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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 150. This is the beginning of the thread.
Posted by Dima on August 13, 2010, at 13:31:35
I came to my hometown to see my friends who I haven't seen in months because of my depression/anxiety and I can't socialize without it feeling like torture. I can't focus on their conversations, I just start worrying every few seconds without even noticing it. I used to be smart and could figure out puzzle games, and I was watching my friend play a puzzle video game and I felt so dumb. My memory is completely gone, so they keep reminding me of things I did in the past that I don't remember at all.
My social anxiety is terrible around them. Like I try my hardest to focus on my breath or something around me to not be anxious, but it's like this incredible tension that I can't relax throughout my whole body. Which is always there, just more so around other people, so I always feel a mental "tug" to get away from people, no matter how long I try to relax with them. Is this just severe anxiety or is this akathisia all the time? It feels kind of like a mild form of the akathisia reaction I had to Abilify.
Should I try Xanax? Ativan and Klonopin both do absolutely nothing for me. I feel so terrible, and I think I'd rather risk an addiction than feel like this. Anything I can do sooner? I don't feel enjoyment for a single minute throughout the day. Help!
Posted by ed_uk2010 on August 13, 2010, at 13:49:13
In reply to I feel horrible, posted by Dima on August 13, 2010, at 13:31:35
Hi Dima,
I'm sorry that you're having such as hard time. Do you see your doctor soon?
Just a thought - have you had the physical causes of anxiety/depression ruled out? Thyroid disease, for example. Your doctor might want to do some blood tests.
>Is this just severe anxiety or is this akathisia all the time?
It sounds like anxiety. Akathisia is a side effect of antipsychotics.
>Should I try Xanax? Ativan and Klonopin both do absolutely nothing for me.
You could do, but Xanax is best taken occasionally since dependence can develop rapidly. You really need something that can be taken continuously.
Take care.
Posted by Dima on August 13, 2010, at 13:58:49
In reply to Re: I feel horrible, posted by ed_uk2010 on August 13, 2010, at 13:49:13
I see my doctor next Thursday. It all seems so hopeless, like my brain is irreparably messed up. What options are there?? I feel like she'll just up the dosage of something like Seroquel, which I'm not taking anymore. I don't even feel like I can be honest about that, saying I stopped the drugs.
Posted by Dima on August 13, 2010, at 14:24:21
In reply to Re: I feel horrible, posted by ed_uk2010 on August 13, 2010, at 13:49:13
And doctors have tested my thyroid but no one has said there's a problem.
Posted by ed_uk2010 on August 13, 2010, at 15:37:43
In reply to Re: I feel horrible, posted by Dima on August 13, 2010, at 13:58:49
>I see my doctor next Thursday. It all seems so hopeless, like my brain is irreparably messed up.
At 19, I don't think that's likely. It's a difficult time because there is so much change and so many expectations. It's difficult to cope with all the pressure when you're not feeling well.
>What options are there??
You mean in terms of medication? I'm sure there are many treatments that you haven't tried. Just as an example, there's clomipramine (Anafranil). Clomipramine is a tricyclic antidepressant which has a good reputation for being effective in severe depression, and also for anxiety disorders. This is not a recommendation, I don't know you well enough to make a recommendation. It's just an example of something that you haven't tried. Also, I'm no expert in psychology but I do know there are many different types of therapy these days. There is probably one which would suit you :)
Before you try any new medication you need to establish a baseline. You've been making a lot of changes to your medication within a short period. You don't really know what each medication was doing. When you make so many changes, you end up in a situation where you have no idea which symptoms are side effects, which are withdrawal symptoms from previous meds, which are symptoms of your condition, which are due to drug interactions etc.
I think you should keep a chart/diary of how you are feeling. Fill it in every day. At the top of each page list your current medication. In time, the diary will help to reveal the effects of different medications on your mood and anxiety. Because a lot of meds take time to work, it's not always obvious whether or not a med is working. When you're trying a lot of medications, it all gets very confusing. It's difficult to remember the effects of so many different drugs without some kind of record. This is where the diary comes in.
>I feel like she'll just up the dosage of something like Seroquel, which I'm not taking anymore. I don't even feel like I can be honest about that, saying I stopped the drugs.
If you're not honest, how will your doctor be able to help you? For example, if Seroquel was making you feel worse, you should tell that to your doctor. This will help her decide what to do next.
Here are some tips which might help you to benefit more from medication.
