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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by phil1909 on May 20, 2010, at 16:24:15
Regarding noradenalin treatments - I thought I might add a few things to do with my experience over 20 years of being basically used as a lab rat with many a/d (and other) meds, AND from my dealings with many docs and patients.
I have suffered from Generalised Anxiety/fear/phobia related issues. This leads to a common chicken/egg type scenario - does depression cause the anxiety or vica versa.
Without listing them I've been treated with over 15-20 (at least that I rem) a/d meds or combos thereof. Over the years I've found that I'm not clinically depressed. I SUFFER FROM CHRONIC PHOBIA/FEAR/WORRY/ANXIETY - BOTH THOUGHTS AND FEELINGS OBVIOUSLY AS ONE CAUSES THE OTHER.
Serotonin & Noradrenalin RI a/d meds are most useful for treating chronic and/or acute 'DEPRESSION'. I.E. General 'blues', worthlessness, deep sadness, compulsive & fitful crying, thoughts of self-harm and suicide, etc, etc. THESE MEDS CAN ACTUALLY AGGRAVATE ANXIETY/PHOBIA ISSUES DUE TO INCREASES IN NERVOUSNESS, TENSION, STIMULATION, ETC.
What I'm trying to say that I've found that Depression and Chronic Anxiety CAN definitely be 2 SEPARATE root causes of many symptoms, AND NOT ALWAYS the cause of the other. However, 'safer' a/d meds as they are called CAN treat both. (the reverse is alsO very possible as meds used to treat phobias such as benzos and some a/ds can and do cause depression-like symptoms)
Treating Generalised phobias/anxieties unrelated to Chronic & Acute Depression is obviously very VERY tough, and the reason many sufferers are co-treated with Benzos, antipsychotics, etc.
Hence, NaRdil (as I've read, been told, and am experiencing so far) seems to treat ANXIETY/WORRY first, i.e. as the primary cause of any or all other symptoms.
IN SUMMARY, DEPRESSION AND GENERALISED ANXIETY DISORDERS ARE NOT NECESSARILY ALWAYS CAUSALLY LINKED. (just as you can be classically depressed without being anxious, fearful, phobic, etc, you can most certainly suffer from chronic generalised and/or situational anxieties and phobias WITHOUT being depressed) IF YOU FIND OUT WHAT COMES FIRST WITH YOU, OR WHAT CAUSES WHAT IN YOU, THEN TREATMENT(S) CAN BE MUCH MORE EFFECTIVE. (THIS IS BLOODY TOUGH AND PROBABLY THE REASON SO MANY PEOPLE OUT THERE RECEIVE AND PROVIDE REGULAR THERAPY)
I hope some of the info above is useful to anyone out there. If not, no worries.
Take care;
Phil
Posted by Phillipa on May 20, 2010, at 18:53:07
In reply to Depression v Anxiety (chicken + the egg) + Nardil, posted by phil1909 on May 20, 2010, at 16:24:15
Something I've always said and know my anxiety, phobias, fears do not make me depressed. But for me for many years low dose benzos work fine except klonopin is depression causing for me. Phillipa
Posted by phil1909 on May 20, 2010, at 21:02:28
In reply to Re: Depression v Anxiety (chicken + the egg) + Nardil » phil1909, posted by Phillipa on May 20, 2010, at 18:53:07
Yeah me too, but I've struggled time & time again to get my gp docs and respective psychs to understand this.
They seem hell bent on NOT prescribing benzos even in very small doses because of reliance & addiction issues, etc. (I don't know if this is a world wide stat but it's definitely the norm in sydney, australia).
Because of this I've battled with a/d after a/d knowing that a smallish maint dose of xanax will do the trick. Remarkably, I then have to take double or triple the dose of benzo to deal with the side effects and withdrawal sympts of these a/ds.
This is has been the story of my life. i'm a grad mech engineer (not that it means much) and I've had 15 jobs in 17 years. Yep that's right, 15 full-time jobs which have ended with me quitting because of anxiety/stress/pressure/worry related issues.
Somehow I've managed to buy a house re. which I've not been able to pay the bank back much more than the interest only. I've have a very very super supportive wife of 13 years & 2 champion little boys (5&6yrs).
Here I go again I'm starting a new job on Monday morning. I'M PRAYING THAT NARDIL HELPS WITH THE SITUATIONAL AND REACTIVE 'social' ANXIETY THAT I EXPERIENCE IN THE WORKPLACE.
