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Dr. Bob is Robert Hsiung, MD,
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Posted by Enigma on August 13, 2007, at 14:08:08
In reply to Re: Still no cure for my depression - tried everyt » Enigma, posted by Bob on August 11, 2007, at 21:24:50
>
> >
> > Heh, my name isn't Joy. I meant it as a sarcastic adjective. I haven't stopped saying it since I saw my first Ren & Stimpy episode.
> >
> > Anyway, I'm not glad you are in the same boat, but it IS good to know that I'm not alone. I could swear I read that a few million people have treatment resistant depression, which is odd, as most doctors I've been to are fairly surprised by it, and by their "treatment" of me, I can swear that I'm the only treatment resistant patient they have ever had.
> >
> > Thanks for responding.
> >
> >
> >
>
> Ha! And I had half a mind to include a statement in my first response commenting on the irony of your name. Good think I didn't.
>
> Anyway, you continue to read my mind. I also have little indication that there are people as disabled or more so than I out there. My therapist has told me more than once how she's been practicing for 35 years and has never seen anyone even remotely like me. I don't probe too much about where I fall in the spectrum of severity relative to my psychiatrist's other patients, as I'm afraid of what the answer might be. I too often feel like I'm the only one, or the first human that's ever felt like this. I know it's preposterous, but this is a lonely disease when it gets this bad. Most other chronic serious diseases seem to have much more public support and recognition. I have yet to see someone with one of those colored ribbons on their cars for "treatment resistant depression". I think the general public thinks that people just go take medicines and get better (that's when they think about it at all).
>
> My guess is severe treatment resistant people are falling into the shadows and the cracks when the options dwindle and drain away. I mean, I've made it as urgently obvious as possible to a number of doctors just how dire I feel my situation is, and nothing good or different ever came out of it. In fact, I sometimes got the feeling that they hoped I wouldn't make another appointment.Hehe, Joy would have been a totally ironic name for me for sure. I'm not even female either.
Anyway, AMAZING post. Now *you* are writing about MY exact experiences. ;) I never heard anyone put it quite the way you did.. "a lonely disease". That gets 5/5 stars *and* 2 thumbs up. Even with a wife and 3 kids, and WHEN I HAD friends, I still felt/feel like the loneliest person on the planet.
Going to a doctor, and then specialists on top of that, and STILL EASILY managing to stump them, is very discouraging/annoying/frustrating/depressing and so on.
Honestly, this sounds sick and all, but I'd rather have cancer (treatable, hopefully)! I had so many problems tying to communicate the severity of my illness to my previous employers, so much so that I'd get more accomplished by hitting myself over the head with a bat for several hours at a time.
The worst for me is how they judge you and belittle you and your condition. I can tell you for a fact, that if several (in fact, MOST) of the people who mistreated me (or even the ones that didn't) had my exact condition, they wouldn't have been able to fight it like I have, and would have committed suicide long ago.I've lost 2 jobs, no 3, due to my depression and previously, hypo/mania and lost many (now all) of my friends. Due to my road rage (that's pretty much subsided - but then again, I don't drive much anymore), I almost died several times, and/or severely injured others (or worse). Lost my license a couple of times as well and lost a LOT of money in fines and penalties and insurance adjustments. But, like I said, most to all of that has subsided, the road-rage, irritability, anger, etc, to be taken over by severely debilitating depression.
Besides the high-risk factors, I was at least able to hold down a job, albeit with great difficulty.
When people say "life is unfair", I just have to laugh and thing, you have NO idea...
Posted by Enigma on August 13, 2007, at 14:11:08
In reply to Re: Still no cure for my depression - tried everything » Enigma, posted by Jedi on August 11, 2007, at 23:52:45
Thanks for the info. I'm cutting a pasting everything you guys/gals are suggesting for my next appt with my doctor.
> ...
> > I'm thinking of going back on the horrible Nardil, which was about the only drug that produced some AD effects, but not without pretty massive side effects. The SE's usually win and I quit taking the drug. This would be my 4th time trying to tolerate it.
