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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Adele on January 23, 2001, at 13:53:14
I am very interested to hear about this connection. My 17 year old daughter was diagnosed with MONO in December 2000. She is also ADHD. She states now that she feels like a completely different person to how she was previously, prior to the MONO diagnosis. She is just about to go into hospital for a psychological investigation...whats hard is to see what is influencing what whether "depression/anxiety" triggers the MONO or vice versa. I am also having her immune system checked for gamma globulin (spelling?). I will post the results here in case it rings a bell with anyone..This seems very complex and no doctors seem to jump on making these connections - in fact doctors only seem able to see one thing at a time..Would love to hear from others....since I am in danger of losing my daughter.. she is no longer at school and is just two credits short of graduating..
Posted by Dr. Bob on January 25, 2001, at 0:49:37
In reply to Re: Mononucleosis and Depression, posted by Adele on January 23, 2001, at 13:53:14
> She states now that she feels like a completely different person to how she was previously, prior to the MONO diagnosis.
Different how?
> whats hard is to see what is influencing what whether "depression/anxiety" triggers the MONO or vice versa.
That can in fact be really hard to know. Sometimes it's one way, sometimes the other...
> I am in danger of losing my daughter..
Losing her how?
Bob
PS: Thanks for getting this board going again. :-)
Posted by Adele on January 25, 2001, at 16:46:51
In reply to Re: Mononucleosis and Depression, posted by Dr. Bob on January 25, 2001, at 0:49:37
> > She states now that she feels like a completely different person to how she was previously, prior to the MONO diagnosis.
>
> Different how?
>
> > whats hard is to see what is influencing what whether "depression/anxiety" triggers the MONO or vice versa.
>
> That can in fact be really hard to know. Sometimes it's one way, sometimes the other...
>
> > I am in danger of losing my daughter..
>
> Losing her how?
>
> Bob
>
> PS: Thanks for getting this board going again. :-)
Thanks for responding so quickly! I must admit because the thread was old I was amazed at your replying and greatly appreciate it.When I say "..losing my daughter.." perhaps I mean slipping away out of the conventional path but also denying herself the reward of completing high school - when she only has two credits to complete. Today, because she is being very forgetful, conveniently so, I did get her to sign a simple statement that said if we could arrange it she would home school for these two credits...but the look of sheer PANIC when any academic studying is mentioned is remarkable... and within a few minutes of signing she is "...out the door.."
Also, I have been so let down getting help for her. She is on a waiting list for being admitted to a hospital for evaluation...and I have not been able to find a psychiatrist who seems knowledgable enough to properly evaluate her, particularly as she is so difficult/angry when we go...They don't seem to know how to approach her...
ADELE
Posted by Dr. Bob on January 25, 2001, at 21:41:09
In reply to Re: Mononucleosis and Depression, posted by Adele on January 25, 2001, at 16:46:51
> Also, I have been so let down getting help for her. She is on a waiting list for being admitted to a hospital for evaluation...and I have not been able to find a psychiatrist who seems knowledgable enough to properly evaluate her, particularly as she is so difficult/angry when we go...They don't seem to know how to approach her...
Good help can be hard to find. :-)
Do you happen to live near any medical schools? They're often a source of experienced psychiatrists. Or, Ivan Goldberg has compiled a list of experts (though not necessarily child psychiatrists) at:
http://www.psycom.net/depression.central.psychiatrists.html
Bob
Posted by Sulpicia on January 27, 2001, at 17:19:05
In reply to Re: Mononucleosis and Depression, posted by Dr. Bob on January 25, 2001, at 21:41:09
> > Also, I have been so let down getting help for her. She is on a waiting list for being admitted to a hospital for evaluation...and I have not been able to find a psychiatrist who seems knowledgable enough to properly evaluate her, particularly as she is so difficult/angry when we go...They don't seem to know how to approach her...
>
> Good help can be hard to find. :-)
>
> Do you happen to live near any medical schools? They're often a source of experienced psychiatrists. Or, Ivan Goldberg has compiled a list of experts (though not necessarily child psychiatrists) at:
>
> http://www.psycom.net/depression.central.psychiatrists.html
>
> BobHi --
I do realize that this can be no more than anectdotal at this point, but I too have a daughter who had mono directly followed by depression. To make a very long and hellish story short, 4 hospitalizations, and 3 committments later, we had a diagnosis of bipolar II and substance abuse. We are very lucky to live in a large NE city AND to have found a truly gifted adolescent pdoc.
