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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 26. This is the beginning of the thread.
Posted by brooke484 on April 21, 2007, at 12:16:02
I really need help. I've been reading this board for awhile but never posted anything. I don't even know where to begin really because this has been going on for so long. My situation seems so hopeless.
I'm 36 now but developed this in college many years ago. It started with a panic attack and then all of a sudden I'm in a dream state. I didn't know what the heck was going on. I thought for sure I was going insane. Nothing looked or felt real anymore. My doctor diagnosed me with panic disorder and put me on 400 mgs of Imipramine. That pretty much cured me and
I thought it was over. Two years later I went off my meds and sure enough, 3 months later it all came back. Of course, it didn't help that I was in my senior year of college and totally stressed. So I'm back on Imipramine (450 mgs this time) and it works for a few weeks until my doctor reduces the dose to 400 and all of the symptoms return. So he ups the dose again but it doesn't work. Since then I've tried it 5 or 6 more times but it never worked again.Anyway, you can guess what I've been through the last 12 years or so because many of you are in the same boat. I've tried all of the SSRI's, anti psychotics, Nardil, Wellbutrin, Klonopin, Lyrica, Effexor, Serzone, tricyclics, etc. Nothing works.
I'm so out of it I don't even feel real anymore. I walk around in a complete daze all of the time. It never goes away. I'm not sure why I'm still here really. I mean, it's been 12 years since I felt normal. So now I'm in a deep depression and I'm also in a panic most of the day because I'm constantly questioning my sanity. I know some of you experienced this derealization feeling and got better with MAOs. I did try Nardil 10 years ago (60 mgs), but it didn't really do much. It helped with my anxiety but not the fog. ENSAM would cost me $100 a month, so my doctor is thinking about Parnate. Other than that does anyone have any suggestions? Right now I'm in the process of going off Wellbutrin, which was a total waste of my money.
I just keep asking myself, "When will this nightmare ever end?"
Thanks for reading.
Brooke
Posted by Ines on April 21, 2007, at 16:46:58
In reply to severe derealization, major depression + anxiety, posted by brooke484 on April 21, 2007, at 12:16:02
Hi Brooke,
I too have been having a difficult time finding something that works. I've had no sucess yet, but hopefull for next trial. I'm afraid I don't have any suggestions for you- I'm not that knowledgeable about treatment options- but just wanted to say welcome, there's a lot of us on the same boat.
Ines
Posted by Phillipa on April 21, 2007, at 22:28:53
In reply to Re: severe derealization, major depression + anxiety, posted by Ines on April 21, 2007, at 16:46:58
Add me to the list. Love Phillipa
Posted by FredPotter on April 22, 2007, at 20:14:08
In reply to severe derealization, major depression + anxiety, posted by brooke484 on April 21, 2007, at 12:16:02
Brooke I spent all my college years in this state. I scared myself stiff that I was becoming schizophrenic, but these are not symptoms of schizophrenia. If only someone had told me that then it would have saved all that suffering. And it's some of the greatest suffering you can get.
Gradually I got better, so now I no longer get the derealisaion. I used to seriously think I was the only thing that existed and the rest was all my dream. I decided one day that just because it's a dream it doesn't have to be a nightmare. I gradually fell in with a great group of close friends and the problem went away. It's resurfaced as anxiety and depression on and off when I've felt frightened and insecure. I found Xanax helped at first.
Did you give Nardil a fair trial? At least 6 weeks and at up to 90mg a day?
Bless you - you're not going insane
Fred
Posted by brooke484 on April 23, 2007, at 9:26:25
In reply to Re: severe derealization, major depression + anxiety, posted by FredPotter on April 22, 2007, at 20:14:08
Thank you for your kind words. When I took Nardil it was for 6 months and at 60 mgs. I'm not sure why the doctor didn't increase the dose. Scared probably.
At this point it can't get any worse. I cannot function. If it wasn't for my 3 year old I would have been gone already. This is no way to live. It's all survival.
I'm talking to my doctor today and I am going to demand he give me Parnate. I can't take this anymore. It's been 12 years this way!