> ...
>
> Hi Enigma,
> The side effects of Nardil can be really bad. I've been off of it four times in the past ten years trying to find something that would work without the side effects. I started Nardil again one week ago.
>
> I am assuming that you only get a partial remission from Nardil, or the side effects would not matter to you. IMHO there is nothing worse than the pain of treatment resistant depression.
>
> What have you augmented Nardil with?
> Some I have tried:
> clonazepam(still using it, currently at 2mg)
> nortriptyline
> bupropion
>
> Some I haven't tried, but are on my list:
> lithium
> lamotrigine
> modafinil
> methylphenidate
> concerta or ritilan sr(generic)
>
> Opioids have always made my depression better. Alas, the legal issues. If I could just get a MD to prescribe buprenorphine, I think I might be OK.
>
> Another option, similar to the "California Rocket Fuel" of venlafaxine combined with mirtazapine; would be duloxetine (the newer SNRI) combined with mirtazapine. Just shooting in the dark here.
> Reference:
> http://www.ijpm.net/content/pdf/327/casemg.pdf
>
> Good Luck,
> Jedi
>
>
>
>
>
>
Posted by Enigma on August 13, 2007, at 14:18:07
In reply to Re: Still no cure for my depression - tried everything, posted by Cecilia on August 12, 2007, at 1:41:00
> You are definitely not alone, Enigma. I too am in the same situation, except haven't tried ECT, did have transcranial magnetic stimulation though, which didn't help. And doctors ARE clueless, they think AD's work better than they do because most of the patients they don't work for either go to another doctor or give up on doctors altogether. It never occurs to them to wonder, how is so and so doing, it's out of sight, out of mind. I'm sure there are exceptions, but they are few, most are quite glad if their treatment resistant patients don't come back. Cecilia
I agree 100%. I've had one doctor almost flat out say that he wouldn't treat me. He tried to work around saying the exact words, probably for legal reasons. I've had other gladly suggest other doctors for me to see. There was one doctor that actually made me so mad because he almost lost me my disability and wouldn't listen to my symptoms. I almost knocked him out.
Funny, after telling him that I just had a year long battle going on/off short term then long term disability with my current (now ex) employer, doing everything in my power to KEEP my job, and THEY were the ones who booted me at the end (either take termination or long term dis. WITH benefits and pay). Wow, tough choice.. not. He actually suggested that I go back to work!!! I almost jumped out the window, taking him with me of course.
These people make over $100 an hour for what again?
I have other doctor horror stories, hell, too many....
Posted by linkadge on August 13, 2007, at 22:10:27
In reply to Re: Still no cure for my depression - tried everyt, posted by Enigma on August 13, 2007, at 14:18:07
It doesn't make sence to me that a doctor would more or less tell you that s/he won't treat you.
How hard is it to take a patient in, listen to their problems and twiddle their meds around a little bit?
That being said, if I felt that I may not be able to help the patient, I would make it clear that I would treat them but could make no guarentees.
Dead ends hurt a depressed patient the most.
Even if a patient spends their entire life moving from placebo to placebo this is better than nothing.
Linkadge
Posted by Bob on August 14, 2007, at 14:22:40
In reply to Re: Still no cure for my depression - tried everyt, posted by linkadge on August 13, 2007, at 22:10:27
> It doesn't make sence to me that a doctor would more or less tell you that s/he won't treat you.
>
> How hard is it to take a patient in, listen to their problems and twiddle their meds around a little bit?
>
> That being said, if I felt that I may not be able to help the patient, I would make it clear that I would treat them but could make no guarentees.
>
> Dead ends hurt a depressed patient the most.
>
> Even if a patient spends their entire life moving from placebo to placebo this is better than nothing.
