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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 11 to 35 of 35. Go back in thread:
Posted by garnet71 on April 6, 2009, at 15:50:52
In reply to Re: My life so far...what should I do?, posted by Dima on April 6, 2009, at 15:36:45
Oh-that explains it. Yeah, Dima, that's happened to me to - inability to function from an SSRI. However, for first time users, that often goes away in a few weeks, though sometimes lethargy lingers - but not as bad as the first couple weeks. If you are still tired after a few weeks, docs normally augment with WB; but I think you have to see if something like the Paxil works first, rather than going straight to WB, esp. since you have anxiety. If your tiredness dissipates, but you don't feel energetic or at par, WB can be a great augment to add.
Could you do your schoolwork at home for maybe 3-5 weeks? When i was in hs, I had to miss something like 4 months because of a virus - conjunctivitis, and did fine that year w/o going to classes. It's def. better to get that over with now then wait till you're in college to have to go through psych drugs.
Or - it's possible you could start Paxil and WB at the same time, depending on the doctor. I'ts important to talk to your doctor about the anxiety symptoms regardless of whether or not you think it comes from depression. Really important to tell him/her this. How would you expect to get the right treatment if the doctor doesn't know all your syptoms--like the worrying and phobias?
You did the right thing finding a psychiatrist rather than continuing treatment with a general practitioner, and to seek advice.
Posted by Garnet71 on April 6, 2009, at 17:08:58
In reply to Re: My life so far...what should I do?, posted by Dima on April 6, 2009, at 15:36:45
Dima,
Just thought I'd ask - do you feel uncomfortable telling the psychiatrist about your phobias?
I'm not saying you are, but if that is the case, you know - they've really heard it all, really. They want to help you be your healthiest, so if they know about such things, they wouldn't judge you; instead, they try to find a remedy/solve the problem.
At first, I thought you were saying you were imagining people being homosexual when they were not, but when I reread, I saw your issue was irrational homophobia. Many irrational phobias go alongside with anxiety, and doctors can help you with that. I have some anxiety-related phobias - like pills and scared of heights, though they aren't full-blown phobias, they do exist.
Also - some psychiatrists are more personable and easy to talk to than others. Some are just plain wierd too.
As for the Buspirone - if your anxiety isn't too dramatic right now, it might be a good idea to try it first rather than the Wellbutrin. It is a good way to avoid the debilitating SSRI side effects - but it doesn't work for everyone. It shouldn't make you all tired and miserable like SSRIs do at first. See what your doc says after you tell him/her about all your symptoms. It would be great if that ended up working for you.
Posted by Dima on April 6, 2009, at 17:09:41
In reply to Re: My life so far...what should I do? » Dima, posted by garnet71 on April 6, 2009, at 15:50:52
> Oh-that explains it. Yeah, Dima, that's happened to me to - inability to function from an SSRI. However, for first time users, that often goes away in a few weeks, though sometimes lethargy lingers - but not as bad as the first couple weeks. If you are still tired after a few weeks, docs normally augment with WB; but I think you have to see if something like the Paxil works first, rather than going straight to WB, esp. since you have anxiety. If your tiredness dissipates, but you don't feel energetic or at par, WB can be a great augment to add.
>
> Could you do your schoolwork at home for maybe 3-5 weeks? When i was in hs, I had to miss something like 4 months because of a virus - conjunctivitis, and did fine that year w/o going to classes. It's def. better to get that over with now then wait till you're in college to have to go through psych drugs.
>
> Or - it's possible you could start Paxil and WB at the same time, depending on the doctor. I'ts important to talk to your doctor about the anxiety symptoms regardless of whether or not you think it comes from depression. Really important to tell him/her this. How would you expect to get the right treatment if the doctor doesn't know all your syptoms--like the worrying and phobias?
