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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 theDad on July 12, 2004, at 21:28:32
My son has just started on Effexor, as his anxiety is getting the better of him. He describes it as a constant battle in his head that robs him of a normal happy life, sleep, at least one relationship, etc. He was originally diagnosed at 10 years of age with OCD, and placed on Prozac, progressivly higher doses, ended up in the childrens hospital (thankfully still alive) on a special program where they live an go to school there. We made it throught he years somehow, though all the various pshyco drugs, and for a couple years he actually was on no prescriptiona at all, and finished a diploma in colldge. Now he is on his own, almost 22 years old, but has had to go get relief from the inner hell. He is afraid (actually just can't face it anymore) of the cycle of progressivly higher doses, the extreme withdrawal, just to have the Dr. say, "let's try this one' and start the cycle again. Can anyone help? He works hard to make a success of his life, has lots going for him, but I am really worried for him as I have an idea what he is going through once again and he really can't take it anymore. It's bad. Any advice?
Posted by Buckeye Fan on July 13, 2004, at 8:12:25
In reply to Help for my son, posted by theDad on July 12, 2004, at 21:28:32
DearTheDad,
My heart goes out to your son...and your family
I assume there must be a more complete diagnosis
made somewhere between 10 and 22...the symptoms you allude to, suggest a greater problem in addittion to OCD....but whats really important is that he needs help now.In my opinion...Effexor is NOT the drug of choice
when wxtreme anxiety is involved, as it tends to add to anxiety. It sems that on this webpage there are many who share this experience...but, as always, some who differ.
I would just watch carefully as to his anxiety level over the next couple weeks.As an adult who was diagnosed as a child...he probably has a genetic predisposition to his condition{s)
Was really touched by your post...but need more info to really try to help
What did treatment include during the Hospital years?
What is current dianosis and list of illnesses'
and Medicines tried to date?Hope to help
Buckeye Fan
Posted by King Vultan on July 13, 2004, at 8:19:24
In reply to Help for my son, posted by theDad on July 12, 2004, at 21:28:32
My own story has some resemblances to your son's except that it is displaced 20 years backwards in time, beginning in a time period where there was more of a stigma about mental illness than there is now. I also suffered from OCD and severe anxiety in my teens and 20's but unfortunately did not ever see a psychiatrist until I was 30. By then, a chronic depression had set in, which has still not completely abated (I'm now 40 and taking an MAOI after trying about 10 other drugs).
I'd be interested to know what drugs your son has been on and which worked better and which worked worse. Also, how much talk therapy has he had? A great deal of the progress I made in dealing with my own anxiety was identifying behaviors that played a role in increasing or decreasing it. For instance, I found that becoming more honest and objective while simultaneously decreasing the strong tendency I had to rationalize had a significant effect in reducing my anxiety levels. Certainly, drugs such as Zoloft and Effexor were a great aid to me in helping create a calmer mental envionment where I could get more of a handle on my problems (severe anxiety can be extremely distracting and crippling), but in the end, the real key to lowering anxiety is figuring out why one is anxious to begin with and then making behavioral changes to gradually lower one's anxiety levels.
At one point in my college years, my stress and anxiety levels were about a 12 on a scale of 1-10, so high that I was a bit mystified as to how my body could even go on functioning. Today, when I'm in an unmedicated state, I am not particularly functional because of my depression, but my anxiety levels, at least, are not drastically higher than what they are when I'm taking an antidepressant. So I seem to have gotten a fairly good handle on the anxiety problem, anyway, and if I can come to terms with a problem that was so deeply ingrained in my personality, I would be hopeful that others can, too.
Todd
Posted by Bill LL on July 13, 2004, at 8:57:26
In reply to Help for my son, posted by theDad on July 12, 2004, at 21:28:32
It seems that Effexor may be the strongest and most effective of the various antidepressants. It's usually great for anxiety and depression and I would assume for OCD as well.
After he has been on it for a few weeks, it will be more apparent how to proceed. He might need an anxiety drug in addition to Effexor.
With Effexor, it's very important to take each dose on time and not to miss a dose.
Posted by Racer on July 13, 2004, at 10:42:45
In reply to Re: Help for my son, posted by Bill LL on July 13, 2004, at 8:57:26
Talk therapy is probably the most useful thing for your son to try now -- in addition to medications, not instead of them -- because even if there is a distinct biochemical imbalance involved, behavior can increase or decrease anxiety. Unfortunately, a lot of insurance companies will cover meds indefinitely, while only covering a few therapy appointments per year, but the therapy really does do a great deal for coping skills.