I'm glad you're better. I think it's one of the worse symptoms you can ever experience.
I'm trying to be strong!
brooke
Posted by FredPotter on April 23, 2007, at 16:43:07
In reply to Re: severe derealization, major depression + anxiety, posted by brooke484 on April 23, 2007, at 9:26:25
Brooke also I'm not trying to minimise it but it seemed to me that the more I thought about the derealisation the worse it got. When I stopped thinking about it it went away. Don't let any of these therapists tell you it's due to over-breathing though. In my case at least I know that's not true.
Best of luck with the Parnate. You're right this is no way to live. Hammer on people's desks until they take notice. However I suppose there's always the possibility they'll give you Zyprexa or something
Best wishes
Fred
Posted by brooke484 on April 23, 2007, at 20:02:01
In reply to Re: severe derealization, major depression + anxiety » brooke484, posted by FredPotter on April 23, 2007, at 16:43:07
I wish it were that simple. It hasn't gone away since 1993. I've tried not to think about it. I went to college, got a job, got married, had a baby, etc. The feeling is always with me. It never goes away no matter what I do. It's like my brain is stuck in DR mode or something.
brooke
Posted by FredPotter on April 23, 2007, at 23:05:32
In reply to Re: severe derealization, major depression + anxiety, posted by brooke484 on April 23, 2007, at 20:02:01
Brooke have you seen this? I must admit I find it unconvincing
http://www.anxietynomore.co.uk/depersonalisation_and_derealisation.html
Posted by brooke484 on April 24, 2007, at 13:59:54
In reply to Re: severe derealization, major depression + anxiety » brooke484, posted by FredPotter on April 23, 2007, at 23:05:32
I read it and I agree with you. I believe my problem is mostly chemical. The only thing (and I tried therapy, relaxation, yoga, etc) that ever worked was medication. Nothing else. I do agree that thinking about it and obsessing over it makes it worse though. I just need to find the right med combo and never go off it the next time!
brooke :)
Posted by cmorhoun on May 12, 2007, at 9:13:34
In reply to severe derealization, major depression + anxiety, posted by brooke484 on April 21, 2007, at 12:16:02
Brooke,
Sorry, I'm comming to this post late. I feel for you, I'm having the same struggle...same age as you too. I noticed you didn't list any stimulants as meds you've tried. I've heard of a lot of people finally finding relief from Stimulants like Adderall or Concerta. They are a bit tricky but for many people they are the answer. Search the archives and read up. So far, they are the only thing that have given me any relief. My probleml is, I'm ultra-sensetive to meds and they can give a bit of a rollercoaster ride with emotions. Defenitly worth a try though since the effects are basically immediate...no waiting 2 months to see if they'll work. The only other suggestion I'd have is to look at dietary things, food allergies, ect. Some people only get better by going on strict diets. Personally, meds have no effect on me at all unless I compliment them with eating ridiculously healthy. Good luck and let me know if you want any more info on my experience with stims.
> I really need help. I've been reading this board for awhile but never posted anything. I don't even know where to begin really because this has been going on for so long. My situation seems so hopeless.
>
> I'm 36 now but developed this in college many years ago. It started with a panic attack and then all of a sudden I'm in a dream state. I didn't know what the heck was going on. I thought for sure I was going insane. Nothing looked or felt real anymore. My doctor diagnosed me with panic disorder and put me on 400 mgs of Imipramine. That pretty much cured me and
> I thought it was over. Two years later I went off my meds and sure enough, 3 months later it all came back. Of course, it didn't help that I was in my senior year of college and totally stressed. So I'm back on Imipramine (450 mgs this time) and it works for a few weeks until my doctor reduces the dose to 400 and all of the symptoms return. So he ups the dose again but it doesn't work. Since then I've tried it 5 or 6 more times but it never worked again.
>
> Anyway, you can guess what I've been through the last 12 years or so because many of you are in the same boat. I've tried all of the SSRI's, anti psychotics, Nardil, Wellbutrin, Klonopin, Lyrica, Effexor, Serzone, tricyclics, etc. Nothing works.
