldn't even compose a post. My ability to think let alone do anything was severely affected. I could say (in response to some of the "more depressed than thou" statements I've read on this board), that anyone who posts here isn't that depressed because they can compose a post. I don't want to play that game, but I think it's something to keep in mind for people who want to make light of others' depression just because they happen to be aware of more than one factor contributing to it.
Posted by Ritch on July 17, 2002, at 13:27:18
In reply to I disagree., posted by mist on July 17, 2002, at 13:06:13
> I think psychological issues can produce symptoms of depression in some people. Depression is simply a condition, there is not one cause for it. Nature/nurture is a two way street.
>
> I also don't agree with the idea that people who think their depression has psychological causes are "not really depressed," or "not as depressed as those with 'biological' depression (again, that's a false dichotomy anyway—it's not either/or). In my case, I believe psychological factors were significant in my becoming depressed. Last year when I was severely depressed not only was I unable to work, but when I was at my worst, I couldn't even compose a post. My ability to think let alone do anything was severely affected. I could say (in response to some of the "more depressed than thou" statements I've read on this board), that anyone who posts here isn't that depressed because they can compose a post. I don't want to play that game, but I think it's something to keep in mind for people who want to make light of others' depression just because they happen to be aware of more than one factor contributing to it.
Mist,I agree with you about the ability to post when depression gets especially bad-especially that anergic, melancholic, dishrag type of depression. You just can't really think (slowed thoughts), and just don't have much to say. It is just like everything (including yourself) is nothing but a big boring zero. Unless of course you are experiencing mixed bipolar stuff-that can be very different!
Mitch
Posted by Geezer on July 17, 2002, at 14:16:29
In reply to I disagree., posted by mist on July 17, 2002, at 13:06:13
> I think psychological issues can produce symptoms of depression in some people. Depression is simply a condition, there is not one cause for it. Nature/nurture is a two way street.
>
> I also don't agree with the idea that people who think their depression has psychological causes are "not really depressed," or "not as depressed as those with 'biological' depression (again, that's a false dichotomy anyway—it's not either/or). In my case, I believe psychological factors were significant in my becoming depressed. Last year when I was severely depressed not only was I unable to work, but when I was at my worst, I couldn't even compose a post. My ability to think let alone do anything was severely affected. I could say (in response to some of the "more depressed than thou" statements I've read on this board), that anyone who posts here isn't that depressed because they can compose a post. I don't want to play that game, but I think it's something to keep in mind for people who want to make light of others' depression just because they happen to be aware of more than one factor contributing to it.Hi Mist,
I respectfully disagree. I do agree, however, with the being able to post comment. When I am at my worst I can't get my head off the desk - but that can ONLY be changed with drug adjustments. For me its a matter of chemistry/physiology-genetics. Any changes in mood, that may be construed a psychological, come as a result of chemistry changes NOT because of cognative therapy.
Maybe the key to the discussion is the meaning of the word sever or REAL. Sounds like your depression is as sever as mine, the question is how does one get out of that state. I have tried "talk therapy" on three different occasions, talking didn't reduce symptoms, prolong intervals of wellness or prevent recurrence. In brief - I wouldn't give you two empty beer cans for a tdoc. and all the psychological wizardry. As it aplies to me only, when I get hit hard with it, I don't "wish upon a star", I get to the pdoc ASAP.
You maybe right, it is a bit like arguing politics or religion, everybody has an opinion. What ever floats you boat.
Regards
Geezer
Posted by mist on July 17, 2002, at 15:26:10
In reply to Re: I disagree., posted by Geezer on July 17, 2002, at 14:16:29
Geezer,
Thanks for the nice civil post even though you disagree.
> When I am at my worst I can't get my head off the desk - but that can ONLY be changed with drug adjustments..
This is what I mean about the false dichotomy. :) Just because psychological and environmental factors are significant in causing a particular depression, doesn't mean meds won't relieve it. It's not either/or. Once it gets to the point where you are actually depressed, the depression is physical. Are meds the only relief in every case? I wouldn't go so far as to say that.
>For me its a matter of chemistry/physiology-genetics
And possibly in your depression that's exactly what it is. My point is that the causes can be different for different people.
> the question is how does one get out of that state. I have tried "talk therapy" on three different occasions, talking didn't reduce symptoms, prolong intervals of wellness or prevent recurrence.
I'm pretty fed up with talk therapy as it's practiced too. In theory I believe something like that could be helpful for some people, but too many therapists lack the ability to be creative or to diverge from the norm. And some of it is just luck. Sometimes it's interpersonal chemistry that makes one therapist better for a particular client than the next. But you can spend your life's income trying to find the right therapist.
