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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by mr.scott on January 10, 2002, at 13:18:26
Hello,
I live in midwest and you might know how the weather is in Janaury...I am so tired that I can no longer listen to conversations all the time and understand what is being said. So instead I nod like I do and smile a lot. I want to sleep ALL THE TIME, but I end up not. In the mornings I awake so profoundly fatigued that I literally cannot get out of bed for an hour. I have the energy of a dead person. I can't focus well, My productivity is way down, and I am more hungry. Is it possible that I was supposed to be a bear but accidentally became a human?
But seriously, this worsening of Depression in the winter, what does it mean and how is it best treated?
Scott
Posted by IsoM on January 10, 2002, at 14:51:29
In reply to Old man winter, posted by mr.scott on January 10, 2002, at 13:18:26
hi Scott. Funny you mention a bear. I always told everyone that they're sensible animals, unlike us, who know what to do about winter. It's exactly what I felt like - eat carbohydrates & hibernate -er, I mean, sleep. Very typical symptoms of SAD, seasonal affective disorder. It started in my twenties & has progressed through the years.
It's often treated with antidepressants, more likely SSRIs. Well, I do take Celexa already & need Synthroid for low thyroid function but it's not enough. A solution might be to up the dosage of ADs in winter but that would mean a horrible period of tapering off for summer, not my idea of a good solution.
I bought a light box for light therapy about four years ago but when I tried sitting in front of it first thing in the morning, I just fell asleep again. Bright light or not, I can sleep lying in full sunshine.
Dexedrine first thing in the morning before I did anything else helped, but of course, it needs dosing throughout the day to maintain the awakefulness. When I was going to university a few years ago, the adrenaline rush of running around like crazy to get to classes in time in the morning would get me going but then I'd often start to fall asleep in classes after I sat for a while. I'd force myself to get *very* involved, asking questions, etc, to keep awake. Class sizes were small so that helped - the prof could see me if I fell asleep. Soon as I got home & tried doing homework, I'd fall asleep again.
Now I'm using adrafinil (Olmifon®). Modafinil (Provigil®) is supposed to do the same. I've written about adrafinil in other posts here & it's here in Psycho-Babble where I got to read others first-hand experiences on it. I won't push it. It may not be the answer for everyone, or perhaps even for many, but for me, it's the best thing out there. The hibernating mode is gone. There are so many other benefits I've noticed & I can't praise it enough.
So all I can say is read up about adrafinil, if it does interest you. Or perhaps talk to your doctor about Provigil®. Adrafinil (Olmifon®) has to be ordered from overseas & I don't know what the regulations are for importing it if you live in the States. It's quite cheap as compared to Provigil®. Here in Canada, I have no trouble getting it from the UK. Provigil® is a prescription med in Canada & the States. It is expensive but if you have medical insurance, it would probably cover the costs.
If you want some more info on either, e-mail me or leave a message in this forum & I'll give you links on them both for you to read & decide yourself.
> Hello,
>
> I live in midwest and you might know how the weather is in Janaury...I am so tired that I can no longer listen to conversations all the time and understand what is being said. So instead I nod like I do and smile a lot. I want to sleep ALL THE TIME, but I end up not. In the mornings I awake so profoundly fatigued that I literally cannot get out of bed for an hour. I have the energy of a dead person. I can't focus well, My productivity is way down, and I am more hungry. Is it possible that I was supposed to be a bear but accidentally became a human?
>
> But seriously, this worsening of Depression in the winter, what does it mean and how is it best treated?
>
> Scott
Posted by SteveS on January 10, 2002, at 15:49:46
In reply to Re: Old man winter » mr.scott, posted by IsoM on January 10, 2002, at 14:51:29
hi Scott,
I live in Italy and i must say that the things i feel are the same!
Here we have a cold weather and a pale, pale sun.
I am most part of the mornig at bed, and i can hardy awake. So i can live only 6 hours of sun, and than i fall in a deep dizzy and drowsy.
I only use amisulpride and a little efedrine.
I drink litres of coffees with little effects on my drowsiness.
I'm thinking to try a serotoninergic (see my post below) for equalize my feeling and my satisfaction, that actually is very deep.
The only think that improve a little my mood is to feel that the days are slowly getting longer, and in my mind i'm already thinking about April!
Let me know something about what you're doing.
Bye
Posted by Mr. Scott on January 10, 2002, at 18:30:49
In reply to Re: Old man winter » mr.scott, posted by IsoM on January 10, 2002, at 14:51:29
Hello IsoM and thanks for your helpful reply. I actually have a bunch of adrafinil I ordered and never took. Funny because I was thinking about how I might need to stop in and get some Ritalin or something from the doc. I will give the Adrafanil a shot tomorrow morning. What is your dosage and how often do you take it. I spent a good deal of time looking at light boxes today and comparing them. I might still get one for the office.
