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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 dazedandconfused on September 2, 2003, at 17:01:11
This is my first time posting a question so hope it makes sense. I haven’t seen this issue discussed and really need help sorting it out.
Does anyone else have trouble determining whether or not their meds are effective?
I don’t notice much of anything (life in general, not just meds). I feel somewhat disconnected; not in touch with feelings (physical or emotional) at all. But when I read other posters say, “on X med, I felt more motivated, focused, etc.” but X med made me feel “agitated, anxious, etc.”, I simply can’t relate. And it really blows me away when a poster can be so specific as to say, “X med improved my motivation level to 70%, and X med is clearing up the residual depression and obsessions”. HUH??? How can you be so detailed in your description of your reaction to meds? What am I missing?
I have no idea whether my meds are effective. When I first started treatment for this round of depression (three years ago), I was laying in bed all day sobbing uncontrollably. So, yes, the meds have been effective in pulling me out of that and I am “better” than I used to be. However, I certainly don’t feel “well”. I haven’t worked in three years and get overwhelmed with the smallest of household activities. (I have other symptoms, but am trying to keep this message from becoming ridiculously long). I have no idea if my motivation levels and ability to focus are normal, but I suspect not. I believe I have suffered from varying degrees of depression my entire life; therefore, if I have never had high levels of motivation or focus, how will I know when / if it happens? How will I know when meds are working and I am getting well (or as well as I can get?)
As an example of being disconnected, of all the meds I have tried I have never noticed the side effect of dry mouth. Now I probably have a dry mouth, but I simply don’t notice it. In fact, I have rarely noticed any side effects from meds (occasional headache). Although this “not noticing” is great for negative side effects, the flip side is I don’t even know what positive effects are coming from the meds. In other words, I have a hard time determining how well my meds are working. Energy, focus, motivation, mood, etc…HUH? HUH? HUH? Obviously, this keeps me from making much progress. How can I tell if I am on the correct meds if I am not aware of how I feel and if I have always suffered from depression?
Is this ADD? Disassociation? Am I just spacey? Apathy? I am on high dosages of all my meds, so it shouldn’t be a dosing question. I really hope someone answers. This is a huge stumbling block for me.
Thank you!
Posted by Sebastian on September 2, 2003, at 19:15:36
In reply to 1st post: How can you tell if meds are working?? , posted by dazedandconfused on September 2, 2003, at 17:01:11
What meds do you take? What does your doctor say? Anything. How do you support yourself? You need a med that gets you out of the house. Ask you doctor for one that does that .. If that doctor can , get anouther one who can. How did the first dose of you med make you feel. Anything? It sounds like it worked, but you still need motivation, try a different med, or none (maybe you don't need them anymore?)(Probably not likely, but you never know). Some times the help of the med is so slow you don't notice the change. Maybe it would work if you just assume the med does this or that and it will, doctors are good at producing that; Do you see a psychiatrist? If you think you can you can. Give it a try.
Do the meds make you feel good or nothing, if good then they work, if nothing they they do nothing or you just don't notice anymore and it might help to try anouther one and see if you like the change.
If at any point I didn't make sense just ask.
Sebastian
Posted by Sebastian on September 2, 2003, at 19:19:05
In reply to 1st post: How can you tell if meds are working?? , posted by dazedandconfused on September 2, 2003, at 17:01:11
One med that did wonders for getting me out of the house was Zyprexa.
Posted by Mimi on September 2, 2003, at 20:36:19
In reply to 1st post: How can you tell if meds are working?? , posted by dazedandconfused on September 2, 2003, at 17:01:11
dazedandconfused,
How old are you? And can you remember any moment of your life when you had feelings and sensations?
What you describe might be deemed to fall into the schizophrenic category. Don't worry: I'm somewhere in that category and I'm learning about emotions now and maybe regaining some. The brain is an amazing healing organ.
Sports are a good way to connect to your body in a visceral sense until you can feel otherwise.
