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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 misty99 on February 27, 2002, at 9:00:57
Hi,
I wanted to pick up on the "How do you know you're feeling good" thread in which people described feeling so great and then having the med poop out.
Again, I had a similar experience - I had gotten to the point where the St. Johns Wort was working so great, I was doing so many things effortlessly, including boring tasks that are normally very hard for me as someone with LD/ADD. But the rug has been pulled out again as in spite of trying possible every trick in the book, the SJW refuses to work.
Anyway, how do you deal with the fact that you got to see what it is like for normal people before someone essentially told you that this is cruel joke? I guess if I had had several years of consistent brain chemistry, it would be one thing but that hasn't happened.
I know I am more fortunate than other people on this board but it still stinks, big time. Maybe I need to accept that brain upheaval is going to be a fact of life but somehow that doesn't seem like a good solution either. Anyway, if people can share what strategies have worked for them in similar situations, I would greatly appreciate it.
Misty
Posted by Ritch on February 27, 2002, at 9:52:13
In reply to Having the rug pulled out from under you, posted by misty99 on February 27, 2002, at 9:00:57
> Hi,
>
> I wanted to pick up on the "How do you know you're feeling good" thread in which people described feeling so great and then having the med poop out.
>
> Again, I had a similar experience - I had gotten to the point where the St. Johns Wort was working so great, I was doing so many things effortlessly, including boring tasks that are normally very hard for me as someone with LD/ADD. But the rug has been pulled out again as in spite of trying possible every trick in the book, the SJW refuses to work.
>
> Anyway, how do you deal with the fact that you got to see what it is like for normal people before someone essentially told you that this is cruel joke? I guess if I had had several years of consistent brain chemistry, it would be one thing but that hasn't happened.
>
> I know I am more fortunate than other people on this board but it still stinks, big time. Maybe I need to accept that brain upheaval is going to be a fact of life but somehow that doesn't seem like a good solution either. Anyway, if people can share what strategies have worked for them in similar situations, I would greatly appreciate it.
>
> MistyHi Misty,
Do your depressions have a cyclic nature? There are unipolar depressives that have a cyclic nature to their recurring depressions. If you have seasonal depression that is a good example. If this is just part of a *cycle* it might just be you need to up the meds or tweak them somehow to become responsive again. I have seasonal bipolarII which requires med changes throughout the year. Sometimes it just turns into a waiting game for the remission. In my case it turns from having the rug pulled out from under you to a *magic* carpet ride you hadn't planned on.
Mitch
Posted by misty99 on February 27, 2002, at 15:20:13
In reply to Re: Having the rug pulled out from under you » misty99, posted by Ritch on February 27, 2002, at 9:52:13
> I have seasonal bipolarII which requires med changes throughout the year. Sometimes it just turns into a waiting game for the remission. In my case it turns from having the rug pulled out from under you to a *magic* carpet ride you hadn't planned on.
>
Mitch,I am curious, what is seasonal bipolarII? It seems there are alot more subtypes of bipolar than the experts initially thought and it's hard to keep track of them.
To answer your question, here is what happens. Just like what happened with Prozac, I got to the point with St. Johns Wort where a certain dose was too low and if you raised it to the next level,it's too high. I don't think it's cyclical or anything like that but it's like my body is just not cooperating with the antidepressant.
What is happening right now as I have to have a four day washout period before starting Luvox, I am actually not depressed but am feeling the withdrawal symptoms from the SJW. In the past, when that particular med was completely out of my body, then I would feel the depression return in full force even if there was nothing for me to be depressed about. I don't think my depression was initially atypical so I don't know how to explain that.
I am not sure I have answered your question so if I haven't, please forgive me. As an aside, I also take Adderall and Remeron for sleep.
Thanks for responding Mitch.