How does one get out of that state? I'm less depressed now than I was last year. In a sense, I waited it out and it changed. But I don't recommend that, especially if someone is likely to commit suicide. Even though I have felt suicidal sometimes and have had an almost constant desire to die since I can remember, when I am very depressed I just don't have the energy or ability to plan (let alone carry out) suicide.
At the same time, since I've been depressed since childhood (to varying degrees), I might have a tendency to put up with too much in terms of depression symptoms. To just accept it, even when it's really bad.
I also took 5-HTP at the end of last year. It helped enough that while it didn't resolve all the symptoms, it made a dent in them.
>Any changes in mood, that may be construed a psychological, come as a result of chemistry changes NOT because of cognative therapy.
My belief is that sometimes changing your thinking and circumstances can cause physiological changes. It's a two-way street. It's like blood pressure (I have posted this before :)). Some people use meds to control high blood pressure, some are able to do it by meditating, biofeedback, and other stress reduction measures (as well as dietary changes). My point is that what applies for one person may not apply for the next.
Posted by mist on July 17, 2002, at 15:37:37
In reply to Re: slowed thoughts » mist, posted by Ritch on July 17, 2002, at 13:27:18
Mitch, your description pretty much fits the type of depression I've had. Slowed thoughts can even become stopped thoughts! Sometimes a darkness would come into my mind that felt like it could obliterate it, when I tried to think even one thought or half a thought. Like my thinking would be smothered by this darkness and just stop.
Posted by Geezer on July 17, 2002, at 16:19:15
In reply to Re: I disagree. » Geezer, posted by mist on July 17, 2002, at 15:26:10
Thanks Mist,
I do try to respect the opinions of others and their right to voice them; thanks to you for the same. I think there is a lot to Dr. Bob's policy of "please be civil" - you can use up a lot of energy arguing - not something we always have a lot of.
This is a "hot topic" for me. I am very anxious to see emperical testing and better meds. to treat this illness. At this point psychopharm. is in a very primitive stage, I have been treated since 1962, the meds of today have fewer side effects for some people but are no more effective (talking ADs now, not APs). I got 30 years completed in the Cardiac Pacemaker business before complete disability in 1998. I guess you never give up hope.
Very best regards,
Geezer
Posted by Ritch on July 17, 2002, at 23:34:26
In reply to Re: slowed thoughts » Ritch, posted by mist on July 17, 2002, at 15:37:37
> Mitch, your description pretty much fits the type of depression I've had. Slowed thoughts can even become stopped thoughts! Sometimes a darkness would come into my mind that felt like it could obliterate it, when I tried to think even one thought or half a thought. Like my thinking would be smothered by this darkness and just stop.
Hi,My pdoc thinks I am one of those "limbic-depressive ADHD" subtypes of late (with mixed bipolar). I wouldn't disagree. I have had the best response to low-dose stimulants for bipolar depressions (with NO hypomania). Stims tend to "cascade" into panic for me, unfortunately, after a few weeks. So they are pretty much out-that's OK because panic is the worst feeling I ever have experienced (even worse than the mixed depressive bleakness). So I am currently on Depakote, Klonopin, Effexor, Wellbutrin (all low-dose-esp. the AD's).
MItch
Posted by mist on July 18, 2002, at 0:50:16
In reply to Re: I disagree., posted by Geezer on July 17, 2002, at 16:19:15
>I got 30 years completed in the Cardiac Pacemaker business before complete disability in 1998. I guess you never give up hope.
Your situation sounds difficult, but it's good that you haven't given up. I agree it can be frustrating that the research isn't farther along. We were all born too early. :)
Posted by mist on July 18, 2002, at 1:13:42
In reply to Re: slowed thoughts » mist, posted by Ritch on July 17, 2002, at 23:34:26
>So I am currently on Depakote, Klonopin, Effexor, Wellbutrin (all low-dose-esp. the AD's).
Are these meds effective for you?
I believe I have Limbic ADD (in addition to unipolar depression). I have all the signs of it and have since childhood. I'm hoping to try provigil and see if it does anything, or else Adderal or another stimulant. I'm afraid of ADs because of reactions I've had to them which rendered me as incapacitated as the depression, so until something better comes out I'd rather try other types of meds.
Posted by Dr. Bob on July 18, 2002, at 7:32:55
In reply to Re: I disagree., posted by Geezer on July 17, 2002, at 16:19:15
> You maybe right, it is a bit like arguing politics or religion, everybody has an opinion.
> I do try to respect the opinions of others and their right to voice them; thanks to you for the same.
Thanks to both of you! :-)
Bob
Posted by Ritch on July 18, 2002, at 10:07:53
In reply to Re: slowed thoughts » Ritch, posted by mist on July 18, 2002, at 1:13:42
> >So I am currently on Depakote, Klonopin, Effexor, Wellbutrin (all low-dose-esp. the AD's).
