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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Theresa Rae on January 21, 2003, at 12:56:03
I wasn't sure if I was supposed to post in last week's section (since that was my first posting to the list). I had mentioned my atypical depressive husband and my attempts to maybe see if he could be taking something else...in reply to some of the previous questions:
Husband has taken Prozac (LOTS AND LOTS at first), then Celexa for a while, and now Effexor, which I think isn't really doing the job. He slept 12+ hours again on Saturday night/Sunday, and then at 2:45 this morning I woke up to get a drink for one of our sons who was coughing and found Husband playing video games.
He does not have sleep apnea (although he will occasionally snore, it's not the kind of snoring that accompanies apnea.
He really is a very nice man, extremely intelligent, and so so low on self-esteem. Depression runs in his family, unfortunately, and when we both were younger, I had no idea that he was depressed (thought he was a jerk, thought he didn't like me, thought he was lazy, thought he was childish, thought I had unrealistic expectations...).
I have two questions, then:
What does anyone with knowlege about atypical think about MAOI's (which are usually recommended for this type of depression)?
And, what does the rest of my life look like living with an atypical? I promised Husband, God, my family and friends that I would stick around through sickness and health; I intend to do that. It is, though, a really difficult condition to live with on a daily basis (for both of us...I don't mean to downplay what he goes through every day), and I'm wondering how much better things could get...?
Posted by 2sense on January 21, 2003, at 20:02:18
In reply to my typical atypical spouse, posted by Theresa Rae on January 21, 2003, at 12:56:03
> I wasn't sure if I was supposed to post in last week's section (since that was my first posting to the list). I had mentioned my atypical depressive husband and my attempts to maybe see if he could be taking something else...in reply to some of the previous questions:
>
> Husband has taken Prozac (LOTS AND LOTS at first), then Celexa for a while, and now Effexor, which I think isn't really doing the job. He slept 12+ hours again on Saturday night/Sunday, and then at 2:45 this morning I woke up to get a drink for one of our sons who was coughing and found Husband playing video games.
>
> He does not have sleep apnea (although he will occasionally snore, it's not the kind of snoring that accompanies apnea.
>
> He really is a very nice man, extremely intelligent, and so so low on self-esteem. Depression runs in his family, unfortunately, and when we both were younger, I had no idea that he was depressed (thought he was a jerk, thought he didn't like me, thought he was lazy, thought he was childish, thought I had unrealistic expectations...).
>
> I have two questions, then:
>
> What does anyone with knowlege about atypical think about MAOI's (which are usually recommended for this type of depression)?
>
> And, what does the rest of my life look like living with an atypical? I promised Husband, God, my family and friends that I would stick around through sickness and health; I intend to do that. It is, though, a really difficult condition to live with on a daily basis (for both of us...I don't mean to downplay what he goes through every day), and I'm wondering how much better things could get...?I know that I should write more than this -- but you are not alone -- this sounds like my husband -- only he's very angry and though he is seeing someone and is on someone -- I took am attempting to stay through the better and worse, sickness and health ... but ... well I'll be thinking and praying for you all.
Just my ... 2Sense
Posted by rainbowlight on January 22, 2003, at 1:07:12
In reply to my typical atypical spouse, posted by Theresa Rae on January 21, 2003, at 12:56:03
Things can be better once he finds the right medication/proper treatment. It can take quite a few trial and error periods to find the right med. If one doesn't seem to help, try another. It is not unusual to sleep 12 hours at a time if you suffer from depression and take these types of medication. Some of the meds can make you very sleepy/lethargic. I feel for you, I am the one with the mental illness in my family and I have to give my hubby credit, he is a saint for putting up with me. Hang in there, I know it's tough. He is lucky to have such a caring, helpful spouse. Don't give up, together you can find help.
Posted by Theresa Rae on January 22, 2003, at 10:56:55
In reply to Re: my typical atypical spouse, posted by rainbowlight on January 22, 2003, at 1:07:12
I talked to my husband this morning, gently, and asked him if he thought he might want to see a psychiatrist to see if there's anything he could be taking that would be even better (I acknowleged that there has been some improvement, but noted that he's still sleeping a lot, and could be doing even better, with the proper medication). He really hesitated, but when I said I was just looking out for him and would be willing to go to the appt., he agreed, but said he didn't want to make the phone call.
After a little more chatting, he said he would call himself, so I'm hoping he can get a referral today.
