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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by benzo85 on June 26, 2010, at 17:25:43
Hello
I've had SAD/dysthymia as long as I can remember. I didnt know what was wrong with me or how much it had always controlled and crippled my life.. i was just "different". Started smoking weed at about 20 or so, but shortly after, that just made me paranoid too, so smoked mostly alone or with roommates. I discovered what SAD was about 4years ago (i'm 25) and it was profound to have a label for this debilitating sh*t. i sought a psychiatrist 3years ago for meds when my anxiety was becoming too overwhelming. I researched the hell out of the options and wanted Nardil.. pdoc made me try zoloft and cymbalta first a month each at admittedly too moderate a dosage (100mg/60mg respectively) w/o success before finally giving me Nardz.
I remember I jumped straight up to the 1mg/kg dosage (75mg) and after just 5 days it completely wiped out my anx/dep. Every time i popped them id get a nice GABA buzz. that went away after a little bit, but the remission stayed.
I began some CBT therapy for a few months, but didnt really do the homework and stopped it because I really had no more problems! the Nardz completely had wiped the distortions and everything out.. i was in a whole new world for the first time.. it felt wonderful!
I stayed on Nard for about 3months.. and stopped after feeling "cured" lol. was smoking tons of weed, livin it up, had lot of money was playing stock market. i did this for several months.. i was becoming increasingly isolated tho, just smoking and focused on the market. anyways, i suffered big misfortune, lost ton of cash and resulted in big life changes. had to move, get a job, sell car, stop smoking. i was still optimistic at first, but after a month, i started getting depressed and general anxiety.I could feel a tangible knot or cloud forming in the front of my brain.. like my brain was atrophying.. i imagine it caused by cortisol flooding.
Then SAD creeped back..depression deepened.. anxiety became insane.. I got back on Nardil. 60mg. was on it for 2weeks with no improvement. that really scared me because i expected it to act like it did before.. it worked so fast the first time. but this time nothing. 2 weeks, nada. Anxiety and Melancholic depression deepened..super tired, nightmares. Pure O ocd popped up aswell, began having suicidal ideation.
Checked myself into hospital psych clinic. stayed a week. upped to 75mg. No real improvement.course went as followed.
-11weeks 75mg, slow but steady climb up into mild depression, anxiety still bothersome.
-6weeks 90mg, depression mostly wiped out 1st week. anxiety still lingering. Adjunct .5-1mg klonopin, prn.
-2weeks 105mg, stop klonopin, slight improvement in anxiety. Annoyance of side effects (weight gain, anorgasmia, insomnia, and others reemerging at new high dosage) make me try a try a week long titration down to 30mg, which quickly led to alleviation of side effects, but also poor mood. I quickly titrated back to 75mg, orginal kg/mg
3 weeks at 75mg. Anxiety finally smushed.I was doing some talk therapy aswell for like 4months, it was helpful to talk to someone.
So it was 6month to remission from that hell.
I stayed on Nardil for 17months, gradually lowering to 60, and then 45 mg to alleviate the annoying insomnia and weight gain.
I began smoking weed daily about 4 months prior to stopping Nard.I decided i wanted to quit smoking again to pursue some goals that needed clean drug test. I was fired from my job for tardiness. I was ok initially, just need to get another, right? well as a few weeks went by i was increasing anxious about my financial situation, and felt a little socially stigmatized. Realistically i had temporary financial options. But this subtle general anxiety /dysthymia and social anxiety was always in the back of my head. after another few weeks, anxiety increased.. I wasnt pursuing my temporary income, or social ties i was avoidant of them. i was basically backing myself into a corner due to this anxiety.
I felt that same knot in my brain returning slowly, then.. one day its like a dam broke and deluge of cortisol flooding in my head. ohh sh*t not again.SAD relapse. dysthymia. GA.
Been on Nardz for 7.5 weeks now. 6 weeks at 45/60, and 1.5weeks at 75mg.
