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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by amy_oz on September 15, 2002, at 20:52:56
Hi,
I'm new here, thanks for making this such a fantastic forum. I just wanted to share my story and ask a couple of questions.I live in Aussie and went home to New Zealand recently to visit the family. A few days before I was about to leave I got food poisoning and couldn't eat for a few days. I ended up making it to the dept. lounge and had a massive panic attack ( I didn't know what it was) and ended up in emergency. They said I was dehydrated and sent me home. Over the next few days I couldn't eat, sleep and started hyperventilating whenever I was left alone, tried to sit up or read. A visit to the doctor saw me sent home with tranqs. They helped but I was a bit freaked out about using them after some horror stories from my friends. Over the next few weeks I slowly managed to control the panic but it was replaced by an aching suicidal anger and loneliness which retriggered the panic attacks. I was rediagnosed with depression, started on 20 mg paroxetine (called Aropax here) and slowly stopped having the panic attacks and with the help of a very good psychologist realised I had been cycling in and out of anxiety/depression for 5 years.
Heres the weird bit. When I started the meds ( 6 weeks ago) I was ridiculously sad and was convinced that I would never be happy again. But after a week or so on Aropax I became convinced that the world was ending (don't ask), then I became convinced that there was no point to all life in general. After 6 weeks thats lessened a bit and I'm now back at work very part time but I can't help feeling extremely detached and surprised about my existance and the the world in general. I'm sick of it!!! I quite frankly want to go back to simply living (by the way my sister's answer is to find God, which is all well and good for her but not so good for an atheist, I can't just suddenly pretend that I believe in anything). Now I'm back in Australia and having trouble finding a good psychologist that isn't booked out until next year.I'm thinking about cutting down on the Aropax and picking up SAM-e and have also started ridiculous amounts of B vitamins and fish oil, meditation, exercise, good food and yoga. Any other suggestions?
Hope you are all having a good day,
Amy
Posted by Ritch on September 15, 2002, at 21:51:36
In reply to meaning to life, posted by amy_oz on September 15, 2002, at 20:52:56
> Hi,
> I'm new here, thanks for making this such a fantastic forum. I just wanted to share my story and ask a couple of questions.
>
> I live in Aussie and went home to New Zealand recently to visit the family. A few days before I was about to leave I got food poisoning and couldn't eat for a few days. I ended up making it to the dept. lounge and had a massive panic attack ( I didn't know what it was) and ended up in emergency. They said I was dehydrated and sent me home. Over the next few days I couldn't eat, sleep and started hyperventilating whenever I was left alone, tried to sit up or read. A visit to the doctor saw me sent home with tranqs. They helped but I was a bit freaked out about using them after some horror stories from my friends. Over the next few weeks I slowly managed to control the panic but it was replaced by an aching suicidal anger and loneliness which retriggered the panic attacks. I was rediagnosed with depression, started on 20 mg paroxetine (called Aropax here) and slowly stopped having the panic attacks and with the help of a very good psychologist realised I had been cycling in and out of anxiety/depression for 5 years.
> Heres the weird bit. When I started the meds ( 6 weeks ago) I was ridiculously sad and was convinced that I would never be happy again. But after a week or so on Aropax I became convinced that the world was ending (don't ask), then I became convinced that there was no point to all life in general. After 6 weeks thats lessened a bit and I'm now back at work very part time but I can't help feeling extremely detached and surprised about my existance and the the world in general. I'm sick of it!!! I quite frankly want to go back to simply living (by the way my sister's answer is to find God, which is all well and good for her but not so good for an atheist, I can't just suddenly pretend that I believe in anything). Now I'm back in Australia and having trouble finding a good psychologist that isn't booked out until next year.
>
> I'm thinking about cutting down on the Aropax and picking up SAM-e and have also started ridiculous amounts of B vitamins and fish oil, meditation, exercise, good food and yoga. Any other suggestions?
>
> Hope you are all having a good day,
> Amy
Amy,It sounds like everything you are doing is OK. I think all that happened to you with the paroxetine was the SSRI "apathy syndrome" most folks run into with those meds sometime or other. Look into CBT (cognitive-behavioural therapy), when you get a chance to see a psychologist, books in the meantime wouldn't hurt. Also meds like Klonopin, Ativan, or Xanax might be a better choice in the meantime if you have troubles with apathy and detachment from antidepressants.
Mitch
Posted by Roman on September 15, 2002, at 22:31:47
In reply to meaning to life, posted by amy_oz on September 15, 2002, at 20:52:56
Hi Amy,
It looks like you're on the right path to getting well. Here's some things I thought of while reading your post (they are all helpful to me):
1) Don't overdo the B vits, some can be toxic in excess. There's a great post on this board by IsoM suggesting proper supplementation--have a look.
