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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by meffect on January 24, 2015, at 2:07:39
I'm so confused. Depression runs in my family and I seem to have an extreme sensitivity to emotions - since i was born. I overact on almost everything. I avoid social situations because I usually end up interpreting someones words,tone,facial expression, etc as negative (even though I tell myself its not) and I end up feeling extremely depressed and I often times end up crying that night and wanting to kill myself. sometimes i wish an accident would happen and kill me because i cant do it myselfI cant achieve my hopes and dreams in life. I cant handle interpersonal communication for any length of time.
I have insomnia, i have an dependence on benzo's, i feel bored all the time. ssri's help but they make me tired i think
i'm tired all the time, i take naps at lunch and i have rem sleep and i hardly get any rest. i wouldnt even call it a nap
every day is different i have no stability or consistency
anyway, back to the subject. im tired all the time so my docs give me stims. stims = dopamine usually. so, i take the dopamine increasers and i seem to lose control. i interpret almost everything negatively and im extremely emotional.
also i cant handle epinephrine increasers, but it seems to cause more anxiety than heightened emotional responses.
wtf is wrong with me!!!!!!! what do I do. I dont want to give up but i've tried almost every drug in the last 5 years
Posted by meffect on January 24, 2015, at 2:34:38
In reply to Dopamine increasing drugs, worsen depression, posted by meffect on January 24, 2015, at 2:07:39
just to clarify a little. the dopamine drugs like dexedrine or provigil, they feel like they are doing their job (good efficacy). but towards the end of the day when they wear off, that's when I lose control of my emotions
Posted by meffect on January 24, 2015, at 2:35:58
In reply to Dopamine increasing drugs, worsen depression, posted by meffect on January 24, 2015, at 2:07:39
grrr auto fill with my previous post
Posted by Lou Pilder on January 24, 2015, at 6:00:34
In reply to Dopamine increasing drugs, worsen depression, posted by meffect on January 24, 2015, at 2:07:39
>
> I'm so confused. Depression runs in my family and I seem to have an extreme sensitivity to emotions - since i was born. I overact on almost everything. I avoid social situations because I usually end up interpreting someones words,tone,facial expression, etc as negative (even though I tell myself its not) and I end up feeling extremely depressed and I often times end up crying that night and wanting to kill myself. sometimes i wish an accident would happen and kill me because i cant do it myself
>
> I cant achieve my hopes and dreams in life. I cant handle interpersonal communication for any length of time.
>
> I have insomnia, i have an dependence on benzo's, i feel bored all the time. ssri's help but they make me tired i think
>
> i'm tired all the time, i take naps at lunch and i have rem sleep and i hardly get any rest. i wouldnt even call it a nap
>
> every day is different i have no stability or consistency
>
> anyway, back to the subject. im tired all the time so my docs give me stims. stims = dopamine usually. so, i take the dopamine increasers and i seem to lose control. i interpret almost everything negatively and im extremely emotional.
>
> also i cant handle epinephrine increasers, but it seems to cause more anxiety than heightened emotional responses.
>
> wtf is wrong with me!!!!!!! what do I do. I dont want to give up but i've tried almost every drug in the last 5 yearsmeffect,
You wrote,[...drugs, worsen depression...so confused...wanting to kill myself...(I) wish an accident would happen and kill me...I can't achieve...I can't handle...have insomnia...have dependence..I have no..lose control...what is wrong with me!!!!...I don't want to give up..tried almost every drug...].Do you think that you have been deceived by those that were those that trafficked in the process of you being drugged with mind-altering chemicals touted as "medicines"?
Lou
Posted by Tomatheus on January 24, 2015, at 8:41:25
In reply to Dopamine increasing drugs, worsen depression, posted by meffect on January 24, 2015, at 2:07:39
meffect,
I think that it would be a good idea to talk to the medical professional who prescribes your medications about testing for known physical abnormalities that may lead to depression or depression-like symptoms, if you haven't already had such tests done. Some tests that might be ordered include those that measure for thyroid disorders, anemia, and deficiencies of vitamin B12, folic acid, and vitamin D. It's possible that all of the tests might come back with "normal" results, but there's also a chance that an abnormal test result might point you toward getting better treatment for a condition related to your depression that you don't even know about.
As far as medications are concerned, it sounds from what you've written like you benefit to an extent from SSRIs. Do you think it's worth taking the SSRI medications, even though you seem to feel tired on them? Does caffeine help to counteract the tiredness at all? Are you currently taking an SSRI?
