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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by mit on August 13, 2000, at 21:57:41
Looking for a little advice. I have tried celexa 60mg (helped a little with guilt but not depression), prozac 40mg (nothing), and now am on Wellbutrin 100mg. The doc said that I would feel something within 3 days (day 4 now..is he right?) and though it has helped a little with energy (usually I want to sleep all the time) not helping depression. He mentioned adding something else (I think effexor) next week. My main problem is an overall feeling of hopelessness, like nothing I can or could do matters. I have accomplished some major things (I have 2 masters degrees and am close to a Ph.d, I have a wonderful gf, etc) and yet I am miserable. I am very good at "sucking up the pain" and moving on (father's abuse was good for something, I guess) But, whatever I am doing I feel like I should be doing something else. I avoid people when possible and am very uncomfortable when my routine changes. Suicide is becoming less and less a theoretical solution. Q:
Does anyone else feel this way? Sometimes I feel my therapist and psychopharm think things aren't so bad for me because of my accomplishments.
Do you think the effexor will help with this type of depression? (I have had no side effects at all with any med so far)
Should I try a different ssri?
Any help is greatly appreciated. The posts here have given me some hope because I know it takes time, yet with each med failure I lose a little more hope. Thanks in advance.
M
Posted by Kath on August 14, 2000, at 10:34:19
In reply to celexa..prozac..wellbutrin, posted by mit on August 13, 2000, at 21:57:41
Hi M. Sounds very discouraging. I'm hoping you've given each med you've tried long enough, but I imagine your doc has made sure of that before suggesting to try another. I haven't much experience, because Celexa is the first one I've tried & it's working well for me. My main problem is anxiety. My thoughts are with you & I noticed a reply to you a little further down the page.
Let us know how it's going. Kath
> Looking for a little advice. I have tried celexa 60mg (helped a little with guilt but not depression), prozac 40mg (nothing), and now am on Wellbutrin 100mg. The doc said that I would feel something within 3 days (day 4 now..is he right?) and though it has helped a little with energy (usually I want to sleep all the time) not helping depression. He mentioned adding something else (I think effexor) next week. My main problem is an overall feeling of hopelessness, like nothing I can or could do matters. I have accomplished some major things (I have 2 masters degrees and am close to a Ph.d, I have a wonderful gf, etc) and yet I am miserable. I am very good at "sucking up the pain" and moving on (father's abuse was good for something, I guess) But, whatever I am doing I feel like I should be doing something else. I avoid people when possible and am very uncomfortable when my routine changes. Suicide is becoming less and less a theoretical solution. Q:
>
> Does anyone else feel this way? Sometimes I feel my therapist and psychopharm think things aren't so bad for me because of my accomplishments.
>
> Do you think the effexor will help with this type of depression? (I have had no side effects at all with any med so far)
>
> Should I try a different ssri?
>
> Any help is greatly appreciated. The posts here have given me some hope because I know it takes time, yet with each med failure I lose a little more hope. Thanks in advance.
>
> M
Posted by allisonm on August 14, 2000, at 21:03:28
In reply to celexa..prozac..wellbutrin, posted by mit on August 13, 2000, at 21:57:41
Hi, M, and welcome!
I take 400mg Wellbutrin daily. I don't recall feeling anything but perhaps irritable and overly "caffeinated" at the start or whenever the dose was upped. Three days is NOT enough time to judge. It can take 6 weeks or more before you might really start feeling better and can look back with any clarity on how things were before. 100mg of Wellbutrin is a low dose. I think the therapeutic level is more like 300mg. Generally one will feel an energizing effect at first, but that wears off eventually. I think there's a thread by Cam W. higher up that explains the Wellbutrin much better than I ever could. Anyway, the gist of that thread is that the extra energy is a side-effect. When it wears off, sometimes people think it's poop-out, but in fact the AD is just now beginning to really work.
