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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Dubya on March 20, 2001, at 19:06:55
At first, my post will sound kind of silly but please read it carefully. How can I tell if my anti-depressant is working? Any tests that can be done to see if Serotonin or Neurotonin is at a good level. I am almost too scared to say if my anti-dep. (Clomipramine-20mg) is working for me. I've been taking it since Jan 15th/01. Basically, I am trying to find out if it is me that is the problem or if it the medicine isn't working. Do "normal" people ever have thoughts of suicide at all? Last thing is, I am basically trying to figure out still if I have depression/anxiety disorder/OCD because, I went to a psychiatrist and he just asked questions and evaluated me from there. Please help me out someone with some advice.
Posted by ChrisK on March 21, 2001, at 5:32:54
In reply to How do I know if my anti-depressant is working ?, posted by Dubya on March 20, 2001, at 19:06:55
The best way to evaluate your depression is through questioning your daily activities and feelings. Blood levels can tell you if you are at theraputic levels of your med but not tell you if you are on the right med for you. Try going to one of these sites and taking the questionaire honestly about once a week or every other week. Keep track of your scores and you will see if the symptoms of depression are decreasing or remaining the same. From my own experience you will see a significant change in your score when you find the "right" med. They are worth a try.
Posted by pat123 on March 21, 2001, at 13:01:08
In reply to How do I know if my anti-depressant is working ?, posted by Dubya on March 20, 2001, at 19:06:55
Quite honestly if you have to ask and are not sure
then that is a good indication your meds are not working or not working well enough. If you are having sucidal thoughts that would be a clue that things are not working as well as they should, med wise.Pat
Posted by MA on March 21, 2001, at 21:44:16
In reply to How do I know if my anti-depressant is working ?, posted by Dubya on March 20, 2001, at 19:06:55
Good question...There was many a time when I was not sure myself. The way I judge it now is by questioning how focused am I on observing life rather than participating in it.
When I'm depressed I feel like life is just happening to me. Also my depression makes me very self conscious to the point of not being able to think or function very effectively. Those are my signs that something is still not right, that I need to still let my doctor know. Don't ever settle for feeling just OK. In the beginning that might feel better than nothing, but you can probably feel better with ongoing treatment especially if your doctor is really an expert.
You have to look at what are the signs of "your" depression and whether or not there has been a reduction in those symptoms. If the signs are not sleeping, not eating, then you have to look at those issues improving. If the problem is more social or with your thought process, you have to evaluate if these are improving on medication.
It is very difficult to do especially if the depression is still in effect. I always kept a journal during my drug trials to help me remember day to day what I was feeling. Trust me, you can not remember these things when you are depressed.
Write them down and then tell your doctor if you feel things are getting better. The only way you will know it is when you finally feel in "sync" with things around you, i.e., comfortable in your own skin...
Posted by pat123 on March 21, 2001, at 22:34:43
In reply to Re: How do I know if my anti-depressant is working ?, posted by MA on March 21, 2001, at 21:44:16
> Good question...There was many a time when I was not sure myself. The way I judge it now is by questioning how focused am I on observing life rather than participating in it.
>
MA makes good points. I also agree that you need to feel well or normal and not settle for better.
i have some things I use to gage things like 1) how often I wash (sad but true) 2) Excessive sleeping for several days in a row 3) Generally I enjoy work if not depressed and don't if the depression is starting. Having critera that is black and white like either I have washed every day or I have not is a big help.It is normal to have a few days of depression here and there, so I consider 1-2 days depressed
to mean nothing unless things continue past day 3.Pat
Pat
Posted by Dubya on March 21, 2001, at 23:11:13
In reply to Re: How do I know if my anti-depressant is working ?, posted by pat123 on March 21, 2001, at 22:34:43
THANKS SO MUCH EVERYBODY! I really appreciate this help! Lately, I've had many cries for help and you've all help me to answer this one! So is it fair to say that I shouldn't blame myself? Also, is it fair to say that I should stop worrying about if I have mood disorders or not? I was diagnosed as having an "Anankastic" personality. I really prefer not to bring things on to myself and am almost always overly intimidated by the silliest (little) things that it affects my everyday life. If a medication is having a side effect i.e. my Clomipramine causing me to have VIVID dreams every single night since I started taking it, is this a good indication my medicine is working?
Posted by pat123 on March 21, 2001, at 23:52:46
In reply to Re: How do I know if my anti-depressant is working ?, posted by Dubya on March 21, 2001, at 23:11:13
So is it fair to say that I shouldn't blame myself?