Misty
Posted by BarbaraCat on February 27, 2002, at 17:04:28
In reply to Having the rug pulled out from under you, posted by misty99 on February 27, 2002, at 9:00:57
Hi Misty,
I think I can claim the dubious title of 'Poop-Out Postergirl". I've had various responses from SSRI's and other analogs, but when they did at last work -hallelujah - I felt like I'd entered Oz when they turn on the color. Then after a few months it would start to fizzle and I'd take more and more of the stuff until I was twitching like a person with bedbugs and STILL depressed. I've tried SJW also - all of them - and same thing. Finally, after reading these posts here over a few months, I realized I had symptoms of bipolar II, primarily from the reaction of my meds. My pdoc prescribed lithium (I'm up to 300 mg and may go highter) and daily clonazapam for anxiety. These seem to boost the effect of my current and favorite AD, Remeron. None of these meds alone works but taken together they accentuate each other.Whenever I hear about consistent poop-out, I now think 'biplolar II'. Run it by your shrink, as there may be other mood stabilizers that would be better for you than lithium. - Barbara
> Hi,
>
> I wanted to pick up on the "How do you know you're feeling good" thread in which people described feeling so great and then having the med poop out.
>
> Again, I had a similar experience - I had gotten to the point where the St. Johns Wort was working so great, I was doing so many things effortlessly, including boring tasks that are normally very hard for me as someone with LD/ADD. But the rug has been pulled out again as in spite of trying possible every trick in the book, the SJW refuses to work.
>
> Anyway, how do you deal with the fact that you got to see what it is like for normal people before someone essentially told you that this is cruel joke? I guess if I had had several years of consistent brain chemistry, it would be one thing but that hasn't happened.
>
> I know I am more fortunate than other people on this board but it still stinks, big time. Maybe I need to accept that brain upheaval is going to be a fact of life but somehow that doesn't seem like a good solution either. Anyway, if people can share what strategies have worked for them in similar situations, I would greatly appreciate it.
>
> Misty
Posted by misty99 on February 27, 2002, at 21:00:12
In reply to Re: Having the rug pulled out from under you » misty99, posted by BarbaraCat on February 27, 2002, at 17:04:28
Barbara,
Thank you so much for your post. I have wondered about that for quite awhile but I don't seem to quite fit bipolar II so I never follow up.
However, on a related note, I took the Dr. Amen subtests today and one of them, temporal lobe issues, which ironically mentions some of my LD stuff, responds best to mood stabalizers.
I will definately call my psychiatrist tomorrow to see what he thinks.
I'll do a search on google for bipolar II. But if you know a site that you think would be helpful, I would sure appreciate it.
Thanks again, Barbara.
Misty
Posted by Ritch on February 28, 2002, at 0:15:16
In reply to Re: Having the rug pulled out from under you, posted by misty99 on February 27, 2002, at 15:20:13
> > I have seasonal bipolarII which requires med changes throughout the year. Sometimes it just turns into a waiting game for the remission. In my case it turns from having the rug pulled out from under you to a *magic* carpet ride you hadn't planned on.
> >
> Mitch,
>
> I am curious, what is seasonal bipolarII? It seems there are alot more subtypes of bipolar than the experts initially thought and it's hard to keep track of them.
>
> To answer your question, here is what happens. Just like what happened with Prozac, I got to the point with St. Johns Wort where a certain dose was too low and if you raised it to the next level,it's too high. I don't think it's cyclical or anything like that but it's like my body is just not cooperating with the antidepressant.
>
> What is happening right now as I have to have a four day washout period before starting Luvox, I am actually not depressed but am feeling the withdrawal symptoms from the SJW. In the past, when that particular med was completely out of my body, then I would feel the depression return in full force even if there was nothing for me to be depressed about. I don't think my depression was initially atypical so I don't know how to explain that.
>
> I am not sure I have answered your question so if I haven't, please forgive me. As an aside, I also take Adderall and Remeron for sleep.
>
> Thanks for responding Mitch.
>
> MistyHi Misty,
When I said "Seasonal BPII"-all that means is that the mood cycling is relatively predictable from year to year depending on what season it is.
Your response about the Prozac being either "too low" or "too high" sounds a little like my experience with antidepressants and how they relate to a "mixed" mood state. I feel like the "envelope" gets inverted and there is no place that works, and no place where I can tolerate the med. I've got ADHD and BPII and Adderall worked to dampen cycling, but only when I was taking it without an antidepressant. In your post to BarbaraCat you talk about temporal lobe "issues" when you took the ADHD test. That is very similar to my results. That is the trouble with the meds available now for folks that have mixed BP/ADHD symptoms. A standard pstim may help a lot with a few major symptoms, but make others worse. A standard "mood stabilizer" may help with one symptom cluster, but make others worse, etc. etc.
