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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by scatterbrained on June 17, 2004, at 1:41:45
This is what's going on with me and I need some answers.I'm 21 years old and have been depressed for about 3 years.The symptoms are as follows.Anhedonia,lack of emotion,and the worst symptoms,confusion and short term memory problems to the point of "psuedo dementia"(I'm sorry if I'm repeating some previous post of mine).My doctor is not quite sure whats causing this "pseudo dementia" but since this is very rare for a 21 year old to have, he thinks it might be some sort of disorganized thought disorder.The thing is that I don't have hallucinations,I'm not paraniod and I'm not delusional,I JUST CANT THINK.I'm currently on lamictal-300,Paxil-10 and ritalin.There HAVE been times,usually only lasting a day or two, when I'm lucid, but then I'm back to being in a torturous and debilitated state of confusion. I think the lamictal has helped a little bit and it's too early to tell in regards to the Paxil but the memory problems and confusion are still there and seem to be pulling everything down.It's hard to even tell what the confusion is coming from at this point.Could it be from the meds?Could it be from the depression? Could it be from a thought disorder?I just want to think straight, thats all I care about.If it's psychosis,thats fine with me.I would be totally content with being a little psychotic.It's not the idea of being psychotic that scares me, it's the medications.I'm VERY sensitive to medications and the last thing I would want is some horrific permanent disfigurement like TD.And although TD is somewhat rare in full blown psychotics, It NOT TOO RARE for people with mood disorders, and can come on fairly quickly; especially med sensitive people who are taking ssri.The strange thing is that when my mood is fully lifted, the confusion goes away.Unfortunatly, those are very brief moments.I'm stuck in this horrible dilemma. Should I take an antipsychotic to try to get me out of this depression and risk TD, or should I continue down the antidepressant road?Anyway,I have a few appointments lined up for some other doctors and I'm not going to decide until I get some more opinions. If any of you guys have any clue as to what this could be and/or have gone or are going through something similar I would really appreciate your impute.And Dr Bob, I don't know if you actually interact with the people who are posting but if you do, it would be great if you could post your thoughts,I need as much help as I can get.
Posted by Anthony Quest on June 17, 2004, at 2:19:48
In reply to HELP-Don't know where to go from here, posted by scatterbrained on June 17, 2004, at 1:41:45
Scatterbrained-
I don't know how much help anyone can give without knowing more and it's hard to know more online without writing a book. However, I can say the following with some confidence.
How would you describe your thought-disorder, "pseudo-dementia". Have you explored non-psychological causes for it? E.G. Have you had an MRI of your brain? Have you had a sleep study? Have you been to an infectious disease doctor? What about a neurologist?
There are quite a few non-psychological diseases that can lead to difficulty remembering, thinking clearly ranging from chronic fatigue syndrome to early onset Alzheimers to low testosterone or other hormones. You should rule out these other conditions if you haven't already.
Assuming you have done that, SSRIs do not cause TD as far as I know (I could be wrong). Unless your MD wants to put you on an old school anti-psychotic like Thorazine or Halidol your risk of TD developing suddenly and irreversibly is very low.
I know there is a risk with some of the newer atypical neuroleptics but it is very low. Seroquel is one that is widely utilized. Zyprexa is another. I think if you had any signs of TD, you could simply stop taking it and it would perhaps reverse hopefully.
Anyhow, why not ask your doctor about the following. If he thinks you have a psychosis - try a short trial of an anti-psychotic (one of the newer ones). If it helps your condition you will know then that the cause is psychosis most likely. If it doesn't help then you'll know that it's not the cause and you have to figure out what it is.
Best luck.
Posted by owenus32 on June 17, 2004, at 11:50:58
In reply to HELP-Don't know where to go from here, posted by scatterbrained on June 17, 2004, at 1:41:45
Get a full physical for stuff that could affect you mentally and than perhaps get a second opinion from another shrink. Don't stop going to your shrink just go to a second one one time for a second opinion. And Do go to a regualr doctor to rule out chronic fatigue, thyroid, lymes disease anything. As for meds when I took depakote I was like walking into rooms and forgetting why I walked into them!
Posted by scatterbrained on June 17, 2004, at 18:29:58
In reply to Re: HELP-Don't know where to go from here, posted by Anthony Quest on June 17, 2004, at 2:19:48
This thread,for some reason,was taken off the main page after only one day.Please read the other posts I've written connected to this tread.THEY ARE VERY IMPORTANT TO MY SURVIVAL.
Posted by scatterbrained on June 17, 2004, at 18:34:33
In reply to Help,very important, posted by scatterbrained on June 17, 2004, at 18:29:58
Either thank you for putting the thread back or sorry for thinking you took it off when I just couldn't find it.