Taking Klonopin randomly.I ended up dropping all my short term goals and changing living arrangements due to this relapse.
Could use a job, yeah. am i motivated to get one? no. i have support right now.
In a mental holiday state, i suppose.Waiting for these Nardz to do something. Theyve stablised me somewhat. exercising. am drinking wine at night.. smoking cigs. temporary self med, i know.
So some conclusions i've drawn.. and questions and insights from anyone is welcomed
I need to stay on MAOI to not relapse. Stressful events trigger downhill slide.
Though MAOIs are far more effective at response and remission of symptoms, people on MAOIs tend to not maintain therapeutic effects after ceasing treatment. But SSRIs and benzos have shown that ability. Damnit, why is that?
CBT shown to prevent relapse as well. I am interested in taking some of that, but have always been skeptical at its true usefulness.
Also, cessation of chronic marijuana smoking.. the cannabinoids have a antipressant/anxiolytic effect and they are lipid stored for a month or so after quitting. As this concentration goes down, would they make one more susceptible to anxiety/depression?Anyone ever maintain remission after stopping MAOI?
Does alcohol negatively affect efficacy of Nardil?
Do cigs? I know tobacco destroys up to 40% of MAO-b. Would that compete negatively with the Nardil?Thoughts, experiences..
Thanks! :)
Posted by linkadge on June 26, 2010, at 17:31:47
In reply to SAD/Relapse/Nardil, story, posted by benzo85 on June 26, 2010, at 17:25:43
Drugs, "livin it up" and risky financial investments....sounds like bipolar to me.
SAD is often comorbid with bipolar.
Linkadge
Posted by benzo85 on June 26, 2010, at 17:59:33
In reply to Re: SAD/Relapse/Nardil, story, posted by linkadge on June 26, 2010, at 17:31:47
I've questioned whether I'm bipolar or not, too. I really can't qualify that I was ever hypomanic or not. I never had excessive energy, pressured speech.
I did have lots of confidence though, and made risky financial choices; but perhaps that's just my personality? I do have very high aspirations for myself.
I wasnt doing drugs other than weed and i wasnt screwing a different girl every night. Although libido was up there.
If anything it would be a very "soft" bipolar, drug induced. type 3 or 4, or whatever the next DSMV will call it.My brother has been in a state of drug induced mania before, and I know bipolar is highly heritable.
Yep, i'm aware of the SAD/bipolar relationship.But where to draw the line? bipolar seems like a very vague term to me. what's the real hardline criteria?
Posted by linkadge on June 26, 2010, at 19:16:25
In reply to Re: SAD/Relapse/Nardil, story, posted by benzo85 on June 26, 2010, at 17:59:33
The line is where is starts f'ing up your life like your describe.
Linkadge
Posted by Phillipa on June 26, 2010, at 19:49:24
In reply to Re: SAD/Relapse/Nardil, story, posted by linkadge on June 26, 2010, at 19:16:25
Risky business deals, illicit drugs, increased libido I also say bipolar. Phillipa
Posted by benzo85 on June 27, 2010, at 0:34:15
In reply to Re: SAD/Relapse/Nardil, story, posted by Phillipa on June 26, 2010, at 19:49:24
Ok, I'm hearing you guys, but really? weed = bipolar? lol come on..
libido is always high even when dysthymic.
Posted by angels78 on June 27, 2010, at 1:52:09
In reply to SAD/Relapse/Nardil, story, posted by benzo85 on June 26, 2010, at 17:25:43
> Hello
>
> I've had SAD/dysthymia as long as I can remember. I didnt know what was wrong with me or how much it had always controlled and crippled my life.. i was just "different". Started smoking weed at about 20 or so, but shortly after, that just made me paranoid too, so smoked mostly alone or with roommates. I discovered what SAD was about 4years ago (i'm 25) and it was profound to have a label for this debilitating sh*t. i sought a psychiatrist 3years ago for meds when my anxiety was becoming too overwhelming. I researched the hell out of the options and wanted Nardil.. pdoc made me try zoloft and cymbalta first a month each at admittedly too moderate a dosage (100mg/60mg respectively) w/o success before finally giving me Nardz.
