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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 35. This is the beginning of the thread.
Posted by hansi555 on May 13, 2010, at 8:38:33
Hi
Been here on the list on/off for a couple of years now.
I am now 2,5 years into a depression that seems very hard to get really out of. It seems like it will stay forever.Recap:
Nov. 2007, 2,5 years ago, I went down with stress and stopped working for 3 months. I had many symptoms, the most significant was total insomnia for a period of 2-3 months. I was not depressed at the time, but couldnt sleep without sleeping pills and benzos, I wasnt eating much either.
Finally my doc prescribed me remeron so I could eat and sleep. After taking remeron for about 2 weeks, out of the blue started massive crying spells, I couldnt understand why but everybody told me it was a depression, so I had to continue with the remeron (didnt knew much about ADs at the time). At this time I was beginning to work a few hours per day - it helped me to think of something else, I didnt think of it as work, it was more therapy.After 3-4 weeks I suddenly felt well again, this lasted 3 weeks, then everything turned around again, had some awful weeks again, then I got well again, then I was depressed again etc. Finally, about 3 moths after starting w remeron, the psyk (not my regular doc any longer) suggested to add Lexapro. At first it seemed to help some, but yet again it didnt really last. I struggled some more with ups and downs. Then in the autumn 2008 I read about Nortriptyline as a solution for treatment resistant depressions. I started out w a low dosage and after some months I was up to the 110 mg I am now - tried to go even higher so I could leave Lexapro and remeron out, but it seemed to work better in combination - kinda like Efexor maybe?? I have since then also tried to stop the remeron but then I have to increase one of the two others and this gives me even more side effects. For the last year I have been on 110 mg Nort, 10 mg Lexapro and 12 mg Remeron - tried minor changes but this seems the best solution.
But still it is upps and down all the time. I had a 3 months period Sept-Oct-Nov 2009 when I thought I was about to recover fully, but yet again my mood slowly went down in Dec and Jan. Since then it is the same picture: A period of days or weeks where it is going very well and ok, then some days of real down, crying spells, then feeling somewhat better, then crying and then a I am well again. It is SO frustrating - also for my family (wife + 2 daughters, 3 and 7). Also the planning of activities, especialy the summer vacations we normally enjoy vey much, seems difficult. Both the vacations in 2008 and 2009 was a mixed pleassure, half the time real down , the other half very well but I cant choose which it will be and when.
I am seeing both my psyk and a psychologist once every 4-6 weeks, but they dont have any answers either. I am regarded by others as a mentally strong person, not the kind of person anybody would suspect as a continuously depressed person hell, I am still wondering if the meds are doing this remember the real depression came 2 weeks AFTER the remeron start up.
I exercise 2 times per week, running and soccer. I dont eat fish at all and a well respected psyk have stated that some of the fish oils have a beneficial effect on how well we break down the AD medication. So a couple of weeks ago I started eating fish pills (big ones) every day.My changes in mood sometimes seem "chemical". I can wake up and feel awful one day and the next I am well again. As if the medicine is working one day but not the next.
And I am so puzzled. Why will (what seems) a uni-polar depression not just go away by it self? 2,5 years is a long time even my psyk admits this fact.
Is it because the medicine is only working partly on me? Is it possible to prolong the lifetime of a depression if the meicine doesnt work?I have been working full time since Sept. 2009 and yes, there have been times of being busy/stressed but I master and like my job as area sales manager very well.
But can a busy period result DIRECTLY in a depressed mood - and thereby somehow skip the "stress period"? It is called stress-RELEASED depression for some reason? I mean first you get busy, then stressed for some time and then depressed?It is like a big equation and I can not figure out how to solve it or how to live my life in away so I can recover fully...
