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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by jaby on October 2, 2002, at 18:38:22
I am in a tough place right now because my problem (BP II) right now is bad enough to rule my life (ie. be the biggest factor influencing any decisions I make about my future), but at the same time I hold a full time job, can force myself to work out, etc. On the other hand though, I can't cook for myself, have trouble doing my laundry, never want to do anything, go anywhere, etc. I have had glimpses of the beautiful world the lucky live in (and I used to), but they have been very brief w/ meds pooping out.
My question is what you all think about ECT in this situation. My sister went catatonic from depression and is now studying abroad in Mexico most likely able to do so as a result of her ECT. My dr. says that he has done ECT on business people that haven't been terribly depressed. They have to take about 3 weeks off for the intensive period, but then have gone back to work happy with the results.
Anyhow, what do you guys think? I've done just about everything but an MAOI. Would you try that first? I'm just sick of all these trials that are possibly prolonging this long break from the giid (normal) life.
Posted by Phil on October 3, 2002, at 5:35:23
In reply to ECT for partial med responders?, posted by jaby on October 2, 2002, at 18:38:22
I have depression but otherwise we seem to be in a similar place. I've thought about ECT but haven't taken the step. My mom had success with it after quickly falling into a terrible depression.
There used to be a doc on here that said he would do ECT first! Don't hear that very often.
No advice to offer really but I get tired of partial responses to meds and would love to feel 100% or close. If I could take enough time for a good recovery afterwards before returning to work, I'd probably go for it.Phil
Posted by jaby on October 3, 2002, at 10:05:18
In reply to Re: ECT for partial med responders?, posted by Phil on October 3, 2002, at 5:35:23
I pretty much agree wholeheartedly. My dr. is very cautious about what he prescribes, doses he uses, etc. (seemingly too cautious sometimes), so I trust him when he says that it's a very safe procedure and one he would recommend. We have talked about it casually and he mentioned doing bifrontal 2x's/week for 3 weeks and then once/week thereafter for a few, then once a month, then maintenence meds. He says he thinks I would only be out of work for the initial 3 weeks and then could have my weekly's done on Fridays. He said it was fine to even try to work during the first three weeks, but didn't think I'd be real helpful.
Posted by Geezer on October 3, 2002, at 12:03:26
In reply to Re: ECT for partial med responders?, posted by jaby on October 3, 2002, at 10:05:18
jaby,
I am glad to read these comments from you and Phil. I am headed for ECT now. Have an apt on Oct 10 with my pdoc to arrange a schedule. I have always been a partial responder to meds. - my best result was with Prozac but poop out after 2 years. High doses of ADs, alone and in combination, have had no effect for the past 15 months.
A little family history. My mother had ECT back in the 50s, her sever Unipolar Depression was in "remission" for 15 years with no maintenance treatments and no meds. Her second set of treatments proved successful for 10 years under the same set of circumstances. Now at age 85 she is on very low does Depakote and in much better mental condition than I am at age 58. I have been researching (I have no experience of my own as yet), and I am beginning to wonder why ECT is not the first choice rather than the last resort, especially for those of us with TRD.
Wish you the best. I will report results when able.
Good cheer
Posted by jaby on October 3, 2002, at 13:32:17
In reply to Re: ECT for partial med responders? » jaby, posted by Geezer on October 3, 2002, at 12:03:26
Geezer,
So comforting to hear from you too. Here's my deal...my diagnosis has gone from GAD to GAD/dep to BP II. This dx has been arrived at looking at the classes of drugs that have worked best (mood stabilizers and AED's). I also never have any clearly manic episodes as it seem that lucky me has my mania expressed in the form of crippling anxiety.Anyhow, ECT brought my sister back from a catatonic state a few years ago that resulted from severe depression. the frustrating thing is that she is now better than me! For all intents and purposes she is cured (fingers crossed). My grandmother has had ECT in the past for depression and alcoholism and it worked well for her too. She still has issues, but I think they stem from abuse and the alcoholism, and the fact that she doesn't take much in the way of maintenence medication as far as I know.
Basically i'm sick of side effects and sick of living a half ass life. One could argue that i'm letting this illness get the best of me by not pursuing things that require monetary or career scrifices, but you seriously have to plan around the problem. I'm sure you can relate. Again I hold down a decent full time job, pay all my bills myself. I'm 26, highly motivated, intelligent individual with unlimited potential, but my illness holds me back for various reasons.
My next visit w/ the doc we are going to talk seriously about ECT-especially with a good time of year for the tax season approaching.