Adele, I sympathize with your frustration, and good help is very difficult to find. Be persistent while trying to stay sane.Bob: I cannot help but wonder about the connection between the mono and the onset of my daughter's disorder. Being an ancient historian by trade [in training :)], I hesitate to lauch into blindly searching PUBMED for research on this. Is there anyone working on this topic, or would you be kind enough to suggest some research strategies? The causality is not a huge issue to me, especially since there is a strong maternal history of neuropsychiatric stuff [great pdoc again!], and I'm much more interested in helping her cope with BP, yet the possibility of a connection is troublesome at the least.
Any thoughts or ideas appreciated.
Sulpicia
Posted by Dr. Bob on January 28, 2001, at 10:34:16
In reply to Re: Mononucleosis and Depression, posted by Sulpicia on January 27, 2001, at 17:19:05
> I hesitate to lauch into blindly searching PUBMED for research on this. Is there anyone working on this topic, or would you be kind enough to suggest some research strategies?
Sorry, but this isn't an area I'm familiar with. Has anyone else looked into this?
Bob
Posted by Adele on January 29, 2001, at 9:07:12
In reply to Re: Mononucleosis and Depression, posted by Dr. Bob on January 28, 2001, at 10:34:16
> > I hesitate to lauch into blindly searching PUBMED for research on this. Is there anyone working on this topic, or would you be kind enough to suggest some research strategies?
>
> Sorry, but this isn't an area I'm familiar with. Has anyone else looked into this?
>
> BobSulpicia: I was very interested in hearing your story. Are you by any chance in the Boston area? If so I'd love your Pdocs name. I still haven't got any help. No hospital placement, still no word from the study, no feedback from people trying to help me find a good pdoc.
In follow up to your story. Do you have a history of bipolar in the family? We do on my husbands side of the family, his brother. This is why we are so worried. His brothers illness was thought to have been triggered by hepetitis when he was 18 yrs old...so possible these debilitating illnesses could trigger depression..??
ADELE.
Posted by Sulpicia on January 29, 2001, at 10:46:57
In reply to Re: Mononucleosis and Depression, posted by Adele on January 29, 2001, at 9:07:12
> >
Hi Adele: here's the long version of how we got here.
http://www.dr-bob.org/babble/child/20000813/msgs/72.htmlI don't know much about the connection except that I saw a thread about this at MGH neuro forums where I usually post.
Her ped mentioned that depression could follow mono.This wasn't something I had planned on researching right away -- especially since my daughter is such a mess and I'M STUCK HERE GRADING EXAMS!
I'll post the link to the other forum a bit later. Just bear with me this morning!
One thing to remember when you hop over to the other forum: I don't how to say this gracefully and I don't have the time for elegant word-play.There is a *strong* belief in that forum [it's for Tourettes] that add/hd, ocd, ts and a whole host of other neuropsychiatric illnesses are the result of PANDAS -- I can't remember what it stands for, but in general there is some prelimary research that shows association and triggering [at least] from strep infection and possibly viral illnesses too.
Since bipolar is frequently co-morbid w/such I asked a question or two. It is *possible* that they don't know what they are talking about. I imagine we would have to use the citations they've compiled as a starting in a very long project.
To business: I'm south of you I'm afraid. Whom does her ped suggest?
What sort of shape is she in right now? Can she go to school or function? Does she have a dx of bipolar?If she isn't stable I might wait on the idea of entering a study. She might need lots of flexibility rather than a rigid study?
I highly recommend Ivan Goldberg site for a referral. My pdoc, whom I think is a minor deity, thinks Goldberg is wonderful. He must be fab.
I know I haven't answered all your questions but things are nuts right now. We'll get it straight asap. Will be back to post the links.
No bipolar that I know of but materal side + for depression.
Tell me again what meds your daughter is taking or put a link to *your* war story?