>
> I remember I jumped straight up to the 1mg/kg dosage (75mg) and after just 5 days it completely wiped out my anx/dep. Every time i popped them id get a nice GABA buzz. that went away after a little bit, but the remission stayed.
>
> I began some CBT therapy for a few months, but didnt really do the homework and stopped it because I really had no more problems! the Nardz completely had wiped the distortions and everything out.. i was in a whole new world for the first time.. it felt wonderful!
> I stayed on Nard for about 3months.. and stopped after feeling "cured" lol. was smoking tons of weed, livin it up, had lot of money was playing stock market. i did this for several months.. i was becoming increasingly isolated tho, just smoking and focused on the market. anyways, i suffered big misfortune, lost ton of cash and resulted in big life changes. had to move, get a job, sell car, stop smoking. i was still optimistic at first, but after a month, i started getting depressed and general anxiety.
>
> I could feel a tangible knot or cloud forming in the front of my brain.. like my brain was atrophying.. i imagine it caused by cortisol flooding.
> Then SAD creeped back..depression deepened.. anxiety became insane.. I got back on Nardil. 60mg. was on it for 2weeks with no improvement. that really scared me because i expected it to act like it did before.. it worked so fast the first time. but this time nothing. 2 weeks, nada. Anxiety and Melancholic depression deepened..super tired, nightmares. Pure O ocd popped up aswell, began having suicidal ideation.
> Checked myself into hospital psych clinic. stayed a week. upped to 75mg. No real improvement.
>
> course went as followed.
>
> -11weeks 75mg, slow but steady climb up into mild depression, anxiety still bothersome.
> -6weeks 90mg, depression mostly wiped out 1st week. anxiety still lingering. Adjunct .5-1mg klonopin, prn.
> -2weeks 105mg, stop klonopin, slight improvement in anxiety. Annoyance of side effects (weight gain, anorgasmia, insomnia, and others reemerging at new high dosage) make me try a try a week long titration down to 30mg, which quickly led to alleviation of side effects, but also poor mood. I quickly titrated back to 75mg, orginal kg/mg
> 3 weeks at 75mg. Anxiety finally smushed.
>
> I was doing some talk therapy aswell for like 4months, it was helpful to talk to someone.
>
> So it was 6month to remission from that hell.
>
> I stayed on Nardil for 17months, gradually lowering to 60, and then 45 mg to alleviate the annoying insomnia and weight gain.
> I began smoking weed daily about 4 months prior to stopping Nard.
>
> I decided i wanted to quit smoking again to pursue some goals that needed clean drug test. I was fired from my job for tardiness. I was ok initially, just need to get another, right? well as a few weeks went by i was increasing anxious about my financial situation, and felt a little socially stigmatized. Realistically i had temporary financial options. But this subtle general anxiety /dysthymia and social anxiety was always in the back of my head. after another few weeks, anxiety increased.. I wasnt pursuing my temporary income, or social ties i was avoidant of them. i was basically backing myself into a corner due to this anxiety.
> I felt that same knot in my brain returning slowly, then.. one day its like a dam broke and deluge of cortisol flooding in my head. ohh sh*t not again.
>
> SAD relapse. dysthymia. GA.
>
> Been on Nardz for 7.5 weeks now. 6 weeks at 45/60, and 1.5weeks at 75mg.
> Taking Klonopin randomly.
>
> I ended up dropping all my short term goals and changing living arrangements due to this relapse.
> Could use a job, yeah. am i motivated to get one? no. i have support right now.
> In a mental holiday state, i suppose.
>
> Waiting for these Nardz to do something. Theyve stablised me somewhat. exercising. am drinking wine at night.. smoking cigs. temporary self med, i know.
>
> So some conclusions i've drawn.. and questions and insights from anyone is welcomed
>
> I need to stay on MAOI to not relapse. Stressful events trigger downhill slide.