>
> I'm so out of it I don't even feel real anymore. I walk around in a complete daze all of the time. It never goes away. I'm not sure why I'm still here really. I mean, it's been 12 years since I felt normal. So now I'm in a deep depression and I'm also in a panic most of the day because I'm constantly questioning my sanity. I know some of you experienced this derealization feeling and got better with MAOs. I did try Nardil 10 years ago (60 mgs), but it didn't really do much. It helped with my anxiety but not the fog. ENSAM would cost me $100 a month, so my doctor is thinking about Parnate. Other than that does anyone have any suggestions? Right now I'm in the process of going off Wellbutrin, which was a total waste of my money.
>
> I just keep asking myself, "When will this nightmare ever end?"
>
> Thanks for reading.
>
> Brooke
>
>
Posted by brooke484 on May 12, 2007, at 9:31:28
In reply to Re: severe derealization, major depression + anxiety » brooke484, posted by cmorhoun on May 12, 2007, at 9:13:34
Thanks for your reply. No, I never tried any stimulants. Maybe the doctors thought it would worsen my anxiety. Can you take those with an MAOI? I'm starting Parnate on Monday. I will definitely mention this to my doctor.
About the food allregies...I've never looked into that. I do eat healthy (mostly organic), only drink water, stay away from sugar, etc. But that never changed how I felt. Do you think it's worth seeing an allergist? Do they find the food allergies with blood tests?Thanks again. :)
Posted by cmorhoun on May 12, 2007, at 14:39:22
In reply to Re: severe derealization, major depression + anxiety, posted by brooke484 on May 12, 2007, at 9:31:28
stimulants are actually very anxiolotic. They run some risk of addiction but that is usually when they are abused. The thing is, with stimulants you will usually feel amazing upon starting them. they sort of get you high. Predictably they loose that umph over time so alot of people keep increasing the dose to chase that original high. If you can avoid that, they can be a very helpful. You'll get lots of energy, you'll loose your appetite which isn't a problem with most women. My problem with them is they make me overly emotional. I get highs and lows even on the extended versions. I'm exceptionally sensetive though so I doubt that's a problem for most people. Adderall XL seems to be the most popular one for depression. Depending on how rigid your doctor is, they may not prescribe it since stimulants are typically used for ADD. Demand it or go to someone else if you have to.
MAOIs...I believe stimulant use is frowned on with them but if you search the archives, you'll find there are some people who take the combo. Doctors will probably tell you it's a no no and you'll probably have a hard time getting presciptions for both. Parnate has actually been said to have similar efficacy to a stimulant. I think because it hits dopamine pretty hard. You might want to try a stimulant before the parnate just to see what it does for you. You'll know within 5 days how it's going to effect you.
Another thing you might try if you haven't already is Lithium. If you're not familar with Lithium the word alone is probalby scary but if you research it, you'll find that it's a pretty amazing and natural substance. I'm just starting it myself. Incidently I'm also starting week 4 of wellbutrin sr and unfortunatly this is the most suicidal I've ever felt. Apperanlty didn't do much for you either.
Have you tried ECT? Probalby wouldn't help you since you've been dealing with this for so long but it's always another option. You'll find lots of literature saying it's an extremely effective and safe treatment with an unfounded stigma. You'll also find lots of literature saying it's not very effective at all and can cause long term memory loss despite what the medical coummunity says. Someone on this forum once said it's more effective for people with atypical depression, not anxious depression or depression from personality dissorders. It's usually the last resort. I'm considering it myself.
Food allergies...honestly, if you're a healthy eater it would probably be a waste of time. The whole subject is very questionable, many methods of testing have been disproven. Generally you hear "stay away from sugar" with depression which you are already doing. Other than that I would emphasise eating lots of raw green veggies...supposedly happy foods. Just for kicks you might do some research on things like Candida Yeast and Leaky Gut syndrome. There are some related yahoo forums. It's all sort of the wholistic approach and will most likely amount to nothing but you might find some things to try. Just be carefull that you don't make things worse.
