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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by Nancy on September 19, 1999, at 22:23:59
I would like to know how can a psychiatrist diagnosis the difference between depression and generalized anxiety disorder? I have been treated for depression, but my main symptom is horrible anxiety, especially stomach problems, mainly nausea. I am currently taking Prozac and have experienced considerable weight gain. I'm wondering if I went off Prozac and took Buspar, would that control everything? When I was a little kid I couldn't stand to be away from my mother, crying, etc. When I was a teenager, I would get physically sick before a date I would get so nervous, and now, even as an adult and a teacher, I get nauseated alot. Any input from anyone would be appreciated. Does anyone else suffer from nausea this way?
Posted by Ian on September 20, 1999, at 3:58:23
In reply to Depression or Anxiety, posted by Nancy on September 19, 1999, at 22:23:59
Anxiety is a response to a threat to yourself it can be either physical or to your personal dignity, self value. Anxiety is a resource in one sense heightened awareness, quickens your responses. Trouble is if you don't find a way to deal with the threat eventually your going to exhaust yourself decompensate and give thereby sustaning a loss which will be depressing.
You can search for drug combo's that will work but I'd say the best way is to identify the reason your getting so stressed ( probably not obvious ) look at what your currently doing, realy reasses whether not coping in these paticular situations is the end of the world and if it is then why, experiment with different approaches. A bit psycho-analytical-well at least you won't build up an addiction to it like a benzodiazepine.
Posted by more on September 20, 1999, at 4:48:16
In reply to Depression or Anxiety, posted by Nancy on September 19, 1999, at 22:23:59
SSRI's like prozac can make some people more edgey and jumpy, a certain percentage of peolpe can get quite manic on them and then there's been all that stuff in California. A psychiatrist differentiation of whether your depressed or have a generalised panic disorder is not much different from what you would pick up intuitively looking at say a friend but all the pointers are paraphrased into medical lingo-low affect, anhedonia etc they give credence to the 'diagnosis'. Buspar is not a benzo either so my reference to them wasn't apt, its mechanism isn't certain. Being psycho analytical again from your brief story looks like your fearing rejection/abandonment in certain situations, why the possibilty of rejection in those circumstances is so significant to you to induce such anxiety is probably worth exploring.
Posted by jamie on September 20, 1999, at 4:51:20
In reply to Re: Depression or Anxiety, posted by Ian on September 20, 1999, at 3:58:23
I have read that anxiety is often very responsive to counseling and psychotherapy. Counseling in depression is often frstrating without drugs, But anxiety is much more responsive to counseling. Might be worth a try before getting too deep into drugs. If no success, then drugs. Both best. In any case, prozac is probably not the best choice for anxiety. Something like serzone or remeron would seem more appropriate.
Posted by Sean on September 20, 1999, at 16:59:18
In reply to Depression or Anxiety, posted by Nancy on September 19, 1999, at 22:23:59
> I would like to know how can a psychiatrist diagnosis the difference between depression and generalized anxiety disorder? I have been treated for depression, but my main symptom is horrible anxiety, especially stomach problems, mainly nausea. I am currently taking Prozac and have experienced considerable weight gain. I'm wondering if I went off Prozac and took Buspar, would that control everything? When I was a little kid I couldn't stand to be away from my mother, crying, etc. When I was a teenager, I would get physically sick before a date I would get so nervous, and now, even as an adult and a teacher, I get nauseated alot. Any input from anyone would be appreciated. Does anyone else suffer from nausea this way?
My experience with anxiety was that counseling
did next to nothing. It almost made it worse as
the weeks and then months went by. There is no
question in my mind, given the response I eventually
had with amitriptyline and xanax, that I was all
but wasting my time talking about the "reason" I
felt how I felt. It simply did not help the
profound suffering I felt.The reason, I beleive, is this: a person likely
inherits a particular vulnerablity in one or
more neurological systems. These systems can be
destabilized through life experience, most importantly,
when we are very young and dependent on our parents
or other in whom we implicitly trust. Or they
can destabilize on their own. For every person
with a horrendous childhood, you can probably find
another whose was worse, but that person is without
psychiatric symptoms.Once this system is out of whack, however, it is next to
impossible to think ones way through it all. In
fact, the very tool - your mind - with which you
might undertake such a journey is compromised to
start with!I made no progress in therapy, really, until I
no longer felt like total crap. I have a very high
opinon of therapy in the long term, but it's role
in situations of acute suffering is, well, somewhat
limited in my opinion. Be well...Sean.