IF NARDIL IS NOT THE WONDER DRUG FOR ME THAT I'M TOLD IT 'CAN BE' FOR SOME, I ALSO HOPE & PRAY THAT I FIND A KNOWLEDGEABLE EXPERIENCED AND UNDERSTANDING PSYCHIATRIST AND/OR GENERAL PRACTITIONER WHO CAN UNDERSTAND THAT I SUFFER FROM A CHRONIC GENERALISED ANXIETY DISORDER AND he/she CAN ACCEPT MY SITUATION AFTER 20 LONG TOUGH YEARS AND PRESCRIBE ME A LOW DOSE OF XANAX (OR THE LIKE) SO I CAN HOLD DOWN A FULL-TIME JOB WITHOUT HAVING TO GO THROUGH A DIVORCE WHICH IS A DEFINITE POSSIBILITY IF MY JOB-HOPPING CONTINUES
.
Geeze I guess that's been brewing for a while. As you can see I'm ever so frustrated with the attitudes and seemingly robotic and 'text-book' approaches to anxiety and depression treatments.Cheers to all & take lots of care;
Phil
Posted by stargazer2 on May 21, 2010, at 0:28:33
In reply to Re: Depression v Anxiety (chicken + the egg) + Nardil, posted by phil1909 on May 20, 2010, at 21:02:28
Hi Phil...you got me thinking about something and that is if you only experience anxiety at work or mostly at work, rather than at home?
I am relatively fine at home but have social anxiety and an inability to tolerate stress in mostly the work environment. I internalize all of the stress at work like a sponge and it pushes me to a breaking point and I end up quitting too. I have done this time and time again but my last job resulted in 5 out of 6 people quitting so I know it wasn't just me.
BTW, Nardil will help you...at least I feel like it will as I have taken it myself.
Why would your wife leave you if you are doing everything humanly possible to help yourself? Can she help out with working when you are not able to? Sometimes that is what has to happen in modern marriages to keep together. This is what my husband and I have done. I feel badly when one person has to shoulder all of the financial responsibilities...it really isn't possible today anyway with job insecurities. Those days where a man supports his wife and children are long gone. Every woman has to be educated and trained before having kids so that she can support herself (and children) in the event of divorce or other separation.
Here's hoping you get relief and keep the newest job. I just quit my last job 2 months ago and I am too afraid to look for another because every job that I take eventually will cause me to quit too. I think job stress today is so much worse than when I graduated 30 yrs ago, no wonder everyone has depression or anxiety and is on something...
Star
Posted by phil1909 on May 21, 2010, at 2:06:23
In reply to Re: Depression v Anxiety (chicken + the egg) + Nardil, posted by stargazer2 on May 21, 2010, at 0:28:33
Thanks very much for the feedback.
I guess I was being a bit dramatic when I wrote my wife would leave me. This is a possibility like everything else but unlikely.I hope I can arrive at an effective dose asap. I know I should be cautious and take the 'easy does it' approach, but I do get a bit impatient when it comes to a/ds.
I'm on 60mgs after 12 days, and I started on 45mg. So far I am very impressed with the slight side effects compared to when I went on SSRIs and I do feel much better already when compared to other a/ds.
My concern obviously is the workplace. I'm an operations and mfg plant manager and I'm constantly under pressure for results from senior management. Coupled with this is the pressure of having to lead and manage 20 plant staff and drive change. MANY TIMES THIS OVERWHELMS ME and I start feeling anxious with a very tight chest, 'knotted fist' type gut cramps, sweating, etc, etc. THEN THE SPIRAL CONTINUES AS I START GETTING CONCERNED, FEELING PANICY/JITTERY/SENSITIVE, WHICH LEADS TO WORRY AND A SUBSEQUENT 'DOWN'. OBVIOUSLY I'M THEN A LOT LESS EFFECTIVE.
Over the my 17 years of full-time employment I've tried everything I know of to control or minimise the effects of the 'physical' symptoms without success.
THE ONLY SUCCESSFUL TREATMENT HAS BEEN LOW DOSES OF BENZOs (ZANAX which I get off my mum or a 1-off script with no repeats from my doc) WHICH DOCTORS WILL NOT PRESCRIBE other than once. AGAIN THEN, I'm cycled through differents a/ds, serouquel, and combinations of sometime 2-3 of these.I'm looking forward to seeing how I go with Nardil. I will increase the dose if I must.
