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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Bonnie J on July 15, 2000, at 1:01:02
i am a 15 female...i have been suffering from depression for almost a year. i have been to a mental hospital and am still seeking counseling, i have tried 5 different anti depresseants and am currently taking Paxil. None of these medicines has worked. and the Paxil isn't working either. Just asking some advice on what to do, because i have no idea. thanks.
~bonnie J
Posted by C.M. on July 15, 2000, at 4:00:48
In reply to still depressed..., posted by Bonnie J on July 15, 2000, at 1:01:02
> i am a 15 female...i have been suffering from depression for almost a year. i have been to a mental hospital and am still seeking counseling, i have tried 5 different anti depresseants and am currently taking Paxil. None of these medicines has worked. and the Paxil isn't working either. Just asking some advice on what to do, because i have no idea. thanks.
> ~bonnie J=================================================
You might have a doctor check for hormone imbalances if it has not been done.
CM
Posted by S.D. on July 15, 2000, at 4:44:06
In reply to still depressed..., posted by Bonnie J on July 15, 2000, at 1:01:02
There is a pattern they usually follow. If 5 have not worked, consider whether each was given long enough to work (at least 6 weeks *at the maximum tolerated dose*, and I think 8 will sometimes make the difference).
If either Wellbutrin, MAO Inhibitors, Effexor, or tricyclics are not one of the five, then there is hope that one of these will work.
Certain things can be added to an antidepressant that isn't working. My experience is that doctors don't suggest this often but I don't understand why because sometimes it works and should be worth a shot before discontinuing a certain antidepressant. The things that can be added (one at a time) include lithium, a TCA antidepressant or a stimulant. There are others too. Some people respond to meds, or combinations, that aren't thought of as 'antidepressants' which also means doctors aren't likely to try such things. If the depression is serious and they tell you they've run out of medication possibilities, Electro-Convulsive Therapy is effective and not as scary as it seems.But also consider an alternate diagnosis!? Maybe CFIDS or bipolar or ??
Tell us more details about the meds they've prescribed, the symptoms you have...
There are many options so there is still every reason to have hope.
S.D.
Posted by Cindy W on July 15, 2000, at 9:00:39
In reply to which 5 different meds did they have you take?, posted by S.D. on July 15, 2000, at 4:44:06
> There is a pattern they usually follow. If 5 have not worked, consider whether each was given long enough to work (at least 6 weeks *at the maximum tolerated dose*, and I think 8 will sometimes make the difference).
>
> If either Wellbutrin, MAO Inhibitors, Effexor, or tricyclics are not one of the five, then there is hope that one of these will work.
> Certain things can be added to an antidepressant that isn't working. My experience is that doctors don't suggest this often but I don't understand why because sometimes it works and should be worth a shot before discontinuing a certain antidepressant. The things that can be added (one at a time) include lithium, a TCA antidepressant or a stimulant. There are others too. Some people respond to meds, or combinations, that aren't thought of as 'antidepressants' which also means doctors aren't likely to try such things. If the depression is serious and they tell you they've run out of medication possibilities, Electro-Convulsive Therapy is effective and not as scary as it seems.
>
> But also consider an alternate diagnosis!? Maybe CFIDS or bipolar or ??
>
> Tell us more details about the meds they've prescribed, the symptoms you have...
>
> There are many options so there is still every reason to have hope.
>
> S.D.Bonnie J, are you also receiving psychotherapy? Being l5 is a very hard time for lots of people (I can remember my own adolescence vividly, and it included some very hard times). There are a lot of changes (physical, emotional, hormonal) and expectations (you're almost an adult and feel in a lot of ways like an adult but still don't have the freedom or privileges of an adult). You have to start dating, may have disagreements with parents, etc. at l5. Suggest you talk out any problems you are having with someone, as well as seek meds (there is no magic pill for life problems). Please feel free to share any concerns you have, and hang in there! People on this board are very caring, and I'm sure no matter how old people are, they can probably relate to what you're going through. BTW, I never thought I'd end up 48 years old since I didn't think I'd even survive high school!--Cindy W
Posted by JohnL on July 15, 2000, at 10:33:36
In reply to still depressed..., posted by Bonnie J on July 15, 2000, at 1:01:02
I'm so sorry Bonnie. Man o man do we all know where you're at. And how. But on the bright side, you've found the right place. Babbleland is full of compassionate people who are in the same boat as you. Many of them know more about depression and treatments than several average doctors put together. Hang in there.
