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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by bmwfan07 on September 25, 2011, at 20:22:07
Hi all,
It's been awhile since I've posted. I've been doing better, generally, than several months ago when I posted about my atypical depression.
Anyway, I'm still trying to figure out what I have diagnostically. My doc would not dx me with bipolar 2, because I've never had a manic/hypomanic episode. But my depression presents atypically, with oversleeping and rejection sensitivity, and the onset was about a year ago at 20, which is much more common/consistent with some kind of bipolar spectrum disorder than pure unipolar major depression--esp in tandem with my social phobia/personality issues.
But what I'm trying to figure out now is whether there's a physical reason for, or at least factor in, my issues, whether low cortisol, hypothyroidism (which I have), etc.
One of the things that mystifies me is that when I drink coffee/large amounts of caffeine, several hours later--without fail--I become agitated and depressed, even suicidal. This is in *stark* comparison to when I haven't consumed caffeine, when I very rarely have serious suicidal ideation anymore these days.
I am wondering what might explain this neurochemically. I do have some moderate reactive hypoglycemia issues and I know caffeine messes with blood sugar. But would that really account for this? This is a different feeling than my low blood sugar anxiety/paranoia/sadness/personality changes. It's much more similar to the "organic" depression I've battled for the past year.
Anyway, any insight into this phenomenon would be much appreciated and might even provide a clue as to the etiology of what I'm dealing with, particularly if it isn't common, which I don't think it is.
Thanks.
Posted by creepy on September 25, 2011, at 20:59:36
In reply to Caffeine triggers depression?, posted by bmwfan07 on September 25, 2011, at 20:22:07
Maybe what youre feeling is just the crash when the stimulant effects wear off?
If I remember right, caffeine metabolism is somewhat complex, there are a few metabolites each with different halflives in the body. Ive also wondered about this since my mood and energy can follow rhythms during the day.
So it may be that one of the metabolites doesnt agree with you.
Posted by bmwfan07 on September 25, 2011, at 21:05:47
In reply to Re: Caffeine triggers depression?, posted by creepy on September 25, 2011, at 20:59:36
It's a possibility, but it never used to affect me this way at all till the onset of the depression a year ago...and possibly more recently than that, perhaps even concomitantly with starting the meds (buproprion and Lamictal). I am hoping the meds didn't change for the worse how I metabolize certain chemicals... but it's remotely possible I suppose?
It may also be worth mentioning that, roughly once a week and even when I was taking both meds (I'm not taking them anymore), I'll have a day where I wake up and just feel dead tired/sleepy/apathetic/fatigued the whole day... It's quite odd, since nothing seems to trigger it, at least that I can see. But it's probably related to depression in some way.
Perhaps the two phenomena are related...
Posted by rjlockhart04-08 on September 25, 2011, at 23:14:53
In reply to Caffeine triggers depression?, posted by bmwfan07 on September 25, 2011, at 20:22:07
you are not alone. Just today I drank caffiene both in pill form and coffee and I felt like shet after a couple house and then it makes me feel like i need to eat sugar after i drink it several hours later.
Try 5 hour energy. Or 5 hour energy caffeine free form
Posted by Phillipa on September 25, 2011, at 23:30:58
In reply to Re: Caffeine triggers depression?, posted by bmwfan07 on September 25, 2011, at 21:05:47
Why drink large amounts of caffeine mayb a cup or so that's enough. Phillipa
Posted by bmwfan07 on September 26, 2011, at 0:04:47
In reply to Re: Caffeine triggers depression?, posted by rjlockhart04-08 on September 25, 2011, at 23:14:53
I don't believe it matters where I get the caffeine from, as strong tea seems to produce a similar effect.
It's interesting you mention you feel like you need to eat sugar. Is it a craving or something else? Blood sugar related?
Posted by bmwfan07 on September 26, 2011, at 0:06:59
In reply to Re: Caffeine triggers depression? » bmwfan07, posted by Phillipa on September 25, 2011, at 23:30:58
See, I don't really drink large amounts. Today I had a medium iced coffee--is that 1.5 cups? 2? not sure--from Caribou and felt like hell later. Still not feeling great. It seems to really destabilize my mood/anxiety/cognition.
