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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Anne-Charlotte on January 10, 2006, at 9:38:32
Has anyone heard of someone just snapping out of a severe depression with psychotic elements?? Presuming that it is a bio-chemical thang, how would this work?? My brother was diagnosed with severe depression about 7 months ago, refused medicinal treatment continually throughout the ordeal (and an ordeal it was, for all of us, with cutting episodes and an obsession with suicide...) with the exception of a few doses of Theralin and Stesolid, from which we felt he actually became worse, ie aggressive and hostile.... Subsequently, around two months ago, the depression developed psychotic elements, that is to say delusions, yet he continued to refuse treatment due to severe fears of prescription medication. ! As of three days ago, he is flying high. He feels subjectively great, has much energy and has been having a 'flash of brilliant work'- stating that he has not written with such insight and ease in nearly a year (he is a writer). From what I have read, this sounds like it could be a bipolar type disorder for which I believe he would need treatment. However, after nearly 8 months of attempting to convince him to be treated for his depression, I certainly can't envision his attitude to such being any more receptive, especially since he feels better than great. I am hesitant to confront him.
Is it possible that he is in fact in remission from the depressive episode; that his mind and body have simply healed, so to speak? Maybe the illness has run it's 'due course'? I certainly hope so, and would appreciate hearing from anyone with any insights on the matter.
Thanks,
Anne-Charlotte
Posted by Ed O`Flaherty on January 11, 2006, at 9:11:14
In reply to Snap-Out of Psychotic Depression??, posted by Anne-Charlotte on January 10, 2006, at 9:38:32
Bipolar disorder is the likely diagnosis here. It would be wise to get him seen by a psychiatrist immediately.
Posted by linkadge on January 12, 2006, at 8:29:04
In reply to Re: Snap-Out of Psychotic Depression??, posted by Ed O`Flaherty on January 11, 2006, at 9:11:14
Depression can, and does often remit on its own, but it ususally does so gradually.
I think that O flaherty is right that it is probably bipolar disorder.
Although, he may be even more resistant to treatment in the manic stage!
Linkadge
Posted by tealady on January 13, 2006, at 20:18:54
In reply to Snap-Out of Psychotic Depression??, posted by Anne-Charlotte on January 10, 2006, at 9:38:32
> Has anyone heard of someone just snapping out of a severe depression with psychotic elements?? Presuming that it is a bio-chemical thang, how would this work?? My brother was diagnosed with severe depression about 7 months ago, refused medicinal treatment continually throughout the ordeal (and an ordeal it was, for all of us, with cutting episodes and an obsession with suicide...) with the exception of a few doses of Theralin and Stesolid, from which we felt he actually became worse, ie aggressive and hostile.... Subsequently, around two months ago, the depression developed psychotic elements, that is to say delusions, yet he continued to refuse treatment due to severe fears of prescription medication. ! As of three days ago, he is flying high. He feels subjectively great, has much energy and has been having a 'flash of brilliant work'- stating that he has not written with such insight and ease in nearly a year (he is a writer). From what I have read, this sounds like it could be a bipolar type disorder for which I believe he would need treatment. However, after nearly 8 months of attempting to convince him to be treated for his depression, I certainly can't envision his attitude to such being any more receptive, especially since he feels better than great. I am hesitant to confront him.
> Is it possible that he is in fact in remission from the depressive episode; that his mind and body have simply healed, so to speak? Maybe the illness has run it's 'due course'? I certainly hope so, and would appreciate hearing from anyone with any insights on the matter.
> Thanks,
> Anne-Charlotte
>I think I'd take a different path first.
Having thyroid receptor antibodies..stimulating and binding (TSI or TBII or TRAb?) or thyroid antibodies (TPO, perhaps TG?) can cause all the symptoms of bipolar to the same intensity as anyone gets it.
A significant no of people on a thyroid forum I was on were previously diagnosed as bipolar, some were or are still on meds for it.
However one their thyroid receptor or thyroid antibodies are treated the bipolar improves or goes away completely. In other words it was the antibodies faring on and off in intensity the caused the bipolar symptoms.As a first step, I'd check his thyroid function and all of those antibodies checked out if possible.