Posted by Janice on September 20, 1999, at 22:27:29
In reply to Re: Depression or Anxiety, posted by Sean on September 20, 1999, at 16:59:18
hi nancy,
As opposed to Sean, anxiety is the one disorder I have completely rid myself of mainly through cognitive therapy and experimenting with anti-anxiety medications. On these anti-anxiety medications I got to feel what my body would feel like without anxiety. I would go as long as i could comfortably throughout the day until the anxiety built up, and then go back to trace my thoughts and actions up to that point; trying to ascertain what exactly was making me so anxious. Was I running late, was i thinking irrational thoughts, did i have any underlying assumptions significant to what was happening, to make me feel this anxious that I could become aware of...? Anti-depressants helped also with my anxiety.
I also had tremendous childhood anxiety (I used to get up in the middle of the night at age 6 to pray to God and hide food under my bed in case my parents died). As it turns out I've had ADD my whole life. My psychiatrist said that it's not too uncommon for children with ADD to have alot of anxiety. you may want to look for any other underlying disorders you may have. It seems were all very different Nancy. I hope some of us have helped. Good luck, Janice
Posted by janice on September 20, 1999, at 22:34:02
In reply to Depression or Anxiety, posted by Nancy on September 19, 1999, at 22:23:59
i forgot to mention, i'm very prone to nausea from emotional distress or nausea from pills. I take ginger root. I am extremely physically sensitive, as well as emotionally sensitive. janice.
Posted by Bob on September 21, 1999, at 8:37:45
In reply to Depression or Anxiety? I wish it were a choice., posted by janice on September 20, 1999, at 22:34:02
It doesn't seem to be a choice for me. Yesterday was a good example, very much along the lines of how Sean feels.
I've been going through a phase for the last five days or so when I've just been mentally scattered. Yesterday being Monday and Yom Kippur (with my boss out of the office), I set out to reorganize my projects -- define tasks, set priorities, that sort of stuff. I couldn't do it. This is the sort of thing that would trigger a panic attack for me prior to clonazepam. This time, I didn't feel that buzz that sets every one of my nerves vibrating like someone was strumming them with a violin bow. I did, however, get a very clear picture, at first void of an emotional response, to how my mind simply could not cope cognitively with the task. THAT little bit of insight sent my mood through the floor, and I had to head to the bathroom every hour or so in the PM just to hide in a stall and try to stem the tears.
This could all be some learned helplessness response to some addressed learning disability, but my gut tells me that the anxiety would still be there even if I had appropriate cognitive strategies for dealing with this sort of task.
Bob
Posted by Bob on September 21, 1999, at 8:39:25
In reply to Re: Depression or Anxiety? I wish it were a choice., posted by Bob on September 21, 1999, at 8:37:45
> This could all be some learned helplessness response to some addressed learning disability....
I meant unaddressed LD
Posted by dj on September 21, 1999, at 17:32:12
In reply to Re: Depression or Anxiety? I wish it were a choice., posted by Bob on September 21, 1999, at 8:37:45
Bob,
I share your challenges with planning, primarily because I often have a black view of my future and past , though in many ways the latter wasn't so bad when I wasn't depressed and/or anxious in my own private hell. It's also because I have an aversion to my current choices and disbelief in my abilities and options though others see me much less bleakly. Learned helplessness?? To some degree I think so... The question is how does one move beyond it and I would be grateful if there are others who have struggled with this and found a way ahead and through the maze, beyond the one day, one minute at a time approach to life...and pharmaceutical overload...
Sante!
dj
> It doesn't seem to be a choice for me. Yesterday was a good example, very much along the lines of how Sean feels.
>
> I've been going through a phase for the last five days or so when I've just been mentally scattered. Yesterday being Monday and Yom Kippur (with my boss out of the office), I set out to reorganize my projects -- define tasks, set priorities, that sort of stuff. I couldn't do it....
>
> This could all be some learned helplessness response to some (un)addressed learning disability, but my gut tells me that the anxiety would still be there even if I had appropriate cognitive strategies for dealing with this sort of task.