I've had years when I did not feel a thing except pain and sadness. Now I'm engaged to be married and have been able to feel happiness at times. This has been the best year of my life and I'm at midlife! I've been medicated for five years now and had multiple ECT treatments less than two years ago.
Keep the faith. Much depends on life circumstances and your social support network. This site is a wonderful place!
Mimi
Posted by Sarahh on September 3, 2003, at 14:10:19
In reply to 1st post: How can you tell if meds are working?? , posted by dazedandconfused on September 2, 2003, at 17:01:11
Wow...you are practically speaking for me. I hope that someone will have some input for us. I too have no idea if my meds are working. I can tell you one thing though...I DID notice a difference right away when I was first introduced to REMERON. It gave me a sense of the real me again, my old self. It lessened my insecurities, gave me motivation, lowered my anxieties and generally gave me my great sense of humor back and my old sense of well being. Unfortunately I had to stop taking the REMERON due to the excessive weight gain that I experienced. I am thankful that I atleast had experience with a med that DID prove positive results to me almost immediately.
Currently my GP talked me into trying out meds again. I am now on 37.5mg of EFFEXOR XR a day for the past 2 weeks. I HAVE NO IDEA IF THIS MEDICATION IS WORKING. We are in a very similar boat it seems. If you would appreciate the support from someone that understands your frustrations please let me know...I would be interested in any help all of us can give one another. Good luck otherwise and hang in there.-Sarahh
> This is my first time posting a question so hope it makes sense. I haven’t seen this issue discussed and really need help sorting it out.
>
> Does anyone else have trouble determining whether or not their meds are effective?
>
> I don’t notice much of anything (life in general, not just meds). I feel somewhat disconnected; not in touch with feelings (physical or emotional) at all. But when I read other posters say, “on X med, I felt more motivated, focused, etc.” but X med made me feel “agitated, anxious, etc.”, I simply can’t relate. And it really blows me away when a poster can be so specific as to say, “X med improved my motivation level to 70%, and X med is clearing up the residual depression and obsessions”. HUH??? How can you be so detailed in your description of your reaction to meds? What am I missing?
>
> I have no idea whether my meds are effective. When I first started treatment for this round of depression (three years ago), I was laying in bed all day sobbing uncontrollably. So, yes, the meds have been effective in pulling me out of that and I am “better” than I used to be. However, I certainly don’t feel “well”. I haven’t worked in three years and get overwhelmed with the smallest of household activities. (I have other symptoms, but am trying to keep this message from becoming ridiculously long). I have no idea if my motivation levels and ability to focus are normal, but I suspect not. I believe I have suffered from varying degrees of depression my entire life; therefore, if I have never had high levels of motivation or focus, how will I know when / if it happens? How will I know when meds are working and I am getting well (or as well as I can get?)
>
> As an example of being disconnected, of all the meds I have tried I have never noticed the side effect of dry mouth. Now I probably have a dry mouth, but I simply don’t notice it. In fact, I have rarely noticed any side effects from meds (occasional headache). Although this “not noticing” is great for negative side effects, the flip side is I don’t even know what positive effects are coming from the meds. In other words, I have a hard time determining how well my meds are working. Energy, focus, motivation, mood, etc…HUH? HUH? HUH? Obviously, this keeps me from making much progress. How can I tell if I am on the correct meds if I am not aware of how I feel and if I have always suffered from depression?
>
> Is this ADD? Disassociation? Am I just spacey? Apathy? I am on high dosages of all my meds, so it shouldn’t be a dosing question. I really hope someone answers. This is a huge stumbling block for me.
>
> Thank you!
>
Posted by dazedandconfused on September 3, 2003, at 15:57:50
In reply to Re: 1st post: How can you tell if meds are working?? » dazedandconfused, posted by Sebastian on September 2, 2003, at 19:15:36
Sebastian,
Thank you so much for your post. I am currently taking 60mg Celexa, 400mg Wellbutrin (200mg X 2 per day), and 54mg Concerta. I will look into Zyprexa, but I really don't have a problem leaving the house. Its just that I always feel overwhelmed with everything and that I should be doing something other than what I am doing. Ex. Perusing Dr. Bob, when I know I should be balancing my checkbook.But again, I don't know if its the meds or me. I would definitely be willing to switch meds (perhaps an MAOI), but it seems somewhat futile until I can better relate my symptoms...