Cheers;
Phil
Posted by Phillipa on May 21, 2010, at 19:31:24
In reply to Re: Depression v Anxiety (chicken + the egg) + Nardil, posted by phil1909 on May 21, 2010, at 2:06:23
Phil here is to your success and please keep us updated. Phillipa
Posted by phil1909 on May 22, 2010, at 3:26:03
In reply to Re: Depression v Anxiety (chicken + the egg) + Nardil » phil1909, posted by Phillipa on May 21, 2010, at 19:31:24
Thanks Phillipa.
I'll let you know how I do at work on Monday. I had another good day today. I was keen to chat and interact after watching a game of soccer. Not like me at all, at least for many years.
Work will be the real test.
Posted by Elanor Roosevelt on May 22, 2010, at 5:40:46
In reply to Depression v Anxiety (chicken + the egg) + Nardil, posted by phil1909 on May 20, 2010, at 16:24:15
are all the MAOIs anxiety first meds?
i have been feeling the same--want to work with my fear and anxiety which are causing what i would describe as "despair"
Posted by phil1909 on May 22, 2010, at 8:07:57
In reply to all MAOIs?, posted by Elanor Roosevelt on May 22, 2010, at 5:40:46
Hi;
Nardil has been great for me. Better that 20 years of at least 15-20 different a/ds - some better than others.
Re. All MAOIs, I tried Aurorix in the past without success (but I'm not saying it wouldn't work now).
I've got a new psych and after telling him my story for nearly 90mins he did not hesitate discussing and recommending NARDIL.PLEASE READ BELOW FOR SOME NARDIL REFERENCE INFO I'VE COLLECTED FROM VARIOUS SITES AND SOURCES. I HOPE IT INFORMS AND HELPS IN SOME WAY.
Take lotsa care;
PhilNardil The Gold Standard for treatment of Social Anxiety
..using this wonder drugIs Nardil for me?
If you have have trialed various other treatments such as SSRI's, SNRI's TCA, etc. And you have tried CBT with no or minimal result.
If your Social anxiety is long standing and causing you significant distress
If your mature, responsible and prepared to make lifestyle changes such as limiting or ceasing alcohol and recreational drug use.
Then Nardil could well be the drug of choice for you
Doctors these days are very litigation conscious and risk adverse. Nardil is a medication with the potential for serious and deadly reactions and as such doctors are inclined to trial you on every drug under the sun before even considering a irreversible MAOI such as Nardil if at all. Many people have had great difficulty convincing their Doctor to give them Nardil for exactly these reasons.Why does Nardil get reccomended for Social Anxiety over Parnate?
Nardil raises GABA levels in the brain while Parnate does not. GABA is the principal inhibitory neurotransmitter in the brain and a deficiency of it creates feelings of anxiety, restlessness, and being overhwhelmed. GABA aids in the production of endorphins which are a chemical that provide people with a sense of well-being. Endorphins can be felt at their peak during a runner's high or an orgasm during sexual intercourse.Re: The Greenhorn's Guide To Nardil
at around 6 months in here is all i can say
1) no side effects for >3 months
2) no food interactions for >3 months (i dont avoid anything)
3) ive held a steady job and even gotten a raise out of a douchebag boss that hates giving raises.Problems with the new Nardil
You will find a lot of information on the net about Pfiser changing the formula of Nardil a few years back and how it doesn't work properly anymore. This info is all particular to the US. Australia and the UK is still getting exactly the same Nardil we always have which seems to be much like the new Nardil sold in the states. In any case, my advice is to ignore it. There are plenty of people getting good results on the new Nardil.NARDIL WORKS
I have gone to great lengths in this post to give you an idea what being on Nardil entails, but maybe the best thing to do is to give you my personal testimony.
Nothing did nothing short of changing my life. My social anxiety has waxed and waned over the years but it has always been there and has always limited my life, more often than not severely.
This is a story of how I was in the past year leading up to me taking Nardil. There were times before this that I was even worse, when I lived like a hermit for years, through my best years (late teens and early 20's) I was very sick and suicidal then. I am in my early 30's now.
Before I started Nardil I hated going on public transport, I would get panic attacks, be nervous about making eye contact with people, nervous about sitting next to people. I found the whole thing extremely stressful and more than once got off early to walk because I felt so confined and anxious.
On a weekend I would get invited out with people but I nearly always turned them down because I knew I would have to drink heaps of alcohol to even come close to enjoying myself and then suffer even worse panic attacks for days to come because of the alcohol.