1. Start new medication at a low dose. Increase the dose gradually up to a therapeutic dose. If you increase too fast and experience side effects as a result, you might give up on a med which could have helped.
2. Do not start, stop or change the dose of more than one psych medication at once. If you feel worse, you will not know which medication is to blame..........and if you feel better, you will not know which medication is helping.
3. Do not stop any psych med abruptly, unless you've only been on it for a few days. Stopping abruptly can cause withdrawal symptoms.
4. Try to get into a regular schedule of taking your medication at the same time each day, this reduces the likelihood that you will miss doses.
5. Do not take combinations of medication without first checking for drug interactions. Some meds can't be taken together. Others may require a different dose if used in combination. Your doctor should check for interactions but it doesn't hurt to double check yourself. There is plenty of information on the internet.
Hope this help. Take care.
Posted by Phillipa on August 13, 2010, at 17:07:30
In reply to Re: I feel horrible, posted by Dima on August 13, 2010, at 14:24:21
Dima do you happen to know the numbers of your thyroid test? Do you ask for copies of all your labs. And I remember back awhile you were unable to get out of bed. Sounds like you are doing somewhat better. Did the seroquel help? Phillipa
Posted by sigismund on August 13, 2010, at 19:02:05
In reply to I feel horrible, posted by Dima on August 13, 2010, at 13:31:35
>because of my depression/anxiety and I can't socialize without it feeling like torture. I can't focus on their conversations, I just start worrying every few seconds without even noticing it. I used to be smart and could figure out puzzle games, and I was watching my friend play a puzzle video game and I felt so dumb. My memory is completely gone, so they keep reminding me of things I did in the past that I don't remember at all.
Dima, I don't know of course, but I wonder if the use of psych drugs that you want to alleviate various symptoms has actually made it harder for you to do the quick thinking needed for socialisation. Benzos for example can do this, while alleviating anxiety. Socialisation at your age is challenge enough. Just something to think about.
Posted by morgan miller on August 13, 2010, at 20:09:34
In reply to Re: I feel horrible, posted by sigismund on August 13, 2010, at 19:02:05
Magnesium Glycinate or Taurinate, Fish oil, Lots of exercise followed by meditative stretching, Yoga, Meditation, and most importantly, Psychodynamic individual and group therapy-you're sooooo young, you really have an opportunity here to get started on(getting to root cause of your anxiety) something that many people don't do till later in life and wish they had done earlier.
I would also look into some very effective herbs like Schisandra(Planetary Herbals), Holy Basil(New Chapter), Ashwagandha(Sensoril), Chavanprash, and Kira St. John's Wort(will take 1 to 2 months to work).
Then there are the amino acids GABA and L Theanine and Taurine(wouldn't use more than 500 mg a day).
A combination of many of these may give you some much needed relief.
I can't remeber, have you tried Lithium? You could just order some lithium orotate or aspartate and experiment with it.
I would come clean with your doc or get a new one.
Sorry your feeling so bad. Nineteen should not be like this. Hope you feel better soon!
Posted by ed_uk2010 on August 13, 2010, at 22:24:13
In reply to Re: I feel horrible, posted by sigismund on August 13, 2010, at 19:02:05
>Benzos for example can do this, while alleviating anxiety.
They can - but I imagine that antipsychotics are worse in this respect! Some doctors are far too keen to prescribe Seroquel.
Posted by sigismund on August 13, 2010, at 22:59:10
In reply to Re: I feel horrible » sigismund, posted by ed_uk2010 on August 13, 2010, at 22:24:13
Doctors have always prescribed drugs with no abuse potential very easily with (IMO) no regard for anything else.
The only thing Dima says helped him was (I think) Adderal which makes you think quicker.
Moclobemide actually increased my verbal fluency at one quarter the usual starting dose.
Posted by Zyprexa on August 14, 2010, at 2:41:39
In reply to I feel horrible, posted by Dima on August 13, 2010, at 13:31:35
I have the same problem. I think its anxiety. If I don't take zyprexa I am so anxious I can't leave the house or talk to anyone.
Posted by ed_uk2010 on August 14, 2010, at 9:05:03
In reply to Re: I feel horrible » ed_uk2010, posted by sigismund on August 13, 2010, at 22:59:10
>Doctors have always prescribed drugs with no abuse potential very easily with (IMO) no regard for anything else.
I suppose it's because in the absence of abuse potential, patients are likely to be more honest about the effects of treatment. If the drug causes a bad reaction, they will stop taking it.
Once drugs of abuse are prescribed, some patients start to tell lies.