Can you tell me what meds you've tried. I wondering how exhaustive me list really is. I would also be so very greatful if you would keep me posted on your progress. What kind of ECT are you having? Anyhow, it would be great to hear from you before your first session, but if not I'll be sending you my best wishes.
Posted by Geezer on October 3, 2002, at 21:41:16
In reply to Re: ECT for partial med responders?Geezer, posted by jaby on October 3, 2002, at 13:32:17
jaby - will respond in AM - falling asleep at the board.
Cheers till then.
Geezer
Posted by Geezer on October 4, 2002, at 12:54:08
In reply to Re: ECT for partial med responders?Geezer, posted by jaby on October 3, 2002, at 13:32:17
Hi jaby,
Sorry for the delay in responding. RE: your DX - I have been the same route, first Unipolar Major Depression/Depressed/Melancholic (had an anxiety component at one time-that is gone now), next DX Bipolar II.....don't know if I ever had any kind of mania but when I was younger I was obsessively self-driven to succeed at my work, then would crash into deep depression (these self driven periods could last years with some depression mixed in but always resulted in a major crash and hospital admission). Now I am DXed back to Unipolar Major Depression, there is no mania, only refractory depression with sever tiredness (sleep 12 hours per day - only half awake when up). I have lost faith in a proper DX because they seem to be as subjective as the drug trials. We have to consider the changing nature of the illness with the passage of time, as well. I have been told "Bipolar II is mostly depression in later years", have also been told, "Bipolar Disorder DX can only be made when mania/hypomania is clearly documented".....more confusing now with 4 or 5 subtypes.
I am approaching ECT simply because I can't stand to live this way anymore and the drugs don't work. Good book.....Electroshock: Restoring the Mind by Dr. Max Fink, Oxford University Press, 1999. My new copy is on its way from Amazon.com.
What drugs have I been on?
All of the SSRIs....not Paxil or Lezapro.
Serzone, Remeron, Wellbutrin.....not Effexor
Geodon the only AP
Several of the TCAs...back in the 70s and 80s.
All of the MAOIs...many years ago, for brief periods, due to side effects.
History of abuse...alcohol (quit 1975), Valium (for 6 mos. quit 1984), Dexadrine (of and on quit 1985), smoking (quit 14 mos. ago).
AEDs...Lithium, Depakote, and Lamictal.
To a large degree my current treatment resistance may be do to my own noncompliance in earlier years and excessive stress from a 24/7 job in the medical industry. The illness itself is hereditary but I have made nearly ALL the mistakes along the way. Currently on full disability. I know what you mean about arranging time for treatment while honoring your employment responsibilities....an admirable character trait. However, I used my work as an excuse to avoid treatment until it almost killed me...don't mean to preach....illness can get worst with time if not treated properly.I am probably in violation of the posting policies again so my e-mail is whiteau@choice.net. Will try to keep you posted as I go.
Good cheer.
P.S. Dr. Bob, would you be so kind as to post a link for posting policies, I am a bit confused and can't find it.....honest!
Posted by Dr. Bob on October 4, 2002, at 18:03:18
In reply to Re: ECT for partial med responders?Geezer » jaby, posted by Geezer on October 4, 2002, at 12:54:08
> P.S. Dr. Bob, would you be so kind as to post a link for posting policies, I am a bit confused and can't find it.....honest!
If you mean the FAQ, it's at:
http://www.dr-bob.org/babble/faq.html
Bob
PS: Follow-ups regarding administrative issues should be redirected to Psycho-Babble Administration, thanks.
Posted by jaby on October 5, 2002, at 0:08:50
In reply to Re: ECT for partial med responders?Geezer » jaby, posted by Geezer on October 4, 2002, at 12:54:08
Well, we definitely have some significant similarities. I wasn't sure why you would have been in violation in your last message (maybe mentioning the book?). My messages are pretty benign here anyway so I haven't gotten in any trouble to know. I have the book and it's a good one. I can echo the using work as a means to not get the ECT. I have been using that as one of many. I just can't sit idle feeling like this while the world passes me by. Throughout my illness I have had some glimpses of the beautiful world I used to live in. The colors are brighter, my body is lighter, and life is just plain easier. Let's get there my man. Keep me posted and I'll do the same. I may not have anything new until I meet with my doc a week from Tuesday, but I might have something new to pester you about before then. Thanks.