Sorry, blame yourself for what ?
Also, is it fair to say that I should stop worrying about if I have mood disorders or not?Since you mentioned suicide thoughts I think it is very safe to say "yes, you do" and get on with it. It is what it is. The disorder does not improve if you think you do not have it and time spent pretending you don't have something is time
you could be spending on healing.
If a medication is having a side effect i.e. my Clomipramine causing me to have VIVID dreams every single night since I started taking it, is this a good indication my medicine is working?
This is a common effect on the class of meds you are taking and is not an indication it is working.Pat
Posted by Dubya on March 22, 2001, at 0:31:50
In reply to Re: How do I know if my anti-depressant is working ?, posted by pat123 on March 21, 2001, at 23:52:46
Thanks Pat! Side effects (@20mg) is tolerable for me. I guess it's normal to "not want to have something" like a depressive disorder but, it is important to get it treated. I mean, in a "normal" person's view of life (if there is a such a thing), how would I know how much stress is actually good? I am guessing that AD's help to reduce stress, my fear is, I would become lethargic without any stress to motivate me? I mean, I am just wondering how much stress is normal stress and how much is actually a result of my anxiety disorder?
Posted by pat123 on March 22, 2001, at 2:21:13
In reply to Re: How do I know if my anti-depressant is PAT, posted by Dubya on March 22, 2001, at 0:31:50
> Thanks Pat! Side effects (@20mg) is tolerable for me. I guess it's normal to "not want to have something" like a depressive disorder but, it is important to get it treated.
Well, no one likes having depression but at some point you have to own it.
I mean, in a "normal" person's view of life (if there is a such a thing), how would I know how much stress is actually good?If the stress moves you foward in life it is most times a good thing. Otherwise it is not so good. If you feel helpless, trapped, ect by stress it is not a good thing. We are also trapped by our slow moving biology. Our lives have become very complex in a short period of time, in the biological context. Our biology has not kept up so we over react (at an autonomic level) to stress. Our bodies are prepairing us to kill dinner using only simple tools but we are really
talking on the cell phone, driving our BMW while having road rage.I am guessing that AD's help to reduce stress, my fear is, I would become lethargic without any stress to motivate me? I mean, I am just wondering how much stress is normal stress and how much is actually a result of my anxiety disorder?
I would say, beware of over thinking (my favorite thing to do), because you can often decide not to do something because "something" might happen. Over thinking leads to never taking risks. AD's made what stress I have managable. The anxiety thoughs stopped. Will AD's help you but leave you
lethargic ? Maybe. I am sure that if they do you can stop taking them, change dose or med, ect. I am sure that you will never can never know what works until you try it. There is little risk because the effects are reversable.
Posted by pat123 on March 22, 2001, at 11:54:13
In reply to Re: How do I know if my anti-depressant is PAT, posted by pat123 on March 22, 2001, at 2:21:13
I mean, I am just wondering how much stress is normal stress and how much is actually a result of my anxiety disorder?
Sorry, did not answer this one last night. Hmmm, this one is best answered by your therapist. It is really hard to answer unless I know you very well. However, with me, I could answer this question once my depression and anxiety were under control. It is hard to know what is normal
unless you have been there.Pat
Posted by Noa on March 22, 2001, at 16:55:17
In reply to Re: How do I know if my anti-depressant is PAT, posted by pat123 on March 22, 2001, at 11:54:13
Dubya,
Sounds like you are still not out of the woods, if you are still having suicidal thoughts, so keep your pdoc updated. But given that it has been just barely 2 months since you started medication, it could be that there is still improvement to come. If not, there are lots of ways for your pdoc to augment antidepressants if you cannot tolerate an increased dose.
But in addition to the medication, I have found there is also a lot of therapy to be done, including the grieving of not having the "normal" life, of having this dread illness, etc. The more I tried to run away from owning it, as Pat said, the harder it was to heal. Owning and grieving are part of the process. And then accepting and adapting. But don't expect it all at once.
BTW, what is "anankastic"?
Posted by Dubya on March 22, 2001, at 22:36:41
In reply to Re: How do I know if my anti-depressant is PAT, posted by Noa on March 22, 2001, at 16:55:17
Thanks everyone for helping me out. Hey, if I mention that I had suicidal thoughts come up, to my Dr., that won't get me hospitalized or anything would it? Hopefully, only an increase of meds or just talk therapy. So far, my Docs don't know about the suicidal component and that suicidal thoughts are unintentional/unconscious/subconscious occasionally.