Scott
Posted by IsoM on January 11, 2002, at 1:05:11
In reply to Re: Old man winter » IsoM, posted by Mr. Scott on January 10, 2002, at 18:30:49
A doctor I had gave me a prescription for Ritalin for a week & then decided he didn't want me taking it. He said that if I've coped without it at my age, I didn't need it that badly. I've used Dexedrine from another doctor instead but I prefer adrafinil to either stim.
It gives me a smooth even lift, wakefulness, alertness, calmness, blah, blah from first thing in the morning (well, at least after I've had my morning tea) till I go to bed at night. No ups & downs like the stim when they take affect & then wear off.
I only take 300 mg adrafinil (1 1/2 pills) first thing in the morning with my tea every day. The benefits take a while to work but continue to increase over a few months.
If you want to, you can read my other posts to Barbara Cat about it starting with
http://www.dr-bob.org/babble/20020103/msgs/89457.html
For someone who doesn't want to push this med on anyone, I sure seem to be writing about it a lot. :)> Hello IsoM and thanks for your helpful reply. I actually have a bunch of adrafinil I ordered and never took. Funny because I was thinking about how I might need to stop in and get some Ritalin or something from the doc. I will give the Adrafanil a shot tomorrow morning. What is your dosage and how often do you take it. I spent a good deal of time looking at light boxes today and comparing them. I might still get one for the office.
>
> Scott
Posted by mr.scott on January 11, 2002, at 10:25:40
In reply to Re: Old man winter » Mr. Scott, posted by IsoM on January 11, 2002, at 1:05:11
Hello IsoM,
I took it this morning, and I like it a lot allready. I am still a bit tired, but I noticed a definate improvement on 1 tablet of addrafinil (Olmifon).
Thanks, I have something new to play with.
Posted by Seamus2 on January 11, 2002, at 19:08:32
In reply to Re: Old man winter » IsoM, posted by mr.scott on January 11, 2002, at 10:25:40
I had some lying around and took a tablet, and I'd swear I felt some stimulation/motivation after just one dose as well.
I'm on my fourth week of Parnate, so there may be some synergism going on.
Will give it a full trial when my ship comes in.
Thanks IsoM!
Seamus
> Hello IsoM,
>
> I took it this morning, and I like it a lot allready. I am still a bit tired, but I noticed a definate improvement on 1 tablet of addrafinil (Olmifon).
>
> Thanks, I have something new to play with.
Posted by noa on January 14, 2002, at 16:53:44
In reply to Re: Old man winter » mr.scott, posted by IsoM on January 10, 2002, at 14:51:29
> hi Scott.
I have chronic "double depression"--recurrent major episodes on top of chronic dysthymia. But one could say I have a "triple" depression in that I also have a seasonal pattern of worsening mood and increased sleepiness from autumn through midwinter. In college, my fall semesters were hard--junior and senior year I dropped courses down to part time, while in the spring I was able to complete full loads.
It doesn't always follow the pattern. Some of my worst depressions were in the spring or summer.
But over the years, it has become pretty obvious that at the very least my energy level has decressed with the waning daylight. Last year, I promised myself to get a light box for this fall/winter because of my mood being a bit lower and because of how hard it is to get out of bed in the morning.
I'm happy to say it works for me!
The problems with it are finding times to sit in front of it, given my schedule. I've managed ok, with the one regular size box, but I just ordered a desk lamp version for my desk at work, where I have no window in my office. I am hoping that will allow me more options of when to use the light (right now I am using the light box in the very very early morning, since I have to be at work by 7:30 am). I also bought a dawn simulator to wake up to.
What I wish is that my gym would have light boxes on wheeled stands so that I could have the light box treatment at the same time as doing the eliptical or treadmill exercisers! Actually, the desk lamp I just bought allows the light part to detach as a portable/travel version. Maybe I can take it to the gym (just have to find a plug near the excercise machines). Someday, maybe the excercise machines will come with light treatment attached!
Posted by Mr. Scott on January 14, 2002, at 19:07:37
In reply to Re: Old man winter, posted by noa on January 14, 2002, at 16:53:44
The light really works? I was going to order the one for my desk at work. It sounds like it might be a good idea after reading your post. What if any meds do you take to help?
Thanks,
Scott
Posted by IsoM on January 14, 2002, at 19:55:10
In reply to Re: Old man winter, posted by noa on January 14, 2002, at 16:53:44
noa, I don't know whether you know this or even how effective it is, but there are light visors made. They're light-weight & you can wear them as you move about your work. That 'may' be a better option than a work light.
Posted by noa on January 15, 2002, at 19:36:13
In reply to Re: Old man winter » noa, posted by Mr. Scott on January 14, 2002, at 19:07:37
> What if any meds do you take to help?
