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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by liliths on February 3, 2008, at 11:45:19
I'm scared and I'm desperate. I've become unable to go out of the house... yet I don't identify with the supposed definition of agoraphobia... I don't feel fear about going out... I simply don't want to do anything. I wish I were dead. I know that 'doing' something, anything, will make me feel better, but the truth is I don't care enough to follow through. It's like I don't want to feel better - I feel as if I've given up. I no longer want to 'get better'. I don't think I trust or belief in it anymore.
I've been diagnosed with add, depression and anxiety and have been on medication for years. I had a very bad protracted experience after a long intense year of going back to school, after which I had to battle the state for my license simply because I admitted to being treated for depression. Had I just said nothing, I would have automatically just gotten the damn thing and who knows where I might be right now. Instead I spent a year fighting for my rights and though I came close to winning, I didn't. I had to accept being 'monitored' and it feels like the experience just broke something in me. It separated me from my education and goals long enough that I already forgot most of what I'd learned. My ability to concentrate and re-learn anything is nil... and despite every good intention to get my s**t together, I just don't or can't try. I don't want to even do it anymore... I don't seem to want to 'do' anything. I'm even too lazy to kill myself, too afraid of any result other than success (what a nightmare that would make!!!), too lazy to get my affairs in order, too lazy to pay attention to any single goal long enough to carry it out.
what can I do to at least start to go out of the house? I've made promises with myself (we ALL know how those go!), agreements & pacts with others & simply just can't follow through. Every day just takes me that much deeper into hell.
I'm totally broke. I'm middle aged, my life is behind me... I really just want out. I keep praying for a 'deadly' disease to do the work for me
and I apologize for this ranting email because I know there's nothing anyone can do about this. I realize all I've done is send out a lot of pain and I'm sorry for that.
but I just had to tell someone...
if you've gotten this far.. thank you listeningnamaste,
liliths
Posted by Phillipa on February 3, 2008, at 12:32:51
In reply to help!?, posted by liliths on February 3, 2008, at 11:45:19
Hi Lilith I remember the horrible time with the massage therphy correct me if wrong. But I know what your're going though don't please dont think of death as did this for a year and now want to live and physical things keep going wrong. My husband said you shouldn't wish for things the might happen not very nice of him as they have. I can no longer nurse identify and age too. But I was told by my therapist to get out everyday even if just for a walk as it will get worse. This is an excellent topic for psychology too. I'm seeing a therapist now and am trying to switch to something I can work at at home and still go out. I need to be with someone. Are you still seeing the pdoc. A call to him/her is in order I think. I do feel for you as know that feeling when you just can't take anymore. But you have to try. You're not a quitter. Please seek help. And know we are here for you night or day someone may be online. You're such a lovely person. Love Phillipa
Posted by Racer on February 3, 2008, at 13:27:15
In reply to help!?, posted by liliths on February 3, 2008, at 11:45:19
Hm... This is the medications board, so one part of me wants to answer with suggestions about medications, but the rest of me wants to suggest the Psych board, as a place to get more helpful behavioral responses...
OK, I'll compromise:
I'd say off hand it doesn't sound as though your medications are all that effective right now. Can you get a medication check? Maybe see about getting a more effective set of medications on board? Sometimes medications can address some of your symptoms effectively, but make others worse -- and often that can point the way towards a more fully effective medication cocktail. In my case, what you're describing as "laziness" is sometimes a sort of amotivation caused by certain sorts of medications. I'd bet you and your pdoc can work together to find a better solution.
That brings up the psychological side: when I read your post, it sounds to me as though you're blaming yourself for the state you're in right now. What you're describing, though, sounds like maybe this thing called "depression..." Honestly -- a lot of the residual symptoms of depression can look remarkably like the picture you're painting of yourself. In my experience, this leads to a perfect opportunity to blame myself for "wallowing in self-pity," "refusing to help myself," "deserving to feel this way," etc. It's not a nice place to be. That's something you could address in therapy, or even just by trying to figure out what you'd say to someone you cared about if she said those things about her own life and behavior.
Also, agoraphobia comes in a lot of flavors. I'm agoraphobic, my mother's agoraphobic, and not only does it show in different ways for us, neither one of us looks exactly like the DSM's description. I'm not a big fan of looking for diagnoses, because I think it can sometimes get in the way of seeing what's actually there, but maybe calling it agoraphobia as the closest thing that fits would be helpful.