Can anyone tell me what the psychiatrist should know, in terms of symptoms (do we give him the grocery list of symptoms, just tell him the major ones, or what?) I'm thinking if husband goes by himself, he'll gloss over most of it, and just say that Effexor might not be the best for him. Husband won't have seen a psychiatrist yet (just have been going through family doctor), so I'm wondering what we should expect, and what can we do to get the most out of the visit (since we're now three years into trying to medicate his depression...)
Thanks -- everyone here is so nice!
Posted by rainbowlight on January 22, 2003, at 16:44:20
In reply to Re: he's going to set up an appt. with psych., posted by Theresa Rae on January 22, 2003, at 10:56:55
It's great that you are going to a psychiatrist. Family doctors/general doctors don't really have the experience needed to prescribe psychiatric medications. Typically on the first visit you will fill out a set of forms that will ask general questions (insurance info, any other health problems, meds currently taking, etc.). When he gets into the doctors office the doctor will go over his symptoms with him. I think it would help to make a list of ongoing problems he is having to have ready. Sometimes you forget to mention important things while you are there. No offense to the men reading this, but many men don't like to admit they have a mental illness, much less get treated for one. But I think if you hold his hand a bit he sounds like he is willing to go. Seeing a psychiatrist isn't really much different than seeing a regular doctor. Your husband may even feel relieved after speaking to someone who REALLY can relate to him and his illness. As far as getting the most out of the visit: Come prepared with the knowledge of what meds he is currently on and dosages (also the length of time he has been on them), a list of meds already tried (and dosages), a list of symptoms/problems he is having and of course, your insurance card. Typically the first visit is an hour or so long. The follow up (med check) visits are typically about 15 minutes once a month or so, depending on how often the doctor wants to see you. I hope it goes well for you. Post back to me and let me know how it goes. Good luck!
Posted by River1924 on January 22, 2003, at 17:07:49
In reply to Re: he's going to set up an appt. with psych., posted by rainbowlight on January 22, 2003, at 16:44:20
You go girl. Last week, I assumed you were seeing a pdoc. That is really important. I agree with Rainbowlight about everything.
You may want to write a list of major problems for you and the major problems for him. They can be different. Keep those lists, too. I find it very easy to forget that I've conquered some of my problems and I get discouraged. Those lists will give you a baseline of treatment goals.
A necessary caution: Go with your gut about the pdoc. They are human. No doc will feel right or be right for everyone.
You are doing great. I admire you patience. If you can afford it, I'd recommend a therapist for you. My sister's husband had "problems" and seeing someone really helped her gain perspective. Family therapy might help the kids, too, but I'm thinking of you, now. Plus, if you go now, he may be more willing to go at some point. Peace, River.
Posted by Theresa Rae on January 23, 2003, at 9:56:26
In reply to Re: he's going to set up an appt. with psych., posted by River1924 on January 22, 2003, at 17:07:49
I just got done with an appt. with my psychologist, who said Husband definitely needs to be on different meds. and get back to visiting a psychologist as well. He told me it's really important that I not take Husband's behaviors/words personally, and that I take time for myself, getting support from others around me. (And if I feel like going out, I should do that.) He also said I should "raise the bar" in terms of what I expect of my husband (if I don't expect much of him, it's no problem for him to meet those expectations.)
Everyone keep your fingers crossed for me -- let's hope we can start "taming the beast" (i.e. a decade+ depression.)
Posted by proud mary on January 23, 2003, at 15:52:48
In reply to my typical atypical spouse, posted by Theresa Rae on January 21, 2003, at 12:56:03
Theresa,
I'm not sure if this is the "correct" thing to do, but I found this posting for you from last year. It seemed to relate to your situation and I thought you might think it helpful.
I also wanted to tell you that when I went to my first pdoc appt., they did an initial interview that was VERY in-depth. It took about two hours and they covered everything, such as my childhood and teenage years, my parents, etc. They also had me have a complete blood work up done, which I would imagine your husband has already had done.