Posted by jaby on October 5, 2002, at 0:12:49
In reply to Re: ECT for partial med responders?Geezer » jaby, posted by Geezer on October 4, 2002, at 12:54:08
Well, we definitely have some significant similarities. I wasn't sure why you would have been in violation in your last message (maybe mentioning the book?). My messages are pretty benign here anyway so I haven't gotten in any trouble to know. I have the book and it's a good one. I can echo the using work as a means to not get the ECT. I have been using that as one of many. I just can't sit idle feeling like this while the world passes me by. Throughout my illness I have had some glimpses of the beautiful world I used to live in. The colors are brighter, my body is lighter, and life is just plain easier. Let's get there my man. Keep me posted and I'll do the same. I may not have anything new until I meet with my doc a week from Tuesday, but I might have something new to pester you about before then. Thanks.
Posted by Chloe on October 5, 2002, at 12:45:25
In reply to Re: ECT for partial med responders?Geezer, posted by jaby on October 5, 2002, at 0:12:49
Jaby,
I am in the middle of a course of ECT. It has been incredibly helpful. I started with unilateral ECT that had very little effect on my memory at all. After about 5 treatments I switched to bilateral ECT because I was no longer having any improvemnt. Well, the bilateral is extremely effective! I have been receiving treatmtent for mental illness since age 11. I am now 36, and I am finally having some relief from the terrible depression, fury, irritablity and distorted thinking without devasting side effects. I have tried almost every med out there, and I most always experience adverse/atypical reactions. I will forever have TD or tongue movements in my mouth from use of typical ap's in the past....I feel truly blessed that my pdoc OK's this procedure, and the my insurance is covering it...since it is regarded as a medical procedure.
IMHO, ECT is extremely effective, and not very disruptive to one's life. The only drawback is that I am not supposed to drive for the duration of my treatments and maintanence treatments...But that is ok, since my coordination is just the teeeniest bit off. So it's probably better that I don't handle heavy machinery. And it's nice to have the increased socialbility from getting a ride...My memory is a bit more impaired with the bilateral. But it's not really troublesome. And frankly, I feel like it's a blessing to forget some things! It's easy enough to ask someone for a reminder. But I kinda enjoy having my mind emptied of it's troubles :)
Good luck to you
Chloe
Posted by jaby on October 6, 2002, at 22:09:01
In reply to Re: ECT for partial med responders? » jaby, posted by Chloe on October 5, 2002, at 12:45:25
Chloe,
I'm fairly certain I'm going with the ECT. It's tough though because I'm BPII and things are really up and down. When I'm up (never quite normal though) I ask myself why I'm considering such a suposedly invasive treatment. I know there is going to be a down side though too. Maybe getting it done while I'm feeling better is exactly what to do(?). I do think I will be a wreck going off meds (neurontin, lithium, lamictal, valium-all anti seizure), but it would be well worth it in the end. Having seen how irt almost literally brought my sister back from the dead is almost a sincher.If I were to do it it would be bifrontal two times a week for three weeks and then taper from there over a good period of time. My dr. says he thinks I will only need to miss work for the first three weeks. Does that sound right to you? I appreciate your input and am so happy things are working out so well.
Take care.> Jaby,
> I am in the middle of a course of ECT. It has been incredibly helpful. I started with unilateral ECT that had very little effect on my memory at all. After about 5 treatments I switched to bilateral ECT because I was no longer having any improvemnt. Well, the bilateral is extremely effective! I have been receiving treatmtent for mental illness since age 11. I am now 36, and I am finally having some relief from the terrible depression, fury, irritablity and distorted thinking without devasting side effects. I have tried almost every med out there, and I most always experience adverse/atypical reactions. I will forever have TD or tongue movements in my mouth from use of typical ap's in the past....
>
> I feel truly blessed that my pdoc OK's this procedure, and the my insurance is covering it...since it is regarded as a medical procedure.
> IMHO, ECT is extremely effective, and not very disruptive to one's life. The only drawback is that I am not supposed to drive for the duration of my treatments and maintanence treatments...But that is ok, since my coordination is just the teeeniest bit off. So it's probably better that I don't handle heavy machinery. And it's nice to have the increased socialbility from getting a ride...