Celexa, Effexor and Wellbutrin all are used in the treatment of depression, but they work in different ways. There are many others; you need to find the right drug for your particular chemical imbalance. Often it can feel like looking for a needle in a haystack.
There is one theory (Dr. Jensen's, I think, but you can find it in threads in the archive) that says a doctor (and patient) can tell whether an AD will work within just a few days of initial treatment. This may work for some, but personally I have not found it to be the case. The general rule is that it can take several weeks (4, 6, 8) before one sees a therapeutic benefit. Sometimes it might be the right drug at the wrong dose. It may take some time to figure out the right level. Wellbutrin may work well for you, but maybe you need more of it. It also will take some time to increase a dose. You can't do it all at once. (Well, you can, but you might not like the outcome.)
It is important to educate yourself on the meds (check Dr. Bob's links at the top of this page) and I think it is imperative that you give your meds time to work. Unless the side effects are unbearable (I couldn't tolerate Zoloft or Effexor XR for example and got right off of them), stick with it awhile. Otherwise, you may never know whether it really worked or could work for you. Even now I wonder whether the Zoloft of the Effexor would have worked if I had put up with the side effects a little longer until they ran their course. After getting some experience with side effects I decided to stick it out with Wellbutrin and am very glad I did. Paired with Remeron, it's been the best combo I've ever had.
All of this will take some time and you're gonna feel rotten while your searching for the right drug, but if you persevere you will find what works for your body. Don't give up! Many times when things were bad, I seriously considered quitting my ADs and my therapy altogether. That's probably one of the worst things you can do.
Many of us here can relate to your feelings of hopelessness. I still get those feelings. I still think about suicide sometimes, but less seriously. I think I keep it in the back of my head as an alternative - a security blanket if you will - in case things get *really* bad. Unfortunately, ADs don't give us immunity. They are not "happy pills." You'll still have to live with yourself. But the right ADs should be able to smooth out the dips so that you don't fall too far down into the pit. Someone awhile ago, Janice maybe, described ADs as putting a floor under your feet. I like that description. My diagnosis after more than 2 years still is major depression - moderate, single episode. I had some extenuating circumstances (divorce and parental loss) in the middle that have slowed my recovery. I'm still working with my psychiatrist on many issues from my past and in my present.
Re' Accomplishment: It shouldn't matter to your doctors. Depression afflicts all kinds of people, in all walks of life, in every income bracket. If you feel that your doctors are not taking your symptoms seriously, it might be good to discuss it with them.
Just my .02. I'll get off my soapbox now...
M., I wish you well. There are many good people on this board who have been where you are right now. Some are still there. Some rise above and fall back. Some have beaten their depression altogether and have moved on. Some do it solely with drugs. Others require drugs and psychotherapy. There are myriad ways to go at this. I myself have learned a lot from this board and have found a good deal of support here. Please stay. Please ask questions.
Best wishes,
allison
Posted by allisonm on August 14, 2000, at 22:13:37
In reply to celexa..prozac..wellbutrin, posted by mit on August 13, 2000, at 21:57:41
Dear M.,
Here's the post by Cam W. that explains the Wellbutrin:
http://www.dr-bob.org/babble/20000811/msgs/42737.htmlA >
Posted by JohnL on August 15, 2000, at 4:43:14
In reply to celexa..prozac..wellbutrin, posted by mit on August 13, 2000, at 21:57:41
> Looking for a little advice. I have tried celexa 60mg (helped a little with guilt but not depression), prozac 40mg (nothing), and now am on Wellbutrin 100mg. The doc said that I would feel something within 3 days (day 4 now..is he right?) and though it has helped a little with energy (usually I want to sleep all the time) not helping depression. He mentioned adding something else (I think effexor) next week. My main problem is an overall feeling of hopelessness, like nothing I can or could do matters. I have accomplished some major things (I have 2 masters degrees and am close to a Ph.d, I have a wonderful gf, etc) and yet I am miserable. I am very good at "sucking up the pain" and moving on (father's abuse was good for something, I guess) But, whatever I am doing I feel like I should be doing something else. I avoid people when possible and am very uncomfortable when my routine changes. Suicide is becoming less and less a theoretical solution.
