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Dr. Bob is Robert Hsiung, MD,
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Posted by floatingbridge on April 4, 2011, at 2:02:48
In reply to Re: Rapid cycling Agitated Depression or Mixed State? » FrustratedMama, posted by floatingbridge on April 4, 2011, at 2:00:12
Posted by bleauberry on April 4, 2011, at 4:53:17
In reply to Rapid cycling Agitated Depression or Mixed State?, posted by FrustratedMama on April 3, 2011, at 23:31:29
For immediate relief I rely on Lemon Balm, Passion Flower, Skullcap, and Valerian. My fav is Lemon Balm tincture. Works fast to settle things down and feels clean.
Longer term, well, if current meds aren't working then they have to be swapped out. Sometimes the meds themselves are causing the issues.
I don't know what meds you are on, or what meds you have previously taken, so I can't really offer any med suggestions without that information. But for some immediate emergency help, go to the health food store or whole foods market.
For longer term consider an herb called Japanese Knotweed, either the raw powder or the brand Source Naturals that says Resveratrol on the bottle. This is not a psychoactive herb, other than it does have some central nervous system calming action, but it happens to cover a lot of bases....things that cause bizarre psych symptoms...infections, inflammation, and more. This won't likely be a cure, but will be a solid step in a new direction...attempting to conquer the evil at its heart rather than just mopping up its mess. This herb just does a whole bunch of good stuff, too much to list here, but most of them related to depression symptoms.
Posted by FrustratedMama on April 4, 2011, at 22:45:37
In reply to Re: Rapid cycling Agitated Depression or Mixed State?, posted by bleauberry on April 4, 2011, at 4:53:17
Thank you everyone.....I guess I should have listed my meds....currently they are
10 mg adderall 2 x day
.5 mg klonopin 2 x day
50 mg Pristiq 2x day
10 mg ambien at nightI have been on a lot of meds with temporary relief at times.....never full remission and never long lasting.....
I do eat healthy, exercise, attend church and study the bible (I also beleive in my faith fully). I have many friends and a great support system with a good job....I have no "reason" to be such a witch but I am miserable and hate myself for it. I also go to counseling and have for several years (tried a variety of therapists and actually like this one). However, when the anger/rage comes on its unbearable and unstoppable! I am hanging on for dear life and praying for the good me to come back to me.
Posted by morgan miller on April 5, 2011, at 0:17:21
In reply to Rapid cycling Agitated Depression or Mixed State?, posted by FrustratedMama on April 3, 2011, at 23:31:29
Sorry to hear you are not well.
Have you ever tried Depakote or Lithium?
Morgan
Posted by floatingbridge on April 5, 2011, at 11:00:48
In reply to Re: Rapid cycling Agitated Depression or Mixed State?, posted by FrustratedMama on April 4, 2011, at 22:45:37
FM, (((hugs)))). This sounds awful :(Well, have you been dx'd cyclthymic or BPlll or BPnos? (BP = bipolar here NOT borderline.)
Not sure what treatment protocol would be or is. You know I have had an awful time. For myself, it's biology plus a lot of psychology. That's mostly what I know,
so that's the lens I usually see through. Since you are relapsing often, I'm thinking of the self-care and thought piece that is important to sustained recovery.You may have answered or considered any of the below.... I'm just thinking out loud. (Unfortunately, my preferred way.)
What percentage do you think is
biological? All or very nearly all? (Sounds biological to me, but I'm asking.)Any trauma in your background?
I also wonder, kinda' bluntly, sorry, if you are asking too much from yourself regarding things like pacing events, down time, productivity, being up or positive.... Not that these are root causes. I don't even mean that. I guess I would like to think you are being really kind to yourself and gentle. Rage and anger can be so awful to experience esp when lashing out at others. I'm sorry. (You probably missed my Lyrica-induced rage a few weeks back. It was like h*ll :( )
Hang in there lady. Babblemail if you ever want. Gotta go.