Assuming that you haven't tried all of the available depression medications, it might be the case that you'd benefit from a medication that you've yet to try. But other than guessing that you probably wouldn't respond favorably to medications that boost norepinephrine, it would be hard to know how you might respond to various medications without going through the trial-and-error process that psychiatrists put us patients through. Ultimately, some patients respond well to medications, others end up being partially responsive, and yet others don't seem to respond very favorably at all to medications. Regardless as to which of these groups you might belong to, you might find your overall treatment to be most effective if you combine drug treatment with other treatment modalities, such as psychotherapy, peer support, and healthy lifestyle choices. Of course, this assumes that you haven't already tried such treatment modalities.
Going through the process of being treated for a mental illness can be difficult, especially when it's hard to know what treatments might be helpful, but I think that options are available for pretty much everybody with a mental illness. Some of these options, like most medications, are well known, but I think that there are also other potentially effective options that don't necessarily get discussed so often. In your case, I think that getting some tests done might be a good thing to do if you haven't already gone that route. Ultimately, though, you play the decisive role in directing your treatment, and I hope that whatever you decide to do that you find something that ends up being beneficial. Good luck.
Tomatheus
Posted by Lou Pilder on January 24, 2015, at 9:41:16
In reply to Re: Dopamine increasing drugs, worsen depression » meffect, posted by Tomatheus on January 24, 2015, at 8:41:25
> meffect,
>
> I think that it would be a good idea to talk to the medical professional who prescribes your medications about testing for known physical abnormalities that may lead to depression or depression-like symptoms, if you haven't already had such tests done. Some tests that might be ordered include those that measure for thyroid disorders, anemia, and deficiencies of vitamin B12, folic acid, and vitamin D. It's possible that all of the tests might come back with "normal" results, but there's also a chance that an abnormal test result might point you toward getting better treatment for a condition related to your depression that you don't even know about.
>
> As far as medications are concerned, it sounds from what you've written like you benefit to an extent from SSRIs. Do you think it's worth taking the SSRI medications, even though you seem to feel tired on them? Does caffeine help to counteract the tiredness at all? Are you currently taking an SSRI?
>
> Assuming that you haven't tried all of the available depression medications, it might be the case that you'd benefit from a medication that you've yet to try. But other than guessing that you probably wouldn't respond favorably to medications that boost norepinephrine, it would be hard to know how you might respond to various medications without going through the trial-and-error process that psychiatrists put us patients through. Ultimately, some patients respond well to medications, others end up being partially responsive, and yet others don't seem to respond very favorably at all to medications. Regardless as to which of these groups you might belong to, you might find your overall treatment to be most effective if you combine drug treatment with other treatment modalities, such as psychotherapy, peer support, and healthy lifestyle choices. Of course, this assumes that you haven't already tried such treatment modalities.
>
> Going through the process of being treated for a mental illness can be difficult, especially when it's hard to know what treatments might be helpful, but I think that options are available for pretty much everybody with a mental illness. Some of these options, like most medications, are well known, but I think that there are also other potentially effective options that don't necessarily get discussed so often. In your case, I think that getting some tests done might be a good thing to do if you haven't already gone that route. Ultimately, though, you play the decisive role in directing your treatment, and I hope that whatever you decide to do that you find something that ends up being beneficial. Good luck.
>
> TomatheusFriends,
In is written here,[...it might be the case that you'd benefit from a (drug) tat you've yet to try...].
What if it isn't? And what kind of benefit as to how much of a benefit could be? And what if one dies from the drug before the benefit from the drug, if there is one? And what if one gets a life-ruining condition from the drug before tis benefit arrives? And what if addiction is a result of taking the drug?
Readers, there are statistics to show that around 42,000 people die each year from psychotropic drugs. And children have their lives ruined and people are compelled t kill themselves and others as a result of taking mind-altered drugs in collaboration with a psychiatrist/doctor.
When one is on the road of psychiatric drugs and sees that the road could lead to addiction and life-ruining conditions and death, they have a decision to make as to continue down that road in the hope that a new drug will benefit them, and others could look for a road that does not lead to death, but could lead to life, and life more abundantly. Which road will you trust today?
Here are some videos that I would like for readers to view.
Lou
[ youtube, E8VJ2iMcps4 ]
[ youtube, McZwUbuTE08 ]
[ youtube, pYyFWe47-V0 ]
Posted by Tomatheus on January 24, 2015, at 10:47:31
In reply to Lou's response-krozwroedz » Tomatheus, posted by Lou Pilder on January 24, 2015, at 9:41:16
Lou,
See below for my responses to your questions.