>Moclobemide actually increased my verbal fluency at one quarter the usual starting dose.
Moclobemide seems to be a drug which has modest benefits, but also modest side effects. I suppose that is not necessarily a bad thing.
Posted by Dima on August 14, 2010, at 16:23:46
In reply to Re: I feel horrible » Dima, posted by Zyprexa on August 14, 2010, at 2:41:39
I went to the ER for anxiety last night, and they ended up prescribing me Valium. Today, I took up to 10 mg and I still felt tense around people and in general. It made me feel more tired, though. Maybe it's not regular anxiety, but a non-drug-induced akathisia. That's what it feels like to me.
Posted by sigismund on August 14, 2010, at 18:46:30
In reply to Re: I feel horrible » sigismund, posted by ed_uk2010 on August 14, 2010, at 9:05:03
Ed, do you know of any studies correlating the prescription of drugs of abuse (opiates, opioids, cocaine, amphetamine) with socio-economic status?
Also, are you aware of studies about any correlation between medical malpractice and socio-economic status. (Stuff like unnecessary mastectomies on 90yo pensioners.)
It seems self evident to me that there is a policy of not wasting good drugs on the riffraff.
Posted by emmanuel98 on August 14, 2010, at 19:40:11
In reply to Re: I feel horrible » ed_uk2010, posted by sigismund on August 14, 2010, at 18:46:30
I know I was prescribed a drug of abuse 10 years ago and promptly started abusing it. Continued for five years. I don't know about socio-economic status, but I do think that, had I been younger, this would not have been prescribed. It would have been assumed I was lying or overstating my pain to get drugs.
Posted by Phillipa on August 14, 2010, at 19:51:26
In reply to Re: I feel horrible, posted by emmanuel98 on August 14, 2010, at 19:40:11
Dima how are you feeling now? Takes a few days for valium to build up in your system. Phillipa
Posted by ed_uk2010 on August 14, 2010, at 20:18:54
In reply to Re: I feel horrible, posted by Dima on August 14, 2010, at 16:23:46
>I went to the ER for anxiety last night, and they ended up prescribing me Valium. Today, I took up to 10 mg and I still felt tense around people and in general. It made me feel more tired, though.
When anxiety is severe, benzos such as diazepam (Valium) often 'take the edge off'. Once you've worked yourself into a state, it can take a few days to calm down. Have you got a few days supply of diazepam? I think the diazepam is a good idea because you are obviously going through a crisis right now. Diazepam is recommended for short term use.
>Maybe it's not regular anxiety, but a non-drug-induced akathisia. That's what it feels like to me.
There are quite a few different types of anxiety. All the med changes which you have made recently make it difficult to know what the cause of your anxiety is. It could be a combination of your underlying condition, side effects, and withdrawal symptoms from recently stopped medication.
'Akathisia' normally refers to a neuroleptic-induced state of intense physical restlessness. High doses of potent neuroleptics such as haloperidol (Haldol) are the worst culprits for causing akathisia. Abilify seems to cause akathisia quite frequently. Abilify is a long-acting medication. It may take several days for the akathisia to wear off after stopping Abilify.
Posted by Dima on August 15, 2010, at 11:37:31
In reply to Re: I feel horrible, posted by ed_uk2010 on August 14, 2010, at 20:18:54
The anxiety I'm talking about is what I've been living with for years. It's around no matter what I'm doing. It doesn't have much to do with my actual thinking, I just feel uncomfortable in any and all situations.
Posted by morgan miller on August 15, 2010, at 12:51:39
In reply to Re: I feel horrible, posted by Dima on August 15, 2010, at 11:37:31
> The anxiety I'm talking about is what I've been living with for years. It's around no matter what I'm doing. It doesn't have much to do with my actual thinking, I just feel uncomfortable in any and all situations.
That really sucks, I've experienced similar anxiety and still do.
Believe it or not, even though you are not consciously thinking about anything that is directly causing your anxiety, it is very possible that one of the main causes of your anxiety is something that you had been exposed to in your environment while developing, even as young as 2, 3, or 4 years old. Actually, when we don't get what we need or are exposed to stressful/traumatic conditions between the ages of 2 and 4(crucial ages in our development), our brains can be hard wired in a way that can affect our development and the way we feel the rest of our lives. Again, anxiety is often likely be something that exists in our being partly as a result of lack of proper nurture and exposure to traumatic or stressful events while we are developing. Not only could your brain be wired or have developed in such a way that makes you more prone to experiencing anxiety, you may also have some things going on in your subconscious mind that are causing anxiety. One of the only long term solutions to this is to get some good old therapy. The key is finding a highly educated, down to earth, likable, empathetic, and compassionate therapist.
