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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Noa on September 17, 1999, at 19:59:13
The worst of my latest depressive episode has faded, and I am able to function adequately at work. I am not sobbing all the time anymore, am beginning to take better care of myself, if only in the most basic ways, and am not suicidal. But I still feel exhausted and oppressed by the burden of the chronic, lingering depressed feelings. It's as though I have been able to make it to the surface of the water to return from drowning, and am actively moving toward life, but am getting awfully tired of treading water just to keep my head at the surface enough to breathe.
Any advice as to how long to wait to determine if my current drug cocktail (375 mg Effexor XR; 10 mg Methylphenidate, 3xday; .25 mcg synthroid; .125 mcg cytomel; and 150 mg serzone) is sufficient? It is clearly helping, as I feel better than I did, but can I expect more improvement over time, or should I move on to the next step, which is lithium or an anticonvulsant?
Are there others with "double depression", ie dysthymia plus cycles of recurrent major depression (I seem to have 3-4 episodes per year)? Do the medications help the dysthymia, or can I only expect them to help the more severe bouts?
My therapist has suggested that if I were to be able to be free of the major depressive episodes for a while, the dysthymia would feel different to me than it does now, because I wouldn't always be dreading the descent into hell that these episodes feel like. I guess if I weren't always in, or recovering from, or fearing another bad bout, I could work on taking better care of myself and building my life, which would help.
Appreciate any thoughts.
Posted by JohnL on September 18, 1999, at 8:54:32
In reply to Treading Water, posted by Noa on September 17, 1999, at 19:59:13
Hi Noa. Me too...double depression that is. I have read that dysthymia is actually tougher to treat than a straight forward major depressive bout. Dysthymia is thought to need higher doses and much longer time. I believe that. I seem to have recovered enough to feel relatively safe from those severe crashes, but I am mostly treading water through life as you said. I told my doc I felt euthymia briefly for a few days and then it was gone. I couldn't get it back. I know it exists, I know what it feels like, it's there. He hinted to me that I may rarely feel that good, but that where I am now may be about as good as it gets, and that at least I am a lot better than some of his other patients. Real encouraging, huh?
I refuse to accept that treading water is as good as it gets. I'm not ready to throw in the towel and accept mediocracy. Your case sounds especially difficult because you are already on quite a cocktail. Since you haven't yet felt complete recovery, that hints at two things...1) it hasn't been enough time yet, or 2) the right drug is not in your arsenal at this time. Trying to find that right drug is tough. I have heard though that some top docs regard effexor+remeron as being "big guns". Just a thought. Your mention of Lithium is a good one. Remeron is probably a lot easier to handle than Lithium. As you know, only a personal trial of whatever will provide answers.
Brief euthymia that I felt was drug induced. Had nothing to do with attitude, lifestyle, counseling, taking care of myself, etc etc. Sadly it didn't last. But it's there somewhere. If I found it once, I can find it again. Others already have. I believe you and I will too. Someday we won't be treading water anymore. We'll be sailing in the sun. (Boy, that's optimistic dreaming isn't it? :) )
Posted by Carmen on September 18, 1999, at 20:19:41
In reply to Treading Water, posted by Noa on September 17, 1999, at 19:59:13
> The worst of my latest depressive episode has faded, and I am able to function adequately at work. I am not sobbing all the time anymore, am beginning to take better care of myself, if only in the most basic ways, and am not suicidal. But I still feel exhausted and oppressed by the burden of the chronic, lingering depressed feelings. It's as though I have been able to make it to the surface of the water to return from drowning, and am actively moving toward life, but am getting awfully tired of treading water just to keep my head at the surface enough to breathe.
>
> Any advice as to how long to wait to determine if my current drug cocktail (375 mg Effexor XR; 10 mg Methylphenidate, 3xday; .25 mcg synthroid; .125 mcg cytomel; and 150 mg serzone) is sufficient? It is clearly helping, as I feel better than I did, but can I expect more improvement over time, or should I move on to the next step, which is lithium or an anticonvulsant?
>
> Are there others with "double depression", ie dysthymia plus cycles of recurrent major depression (I seem to have 3-4 episodes per year)? Do the medications help the dysthymia, or can I only expect them to help the more severe bouts?
>
> My therapist has suggested that if I were to be able to be free of the major depressive episodes for a while, the dysthymia would feel different to me than it does now, because I wouldn't always be dreading the descent into hell that these episodes feel like. I guess if I weren't always in, or recovering from, or fearing another bad bout, I could work on taking better care of myself and building my life, which would help.