>
> My memory is a bit more impaired with the bilateral. But it's not really troublesome. And frankly, I feel like it's a blessing to forget some things! It's easy enough to ask someone for a reminder. But I kinda enjoy having my mind emptied of it's troubles :)
>
> Good luck to you
> Chloe
Posted by Chloe on October 7, 2002, at 22:12:52
In reply to Re: ECT for partial med responders?Chloe, posted by jaby on October 6, 2002, at 22:09:01
> Chloe,
> I'm fairly certain I'm going with the ECT. It's tough though because I'm BPII and things are really up and down. When I'm up (never quite normal though) I ask myself why I'm considering such a suposedly invasive treatment. I know there is going to be a down side though too. Maybe getting it done while I'm feeling better is exactly what to do(?). I do think I will be a wreck going off meds (neurontin, lithium, lamictal, valium-all anti seizure), but it would be well worth it in the end. Having seen how irt almost literally brought my sister back from the dead is almost a sincher.Hi Jaby,
I know how difficult it is to decide about embarking on such a life altering treatment. And of course no one knows for sure how ECT will work for you. But having a family member who benefited would really put my mind at ease...I am BP2 as well, and I know it seems crazy to consider ECT with I was feeling on an up swing. But in hindsight, I am so glad I went for ECT. Because ECT doesn't just treat the depression...The shrinks are now trying to stabilize my brain. I have had about a week of very hypomania, the closest to mania I have ever had...but the edocs believe in treating through that. That ECT releases neurotransmitters in the brain. And the edocs want to find the right "mix" so I feel stabile and happy. Which is where I am starting to find myself. Phew. It's nice to finally come down. But I still feel very optimistic and positive :).
You mentioned you are on alot of mood stablizers. Well, I was on depakote, neurontin, lithium and valium. It was really tough coming off the neurontin. My body ached and ached. I still kinda miss that one. Don't miss the depakote. I still take lithium, I just don't take it the night before ECT, and take it immediately when I get home. And I am on 10 mgs of valium with no problem with my treatment. I think you can be on an equivalent of 3 mgs of Ativan with no interference of the seizure. I would taper the mood stabilizers slowly. Going off meds can be extremely destabilizing and make you feel lousy and unsafe...So be careful.
> If I were to do it it would be bifrontal two times a week for three weeks and then taper from there over a good period of time. My dr. says he thinks I will only need to miss work for the first three weeks. Does that sound right to you? I appreciate your input and am so happy things are working out so well.The edocs do not use bifrontal at my hospital, only bilateral. I have heard bifrontal is slightly less traumatic to the memory...If this is so, you would easily be able to go back to work once you are down to one treatment a week.(Is two per week enough during the initial phase of treatment? I always had three. You might want to ask your pdoc about that.) Just be forwarned...that you may be a bit of a "spaceshot." I am on once a week maintanance treatments, and I find I don't always know what is going on, or know what is being talked about. But I quickly catch up when I am given a hint or clue as to the topic of conversation...I find if I am introduced to someone, if I don't write down the name, I immediately forget it...Things like that...You will just have to work a little bit harder to remember or follow along. But your mood should be so improved, forgetting things can be amusing!
I saw my pdoc today and I asked her why should we continue if my mood has evened out now and I feel good. She said one should never quickly discontinue ECT or any medication that causes a release of neurotransmitters in the brain...So once a week for me for a while I guess. But finally, a therapy that actually works. I feel blessed.
I hope you try ECT, Jaby. ECT is scary, but so is living with an unstabile mood. There is hope out there...I hope you try it. And BTW, thank you for telling me about your sister's experience with the numb face. My edoc and pdoc had never heard of it. It made me feel releaved that I wasn't alone or crazy! Thank you so much and good luck with your decision. Feel free to ask more Q's if you need to...
Chloe
>
>
>
> > Jaby,
> > I am in the middle of a course of ECT. It has been incredibly helpful. I started with unilateral ECT that had very little effect on my memory at all. After about 5 treatments I switched to bilateral ECT because I was no longer having any improvemnt. Well, the bilateral is extremely effective! I have been receiving treatmtent for mental illness since age 11. I am now 36, and I am finally having some relief from the terrible depression, fury, irritablity and distorted thinking without devasting side effects. I have tried almost every med out there, and I most always experience adverse/atypical reactions. I will forever have TD or tongue movements in my mouth from use of typical ap's in the past....
> >
> > I feel truly blessed that my pdoc OK's this procedure, and the my insurance is covering it...since it is regarded as a medical procedure.
> > IMHO, ECT is extremely effective, and not very disruptive to one's life. The only drawback is that I am not supposed to drive for the duration of my treatments and maintanence treatments...But that is ok, since my coordination is just the teeeniest bit off. So it's probably better that I don't handle heavy machinery. And it's nice to have the increased socialbility from getting a ride...
> >
> > My memory is a bit more impaired with the bilateral. But it's not really troublesome. And frankly, I feel like it's a blessing to forget some things! It's easy enough to ask someone for a reminder. But I kinda enjoy having my mind emptied of it's troubles :)
> >
> > Good luck to you
> > Chloe
>
>
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