Has your son tried any of the older anti-depressants? The newer drugs, like the SSRIs (Prozac, Zoloft, Paxil) and Effexor, are quite popular with doctors, because they have fewer side effects than the older drugs. It's a trade off, though, because the newer drugs may not be as effective for as many people as the older, "dirty" drugs. ("Dirty" because they are not as precise in their mechanisms. While the primary focus may be, say, norepinephrine, they'll also hit serotonin or dopamine or one of the other neurotransmitters. SSRIs, by contrast, hit serotonin pretty exclusively. Thus, "clean" drugs.) While that's good -- cleaner action generally means fewer side effects -- it also means that for people who need a little tweaking on several transmitters, the newer drugs are less likely to provide complete remission. It may be that your son would respond better to a TCA or even an MAOI than he does to one of the newer drugs.
As someone who has also suffered from depression with some anxiety since childhood, I'll tell you I believe that there is hope for your son. He's already one up on the game, because he has a father who is providing emotional and practical support. (Even if the only thing you did was post here, that's still practical support -- at least in my book.) That level of social support, familial support, is so crucial to a good outcome. That alone can improve your son's chances for an optimal outcome.
Best luck to you, and to your son.
Posted by Ilene on July 13, 2004, at 16:47:44
In reply to Help for my son, posted by theDad on July 12, 2004, at 21:28:32
I started taking Zyprexa a few weeks ago for anxiety. It's worked wonders. Despite being in a stressful situation (moving) that has caused my depression to return my anxiety levels are manageable. I take the occasional Klonopin, and I mean occasional. I've gained some weight, but I can't say for sure whether it's the Zyprexa or my circumstances.
Posted by theDad on July 13, 2004, at 20:59:31
In reply to Re: Help for my son, posted by Buckeye Fan on July 13, 2004, at 8:12:25
Wow. First of all, thank you all, and Dr. Bob for providing a great forum for support.
It just seemed like way to much to post to place 12 years of treatment/situation, plus background, on this forum. My son has been on Prozac, Zoloft, Paxil (sp?) and a few others I don't remember. Most of the decade we were a 'family' of two (dad and son) and we were trying to apply the 'take-away itmes' from therapy that we would attend, sometimes with his mother (another case study alogether, but thankfully doing much better now) A quick update; things seem to be taking shape and here is my take:The boy has always been behind the curve so to speak (comparing to others - stupid I know) with respects to preparing for the real world - how to cook, find a job, balance a checkbook, drivers license, credit card bill, career, and other 'life skills' but I have had to prioritize on what was important - the real life skills such as, at times, imparting hope for just another day togther in the hopes of 'the sun coming out' As a young man, he has completed six years of training three times a week, often at his worst emotionally, and achieved the status of Black Belt in Korean Hwa Rang Do (a martial art) He is also a wicked lead guitar player (I have been in one band with him - a real treat and life goal) I believe what has triggered the situation is that he has been through a second bad relationship, living with the girl, and his confidence is at an al time low and it is just too much to handle all the demands and responsibilites adult life demands in our society. As of today, he has taken what matters (his guitar and game system) and left an deteriorating relationship, and moved in with his mother. Thank goodness she is holding a job (at 50+) for the first time in her life (she has had many problems over the years) He now can just rest, take a break, and will be flying out to see me weekend ofter next to spend a couple days fishing and bbq'ing. Now that he is not living with a girl, and is with a parent, and knows that he has his own room at my house whenever he needs it for as long as he needs it, it seems to be a great relief. As you can imagine, having him move in with a girlfriend to 'rest' is not the same. I tried it. Anyway, I hope this reply can be seen by all that gave such prompt and wonderful feedback, and that a sudden change for the better is encouraging to as many as possible, and again, thank you for the support. We are at a good start once again, odd that I got the call today from across the country just after cioming to the forum last night. Anyway,this is already too long, I'll be talkin with his Dr about meds and will bring what I have learned from you in order to aske much more informed questions. My son's question will be the same - "why do we keep 'trying this and that' instead of 'treating'. I am tired of being a ginnea pig!"
cheers all, will watch and be in touch
thedad
Posted by theDad on July 13, 2004, at 21:02:45
In reply to Re: Help for my son » theDad, posted by King Vultan on July 13, 2004, at 8:19:24
Sorry - King Vultan, dumb question I know, what is King Vultan 'MAOI'?
Posted by theDad on July 14, 2004, at 1:15:27
In reply to Re: Help for my son, posted by Ilene on July 13, 2004, at 16:47:44
Thanks Ilene. Our most valuable takaway from the group sems to be that we need to talk to the Dr. as an informed customer, as opposed to just swallowing the flavour of the week and living the experiment.