Good luck.
Posted by Justherself54 on February 3, 2008, at 13:59:58
In reply to Re: help!?, posted by Racer on February 3, 2008, at 13:27:15
Please call your doctor or your pdoc as soon as you can..even print your post off and take it with you..you explained very articulately what you are feeling..my reaction when I read your post was depression..
Please keep posting and updating us..we may not have all the answers, but we sure can offer support while you're going through this..
Posted by ny2bk on February 3, 2008, at 14:24:31
In reply to help!?, posted by liliths on February 3, 2008, at 11:45:19
I know how it is when its recomended at times to try cbt type stuff such as will power etc to make small moves out of the situation,however not downplaying or contradicting those,i will say personaly i felt at times those were my GOALS not options.
With that said,and my med history pretty much posted to death here,promsing not to be partial ill still ask have you tried or thought about parnate with a good benzo.
I say this because parnate is still one of the fastest acting meds,and you sound like ur in a spot in which u need help yesterday.
Benzos cover the small wait time and residue anxiety not covered by parnate alone,but again far as i know parnate is one of the most fastest acting anti depressants,even if it gets u to sq 1,you can at least work from there and move to another med,but you in my view need a strong med now to work fast so you can start on the suggestions the other posters left,i know how hard it is,im 250 and bench press over 300 pds,and in bad bad days i literaly crawl from spot to spot,so the many recomendations from loved ones sound logical but when your neck and back literaly ache from anxiety those recomended tasks are simply not an option.
wishing u the best,and know ur not alone
Posted by Sigismund on February 3, 2008, at 17:04:45
In reply to help!?, posted by liliths on February 3, 2008, at 11:45:19
Lilliths
You do not have to apologise to me.
Your post made me laugh, that rather worrying bitter laugh we can get.
So with me it's like 'Yes, I understand what you are saying, only too well, I'm afraid. And like you I'm not much good at digging my way out of this particular hole.'
Thank you anyway.
Posted by elanor roosevelt on February 3, 2008, at 22:11:51
In reply to help!?, posted by liliths on February 3, 2008, at 11:45:19
What meds are you on at this point?
If you are on meds they are going through a med melt downthe not trusting that things can even be okay
this is about having absolutely no sense of futureand you are not going out because it is just too much effort
this is called depression
you are lucky you reached out here
i hope you are going to call the doctor on monday morning
> what can I do to at least start to go out of the house?Can you call a good friend and ask for some help walking out the door?
>
> I'm totally broke. I'm middle aged, my life is behind me...three years ago i lost every penny in a business partnership
i am still pulling out
i'm 56
but it's getting better
for much of the time it didn't seem like that could happen
hang in there> and I apologize I'm sorry for that.
>
>why are you apologizing to the people on this board--every one of us knows you are trapped and we want to help you outplease post tomorrow and tell us what's up
Posted by Phillipa on February 3, 2008, at 22:50:09
In reply to Re: help!?, posted by elanor roosevelt on February 3, 2008, at 22:11:51
Eleanor you have had some bad times too. Love Phillipa
Posted by Molybdenum on February 5, 2008, at 2:17:07
In reply to help!?, posted by liliths on February 3, 2008, at 11:45:19
Hi,
well you sure do have a bag of pains to deal with. I agree with whoever suggested that you're probably not on the right bunch of meds, so maybe try changing doctors too...?
My pdoc says that some studies have shown that exercise is just as effective as meds for depression. I hate exercising personally, but I've found that going for a bike ride alone is quite fun. Makes me feel like a kid again. So maybe there's some exercise that might be fun for you?
I can relate to your fear. I'm so afraid of failure that I just can't seem to get a job. Sure I could get a job doing some menial crap thing but I think that would be so bad for me that I'd have to pull my own plug and / or go postal. So in the meantime I keep applying for jobs I'll never get.
What a dickwad am I.....!
Have you thought about moving house? Sometimes a new area, new streets, shops - all helps to make you focus on forwards. There - now I won't have to be optimistic again for 6 months.. ;)
Good Luck...!
Posted by liliths on February 7, 2008, at 9:24:12
In reply to help!?, posted by liliths on February 3, 2008, at 11:45:19
... all so much for responding. It took so much out of me to actually write that other email, I haven't been able to reply. I knew it would mean writing more about something that can't really be helped and I know I can't un-ring the bell, so to speak, but here goes:
phillipa - bless you for remembering! and for the babblemail - I promise to write you back :)
So unfortunately, I'm stuck with my meds and can only manipulate the ones I'm already taking... part of 'monitoring' is that I have to send in copies of ALL prescriptions written as well as my pdoc filing a quarterly report on my 'condition'. If I admit to being depressed, they're allowed to initiate random drug testing, consults with their doctors and all at my own expense...