>
> Are these meds effective for you?
>
> I believe I have Limbic ADD (in addition to unipolar depression). I have all the signs of it and have since childhood. I'm hoping to try provigil and see if it does anything, or else Adderal or another stimulant. I'm afraid of ADs because of reactions I've had to them which rendered me as incapacitated as the depression, so until something better comes out I'd rather try other types of meds.
Mist,Yes, they do work reasonably well. After trials of all sorts of "mood stabilizers" Depakote works the best for hypomania and temper outbursts (mixed hypomania-rage reactions) that I can tolerate. The only thing I don't like is a little weight gain (I have countered it with a super low-fat diet and increased exercise, however). Lithium worked better for the depressive side of things, but I have to push the dose up in order for it to control the hypomania and irritability (as well), and when I get the dose of lithium up it becomes tough to tolerate because of the gastrointestinal upset it causes me. Klonopin keeps the panic attacks away and helps with social anxiety. It also seems to settle hypomania as well. But, I have to be careful with Klonopin when I am depressed and I will feel better if I cut the dosage (which I am doing now). Effexor+Wellbutrin.... Well, the Wellbutrin comes the closest to being a stimulant as possible (of the AD's). All I am really taking that for is so I can stay AWAKE during the day, otherwise I will be yawning, sleepy, etc, all day long (I am just taking 18.75mg). I can't tolerate it as well when I am hypomanic-it is more prone to setting off rages. The Effexor.. well I just take about 12.5 mg a day, that's it. Any more and it will disrupt my sleep and give me bad heartburn and reflux. All the SSRI's aggravate my reflux problems bigtime. I wonder if duloxetine, when it comes around next year, will be weak enough on the serotonergic side for me to tolerate, and yet still be activating and alerting enough for me to concentrate. Wellbutrin by itself is too anxiogenic. Effexor by itself is too "numbing". I never realized just how numbing SSRI's can be until I raised the dose up on the Effexor-whew!
Mitch
Posted by Geezer on July 18, 2002, at 11:00:09
In reply to Re: slowed thoughts » mist, posted by Ritch on July 18, 2002, at 10:07:53
Hey Mitch,
I called Lilley about 3 weeks ago. All they would tell me is they have a "target release date" of 2003. If what I have read is correct, Duloxatin should have a 50%-50% effect on serotonin and norep. from the first dose. With Effexor, it is my unserstanding, you have to wade through a lot of serotonin effect before you get to the norep. Correct me if I am wrong.
Geezer
Posted by Ritch on July 18, 2002, at 22:20:22
In reply to Re: slowed thoughts, posted by Geezer on July 18, 2002, at 11:00:09
> Hey Mitch,
>
> I called Lilley about 3 weeks ago. All they would tell me is they have a "target release date" of 2003. If what I have read is correct, Duloxatin should have a 50%-50% effect on serotonin and norep. from the first dose. With Effexor, it is my unserstanding, you have to wade through a lot of serotonin effect before you get to the norep. Correct me if I am wrong.
>
> Geezer
Hi,I was reading a post here recently that mentioned the transporter affinity ratios for Effexor and Cymbalta (duloxetine). Effexor is supposed to have approx. 30x more affinity for serotonin reuptake transporters than NE reuptake transporters, whereas duloxetine is supposed to have approx. 9x more affinity for serotonin reuptake transporters than for NE reuptake transporters. So, I view Effexor and duloxetine as SSRI's that also happen to block NE reuptake to a significant extent. And that's what Effexor *feels* like, anyhow. I have heard all of the stuff about boosting the Effexor dosage to get to a more significant NE reuptake. UGGH, I can't go there, because what is happening is Effexor probably "flattens" out on its ability to block reuptake of serotonin at some point (a saturation effect) and then the blockade of NE reuptake continues to increase significantly with further increased doses. Yuck. I would rather take a selective NE reuptake inhibitor, that happens to block reuptake of serotonin to a *lesser* extent, AND just take a *low* dose of *that* one antidepressant.
Mitch
Posted by mist on July 19, 2002, at 0:53:24
In reply to Re: slowed thoughts » mist, posted by Ritch on July 18, 2002, at 10:07:53
>But, I have to be careful with Klonopin when I am depressed and I will feel better if I cut the dosage (which I am doing now).
I found klonopin effective for social anxiety as long as I didn't take it every day. When I did, it make me more depressed. On an ocassional, as needed basis it was good. I'd like to get another klonopin prescription when I can stand to deal with the medical/mental health establishment again. I'm hoping I can get .25 mg tablets. I'm very sensitive to substances and can't take a high dose of anything.
It's great that you've found a combination of meds that works for you.
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