Sigh,,,frustrating,,,but thanks for your help!
Julie
> What meds do you take? What does your doctor say? Anything. How do you support yourself? You need a med that gets you out of the house. Ask you doctor for one that does that .. If that doctor can , get anouther one who can. How did the first dose of you med make you feel. Anything? It sounds like it worked, but you still need motivation, try a different med, or none (maybe you don't need them anymore?)(Probably not likely, but you never know). Some times the help of the med is so slow you don't notice the change. Maybe it would work if you just assume the med does this or that and it will, doctors are good at producing that; Do you see a psychiatrist? If you think you can you can. Give it a try.
>
> Do the meds make you feel good or nothing, if good then they work, if nothing they they do nothing or you just don't notice anymore and it might help to try anouther one and see if you like the change.
>
> If at any point I didn't make sense just ask.
>
> Sebastian
Posted by dazedandconfused on September 3, 2003, at 16:11:24
In reply to Re: 1st post: How can you tell if meds are working?? » dazedandconfused, posted by Mimi on September 2, 2003, at 20:36:19
Mimi,
Thank you for your post!! I am a 35 yo female. I had never even considered schizofrinia (sp?), no one had ever mentioned it as a possiblity, but I will look into it. This is so difficult to describe and I don't feel like I am doing a very good job.
I don't really remember feeling any differently when I was younger. I guess I can feel certain feelings and sensations, its just that I don't notice them. Again, its more of a feeling of being out of touch. For example, if someone asked if I had a headache, I would think about it and be able to respond yes or no (this is a minor headache I am talking here). In other words, I would know if I had a headache and I would be able to feel it. But unless I made a conscious effort to "check in" I would normally not notice it.
Its just so frustrating becuase I can't help my PDOC much if I can't determine whether or nor my meds are working....
Thank you for your help! And congrats on getting married!!
dandconfused,
>
> How old are you? And can you remember any moment of your life when you had feelings and sensations?
>
> What you describe might be deemed to fall into the schizophrenic category. Don't worry: I'm somewhere in that category and I'm learning about emotions now and maybe regaining some. The brain is an amazing healing organ.
>
> Sports are a good way to connect to your body in a visceral sense until you can feel otherwise.
>
> I've had years when I did not feel a thing except pain and sadness. Now I'm engaged to be married and have been able to feel happiness at times. This has been the best year of my life and I'm at midlife! I've been medicated for five years now and had multiple ECT treatments less than two years ago.
>
> Keep the faith. Much depends on life circumstances and your social support network. This site is a wonderful place!
>
> Mimi
Posted by dazedandconfused on September 3, 2003, at 16:25:04
In reply to Re: 1st post: How can you tell if meds are working?? , posted by Sarahh on September 3, 2003, at 14:10:19
Sarah,
I must say that I am thrilled that you can relate! (although of course I am sorry that you do also!). This is such an odd thing to describe and I feel like I can't make progress until I get a better handle on it.Again, how can I determine which meds are right for me if I can't describe how I feel on them. I would switch meds, or take supplements, but it seems futile if I can't tell the effects of them. I can do OK if its something extreme; like when I first started a couple of my meds, I awoke very early in the morning which is unusual for me. But another time, I started crashing for a nap in the early evening...then the naps started getting longer...then I would crash earlier and earlier. Finally, my husband said, "Hey,,,do you think your meds are making you tired?". DUH! Only THEN do I make the connection to the meds; otherwise I would just say I've been tired. Isn't that weird??? Do you think it is an ADD symptom? Apathy? I almost prefer I had an outside party to help me determine whether or not the meds are working....like a parent monitoring a child's progress on a med. And no,,,my PDOC,,,is NOT that person. She is pretty clueless so I am looking for a new one. The only symtoms we can cover are whether I am sleeping and whether I am eating; neither of which have ever been problems for me (I've always slept too much and eaten too much; not the other way around).