> Friends,
> In is written here,[...it might be the case that you'd benefit from a (drug) tat you've yet to try...].
> What if it isn't?I mentioned in my post that the extent to which individuals with depressive disorders benefit from medications can vary, with some individuals deriving little to no benefit from medications. I also mentioned in my post other treatment modalities that could be of benefit in alleviating depression. Specifically, I mentioned psychotherapy, peer support, and healthy lifestyle choices, but there are, of course, other interventions that might also be of use in the management of depression. I think that it should go without saying that if one doesn't benefit from medications that some of the other interventions that I've mentioned might be helpful.
> And what kind of benefit as to how much of a benefit could be?
I don't understand what you're asking here, Lou.
> And what if one dies from the drug before the benefit from the drug, if there is one? And what if one gets a life-ruining condition from the drug before tis benefit arrives? And what if addiction is a result of taking the drug?
Well, of course, there are risks involved with taking medications for depression and other mental illnesses. Patients should ask the medical professionals who prescribe their medications to discuss such risks so they can be informed of all known risks associated with the medications that they're taking. The decision to take a medication for any health condition shouldn't be made without considering both risks and benefits. You, Lou, made a point to identify some of the possible risks of taking psychiatric medications, and those risks should be known. But what should also be known are the consequences of leaving depression untreated. The facts that depression is a leading cause of disability and that it obviously greatly increases one's risk of committing suicide should not be ignored. You speak of life-ruining conditions, Lou, but those of us here who suffer from depressive disorders know that depression itself can have a devastating impact on not only the lives of depressed individuals but also the lives of those around them. It is for this reason (and possibly other reasons, as well) why many of us here are willing to accept the risks associated with taking psychiatric medications.
Tomatheus
Posted by ed_uk2010 on January 24, 2015, at 14:49:28
In reply to Dopamine increasing drugs, worsen depression, posted by meffect on January 24, 2015, at 2:07:39
Hi.
>I'm so confused. Depression runs in my family and I seem to have an extreme sensitivity to emotions - since i was born.
OK, are you also diagnosed with depression or something else? Like borderline personality disorder, for example? What sort of illness runs in your family? Severe/recurrent depression... bipolar disorder (manic-depression) etc?
>I overact on almost everything. I avoid social situations because I usually end up interpreting someones words, tone, facial expression, etc as negative (even though I tell myself its not) and I end up feeling extremely depressed and I often times end up crying that night and wanting to kill myself. sometimes i wish an accident would happen and kill me because i cant do it myself
Do you feel temporarily OK when things are going better? It sounds like your emotions are very over-reactive to the situation/circumstances. Have you ever had cognitive-behavioural therapy?
>i have an dependence on benzo's, i feel bored all the time. ssri's help but they make me tired i think
What medication are you taking at the moment? Tell us about the benzo situation... Long-term use of benzos can aggravate depression. I expect you'd do better on an antidepressant alone (assuming you find the right one), an MAOI could potentially be very effective if you could tolerate one and stick to the dietary restrictions. Nardil, for example. MAOIs do often aggravate insomnia unfortunately. As for SSRIs and related antidepressants.... what have you tried? Some tend to cause more tiredness than others.
>I'm tired all the time, i take naps at lunch and i have rem sleep and i hardly get any rest.
Do you mean you have vivid dreams?
>im tired all the time so my docs give me stims.
You must be in the US? That's the only place (pretty much) where docs think amphetamines and similar drugs are a sensible solution to fatigue. Clearly, for you, they are not. This is not unusual. In general, it's best to remove the cause of the fatigue where possible. If one antidepressant is making you too tired it would be worth trying another. I understand you've already tried several but I imagine there are still options.
It is common for stimulants to give an initial confidence boost but this may (at times) be followed by a roller coaster of emotions, and a rebound 'crash' when the med wears off. Of course, potent stims often cause further sleep disturbances and increased anxiety in the long run. They rarely improve severe depression beyond the initial stage of treatment, if at all. It was known in the 1960s that stimulants are a poor treatment for chronic depression. Fatigue may be improved temporarily but then potentially worsened, especially if sleep is negatively affected. Stimulants can be useful to give a short term 'boost' in special circumstances eg. in palliative care, but for someone with such long term problems as yourself, they really aren't very suitable. You need something which is likely to help you in the longer term. If you stop the stimulant, you may feel very tired and depressed for a couple of weeks but you should then feel better.
