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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Sarahmarie on May 18, 2002, at 16:36:33
I have really been happy with the higher dose of Prozac over the last two weeks. It seems to be making such a big difference. However, today, I am really in a "funk" and I don't know whether its because of the medications or because I am so hung up on the fact that my therapist told me that I have BPD (see my posts on Psycho-Social Babble). Anyway, I am on the verge of tears, so I am going to take an Ativan and hope that helps-usually I don't have to take the Ativan this early in the day. I think I would find it very hard to deal with if the medications stopped working again. I have been doing great these past two weeks. Any suggestions?
SarahMarie
Posted by paulb on May 18, 2002, at 18:19:16
In reply to OKAY --NOW WHAT Am I being faced with med-failure?, posted by Sarahmarie on May 18, 2002, at 16:36:33
Im pleased to hear your doing well on a higher dose of Prozac. A higher dose of an antidepressant can be very effective and this is certainly true of Prozac. The reason I believe you may be in a flunk is because serotonin moves in cycles hence the reason your pdoc suggested you may be BP. Perhaps Pindolol would be beneficial as it would serotonin levels consistently high.
paulb
Posted by sid on May 18, 2002, at 20:08:42
In reply to OKAY --NOW WHAT Am I being faced with med-failure?, posted by Sarahmarie on May 18, 2002, at 16:36:33
Honey,
you need to be good to yourself. The BPD thing is hurting you; stop thinking about it. This therapist is the first one to discuss this with you. You don't think it's true in your case, that's what matters.How about tomorrow, you do something you like to do, something nice - read, go see a movie, cook something you haven't cooked in a while, whatever would make you fell good, and feel good about yourself. Don't let what the therapist said hurt you so much. You need to be stronger with your defense mechanism. Close your eyes and see the huge fence go up in your mind, that will separate you from all this. Enjoy tomorrow and heal from your depression. That's what the real problem is.
- sid
Posted by Sarahmarie on May 18, 2002, at 21:10:06
In reply to Re: OKAY --NOW WHAT Am I being faced with med-failure? » Sarahmarie, posted by sid on May 18, 2002, at 20:08:42
> Honey,
> you need to be good to yourself. The BPD thing is hurting you; stop thinking about it. This therapist is the first one to discuss this with you. You don't think it's true in your case, that's what matters.
>
> How about tomorrow, you do something you like to do, something nice - read, go see a movie, cook something you haven't cooked in a while, whatever would make you fell good, and feel good about yourself. Don't let what the therapist said hurt you so much. You need to be stronger with your defense mechanism. Close your eyes and see the huge fence go up in your mind, that will separate you from all this. Enjoy tomorrow and heal from your depression. That's what the real problem is.
>
> - sidThe Ativan helped although I ending up taking 3. I will try and do something nice for me tomorrow. Perhaps I can look for a belt to go with a dress I am making. And spend some time on making the dress -- which I have been wanting to do for two weeks now. Thank you for your kind words and support and encouragement. At least I am not crying my heart out right now. That should be a good thing. SarahMarie
Posted by Sarahmarie on May 19, 2002, at 9:45:00
In reply to Re: OKAY --NOW WHAT Am I being faced with med-failure? » Sarahmarie, posted by sid on May 18, 2002, at 20:08:42
Hi Sid,
Thank you so much for the encouraging words. I woke up this morning and decided that I would start sewing on a dress I have wanted to make for myself for several weeks. I went out yesterday and bought the buttons, these are fabric covered buttons that I make so they will match the dress. I'm not sure I will finish the dress today, however I will be able to come next weekend I have four days off.
I did go to a link for the Personality Disorder Test and according to the test I do not have Borderline Personality Disorder, however it correctly stated that I have Obsessive-Compulsive Disorder. I am feeling better today, although I really think the augmentation with the Ativan yesterday really helped.
I'll let you know how my sewing project comes out. I making a dress from a Vogue 1937 Vintage pattern. I am just a little fascinated with Vintage clothing. Thanks again for your kind words. SarahMarie
Posted by sid on May 19, 2002, at 20:12:54
In reply to Re: OKAY --NOW WHAT Am I being faced with med-failure? » sid, posted by Sarahmarie on May 19, 2002, at 9:45:00
I hope your day went well. Keep it up!