> Any help is greatly appreciated. The posts here have given me some hope because I know it takes time, yet with each med failure I lose a little more hope. Thanks in advance.
I sure know how you feel, and it hurts to know someone else hurts in the same way. I've always excelled at whatever I do and have made many accomplishments, yet have been very very depressed throughout most of it all. Sometimes I think diving into whatever project and achieving high success is merely a survival means of escape from the relentless depression.
As to psychotherapy, if it is proving useless so far then I doubt it will ever be much help. That is, until some medication works. Once a medication works, then and only then can psychotherapy make a big difference. Otherwise, the depressed brain just doesn't have the capability to process the psychotherapy information in a way that does any good. With me anyway.
As to medication, if Wellbutrin doesn't work out there are plenty of other choices. Just so you know, there are a lot of medications that can and will work even though they aren't specifically intended for depression. Just because a med is called 'anti'depressant doesn't mean it will truly be anti depressant. And just because a medication is not called an antidepressant doesn't mean it can't work miracles against depression. It's all in the brain chemistry. Each of us has unique chemistry, and each of us will require a unique medication to fix it, and it may end up not being an antidepressant at all.
For example, Zyprexa. Now here's an antipsychotic that is showing surprising promise as both a mood stabilizer and an antidepressant. You don't have to have schizophrenia to respond to it well. The more antidepressants you've tried that don't work, the more likely it seems to me a different kind of medication will work instead. Your odds for success increase with each failure, but most especially when you limit your future choices to medication of different classes than the ones you've already failed.
Zyprexa is just one example. Any of the stimulants (Ritalin, Adderall) could work beautifully. Adrafinil from overseas mailorder could be a nice alternative. The anticonvulsant Lamictal is showing a lot of promise in treating depression. And if one was to stay with the antidepressant group, one might consider either Desipramine or Nortriptyline...older meds that often work the best but come with more side effects too.
To make my long story short, you might consider other classes of psychiatric meds next. Forget about antidepressants. Any combination of Zyprexa, stimulants, or either alone would be my top choices at this point.
John
Posted by mark on August 17, 2000, at 3:37:46
In reply to celexa..prozac..wellbutrin, posted by mit on August 13, 2000, at 21:57:41
Does anyone else feel this way? Let's see, I have 2 Associates, a Bachelor, Masters, and a Ph.D in International
Business, a good job, a great significant other, and I can suck it up with the best of them. Well, used to be
able to suck up the pain. Then the pain, the feelings of being "stuck" in the depression and not being able
to get out got too bad. I was still able to hide it from the outside world, but inside I was falling apart.
I went to my doctor and two therepists who decided that because of what I had accomplished and what I was
still able to accomplish nothing was wrong with me. It wasn't until I found a sympathetic doc who was really
willing to listen that I started to find the help that I needed.I've tried Pamelor, Prozac, Wellbutrin, and Celexa to no avail. It wasn't until the doctor started me on
Effexor before I found some relief. It certainly hasn't made me 100%, but it's made me feel better
than I have in a long time. I still have days where I think taking the big "dirt nap" would be better
than feeling this way, but it doesn't last long. I have a little more energy than I used to and this big
fog that's been engulfing my brain for the last thousand years feels like it's lifting somewhat.Give the med a couple of months and talk to your doctor about how you feel. He/She might need to adjust the
dosage or add a companion drug to get the results you desire. And please don't give up hope. It's not
hopeless. Trust me, I have a Ph.D! :-)Mark
> Looking for a little advice. I have tried celexa 60mg (helped a little with guilt but not depression), prozac 40mg (nothing), and now am on Wellbutrin 100mg. The doc said that I would feel something within 3 days (day 4 now..is he right?) and though it has helped a little with energy (usually I want to sleep all the time) not helping depression. He mentioned adding something else (I think effexor) next week. My main problem is an overall feeling of hopelessness, like nothing I can or could do matters. I have accomplished some major things (I have 2 masters degrees and am close to a Ph.d, I have a wonderful gf, etc) and yet I am miserable. I am very good at "sucking up the pain" and moving on (father's abuse was good for something, I guess) But, whatever I am doing I feel like I should be doing something else. I avoid people when possible and am very uncomfortable when my routine changes. Suicide is becoming less and less a theoretical solution. Q:
>
> Does anyone else feel this way? Sometimes I feel my therapist and psychopharm think things aren't so bad for me because of my accomplishments.