Getting to know your depression and getting to know how expert doctors approach it are two powerful pieces of ammunition to do battle against the beast. You could go to Dr Bob's 'Tips' at the top of the main page. Click on Tips. Then, leave the search box empty, but click on the search button. You'll get a large list of topics. Many will pertain directly to you. These are doctor discussions of what works, what doesn't, how and why they do this or that.
Did your doctor do a thorough blood test? Did we rule out thyroid or other hormonal causes?
Did any one else in your family--parents, brothers, sisters, grandparents, great grandparents--suffer psychiatric illness of any kind? Bipolar? Schizophrenia? Depression? If so, there could likely be a genetic link.
Age 15 for me was not easy. I've had two good counselors in my life, and I believe a good counselor could help you quite a bit.
Or maybe your depression is biological instead of psychological? If so, you won't respond very well to counseling. That's why it might be worth trying counseling, just to see. To better define the underlying cause...biological or psychological.
Two books worth reading. "An Unquiet Mind", and "The Successful Treatment of Brain Chemical Imbalance". You'll know your depression better than the back of your hand after reading these two books.
Having a doctor skilled at psychiatry is very important. If they have a routine, like X medication first, then Y, then Z; or maybe they have a favorite medication; or maybe they think antidepressants are the only appropriate treatments...well, these aren't good signs. These can all lead to recovery, though the process will be very very long. It just seems logical and obvious to me that if 5 antidepressants haven't worked, maybe we're barking up the wrong tree? Does it take a rocket scientist to figure that out? Judging by the way some doctors treat us, you would think it does!
Each of us is a unique individual with unique brain chemistry, unique genes, unique personality, unique circumstances, and ultimately a unique response to whatever medication. Insist that your doctor treat you as a unique patient, not a statistic.
Back in the old days there were few medications to choose from. They didn't very often directly target the underlying problem, but rather got around to it through a trickle down cascade effect which takes 6 to 8 weeks. From that was born the popular conception (or misconception as I see it) that these medications take 6 to 8 weeks to work. That's what doctors are taught. As if it were a fact. It's not. We see people respond quickly...days, a week, two weeks. What's the difference? Today there are a vast array of medications to choose from. One of them will target the problem directly without the long wait of the cascade effect. When that happens, response is quick and rather dramatic. Side effects are often minimal in that situation. Generally speaking, the longer a medication takes to work (if it will ever work at all) and the worse the side effects, the farther away it is from targeting the real problem. With that in mind, your nonresponse to antidepressants provide powerful clues to guide your doctor into choosing medications that target different brain chemistries. Sadly doctors aren't trained to diagnose this way. That's too bad. Using clues to guide treatment can lead to highly accelerated recovery.
Top choices for you could be stimulants like Ritalin or Adderall, the antipsychotic Zyprexa (wide spectrum med good for a lot of things besides psychosis--you don't have to be psychotic to respond well to it), or both. These will address things totally missed by the antidepressants. And if they are to work, they will do so fast. That in my mind is a very important component to consider. I don't know the nature of your depression or what meds you've tried, so this is just off the top of my head.
If your doctor resists things like that, that's when your printed research from 'Tips' can be a real benefit. Show your doctor in writing what the experts are doing.
I am wishing you a smooth day Bonnie.
John
Posted by Noa on July 15, 2000, at 13:44:13
In reply to Re: still depressed...L O N G, posted by JohnL on July 15, 2000, at 10:33:36
Bonnie, welcome back, I wish you were visiting in better spirits, but I am glad you came back for support.
You have gotten good advice from the others here. I have to agree especially about getting a good endocrine workup, esp. thyroid. For more info, see the folder on thyroid and depression at http://www.egroups.com/links/psycho-babble-tips
Posted by shar on July 15, 2000, at 19:39:48
In reply to still depressed..., posted by Bonnie J on July 15, 2000, at 1:01:02
Bonnie,
I was around 14-15 when I experienced my first heavy-duty bottoming out with depression. I hope that you will get your med situation straightened out soon (lots of good info here).I'm wondering about your hospital stay, and what got you in there. Was it for depression, or were you using other drugs to self-medicate (I think we've all done that). Is that where you tried your anti-depressants?
Did you get counseling in the hosp? With your peers (not a bunch of old people like me)? Did they do any of the A's as a group (AA, NA, Co-dependents A, Emotions A, etc.)? I'm wondering about your support system.
There are so many things that can make a difference! I hope you will keep posting here, and let us know what's happening.
Shar
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