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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by JasonR on April 7, 2003, at 23:29:27
If any of you know an engineer, then you probably have a good idea as to how my thinking works... Logical, methodical, orderly. Everything has a reason for being, and all problems have solutions. Some things that do not make logical sense then seem to conflict with my engineer mentality...
Ok, that is out of the way...
For many years, I have had minor depressive bouts that hit in the end of fall. I think it is SAD or whatever, but for some reason this year it was bad...
Depression seems illogical to me. Back in November, I was at a point where my family life was suffering, work was suffering, and my relationships with friends was suffering. Suicidal thoughts appeared for the first time since my teens (silly hormones!). I took a deep breath, talked things over with my wife.
This was a hard step for me. Depression is illogical. It is silly that I am unmotivated, withdrawn, irritable, and just a general pain in the a-- to be around. My engineer attitude keeps saying 'SNAP OUT OF IT! THIS IS SILLY!' But I can't seem to do it.
My wife and I decided that some professional help was a good step to take. So I reluctantly went to see my doctor (general practioner). I described what was happening. (minus the suicidal thoughts, for fear of hospitilization) He said that it was something that could be managed with some medication. Lexapro was on its way..
10mg... 2wks into the meds and no major mood change. Sideeffect of no orgasm still present. I am going to stick to it as he (my doc) said it might happen. Christmas comes, I see my family and it takes everything that I have to put on a smile through family functions, as I feel that depression is embarrasing. 4more weeks on lexapro, no major mood change.
We upped the dose to 20mg/day. Mood improves a little, I am still unmotivated, and my sleep requirement is over 15h/day and I am exhausted the other 9. Time to stop. 2wk taper off... 4 days on nothing.
This gets me to Saturday. Effexor 37.5mg starts up. I am at my parents house on a visit, and I have a heart to heart talk with mom (I'm 25btw). I explained the whole situation to her. She is supportive of the whole thing and acted as a good sounding board for me...
I am a week into the effexor... Tomorrow starts the 75mg a day. I understand that it will take a few weeks to see how things are going to work out for me.
(sorry for the long post... need to get some details out for hopefully some good responses ;-)
Tuesday I send a message to boss at work explaining my current difficulty with depression. (big step #2) This probably saved my job, as everyone at work has pointed out that my performance has been not nearly what it was previously. (none ever to my face however!) Being in a small company is nice in that we are working to focus my efforts on items that I enjoy and less of the monotonous aspects of software engineering...
Ok, there is the background. Now for the questions:Is my general doctor the right person to be seeing?
Whats the deal with a p-doc?? Is it the laying down on a couch stuff you see on TV? Does it help? How do I find someone that can understand this frustrating logical view that I have?
My readings are starting to show me that this may not be illogical. This only holds true for me if the meds fix a chemical inbalance. (problem w/ logical solution) However, if it is not a chemical thing, I am not sure how I will take it. Am I broken? Whats wrong with me? (these are questions I ask all the time)
How can I equip my wife to help me? She finally broke down a few nights ago crying b/c she can't make me happy and hates seeing me unhappy. This hurt me deeply.
Ok, enough babble. I will leave it at this point for now....
Posted by waterlily on April 8, 2003, at 17:13:49
In reply to General questions and guidance..., posted by JasonR on April 7, 2003, at 23:29:27
Unfortunately, psychiatry is not at the point where it can be merged into neurology. We don't yet know exactly what happens with the brain in clinical depression vs. run-of-the mill circumstantial depression, so it cannot be tested for. It makes it very frustrating for people like you and me who want things to be black and white. I want a lab test or EEG to tell me if my depression/anxiety is caused by myself or by my biology. Too bad it doesn't work that way.
I see a 'p-doc' - a psychiatrist. A psychiatrist is a medical doctor who can prescribe medication for various mental illnesses. Mine referred me to a psychologist, who has a Ph.D., and does talk therapy with me. With my pdoc, I see him every 3 months for a medication check. I tell him how my mood is generally, what problems I'm having, and any side effects from medication I may have. I try to stick with surface issues only and just give him my assessment of how I feel the medication is working. With the psychologist, I get into the feelings I'm having and why I'm having them. I don't lay on a couch. We talk face-to-face and she gives me input every now and then. With her I learn more about myself and how my attitudes may contribute to depression.
I hope this at least answers a few of your questions and that the Effexor works for you. Good luck!
Posted by noa on April 8, 2003, at 19:37:01
In reply to Re: General questions and guidance..., posted by waterlily on April 8, 2003, at 17:13:49
What is interesting, though, is that even though the science of the brain is still so new and so much is not known about how experience and biochemistry interact, there is new research all the time that is quite exciting. For example, there are studies that found that the experience of depression actually changes at least one aspect of brain structure--the hippocampus is negatively impacted by depression and the release of chemicals like cortisol. Depression may be on a continuum from highly genetically "scripted" to much more reactive to what happens in life, and every possible combo in between! And once depressed, it can affect the brain and how the brain reacts to stressors.
It is a complex system with feedback loops.
The advantage of seeing a pdoc for medication is that a pdoc, one specializing in psychopharmacology, does psych meds prescriptions all day, all the time, and has seen a lot of patients, and is familiar with many psych meds, the advantages and disadvantages of each, etc. etc. If you are taking a med combo of more than one med, you might want to do at least one consultation with a pdoc (one you find with careful referral). However, if you feel your regular doc has a good handle on the med situation and your response, as well as side effects, etc., you might decide to stick with that doc.
Since you are a logically-oriented person, you might like a cognitive therapy approach to treating depression, if you are looking for therapy in addition to medication. This would involve increasing awareness of things like automatic negative thoughts and how they affect your feelings and assumptions about yourself, etc. and devising ways to teach yourself to challenge your assumptions and think differently.
Posted by fallsfall on April 9, 2003, at 7:51:20
In reply to Re: General questions and guidance..., posted by noa on April 8, 2003, at 19:37:01
I, too, am a software engineer. I've been treating my depression for 8 years. You are right - the depression stuff is completely opposite the engineering mindset. One thing that I have learned is that some of my problem is that I _am_ so logical, that I miss the feeling aspects of life. It is really hard to learn about that squishy part of life, I still have a long way to go.
So know that your engineering background will make working on depression a bit harder, but it can be done. And you are not alone.
Good luck
Posted by Tabitha on April 11, 2003, at 1:56:11
In reply to Re: General questions and guidance..., posted by fallsfall on April 9, 2003, at 7:51:20
Just think of therapy as an adjunct to medication. It's hard dealing with the changes and the stigma, and you might benefit from some extra support.
A therapist once told me that when doing therapy with highly intelligent clients, it can be slower getting started, since the intelligence is usually used as a defense against feeling, but the ultimately those clients progress more quickly since their intelligence helps them have the necessary insights.
Another trick that helps when I feel bad about having so much therapy.. think of it as education rather than medical care. You are getting education into functioning better as a human being, and integrating your emotions into your life. They don't teach that in engineering school.
Posted by noa on May 21, 2003, at 17:44:22
In reply to General questions and guidance..., posted by JasonR on April 7, 2003, at 23:29:27
JR,
Just curious how ya been?
This is the end of the thread.
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