- sid
Posted by Sarahmarie on May 19, 2002, at 21:27:52
In reply to Good for you » Sarahmarie, posted by sid on May 19, 2002, at 20:12:54
> I hope your day went well. Keep it up!
>
> - sidI finished cutting out the dress and have marked it for the sewing lines. My day was pleasant. Thank you.
SarahMarie
Posted by BarbaraCat on May 23, 2002, at 21:59:13
In reply to OKAY --NOW WHAT Am I being faced with med-failure?, posted by Sarahmarie on May 18, 2002, at 16:36:33
SaraMarie,
Are you taking anything for the BPD thing? That turned out to be my dx after lo these 20 years as a former unipolar med-resistant depressive. I know I've talked with you before, but don't remember if you're on a mood stabilizer. Lithium is my best friend these days and I'm SOOOO glad I now know that I'm BP-II and there's stuff that makes it go away. - BCat
Posted by Sarahmarie on May 23, 2002, at 22:34:49
In reply to Re: OKAY --NOW WHAT Am I being faced with med-failure? » Sarahmarie, posted by BarbaraCat on May 23, 2002, at 21:59:13
I am taking a very high dose of Prozac (180 mg per day), but I also take Lorazepam 3-4 per day and Trazadone 50 mg. at night. Does the Lorazepam qualify as a mood stabilizer -- I was thinking about asking my pdoc to augment the Prozac with wellbutrin -- not sure. Thank you for your concern.
Posted by BarbaraCat on May 24, 2002, at 0:05:02
In reply to Re: OKAY --NOW WHAT Am I being faced with med-failure? » BarbaraCat, posted by Sarahmarie on May 23, 2002, at 22:34:49
No, lorazepam is a benzo, an anti-anxiety med and is not a mood stabilizer. You're not taking anything that qualifies as such. Your 180mg of prozac is an amazingly high dose and it's pretty clear that this particular SSRI isn't doing the trick. Hopefully you will resist any suggestion that you raise it any higher.
Let me tell you a little of my own history, which may be similar to yours. I was a non-responder for 20 years. Horrible agitated depressions that were cyclic in nature, started in my youth and picked up steam in my 20's. Really ghastly - I don't know how I survived (and I hope I continue to describe them in the past tense). I started with the tricyclics, then went on to trazodone which helped alot but pooped out and made me very dopey. Then Prozac which made me hyper. Then on to Zoloft which worked very well for a while then pooped. Pdocs kept raising the dose until I was at 300 mg with a pinch of Wellbutrin thrown in. That's a criminal dose, by the way, but they didn't have any other ideas what to do with me at the time.
After 4 years on this cocktail life still was unbearable - Oops, breakdown, hospital stay for two weeks. New drug - Celexa! Poop-out! Gee, (scratch-scratch) let's raise it some more! Wired, twitchy, depressed. No more, thank you very much. Then nothing for awhile except for vitamins and fish oil and I did OK til I crashed. Then onto Paxil which pooped within 2 months. Pdoc kept raising it and raising it and I practically went crazy on it. Was also taking lorezapam for the panic attacks. Got fed up and tapered off everything. Did OK for a year til I crashed again. Went on Remeron which worked great for 2 months then pooped. Pdoc kept raising it and and so on - you get the picture.
I was suicidally depressed this past winter and my current pdoc, one of the 8-10 psychiatrists I've seen, said 'well, you sure are a classic non-responder!' Duh!! And your point is??
I was in such despair, hurting all over from fibromyalgia on top of the depression, couldn't work and was desperately surfing the web for answers. That's when I came upon this site. It quickly became evident from reading other posts here that I displayed classic Bipolar II symptoms. I went to my pdoc and said 'Hey Doc, I think I'm Bipolar II'. He said, 'Well, you may be and even if you're not, lithium is a good way to augment your ineffective SSRI response'. So I started taking lithium (a mood stabilizer, one among many) and within 1 week I felt like God had heard my prayers at last.
Mood stabilizers act in a completely different way from SSRIs or any of the other meds you're on. Lithium, as one example, helps to make the neurons more permeable to serotonin and norephinephrine and also helps anxiety by allowing the GABA receptor system to work more effectively. It also has neuro-protective value in that it helps to generate new dendrites - it's like a good mineral or vitamin for the brain. People who are not depressed are taking small doses for it's supposed anti-anging benefits.