Florida is the ONLY state in the country that treats an admission of depression as a potentially dangerous condition for the public regarding massage therapists and automatically forces a 5-year monitoring contract. I fought long and hard to get it overturned - it took close to a year and in the end, though I came close, I didn't win. And something in me feels like it just broke as a result.
I currently have a possible 3 year out and am planning on requesting one after one year, which would be in august. But only if I can keep my depression a secret
My pdoc also turned against me in the process!! After assuring me that admitting my depression on my application would be no problem, once it turned into one, he seems to blame me. He was forced to change my meds - something we were both upset about and though it is supposedly illegal, they have the right to do it. Anyway, not only do I now have to fear what he may write in my reports, he refuses any change in my meds. I initially cut back a lot of them during the process - hell I would've quit them all if I believed it would get them off my back - and when I requested to go back on buspar 3 months ago as an augmenter to my wellbutrin, he began to yell at me and reduced me to tears.... yelling "you think you know more than the doctors"
well DUH! it IS my mind and body!
anyway, in addition to a ton of vitamins (including 5-htp, magnesium, dhea, dmae, just to name a few) that I take in the mornings I'm currently on
morning
81mg concerta
(supposed to take 2-54's but I've been breaking one in half) I was on focalin xr which I preferred but my current insurance won't accept it
200mg wellbutrin (generic - all my insurance will take)
15mg buspar
1mg klonopinafternoon:
100mg wellbutrin
15mg buspar
(also take 500mg magnesium)evening
1 or 2 klonopinanyway, thanks again... there's really nothing that can be done except for me to try and fight my way through this... if I can
I love you all for being here
namaste,
lilith
Posted by Racer on February 7, 2008, at 13:05:40
In reply to thank you...., posted by liliths on February 7, 2008, at 9:24:12
That's terrible, and I'm very sorry you're struggling with all this. I well understand that limp feeling you're describing, as though a spring has snapped, and I certainly understand why you'd be feeling that way.
I do have a few suggestions, none of which are likely to make you feel a whole lot better at this point, but most of which have a chance at helping down the line.
First, that is *not* a description of a good fit with your psychiatrist. I strongly recommend that you consider interviewing some other pdocs, and maybe getting a second opinion or even third opinion. (I won't suggest you fire your current pdoc, but the thought certainly crossed my mind...) Alternately, if you have a good GP, maybe get your meds refilled there, since your pdoc won't change anything anyway?
Also, Concerta's mechanism of release means that cutting it in half is a bad idea. In fact, it basically negates the whole slow-release thing. If you're finding the 108mg too high, maybe ask about dropping to the 36mg or even 18mg size, and combining two or three of them to get a good dose for you. Cutting the pills just isn't a good idea.
As far as the licensing goes, my blood pressure went up when I read that. Aside from moving to a state without that sort of restriction, my knee jerk reaction is "VOTE!" Other than that, though, there are a few ideas floating in my brain about fighting it, but they'd all require you to be in fighting fit -- which means over this breakthrough depression.
By the way, this sounds like a good situation for therapy -- just for the support and help learning to cope and with help brainstorming solutions. Have you got a good therapist? Or can you get in to see a therapist? I think it would help. (Although not as much as more reasonable licensing laws, perhaps, and more effective medication...)
Good luck.
Posted by Phillipa on February 7, 2008, at 18:54:21
In reply to What a terrible situation » liliths, posted by Racer on February 7, 2008, at 13:05:40
Lilith lived in Florida in l970 and 1971 and I couldn't believe then that you couldn't live in neighborhoods with kids as I thought it was discrimination. And at the time had two little ones. I heard years ago that nursing was also very restrictive. Travelings nurses was the only way to go then as they honored your state license you lived in. Come to NC we need good massage therapists. Love Phillipa
Posted by liliths on February 8, 2008, at 11:26:58
In reply to What a terrible situation » liliths, posted by Racer on February 7, 2008, at 13:05:40
hi racer... thanks for understanding.