Posted by Phillipa on September 26, 2011, at 0:15:21
In reply to Re: Caffeine triggers depression?, posted by bmwfan07 on September 26, 2011, at 0:06:59
Last time I had coffee it was an iced starbucks and I had the worst panic attack ever. Somehow also my thyroid changed at same time and had to increase dose so wierd?
Posted by bmwfan07 on September 26, 2011, at 0:18:44
In reply to Re: Caffeine triggers depression? » bmwfan07, posted by Phillipa on September 26, 2011, at 0:15:21
That's no fun, Phillipa... I've had a couple panic attacks and they were horrible.
(As an aside, It's interesting how many people with depression/bipolar/other mental issues have thyroid issues. I'm thinking that's not totally coincidental. It's statistically significant from studies I've read.)
Perhaps once bipolar/depression was triggered, my neurochemistry changed to the extent that I respond differently to or metabolize differently chemicals that I used to handle just fine. I dunno, I just can't understand what's going on.
Posted by AlexanderS on September 26, 2011, at 0:47:35
In reply to Caffeine triggers depression?, posted by bmwfan07 on September 25, 2011, at 20:22:07
Caffiene is a stimulant and it depletes an already battered nervous system of energy.
Posted by SLS on September 26, 2011, at 8:06:40
In reply to Re: Caffeine triggers depression?, posted by AlexanderS on September 26, 2011, at 0:47:35
> Caffiene is a stimulant and it depletes an already battered nervous system of energy.
How so?
Caffeine can be relaxing for some people.
- Scott
Posted by SLS on September 26, 2011, at 8:11:04
In reply to Re: Caffeine triggers depression?, posted by creepy on September 25, 2011, at 20:59:36
> Maybe what youre feeling is just the crash when the stimulant effects wear off?
This is very possible. I find that I suffer an intensification of depression after the caffeine wears off, especially the day after.
I never knew that caffeine had psychoactive metabolites.
- Scott
Posted by bmwfan07 on September 26, 2011, at 15:45:56
In reply to Re: Caffeine triggers depression?, posted by AlexanderS on September 26, 2011, at 0:47:35
That makes sense conceptually, but how does it translate physiologically? Is it a cortisol/adrenal issue? Some other hormone/imbalance?
Posted by bmwfan07 on September 26, 2011, at 15:49:32
In reply to Re: Caffeine triggers depression? » creepy, posted by SLS on September 26, 2011, at 8:11:04
Interesting--I don't think I notice too much the day after, just several hours after consuming the caffeine. Perhaps it's all a function of the same process, though.
I seem to have a lot of confounding variables, too. I also have some kind of sleep disorder, probably sleep apnea or RLS. I have terrible brain fog and feel exhausted many days, despite getting sufficient sleep. It's no way to live, combined with the psychological issues, and it's certainly tough to know where one thing ends and another begins.
Posted by Phillipa on September 26, 2011, at 18:50:19
In reply to Re: Caffeine triggers depression?, posted by bmwfan07 on September 26, 2011, at 0:18:44
Seriously did my own study of thyroid and mental illness when working inpatient psych as RN. When reviewing labs in charts It stuck me that the majority of patients had thyroid issues. And along with thyroid issues comes depression, weight gain or loss, anxiety etc depending on whether TSH high or low. Of course other measurement also used. I've gone through periods in life where could drink a pot of coffee no anxiety. Once worked CCU and 3-11 drank coffee slept fine? I think coffee has theophylline in it or the similar name same as chocolate does and supposed to be stimulating. Used for Copd a lot and other breathing problems. Phillipa good for a google search
Posted by creepy on September 27, 2011, at 4:20:25
In reply to Re: Caffeine triggers depression? » creepy, posted by SLS on September 26, 2011, at 8:11:04
I quit caffeine for awhile as a test. And really all it did was lower my irritability a notch.