>
My cocktail is:Effexor XR 262.5
Serzone 500
Adderall 10 3x dayplus:
synthroid
cytomel
(for depression and hypothyroid)and:
ativan .25 mg at night for sleep
Posted by noa on January 15, 2002, at 19:38:44
In reply to Re: wearable light therapy » noa, posted by IsoM on January 14, 2002, at 19:55:10
Yes, thanks. I know about the visors, but they are really expensive and I've read mixed reviews about the amount of wearing time needed for them to be effective. They would be a good option for at they gym, too.
Posted by Mr. Scott on January 15, 2002, at 22:22:24
In reply to Re: Old man winter, posted by noa on January 15, 2002, at 19:36:13
What if any side effects does this combo give you?
..If you don't mind me asking that is..
Scott
Posted by petters on January 16, 2002, at 1:27:09
In reply to Re: Old man winter, posted by noa on January 15, 2002, at 19:36:13
> > What if any meds do you take to help?
> >
> My cocktail is:
>
> Effexor XR 262.5
> Serzone 500
> Adderall 10 3x day
>
> plus:
> synthroid
> cytomel
> (for depression and hypothyroid)
>
> and:
> ativan .25 mg at night for sleepHi Noa...
What about Serzone? Are you satisfied with it?
I am treating an refractary depression, and possible bipolar 2 disorder.
My currrent cocktail is:
T. Venlafaxine 300 mg
T. Litium 2+3 tab
T. Lamotrigin 100 mg
T. Mirtazepine 45 mg.I have had reccurent infections, sore throth, and think it si because the Remeron, despite normal serumtest (white bloodcells)
I would like to replace the Mirazepine, with another med with sedative properties. What do you think of Nefazodon? Or any other suggestion...
Sincerely.Petters.
Posted by noa on January 16, 2002, at 6:25:13
In reply to Re: Old man winter » noa, posted by Mr. Scott on January 15, 2002, at 22:22:24
I still get some restlessness from the effexor. The serzone and ativan help but don't eliminate it altogether.
Very tight jaws--I think it is from the effexor, but could also be the adderall. This causes occassional headache, but not severe headache.
I have some bladder/urinary problems--I think they are from the effexor (they began after I was on a significant dosage). One hypothesis suggested by another member of this board is that the serotonin activates the muscles so the bladder walls can't relax enough to fill up. So, I have frequent need to go, and urgency. Also, I've heard from one member of this board that the ureter muscles get activated by the serotonin, too.
Posted by noa on January 16, 2002, at 6:27:24
In reply to Re: Old man winter, posted by petters on January 16, 2002, at 1:27:09
Serzone has helped me a lot. It has added AD effect and provided the needed balance to Effexor's overactivating tendencies.
Starting it was a bit rough--for about 3-4 weeks, as I was titrating up. I felt groggy and uncoordinated as well as emotional. Then these initial effects wore off. It is definitely sedating for me, although not as intensely as trazodone was.
Posted by noa on January 16, 2002, at 6:28:28
In reply to Re: Old man winter, posted by petters on January 16, 2002, at 1:27:09
PS--But now I have the new liver concern to think about with Serzone!
Posted by IsoM on January 16, 2002, at 12:14:30
In reply to Re: Old man winter » Mr. Scott, posted by noa on January 16, 2002, at 6:25:13
Noa, I can't remember whether you take lithium or not. My son was on lithium for a long time to augment his other meds & it helped, but he started developing urinary/bladder problems. It got to the point where he was receiving signals that it was full & couldn't control it anymore. When se checked with the doctor, he said long-term lithium use can trigger this. When he stopped lithium, it cleared up.
Now this was just one doctor's opinion & I don't know how common this is, but seeing I've never seen lithium & bladder problems posted before, I thought I'd mention it.
Posted by IsoM on January 16, 2002, at 12:16:05
In reply to Re: Old man winter » Mr. Scott, posted by noa on January 16, 2002, at 6:25:13
Posted by Noa on January 16, 2002, at 18:28:05
In reply to Re: bladder/urinary problems » noa, posted by IsoM on January 16, 2002, at 12:14:30
I took lithium for a couple of months two years ago, as an augmentation agent for the ADs. It worked for a while, but then my depression worsened because the lithium exacerbated the hypothyroid, so I discontinued it. Later on, my endo said I could have continued it, just upped the thyroid doses.
Anyway, the bladder thing was worse on the lithium. I don't know if it was simply because on lithium, I was insatiably thirsty and drank tons, making me have to pee a lot more, combined with the inefficient bladder thing from the other meds, or whether the lithium itself caused more inefficiency or signal problems. It kind of felt like a combo--increased volume, and decreased signals. I remember thinking that the urge came on so unexpectedly and strongly, and I wouldn't have time to get to the bathroom.
This is the end of the thread.
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