>
>
> Linkadge
>
>
>I've encountered multiple doctors who say right over the phone that they simply are taking no more new patients. I even called one once who had that on his answering machine. In these cases it wasn't that they didn't want my particular case, but rather that they were ultra-overloaded and probably wouldn't need another patient for the rest of their careers.
Posted by linkadge on August 14, 2007, at 21:46:27
In reply to Re: Still no cure for my depression - tried everyt » linkadge, posted by Bob on August 14, 2007, at 14:22:40
I see what you are saying. The only reason I commented was because there have been doctors who would not treat my mother, for example, on account of the chronicity of her problems.
Linkadge
Posted by Phillipa on August 14, 2007, at 21:54:54
In reply to Re: Still no cure for my depression - tried everyt, posted by linkadge on August 14, 2007, at 21:46:27
Link I feel so bad for you and your Mom. Not her fault or yours. I know you love her dearly. Love Phillipa
Posted by Enigma on August 15, 2007, at 10:29:52
In reply to Re: Still no cure for my depression - tried everyt » linkadge, posted by Bob on August 14, 2007, at 14:22:40
> > It doesn't make sense to me that a doctor would more or less tell you that s/he won't treat you.
> >
> > How hard is it to take a patient in, listen to their problems and twiddle their meds around a little bit?
> >
> > That being said, if I felt that I may not be able to help the patient, I would make it clear that I would treat them but could make no guarentees.I agree 100%. I would tell them I'm not qualified (for treatment resistant patients, or whatever is actually true), and let the patient know exactly where they stand in regards to getting treatment from me.
> >
> > Dead ends hurt a depressed patient the most.
> >
> > Even if a patient spends their entire life moving from placebo to placebo this is better than nothing.
> >I agree. I've been fairly suicidal and open about it to doctors and still they could literally care less, and this, blows my mind. I guess there are a LOT of doctors out there who DO, do it for the money and not to help people.
> I've encountered multiple doctors who say right over the phone that they simply are taking no more new patients. I even called one once who had that on his answering machine. In these cases it wasn't that they didn't want my particular case, but rather that they were ultra-overloaded and probably wouldn't need another patient for the rest of their careers.
In my posts, I'm not talking about these doctors. I'm talking about the ones who ARE taking patients. It's actually the very first question I ask them. Once I find out they are available, it's AFTER they are unable to help me (and some give up VERY QUICKLY) that they dump me back on the street.
I don't blame any doctor (of any discipline) for having a full patient load. I'm only criticizing doctors who very easily give up on tough to treat patients.
Posted by Bob on August 15, 2007, at 11:30:59
In reply to Re: Still no cure for my depression - tried everyt, posted by Enigma on August 15, 2007, at 10:29:52
> I don't blame any doctor (of any discipline) for having a full patient load. I'm only criticizing doctors who very easily give up on tough to treat patients.I think both situations are frustrating, but I can see how the latter is more aggravating.
I'm not really blaming doctors for full patient loads, but it's pretty disappointing when I search for a new doctor and the first 3 or 4 can't handle a single additional patient. Scary situation, really.
Posted by jhj on August 16, 2007, at 6:12:20
In reply to Re: Still no cure for my depression - tried everyt » Enigma, posted by Bob on August 15, 2007, at 11:30:59
Why do not they try drugs like ketamine under strict supervision.If it can get rid of TRD,then it is worth the effort.They can hospitalize patient if they fear extremely serious side effects.Well as far as Doctors not taking patients because they are overloaded,i think it is very suprising.I am from India and here you can wake up most of the doctors even in the night and get the treatment if you feel your condition is very bad.Thanks
Posted by calamityjane on August 23, 2007, at 21:18:02
In reply to Still no cure for my depression - tried everything, posted by Enigma on August 11, 2007, at 11:35:41
Enigma - please please please email me. Never would I think I would post my real email address in a message board, but I am desperate to talk to you. Here is my email address - i am putting spaces in between so that nobody will search my email on google and have this show up, as this site is obviously a very personal one. At any rate, my email is
[xxx]but all together with no spaces at all.