Mitch
Posted by JohnX2 on February 28, 2002, at 2:09:22
In reply to Having the rug pulled out from under you, posted by misty99 on February 27, 2002, at 9:00:57
I'm bipolar II and I've had the rug pulled out
from under me on every medicine except for LAMICTAL.
Lamictal can be used to treat unipolar depression to.
Why don't you give it a consideration. Its very
popular for bipolar.-John
> Hi,
>
> I wanted to pick up on the "How do you know you're feeling good" thread in which people described feeling so great and then having the med poop out.
>
> Again, I had a similar experience - I had gotten to the point where the St. Johns Wort was working so great, I was doing so many things effortlessly, including boring tasks that are normally very hard for me as someone with LD/ADD. But the rug has been pulled out again as in spite of trying possible every trick in the book, the SJW refuses to work.
>
> Anyway, how do you deal with the fact that you got to see what it is like for normal people before someone essentially told you that this is cruel joke? I guess if I had had several years of consistent brain chemistry, it would be one thing but that hasn't happened.
>
> I know I am more fortunate than other people on this board but it still stinks, big time. Maybe I need to accept that brain upheaval is going to be a fact of life but somehow that doesn't seem like a good solution either. Anyway, if people can share what strategies have worked for them in similar situations, I would greatly appreciate it.
>
> Misty
Posted by pedr on February 28, 2002, at 8:29:34
In reply to Having the rug pulled out from under you, posted by misty99 on February 27, 2002, at 9:00:57
Mist,
I don't have suggestions re: your dx like the others but I do have a suggestion w.r.t. coping with the dismay and depression caused by having yet another crash.The way I see it is like this. When the crash happens, beliefs such as:
- this is unbearable, I can't take another dive like this
- this is not fair, I don't deserve thismay come in to play. That's how I think a lot of the time when I dive downwards. A better way to look at things, which helps you to recover quicker and be less upset and disturbed by a dive is to go:
- this is pretty horrible. But, I've borne it in the past and I can bear it again until I find a solution to my problem - I will not disintegrate and die.
- I *wan't* to be treated fairly but there is no law of nature that says this has to be the case. It's rotten that I have these crashes but things *could* be worse.Ok, this might sound like total "convince yourself things are ok" shite but when you really think about the two sets of beliefs, the second set are more accurate, logical and certainly more helpful, in that they help you to deal with really adverse situations such as poop-out. It's taken me a lot [years] of practice to *begin* accepting the second set as opposed to the first set.
Feel free to ignore this suggestion, I just thought I'd [very] briefly point out some techniques that I find are beginning to help me after years of practicing them.
Best wishes,
pete.
Posted by BarbaraCat on February 28, 2002, at 10:33:20
In reply to Re: Having the rug pulled out from under you » misty99, posted by Ritch on February 28, 2002, at 0:15:16
Ritch and Misty,
I relate to your post re mixed states, ADHD etc. Some questions: 1. How does lamictal differ from lithium, i.e., why choose one over the other? 2. where does ADD leave off and bipolar begin and vice versa? How do we know these are different states and not just different points on the continuum of one state?In my wild and crazy days, methamphetamine was my self medicating drug of choice and in large quantities would calm me down. However, any speedy substance now in normal quantities makes me feel restless and can tip me into a weepy anxiety state. When I'm in the throes of a panic episode, nothing helps except time. I wonder if those selfmedicating days overamped me and burned something out.
Reevaluating a patient to Bipolar II seems to be a popular trend recently since so many of us are treatment resistant. Only time will tell if these mood stabilizers continue to work and don't have their own poop out. I don't know what my condition is for certain (pdoc and I are playing drug roulette) and sure do wish they sold Dr. Amen's SPECT gizmos at Radio Shack. Barbara
> > > I have seasonal bipolarII which requires med changes throughout the year. Sometimes it just turns into a waiting game for the remission. In my case it turns from having the rug pulled out from under you to a *magic* carpet ride you hadn't planned on.
> > >
> > Mitch,
> >
> > I am curious, what is seasonal bipolarII? It seems there are alot more subtypes of bipolar than the experts initially thought and it's hard to keep track of them.