2) Fish oil can be good, or it can be a problem. I found that it made me feel strange in large quantities--experiment.
3) Try and get at least one hour of sunlight a day. This made a huge difference for me. I try and stay in as much light as possible.
4) Drink lots of water--avoid caffeine and sugar.
5) Keep your mind on things that hold your interest. Reading, studying, playing an instrument, painting, etc.
6) Spend time with family and friends that make you feel good.
7) Get out of doors when ever possible. Especially if you can make it to a beach, park, or other nature-ish setting.
8) I found the best exercise for the mind is running. Something wonderful happens when we humans run free as we did aeons ago.
9) Listen to the music you love.
10) Stay on a regular schedule: wake, meals, bedtime, etc. Helps to regulate mind and body. Plan the week out in advance in a book or calendar--gives a solid sense of control.
11) While waiting to see a psychologist, you might visit a social worker or other counselor.
12) Watch comedy films--I found laughing to be great therapy.
13) Make some personal changes: new hairstyle, clothes, shoes. Day at the spa, massage, etc.
Hope this helps.
Good luck.
-Roman
Posted by Arthur Gibson on September 16, 2002, at 9:01:33
In reply to meaning to life, posted by amy_oz on September 15, 2002, at 20:52:56
Don't stop the PROZAC or whatever you call it without a doctor's advice, or your depression may return.
PROZAC often makes you worse before you get better.
Give yourself a few months to get over the depression. Get a new boyfirend or something.
Posted by joy on September 16, 2002, at 17:45:52
In reply to meaning to life, posted by amy_oz on September 15, 2002, at 20:52:56
I like the advice Roman gave you. Don't get frealed out taking a benzo. Xanax has been so helpful to me. SAM-E will do nothing for you. Stay on the Paxil [forgot what you call] until you see the doc. Detachment can be a good thing is you are too caring as I was; I needed that. It was the only way I could be 'on' and work during the day when I had to do that. I still take Xanax, but not very much. It does help for insomnia, and I usually only take it for that. I am off all antidepressants now, as I have destressed my life. Try to take it one day at a time. Wish you the best,
Joy
Posted by JonW on September 16, 2002, at 17:52:18
In reply to meaning to life, posted by amy_oz on September 15, 2002, at 20:52:56
Hi Amy,
It sucks that most anti-depressants take weeks to work, but it can be worth the wait. Please try to hang in there! SSRIs exert their full anti-anxiety effect slowly over time. One example of this is Aropax in particular for social phobia. The majority of clinical studies show many people being non-responders at week 6, but going on to be responders at week 12. Also, chronic depression/anxiety can take longer to respond so tough it out if you can. You may need a higher dose of Aropax or need to augment it with something else. You say you've been cycling in and out of depression for the last 5 years so you might want to be evaluated for bipolar disorder as well which would indicate mood stabilizers. My pdoc suggests treating the apathy caused by SSRIs with Mirapex (pramipexole), and I know I've read one abstract that talks about Provigil (modafinil) effectively treating the fatigue caused by anti-depressants.
Good Luck,
Jon
Posted by JonW on September 16, 2002, at 18:00:17
In reply to Re: meaning to life » amy_oz, posted by Roman on September 15, 2002, at 22:31:47
Posted by Mr.Scott on September 16, 2002, at 23:50:52
In reply to meaning to life, posted by amy_oz on September 15, 2002, at 20:52:56
My view...Consider it education or simply reject it
There is no meaning to life. Capitalistic narcotic band-aids may convince you otherwise for a while, or dampen your senses so you can return to employment or whatever societal responsibilities the world demands of you, but they will not restore any sense of meaning. That is unless the meaning in your life revolves around trying to extinguish nasty side affects like obesity and sexual dysfunction. Meaning if it exists is something you will find nowhere near the pharmacy and equally unlikely in a shrinks office. My suggestion is to accept that you're simply one of those people who can see the ugly underbelly of reality.
Sorry I cant be more uplifting.
Posted by butterbay on September 17, 2002, at 1:12:58
In reply to There is none » amy_oz, posted by Mr.Scott on September 16, 2002, at 23:50:52
i was so saddened at your response to her question. what is so terrible about life?
Posted by butterbay on September 17, 2002, at 1:22:21
In reply to meaning to life, posted by amy_oz on September 15, 2002, at 20:52:56
i have also been in that state of mind about life. i have major depressive disorder and also have had panic attacks. i take effexor and it helps both the depression and the anxiety. it sound like you are just on the wrong medication. i have heard that if you are not on the right medicne that it can indeed worsen your symptoms. is there an emergency psychiatric place near your home? if so, go there and tell them of your symptoms, if you can't get into a doctor any sooner. you don't want to waste your days away being depressed if you can get help sooner, right? life is wonderful and if you think back, i know you will remember times when you were so happy. you will find that again, just get on the right medicne, i would recommend effexor to anyone. as far as your sister's opinion, well that would also be mine. i believe in god very strong and have been blessed with receiving the holy ghost. that of course, is your right of whether or not to believe in god, but i will tell you this from personal experience, god will give you strength you never thought possible. anyways, i don't want to give you an unwanted lecture, i just want to let you know that life is wonderful and you need to get the right help and you will know that again. good luck!