>
> You did the right thing finding a psychiatrist rather than continuing treatment with a general practitioner, and to seek advice.It really would be more effort than it's worth to miss school for that long. I am finishing senior year in May, so if I'm trying any extremely drowsy drugs, it'll be after that in the summer. And I am already tired almost all the time, so I would much prefer a drug which carried no drowsiness with it at all.
Also, I've read numerous reports that Paxil takes away the depression, but leaves you emotionally numb. That sounds no better than my current situation. And I am already tired almost all of the time, so I would much prefer a drug which carried no drowsiness with it at all.
Why wouldn't you suggest trying the Buspirone?
Posted by Garnet71 on April 6, 2009, at 17:14:23
In reply to Re: My life so far...what should I do?, posted by Dima on April 6, 2009, at 17:09:41
I was writing you while you were writing me - lol
Yes, give Busprione a try, but make sure you tell your doc all your symptoms first :))
Some docs though are biased for and against specific medications though. But yeah, Buspirone doesn't make you tired. Some people say it works and some say it doesn't, but if you are not TOO bad off now in terms of anxiety, I'd say give it a try.
Good luck :-)
Posted by Dima on April 6, 2009, at 18:10:17
In reply to Re: My life so far...what should I do? » Dima, posted by Garnet71 on April 6, 2009, at 17:14:23
Well thanks for the replies! During my visits to the doctor so far, I have in fact been afraid to talk about that stuff. And I thought they would just go away with the meds. Now that I'm realizing that she probably should know about that too, I think I'll feel more comfortable telling her next visit.
Posted by metric on April 7, 2009, at 12:01:59
In reply to Re: My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:55:33
> I forgot to mention something, and I don't know if it's important. I've tried Adderall three times in the past month at doses no higher than 40 or 60mg in the time release capsule. After about two hours, when the drug is fully working, I feel almost perfect. I have virtually no fear of speaking to people, and love talking. Topics of discussion just roll out of me like crazy. Also, the fatigue I almost always have goes away. Of course, I know that Adderall is not the miracle drug for me, as the effects wear off over time, and tolerance quickly develops. I just thought that maybe the great effects of this could be mimicked in a healthier way.
Try to obtain d-amphetamine (Dexedrine, DextroStat). It's a better antidepressant than Adderall. None of the traditional "antidepressants" are remotely similar to amphetamine if that's what you're hoping. You could try modafinil (Provigil).
Did you become tolerant to it? Or is that just something you're concerned will eventually happen?
Posted by fuzz54 on April 7, 2009, at 20:40:57
In reply to Re: My life so far...what should I do?, posted by garnet71 on April 6, 2009, at 8:14:10
Your fear of being gay is irrational since you aren't attracted to men. That could be a sign of anxiety, depression, or both. I'd stay away from Wellbutrin unless you just can't get out of bed as it can be a double edge by giving you motivation and also more anxiety. Drugs are usually only part of a larger picture when trying to get better. Sometimes it takes awhile to get used to therapy, but it has to be something you want to do. There is hope. You may not see any, but that's just depression clouding your view on reality.
Posted by rjlockhart04-08 on April 8, 2009, at 1:33:20
In reply to My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:42:26
Looking back, they are fears that start at 18, phobia's, and fears that where not thought about in the past. They start poppin up, it's a wierd feeling because you have never experienced this feeling "unknownness, semi-confusion". Back them, i did not talk, alot, i was mellow, and kept back because i didnt have common relating with people. I just made aquantanices....didnt keep relationship, buddies, because i was unstable, i would just say somethings, and people thought i was wierd. I hated going to social's.
Get to the point on this: fears about unknown, phobia's, can become severe, studdering, mmmm unstable image. Not using my personal background, but it can come to the point of "stiff, to nervous on a thought".