I'm sure you've done the psycho therapy stuff. Perhaps you could find a local support group, just to have a place to vent or not feel alone.
There are also all the altenative wholistic things like SAM-e, St. John's Wort, Amino Acid suppliments, L-Trytophan, ect. If you haven't gone down that road, it might be worth a shot.
Any therapy, suppliment, idea you come accross relating to depression has most likely been discussed on this forum or the alternative forum so search the archives on any of it. You'll learn alot. You might try searching "treament resistant" too.
I feel for you and I admire you. If you feel anything like I do I just can't fathom lasting 12 years. I've dealt with depression on some level my whole life and had a few really bad episodes around my college days. About a year ago is when I finally crashed hard and I've been in a sureal nightmare ever since. There are lots of meds and combos I haven't tried yet but I'm just not sure I'll be able to hold out much longer for more trials. I'm lucky in that I don't have a family...I don't have a 3yr old to leave behind. Hang in there and let me know if you have any more questions or just want to chat.
> Thanks for your reply. No, I never tried any stimulants. Maybe the doctors thought it would worsen my anxiety. Can you take those with an MAOI? I'm starting Parnate on Monday. I will definitely mention this to my doctor.
> About the food allregies...I've never looked into that. I do eat healthy (mostly organic), only drink water, stay away from sugar, etc. But that never changed how I felt. Do you think it's worth seeing an allergist? Do they find the food allergies with blood tests?
>
> Thanks again. :)
>
>
Posted by brooke484 on May 12, 2007, at 19:56:04
In reply to Re: severe derealization, major depression + anxiety » brooke484, posted by cmorhoun on May 12, 2007, at 14:39:22
I appreciate all of your suggestions. I honestly don't know how I've done it for 12 years. I guess because I got better two times before and I believe it will happen again. The deep depression I am in now all happened after I gave birth. It has nothing to do with my son, obviously, it's the boredom and me constantly thinking about my problems. At least when I went to work I had that to think about. Now all I do is think about how bad I feel. If Parnate doesn't help I don't know what I'll do. I'm barely holding on. I thought I was going through some kind of horrible Wellbutrin withdrawal, but I guess this is just how I feel without any meds. Ugh. Sorry for rambling.
Thanks again.
brooke
Posted by Greif on May 26, 2007, at 6:11:40
In reply to Re: severe derealization, major depression + anxiety, posted by brooke484 on May 12, 2007, at 19:56:04
Lex and Klon combo have the best results if you visit a goup of DP DR victims. Very similar to PTSD.
Posted by brooke484 on May 26, 2007, at 10:05:24
In reply to Re: severe derealization, major depression + anxiety, posted by Greif on May 26, 2007, at 6:11:40
I did take lexapro in 2002 and it helped about 75%. Unfortunately I went off it because I wanted to feel 100% (really stupid). Well, it never worked again so that's where I am right now. When will I learn???
brooke
Posted by Phillipa on May 26, 2007, at 19:07:41
In reply to greif, posted by brooke484 on May 26, 2007, at 10:05:24
Why does it seem as if an ad will only work the first time you use it? I don't get it? Love Phillipa
Posted by brooke484 on May 26, 2007, at 20:45:06
In reply to Re: greif » brooke484, posted by Phillipa on May 26, 2007, at 19:07:41
Phillipa,
I wish I knew why they did that. The same thing happened with Imipramine. I needed 400 mgs the first time, the second time I needed 450 and then it never worked again. I even went all the way up to 600 mgs to try to get it to work but it didn't. Lexapro worked only one time. I never should have quit taking it.
brooke
Posted by Phillipa on May 26, 2007, at 21:29:48
In reply to phillipa, posted by brooke484 on May 26, 2007, at 20:45:06
Same thing happened to me with the l0mg of paxil I had been on never worked again. What causes this? Love Phillipa
Posted by jflange on May 26, 2007, at 21:56:16
In reply to Re: phillipa » brooke484, posted by Phillipa on May 26, 2007, at 21:29:48
Hi!