Posted by Dubya on March 22, 2001, at 22:44:53
In reply to Re: How do I know if my anti-depressant is PAT, posted by Noa on March 22, 2001, at 16:55:17
According to Encyclopedia Britannica, Anankastic is:
"Anankastic, or compulsive, personality disorder:
A person with this disorder shows prominent overscrupulous, perfectionistic traits that are expressed in feelings of insecurity, self-doubt, meticulous conscientiousness, indecisiveness, and rigidity of behaviour. The person is preoccupied with rules, procedures, and efficiency, is overly devoted to work and productivity, and is usually deficient in the ability to express warm or tender emotions. This disorder is more common in men and is in many ways the antithesis of antisocial personality disorder."
Posted by Noa on March 23, 2001, at 7:21:08
In reply to What ANANKASTIC PERSONALITY is, posted by Dubya on March 22, 2001, at 22:44:53
Dubya,
Thanks for translating--I hadn't heard the word "anankastic" before.
About suicidal thoughts: My belief is that you should be honest with your doctor. Having the thoughts won't put you in the hospital. You would need to be in the hospital if you were at risk of acting on those thoughts. The doctor would ask you questions about this to help determine how at risk you are.
Also, you describe them as being unintentional or unconscious, which makes me wonder if it is more a function of the obsessive disorder--like intrusive, unwanted thoughts. Or maybe they are both---ie, sometimes a reflection of really feeling suicidal, and sometimes intrusive thoughts?
But in general, I have found that my treatment works best if I am up front with the therapist and psychopharmologist.
Posted by Dubya on March 23, 2001, at 16:16:51
In reply to Re: What ANANKASTIC PERSONALITY is » Dubya, posted by Noa on March 23, 2001, at 7:21:08
YES!!! Thank you, I think it is a function of the obsessive disorder--like intrusive, unwanted thoughts. In addition maybe they are both---ie, sometimes a reflection of really feeling suicidal, and sometimes intrusive thoughts? more of the OCD.
I am a guy perhaps overly sensitive to other people to the point where, my pain threshold is abnormally high and that I always 'feel' out of place, perhaps anticipatory anxiety? Argh, guys on the most part, are scared to talk as opposed to a woman who would be more likely to explain all of the symptoms without feeling helpless.
Posted by Dubya on March 23, 2001, at 16:22:23
In reply to Re: What ANANKASTIC PERSONALITY is » Dubya, posted by Noa on March 23, 2001, at 7:21:08
Also more often than not, I do things like drive (rationally) but ask myself, what am I doing, shouldn't I be doing something else? As if, I am obssessive, compulsive and impulsive. I go on eating binges and shopping 'sprees' for no reason. I am kinda sick of myself in that way that, I can't be successful at anything. My parents seem completely normal, my bro is normal but me, I am like ??? I can't take boredom well, I am a freak 'almost'. The whole problem is, I don't know what I want, indecisive and then impulsively but rationally (nobody gets injured or anything) decide. Argh. I am willing do almost anything in my hands to live a 'successful' academic life.
Posted by Dubya on March 23, 2001, at 16:24:39
In reply to Re: What ANANKASTIC PERSONALITY is » Dubya, posted by Noa on March 23, 2001, at 7:21:08
I am willing do almost anything in my hands to live a 'successful' academic/emotional life. I am too embarrassed to do anything, much of which I always think I brought on to myself. I'm weird, do stupid things which are unexpected. :-( It's no use being 'intelligent' all I do is think every second of the day rather than be able to relax. I am too different from everybody else (I am not better than anyone else). I can't understand why I am 'unhappy', I am never satisfied despite the fact that I am not greedy/selfish. I am only satisfied when people are friends with me, perhaps a reassurance is essential for me. Very rarely do I ever feel I have any friends at all.
Posted by Noa on March 26, 2001, at 6:39:52
In reply to Please read 2/2 NOA, posted by Dubya on March 23, 2001, at 16:24:39
The always thinking, never able to relax, intrusive thoughts, etc.--seems like OCD, an anxiety disorder.
You just started meds, so, perhaps give it a bit of a chance to work. Tell your pdoc all this that you wrote here (you can even print it out to bring to your appointment, if talking about it is hard).
I do hope the meds start to make a difference. Remember that it often takes some time and effort to get the meds just right.
Also, are you in therapy, too?
This is the end of the thread.
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