I would get attacks of social anxiety to the point where I would become highly anxious around my family and good friends that I have known for years. I would become mute and couldn't speak. To the point where it was nothing short of strange. I would feel so embarrassed about this and I would get flashbacks of this embarrassment which would stop me in my tracks as I walked down the street.
Work was a nightmare, it took all my will to force myself to go in a few times per week, I would often do night shifts so I didn't have to interact with people. Night shifts would make my SA worse, it was all crap. I couldn't remember anyone's name, I constantly felt like I was doing a bad job no matter how hard I tried and as such I didn't want to try, I resented my job because it made me feel so bad. I couldn't build relationships with my work colleagues and became totally overwhelmed even with a light workload. I took heaps of sick days, I quit multible jobs. I suffered migraines, I could only breath through my mouth because my nose was always blocked. I had fibromyalgia, I was always full of aches and pains. I finished work utterly mentally and emotionally exhausted. It was hell and for no good reason. The job was not that hard, I just couldn't stop stressing out and panicing about it.
I had huge amounts of trouble sleeping, my thoughts would race, I would get stupid songs repeating over and over in my head that wouldn't go away and drove me insane. I had terrible nightmares, I slept in longer and longer every day and had huge trouble dragging myself out of bed. Even a small disturbance in my sleep would make my mental state even worse.
I was so depressed, I felt so lonely all the time, constantly dissatisfied I hated the world and was extremely anti about everything and everyone. I would always find the worst in everything. I always felt low and down, I literally dragged my feet and was so obviously depressed. I would have trouble speaking and be just sad and down. Whenever the depression lifted the anxiety would get worse and vice vesa. I went through a long periods of lying in bed, hardly eating and not even washing.
I would get disturbing and bizarre OCD symptoms that were hugely socially disabling even on top of my anxiety.
I isolated so much, spent huge amounts of time on the internet. I would constantly trawl forums looking for the magic something that would cure me. I would constantly ruminate about the meaning of life and what I should do with my life rather than living it.
I tried everything and I mean everything, ssri, tricyclics, TCA's, SNRI's, mood stabilisers, antipsychotics, stimulants, every herbal thing you can imagine as well as a huge variety of recreational drugs. I tried psychotherapy, CBT, hypnosis. Nothing worked.Nardil Works
This huge list of things I listed above are no longer an issue. My anxiety is 95% gone, no panic attacks, no depression.
This is my third time on Nardil, the other times I tried it and stopped it because of the side effects. This time I am working through them.
Life is sweet, I love coming to work and am making great money and putting in big hours.
No aches and pains, no migraines, I can have a few drinks without massively paying for it the next day. I have hope and plans for the future. I go on dates, I make new friends. I dont care what people think about me anymore.
I have a life
I love life.
Please do not suffer any longer, I read some of the posts on this site and my heart goes out to you, because I used to be there.
If all else fails, give Nardil a go. I know the side effects sound a little scary, but the fact is that when you feel good, you can cope with these things. I would cope with a lot more to stay on this medication.Enough said...for now
Posted by stargazer2 on May 24, 2010, at 18:31:19
In reply to Re: all MAOIs? - back to NARDIL, posted by phil1909 on May 22, 2010, at 8:07:57
I came off Nardil to try Vyvanse and that has about done me in...
Did you ever think about ending your life when you were in the middle of all that suffering?
If so, how did you keep from doing it?
I can relate to most of what you said...obviously your experiences are very different than mine but many were very similar.
Did you ever try Parnate or Marplan with any success?
What dose of Nardil are you on and do you take anything with it?
I can't believe how positive you sound now, even when Nardil has worked my attitude was never what yours is today...lucky you.
SG2
Posted by phil1909 on May 25, 2010, at 4:58:26
In reply to Re: all MAOIs? - back to NARDIL, posted by stargazer2 on May 24, 2010, at 18:31:19
Hey there;
Oddly enough, to this day I've never even contemplated suicide. Probably, cause I suffer from generalized anxiety disorder and I'm absolutely shyte scared of death (probably to a very unhealthy degree). BUT, I practiced MY OWN suicide by quitting jobs, dabbling in illegal drugs, hiding & running away from social situations, and sleeping way way too much up to 14 hours a day up to 16 hrs a day on weekends and holidays.