Any thoughts welcome
Posted by Phillipa on May 13, 2010, at 12:25:20
In reply to How long can this thing last?, posted by hansi555 on May 13, 2010, at 8:38:33
Hansi I know what you mean but just don't know hope others do. Phillipa
Posted by manic666 on May 13, 2010, at 13:32:12
In reply to How long can this thing last?, posted by hansi555 on May 13, 2010, at 8:38:33
sure work played a big down fall in me/// nothing fancy a bricklayer on construction sites// i used me anxierty to work like a nut ball, your body tell.s you when the stress is to much, ignore that an your brain switch,s your body an your mind off //ie depression//the more you carry on then breakdown happens end of cicle//it clear your meds are wrong for your illness ,but what to take mabye someone on babble has a better idea//i learned from hear an use ssri,s ,any one at a given time //easy to tapper an not to bad on the body parts //stay safe
Posted by MrTook on May 13, 2010, at 15:44:11
In reply to How long can this thing last?, posted by hansi555 on May 13, 2010, at 8:38:33
Hey man I feel for you.
I am just curious what sort of therapy are you approaching with your psycologist? Have you done any "bibliotherapy" (I.E. book reading?)
Posted by hansi555 on May 13, 2010, at 16:54:59
In reply to Re: How long can this thing last?, posted by MrTook on May 13, 2010, at 15:44:11
> Hey man I feel for you.
>
> I am just curious what sort of therapy are you approaching with your psycologist? Have you done any "bibliotherapy" (I.E. book reading?)I have read the book by Andrew Solomon:
The Noonday Demon: An Atlas of Depression.Do you have any suggestions?
Posted by MrTook on May 13, 2010, at 17:25:04
In reply to Re: How long can this thing last?, posted by hansi555 on May 13, 2010, at 16:54:59
Feeling Good: The New Mood Therapy to me is kind of the gold standard of Cognitive Behavioral Therapy. It was one of the first books written on the subject for the patient to use directly.
If you haven't had exposure or much success with CBT before it would probably be worth a read. Just know that it is not a instant cure, but a more like a treatment plan.
Also note that I am not at all against medication. I currently take Lexapro 20 mg, and a vitamin/prescription called deplin. But I still flip through my dog earred copy of Feeling Good whenever my anxiety starts to creep up.
I wish you the best of luck in whatever you try.
Posted by Zyprexa on May 13, 2010, at 20:29:46
In reply to How long can this thing last?, posted by hansi555 on May 13, 2010, at 8:38:33
I had a similar thing happen to me. I over worked myself for 10 years. I was very stressed out. I could feel it for a long time, years. I could not tell if it was my meds or some thing else. I think it was just working too much. I made a lot of med changes for a number of years. Finaly I tried abilify, and that was the straw that broke the camels back. I was getting no sleep, could not function at work. I was not making good relationships at work. I finaly got so frustrated that I was going to trash everything at work. So I walked. Went straight home and drank. I tried to get a job after that, but no one would hire me. I've been out of work now for the most of the last 3 years. I had one job that lasted 4 months and anouther for 2 weeks.
I've been back on the zyprexa now for 3 years and slowly getting better, very slowly. Some times it does not seem like its working. But I don't change it because I know its helping. Right after the abilify I went back on zyprexa and took as much as 50mg a day with little relife. 3 years later and I don't need more than 15mg, but I added perphenazine to it, which helps to calm me. I'm trying to get a job now, and its looking promissing, hopfully they will hire me soon. She atleast made it sound like she is going to hire me. We'll see. I feel like I'm back where I started when I first got sick. Starting over again.
Its funny though, for the longest while the meds seemed to not work as well on some days as opposed to others, or for periods days. Wonder if it has anything to do with being manic or what. I'm schitzoaffective. I could tell because some days I was calm and some days I was so frustrated that I could not work even cooking dinner, or leave the house. I would feel crazy like I wanted to just throw the remote through the TV. I drank more on days that I could not handle. It seemed to help a little.
Posted by Dr. Bob on May 13, 2010, at 20:50:01
In reply to Re: How long can this thing last?, posted by MrTook on May 13, 2010, at 17:25:04
> I have read the book by Andrew Solomon:
> The Noonday Demon: An Atlas of Depression.> Feeling Good: The New Mood Therapy to me is kind of the gold standard of Cognitive Behavioral Therapy.
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book, a movie, or music without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though.
Thanks!