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Posted by floatingbridge on April 6, 2011, at 23:13:35
In reply to Rapid cycling Agitated Depression or Mixed State?, posted by FrustratedMama on April 3, 2011, at 23:31:29
Hey ya. Didn't mean to go all preachy on you.
How goes it?
fb
Posted by SLS on April 7, 2011, at 5:26:20
In reply to Rapid cycling Agitated Depression or Mixed State?, posted by FrustratedMama on April 3, 2011, at 23:31:29
> HELP ME! There is a mean and angry person inside of me who is lashing out at everyone over every litte thing and is miserable no matter what I am doing. Meds not working need to go back to square one and start over.....IDEAS? please....I AM going CRAZY for real this time.
Can you describe in greater detail how you think, feel, and behave?
Lashing out at others can be the result of a mixed-state, agitated depression, or medication.
Is lashing out the only thing that occurs that you are concerned with?
How is your sleep and sex-drive? Do you begin one project before finishing another so that very little gets done? Do you talk too fast such that it seems others are too slow to keep up with you? Do you feel "burned out" despite having lots of energy?
- Scott
Posted by FrustratedMama on April 7, 2011, at 22:19:13
In reply to Re: Rapid cycling Agitated Depression or Mixed State? » FrustratedMama, posted by SLS on April 7, 2011, at 5:26:20
>
> Can you describe in greater detail how you think, feel, and behave?Hi Scott,
Well, I feel like giving up but at the same time I am so full of this agitated energy that I cant sit still. I have trouble sleeping and am taking ambien to help with that. However, I also have trouble waking up....(I would love to be able to sleep from 4 AM-2PM daily)...but I am a single parent and work full time.
>
> Lashing out at others can be the result of a mixed-state, agitated depression, or medication.
>
> Is lashing out the only thing that occurs that you are concerned with?
>No, I am also losing motivation, haven't been happy, all I want to do is sleep or hibernate in my house...I miss enjoying life and am full of hatred for no apparent reason (I almost wish I could focus this negative energy on a purpose...but I am not a victim of PTSD or anything of that nature) I mean no disrespect to those with PTSD as I KNOW it is HORRIBLE...I just have no reason to feel this way so it makes the guilt even worse cause I feel like I should be able to change my way of thinking....
> How is your sleep and sex-drive? Do you begin one project before finishing another so that very little gets done? Do you talk too fast such that it seems others are too slow to keep up with you? Do you feel "burned out" despite having lots of energy?
> SLeep sucks and sex drive has been gone for several years now (abstinence and no dates to speak of). I do get annoyed when others cant keep up with me but I dont think I talk super fast...just not slow....I get to the point I guess....I defintely feel burned out all the time and in spite of that full of "anxious irritable energy" not the useful energy that could be of help to my life....I hope this may help you or others to help me understand what I am going through as I dont.
>
> - Scott
Posted by SLS on April 8, 2011, at 5:01:35
In reply to Re: Rapid cycling Agitated Depression or Mixed State?, posted by FrustratedMama on April 7, 2011, at 22:19:13
Hi FM.
I don't think you are suffering from a mixed-state or any other bipolar diathesis. It sounds more like agitated depression. Tricyclics are usually good for this subtype. Your agitation and angry outbursts are a part of the depression and not a manic dysphoria.
Has anything helped at all - even slightly?
Has anything made the depression worse?
- Scott
Posted by floatingbridge on April 8, 2011, at 11:25:27
In reply to Re: Rapid cycling Agitated Depression or Mixed State? » FrustratedMama, posted by SLS on April 8, 2011, at 5:01:35
FM,
I'm so sorry. No disrespect taken regarding ptsd or anything psychological.
Being a single parent itself can be a stressor. I somehow had forgotten you were parenting solo, though sounds good you have your church community.
About therapy. If your depression is physically driven, therapy could help with stress reduction and be part of an overall plan to cope with and reduce episodes. That would be the purpose of it, up front.
Big hugs, FM. I'll be following your thread and sending good thoughts to you.