Posted by JonW on September 17, 2002, at 7:33:41
In reply to There is none » amy_oz, posted by Mr.Scott on September 16, 2002, at 23:50:52
>office. My suggestion is to accept that you're simply one of those people who can see the ugly underbelly of reality.
Scott, are you OK? I know you've had one of the most difficult times here, but please, continue to hang in there and keep trying. While what you've written is very poetic, it sounds to me like you're looking at life through the fog of depression. I know, big surprise to you! :) But seriously, I wish I could give you hope. It should come in pill form... that way we could all have hope while we continue our search. However, if you've found happiness accepting your current situation, more power to you. It doesn't sound like you have, though. Don't give up, Scott... reality can change.
Jon
Posted by joy on September 17, 2002, at 8:27:02
In reply to There is none » amy_oz, posted by Mr.Scott on September 16, 2002, at 23:50:52
Mr. Scott, I was in the black hole a few years ago. Paxil helped me; and later Prozac with Xanax helped after trying many other ADs. I have a better life now; have destressed my surroundings, am not on medication except Xanax for insomnia now and rare anxiety. As a very last resort if you have tried everything possible for a number of years, would you think about ECT? I know it's helped some people but it is not an easy decision. I've felt the same way as you, and I do think reality and the world are very difficult for sensitive souls. I could not have made it without medication a few years ago, but things are much better now. They can be for you too. Try to be helpful somewhere where you are needed; Im sure you have more to give than you think, and it may help you with your depression. I wish you the best.
Joy
Posted by Eddie Sylvano on September 17, 2002, at 10:14:44
In reply to There is none » amy_oz, posted by Mr.Scott on September 16, 2002, at 23:50:52
> Sorry I cant be more uplifting.
This is an issue I've struggled with for a long time as well. I completely understand the author's viewpoint, in as much as there is indeed no objective point to life (a Sartre-esque "absurb joke"). Now, you can either dwell on that (and sink deeper into apathy) or refocus your attentions on the smaller realities of existance, like puffy clouds, running dogs, and Pop-Tarts. It's almost unfortunate that as human beings, we stand alone on the planet in realizing our mortality and ruminating on the nature of existance. For most people, no good comes of this. We're an evolutionary stone's throw from basic, reactionary animals, and not well equipped to deal with existential matters. 99% of the human experience has been simple: find food, reproduce, explore things, get along with other humans, etc. I imagine that we're most functional in that state. For that matter, I've often wondered if suicide rates are lower among peoples living in isolated, primitive conditions.
Anyway, the point is that if the nature of being is bothering you, you need to stop thinking about it. Train yourself to think more fundamentally about your enviroment, the people in it, and the things that give you pleasure. It's how most people live. For me, that has meant being more physically active (which forces you to think about what you're actively doing), talking to people more often (I've always been extremely shy), doing things I enjoy (listening to the new Flaming Lips album right now), and culturing compassion in general (doing what I can to alleviate the suffering of other people). Love for others helps a lot. We're all scared, lonely people people in a way, deep down, and we all need steady love and nurturing to get by. Loving others and being loved is the most obvious reason I can see for living.
Posted by amy_oz on September 17, 2002, at 18:34:18
In reply to Re: There is none, posted by Eddie Sylvano on September 17, 2002, at 10:14:44
Hi,
Thanks all for your replies its nice to know that theres some people out there that understand. I think that the thing that has scared me the most about my recent experiences is that I used to be passionate about life, just unbelievably sad. I think my anxiety/depression has a lot to do with a number of traumatic experiences over the last 5 years + SAD + an amazing genetic predisposition (80% mums side, 50% dads side, with a number permanently on medication). I've been struggling barely keeping my head above water, you know its ok to be sad right now, my best friend has died, or I have glandular fever, or I've just moved countries and don't know anyone yet....+ more etc.etc. Always the thought that I'll be happy in the future.....my crash came when things started going right (oh the irony) I was still ridiculously sad....then comes the thought that I'll never, ever, be happy..........Many years ago (before depression) i had the thought that there is no inherent meaning to life. I actually found it uplifting cause life suddenly becomes what you make it! I chose love, music, friends, family, creativity and science (I'm a science communicator for the National Science and Tech Centre in Australia).
I can remember having these thoughts and I think a little is now coming back but its so difficult to feel it when you're in a depressive state.