Liz [actually] :)
Posted by Dr. Bob on January 30, 2001, at 1:02:23
In reply to Re: Mononucleosis and Depression, posted by Sulpicia on January 29, 2001, at 10:46:57
> PANDAS -- I can't remember what it stands for, but in general there is some prelimary research that shows association and triggering [at least] from strep infection and possibly viral illnesses too.
I was wondering about PANDAS, too, but I'm not following that research...
Bob
Posted by Noa on January 30, 2001, at 15:36:42
In reply to Re: Mononucleosis and Depression, posted by Dr. Bob on January 30, 2001, at 1:02:23
I think you can find PANDAS info at the NIH website, or the Tourettes Syndrome Association web site.
Posted by Noa on January 30, 2001, at 15:46:04
In reply to Re: Mononucleosis and Depression, posted by Dr. Bob on January 30, 2001, at 1:02:23
Here is some info on PANDAS--pediatric autoimmune neuropsychiatric disorders associated with strep:
http://intramural.nimh.nih.gov/research/pdn/web.htm
http://www.nimh.nih.gov/research/pandassummary.cfm
and a press release on risks of one experimental treatment for PANDAS:
Posted by Noa on January 30, 2001, at 15:57:22
In reply to Re: Mononucleosis and Depression, posted by Sulpicia on January 29, 2001, at 10:46:57
Another thought--if she just is getting over the mono (had it just in December?), it is still quite early, and from what I hear, it can take a long time to truly recuperate, so it might be good to not go slow getting back into full action mode anyway.
I remember when I was 10 and my sister was 18, she had to come home from college because of mono and it took her a very long time to fully recover. She was exhausted all the time.
I know that when I have a virus or something, my depression worsens. And, when I am exhausted for any reason--lack of sleep, thyroid problems, or illness (I had coxsackie virus last year and that was painful, exhausting, and it made me depressed), I do get depressed. What I have learned to do is to try to interpret the depression differently, though, as a function of the illness, which helps me keep some hope that when the illness is better, my mood will be, too.
Your daughter's body is struggling to regain strength. I would think it could affect her emotionally too.
To her this probably feels like a lifetime and she'll never get her "self" back, and that can create panic. I think it can help if you try to not "catch" her panic, too, which I bet is asking a lot of a mother. But if you can help her put the time in perspective and convey hope that she needs time to recover, that might help.
At the same time, I would keep looking for info and options for helping her medically and therapeutically.
Posted by Sulpicia on January 30, 2001, at 16:03:06
In reply to Re: Mononucleosis and Depression, posted by Noa on January 30, 2001, at 15:57:22
> Noa -- great links. Thanks a bunch. I'm copy them and get to it when my daughter is stable.
Excellent suggestion re: depression and illness. If we just *know* why something is happening, it helps.Coxsackie in an adult?? OUCH. Many sympathies.
Liz
Posted by Sara T on March 29, 2001, at 23:55:58
In reply to Re: Mononucleosis and Depression » Noa, posted by Sulpicia on January 30, 2001, at 16:03:06
This thread brings back some memories I'd rather not have. This is anecdotal, of course, but my experience may be of some value here.
When I was 19, and my first year away in college, I came down with Mono and Hepatitis A. I lost a whole semester and probably should have stayed out the next semester because I ran the risk of relapse. I remember how sick I was, and really dragged out. I looked like a zombie full of pin pricks from all the blood tests. To this day I cannot donate blood. Since depression had been a feature in my life probably before that time, I don't remember it as a watershed event that triggered depression. But I can tell you that it was a big setback. I probably did experience depression, I cannot recall, I was depressed alot during that time.
ADHD, is a diagnosis that is made in an older person by considering their history. It doesn't appear after an illness. But if you are ill, you really don't have the reserves to fight off depression, and it isn't all that uncommon for a prolonged illness to trigger depression. It takes about 6 months to a year to recover from Mono. Don't underestimate the impact that it could be having.
About PANDAS: I believe there are tests that can be given to establish the presence of a PANDA. There are alot of conditions that people believe to be attributed to infections. Autism, ADHD,Tourettes, ect. There may be some conditions that mimic autism (for examle) and can be treated by clearing up the infection, but that isn't the case for most. There is more consensus among researchers in ADHD and Autistic Spectrum Disorders that the origins are genetic and are present from birth.
Hope this adds something.
Sara t.
This is the end of the thread.
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