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Posted by morgan miller on April 8, 2011, at 22:39:29
In reply to Re: Rapid cycling Agitated Depression or Mixed State?, posted by FrustratedMama on April 4, 2011, at 22:45:37
> Thank you everyone.....I guess I should have listed my meds....currently they are
> 10 mg adderall 2 x day
> .5 mg klonopin 2 x day
> 50 mg Pristiq 2x day
> 10 mg ambien at nightTo me this looks like a recipe for instability. Adderall and klonopin stand out the most here. You're taking things that temporarily both powerfully stimulate and powerfully tranquilize, and none of their effects last very long. Also, ambien is a hyptotic and does not restore restful sleep, it simply just knocks people out. I always hear about people talking and walking in their sleep when taking ambien, I think it's a bad way to tackle sleep issues, especially when there are so many natural alternatives.
It looks like a doctor made some poor decisions in using polypharmacy. What you likely need are medications that stabilize mood. You should stay on Pristiq of course, if it is really helping.
Weening off Adderall and Klonopin and replacing them with a good mood stabilizer is what I would do. It's going to take time for your brain to heal and adjust. Time is half the battle of getting better, as long as the right conditions are there.
If you feel well enough, you will likely benefit from intense cardiovascular exercise, 20 mins 5 to 6 days a week. Always follow up cardiovascular exercise with a meditative full body stretch. Breathing is crucial! Breath through both nose and mouth. I often start with the mouth and finish through my nose. The nose breathing really makes a difference in the way your mind functions and feels. To test this, just sit there, close your eyes and take a deep breath through your mouth using your diaphragm. Then do the same with your nose. You should feel the difference in your brain when you nose breathe.
Morgan
Posted by morgan miller on April 8, 2011, at 22:43:45
In reply to Re: Rapid cycling Agitated Depression or Mixed State? » FrustratedMama, posted by SLS on April 8, 2011, at 5:01:35
> Hi FM.
>
> I don't think you are suffering from a mixed-state or any other bipolar diathesis. It sounds more like agitated depression. Tricyclics are usually good for this subtype. Your agitation and angry outbursts are a part of the depression and not a manic dysphoria.
>
> Has anything helped at all - even slightly?
> Has anything made the depression worse?
>
>
> - ScottI may have jumped the gun on the mood stabilizer angle. Still, it sounds like, at least temporarily, a little lithium or depakote could be very beneficial. I don't think taking either of these for a month or so with hurt in any way.
Posted by FrustratedMama on April 8, 2011, at 23:16:22
In reply to Re: Rapid cycling Agitated Depression or Mixed State? » FrustratedMama, posted by SLS on April 8, 2011, at 5:01:35
CYmbalta helped for a while, pristiq for a while and other AD's for a while....all poop out though...I also have been taking adderall and libirum with some success for a while....again....POOP OUT kills me every few months and its back to square one....each time worse than the previous episode.
Posted by FrustratedMama on April 8, 2011, at 23:17:59
In reply to Re: Rapid cycling Agitated Depression or Mixed State?, posted by floatingbridge on April 8, 2011, at 11:25:27
Thanks FB and Big hugs to you....I really hate this feeling and so wish I was sick with something else so I wasn't alienating everyone around me all the time...
Posted by FrustratedMama on April 8, 2011, at 23:22:57
In reply to Re: Rapid cycling Agitated Depression or Mixed State?, posted by morgan miller on April 8, 2011, at 22:43:45
I am so confused as to what agitated depression is.....lots of articles nowadays are calling it bipolar depression...and of course the fact that my depression changes its presentation makes me lean toward the bipolar angle....I have two depressions
(1) is lethargic, over-eating, flat affect, hopeless, and isolated and the other
(2) is angry, wired but tired, can't sleep, disorganized, and irritable...also sensitive to sound, touch, light, and any slight changes in my routine.