> Though MAOIs are far more effective at response and remission of symptoms, people on MAOIs tend to not maintain therapeutic effects after ceasing treatment. But SSRIs and benzos have shown that ability. Damnit, why is that?
> CBT shown to prevent relapse as well. I am interested in taking some of that, but have always been skeptical at its true usefulness.
>
> Also, cessation of chronic marijuana smoking.. the cannabinoids have a antipressant/anxiolytic effect and they are lipid stored for a month or so after quitting. As this concentration goes down, would they make one more susceptible to anxiety/depression?
>
> Anyone ever maintain remission after stopping MAOI?
> Does alcohol negatively affect efficacy of Nardil?
> Do cigs? I know tobacco destroys up to 40% of MAO-b. Would that compete negatively with the Nardil?
>
> Thoughts, experiences..
>
> Thanks! :)
>
>My friend, your life story sounds almost as accurate as mine.
Weed causes social phobia. I used to smoke an 8th a day, every single day for 4 years. Yes, that is a ton, all straight to my dome. Caused major paranoia, agorphobia, social anxiety, panic attacks after I quit smoking and became permananet. Nardil has helped this, but not completely. My suggestion to you, STOP SMOKING WEED with Nardil, your just puttting yourself backwards.
Posted by benzo85 on June 27, 2010, at 4:26:41
In reply to SAD/Relapse/Nardil, story, posted by benzo85 on June 26, 2010, at 17:25:43
I agree with that
Posted by linkadge on June 27, 2010, at 7:19:35
In reply to Re: SAD/Relapse/Nardil, story, posted by benzo85 on June 27, 2010, at 0:34:15
Bipolar is not one symptom but a whole cluster of little things that add up.
I believe I am bipolar, although I hate mood stabilizers and so I hide a lot of symptoms from my doctor. Bipolar becomes evident when your behavior starts setting you up for more depressive relapses.
For me, that manifests as overproductivity at work - taking on more tasks than I can really handel and giving co-workers the preception that I am just extremely high energy and peppy all the time.
Sure, at the time, I feel I can do it all, but striving for that image simply sets me up for stronger depressive relapse.
I don't have the problem with money, however. All my investments are guarenteed (I've always been extremely frugal), but OTOH, I do have some problems in the sexual rhelm (which I won't get into).
When you're manic (or hypomanic) you take more risks, sometimes they pan out, and you look like a hero, sometimes they don't and you're screwed. In the manic state you lose insight. You just act without sitting and thinking actions through.
Bipolars tend to use more drugs because they want to control their moods. Weed can be a mood stabilizer for many people.
I'm certainly not a doctor, but bipolar manifests differently for differnt patients.
Linkadge
Posted by benzo85 on June 27, 2010, at 19:25:52
In reply to Re: SAD/Relapse/Nardil, story, posted by linkadge on June 27, 2010, at 7:19:35
Do you have any links to useful sites/publicatons elaborating on this loose bipolar spectrum?
Posted by Huxley on June 27, 2010, at 21:48:42
In reply to Re: SAD/Relapse/Nardil, story, posted by benzo85 on June 27, 2010, at 19:25:52
> Do you have any links to useful sites/publicatons elaborating on this loose bipolar spectrum?
It's almost becoming trendy to be called bi-polar these days.
Posted by benzo85 on June 28, 2010, at 0:07:24
In reply to Re: SAD/Relapse/Nardil, story, posted by Huxley on June 27, 2010, at 21:48:42
Lol, yeah.. it's becoming a looser and looser term/diagnosis
Posted by linkadge on June 28, 2010, at 7:16:49
In reply to Re: SAD/Relapse/Nardil, story, posted by Huxley on June 27, 2010, at 21:48:42
It its, but the real problem (IMHO) is the fact that long term AD use can destabilize people, even otherwise normal stable people. If that results in more bipolar diagnosis, then I suppose this is just a casualty.
Lihnkadge
This is the end of the thread.
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