Posted by snapper on June 17, 2004, at 22:58:27
In reply to Re: Help,very important, posted by scatterbrained on June 17, 2004, at 18:34:33
hey scatterbrained(sp)?, I am sorry that your post was lost in the shuffle or if it seems like no one is responding to your urgent replies for help and or support. that can happen on the internet and certainly not exclusive here on PB. Sometimes it helps to remember that just because you don't get an immediate response to your post or thoughts /concerns or cries for support, are not anything to be taken personal. I have read your posts, as well as i am sure many others have and just because no-one seems to be responding now or yesterday for that matter, does'nt mean that no-body will. people come and go on this board on a near constant basis. I know you are struggling very bad and this boards' broad based support is vital to you you to give you some hope! You have our support! No matter what! I don't remember what all of your symptoms and issues are for sure, but I wanted to let you know that you are not alone. If on the other hand , you are literally alone and you live by yourself and are looking for total support by just posting and waiting can be hard on you or anyone else for that matters. Do you have support, at school, work, at home? It is vital to have multipe sources of support. Not just meds and your doctor/theapist or other. I no just how hard it can be to try to reach outside of our small circles of safety. If your dr. does'nt attribute your cognitive problems with you ,to deprssion, anxiety, or other mental disorder then I would be sure if I were you to nail him/her down and ask:what is it that you are treating me for, what are my diagnosis,what meds do you possibly need to be treated with etc. none of these things I have purported to you in this reply, may seem obvious in helping to get you feeling better but they certainly can be a good start . are you happy with your current pdoc? if not ... seek out another and another if you need to till you get one that can give you some concrete answers. PB is valuble in many many ways..but can not serve as the primary source for the answers to the things that ail you. Keep in mind also, that when you post something here on PB, that sometimes many people read it but may not know what to say to you in responce. do not take that personally.afterall you have had some replies(mine) included and that should tell you that we are reading and listening and thinking...what can we think to say or post or offer up on suggestions to your original questions. I have babled enough in reply to you so I will give you a chance to re-post some if not all of your original questions and what is going on with you.keep in mind also that if there is'nt a lot of action on any particular thread on this board, often times they will fall off. so it is'nt your fault....anyhow thats what I can offer to you for now and I am sure others will chime in .hope this helps
snapper
Posted by King Vultan on June 18, 2004, at 8:04:02
In reply to HELP-Don't know where to go from here, posted by scatterbrained on June 17, 2004, at 1:41:45
I think Anthony's advice is very good, and I agree completely. Confusion and memory problems are sometimes seen with psychiatric meds if they are extremely anticholingergic, that is, if they interfere with acetlycholine transmission. Acetylcholine is a key brain transmitter, and disruption of the transmission of it is one of the key components of Alzheimer's Disease.
I think it is essentially impossible for you to get Alzheimer's Disease at such a young age, but you may have some other condition affecting acetylcholine transmission, which is why you might want to see a neurologist. I also think it's quite possible that your memory and confusion problems could just be the result of your depression, as I have experienced this sort of thing myself.
I also think it is essentially impossible to get tardive dyskinesia from an SSRI, and while there is a chance to get it from an atypical antipsychotic, it is quite low in comparison to older psychotic meds and would be virtually zero for a short term trial of an atypical as Anthony suggests considering. I have a very low opinion of atypical antipsychotics for non-schizophrenic/non-bipolar individuals, but some kind of trial of one might be worth pursuing, if only to put your mind at rest on this business of schizophrenia. Even if you aren't schizophrenic, if you can tolerate the side effects and the med provides some other benefit, it still might be worthwhile.
Todd
Posted by jasmineneroli on June 19, 2004, at 1:36:35
In reply to Re: HELP-Don't know where to go from here » scatterbrained, posted by King Vultan on June 18, 2004, at 8:04:02
Hey:
I wonder if you have ever been diagnosed with an anxiety disorder? Anxiety disorders can often lead to depression, or be mistaken for depression.
I have GAD and sometimes my anxiety attacks manifested themselves as complete mental confusion breakdowns. I just couldn't THINK at all. Everything (all stimuli coming in...questions, voices, sounds,ideas) just overwhelmed my brain and I felt paralyzed, thinking-wise. I would forget things (leave my car running with the keys in it, whilst grocery shopping etc.etc.). I just felt like I couldn't sort out all the input and my brain would kind of shut off!!! This would come and go and didn't seem to have any connection to an event or be related to panic disorder. GAD is an odd sort of Anxiety Disorder, in that you always kinda live in a state of worry or vigilance or very conscientious or very "aware". My Pdoc described my situation as my brain/body being totally flooded with adrenaline all of a sudden, all senses on overload, and it just "shuts down".
My original Dr. thought I had depression with anxiety, and I took Celexa for nearly a year. The forgetful, brain shutting down episodes got worse during this period, however the GAD constant racing thoughts improved. I tried other SSRI's with worse effects. The only thing that has helped me is Klonopin ( a benzodiazapine). It works on GABA and acts like a "brake" on the brain that is going into overload (Gaba is an anti-excitory neurotransmitter). I keeps my anxiety under control and I have far fewer epsiodes of total Brain Failure!!
I know benzo's aren't for everyone, but I can't function without Klonopin. I am on the same very low dose of 1mg to 1.25mg per day as when I started it last August and have not felt the need to increase it at all.
I don't know if the above is anything like you experience, but maybe consider severe anxiety as a diagnosis and get yourself checked out for all the possible physiological causes too. I was checked for thyroid, iron deficiency, B12/folate deficiency, hormone functioning, immune functioning etc etc.
Even if we have different diagnoses, Scatterbrained, I can totally relate to the feelings you describe, and truly hope you can find an answer. Just keep digging, researching and persisisting. It took me nearly 4 years! Good luck, don't give up!.
Jas
This is the end of the thread.
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