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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by damnthislife on March 21, 2013, at 10:35:15
Hello all.
First post, I'll try to keep this short so I don't bore.
I'm a 31 y.o. Male. I have been struggling with what I can only imagine is depression, now, for over 7 years. My family history is severe with depression. My symptoms are not like those in my family, though. I want to sleep all day long, have very low energy, can eat like a horse, but crave chocolate and carbs mostly. I hate being out in public or going anywhere socically and I'm very sensitive to rejection.
When I found Atypical Depression definition, I thought this had to be me. I confronted my Pdoc with this and said to me that I don't seem that depressed to him. I don't get it! So, I fired him and have a new Pdoc appointment coming up.
I don't understand how I don't seem depressed with what I have already told you. I go to sleep each night hoping I won't wake in the morning. I would be happy if someone told me tomorrow that my life was ending soon.
I have tried just about EVERY SSRI, SNRI, and Welbutrin. They all did nothing for me. I've also taken provigil, and some stimulants. All didn't touch my symptoms. Would like my new doctor to hopefully try an MAOI.
I have (in the past 7 years) ruled out all other physical reasons for my symptoms. I have been to so many different doctors and have blood work out the yin-yang. It's a struggle each day just to get out of bed, to have to put on a smile around co-workers and friends when I really just hate being around everyone and want to scream when someone seems happy.
Can anyone relate? Does this sound like it might be Atypical Depression? Anyone with similar symptoms as me?
Thanks!
Posted by Phillipa on March 21, 2013, at 12:06:51
In reply to Atypical Depression?, posted by damnthislife on March 21, 2013, at 10:35:15
Glad you reposted a wealth of knowledge on this board. May great suggestions come you way. And welcome to babble. Phillipa
Posted by Tomatheus on March 21, 2013, at 12:27:51
In reply to Atypical Depression?, posted by damnthislife on March 21, 2013, at 10:35:15
Hi damnthislife,
Welcome to Psycho-Babble. Although I'm not in a position to diagnose anyone, it does sound to me like you might have atypical depression. You do seem to be experiencing the overeating, the oversleeping, and the rejection sensitivity that individuals with atypical depression tend to experience. Do you also experience a boost in mood in response to positive events? This, from what I understand, is something called "mood reactivity," and I think that it's technically necessary for a diagnosis of atypical depression. Even if you don't experience mood reactivity, I would think that the fact that you experience the overeating, the oversleeping, and the rejection sensitivity should be of significance, and I would definitely mention this to the psychiatrist that you're about to see.
To respond to your question as to whether anyone experiences symptoms that are similar to yours, I will say that I do experience the hypersomnia that you experience and the low energy, but not the overeating or rejection sensitivity. So, I don't think that I have atypical depression. I don't even like to use the word "depression" to describe the affective aspect of my condition because what I seem to struggle with is not so much an absence of happiness as much as it is an absence of energy. However, I've had a diagnosis of one depressive disorder or another (now schizoaffective disorder, since I also experience psychosis) for many years now, so it's kind of hard to talk about the affective aspect of my condition without using the word depression.
Anyway, I hope that your upcoming appointment with your psychiatrist will go well, and most importantly, I hope that you'll end up getting the treatment that you've been needing for some time now. I wish you luck with everything, and if you have any additional questions, please feel free to ask them.
Tomatheus
Posted by damnthislife on March 21, 2013, at 12:45:34
In reply to Re: Atypical Depression?, posted by Tomatheus on March 21, 2013, at 12:27:51
Tomatheus,
I can say that I do perhaps have mood reactivity. I do feel happier when great things happen or if I go out and treat myself to a new "toy". That said, it doesn't remove my symptoms.
Now, when this all started and I decided to go away, I felt great after being away for a week. Upon returning home, though, I fell back into a slump and my fatigue and other symptoms returned.
Have you had any luck with treating your fatigue? Have you tried the strong Anti-D's such as Nardil or Parnate?
Posted by Tomatheus on March 21, 2013, at 13:46:39
In reply to Re: Atypical Depression?, posted by damnthislife on March 21, 2013, at 12:45:34
damnthislife,
It does sound like you may be experiencing at least some mood reactivity. I think that it would definitely be worth mentioning this, along with your other symptoms, to the psychiatrist that you're about to see.
Unfortunately, I have not had any long-term success with treating my fatigue, although I will say that my energy level isn't nearly as low as it used to be before the onset of my psychosis. Nardil is really the only medication that I've tried that's significantly reduced the severity of my symptoms for more than a few days at a time, but ultimately, I couldn't even get Nardil to last indefinitely for me. I also experienced some partial relief when I tried a combination of tranylcypromine (generic Parnate -- the version made by Goldshield, which I ordered from a U.K. pharmacy) with SAM-e, but it was on that combo that I started to experience my psychosis.