unfortunately, I can't change pdocs without raising red flags with PRN (that's the 'governing agency' responsible for the monitoring). I'm stuck with him until I can get out of this contract or I just can't take it anymore and walk away from the profession (which I'm not earning anything from anyway but worked SO hard for)
I did think about having my primary prescribe my meds until I realized PRN probably wouldn't accept my not being 'monitored' by a psychiatrist and would most likely make me see one of theirs (at my own expense!) and who knows what kind of disaster that could yield, besides putting me deeper into debt
And I understand completely about what breaking a concerta pill does - that's one of the reasons I do it. I preferred focalin XR as it came on faster. Breaking one of the concertas helps with that. If I take 1- 1/2, I do have 1 concerta working properly
But the other reason I do it is that I have to 'stockpile' my meds as my insurance won't cover them all year. I have a limit of about $2400 per year. My new insurance, though much better for doctors, is worse for my meds - they charge MUCH more and I'll hit my ceiling much faster - am likely to barely make 6 months at this rate. With the other one I almost made 11 months before I had to pay 100% and that's simply not an option. I'd end up on nothing! This insurance doesn't cover focalin and is charging over $300 for each concerta script! Though my co-pay is only $30, they tally both costs in my 'covered' expenditure of $2400 . My other one only charged about $200 for either concerta or focalin and that co-pay was $25. All my other meds are much more expensive as well. My co-pays are higher (in most cases $0 is now $8) but 'their' costs are considerably higher than what the other insurance used. I think this one is charging my account what I would have to pay, whereas the other must have used their actual cost. I don't really know. But I probably should cut down to only 1 concerta per day within the next month or so if I'm to have enough for 12 months and may need to start cutting back on my others as well. My other option is to go onto something cheaper, like plain old ritalin. But I hated the ups and downs of ritalin and don't think those crashes would do me any good, particularly under the circumstances I'm stuck with
as for fighting, I fought a good long one and did look into legal representation. PRN makes almost 85% of it's revenue from the state... they're quite a big fish here. I did shell out $350 to a Health Law firm only to have them tell me that yes, what PRN was doing was illegal, but good luck trying to get anything done about it - and they were right, I couldn't find a lawyer (including them!) willing to even consider taking them on. I suppose if I were wealthy and could afford to pay, I 'might' be able to fight some sort of suit but even then..
the law is the law and unless that changes, the best I can hope for is an early release. You'd be surprised how apathetic people are to this kind of thing - unless it's hitting them directly, nobody really wants to get involved.now as for the therapist, that's just another chapter in this amazing unfortunate farce. I was with the same therapist for over 10 years and we had a great relationship. When this whole thing hit, I knew I needed to be back in therapy but it was around the same time as hurricane Katrina. My therapist literally disappeared on me and never really looked back. He became quite involved in Katrina and in fact, had I been licensed when I was supposed to, I had opportunities through him waiting for me in Louisiana as they have reciprocity with Florida. So as my therapist began spending a lot of time in LA, it never even occurred to him to refer me to someone and I was so nuts it never occurred to me to ask him to. I went through this entire ordeal with NO support beyond that of friends, family and this board. My therapist did write letters of recommendations etc, and I saw him a couple of times but as time passed he spent more and more time away till he was simply gone from my life. I must admit the betrayal I have felt as a result has been enormous and on top of many other experiences I've had, I've learned I simply can't trust therapists or pdocs not to betray me when I need them most
Now I don't have the strength, or the money to start over again... though I recognize I really should be seeing someone. But I'm totally and utterly broke. My old therapist was only charging me $10 a session by then - maybe that made it easier for him to walk away. I'll never know - my last attempts to reach him have gone unanswered. And like I said, we'd had a very close relationship over the years - the way he abandoned me was devastating.
PRN supposedly gave me a fairly lenient contract as compared to most. My therapist was also expected to 'have to' file quarterly reports. I explained I didn't see him on a regular basis anymore - that after all these years I only used him occasionally. They agreed to allow him to only file reports when I did see him and we did manage to file one... hopefully that will keep them off my backs. So not having a therapist anymore is just another secret I have to keep from them.
I try and tell myself to just hang in there until august, after 1 year of monitoring, when I feel I can reasonably ask for an early out of my contract. Right now, my contract reads I may be 'considered' after 3 years but I doubt I can do this that long.
anyway, as I initially wrote, I recognize that there's really nothing anyone can do for me so again, I thank you just for being here.
it was a futile post and I'm sorry if I wasted anyone's time
namaste,
lilith> That's terrible, and I'm very sorry you're struggling with all this. I well understand that limp feeling you're describing, as though a spring has snapped, and I certainly understand why you'd be feeling that way.