Bob
Posted by Polarbear206 on May 13, 2010, at 22:09:45
In reply to How long can this thing last?, posted by hansi555 on May 13, 2010, at 8:38:33
Most likely an underlying bipolar spectrum. Plenty of red flags going up. Has your doctor mentioned this to you?? Please go to psycheducation.org This is an excellent site for education.
Posted by hansi555 on May 14, 2010, at 2:58:14
In reply to Re: How long can this thing last?, posted by MrTook on May 13, 2010, at 17:25:04
> Feeling Good: The New Mood Therapy to me is kind of the gold standard of Cognitive Behavioral Therapy. It was one of the first books written on the subject for the patient to use directly.
Thank you for this, will buy most probably buy this.
> If you haven't had exposure or much success with CBT before it would probably be worth a read. Just know that it is not a instant cure, but a more like a treatment plan.
I am not used to all this short words, what is CBT?
>
> Also note that I am not at all against medication. I currently take Lexapro 20 mg, and a vitamin/prescription called deplin. But I still flip through my dog earred copy of Feeling Good whenever my anxiety starts to creep up.
>
> I wish you the best of luck in whatever you try.Thanks - and you too!
I am not against drugs either but I just dont think they are helping me in the long run.I have absolutely NO reasons for being unhappy.
I managed to keep my job, get a lot of support, could even choose exactly how many hours I would like to work, they paid for all treatment - even after the insurance ran out ( ok I am cash cow for them also, money talks...).My family supports me in all sorts of ways, I am doing some real exiting stuff in my spare time. No one would ever suspect me as your "typical" in the danger zone of depression guy (drug, alcohol, no money, no education, some one died etc.)
I couldnt ask for a better setup in my life but still I just get sad, it is so strange to me.
Posted by hansi555 on May 14, 2010, at 3:04:52
In reply to Re: How long can this thing last?, posted by Polarbear206 on May 13, 2010, at 22:09:45
> Most likely an underlying bipolar spectrum. Plenty of red flags going up. Has your doctor mentioned this to you?? Please go to psycheducation.org This is an excellent site for education.
Thanks PB206 - will do this.
So you would reckon me Bipolar II? Dont know if the docs know this definition in Europe...?Anyhow, as stated previously, I am not manic - just swinging between normal and depressed.
Over these 2,5 years the cycles has become shorter (well apart from that 3 months period last autumn), happend already 6 months into the treatment.
Posted by Hombre on May 14, 2010, at 3:13:07
In reply to How long can this thing last?, posted by hansi555 on May 13, 2010, at 8:38:33
Don't beat yourself up. I know how it feels to want to scream, "I'm really a hard working person! I am not doing this to myself on purpose!!" and to have no seeming consistency in terms of days you feel ok and days when you are the walking dead. But the fact that meds sometimes work and sometimes don't leads me to ask:
Do you think you are getting the right nutrition so your body has all the raw materials, cofactors and other essential nutrients so the meds have something to work with? Although med regimes are rather stiff, individual nutrition is personal. I personally don't hold to the macho line, "just eat food. real food. you'll get all the vitamins you need..." blah blah. You already got your exercise going (good on ya for that) and you obviously care about getting well. Just hope nutrition isn't the weak link that is holding you back.
Posted by manic666 on May 14, 2010, at 3:14:02
In reply to Re: How long can this thing last?, posted by hansi555 on May 14, 2010, at 2:58:14
there is no perfect set up in life //when you talk depression//ask britny spears an any person who thinks they had the pefect life//depression make you equal to any one on earth/ from rich or poor your still on the depression hit list
Posted by MrTook on May 14, 2010, at 10:18:11
In reply to Re: How long can this thing last?, posted by hansi555 on May 14, 2010, at 2:58:14
CBT is just an acroynm for Cognitive Behavioral Therapy. There is lots to read about it on the web.
Best Of Luck!