Thank you all.
PS; I am out of the country for 5 days so please don't take it the wrong way when I don't reply. When I get back, my son is flying out and we are going to live LARGE for a few days. Can't wait. Maybe he'll stay if I put a Star Wars poster on his bedroom door..... Has anyone listened to that song 'Everyting is Wonderful', or Huey Lewis and the News 'Walking on a Thin Line'? These are hit that are great songs that speak to PTSS (in case I am acronym deficient - post traumatic shock syndrome)
Posted by King Vultan on July 14, 2004, at 9:07:34
In reply to Re: Help for my son, posted by theDad on July 13, 2004, at 21:02:45
> Sorry - King Vultan, dumb question I know, what is King Vultan 'MAOI'?
An MAOI is also known as an MAO inhibitor, a somewhat archaic but extremely powerful antidepressant. They were among the first antidepressants developed in the 50's but aren't used much anymore mainly due to fears about certain dietary restrictions and interactions with some OTC (over the counter) drugs. The dietary restrictions are overblown, but there are definitely some items that have to be avoided--cheddar cheese and tap beer being a couple of them. There are two MAOIs generally available in the US, where I live--Nardil and Parnate. A third, Marplan, is harder to get here but may be more available in some other countries.
Todd
Posted by Caper on July 15, 2004, at 1:58:55
In reply to Help for my son, posted by theDad on July 12, 2004, at 21:28:32
Isn't "exposure and responsive prevention" still the preferred treatment for OCD? Sort of a tough love kind of therapy?
I ask because I had a very close friend who suffered from severe OCD. If he had a "bad thought" while driving past a certain building, he'd go back and drive past it again and again until he got past that building without the "bad thought". He'd wash his hands after "bad thoughts" too, over and over and over.
The treatment (in addition to meds) that seemed to help him most was exposure and response prevention. Making him think the "bad thoughts" and then denying him the opportunity to do his OCD rituals. It was not a miracle cure, but it did help him get back to a much more normal life and it did a lot more than meds ever did for him.
Just wondering if your son has tried this. Maybe some others here have more personal experience with this sort of behavioral therapy. Mine was pretty personal-- he was my best friend and practically lived with me for a while, but still it's not the same as having OCD yourself.
Opinions, anyone?
Best wishes,
Caper
Posted by Dr. Bob on July 15, 2004, at 19:35:29
In reply to OCD exposure and response prevention, posted by Caper on July 15, 2004, at 1:58:55
> Isn't "exposure and responsive prevention" still the preferred treatment for OCD?
I'd like to redirect follow-ups regarding psychological treatments to Psycho-Babble Psychology. Here's a link:
http://www.dr-bob.org/babble/psycho/20040703/msgs/366658.html
Thanks,
Bob
Posted by theDad on July 22, 2004, at 21:03:10
In reply to OCD exposure and response prevention, posted by Caper on July 15, 2004, at 1:58:55
> Isn't "exposure and responsive prevention" still the preferred treatment for OCD? Sort of a tough love kind of therapy?
>
> I ask because I had a very close friend who suffered from severe OCD. If he had a "bad thought" while driving past a certain building, he'd go back and drive past it again and again until he got past that building without the "bad thought". He'd wash his hands after "bad thoughts" too, over and over and over.
>
> The treatment (in addition to meds) that seemed to help him most was exposure and response prevention. Making him think the "bad thoughts" and then denying him the opportunity to do his OCD rituals. It was not a miracle cure, but it did help him get back to a much more normal life and it did a lot more than meds ever did for him.
>
> Just wondering if your son has tried this. Maybe some others here have more personal experience with this sort of behavioral therapy. Mine was pretty personal-- he was my best friend and practically lived with me for a while, but still it's not the same as having OCD yourself.
>
> Opinions, anyone?
>
> Best wishes,
>
> CaperWow, this makes some sense. The answer is no, back when this diagnosis was made, it was as a result of my son feeling anxcious over noticing an odd number of whatever while driving by whatever and it being a bad omen, wheras he would find conmfort in seeing an even number. Looking back, I see it as he was either sinking as a result of hearing something from his disfunctional parnets that he could not shake or actually looking forward to something and not noticeing. Am I making any sense? Anyway, I am so glad he is flying out to se me tomorow for the weekend and will review all of the help we have been sent/replied at that time. (sorry of this is too cheerful - at his choice it will be in between fishing for two days)
cheers,
Father & son
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