I would suggest you write down any and all that might be a clue or helpful to the pdoc. Rainbow is absolutely right and one of the things that will probably help your husband right away (ESPECIALLY as a man) is to find out there are people and doctors out there that don't view him as strange or unique or freaked out--just ill. And, I hope that your pdoc stresses to your husband that there IS going to be something that will help. I know many may disagree with me on this, but my pdoc stresses to me that they are ALWAYS working on new psych meds. It's lucrative for pharm. co. and that is to all of our benefit's, since it will keep them doing the research and trying to get better and better meds. One reason I included the posting below is that I have read of people who found relief with MAOIs after trying everything else. From what I understand, they are not easy to deal with (restrictions, etc.) but as many of us know, dealing with side-effects and restrictions can be a breeze compared to depression! Plus, keep in mind that in the past, before SSRIs and all the more modern meds, MAOIs SAVED LIVES.
I wish you all the luck in the world. He's lucky to have you and I know what it is like to live with a difficult person or to deal with some one you love being in pain...good luck! Mary
OH I just thought of something...be sure and try to do a family history of his side with your husband before the appt. The pdoc might be able to tell something from that, such as what, if any meds worked for that relative. Also, even if relatives didn't have diagnosed depression or other mental illness, sometimes the pdoc can glean something if you tell him about wacky aunt jeanie or sad uncle ben or in my case, my dad's late-in-life depression that made him stay in bed until about 5 p.m. most days (he was finally put on prozac which helped him alot). And the chances are that if one of his relatives got relief from a certain med, they will try that out to see if it works for him. But, since I'm already getting a rep (probably) for being a postings hog, I'll go now....This is the posting I was refering to:
Posted by M in Boston on April 2, 2002, at 12:24:54I have treatment resistant depression that has been defined as atypical and reactive with a high degree of rejection sensitivity. Over many years I have tried more than 10 anti-depressants (including a range of SSRIs and Tricyclics - none with any significant success. My condition has worsened lately, due to a number of circumstances and reaction to an ended relationship, etc. My psychiatrist has reccommended for some time that I try an MAOI, but, having high blood pressure, I have been afraid of the apparently unpredictable and sometimes deadly potential for a hypertensive crisis, and the anxiety produced as a result. Another alternative that was suggested was to try lithium (about which I know little, particularly its efficacy in atypical reactive depression. Does anyone have any thoughts on the pros and cons of each, or which order of trial between the two makes sense?
Thanks so very much for your help.
Posted by Theresa Rae on January 24, 2003, at 13:15:19
In reply to Re: my typical atypical spouse, posted by proud mary on January 23, 2003, at 15:52:48
Depression does run in his family, for sure...although as anyone reading knows, getting anyone to talk about it is difficult. I don't think Husband had anything strange come up on his blood work before...what would they be looking for?
He did seem to cheer up a little since agreeing to go in and see someone again, but I know that will be short-lived. I wish these guys came with instruction manuals. :}
I have heard a lot of scary things about MAOI's, although I know Husband would be good about avoiding foods/medications where interactions were likely. I'll have to go digging around on this site to see what information is available about them. My psychologist was pretty disgusted that his doctor has been so lax in tweaking his meds -- he's been on three different medications in varying doses over three years -- Dr. said three years is a ridiculous amount of time to wait for results...how would I know?
Posted by proud mary on January 25, 2003, at 10:50:14
In reply to Re: my typical atypical spouse, posted by Theresa Rae on January 24, 2003, at 13:15:19
Theresa, It sounds like you guys have found a good pdoc and are on your way to getting real help.
You can't be expected to know how to deal with a person (especially a man, which every woman knows are different creatures) with a mental illness/chemical imbalance. You guys are doing the right things and it sounds like you are more than good for him--supportive, helpful, caring--so please realize you are doing the right things and do NOT let the situation drag your self esteem through the mud.
When they find the right meds for him and perhaps some therapy (I've had a lot of therapy and recommend it to everyone :>)) things will get better and you guys can begin working on making your marriage joyful again. One word of caution, though...please do not start feeling like you must "do it all" for him. He is part of the equation and he must do things to help himself. Even when I was at my worst mental state, I did what I could to get the help I knew I needed and keep up my part of the bargin such as making my appts., taking my meds, etc.
You should go to a happy movie, take a walk on a beautiful day, treat yourself to a long, hot bath...something...whatever you can to treat yourself and make yourself feel good. You have alot to deal with and you need to treat yourself so you can be the strong one for now. Keep your spirits up...you guys are doing everyting you can do right now.Oh, and I know this is going to sound really out in left field, but if you go to the library and get "Men are from mars, women are from venus" by JOhn Gray, I swear its the closest thing to an owners manual about men I have ever read. I've tried some of his techniques about dealing with men on my husband and it works like a charm and it is just using what gray reveals about how men think, nothing devious or anything like that.