>
> Appreciate any thoughts.Noa, Hi! I feel for you. I like your illustration of living w/depression. I've had one bout w/clinical depression and mild depression since. Have been on various meds which work for awhile until I can't tolerate them anymore. Just stay close to your psychiatric dr.'s care. It is frustrating because it takes time for these drugs to work and then you might have to up your dose which takes time to see its affect. Or worse yet, start all over w/something new. Just hang in there. Right now I'm on Neurontin which is working very well w/ no side affects for me. Good luck and try to stay as busy as you healthfully can to keep your mood elevated. Carmen
Posted by Janice on September 19, 1999, at 16:25:53
In reply to Re: Treading Water, posted by Carmen on September 18, 1999, at 20:19:41
> > The worst of my latest depressive episode has faded, and I am able to function adequately at work. I am not sobbing all the time anymore, am beginning to take better care of myself, if only in the most basic ways, and am not suicidal. But I still feel exhausted and oppressed by the burden of the chronic, lingering depressed feelings. It's as though I have been able to make it to the surface of the water to return from drowning, and am actively moving toward life, but am getting awfully tired of treading water just to keep my head at the surface enough to breathe.
> >
Hi Noa, I've definately been where you are, and may be back there soon...lots of coctails and trying to stay afloat.I have a double type of depression, cyclothymia and seasonal affective disorder. I answered one of your first postings about this so I won't go into too much detail. How I became so intimate with my cycles was by keeping a mood journal (this is definately a long term committment because some cycles are a year long); from here I'd guess, with the help of my psychiatrist, as to what was causing these depressions. Lack of a regular schedule, and lack of sunlight were the major factors for me. Everyone is different. You sound so intelligent and sensitive in your postings...have you ever thought of a mood journal. I'm on lithium and would recommend it without hesitations.
That is quite the coctail you're on.
Take very, very good care, Janice.
Posted by Bob on September 19, 1999, at 16:40:55
In reply to There should be a Treading Water contest, posted by Janice on September 19, 1999, at 16:25:53
Hi Noa!
I know what you mean about the meds. For me, its been eleven combinations in a little over two years or so. That's only 2-3 months on average, which just isn't enough -- but most of those changes were due to severe side effects than purely lack of effectiveness.
God, I hate to suggest sticking with the course of mediocity. I was two steps from the edge myself just a month ago, and I wouldn't want anyone to go through that (even my boss ... but I *do* think that she should be subjected to me off meds completely ;^). I have no idea how to tell when things are working well enough or not. But even though my current cocktail is more life-preserver than jetski, I'm glad my work situation is forcing me to stick with it for a while. The only other time I was on one plan for more than four months was when I first started, and settling into this life preserver without having to search desperately for one that might be better is a bit of a relief. It's giving me some time to focus on the psychological without running myself ragged worried about the pharmacological.
We're all out here treading with you. Take care.
Cheers,
Bob
Posted by Lauri on September 21, 1999, at 19:59:35
In reply to Re: Treading Water, posted by JohnL on September 18, 1999, at 8:54:32
I understand how you feel, I can really identify with a song Pink Floyd sang that says "When I was a child I caught a fleeting glimpse out of the corner of my eye I turned to look but it was gone I cannot put my finger on the child has grown the dream is gone .... I always thought it was "normal" that he glimpsed.
I have been suffering with major depression, and mild bouts of manic depression, since I was about 8 years old. I wrote my first will when I was 9.
Meds and doctors have kept me going and though I am not better I live to see the day when I can make that glimpse a reality and become free of my depression- enough to find myself. Hang in there the answer is out there for all of us.
Posted by Bob on September 21, 1999, at 20:10:34
In reply to Re: Treading Water, posted by Lauri on September 21, 1999, at 19:59:35
>... I can really identify with a song Pink Floyd sang that says "When I was a child I caught a fleeting glimpse out of the corner of my eye I turned to look but it was gone I cannot put my finger on the child has grown the dream is gone .... I always thought it was "normal" that he glimpsed.
Nice song to pick to describe it, Lauri -- sometimes "Comfortably Numb" is as good as it gets.
Bob
Posted by Noa on September 21, 1999, at 20:34:56
In reply to Re: Treading Water, posted by Bob on September 21, 1999, at 20:10:34
Lauri, you have been dealing with this for so long, how is it that you stay so hopeful?
This is the end of the thread.
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