As you may or may not know, the MAOIs can be particular beneficial for individuals suffering from atypical depression. There is research to indicate that they're more effective than the tricyclics in treating depressed patients with atypical features. These days, medications such as the SSRIs, SNRIs, and Wellbutrin are used before the MAOIs to treat atypical depression because they don't carry dietary restrictions and are less likely to interact with other medications. I don't know how the MAOIs compare with the newer-generation medications as far as effectiveness is concerned, but I think that there are some patients who've responded to either Nardil or Parnate after failing trials with the newer medications. So, given the reputation that the MAOIs have as treatments for atypical depression, along with the possibility that you may be suffering from atypical depression, I would be optimistic about your chances of responding to an MAOI. That's not to say that you'll necessarily be prescribed an MAOI or that the chances are 100 percent that you'll respond to an MAOI if you're prescribed one, but I would say that you should have some reason to be hopeful about responding to an MAOI if you end up being prescribed one.
Tomatheus
Posted by vanvog on March 22, 2013, at 9:16:05
In reply to Re: Atypical Depression? » damnthislife, posted by Tomatheus on March 21, 2013, at 13:46:39
There is also the symptom of so called "reversed diurnal variation" (feeling best in the morning, mood worsening in the evening) it's still controversial but I guess it has been observed by clinicians to some degree otherwise it would have not made it into psych literature.
Posted by AMB on March 22, 2013, at 10:31:07
In reply to Atypical Depression?, posted by damnthislife on March 21, 2013, at 10:35:15
I am similar to you in that my high or low moods/depression tends to be reactive and therefore really unpredictable. Overall, I have a sense of lethargy paired with anxiety that made it difficult to get anything other than the bare essentials in life done.
MAOI's have been the most effective meds I have ever taken, and I've taken a lot (ssri's, snri's TCAs and wellbutrin...). Parnate is more activating than Nardil and for me was a powerful tool that enabled me to finally function. While it didn't cure everything, for the first time in ages I enjoyed things and felt inspired.
Although it is technically containdicted with maoi's, I also took ritalin with it and it was a great. I know many pdocs won't prescribe this combo, but some who are more up on cutting edge treatments and recent literature will. But to start, if you look for a new pdoc you might want to seek out one who is experienced with treatment resistant depression and state of the art med combos. There is a certain amount of creativity needed on the pdoc's part to really find an effective treatment plan.
The reason I no longer take Parnate is I just couldn't handle the weight gain/blood sugar issues. A lot of people don't have these side effects on Parnate though, so it may not be an issue if you do go that route.
Posted by damnthislife on March 25, 2013, at 10:37:41
In reply to Re: Atypical Depression?, posted by AMB on March 22, 2013, at 10:31:07
It's funny you mention anxiety because I believe I too have this. I hate being out in public and cannot wait to get out of shopping malls. The smallest things tend to set me off!
Not sure how that fits into my depression or what it means all together. Guess I'll wait until I see my new doctor.
I'm already starting to taper off my Lexapro. It's doing nothing for me so I do not see the need in taking it any further. After 5 months, it should have helped by now at 20mgs.
Posted by Phillipa on March 25, 2013, at 18:56:37
In reply to Re: Atypical Depression?, posted by damnthislife on March 25, 2013, at 10:37:41
I'm down to 2.5mg of lexapro and down to 25mg of luvox. Don't do a thing so why pay and take them? Phillipa
Posted by AMB on March 27, 2013, at 19:35:08
In reply to Re: Atypical Depression?, posted by damnthislife on March 25, 2013, at 10:37:41
> It's funny you mention anxiety because I believe I too have this. I hate being out in public and cannot wait to get out of shopping malls. The smallest things tend to set me off!
>
> Not sure how that fits into my depression or what it means all together. Guess I'll wait until I see my new doctor.
>
> I'm already starting to taper off my Lexapro. It's doing nothing for me so I do not see the need in taking it any further. After 5 months, it should have helped by now at 20mgs.Well maybe a new doc will start you on an MAOi once the Lexapro is out of your system (I think they have to wait 2 weeks after ssri's are stopped). One thing I'll mention is that Nardil was better for depression + anxiety than parnate is. My father was on Nardil for 30 years though and it changed his life. He also had horrible anxiety. So bad that he couldn't go out in public. It was a life saver.
Posted by damnthislife on March 29, 2013, at 10:29:07
In reply to Re: Atypical Depression?, posted by AMB on March 27, 2013, at 19:35:08
I would honestly be happy with trying either Parnate or Nardil. I just need to try something other than going back to SSRI's/SNRI's that haven't touched my depression or symptoms.
Just hope they work if I try them. The washout period of my lexapro SUCKS!
Posted by damnthislife on March 29, 2013, at 10:30:29
In reply to Atypical Depression?, posted by damnthislife on March 21, 2013, at 10:35:15
BTW... I found this video the other day on Atypical Depression. By far the best video I have seen out there.
This is the end of the thread.
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