Posted by manic666 on May 14, 2010, at 13:12:05
In reply to How long can this thing last?, posted by hansi555 on May 13, 2010, at 8:38:33
if you are severly depressed you would not be able to hold down any job// let alone a managerial//if you are stressed you wont get well till you remove the stress//if your doc has no clue to your illness he should not prescibe meds for something he has no clue to//you may be good at your job ,but is your job good to you???????im great at construction an could make a fotune// but i carnt go back it would kill me,,no you limits is the key///cbt would not help in your case you have none of the issues it cover,s
Posted by hansi555 on May 14, 2010, at 14:05:31
In reply to Re: How long can this thing last?, posted by manic666 on May 14, 2010, at 13:12:05
> if you are severly depressed you would not be able to hold down any job// let alone a managerial/
Well it comes in waves, my depressed periods are anyting from a couple of days up to 2-3 weeks.
I just get trough it and wait for a better period.
If it is severly, I dont know, my psyc says it originally was a moderate one, it is not as bad now, but hey, it is more than 2 years ago it first started.
All my stress symptoms have gone now, since 9 months ago - only the mood swings remain/if you are stressed you wont get well till you remove the stress//
Stressed or not - that is a good question...
if your doc has no clue to your illness he should not prescibe meds for something he has no clue to//
Well he is not the most skilled guy, he just hope to avoid to many problems, he is not talking much about recovery
you may be good at your job ,but is your job good to you???????
Point taken, I really enjoy and master it but it can be too much
im great at construction an could make a fotune// but i carnt go back it would kill me,,no you limits is the key///cbt would not help in your case you have none of the issues it cover,s
Posted by manic666 on May 14, 2010, at 14:12:53
In reply to Re: How long can this thing last?, posted by hansi555 on May 14, 2010, at 14:05:31
yes ,dont think i was being harsh //i am blunt ,i admit//there is something amiss an your doc seem,s a dork///if on the wrong med,s could be a major factor//you may have come good without them who knows //but he want,s a kick up the *rs* on this//its not fair on you an your family
Posted by MrTook on May 14, 2010, at 14:37:50
In reply to Re: How long can this thing last?, posted by manic666 on May 14, 2010, at 13:12:05
CBT was developed for the most part in regards to treating depression. As far as I know it has shown positive results across a whole spectrum of disorders.
I am not trying to force this on anybody, I was just asked what books I have read.
Have a great day!
Posted by hansi555 on May 14, 2010, at 17:14:39
In reply to Re: How long can this thing last?, posted by MrTook on May 14, 2010, at 14:37:50
> CBT was developed for the most part in regards to treating depression. As far as I know it has shown positive results across a whole spectrum of disorders.
>
> I am not trying to force this on anybody, I was just asked what books I have read.
>
> Have a great day!And I appreciate it, have ordered that book on ebay already. I will be my own judge on wether it is useful to me or not.
Thanks!
Posted by bleauberry on May 14, 2010, at 17:50:23
In reply to How long can this thing last?, posted by hansi555 on May 13, 2010, at 8:38:33
I don't believe in the names given to various psychiatric conditions for a variety of reasons. It's just too complicated to mold into such a defined picture. So call it bipolar of one kind or another, whatever, it is obviously instability of nervous system chemicals for some unknown reason.
Maybe hidden infections having ebbs and flows, the effects of unsuspected mercury or lead, an adrenal system taxed beyond the ability to find steady ground, who knows at this point without some deeper diagnostic work. Could even be as simple as an allergy or intolerance of foods you commonly eat and don't realize they are the ones. Sometimes the obvious is so obvious as to be invisible.
So for now we are left with smoothing out the symptoms, which means meds that have a reputation for having potential to do that.
Zyprexa would be a strong candidate to replace remeron, for both depression and mood stabilization.
Lithium is a possibility, in the dose range of 150mg to 600mg...considerably less than commonly prescribed doses which I see as overburden.
A million doctors and people will immediately say Lamictal but I don't personally like that choice. I have hardly ever seen anyone do great with it for longer than a year, and t didn't happen in clinical studies either.
Mentioned zyprexa already. In that same class I would put abilify as a second choice.
I have good reasons for the above comments but it needs to be considered they are only one person's view.
Posted by alchemy on May 14, 2010, at 19:50:40
In reply to Re: How long can this thing last?, posted by bleauberry on May 14, 2010, at 17:50:23
This is definitely very chemical. The other suggestions (reading, etc) will likely not be very helpful unless you get some medication that works.