What happen's, people catororize people from what there outer actions, their looks, their personality, if its good thats great, but inner thoughts come.. In the past, i fought alot of my fears, and denied them inside. They came back, to a point where "reprogram" thinking. Starting having diffrent images, and when you think of something, or maybe a "daydream" of the future how you want to see yourself, it does happen, but not fact.Personality change, i would get really random, and people thought i was random. Well, after years, it turned into "passive-agressive" basically walk around, things get on your nerves, people, say things, I would make indirect dis remarks, that where deep, i'll had to them apologize later. It's the sub-coun, operating. People give me a hard time, I usally will make up a fast comment, "Well, patty, or sue, whatever the hell your name is, havin a bad day? join the club!" Gotta a Light? i smoke light's.
Sometimes people walk off, say: bye, don't come back, got on my nerves in the first place, thanks.Its dynamic rotates to any circumstance, or new image, drop the old one. It's from an unstable self-image, in the past. So, establish "unique" changes. Not wanting to associate with other's.
Medications:
Paxil, first thing, in the past it been "blackboxed" for people under 18, because of bad reactions. Paxil increases Serotonin in the nerve synpase, the tranmisstion is full. Serotonin is mainly for happiness in seeing life as it is, sleep, feeling stable, definetly elimiates depression.. Main it causes "mental fog", great for anxiety, i've read various articles, "unmotivated, tired, lethargic" yet "not in the dump's" which, feel empty, incomplete inside. It deals alot with how you look at life. Paxil is a strong SSRI. Dopamine/norephinephrine are low, or cancelled out because the serotonin satruration is full.
Wellbutrin, increases motivation, indirectly, people who have "low energy". But, also, it made me, battery-like, the worst mood, irrtiblible, i would make saracastic comment's to every second if something happened. It works, good with some ADHD cases, by increasing dopamine, motivation, norephienphrine, attention, vigilent, staying alert.
Some thought, imput:Prozac is good, because it provides "lift" and it's mild stimulating, but i've read it helps with anxiety. Reason, it's stimulating, it also effect's NE and increases "lift". It's good, but i've also read the bad reports too.
Adderall/Dexedrine is psychoactive, produces increased motivation, dilegence, on something, or getting things done Feeling like you cant think. Also is abusable, which can lead to tirenesss, and horrible depression. So, follow the intructions on the bottle.
There's something called Strattera, it's for ADHD, and said to be AD, it's not. It increases NE levels, more alert. Takes about 3 weeks to start working.Have you heard of Nuerontin, Lycria are the new generation anti-anxiety GABA associated, medications. Older, where Ativan, Valium, Xanax which are still used in needed cases.
Mood stablizer's: Lamictal, Lithium, are ok, but not the best. They normalize nuerotrasmitter's back to normal nevel's. That may help. Tell your doctor, Wellbutrin, it's making "moody", like you said, somedays are ok, other's are bad. That's not a stable balance, effect's how you operate in general, negative feelings, moods.
Lamicatal may help. Reconsider on the Paxil, it causes drowsiness in general. Prozac, is diffrent, but more "lifting".
Best luck, take care
rj
Posted by desolationrower on April 8, 2009, at 7:06:17
In reply to Re: My life so far...what should I do?, posted by fuzz54 on April 7, 2009, at 20:40:57
> Your fear of being gay is irrational since you aren't attracted to men. That could be a sign of anxiety, depression, or both. I'd stay away from Wellbutrin unless you just can't get out of bed as it can be a double edge by giving you motivation and also more anxiety. Drugs are usually only part of a larger picture when trying to get better. Sometimes it takes awhile to get used to therapy, but it has to be something you want to do. There is hope. You may not see any, but that's just depression clouding your view on reality.
wellbutrin doesn't cause more anxiety than an ssri
its not as good as a benzo for anxiety, but at least make the comparison to something equivalent
-d/r
Posted by garnet71 on April 8, 2009, at 8:45:35
In reply to Re: My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:55:33
"I forgot to mention something, and I don't know if it's important. I've tried Adderall three times in the past month at doses no higher than 40 or 60mg in the time release capsule."