So I think I'm Bipolar II because of other things, but mainly it's a pretty good tipoff when SSRI's keep pooping out that Bipolar II should definitely be considered. Other mood stabilizers are Lamictal, Neurontin, Depakote, Tegretol, Risperdal, and more. So, I hope this has shed a little light on things. I don't want to criticize your health care since I don't know the whole story, but 180 mg of Prozac is way too much, and you're still feeling like hell. Good luck - BarbaraCat
> I am taking a very high dose of Prozac (180 mg per day), but I also take Lorazepam 3-4 per day and Trazadone 50 mg. at night. Does the Lorazepam qualify as a mood stabilizer -- I was thinking about asking my pdoc to augment the Prozac with wellbutrin -- not sure. Thank you for your concern.
Posted by Sarahmarie on May 26, 2002, at 23:58:03
In reply to Re: OKAY --NOW WHAT Am I being faced with med-failure? » Sarahmarie, posted by BarbaraCat on May 24, 2002, at 0:05:02
> No, lorazepam is a benzo, an anti-anxiety med and is not a mood stabilizer. You're not taking anything that qualifies as such. Your 180mg of prozac is an amazingly high dose and it's pretty clear that this particular SSRI isn't doing the trick. Hopefully you will resist any suggestion that you raise it any higher.
>
> Let me tell you a little of my own history, which may be similar to yours. I was a non-responder for 20 years. Horrible agitated depressions that were cyclic in nature, started in my youth and picked up steam in my 20's. Really ghastly - I don't know how I survived (and I hope I continue to describe them in the past tense). I started with the tricyclics, then went on to trazodone which helped alot but pooped out and made me very dopey. Then Prozac which made me hyper. Then on to Zoloft which worked very well for a while then pooped. Pdocs kept raising the dose until I was at 300 mg with a pinch of Wellbutrin thrown in. That's a criminal dose, by the way, but they didn't have any other ideas what to do with me at the time.
>
> After 4 years on this cocktail life still was unbearable - Oops, breakdown, hospital stay for two weeks. New drug - Celexa! Poop-out! Gee, (scratch-scratch) let's raise it some more! Wired, twitchy, depressed. No more, thank you very much. Then nothing for awhile except for vitamins and fish oil and I did OK til I crashed. Then onto Paxil which pooped within 2 months. Pdoc kept raising it and raising it and I practically went crazy on it. Was also taking lorezapam for the panic attacks. Got fed up and tapered off everything. Did OK for a year til I crashed again. Went on Remeron which worked great for 2 months then pooped. Pdoc kept raising it and and so on - you get the picture.
>
> I was suicidally depressed this past winter and my current pdoc, one of the 8-10 psychiatrists I've seen, said 'well, you sure are a classic non-responder!' Duh!! And your point is??
>
> I was in such despair, hurting all over from fibromyalgia on top of the depression, couldn't work and was desperately surfing the web for answers. That's when I came upon this site. It quickly became evident from reading other posts here that I displayed classic Bipolar II symptoms. I went to my pdoc and said 'Hey Doc, I think I'm Bipolar II'. He said, 'Well, you may be and even if you're not, lithium is a good way to augment your ineffective SSRI response'. So I started taking lithium (a mood stabilizer, one among many) and within 1 week I felt like God had heard my prayers at last.
>
> Mood stabilizers act in a completely different way from SSRIs or any of the other meds you're on. Lithium, as one example, helps to make the neurons more permeable to serotonin and norephinephrine and also helps anxiety by allowing the GABA receptor system to work more effectively. It also has neuro-protective value in that it helps to generate new dendrites - it's like a good mineral or vitamin for the brain. People who are not depressed are taking small doses for it's supposed anti-anging benefits.
>
> So I think I'm Bipolar II because of other things, but mainly it's a pretty good tipoff when SSRI's keep pooping out that Bipolar II should definitely be considered. Other mood stabilizers are Lamictal, Neurontin, Depakote, Tegretol, Risperdal, and more. So, I hope this has shed a little light on things. I don't want to criticize your health care since I don't know the whole story, but 180 mg of Prozac is way too much, and you're still feeling like hell. Good luck - BarbaraCat
>
> > I am taking a very high dose of Prozac (180 mg per day), but I also take Lorazepam 3-4 per day and Trazadone 50 mg. at night. Does the Lorazepam qualify as a mood stabilizer -- I was thinking about asking my pdoc to augment the Prozac with wellbutrin -- not sure. Thank you for your concern.I have been in treatment for a about 10 years. And I have been labeled with "treatment resistant depression", among other things. When I met with my therapist on Thursday, we talked a lot about my diagnosis. She says that on the Axis I diagnosis I have Major Depression and OCD, however on the Axis II Diagnosis she considers me to be Borderline Personality Disorder.