>
> Do you think the effexor will help with this type of depression? (I have had no side effects at all with any med so far)
>
> Should I try a different ssri?
>
> Any help is greatly appreciated. The posts here have given me some hope because I know it takes time, yet with each med failure I lose a little more hope. Thanks in advance.
>
> M
Posted by JaneST on August 17, 2000, at 13:18:01
In reply to Re: celexa..prozac..wellbutrin, posted by JohnL on August 15, 2000, at 4:43:14
>
> I sure know how you feel, and it hurts to know someone else hurts in the same way. I've always excelled at whatever I do and have made many accomplishments, yet have been very very depressed throughout most of it all. Sometimes I think diving into whatever project and achieving high success is merely a survival means of escape from the relentless depression.
>
> As to psychotherapy, if it is proving useless so far then I doubt it will ever be much help. That is, until some medication works. Once a medication works, then and only then can psychotherapy make a big difference. Otherwise, the depressed brain just doesn't have the capability to process the psychotherapy information in a way that does any good. With me anyway.
>
> As to medication, if Wellbutrin doesn't work out there are plenty of other choices. Just so you know, there are a lot of medications that can and will work even though they aren't specifically intended for depression. Just because a med is called 'anti'depressant doesn't mean it will truly be anti depressant. And just because a medication is not called an antidepressant doesn't mean it can't work miracles against depression. It's all in the brain chemistry. Each of us has unique chemistry, and each of us will require a unique medication to fix it, and it may end up not being an antidepressant at all.
>
> For example, Zyprexa. Now here's an antipsychotic that is showing surprising promise as both a mood stabilizer and an antidepressant. You don't have to have schizophrenia to respond to it well. The more antidepressants you've tried that don't work, the more likely it seems to me a different kind of medication will work instead. Your odds for success increase with each failure, but most especially when you limit your future choices to medication of different classes than the ones you've already failed.
>
> Zyprexa is just one example. Any of the stimulants (Ritalin, Adderall) could work beautifully. Adrafinil from overseas mailorder could be a nice alternative. The anticonvulsant Lamictal is showing a lot of promise in treating depression. And if one was to stay with the antidepressant group, one might consider either Desipramine or Nortriptyline...older meds that often work the best but come with more side effects too.
>
> To make my long story short, you might consider other classes of psychiatric meds next. Forget about antidepressants. Any combination of Zyprexa, stimulants, or either alone would be my top choices at this point.
> JohnJohn:
What a great, well-thought answer...or maybe I just think so because it made me feel like you were talking to me???
Very positive and hopeful...plus good info...I'll be taking this with me tomorrow to my pdoc appointment.
Thanks for your insight!!
Jane
Posted by caroline on August 20, 2000, at 2:50:50
In reply to celexa..prozac..wellbutrin, posted by mit on August 13, 2000, at 21:57:41
Mit,
Between the ages of 15 and 29, my world felt much as it seems yours does. I felt utterly hopeless, like nothing I could ever do would matter. I won the national title for figure skating, got a first class honours degree, followed by a masters, I even managed to get and do well in a job I badly wanted and find a wonderful partner. None of it mattered. I wanted to die because life hurt too bad and year on year, it seemed to get worse. I avoided people more and more as the years went by and felt the need to starve myself to death or injure myself in other ways if anything threatened to get in the way of my routines.