If he does have antibodies depending on severity, he may be able to get at least some relief with things like selenium .. which helps lower the antibodies. This is more likely to work if his selenium levels are low in range in his blood.. even if still within normal range. Others have found help with acupuncture or other methods.. but if he does have high TSI antibodies, maybe block and replace is best as it gets rid of the antibodies if kept on for long enough(years):-) OTOH, antibodies can sometimes just go away all by themselves. maybe it is something in the environment or water. Stress itself raises them.Not all docs will treat or test..so good luck if he is willing to be checked out:)
It's just something that is worth checking and ruling out first I think.
there are studies coming out which are starting to find higher antibody levels in bipolar.Hope this helps.
yeah, being someone who ha experienced swings, I think if you feel good.. enjoy it! LOL .. but he could still get his antibodies tested.
The problem is his TSH (a reasonable over measure of thyroid function in healthy humans) will still most likely be in normal range.. so most docs won't then test the antibodies. Still its worth a try :)
I only got my antibodies tested when I found out that all the female in the other branches of the family had thyroid antibodies :-)
They're have been people completely cured of their bipolar who have managed to receive good treatment for their thyroid antibodies. This is more likely with some docs in the US.
Unfortunately docs are difficult to find even if you do find the antibodies,as most don't treat for antibody reduction only for replacing or lowering thyroid hormones levels. My endo says he doesn't and the endocrinology profession doesn't aim to treat the antibodies.
Still if you do find antibodies .. its good to know what the problem is and be able to do what you can with lowering them, or possibly preventing the more severe flares.It is more common in females but its not unknown in males.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12897379&query_hl=3&itool=pubmed_docsum
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11958781&query_hl=3&itool=pubmed_docsum
Jan
Posted by Anne-Charlotte on January 17, 2006, at 10:42:31
In reply to Re: Snap-Out of Psychotic Depression?? » Anne-Charlotte, posted by tealady on January 13, 2006, at 20:18:54
Hi tealady,
I just wanted to thank you for your suggestion re thyroid antibodies, and the links you posted. I find it an interesting possibility, definitely worth checking out... I will just have to try to drag my brother for some tests. Who knows how it will work here in Denmark, medicine is very 'streamlined' so one's treatment/test options tend to be limited... but Thank You!
A-C
> > Has anyone heard of someone just snapping out of a severe depression with psychotic elements?? Presuming that it is a bio-chemical thang, how would this work?? My brother was diagnosed with severe depression about 7 months ago, refused medicinal treatment continually throughout the ordeal (and an ordeal it was, for all of us, with cutting episodes and an obsession with suicide...) with the exception of a few doses of Theralin and Stesolid, from which we felt he actually became worse, ie aggressive and hostile.... Subsequently, around two months ago, the depression developed psychotic elements, that is to say delusions, yet he continued to refuse treatment due to severe fears of prescription medication. ! As of three days ago, he is flying high. He feels subjectively great, has much energy and has been having a 'flash of brilliant work'- stating that he has not written with such insight and ease in nearly a year (he is a writer). From what I have read, this sounds like it could be a bipolar type disorder for which I believe he would need treatment. However, after nearly 8 months of attempting to convince him to be treated for his depression, I certainly can't envision his attitude to such being any more receptive, especially since he feels better than great. I am hesitant to confront him.
> > Is it possible that he is in fact in remission from the depressive episode; that his mind and body have simply healed, so to speak? Maybe the illness has run it's 'due course'? I certainly hope so, and would appreciate hearing from anyone with any insights on the matter.
> > Thanks,
> > Anne-Charlotte
> >
>
> I think I'd take a different path first.
> Having thyroid receptor antibodies..stimulating and binding (TSI or TBII or TRAb?) or thyroid antibodies (TPO, perhaps TG?) can cause all the symptoms of bipolar to the same intensity as anyone gets it.
> A significant no of people on a thyroid forum I was on were previously diagnosed as bipolar, some were or are still on meds for it.
> However one their thyroid receptor or thyroid antibodies are treated the bipolar improves or goes away completely. In other words it was the antibodies faring on and off in intensity the caused the bipolar symptoms.