She also indicated that there is crossover between Borderline Personality Disorder and Bipolar II.
I have never experienced "rapid cycling" (to my knowledge; However, I would like to know what is really wrong with me. I am very unhappy about the possibility of Borderline Personality Disorder -- and I am not sure of my attitude towards Bipolar II. I know that I have been tried on Depakote -- they said due to my severe migraines. They stopped the Depakote due to side effects. My pdoc thinks that I am a fast metabolizer and that is why they increased the Prozac dose to 180 mg. There have been Pdocs prescribe dosages as high as 200mg (Dr. Ivan Goldberg's site)and this last jump from 160 mg. to 180 mg. seems to have helped the depression and the OCD dramatically. I am willing to go to 200 mg of Prozac if necessary in case I relapse again, but not beyond that.
I am just concerned that if I do have Borderline Personality Disorder -- that this diagnosis is a very grim one--- it is hard to accept and I am not sure if it is accurate.
They also have to use higher than normal doses on other medications for me like thyroid hormone and estrogen. When my migraines are so bad that I can't get any control with a prescription med (Fiorcet with codeine) then I have to go the E.R. and they give me 150 mg. Demerol plus 100 mg Vistaril. Unfortunately, I am allergic to Imitrex which is a very popular migraine medication -- I go into cardiac arrest.
I guess bottome line, I just really want to know what is wrong and get the right medicine to help. I kept myself busy this weekend and I my depression is under control -- however, I am finding that I just have moments when I could cry and today I slept most of the day. I hope my meds aren't pooping. Thanks for your support and help. I am sorry this is so long. SarahMarie
Posted by BarbaraCat on May 27, 2002, at 1:14:14
In reply to Re: OKAY --NOW WHAT Am I being faced with med-failure? » BarbaraCat, posted by Sarahmarie on May 26, 2002, at 23:58:03
SarahMarie,
Well, all this diagnosis stuff is pretty much like the word 'Jazz'. It's just a word, but very inept at describing the many shades, colors, and moods of the many faces of jazz music. You get something that doesn't fit neatly into a standard genre of music and it gets lumped into 'jazz'. There are so many flavors of mood disorders that our poor docs don't know how to get a handle on them.I was horrified at first when I realized that I was Bipolar II, instead of just severely depressed. I mean, Egads - lithium! That label doesn't feel exactly right either, even though the drug works. I only know that all of us here on this board have something that cannot be dismissed with a name. Perhaps it boils down to being extremely sensitive and exhausted and freaked out by how brutal life can be. Unfortunately, insurance companies don't cotton to 'Life Sucks' as a valid diagnostic label.
I wouldn't worry about the Borderline diagnosis. If it means anything, you don't strike me as Borderline Personality at all. But if it makes your pdocs more comfortable, then let them sit with it until it looks like some other disorder du jour. Then they'll diagnose you with that. Don't fret about it - it's just a word and does not describe you or your soul. As long as the meds work, call it whatever. Look on the bright side, at least you're exquistely complex! - Barbara
Posted by Sarahmarie on May 27, 2002, at 8:52:08
In reply to Jazz » Sarahmarie, posted by BarbaraCat on May 27, 2002, at 1:14:14
Thanks Barbaracat, I am going to try and focus on other things today and not think about the diagnosis. i appreciate the support of others fromthis board so much and thak you foryour encouraging words. I will keep you posted.
SarahMarie
Posted by Leighwit on May 29, 2002, at 16:25:13
In reply to Jazz » Sarahmarie, posted by BarbaraCat on May 27, 2002, at 1:14:14
Wow Barbara,
While there are always many helpful posts on this board at any given time, some will resonate better than others with each of us.