In my opinion you have a bipolar spectrum problem. You do not need to have the happy "manic" phase to be bipolar. This is especially true for those with bipolar 2. Bipolar 2 is something that is a more recent diagnosis as psychiatrists realize there is a spectrum of bipolar illnesses. Agitation can also be considered the manic phase. I have never had the happy manic phase, I wonder what that would feel like.
I myself do not fall exactly into the bipolar 2 category, but my dr. said that is the closest disorder I match.
To me it is obvious that you "cycle" from the very bad to the not so bad. This requires a mood stabilizer. Let's hope that you have a good response to one right away. Then if there is some lingering depression, they may also want to put you on an antidepressant. But you probably shouldn't be on an antidepressant without a stabilizer.
Lamictal is the drug that they often first prescribe for the bipolar 2ish stuff. But of course that is only one option and it may not be the best for you.
I take Lamictal, Celexa, and Wellbutrin. I still have depression, but it is not as bad as it would be otherwise. And the SSRIs (like Celexa), would be making my moods more all over the place without Lamictal (a stabilizer)
I am so sorry you have gone through this. It sounds like you might have many more options to try. Take care
Posted by manic666 on May 15, 2010, at 3:40:08
In reply to Re: How long can this thing last?, posted by alchemy on May 14, 2010, at 19:50:40
CTB i have done this course ,thats why i say its not really your bag//i was the only guy among a lot of women it was a group course //the only kind you get in england an then your lucky///it is mainly for panick control/ in every day life situations//the reason i said its not for you//you are able to go to work without falling to bits will anxierty //a cbt no1 /you have not got agoraphobia no 2//you can sit in a rooom without bolting for the door//no3/// you can go in a superstore without looseing you bowel movments ,thats how bad a person gets ///ctb is to learn you these things are not real an you can control them//but try telling that to a person who cr*ps themself with anxierty in public//it has many floors an out of the 11 that did the course// it helped 1 //damaged 3 worse than before //others left because ir was not helping/// an me it was the wrong course for me i had mastered those probs myself//but for someone to tell a class its not real thats happening to you// an dump you at the end of the course to your own fate is sadistic an totally out of order///as you see i think its crap
Posted by hansi555 on May 15, 2010, at 5:23:34
In reply to Re: How long can this thing last?, posted by bleauberry on May 14, 2010, at 17:50:23
I tend to see my situation and solutions as 2 alternatives:
1) I am (still) stressing myself too much in terms of hours spend on all sorts of things, including work and even things in my spare time.
I go to bed too late, forget to take some breaks during my work days, my weeks are too busy.
I need to work less, take care of bedtimes and make exercise on a more regular basis.
Stress => depressed periods directly.I am even suspecting that the meds are not really helping me as I have these none-controllable mood swings that can happen at all times - also when on vacations, in weekends etc.
or
2) I am bipolar II in some kind of way, not the typical one, and I need to add some mood stabilizer, could be lithium or lacmital.
I have done enough in terms of reducing my work load and I sleep enough already as it is (7-8 hours). It is a chemical problem in my brain and I need to change my meds.
Posted by MrTook on May 15, 2010, at 11:30:08
In reply to Re: How long can this thing last?, posted by manic666 on May 15, 2010, at 3:40:08
Manic666, it appears that you did not have a good experience with CBT. I am sorry that happened. Please know that CBT is much more than a group session for anxiety. I don't really know what is wrong with you or hansi, but some studies have shown CBT to be as effective as medication for a variety of ailments, and the two are even more effective when used in combination.
I do know that reading through the list of common cognitive distortions was like reading a list of how I respond to different events. Seeing the harm in these ways of thinking was very beneficial to me.
Again, I do both. I am not a no medication type of guy, but I do think you have to address both the mind and the brain when tackling the problems we face.
Best of Luck to you all,
MrTook
Posted by MrTook on May 15, 2010, at 11:36:00
In reply to Re: How long can this thing last?, posted by MrTook on May 15, 2010, at 11:30:08
I just wanted to add that if you have tried and failed with any sort of therapy then I don't think any less of you for that. I imagine that different forms of therapy are a lot like different types of medication, they will work for some, but not for others.
All the best,
Mrtook
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