>
> I do have a few suggestions, none of which are likely to make you feel a whole lot better at this point, but most of which have a chance at helping down the line.
>
> First, that is *not* a description of a good fit with your psychiatrist. I strongly recommend that you consider interviewing some other pdocs, and maybe getting a second opinion or even third opinion. (I won't suggest you fire your current pdoc, but the thought certainly crossed my mind...) Alternately, if you have a good GP, maybe get your meds refilled there, since your pdoc won't change anything anyway?
>
> Also, Concerta's mechanism of release means that cutting it in half is a bad idea. In fact, it basically negates the whole slow-release thing. If you're finding the 108mg too high, maybe ask about dropping to the 36mg or even 18mg size, and combining two or three of them to get a good dose for you. Cutting the pills just isn't a good idea.
>
> As far as the licensing goes, my blood pressure went up when I read that. Aside from moving to a state without that sort of restriction, my knee jerk reaction is "VOTE!" Other than that, though, there are a few ideas floating in my brain about fighting it, but they'd all require you to be in fighting fit -- which means over this breakthrough depression.
>
> By the way, this sounds like a good situation for therapy -- just for the support and help learning to cope and with help brainstorming solutions. Have you got a good therapist? Or can you get in to see a therapist? I think it would help. (Although not as much as more reasonable licensing laws, perhaps, and more effective medication...)
>
> Good luck.
Posted by liliths on February 8, 2008, at 11:35:59
In reply to Re: What a terrible situation, posted by Phillipa on February 7, 2008, at 18:54:21
hi phillipa... one of the more 'charming' aspects of this whole nightmare is that if I move to another licensed state, I'm required to enter into THEIR 'impaired practitioner's program' and considering no other state even categorizes depression as 'dangerous' imagine what kind of nightmare I'd up in!
Plus they could reasonably also turn down my application for licensure simply because florida has branded me 'impaired'
believe me, leaving florida was one of the first things I considered but as long as I'm being 'monitored', I'd carry that stigma whereever I went.
as I told racer, the best I can hope for is to hold on until august and pray that they'll let me out after only one year!
and as I also said, I'm sorry for posting such a futile post.
I apologize if I've wasted anyone's time.yes, florida is one very screwed up state!!
thank you for being you :))
namaste,
lilith> Lilith lived in Florida in l970 and 1971 and I couldn't believe then that you couldn't live in neighborhoods with kids as I thought it was discrimination. And at the time had two little ones. I heard years ago that nursing was also very restrictive. Travelings nurses was the only way to go then as they honored your state license you lived in. Come to NC we need good massage therapists. Love Phillipa
Posted by 4WD on February 20, 2008, at 18:52:09
In reply to help!?, posted by liliths on February 3, 2008, at 11:45:19
Hi, Liliths,
First of all, you have my deepest sympathy. I can so totally identify with you. It's an effort to even get dressed, let alone leave the house and go run errands or go to the gym or meet someone for coffee or do any of those things "people" suggest as a remedy for when we don't feel like doing anything.
I'm not quite in as bad a shape as you but I've had the same thoughts about wishing I'd get cancer or something to put me out of my misery. I'm scared to try and commit suicide, I'd probably just make myself really sick. There's no good, clean sure way to do it. And I really don't want to do it. I don't think you do either or you wouldn't be posting here for help.I have one suggestion. My therapist suggested this to me and it has really really helped, as hard as it is to make myself do it. Every morning after I have had my coffee, I make myself go for a walk. He suggested I start out with a ten minute walk and work up. So I tried it. It was pretty striking how different I felt after I got back. It gets your endorphins to kick in or something. And it gets you our of the house and it gives you a feeling of accomplishment. I treat myself to a reward when I get back - I promise myself a reward to motivate myself to go. My reward is a couple of glasses of diet Mt. Dew and a couple of cigarettes.
I've worked up to about a mile or a mile and a half a day. I've been doing this for a couple of months now and it still helps. The improved mood doesn't last more than a couple of hours but at least that's two hours I'm not miserable.
Maybe you promise yourself to try it one time. After all, what's ten minutes? Surely you can do ten minutes of something you don't really want to do.
Keep posting here. We all care about you.
Marsha
This is the end of the thread.
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