>
> Bob
Posted by Bob on September 21, 1999, at 20:06:06
In reply to Re: Planning & Choice?, posted by dj on September 21, 1999, at 17:32:12
>Learned helplessness?? To some degree I think so... The question is how does one move beyond it....
Attributional retraining. I've only dealt with it in educational situations, but the principle's the same for clinical situations, I'd guess. If you'd like to know more, just email me. I'm long-winded enough as it is -- don't get me started on something on which I'm supposed to be an "expert" ... yikes! But that's just for learned helplessness issues...
... for the rest? If I had an answer to that, I'd bottle and sell it.
Cheers,
Bob
Posted by Noa on September 21, 1999, at 20:51:14
In reply to Re: Planning & Choice?, posted by Bob on September 21, 1999, at 20:06:06
I have similar problems, but I don't think I have an LD or ADD. I think depression and anxiety can cause some of the same "executive function" disabilities as LD or ADD. In some ways, the strategies to deal with are the same, tho. For me, these include vocalizing out loud, writing lists, breaking tasks down into small pieces and committing to only one piece at a time, physically moving things around (ie making the organizational tasks as concrete as possible), and most successful of all--having a friend be present. For some reason, I can do tasks with another person there as a sort of witness, that I talk to about it, whereas by myself, I become too overwhelmed and anxious. Also, like many people with LD or ADD, I often need the adrenaline rush of an impending deadline, doing things at the last minute. I think a lot of my organizational problems come from being so avoidant, and letting things pile up.
Posted by Janice on September 21, 1999, at 22:23:09
In reply to Re: Planning & Choice?, posted by Noa on September 21, 1999, at 20:51:14
but i farmiliar with your lack of success with medications from your previous posts...Very much like my history, until I got the ADD diagnosis. Boom, my whole life started to make sense. Insight after insight after insight, almost too fast for even my ADD brain.
Your last posting sounded like i was. I know, of course, these can also be symptoms of depression - which many people with ADD get.
Here's the question...How fast is your brain? You're obviously very bright regardless of speed. Hoping, at best, to make someone's life a little easier, Janice
Posted by Bob on September 22, 1999, at 11:31:03
In reply to Noa, I'm not trying to sell it..., posted by Janice on September 21, 1999, at 22:23:09
Geez, Noa, it sounds like you and me got our brains from the same bin in the baby factory.
One of the 'reasonable accommodations' I asked for was to have my boss come in and talk me through my to do list on my white board, fixed to the wall right in front of my desk. After reading all the info I gave her on depression, she went from seeing it as a nuisance to agreeing that it was the best strategy. Thank goodness for that!
Cheers
Bob
Posted by Carmen on September 22, 1999, at 12:11:38
In reply to Depression or Anxiety, posted by Nancy on September 19, 1999, at 22:23:59
I would like to know how can a psychiatrist diagnosis the difference between depression and generalized anxiety disorder? I have been treated for depression, but my main symptom is horrible anxiety, especially stomach problems, mainly nausea. I am currently taking Prozac and have experienced considerable weight gain. I'm wondering if I went off Prozac and took Buspar, would that control everything? When I was a little kid I couldn't stand to be away from my mother, crying, etc. When I was a teenager, I would get physically sick before a date I would get so nervous, and now, even as an adult and a teacher, I get nauseated alot. Any input from anyone would be appreciated. Does anyone else suffer from nausea this way?
Hi Nancy! Depression and anxiety usually go together. I really don't know how the psychiatrists decide what meds would be good. I have suffered both since I was small too. Yes. Anxiety makes me feel nauseated. I have had to live w/this every day. Right now have been put on Neurontin for social anxiety because that is a real stressor for me. I still have to take Clonopin as needed which usually is in the am around 10. The anxious feeling comes on terribly at that time and I don't know why. I really feel that there's something missing in the brain chemicals or whatever though I was raised in a very stressful environment w/ little affection from mom. I just have consigned myself to the fact that this is my battle to fight in life. Not fun! But from this board I can see that I'm not alone. Hope I've helped you some. Carmen
Posted by Noa on September 22, 1999, at 22:56:50
In reply to Re: Depression or Anxiety, posted by Carmen on September 22, 1999, at 12:11:38
Nancy, someone might have already said this, but the two--depression and anxiety--often travel together. I think the anxiety is the first, usually, and the depression comes in to lower the intense stress of anxiety--being in a constant state of alert can wear you out. Also, it feels lousy, and you feel out of control, which, face it, is pretty depressing. I mean, it can make you feel helpless, which can lead to feeling like you are hopelessly perpetually helpless. For me, as lousy as it feels, depression comes in to quiet the anxiety, but it doesn't do it successfully. You certainly sound like you had some separation anxiety and social anxiety. The thing is that sometimes, for some people, the same medicine can address both the depression and the anxiety.