Mild stimulants such as caffeine may be tolerable, assuming that caffeine doesn't worsen your anxiety. You should certainly avoid caffeine in the late afternoon and evening if you suffer from sleep problems.
>i cant handle epinephrine increasers, but it seems to cause more anxiety than heightened emotional responses.
Which drugs in particular are you referring to? Wellbutrin?
Take care.
Posted by meffect on January 24, 2015, at 21:57:08
In reply to Re: Dopamine increasing drugs, worsen depression » meffect, posted by ed_uk2010 on January 24, 2015, at 14:49:28
> Hi.
>
> >I'm so confused. Depression runs in my family and I seem to have an extreme sensitivity to emotions - since i was born.
>
> OK, are you also diagnosed with depression or something else? Like borderline personality disorder, for example? What sort of illness runs in your family? Severe/recurrent depression... bipolar disorder (manic-depression) etc?
>I've never had a pdoc diagnose me with anything. In my town they dont seem to be interested in diagnosis. They just give drugs. Never taken a test or anything. I've seen 3 pdocs in my town. My moms side of the family has something psychologically wrong but they never got a diagnosis either. My mom takes lexapro. I dont think bipolar -- though I do have high's and lows that can happen very rapidly depending on the situation I put myself in, it doesn't seem like bipolar. Honestly, in my research, borderline personality disorder fits me the most -- except i dont self harm
> >I overact on almost everything. I avoid social situations because I usually end up interpreting someones words, tone, facial expression, etc as negative (even though I tell myself its not) and I end up feeling extremely depressed and I often times end up crying that night and wanting to kill myself. sometimes i wish an accident would happen and kill me because i cant do it myself
>
> Do you feel temporarily OK when things are going better? It sounds like your emotions are very over-reactive to the situation/circumstances. Have you ever had cognitive-behavioural therapy?Yea i feel ok today. I took a higher dose of vybrid. never had cbt. I was having problems with my marriage when I made the original post. good point...
>
> >i have an dependence on benzo's, i feel bored all the time. ssri's help but they make me tired i think
>
> What medication are you taking at the moment? Tell us about the benzo situation... Long-term use of benzos can aggravate depression. I expect you'd do better on an antidepressant alone (assuming you find the right one), an MAOI could potentially be very effective if you could tolerate one and stick to the dietary restrictions. Nardil, for example. MAOIs do often aggravate insomnia unfortunately. As for SSRIs and related antidepressants.... what have you tried? Some tend to cause more tiredness than others.I'm taking 1mg of Klonopin at night for sleep. 30mg of temazepam at night for sleep. 2mg of Xanax which I take only at night if I really have trouble sleeping; and I usually cut it in half first. Actually lately with the Provigil, I will take 1mg of xanax during the day if things get too much to handle. Vybrid 10-20mg daily. I'm trying to go down to 10mg because of the sexual side effects. I've tried every SSRI. Lexapro and Vybrid seem to work the best for calming my emotions, but Lexapro makes me SOOOO tired to the point where I can not avoid taking a 3 hour nap no matter how hard i try. Zoloft and Prozac make me too anxious and irritable. Paxil made me tired like lexapro but i never gave it a good trial run. On Parnate, I had to take a nap at lunch. Parnate felt like a week dexedrine with a crash that = nap. Nardil was better than Parnate but I did not like it; i felt very drugged on it and it felt wrong. The Vybrid is the only ssri that doesnt make me overly tired. It makes me tired, but I can overcome it with provigil or caffeine.
>
> >I'm tired all the time, i take naps at lunch and i have rem sleep and i hardly get any rest.
>
> Do you mean you have vivid dreams?
I have dreams about random things over and over and I never actually seem to fall asleep. I think 1 hour passes but really only 20 minutes passed. It's like im borderline between falling asleep (unconscious) and awake, but having these very weird dreams while trying to get fully asleep. The dreams are very vivid and are usually about current events like work> >im tired all the time so my docs give me stims.