Hey Dima - I somehow missed your post about Adderall. That's a really high dose to take when you first try it (they started me at 10 mg). I just wanted to let you know that Adderall can cause extreme ~paranoia~ in some people, anxiety. So, if you had those thoughts after you took Adderall, that is not uncommon, esp. in high doses.
Posted by garnet71 on April 8, 2009, at 10:13:35
In reply to Re: My life so far...what should I do?, posted by desolationrower on April 8, 2009, at 7:06:17
> wellbutrin doesn't cause more anxiety than an ssri
>
> its not as good as a benzo for anxiety
>
> -d/rOh-sorry, Dima, I said something like that too...
"WB causes anxiety in some people"Feeling kind of stupid now :(
well, I guess you'll have that on forums from time to time.
Posted by rvanson on April 9, 2009, at 21:58:57
In reply to My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:42:26
> Sorry if this post is kind of long, I feel like all details should be accounted for. So I am an 18 year old male. Pretty much as long as I can remember, I haven't been genuinely happy. Maybe for brief periods due to great circumstances, but in general, my outlook on life has been bleak.
>
> Also, I have some irrational fears, which I am just recently beginning to think may be anxiety. First, I get nervous and anxious when I have to talk to someone. Anyone. I fear not knowing what to say to keep the conversation going, and most of the conversation is spent with my mind racing trying to think of topics. I am fine in front of large crowds. If a speech is prepared beforehand, I could probably say it in front of a thousand people, with little problem. Second, and a lot more weird and embarrasing, I have a fear of being gay. I have not been attracted to males, and have certainly been attracted to females, yet every time the thought crosses my mind, my stomach does a somersault. I have nothing against gays, and do not feel there is anything wrong with living that way, but I have a huge fear of one day waking up and realizing that I am in fact gay. For a perfect future, I see myself living happily with a great girlfriend.
>
> At the beginning of 2009, I decided to finally see a doctor. I went to my family doctor, who quickly prescribed Paxil 20mg and sent me on my way. I took it for three days, but the insane drowsiness and sexual side effects were too much too bear.
>
> I scheduled an appointment with a real psychiatrist. First I went to two therapy sessions, which seemed extremely pointless and it seemed that we were both just saying things to fill the hour time slot.
>
> After that, I was scheduled to see another doctor there, who prescribed Wellbutrin SR 150mg. Well, Budeprion, which I've read can be quite different. I took it for a week, but I had to stop because of a never ending feeling of a lump in my throat and my mouth constantly filling with saliva. I saw the doctor again, and she decided to try the XL version. She gave me a prescription for the 150mg pills, and said after about two weeks, go ahead and take two per day.
>
> I've been on the Budeprion XL for about three weeks, and just started taking two pills per day three days ago. The three weeks have been like a rollercoaster of moods, and I don't know if it's the drug or I'm just attributing how I normally feel to it. Some days I feel good. Not great, but good. At those times all I think is that this drug is perfect, and to keep at it. Other days, like today, I feel horrible. Nothing worse than it was before the drug, but still not what I was looking forward to. If I realize the drug is not working, I plan on trying brand-name before any other drug, because of the many reports of differences I've read.
>
> Recently, I found information about Buspirone, which seems like a possibility if Wellbutrin doesn't work. I assume that maybe the depression is only there because of the irrational fears.Wellbutrin is called "Bupropion" as a generic.
Buspirone is a good idea for an add-on med, but it's more for anxiety then depression. However its worth a try. Thhe side effects were not too bad for me but it didnt do anything for me.
Posted by Amelia_in_StPaul on April 11, 2009, at 22:35:53
In reply to My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:42:26
Dima, are you still here? It sounds like you may have OCD. A common obsession with OCD is fear of being gay.