>
> As a first step, I'd check his thyroid function and all of those antibodies checked out if possible.
> If he does have antibodies depending on severity, he may be able to get at least some relief with things like selenium .. which helps lower the antibodies. This is more likely to work if his selenium levels are low in range in his blood.. even if still within normal range. Others have found help with acupuncture or other methods.. but if he does have high TSI antibodies, maybe block and replace is best as it gets rid of the antibodies if kept on for long enough(years):-) OTOH, antibodies can sometimes just go away all by themselves. maybe it is something in the environment or water. Stress itself raises them.
>
> Not all docs will treat or test..so good luck if he is willing to be checked out:)
>
> It's just something that is worth checking and ruling out first I think.
> there are studies coming out which are starting to find higher antibody levels in bipolar.
>
> Hope this helps.
> yeah, being someone who ha experienced swings, I think if you feel good.. enjoy it! LOL .. but he could still get his antibodies tested.
> The problem is his TSH (a reasonable over measure of thyroid function in healthy humans) will still most likely be in normal range.. so most docs won't then test the antibodies. Still its worth a try :)
> I only got my antibodies tested when I found out that all the female in the other branches of the family had thyroid antibodies :-)
> They're have been people completely cured of their bipolar who have managed to receive good treatment for their thyroid antibodies. This is more likely with some docs in the US.
> Unfortunately docs are difficult to find even if you do find the antibodies,as most don't treat for antibody reduction only for replacing or lowering thyroid hormones levels. My endo says he doesn't and the endocrinology profession doesn't aim to treat the antibodies.
> Still if you do find antibodies .. its good to know what the problem is and be able to do what you can with lowering them, or possibly preventing the more severe flares.
>
> It is more common in females but its not unknown in males.
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12897379&query_hl=3&itool=pubmed_docsum
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11958781&query_hl=3&itool=pubmed_docsum
>
>
> Jan
>
>
>
>
Posted by tealady on January 18, 2006, at 20:26:36
In reply to Re: Snap-Out of Psychotic Depression?? » tealady, posted by Anne-Charlotte on January 17, 2006, at 10:42:31
Hi Anne-Charlotte,
Thanks I hope the thought helps, but it Is difficult to get testing.
This post might have some more ideas for you to consider for some degree of improvement.
http://www.blog.co.uk/index.php/tealady-health/2006/01/16/diet_and_mental_health~478267It's discussed a bit in the thread http://www.dr-bob.org/babble/alter/20051208/msgs/599584.html below on this page too.
Jan
Posted by helpme on July 4, 2006, at 19:21:04
In reply to Snap-Out of Psychotic Depression??, posted by Anne-Charlotte on January 10, 2006, at 9:38:32
Why yes- google this up:Apparently, a high dose (in hospital setting) of the abortion drug RU-486 can cure a severe psychotic depression almost immediately, but for political reasons and pressure from anti-abortionists, treatment is denied. They want the drug illegal. I think the research was done- forgive me if I get this wrong- Stanford?
> Has anyone heard of someone just snapping out of a severe depression with psychotic elements?? Presuming that it is a bio-chemical thang, how would this work?? My brother was diagnosed with severe depression about 7 months ago, refused medicinal treatment continually throughout the ordeal (and an ordeal it was, for all of us, with cutting episodes and an obsession with suicide...) with the exception of a few doses of Theralin and Stesolid, from which we felt he actually became worse, ie aggressive and hostile.... Subsequently, around two months ago, the depression developed psychotic elements, that is to say delusions, yet he continued to refuse treatment due to severe fears of prescription medication. ! As of three days ago, he is flying high. He feels subjectively great, has much energy and has been having a 'flash of brilliant work'- stating that he has not written with such insight and ease in nearly a year (he is a writer). From what I have read, this sounds like it could be a bipolar type disorder for which I believe he would need treatment. However, after nearly 8 months of attempting to convince him to be treated for his depression, I certainly can't envision his attitude to such being any more receptive, especially since he feels better than great. I am hesitant to confront him.
> Is it possible that he is in fact in remission from the depressive episode; that his mind and body have simply healed, so to speak? Maybe the illness has run it's 'due course'? I certainly hope so, and would appreciate hearing from anyone with any insights on the matter.