> >
> > To answer your question, here is what happens. Just like what happened with Prozac, I got to the point with St. Johns Wort where a certain dose was too low and if you raised it to the next level,it's too high. I don't think it's cyclical or anything like that but it's like my body is just not cooperating with the antidepressant.
> >
> > What is happening right now as I have to have a four day washout period before starting Luvox, I am actually not depressed but am feeling the withdrawal symptoms from the SJW. In the past, when that particular med was completely out of my body, then I would feel the depression return in full force even if there was nothing for me to be depressed about. I don't think my depression was initially atypical so I don't know how to explain that.
> >
> > I am not sure I have answered your question so if I haven't, please forgive me. As an aside, I also take Adderall and Remeron for sleep.
> >
> > Thanks for responding Mitch.
> >
> > Misty
>
> Hi Misty,
>
> When I said "Seasonal BPII"-all that means is that the mood cycling is relatively predictable from year to year depending on what season it is.
>
> Your response about the Prozac being either "too low" or "too high" sounds a little like my experience with antidepressants and how they relate to a "mixed" mood state. I feel like the "envelope" gets inverted and there is no place that works, and no place where I can tolerate the med. I've got ADHD and BPII and Adderall worked to dampen cycling, but only when I was taking it without an antidepressant. In your post to BarbaraCat you talk about temporal lobe "issues" when you took the ADHD test. That is very similar to my results. That is the trouble with the meds available now for folks that have mixed BP/ADHD symptoms. A standard pstim may help a lot with a few major symptoms, but make others worse. A standard "mood stabilizer" may help with one symptom cluster, but make others worse, etc. etc.
>
> Mitch
Posted by Ritch on February 28, 2002, at 11:49:11
In reply to Re: Having the rug pulled out from under you » Ritch, posted by BarbaraCat on February 28, 2002, at 10:33:20
> Ritch and Misty,
> I relate to your post re mixed states, ADHD etc. Some questions: 1. How does lamictal differ from lithium, i.e., why choose one over the other? 2. where does ADD leave off and bipolar begin and vice versa? How do we know these are different states and not just different points on the continuum of one state?
I haven't had any experience with Lamictal, but it is an anticonvulsant whereas Lithium lacks anticonvulsant activity. I think many would think that Lithium would be the stabilizer of choice if there was some psychosis, it is a more powerful antimanic agent than Lamictal, generally. If depression tends to predominate and there is rapid-cycling, probably Lamictal would be a better choice. I haven't heard of many bipolars on Lamictal monotherapy, usually it is combined with something else-Lithium, Topamax, Neurontin, etc. There are several on the board on Lamictal who could answer Lamictal questions more thoroughly.I really don't think bipolarII and ADHD are in a "sequence" of any kind. I think there are folks that are BP and have very prominent ADHD symptoms (primarily inattentiveness). I really think it is a comorbid condition. I have had ADHD probs since I started grade school. If you want to look at med responsiveness-I tried Adderall once (small dose) during a bipolar depressive episode and it *vanished* completely (and that was without any antidepressants). My rapid-cycling patterns also became very tough to pick out, my sleep quality and architecture improved greatly. That makes me wonder a lot whether I just have a quirky form of ADHD that is characterised by seasonal patterns, mood reactivity, lability, and GAD/OCD/SP/panic stuff. Or it is just a quirky form of bipolar that is ADHD predominant. My cycle lengths haven't changed for over 25 years. Nothing seems to be getting *worse* really. It is just a chronic, relatively predictable, that adversely impacts my ability to learn new things, listen to people, etc. It would be nice to just feel half-ass normal for a solid month-wow.
>
> In my wild and crazy days, methamphetamine was my self medicating drug of choice and in large quantities would calm me down. However, any speedy substance now in normal quantities makes me feel restless and can tip me into a weepy anxiety state. When I'm in the throes of a panic episode, nothing helps except time. I wonder if those selfmedicating days overamped me and burned something out.
>Hey, anything is possible. I do know there is NO way I can take a stimulant by itself (like people with plain ADHD can). It looks like polypharmacy for some time until something innovative comes along. I am not taking a pstim now (am on a pinch of Wellbutrin, though).
good luck,
Mitch
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