I have been diagnosed with aspergers, anorexia nervosa, OCD and depression.
I responded to your post because I felt deep empathy with what you wrote. I also thought maybe I could give you some hope. I say this because thanks to the advice I received from generous people at psychobabble, I now feel 100% better; the best I have ever felt, in fact. I spent 15 years trying meds prescribed by pdocs, who seemed to understand little of what I was going through. None of the meds they prescribed changed anything very dramatically for me. People at psychobabble suggested combinations I could try and spelled out reasons why these combinations might work for me, based on the way my brain chemistry had responded to previous meds etc. I could not be more grateful to them (especially JohnL). The combination I am on now works for me. I am now the person I always Knew I was but could never be. I still have aspergers, which means my life takes more planning than other peoples might and my anorexia and OCD are still active - though I am managing them better. I no longer feel hopeless or remoteley depressed.
I wish you all the best. Please keep trying with different meds. I am confident you could find a combination that would work for you.
Take care
Caroline
Posted by Cindy W on August 20, 2000, at 9:50:34
In reply to celexa..prozac..wellbutrin, posted by mit on August 13, 2000, at 21:57:41
> Looking for a little advice. I have tried celexa 60mg (helped a little with guilt but not depression), prozac 40mg (nothing), and now am on Wellbutrin 100mg. The doc said that I would feel something within 3 days (day 4 now..is he right?) and though it has helped a little with energy (usually I want to sleep all the time) not helping depression. He mentioned adding something else (I think effexor) next week. My main problem is an overall feeling of hopelessness, like nothing I can or could do matters. I have accomplished some major things (I have 2 masters degrees and am close to a Ph.d, I have a wonderful gf, etc) and yet I am miserable. I am very good at "sucking up the pain" and moving on (father's abuse was good for something, I guess) But, whatever I am doing I feel like I should be doing something else. I avoid people when possible and am very uncomfortable when my routine changes. Suicide is becoming less and less a theoretical solution. Q:
>
> Does anyone else feel this way? Sometimes I feel my therapist and psychopharm think things aren't so bad for me because of my accomplishments.
>
> Do you think the effexor will help with this type of depression? (I have had no side effects at all with any med so far)
>
> Should I try a different ssri?
>
> Any help is greatly appreciated. The posts here have given me some hope because I know it takes time, yet with each med failure I lose a little more hope. Thanks in advance.
>
> MM, I take Effexor-XR 375 mg/day, and feel it has helped me a lot! I too have OCD and depression, and would probably also qualify for avoidant personality disorder. At times, I think about suicide, but this has become less with the Effexor-XR. I have a Ph.D. and am a psychologist, but that doesn't mean all my problems have gone away, not by any means! Hope things are getting better for you. What are you taking now, and how are you feeling? Hope you are also in therapy with someone.
Posted by mit on August 20, 2000, at 10:43:13
In reply to celexa..prozac..wellbutrin, posted by mit on August 13, 2000, at 21:57:41
Thank you all for your comments. Just wanted to let you know that I saw my psychopharm and we discovered that maybe the Celexa has some benefits for me. I guess sometimes you expect the world from a drug and when you don't get it you think it isn't working. During my time on Celexa things weren't perfect but they were better than now (We went over what I was doing during that time and how I felt and I was surprised to recall that things weren't so bad).
We added the Celexa (20mg) back to the Wellbutrin (100mg). It has been 5 days now and things seem very well. I'm not sure if I will slip back into a low (my moods seem to go in cycles) but I can see a glimmer of hope on the horizon for the first time in quite a long time. Could this be from the drug combo? Is it possible that a combonation of drugs is more than the sum of its parts because each on its own didn't have this effect?
My fingers are crossed. Thanks again for your help.
M
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