please please please email me.....
thanks!
ashley
Posted by Phillipa on August 23, 2007, at 21:34:02
In reply to Re: Still no cure for my depression - tried everything, posted by calamityjane on August 23, 2007, at 21:18:02
I wouldn't post my e-mail on a public message board no not safe. But is his or her babblemail off? Phillipa
Posted by Phillipa on August 23, 2007, at 21:36:07
In reply to Re: Still no cure for my depression - tried everything, posted by calamityjane on August 23, 2007, at 21:18:02
CJ e-mail bob and ask him to delete it I did once and he did and ask Enigma to babblemail you. Phillipa
Posted by Enigma on August 24, 2007, at 8:36:32
In reply to Re: Still no cure for my depression - tried everything, posted by calamityjane on August 23, 2007, at 21:18:02
Ok, I emailed ya, you can have the doc delete your post now.
I thought my babble-mail was on. I'll check right now.
If anyone is curious, I'm a 38yo guy.
Posted by jhj on August 24, 2007, at 8:47:20
In reply to Re: Still no cure for my depression - tried everything » calamityjane, posted by Phillipa on August 23, 2007, at 21:36:07
Hi Philipa,
We have a famous adage in India.I do not know you have any proverb like that in west.The adage goes like "Once an arrow leaves the bow,it never comes back".What is the point in deleting email address now.I understand that this is site for a particular kind of people only and not many ordinary people visit it.But,what if i have noted down this email address and start distributing in India?
Posted by Enigma on August 24, 2007, at 8:48:19
In reply to Re: Still no cure for my depression - tried everything, posted by calamityjane on August 23, 2007, at 21:18:02
Ok, my babble-mail was off, which surprised me, but, it's on now.
Posted by jhj on August 24, 2007, at 9:11:41
In reply to Re: Still no cure for my depression - tried everyt, posted by Enigma on August 24, 2007, at 8:36:32
Thanks.But i am only 29 years old.38 is too old for me to be interested.Can not you reduce your age by some years? okey wish me better luck next time.
Posted by calamityjane on August 24, 2007, at 18:11:02
In reply to Re: Still no cure for my depression - tried everyt, posted by Enigma on August 24, 2007, at 8:36:32
> Ok, I emailed ya, you can have the doc delete your post now.
>
> I thought my babble-mail was on. I'll check right now.
>
> If anyone is curious, I'm a 38yo guy.
>You are 38? wow - that is exactly the age of my father.
Posted by calamityjane on August 24, 2007, at 18:11:51
In reply to Re: Still no cure for my depression - tried everything » calamityjane, posted by Phillipa on August 23, 2007, at 21:34:02
thanks guys - - his babble was off, and i very much wanted to contact him....but i will email dr bob now...
Posted by Phillipa on August 24, 2007, at 19:35:42
In reply to Re: Still no cure for my depression - tried everything, posted by jhj on August 24, 2007, at 8:47:20
Very true but the less time online the better just how I feel others feel differently as we are all different. Good luck to you and glad you two got together. Phillipa
Posted by Existentialist on August 24, 2007, at 22:09:07
In reply to Re: Still no cure for my depression - tried everything » jhj, posted by Phillipa on August 24, 2007, at 19:35:42
Most psych meds I've tried have been pretty gross feeling. When I was 16 (22 now) I had good results with paxil 10mg for 6 months in which I went from being quite depressed and introverted to having had 2 girlfriends, a first for me. It was a strange year where I was someone else on them. I never liked that fact. When I came off it, I was glad to just be myself again. I also used Effexor for a while at 37.5, both times they wanted me on higher doses which would have been intolerable to me. Do you think your doses have been too high?
As far as alternatives if it was the mid 60's you'd be a candicate for LSD psychotherapy as a means to bring about a spiritual and personal catharsis. The literature is filled with instances of people being cured by it. One instance reports a little girl who would only scream and was uncommunative and unresponsive to human contact, but thorugh a serries of sessions recovered.