>
> You must be in the US? That's the only place (pretty much) where docs think amphetamines and similar drugs are a sensible solution to fatigue. Clearly, for you, they are not. This is not unusual. In general, it's best to remove the cause of the fatigue where possible. If one antidepressant is making you too tired it would be worth trying another. I understand you've already tried several but I imagine there are still options.Yes, US. I've tried Provigil, Dexedrine Spansules, and Vyvanse. With the dexedrine spansules, i feel amazing. Calm and clear headed and no social anxiety whatsoever. Except, it only lasts about 3 hours. Then the comedown is pretty brutal; i need a benzo. Vyvanse only lasts about 4 hours in my system, same problem as dexedrine. Provigil on the other hand, seems to last all day; which is great. Actually I took 200mg of provigil the day I made my original post, and the comedown from that made me break down :/
> Mild stimulants such as caffeine may be tolerable, assuming that caffeine doesn't worsen your anxiety. You should certainly avoid caffeine in the late afternoon and evening if you suffer from sleep problems.I drink two 16oz rockstar energy drinks and it barely does anything. thats 160mg of caffeine x2 + whatever other stuff is in those drinks. Yea i usually stop drinking caffeine by 2:00pm. I have this weird issue where im tired all day, but as soon as it's time to go to bed, I feel more alert and awake.
> >i cant handle epinephrine increasers, but it seems to cause more anxiety than heightened emotional responses.
>
> Which drugs in particular are you referring to? Wellbutrin?Wellbutrin, i can handle about 75MG SR, but not on a daily basis. Only when I need something to stay awake. Anything higher than that and I feel very anxious and I'm snappy at people. Pristiq was probably the best I've tried for SNRI's, but the anxiety did catch up to me to where I couldnt handle it anymore. Fetzima was very bad from the beginning, i could only handle 3 days on it before i was so anxious I had to stop.
Posted by meffect on January 24, 2015, at 22:00:18
In reply to Dopamine increasing drugs, worsen depression, posted by meffect on January 24, 2015, at 2:07:39
sorry chrome keeps auto filling the subject line with the wrong one
Posted by ed_uk2010 on January 25, 2015, at 5:04:37
In reply to Re: Nardil from Greenstone or Gavis??????, posted by meffect on January 24, 2015, at 21:57:08
Hi again!
>I dont think bipolar -- though I do have high's and lows that can happen very rapidly depending on the situation I put myself in, it doesn't seem like bipolar. Honestly, in my research, borderline personality disorder fits me the most -- except i dont self harm
Yes, I get the impression your mood is reactive to the situation rather than having more prolonged and less reactive mood episodes typical of bipolar disorder. Most people with bipolar disorder have weeks or months of manic/mixed symptoms followed by prolonged periods of depression, but the course is very variable and there are different forms.
Whether you're bipolar or not, have you tried any 'mood stabilising' meds at all? Like Depakote, Tegretol or lithium? Many people use these in combination with antidepressants. They might be helpful if you feel very angry or irritable in response to difficult situations. I'm interested in hearing how you've responded to meds other than antidepressants and benzos, what have you tried?
>never had cbt. I was having problems with my marriage when I made the original post. good point...
Do you know if CBT might be available to you? It might help to reduce your negative thought patterns. For those who do well, the response to CBT is usually long term.
>I'm taking 1mg of Klonopin at night for sleep. 30mg of temazepam at night for sleep. 2mg of Xanax which I take only at night if I really have trouble sleeping; and I usually cut it in half first. Actually lately with the Provigil, I will take 1mg of xanax during the day if things get too much to handle. Vybrid 10-20mg daily. I'm trying to go down to 10mg because of the sexual side effects. I've tried every SSRI. Lexapro and Vybrid seem to work the best for calming my emotions, but Lexapro makes me SOOOO tired to the point where I can not avoid taking a 3 hour nap no matter how hard i try. Zoloft and Prozac make me too anxious and irritable. Paxil made me tired like lexapro but i never gave it a good trial
How long did you try Zoloft for? The reason I ask is because the initial anxiety generally passes. Some people find it helpful to start very low eg. at 25mg and then increase gradually. I was mainly asking in case you would feel less tired on Zoloft than on related meds.
One med you could consider is vortioxetine (Brintellix). It has some similar properties to Viibryd but acts at a greater range of receptors. Have you tried it?
>On Parnate, I had to take a nap at lunch. Parnate felt like a week dexedrine with a crash that = nap. Nardil was better than Parnate but...
OK, not an option again then!
>and the comedown from that made me break down :/
Yeah, meds which make you feel amazing and then give you a brutal comedown will only make you worse in the long run... and this problem only gets more severe over time, which is really not good for your health. It's also a problem if you're having to take more benzos to get over the come down. I really think you should reduce and then stop all potent stimulants and try to minimise your use of additional benzo doses... you're already on a substantial dose regularly.
>I have this weird issue where im tired all day, but as soon as it's time to go to bed, I feel more alert and awake.
That's common in anxiety/depression. Have you tried a melatonin capsule at night to see whether it helps you sleep?
Take care.
This is the end of the thread.
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