I've never really had trouble staying positive because I've become very AWARE of my condition and accepted it. Money and status do not effect me anymore. I appreciate and treasure time with my family like never before (though I have no friends that I socialize with anymore). I'm FAIRLY SPIRITUAL without being religious and basically I'm EGO-LESS. MY 'EGO' never really developed as my condition from a young age made me very self-critical. Eckhart Tolle is one modern spititual teacher I highly recommend as is Adyashanti (although Adyas teachings are very esoteric and less practical than Tolle). Anthony De Mello is also a brilliant enlightened priest with great PRACTICAL teachings. PLEASE NOTE: MY LIFE SITUATION LED ME TO SPIRITUAL SEEKING. IT IS NOT FOR EVERYONE. I'M VERY CURIOUS BY NATURE AND THESE TEACHINGS WERE A LOGICAL STEP FOR ME STEMMING FROM DISSATISFACTION WITH MY CATHOLIC STRICT ITALIAN UPBRINGING AND TOTAL FRUSTRATION WITH THE WORLD PLIGHT AND ORGANIZED RELIGIONS.
Unfortunately for me I've never been prescribed any MAOIs in my life (aside from Aurorix a very long time ago). Like many meds they are taboo in the medical circles because of their unpredictable side effects. HOWEVER, for me the mixtures and high doses of TriCyclcs, SSRIs, SNRIs, antipsychotics, beta-blockers, epilepsy meds, etc, have been nothing but maskers of my symptoms (leading me to eventually accept the zombie-like state they put me in) and completely useless in treating my 'anxiety' issues in the workplace and and general social awkwardness. Since uni ***I've had 15 jobs in 17 yrs and only been able to get jobs in the first place with the help of benzos such as xanax and valium***.
I've spent my life trying to explain to and convince GPs and psychiatrists that I do not suffer from depression. I actually have, at times, severe and unfounded worries, fears and phobias that can and do lead to 'tension', 'tightly-strung nerves', 'sensitivity', 'sadness' and 'frustration' BUT NOT 'clinical' depression.
Nardil has been pretty good so far, 2 full weeks in. The side effects have been minimal and I've been able to up my dose to 90mg (30mg x 3 times per day). (note, this in not recommended but it can be done with strict attention to diet and with no taking of cold'n'flu meds with pseudoephedrine and no seretonin-affecting pain killers such as Tramadol). I'm pretty comfortable in 'mild' social interactions, and work at the moment.
IF NARDIL PROVES TO BE INEFFECTIVE in dealing with my social dysfunction(s) in the workplace I WILL consider trying PARNATE, etc.
Cheers and best wishes.
Phil
Posted by Phillipa on May 25, 2010, at 19:26:07
In reply to Re: all MAOIs? - back to NARDIL, posted by phil1909 on May 25, 2010, at 4:58:26
Phil you remind me of me. Phillipa only my fears also extend to meds so benzos and a low dose of luvox is all I will take and they no longer work.
Posted by phil1909 on May 26, 2010, at 5:09:54
In reply to Re: all MAOIs? - back to NARDIL » phil1909, posted by Phillipa on May 25, 2010, at 19:26:07
G'day Phillipa;
nice name by the way :) I've always joked that if I had a baby girl I would name her Phillipa or Phylis.Yeah I know the feeling re. fear of hardcore meds. Many years ago I would discontinue meds every other month, as I was anxious or 'worried about' or concerned that I was taking a/ds. 20 years ago, a psychiatry/ology professor at uni once said to me that 'if I knew exactly how these meds affected the brain and the subsequent lasting impacts or changes to brain biology and chemistry, THEN I WOULD NEVER EVER EVEN CONTEMPLATE TAKING THESE MEDS)
Unfortunately, I (and my docs) was ignorant and in constant cycleS of side effects and withdrawals, month in month out. Looking back, if I had been prescribed a very small dose of a benzo, I may have been off the a/ds a long time ago - maybe. Oh well, maybe in my next life.
The withdrawal symptoms of these a/ds are so wicked that one needs to plan to be off work, and to be around understanding people for AT LEAST 6-12 months. And even then, many people have had to go back on these 'NON-ADDICTIVE' drugs. Non-addictive - crap (just termed that so the nasty hypocritical lying over-profiting pharma companies can keep making zillions).
Anyway, (geeze I get carried away - oh well);
Take lotsa care;
Phil
Posted by Phillipa on May 26, 2010, at 20:01:42
In reply to Re: all MAOIs? - back to NARDIL, posted by phil1909 on May 26, 2010, at 5:09:54
Phil it's true. And for the name found it in a novel I once read when could concentrate. Phillipa
This is the end of the thread.
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