People also report profound changes on the outlook of their life after MDMA which was used theraputically in the 80's.
And of course medical marijuana. I myself when I was 19 and tried it fo the first time experienced a sense of life and emotional and spiritual awakening, and feelings of joy I had not known possible or felt since I was perhaps a small boy. I've cried with joy from pot and the emotional release it had on me after feeling so dead inside for so long.I believe these choices should be considered before ECT or suicide despite the legal issues involved.
Posted by Existentialist on August 24, 2007, at 22:24:27
In reply to Re: Still no cure for my depression - tried everything, posted by Existentialist on August 24, 2007, at 22:09:07
The one book talks about a variety of researchers and their experiences in the field doing work with LSD, it's called "Higher Wisdom: Eminent Elders Explore the Continuing Impact of Psychedelics ". One psychatrist talks about his own experience and how hard headed he was having been through 12 years of med school and how it changed him.
Another great book but specifically about LSD is called "The Varieties of Psychedelic Experience". Even reading these without doing the drugs might be helpful. Another great book is called "The primal wound" It has nothing to do with drugs but advocates methods to 'unlock' people who have detatched and shutdown as it sounds you have.
Posted by jhj on August 25, 2007, at 1:58:05
In reply to Re: Still no cure for my depression - tried everything » jhj, posted by Phillipa on August 24, 2007, at 19:35:42
Hi Philipa,I do not feel differently.what you had suggested is absolutely correct.I wrote that in lighter vein.sorry,if you have misunderstood me.I am least interested in noting down email addresses of other people without their permission.I am always busy tackling anxiety and depression.No time for other things.
Posted by jhj on August 25, 2007, at 2:09:13
In reply to Re: Still no cure for my depression - tried everything, posted by Existentialist on August 24, 2007, at 22:09:07
I believe these choices should be considered before ECT or suicide despite the legal issues involved.
Hi Existentialist,
do you mean that if your suggested choices fail,then suicide should be cosidered? Well let me say that suicide can never be the option even option of last report.I have problems of depression,social phobia and GAD for past 15 years with out any drugs giving me even iota of benefit.But,not once even i have thought about suicide.Research is always going on and companies are trying to develop new medicines with different mechanism.So,there is always a chance.I do not see why suicide should even be considered.
Posted by Existentialist on August 25, 2007, at 13:27:05
In reply to Re: Still no cure for my depression - tried everything, posted by jhj on August 25, 2007, at 2:09:13
No, I didn't mean that suicide was a 'serious' option to consider, but I was trying to imply that before that level of desperation is reached, that psychadellic illegal drugs should be on the table. I'm not sure how controversial it is to talk about that here.
Also I think before you look at those drugs there is a lot to be done as far as understanding ourselves and our lives and the root causes of human distrubance. I think it's a result of personal and social development, and general lack of sanity modern life can have. It's a repressive way of life we live and control games and psychological defense mechanisms are abundant.
Healthy lifestyle and diet and exclusion of other biological illness. Perhaps visit a bhuddist monestary and live there for a year and see if your perspective changes. Some sort of massive lifestyle overhaul and self help where you try and rebuild yourself, think about why you have the emotions you do, and work to develop new emotional and cognitive patterns.
My life has had a lot of ups and downs, and for most of it I've felt quite off. Growing up in my family was totally screwed up, socially in school I was totally screwed up. I finally made it to college and things got screwed up there as well. It's all been a huge process of evolution. The danger is getting stuck in a reppressive lifestyle and mental and physical pattern (bad diet, lack of exercise) that you can't escape from.
jhj, Have you tried social immersion? I went from being quite poor and uncomfortable socially to be able to strike up conversations and being outgoing in about a year. I changed how I understood other people and learned new social skills I did not have before. I changed my lifestyle so I was not constantly avoiding social interaction. Through many interactions I found a personality and parts of myself I wanted to express back to them.
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