Don't take this the wrong way, but since you are young, you may be more averse to the idea of going to therapy, doing some heavy lifting, and dealing with some of your inner anger and sadness. Most of us when we are young just want to feel good and have fun and not deal with anything. Being young also tends to be a time when we are more likely to use the most powerful of coping mechanisms, denial.
I do believe in using medication as I have used medication for a better feeling of well being for years. But, medication will only take you to a certain point. Therapy will take you further and help you give yourself what you need in order for optimal personal growth. Medication + Therapy = Best chance of full recovery and a meaningful life.
Morgan
Posted by ed_uk2010 on August 15, 2010, at 13:45:56
In reply to Re: I feel horrible, posted by Dima on August 15, 2010, at 11:37:31
> The anxiety I'm talking about is what I've been living with for years. It's around no matter what I'm doing. It doesn't have much to do with my actual thinking, I just feel uncomfortable in any and all situations.
Is diazepam helping at all? What dose are you taking?
Posted by Dima on August 15, 2010, at 17:57:53
In reply to Re: I feel horrible, posted by ed_uk2010 on August 15, 2010, at 13:45:56
I didn't take it after I tried a 10 mg dose and only felt tired.
This definitely is not normal anxiety. There's a physical aspect to it. My muscles all feel tensed up even though I know they're relaxed. It's like restless leg syndrome all day with your whole body, which makes me incapable of focusing on anything, thus enjoying nothing.
Posted by morgan miller on August 15, 2010, at 18:37:31
In reply to Re: I feel horrible, posted by Dima on August 15, 2010, at 17:57:53
> I didn't take it after I tried a 10 mg dose and only felt tired.
>
> This definitely is not normal anxiety. There's a physical aspect to it. My muscles all feel tensed up even though I know they're relaxed. It's like restless leg syndrome all day with your whole body, which makes me incapable of focusing on anything, thus enjoying nothing.Do you think you might be going through some sort of withdrawal? You were on Seroquel, right?
You already have anxiety to begin with, and now, after being on and off certain medications, your physiology may be going through an adjustment period.
I really wish you were open to taking some herbs, supplements/vitamins and medicinal mushrooms that might help you get through this. I will list some that I think might help.
Ashwagandha-great for me before bed
Schisandra-smooth relaxing energy
Chyavanprash-overall better feeling of well being
Holy Basil-New Chapter's-relaxing and uplifting
Magnesium-glycinate or taurinate
GABA
Poria cocas-mushroom-haven't tried yet
Cordyceps(love this one)-mushroom-2 to 3 grams
Reishi-mushroom-haven't tried yetYour system has temporarily been throw out of whack and you may need some things to help get you back to wellness.
Can you exercise? Are you able to eat well right now?
Also, since you were on Seroquel(I think!?), would you be open to trying a low dose of lithium to help you relax and help your brain recover from the stress it's been under? Lithium at low non toxic doses may be very beneficial to brain health and function.
Morgan
Posted by morgan miller on August 15, 2010, at 18:56:24
In reply to Re: I feel horrible, posted by Dima on August 15, 2010, at 17:57:53
Sorry Dima, just went back to look over your posts and realized you never took Seroquel, my bad.
Are you still taking the medications you listed?
How about trying Lexapro instead of Celexa? I think it is superior.
Have you have a full check up at the doctor? Have you considered seeing a neurologist for some of your other symptoms?
Sounds like you are experiencing some type of withdrawal or side effects.
I still think a low dose of lithium may be worth a try.
Hope you feel better, you're too young for this sh*t.
Morgan
Posted by Dima on August 15, 2010, at 19:10:12
In reply to Re: I feel horrible, posted by morgan miller on August 15, 2010, at 18:56:24
This isn't a reaction to some med. I'm talking about what I've gone through for the past half of my life. Adderall is the only thing that slightly removes the painful mental illness. Ed, the reason I don't keep a journal is because I don't feel an effect from any drug. I feel completely terrible with no change all the time, so there's not much to document.
Posted by Phillipa on August 15, 2010, at 20:10:11
In reply to Re: I feel horrible, posted by Dima on August 15, 2010, at 19:10:12
Didn't you see a prominent doc? I could be mistaken of course. If so what did he prescribe.Phillipa
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