Thanks to all for pointing out that it could be partially the medication cause it gives me a weapon to fight back to my head with.I've finally managed to find a psychologist to see me soon (next week) and have seen my medical doctor who doesn't want me to switch just yet but will fast track me to a psychiatrist next month if I don't improve.
Cheers,
Amy
Posted by Mr.Scott on September 17, 2002, at 19:53:31
In reply to meaning to life, posted by amy_oz on September 15, 2002, at 20:52:56
Life has meaning...I'm just being a crotchety beast. It's nice to know people care about my well being. I never anticipated anyone even paying attention to that post let alone replying so emphatically about it. Anyways I apologize for intruding with my pessimism.
Be Well
Posted by johnlund on September 17, 2002, at 22:15:19
In reply to Maybe I Overstated my case, posted by Mr.Scott on September 17, 2002, at 19:53:31
For me the meaning in life is to win over depression. If at the end of my life, I haven't died by my own hand, and I have managed to love my family and friends, and have been considered by others to be a worthwhile person to know, then I consider my life to have meaning. I will have beaten the genetics that put all the bad chemistry in my brain.
However, I know I would have lost the battle if it were not for ADs. I wish I could have said I would have won on my own, but that would be a lie. I tried for many years on my own, and the depression only got worse. To the point were I was at the end of my rope. ADs were the helping hand I needed to give me a second chance at beating the depression. It is like I was pushing a big load up a hill, and I couldn't make it up the hill pushing the load only with my own strength, but I almost could. All I needed was a little help to add the force that I was exerting already, and am still exerting. It is not like I had to stop pushing, I just needed a little help so the load would not over power me and run me over when I gave up pushing.
Anyway, that is what the meaning of life is for me - to win the battle in my own brain.John
Posted by Ritch on September 17, 2002, at 23:59:32
In reply to Maybe I Overstated my case, posted by Mr.Scott on September 17, 2002, at 19:53:31
>
>
> Life has meaning...I'm just being a crotchety beast. It's nice to know people care about my well being. I never anticipated anyone even paying attention to that post let alone replying so emphatically about it. Anyways I apologize for intruding with my pessimism.
>
> Be Well
>
Hey Scott,Check out these links about duloxetine and sibutramine
http://www.acnp.org/sciweb/journal/Npp11300049/default.htm
http://www.psychotropical.com/note/850.htmAfter reading all of this, it seems that PLENTY of BACKDOOR activities must be going on with effective antidepressants that may have little to do with the touted "mechanisms of action" such as 5-HT, NE reuptake inhibition. That said, what is the true MOA of effective antidepressants, if not reuptake inhibition?? With those questions, there has got to be a mother lode of research POSSIBILITIES.
Mitch
Posted by Mr.Scott on September 18, 2002, at 0:24:09
In reply to Re: Maybe I Overstated my case » Mr.Scott, posted by Ritch on September 17, 2002, at 23:59:32
Mitch,
That is some pretty cool literture. Have you tried Sibutramine? And also are you still experimenting with amphetamine? I respond so well to stims it's like magic, but then they seem to peter out or agitate me...but since I have a test to study for I may need it as I can hardly think clearly anymore... Thanks for the information!
Scott
Posted by Ritch on September 18, 2002, at 9:42:38
In reply to Re: Maybe I Overstated my case » Ritch, posted by Mr.Scott on September 18, 2002, at 0:24:09
> Mitch,
>
> That is some pretty cool literture. Have you tried Sibutramine? And also are you still experimenting with amphetamine? I respond so well to stims it's like magic, but then they seem to peter out or agitate me...but since I have a test to study for I may need it as I can hardly think clearly anymore... Thanks for the information!
>
> ScottScott,
I am on Dep. 250mg + Klon. .25mg at bedtime, Effexor 12.5mg + Wellbutrin 18.75mg A.M., with a couple of Omega-3's during the day. The Depakote looks like a permanent fixture for me I think. I haven't had a serious temper spell since I started taking it again (for the last three months). I am certain 500mg would be better, but I don't want the weight back. I have been keeping it at bay with double the CV exercise I was doing before. Pdoc did write for some Adderall last time and on days that I have some real challenges at work I swap out the little WB with 2.5mg of Adderall, so I can work around distractions. It works OK the first few hours (I actually feel quite calmed), but then leaves me buzzy and restless later on. The calming first few hours feel just like dex, and that's why I think a single 5mg spansule would be much better (will talk about that next visit). I have never tried sibutramine. It is intriguing to me however, precisely *because* it flunked out of depression trials. IOW, I wonder if it would be a good med to help keep me awake, without making me hypomanic, so I could possibly do without WB,ADD, or Effexor. I have a strong hunch that I could get by on just Dep and T4, but that would be a big fuss to get started.
Mitch
This is the end of the thread.
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