I think the reason SSRIs only seem to work on the first dose is that eventually your brain starts to down regulate the neurotransmitters in response to the medication. According to my neurobiology phd friend, it's a more complicated process than that, but the short story is that the therapeutic benefit over time comes from how your body responds to the drug over the long term. That first dose is just the joy that comes from an initial serotonin dose before the body responds.
Brooke- I have read through your posts and agree with the person who suggested Lex and Klonopin. from what I hear from you, I think that DP is really how your body responds to anxiety/ panic attacks. And anxiety is rarely conquered with just one medication. Try a combination, like an SSRI you can tolerate and a benzo or buspirone. That's how I licked depersonalization after suffering from PD/PTSD for a little over 12 years!
Best of luck to you,
jflange
Posted by brooke484 on May 27, 2007, at 11:36:16
In reply to Re: phillipa, posted by jflange on May 26, 2007, at 21:56:16
You just gave me some hope. I've also been suffering for over 12 years. What meds are you taking now? I just started Nardil today. Thank goodness I'm not having any side effects (Parnate made me nuts). I took this 10 years ago and tolerated it pretty well. I just hope it works again!
Glad you recovered. DP/DR is the worst.
brooke
Posted by jflange on June 2, 2007, at 10:16:58
In reply to jflange, posted by brooke484 on May 27, 2007, at 11:36:16
Hi Brooke-
sorry I have been out of the loop for a few days so it took me awhile to respond.i take zoloft and buspar for the panic/anxiety disorder caused by ptsd. i could not find relief on zoloft alone - in fact i continued to feel depersonalization and anxiety with almost all the ssris i tried. the zoloft kept me from having panic attacks but i still felt on the edge of having one a few times a day. that meant i felt strange and irritable and had depersonalization big time.
my pdoc suggested buspar or klonopin to curb the general anxiety and the depersonalization that i had when i anticipated or feared a panic attack - or just impending doom. i had tried both these meds before alone and they brought me only partial relief of my problems before. but i chose to take a low dose of buspar - titrating up slowly - to add to the zoloft and i can remember vividly the day when i realized i had been symptom free for a week. that was 2004 and I have continued to feel the same way since then.
i have never tried nardil so i can only hope you get the relief you had before. my pdoc explained to me that anxiety is often hard to treat with one medication alone since it accompanies many other disorders (e.g. my panic disorder). i can assure you though that depersonalization is almost always related to anxiety. if one medication is not your "magic bullet" then stay open to supplementing it with something else. Best of luck to you, jflange
Posted by brooke484 on June 2, 2007, at 12:40:16
In reply to Re: jflange, posted by jflange on June 2, 2007, at 10:16:58
Thanks for your response. I have never tried buspar, but I have heard it's used to augment other medications. I wouldn't be able to take it now, but it's something I would consider. This all started with a panic attack so I know it's mainly anxiety related (well, the depression doesn't help either). When I took Lexapro I remember the day I went outside and saw everything clear for the first time in many many years. The fog was gone. I'll never forget that. I would do anything to get that back again. Fortunately I have a good doctor who knows his meds. He never has me on just one, except for right now. I can't take buspar with nardil though.
Glad you're better. I would do anything to be rid of this feeling.
brooke
Posted by cmorhoun on June 3, 2007, at 14:07:04
In reply to Re: jflange, posted by brooke484 on June 2, 2007, at 12:40:16
Have you ever seen an edocrynologist or checked out your thyroid? Tried any T3 or T4 supplimentation? A number of people without any thyroid issues report help from thyroid supplimentation.
Posted by brooke484 on June 3, 2007, at 20:53:14
In reply to Re: jflange » brooke484, posted by cmorhoun on June 3, 2007, at 14:07:04
Yes, I have thyroid issues as well (I'm hypo) and I take Armour. When I tried T3 it just made me anxious.
brooke
Posted by Phillipa on June 3, 2007, at 21:55:07
In reply to Re: jflange, posted by brooke484 on June 3, 2007, at 20:53:14
Booke the t3 did that is cytomel right? As I had thought of adding that then heard about the anxiety so decided against it. Was it real bad? Love Phillipa
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