For some people maybe the depression is a result of poor sleep quality?I looked for some info to link to regarding caffeine metabolites and I think I was wrong about them being psychoactive. I cant recall where I read that but I didnt find anything to back it up. =(
Posted by Phillipa on September 27, 2011, at 18:56:53
In reply to Re: Caffeine triggers depression?, posted by creepy on September 27, 2011, at 4:20:25
Creppy received an article from online RN newsletter one of the articles is titled caffeine helps depression or something like that. Will open it and post it now. Good time. Phillipa
Posted by bmwfan07 on September 27, 2011, at 19:01:35
In reply to Re: Caffeine triggers depression? » creepy, posted by Phillipa on September 27, 2011, at 18:56:53
> Creppy received an article from online RN newsletter one of the articles is titled caffeine helps depression or something like that. Will open it and post it now. Good time. Phillipa
I saw something about that too on CNN, if it's the same study. It found that the higher the caffeine consumption for women, the lower their risk of developing depression. Intriguing.
Stimulants can definitely help with depression. Some people take amphetamines for their major depression with great success. But I also had an unusual response to Adderall when I was first diagnosed with ADHD. The next morning I woke up severely depressed for the first time in my life. So I'm probably not normal in how I respond to things. :)
Posted by Phillipa on September 27, 2011, at 21:24:46
In reply to Re: Caffeine triggers depression?, posted by bmwfan07 on September 27, 2011, at 19:01:35
Normal? What's that? Strange times in my life could only drink iced coffee with added milk never did a thing. Since thyroid haven't touched a drop out of fear of panic. Phillipa
Posted by zatar on September 30, 2011, at 12:17:49
In reply to Caffeine triggers depression?, posted by bmwfan07 on September 25, 2011, at 20:22:07
Strattera, an NRI, induced depression in my daughter. Weaned her off it and her mood lifted. Don't think it was a crash with the drug wearing off, but caused the depression.
Caffeine and other stimulants can increase the stress response, which may worsen depression in people. Go figure that a recent study showed that coffee consumption lessens depression in women. I think that should say "some" women. Everyone is different. That the problem with many studies - they tend to generalize. I think most mental disorders will be found to have different subtypes, with different causes.
Caffeine can effect sleep and that might have an impact on symptoms of depression.
When my panic disorder acts up, I can't even have decaf coffee or chocolate without them affecting sleep, increasing muscle tension, and increasing panic attacks. When my system settles down, I can consume some.
Good luck to you.
-Zatar
Posted by Phillipa on September 30, 2011, at 20:08:19
In reply to Re: Caffeine triggers depression?, posted by zatar on September 30, 2011, at 12:17:49
How very true. Explains why sometimes could drink it and not now but chocolate doesn't keep me up and eat a lot as no taste and smell and texture gives some pleasure. It must up my blood sugar though then drop it swiftly as experience extreme fatigue as eat before dinner. Phillipa
Posted by bmwfan07 on September 30, 2011, at 22:06:52
In reply to Re: Caffeine triggers depression?, posted by zatar on September 30, 2011, at 12:17:49
> I think most mental disorders will be found to have different subtypes, with different causes.
This is definitely an important point. I totally agree. It's kind of like declaring all lung cancer to be caused by the same thing. Since people's depressive and anxious symptoms vary so widely, it's clear different things are going on in their brains. I think they'll discover at least 5 causes for, or at least sources of, depression, bipolar, anxiety disorders, ADHD, etc.
BTW, dunno if I mentioned I have ADHD too. I haven't tried Strattera, which I assume your daughter was taking for ADHD, but as I mentioned before, I believe ADHD triggered severe depression/bipolar for me, which I'd never had before. Interesting.
> Caffeine can effect sleep and that might have an impact on symptoms of depression.
This is a good point, too. I have terrible brain fog and fatigue some days, and when clustered together I'm sure there's a sleep issue/disorder going on (when I'm just fatigued I believe that can be caused solely by depression). I'm currently doing a no-caffeine test to see if that helps, as the brain fog is nearly as debilitating from a cognitive perspective as the depression.
>
> When my panic disorder acts up, I can't even have decaf coffee or chocolate without them affecting sleep, increasing muscle tension, and increasing panic attacks. When my system settles down, I can consume some.That's terrible. I hope you're being treated, and improving.
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