Posted by Phillipa on April 8, 2011, at 23:40:42
In reply to Re: Rapid cycling Agitated Depression or Mixed State? » morgan miller, posted by FrustratedMama on April 8, 2011, at 23:22:57
FM depression/anxiety. You mention that you keep going back and forth with the meds due to poop out. What if you rotated those meds before poopout? One thought says some say won't work again but are you doing that now as if so maybe they continue to work for you second time round. I had a pdoc at one time and I asked what happens if benzo stops working and he said go to another wait a while and then go back to the other. Kind of sounds like the same thing? Seems if pristiq and was it cymbalta work for you maybe it's the ssnri's that are your best bet in ad's? Phillipa
Posted by SLS on April 9, 2011, at 6:54:16
In reply to Re: Rapid cycling Agitated Depression or Mixed State? » morgan miller, posted by FrustratedMama on April 8, 2011, at 23:22:57
> (1) is lethargic, over-eating, flat affect, hopeless, and isolated and the other
> (2) is angry, wired but tired, can't sleep, disorganized, and irritable...also sensitive to sound, touch, light, and any slight changes in my routine.
Here, it does sound like there might be some bipolarity involved. It would help to describe the pattern of how the two phases of your illness occur in time. How long does it take for the "switch" to occur once it begins (hours, days)? How long does each phase last for? Is it a regular cycle? Do you experience any periods of normalcy, particularly after your depressive phase? Would you describe your anger outbursts as "rage"? Are you easily distracted such that you complete very few tasks? Do you talk too much or too fast? Racing thoughts? Perhaps you are experiencing a mixed state punctuated by episodes of atypical-like depression, which is what bipolar depression usually looks like.
It can be very difficult to differentiate between bipolar mixed-states and agitated depression with racing thoughts. Perhaps you can continue to describe the features of your mixed-state.
One step at a time.
- Scott
Posted by Frustratedmama on April 9, 2011, at 9:19:51
In reply to Re: Rapid cycling Agitated Depression or Mixed State? » FrustratedMama, posted by SLS on April 9, 2011, at 6:54:16
> > How long does it take for the "switch" to occur once it begins (hours, days)?
Can take days to weeks - I often notice myself "slipping" or tell my doc that meds "aren't working as well anymore"
How long does each phase last for?
Depends.... But the phases usually last at least a month or two and I usually think they get better "normalcy" due to a change in meds and new meds "working"I DEFINITELY think the anger is RAGE
I am very easily distracted and can't focus at all my thoughts are like a whirlwind of irritability Whig is why I think stimuli bother me....I startle more easily then want to jump out of my skin as I can't handle any thing when I am wired.
I think the only reason I want to know is cause my treatments keep failing me an yes it is predictable..... Spring and fall are my worst enemies!!!!!!
Is it a regular cycle? Do you experience any periods of normalcy, particularly after your depressive phase? Would you describe your anger outbursts as "rage"? Are you easily distracted such that you complete very few tasks? Do you talk too much or too fast? Racing thoughts? Perhaps you are experiencing a mixed state punctuated by episodes of atypical-like depression, which is what bipolar depression usually looks like.
>
> It can be very difficult to differentiate between bipolar mixed-states and agitated depression with racing thoughts. Perhaps you can continue to describe the features of your mixed-state.
>
> One step at a time.
>
>
> - Scott
>
>
>
>
Posted by floatingbridge on April 9, 2011, at 10:10:15
In reply to Re: Rapid cycling Agitated Depression or Mixed State? » SLS, posted by Frustratedmama on April 9, 2011, at 9:19:51
FM,
Sorry to ask. You dx'd with ADD or ADHD?
Stim therapy left me worse off, that's my latest suspicion. I was doing pristiq, dex, Xanax xr, sonata as needed.
W/o stims, well, how do you think you'd
be?Something about your intolerance for sound, did you say light, and activity? (Aka life with kids :-/ )
My son has a low threshold for stimulation that we are learning about and learning to respect. There are
'sensory diets' suggested to help kids build neuropathways (I'm kinda' talking sensory integration issues here, rehashed; I'm just learning) to handle
more incoming stimulation. That's just thoughts towards the long view.Of course, stimulants (meds) can create the crash affect, too.