GOOD LUCK...hang in there....keep me posted on how it's going...Mary
Posted by Theresa Rae on January 25, 2003, at 12:19:52
In reply to Re: my typical atypical spouse, posted by proud mary on January 25, 2003, at 10:50:14
Well, he hasn't made an appt. yet, and in fact, went and got his old prescription for Effexor refilled (the day after he agreed to make an appt. with a psychiatrist.) He's seemed pretty OK the last couple of days (even managed to call me regarding a change in his travel schedule, which is atypical.)
He must really not want to go get treated, but my psychologist said it is up to Husband to get the help that he needs (just like you said.) And he said even the patients he treat who are about the worst off still manage to complete tasks, get to appointments, and such. I think Husband believes it's better to kind of hover in this middle depression zone than finally go all of the way through some thorough drug and therapy treatment. And I can't do that for him.
So, we definitely have some more talking to do. Thanks for all of the support :)
Posted by River1924 on January 25, 2003, at 14:16:46
In reply to Re: my typical atypical spouse, posted by Theresa Rae on January 25, 2003, at 12:19:52
I agree with proud mary. I'm rather amused by your husband. I suspected he would make a U-turn or go in any direction other than what you expected. (I.E. He gets better AND doesn't change.)
You just keep seeing your therapist. Right now, that is really important. You say he notified you of his travel plans. That's nice but big deal. That is just common courtesy. Your expectations are too small ...his inconsistent behavior and (yes)neglect can easily turn into feelings worthlessness for both of you. It does neither of you any good. Although it may feel hopeless (I've been in relationships, I know how it is), it won't always be.
With men, you must not "ask" your requests. "Will you call tomorrow?" You must state them. Women ask out of politeness but assume the person will do it. Men take questions like this very casually. You must say...assert "I want you to call the psychiatrist's office at nine a.m." Then get a specific answer.
Does your husband have a job that might (at least in his mind) be affected by others knowing he sees a psychiatrist?
Would your husband work better with a male or female psychiatrist? Most men can be more open emotionally with a woman (I'd guess.)
Sorry to write so much. I'm just thinking of you and your situation. Good Luck, River.
Posted by Theresa Rae on January 28, 2003, at 15:22:28
In reply to Re: my typical atypical spouse » Theresa Rae, posted by River1924 on January 25, 2003, at 14:16:46
I made his appt. yesterday after discussing Husband's condition with a friend. She is studying psychology now (at the graduate level), and wondered if he is perhaps ADD (and depressed). She read a list of symptoms, and I must say he has a good number of them: fidget-y (he shakes his foot constantly), disorganized, drinks a lot of caffeine, can't finish a book, listens to a lot of music, watches a lot of TV, very intelligent, but lacking in self esteem, PILES OF STUFF EVERYWHERE, procrastinates, has trouble starting a project, but has lots of projects started but not finished...and so on.
Our son has ADD, and has been taking medication for it since the third grade (he's now in Junior High). Would make sense for dad to have it, no?
Anyhoo, I made an appt. for Hubby to go see gen. practitioner (they wouldn't do a referral over the phone, even though he's been "treating" husband for three years now for the same condition). Doh. He's going in on Friday, but it will probably be a month until he can get in to see a specialist.
On my front, I have found a piano teacher, and am going to start taking lessons again. More me time...
Theresa Rae
Posted by proud mary on January 29, 2003, at 10:36:29
In reply to Re: interesting development?, posted by Theresa Rae on January 28, 2003, at 15:22:28
Theresa,
Piano lessons for YOU...DEFINATELY a good thing!
I recognize some of the traits you said your husband possesses--procrastination, beginning many projects but having a difficult time finishing them, disorganization...I recognize them because I do those things! I am not ADD, by the way.
I'm beginning to think he needs psychologic help more than psychiatric help. I am very aware of my shortcomings but women are usually more introspective than men, anyway. I know I have these things about me that bug ME, but I also read to find solutions and talk it over with people I feel can help me and motivate me (including a therapist). Again, men are less apt to be introspective and try to figure out what the heck is going on with themselves mood-wise and all, so you might have to back off big time until he notices you are carrying on with your life just fine..that tends to get their attention!
However, this is just theory. Hopefully he will follow up with his appointments and that will lead to more help, therapy, whatever he might need.Again, good luck and keep us posted!
Mary
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