Posted by Noa on September 22, 1999, at 22:59:03
In reply to Re: Noa, I'm not trying to sell it..., posted by Bob on September 22, 1999, at 11:31:03
Bob, I admire your guts. I don't think I could ask for that kind of help from a boss. Question: who decides what "reasonable" means in "reasonable accommodations"?
LOL about the baby bin.
Posted by Noa on September 22, 1999, at 23:02:26
In reply to Noa, I'm not trying to sell it..., posted by Janice on September 21, 1999, at 22:23:09
I do wonder, but I don't know. I still think it could be depression/anxiety, ie, *internal* distractibility. I think there might be some relationship between some depressive/anxiety disorders and some forms of ADD. I think the vulnerability runs in families. It is somewhat academic of a question at this point, because I take ritalin anyway, for my depression! The fact that it helps does not diagnose ADD tho.
Posted by Bob on September 23, 1999, at 9:00:18
In reply to Re: Noa, I'm not trying to sell it..., posted by Noa on September 22, 1999, at 22:59:03
> Bob, I admire your guts. I don't think I could ask for that kind of help from a boss. Question: who decides what "reasonable" means in "reasonable accommodations"?
Noa, I didn't need any guts, I was far to p*ss*d off to need any courage -- she was trying to maneuver me between a rock and a hard place, so I pulled out a jackhammer ;^). Anyway, what is "reasonable" as a "reasonable accommodation" under the ADA has been left to the courts to interpret. The National Alliance for the Mentally Ill has a wonderful brief on the ADA, including in its section on Title 1, the part that deals with workplace issues, a list of reasonable accommodations that have been upheld in the judicial system. I happen to have that brief stored as a PDF on my website -- the URL is http://idt.net/~raboyle/babble/nami2.pdf. I recommend it for everyone who has any concern about discrimination due to your disorder at work, in housing issues, or in dealing with any public or private organization that needs to comply with non-discriminatory practice assurances due to federal or state funding, or whatever. It does a great job of explaining both your rights and your responsibilities, and it does so in a concise, mostly-jargon-free manner.
... ritalin for depression?
> LOL about the baby bin.
=^P ;^)Cheers,
Bob
Posted by Noa on September 23, 1999, at 13:34:22
In reply to Re: Noa, I'm not trying to sell it..., posted by Bob on September 23, 1999, at 9:00:18
> ... ritalin for depression?
Ritalin as an augmenter for the AD. Actually ritalin is used as an antidepressant strategy for the elderly or people who are medically fragile. Also, it is sometimes used as a jumpstarter while waiting for the AD to kick in, which can be weeks.
>> =^P ;^)
Bob, what is =^P ? OH, now that I wrote it out separately, I see it. Does this mean that you are two-faced?
Thanks for the ADA info.
>
> Cheers,
> Bob
Posted by Noa on September 23, 1999, at 13:35:38
In reply to Re: Noa, I'm not trying to sell it..., posted by Noa on September 23, 1999, at 13:34:22
Oops, did not mean to sign off as Bob....Noa
Posted by Noa on September 23, 1999, at 13:59:28
In reply to Re: Cheers, Bob, posted by Noa on September 23, 1999, at 13:35:38
> Oops, did not mean to sign off as Bob....Noa
... and your asking if **i'm** two-faced?!
=^P again.
Bob
Posted by Bob on September 23, 1999, at 16:01:27
In reply to Re: Cheers, Bob, posted by Noa on September 23, 1999, at 13:59:28
> > Oops, did not mean to sign off as Bob....Noa
>
> ... and your asking if **i'm** two-faced?!ACK!!!!
And *I* didn't mean to use your handle when I entered that last follow-up!
Mea culpa, mea culpa, mea maxima culpa!
Bob
(well, at least I'm pretty sure its Bob)
This is the end of the thread.
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