For your Effexor, it sounds like it is way too early to tell the effectiveness. I hope it works for you! And Thank you, Thank you, Thank you...for responding to my post. I hope we both get more feedback!
> Wow...you are practically speaking for me. I hope that someone will have some input for us. I too have no idea if my meds are working. I can tell you one thing though...I DID notice a difference right away when I was first introduced to REMERON. It gave me a sense of the real me again, my old self. It lessened my insecurities, gave me motivation, lowered my anxieties and generally gave me my great sense of humor back and my old sense of well being. Unfortunately I had to stop taking the REMERON due to the excessive weight gain that I experienced. I am thankful that I atleast had experience with a med that DID prove positive results to me almost immediately.
> Currently my GP talked me into trying out meds again. I am now on 37.5mg of EFFEXOR XR a day for the past 2 weeks. I HAVE NO IDEA IF THIS MEDICATION IS WORKING. We are in a very similar boat it seems. If you would appreciate the support from someone that understands your frustrations please let me know...I would be interested in any help all of us can give one another. Good luck otherwise and hang in there.
>
> -Sarahh
>
> > This is my first time posting a question so hope it makes sense. I haven’t seen this issue discussed and really need help sorting it out.
> >
> > Does anyone else have trouble determining whether or not their meds are effective?
> >
> > I don’t notice much of anything (life in general, not just meds). I feel somewhat disconnected; not in touch with feelings (physical or emotional) at all. But when I read other posters say, “on X med, I felt more motivated, focused, etc.” but X med made me feel “agitated, anxious, etc.”, I simply can’t relate. And it really blows me away when a poster can be so specific as to say, “X med improved my motivation level to 70%, and X med is clearing up the residual depression and obsessions”. HUH??? How can you be so detailed in your description of your reaction to meds? What am I missing?
> >
> > I have no idea whether my meds are effective. When I first started treatment for this round of depression (three years ago), I was laying in bed all day sobbing uncontrollably. So, yes, the meds have been effective in pulling me out of that and I am “better” than I used to be. However, I certainly don’t feel “well”. I haven’t worked in three years and get overwhelmed with the smallest of household activities. (I have other symptoms, but am trying to keep this message from becoming ridiculously long). I have no idea if my motivation levels and ability to focus are normal, but I suspect not. I believe I have suffered from varying degrees of depression my entire life; therefore, if I have never had high levels of motivation or focus, how will I know when / if it happens? How will I know when meds are working and I am getting well (or as well as I can get?)
> >
> > As an example of being disconnected, of all the meds I have tried I have never noticed the side effect of dry mouth. Now I probably have a dry mouth, but I simply don’t notice it. In fact, I have rarely noticed any side effects from meds (occasional headache). Although this “not noticing” is great for negative side effects, the flip side is I don’t even know what positive effects are coming from the meds. In other words, I have a hard time determining how well my meds are working. Energy, focus, motivation, mood, etc…HUH? HUH? HUH? Obviously, this keeps me from making much progress. How can I tell if I am on the correct meds if I am not aware of how I feel and if I have always suffered from depression?
> >
> > Is this ADD? Disassociation? Am I just spacey? Apathy? I am on high dosages of all my meds, so it shouldn’t be a dosing question. I really hope someone answers. This is a huge stumbling block for me.
> >
> > Thank you!
> >
>
>
Posted by badhaircut on September 3, 2003, at 19:46:29
In reply to 1st post: How can you tell if meds are working?? , posted by dazedandconfused on September 2, 2003, at 17:01:11
>How will I know when meds are working and I am getting well (or as well as I can get?)
That used to be my question, too!!