Posted by Dima on April 11, 2009, at 23:09:18
In reply to Re: My life so far...what should I do?, posted by Amelia_in_StPaul on April 11, 2009, at 22:35:53
I have never had the notion that I have OCD. I don't really see what other obsessions I would have.
I just looked up what you said, though, and it seems pretty similar to what I experience. I've never been able to find people who seem to share the same fear.
Posted by Neal on April 12, 2009, at 2:30:50
In reply to Re: My life so far...what should I do?, posted by Dima on April 11, 2009, at 23:09:18
the irritation with your dad could be from the Wellbutrin (buproprion) partly; it's a prime side-effect of the drug, especially at first few weeks.
Posted by Dima on April 12, 2009, at 9:47:03
In reply to Re: My life so far...what should I do?, posted by Amelia_in_StPaul on April 11, 2009, at 22:35:53
> Dima, are you still here? It sounds like you may have OCD. A common obsession with OCD is fear of being gay.
Wow, Amelia, thank you so much. I've read a few articles already on HOCD. It matches my thoughts perfectly. It's amazing to finally have an explanation and to have hope for an end to it. I see my psychiatrist on Tuesday, and I will tell her about it.
Posted by Amelia_in_StPaul on April 12, 2009, at 11:40:55
In reply to Re: My life so far...what should I do?, posted by Dima on April 11, 2009, at 23:09:18
A person can have only one obsession. I have only one but have been dx'ed with OCD. Also, classic OCD has observable compulsions, but with "pure O" OCD, the compulsions are mental. For instance, do you find yourself trying to distract or to think about something else when you have the thought that bothers you? Or do you have any other tricks to get through it like rationalizing to yourself, telling yourself something to soothe the fear? That would be an OCD compulsion. Pure O OCD is a misnomer because it isn't just obsessions--there are compulsions, but again, they are internal, mental, and other people can't see them (as they would see a hand washer).
Posted by Amelia_in_StPaul on April 12, 2009, at 11:43:10
In reply to Re: My life so far...what should I do?, posted by Dima on April 12, 2009, at 9:47:03
Oops, sorry, I just responded to your prior post. OK, great!, I'm so glad you have an explanation now. It's scary to have these intrusive thoughts and not realize that they are part of something that others have. Good luck to you!
> > Dima, are you still here? It sounds like you may have OCD. A common obsession with OCD is fear of being gay.
>
> Wow, Amelia, thank you so much. I've read a few articles already on HOCD. It matches my thoughts perfectly. It's amazing to finally have an explanation and to have hope for an end to it. I see my psychiatrist on Tuesday, and I will tell her about it.
Posted by Dima on April 12, 2009, at 19:00:55
In reply to Re: My life so far...what should I do?, posted by Amelia_in_StPaul on April 12, 2009, at 11:43:10
It seems I've got one problem almost figured out, but I still have the socializing problem. I hate that I usually find no joy in conversation, and consider it more of a chore than a pleasure. I want to have a desire to talk to others. I am not great at holding conversations because I'm thinking both that I do not care enough to talk and that I have nothing to say.
I have never had a girlfriend for over a few weeks because I don't have the interest and they lose interest. I am not just an introvert who doesn't feel the need to talk, and accepts that. I consider myself an extrovert with an engine malfunction. It's not a question of being afraid to say things. If you asked me to, I could walk up to anyone in a store and tell them their pants are nice. But the thought of failing horribly at conversation scares me. The only time I've felt almost completely normal, conversation-wise, was when I took Adderall. I truly had a desire to hear what people had to say, and I wanted them to hear what I said.
I've tried to find others online who have the same concerns, but it's not going great. Does anyone know anything about what I could be experiencing?
Posted by Amelia_in_StPaul on April 12, 2009, at 21:01:34
In reply to Re: My life so far...what should I do?, posted by Dima on April 12, 2009, at 19:00:55
I'm just a layperson with some advanced schooling in psychology. But I'd say, as a layperson with my own anxiety issues, that your original message sounded exactly like social anxiety, severe social anxiety. But it's different to have no desire to talk than to have no desire because you are exhausted by the anxiety involved in it. Is that the case--do you really have no desire to have relationships or conversations?