> Thanks,
> Anne-Charlotte
>
Posted by helpme on July 4, 2006, at 19:22:19
In reply to Re: Snap-Out of Psychotic Depression??, posted by helpme on July 4, 2006, at 19:21:04
Forgot to say- apparently it works by shutting down and eliminating the body's stress hormones, ie cortisol- immediately.
Posted by cloudydaze on July 16, 2006, at 21:38:24
In reply to Snap-Out of Psychotic Depression??, posted by Anne-Charlotte on January 10, 2006, at 9:38:32
I agree, it sounds very much like bipolar. From what I've read and been told by my psychiatrist, sometimes people with bipolar disorder can suffer very severe depressive episodes that can cause "temporary psycotic episodes". I have experienced this myself. I was delusional, and had both auditory and visual hallucinations. I felt like a puppet who was made to do things. I felt detached from my body at times. Once when i was at school, i forgot where i was and even who i was for a few hours. I lost myself. I wandered around campus until i remembered that it was nighttime and i was supposed to go home. I cut myself because i heard someone or something tell me to do it, and later i didn't remember doing it, but saw the scars...
It's a very confusing and frightening experience, and I don't blame anyone for not wanting to medicate. For me, the medication was worse than the symptoms. Many anti-psychotic drugs have nasty side effects. I went through about 6 of them...until i started having really scary symptoms like high Blood pressure and facial spasms...eventually (in about six months i think) the psychotic episode passed. thankfully, i have never had another episode, at least not a severe one.My diagnosis was "temporary psychotic episode" which actually made me quite relieved because i thought i was schizophrenic. Apparently it's not uncommon.
> Has anyone heard of someone just snapping out of a severe depression with psychotic elements?? Presuming that it is a bio-chemical thang, how would this work?? My brother was diagnosed with severe depression about 7 months ago, refused medicinal treatment continually throughout the ordeal (and an ordeal it was, for all of us, with cutting episodes and an obsession with suicide...) with the exception of a few doses of Theralin and Stesolid, from which we felt he actually became worse, ie aggressive and hostile.... Subsequently, around two months ago, the depression developed psychotic elements, that is to say delusions, yet he continued to refuse treatment due to severe fears of prescription medication. ! As of three days ago, he is flying high. He feels subjectively great, has much energy and has been having a 'flash of brilliant work'- stating that he has not written with such insight and ease in nearly a year (he is a writer). From what I have read, this sounds like it could be a bipolar type disorder for which I believe he would need treatment. However, after nearly 8 months of attempting to convince him to be treated for his depression, I certainly can't envision his attitude to such being any more receptive, especially since he feels better than great. I am hesitant to confront him.
> Is it possible that he is in fact in remission from the depressive episode; that his mind and body have simply healed, so to speak? Maybe the illness has run it's 'due course'? I certainly hope so, and would appreciate hearing from anyone with any insights on the matter.
> Thanks,
> Anne-Charlotte
>
Posted by SLS on July 17, 2006, at 7:04:04
In reply to more about ru-486, posted by helpme on July 4, 2006, at 19:22:19
> Forgot to say- apparently it works by shutting down and eliminating the body's stress hormones, ie cortisol- immediately.
Actually, mifepristone (RU-486) blocks directly the cortisol receptors. It does not shut down the production of cortisol by the adrenal glands. On the contrary, it actually produces an acute increase in cortisol secretion as the body is tricked into thinking that none is available. However, during this time of receptor blockade, the number of receptors actually increases (receptor upregulation). Once the mifepristone is discontinued, this new "thermostat setting" tells the adrenal glands to reduce their secretion of cortisol on a more permanent basis.
This whole process is not immediate. It takes about a week. The mifepristone treatment protocol is built around this biological phenomenon. One takes the drug (600mg/day) for only 7-8 consecutive days and then discontinues it. It is hoped that the HPA (hypothalomus-pituitary-adrenal) axis resets itself during this period of time and results in a new "thermostat setting".
There is some debate as to whether mifepristone treats only the psychotic symptoms or the entire depressive syndrome.
- Scott
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