David Burns says the best way to know if you're improving is to take a depression test like the one at
http://www.personal.psu.edu/users/d/c/dca114/school/BDI.html
I think he says to take it once a week while you're trying a new med.It's easy and it gives you *something* to judge by. I printed it out and changed some of the questions to reflect my own problems a little better.
Burns says, "If a drug does not have fairly substantial beneficial effects, as indicated by a clear and continuing improvement in your score on a depression test..., then it is usually appropriate to switch to another antidepressant medication." (In "Feeling Good" .)
Of course, that's after you've given it a fair trial -- a high enough dose for a long enough time.
Somewhere else, I'm sure I read that Burns pegged the minimum improvement for staying on a drug at a 50% lower score than before the meds. But Burns is openly skeptical about meds for depression, so that may be a high bar.
I know if I felt so much better that I could see even 30% reduction in my score (from 34 to 24?), *I* would stick with that drug, side effects & all.
Anyway, I no longer wonder if I'm getting better on any drugs. So far, I'm not. But I'm still trying.
-badhaircut
Posted by Mimi on September 4, 2003, at 12:41:21
In reply to Re: 1st post: How can you tell if meds are working?? » Mimi, posted by dazedandconfused on September 3, 2003, at 16:11:24
dazedandconfused,
Disassociative Disorder is another possibility. Not to worry, that can be overcome, too. Surround yourself with positive people and try to find a proactive support group around emotions/psyche disorders. I made a lot of progress attending a group once a week.
Mimi
Posted by Budgie on September 6, 2003, at 14:33:47
In reply to Re: 1st post: How can you tell if meds are working?? » Sarahh, posted by dazedandconfused on September 3, 2003, at 16:25:04
> The only symtoms we can cover are whether I am sleeping and whether I am eating; neither of which have ever been problems for me (I've always slept too much and eaten too much; not the other way around).
Hi Dazed,
I know I brought it up before, but these are classic symptoms of atypical depression. Not that other things couldn't be invloved, and I'm no diagnostician, but just for your info...Also, it's often hard to tell in general what effects (both positive gains as well as annoying side effects) are due to your medication and what are the products of outside influences. At least with the side effects, just look at the research, including the info sheet that comes with the prescription, to see what's "legitimate." As far as not being depressed- basically, do you still feel constrained, prevented from doing things, by your own thoughts? This has been the biggest realization for me since I started feeling genuinely "better."
Hope this helps,
Budgie
Posted by KimberlyDi on September 8, 2003, at 15:52:10
In reply to 1st post: How can you tell if meds are working?? , posted by dazedandconfused on September 2, 2003, at 17:01:11
hello there!
who's managing your medicines? your general practicioner isn't going to know the latest options in AD's as a p-doc that specializes in it.
I'm glad that you aren't as deep down into depression as you used to be. and wanting to get even better surely is a positive sign. you may need a cocktail of meds to work with your most debilitating symptoms.
For example, I had a problem with anxiety. Effexor helped with that, but Effexor's Side Effects (SE's) made my insomnia even worse so I was prescribed Trazadone at night. (Traz is an AD that is prescribed more for it's SE's(sedation) than its original purpose. Effexor took care of the anxiety, which was masking my newly diagnosed ADD symptoms. I'm now taking Strattera for that.
And I'm feeling good. I still have occassional bouts of depression and negative thoughts. I don't want to add anything else right now because I'm afraid I'll start rattling when I walk (all those pills in side of me)!!!
Good Luck and Keep Trying!
Keep Posting at Psycho-Babble, it's a fantastic source of knowledge and experience. The detailed descriptions is something that'll come with time after you start doing your own individual research and also read the posts pertaining to you. With computers I used to call it techie-talk, maybe i'll call the lingo here med-speak.
Posted by dazedandconfused on September 8, 2003, at 20:55:47
In reply to Re: How can you tell if meds are working?? , posted by badhaircut on September 3, 2003, at 19:46:29
Thanks so much everyone for your feedback! I will keep reading / learning /posting!
Dazed
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