When reading yours, I am always in awe; amazed that someone else has observations, experiences, and emotions that so closely resemble my own. I'm sure a large number of people here think the same thing. You're a gifted writer and can reach into places that some of us thought we possessed exclusively ~ only to find that the ugliness isn't quite as impermeable as we'd imagined.
Long before I became depressed, I would always cry at the lyrics to "Vincent" (the song about Vincent Van Gogh.) Do you know it?
I'm not sure what symptoms you experienced other than the non-responsiveness to the SSRIs and other AD drugs, that led you to conclude you are BP II. I searched through previous threads but couldn't find where you might have listed them. Would you mind sharing those symptoms again?
I've started the Lamictal last night and am hopeful this will be the start of something better. I get so angry and agitated at times that I fear I'm giving myself heart disease (which is typically a high risk complication from Type I juvenile-onset diabetes anyway.) I'm tired of being angry AND depressed.
I read recently that Bipolar is progressive. Now that's a scary thought. Tell me it isn't so....
I have two of three siblings in my family who have (or had - one commited suicide) schizophrenia. As a result, I've always thought I was lucky to be diabetic. Better to need insulin than to hear voices. Now in my mid-forties, I still think I'm lucky to "just" have major depression (or maybe bipolar II) and diabetes.If, however, BP II is "progressive", I'm wondering what that means for my luck holding...
Laurie
PS ~ Apologies for the melodrama ~ but it felt good to get that one off my chest! Guess some anxiety is surfacing too....
> Well, all this diagnosis stuff is pretty much like the word 'Jazz'. It's just a word, but very inept at describing the many shades, colors, and moods of the many faces of jazz music. You get something that doesn't fit neatly into a standard genre of music and it gets lumped into 'jazz'. There are so many flavors of mood disorders that our poor docs don't know how to get a handle on them.
>
> I was horrified at first when I realized that I was Bipolar II, instead of just severely depressed. I mean, Egads - lithium! That label doesn't feel exactly right either, even though the drug works. I only know that all of us here on this board have something that cannot be dismissed with a name. Perhaps it boils down to being extremely sensitive and exhausted and freaked out by how brutal life can be. Unfortunately, insurance companies don't cotton to 'Life Sucks' as a valid diagnostic label.
>
> I wouldn't worry about the Borderline diagnosis. If it means anything, you don't strike me as Borderline Personality at all. But if it makes your pdocs more comfortable, then let them sit with it until it looks like some other disorder du jour. Then they'll diagnose you with that. Don't fret about it - it's just a word and does not describe you or your soul. As long as the meds work, call it whatever. Look on the bright side, at least you're exquistely complex! - Barbara
Posted by BarbaraCat on May 29, 2002, at 16:57:15
In reply to Re: Jazz » BarbaraCat, posted by Leighwit on May 29, 2002, at 16:25:13
Laurie,
Thanks so much for your post. It couldn't have come at a better time as I'm having a very rough time today and feeling pretty discouraged. It always seems to be about money and survival. I'm not able to work right now and am supposed to be 'healing' since I've also got fibromyalgia (or so I think - who knows). My husband is also out of work and we're squeaking by financially and of course the bills don't stop and the kitty had a big vet bill and we can't pay our mortgage and yada yada. So 'healing' is pretty difficult when I'm always stressed out about the stinkin' survival issues, not being able to afford car or house or health insurance.So, the reason I think I'm BP2 is because of the classic response pattern with SSRIs and also because I've had some definite hypomanic episodes - not sleeping, starting many projects, spending alot of money (my garage literally could be a Michael's Craft Store. I do not exaggerate!), having sublime visions, and then crashing into black depressions. But then again, maybe those 'manias' were just me feeling darn good again after my cyclical depressions and making up for lost time. I have alot of anxiety and panic with the depressions which made me think that the mania and dysphoria were starting to merge.
But I'm no longer sure of the BP2 dx. It's also true that I've had a great deal of stress and extreme life events visited upon me, including a very abusive childhood. I learned very early to be hypervigilant and afraid. The anxiety I get with depression could be just that - anxiety in response to perceived and real danger in my life. I think the constant stress shoots my cortisol level way up and exacerbates my mood disorder, whatever it is. Lithium is definitely helping, but just in the last few days I'm starting to slip again. That's why Lamictal sounds promising. So your experience with it is very helpful, as is your cyber friendship. Thanks. Barbara
This is the end of the thread.
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