Posted by Dima on April 12, 2009, at 23:53:59
In reply to Re: My life so far...what should I do? » Dima, posted by Amelia_in_StPaul on April 12, 2009, at 21:01:34
> I'm just a layperson with some advanced schooling in psychology. But I'd say, as a layperson with my own anxiety issues, that your original message sounded exactly like social anxiety, severe social anxiety. But it's different to have no desire to talk than to have no desire because you are exhausted by the anxiety involved in it. Is that the case--do you really have no desire to have relationships or conversations?
I definitely have a desire to have relationships. That's one of my biggest desires, which makes this even worse. I just never feel the effort to talk and have conversation is worth it. It's not that I can't have a pleasurable conversation. Every once in a while I'll get into one and be fine, but usually, I feel much more uncomfortable trying so hard to hold up a conversation.
Posted by Amelia_in_StPaul on April 13, 2009, at 11:25:35
In reply to Re: My life so far...what should I do?, posted by Dima on April 12, 2009, at 23:53:59
Dima, that's definitely severe social anxiety. In addition to meds, I would suggest you see a therapist who specializes in anxiety and OCD. OCD is an anxiety disorder, so one who can do all would be great. The OC Foundation has a web page from which you can access the names of people in your area who address OCD. If there aren't any listed, try Psychology Today or, even better, if your state has a psychological association web site, try that. My state has a search function for clients and you can search by area of practice. When you find potential therapists, make sure to ask them if they have experience with exposure and response prevention (ERP). Only someone with that experience will have truly treated OCD patients.
Posted by Dima on April 13, 2009, at 19:30:55
In reply to Re: My life so far...what should I do?, posted by Amelia_in_StPaul on April 13, 2009, at 11:25:35
> Dima, that's definitely severe social anxiety. In addition to meds, I would suggest you see a therapist who specializes in anxiety and OCD. OCD is an anxiety disorder, so one who can do all would be great. The OC Foundation has a web page from which you can access the names of people in your area who address OCD. If there aren't any listed, try Psychology Today or, even better, if your state has a psychological association web site, try that. My state has a search function for clients and you can search by area of practice. When you find potential therapists, make sure to ask them if they have experience with exposure and response prevention (ERP). Only someone with that experience will have truly treated OCD patients.
I've never really thought social anxiety is the problem. I don't have any physical symptoms, but I understand they don't have to be there. But mainly, I haven't considered it because it doesn't seem like I'm just getting too anxious and that's causing me to not talk. I just have trouble continuing a conversation and thinking of things to say. I do not get very engaged in conversation, so the conversation usually becomes awkward, and this fear of the awkwardness causes the anxiety. But maybe that's exactly what social anxiety is, and I don't know it.
Posted by Dima on April 14, 2009, at 18:41:31
In reply to Re: My life so far...what should I do?, posted by Dima on April 13, 2009, at 19:30:55
I went to the doctor today. I told her about the social anxiety and OCD. She prescribed Zoloft and is going to find a therapist to recommend.
Posted by 4ed on April 15, 2009, at 16:27:02
In reply to Re: My life so far...what should I do?, posted by Dima on April 14, 2009, at 18:41:31
Hi, I just joined and don't want to jump in giving advice just maybe some support. You sound a lot like I did around your age, and although I didn't have some of the trauma you've had, a lot of your fears seem pretty normal. I did find stimulant type drugs very useful as well but you are right to see them as just a temporary fix. In my case I turned a corner and stimulants suddenly made my life full of paranoia - not confidence and well-being as they did in the beginning. I'm now on the path to giving up the meds/drugs in favor of learning new coping skills, even at my late age - essentially this is the #1 problem many of us face. Best of luck with your treatment.
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