My best towards sorting your meds asap;
I'll follow your threads. If you need to ditch the stims, there is life after them. I can attest in the strong affirmative.Hugs, and God bless.
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Posted by floatingbridge on April 9, 2011, at 11:26:54
In reply to Re: Rapid cycling Agitated Depression or Mixed State? » SLS, posted by Frustratedmama on April 9, 2011, at 9:19:51
FM,
A mood/med diary helps tons. One less thing to keep in my head.
I'm going through three year's worth of graphs (very crudely done, on graph paper notebooks).
Also a place for random symptoms,
triggers, and plain old activity. Since my rage episodes, I've added emotional affect. So maybe anxiety is high (!) and depression is kinda' low, I will note emotional expression as anxious, cranky, anger, rage, teary, fearful. I suppose I could add avoidant.With barely a few seconds to Stitch together, some days I just check stuff off before I go to bed. Not science, but helps me track, esp when the going gets rough.
(Scott posted a link to a mood chart to download. Search the archives or ask him. Googling produces some mood charts, too. I think my ADD is such that I just had to make my own, lol :-/ )
Posted by Frustratedmama on April 9, 2011, at 11:53:58
In reply to Re: Rapid cycling Agitated Depression or Mixed State? » Frustratedmama, posted by floatingbridge on April 9, 2011, at 11:26:54
Yes I have been diagnosed ADHD but my diagnosis changes based on the pdoc....
Past diagnoses include
ADHD
Depression
Anxiety
Dysthymia
Cyclothymia
Bipolar 2
And agitated depression
I worry about diagnosis because I find it guides treatment and I just wish there was a treatment that would sustain itself
Posted by floatingbridge on April 9, 2011, at 12:22:43
In reply to Re: Rapid cycling Agitated Depression or Mixed State?, posted by Frustratedmama on April 9, 2011, at 11:53:58
> Yes I have been diagnosed ADHD but my diagnosis changes based on the pdoc....
> Past diagnoses include
> ADHD
> Depression
> Anxiety
> Dysthymia
> Cyclothymia
> Bipolar 2
> And agitated depression
> I worry about diagnosis because I find
it guides treatment and I just wish there
was a treatment that would sustain itself
>Yes, true. (I have a long dx list, too :( ) Then there is something I've heard said about treating core symptoms (the ones
that overlap different dx's ) and remaining observant without rushing to dx. I don't know.I think you can find a treatment that will sustain itself. And I'm hoping swiftly--that the symptoms you dislike the most,
maybe rage, will diminish. Then maybe next, anxiety or depression. You know I
hope for a miracle for you, and in the meantime, I wish there was a way to help take the pressure off you. Remember that you're a good person even when you feel hateful or else you wouldn't be so appalled. Really. You will get back to you.Take care. I'll watch the thread and be
thinking of you.fb
Abilify at a tinsy dose? Been there already?
Posted by Phillipa on April 9, 2011, at 19:30:15
In reply to Re: Rapid cycling Agitated Depression or Mixed State? » SLS, posted by Frustratedmama on April 9, 2011, at 9:19:51
FM I've heard that with light changes in Spring and Fall that this is when a switch changes in bipolar disorder. This would be my hunch. Mood stablizer. Phillipa
Posted by FrustratedMama on April 11, 2011, at 23:24:21
In reply to Re: Rapid cycling Agitated Depression or Mixed State? » Frustratedmama, posted by Phillipa on April 9, 2011, at 19:30:15
Change in meds from klonopin to valium and from adderall back to vyvanse...no mood stabilizer yet. Will start new thread....
Posted by floatingbridge on April 13, 2011, at 0:00:03
In reply to Re: Rapid cycling Agitated Depression or Mixed State?, posted by FrustratedMama on April 11, 2011, at 23:24:21
Sounds like you have a good patient pdoc. Hope that my sense is correct.
Hope, too, that new meds are taking the edge off.
I'll look at your next thread.
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