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Re: hanging in there » Lorraine

Posted by shelliR on October 3, 2001, at 20:53:28

In reply to Re: hanging in there » shelliR, posted by Lorraine on October 2, 2001, at 10:00:41

Hi Lorraine.
> > > > I think it will, only for the last two days I have lay down, setting my clock for a 30minute nap, and woken up three hours later. I have been very very tired. I'm not sure why, whether the oxy at night is affecting the quality of my sleep. All the sudden I went from very stimulated on the oxy and wellbutrin to very sleepy. But I'm not going to worry about it yet, although certainly I can't live this way. Sometimes I am like this premenstrually, but I can't figure out my cycle at all now, to see if it's related.
> Maybe with the increase in oxy you need to increase the Wellbutrin?

Actually, I might ask about raising the wellbutrin and keeping the nardil at 30mg. Nardil at 45mg really messes up my sleep.
He'll probably want to add more for me to sleep, but I'm curious anyway what wellbutrin at 400 or 450mg might feel like.
I do think the tiredness is premenstrual. This is my normal premenstrually, different from the last few crazy months.
> > > > >Oh, and I am up to 45 mg of nardil (well, I'm alternating every other day with 30mg, instead of splitting pills).
> What does this mean? 60 mg one day and 30 the other? Any reason for not splitting? I'm at 45 with splitting.
No, it comes back to idea that the half-life is long enough that it shouldn't matter. Except for very sensitive and/or stange people. < g >
> > > > He told me the other doctor's name, but I already forget. And I'll have to wait a bit to work it into a conversation so I can get it there again (without hurting my pdoc's feelings).
> Don't you hate that? Pay attention to these things, shelli!

Actually, it's getting to write down these things. Paying attention isn't even quite enough anymore. Especially with names and other things that don't hold any meaning. And this was before any senior moments. It used to cause a huge scatter on my IQ test. I have a very hard time with languages, and even with English, I don't pick up new words the way one would expect an avid reader would.

I have the suspicion that oxy and other opiates are being used with fms patients, who frequently (always) have depression as well as tender points and that this is how its use is spreading.

that may be true. Have you read about opiates used for fms patients? Last time I followed anyone with fms they were given elivil for the fms and it seemed to really work. Interesting to use tricylics in that way. Definitely not as an antidepressant (she was already on prozac), but for targeting the specific pain of FMS. I know that there there is now a field for pain specialists and pain management clinics and I don't know how long these clinics have been around, like whether these are new things being moved away from internists.

> > If my the physical elements of my depression really go away, then how much more therapy will I need? I talked some with my therapist about this on Thursday and we also used EMDR to start to process how much of my life I have missed. I am so so sad, under the depression. I am not ready to be my age. I want those years back. Things that I was working on two years ago when everything (with the exception of survival and work came to a halt.) But there were lots of years lost before that because of my self-image, because of my dissociation, etc. So, now, if I depression is sad, and I have mourned enough, what is next in my life. Am I up to the challenge of looking for an emotiona/sexual relationship, and do I really think I have the potential to love someone fully. I don't know, and I'm not even sure I want to go through all the effort.
The can I love stuff though is probably going to be resolved experientially (although you may need a coach along side). When I first got involved with my husband, I went into therapy because I knew this was a good thing and I didn't want to screw it up--the urge to push him away was pretty overwhelming, but I was healthy enough to distrust the feeling.

Good move. Was your inclination to push *him* away , or *anyone* away who was interested in a long-term relationship.

> Embracing the future instead of living in the wreckage of your future--sure sounds like your mood is in the right place.

My mood is getting better with some major setbacks. But I try to remember that the on and off again suicidal feelings that on when I am prementstual, will not last. In the past few days, I decided I wanted to terminate with my therapist, then last night I talked to my therapist friend to get her feedback. I wasn't happy with any of the options that my friend was bringing up in trying to help. (I hate that. I hate when I ask for help,then I keep saying, no, that wouldn't work, no I couldn't do that, no, etc. etc. etc., and I end up being sorry that I brought the whole thing up, and I'm sure that my friend felt so also.). And then this huge black cloud came whirling, pushing me in another state of being, entirely, and I wanted to hurt myself in lieu of dying. My therapist would call it poor affect management. Her constant need to classify everything in psychobabble (if you'll excuse that term on this board!) makes me feel that she needs to push her status up (really all therapists) and mine(patients) down. I am feeling sick of having a therapist, told her what I really wanted was a coach. I don't know if I should leave her and go to another therapist, or leave and see what happens. Or stay until I am more stable. She has always been very supportive when i feel that I am completely becoming unraveled and the thought of giving up that support is scary. But I also feel that I've worked with her for over three years and it may be that I have gotten all that I can out of this relationship and that some new ideas coming from other therapist might prove to be very useful to me now. Known vs the unknown at a time when I can descend into very black feelings very quickly. Also I remember what you said about getting more from a therapist who is not necessarily smarter than you, but my experience has been that having a very very quick and smart therapist has helped me so much. She taught me more in these three years than I have ever learned from theapist who were stronger in their feeling rather than thinking function. Have you taken the Myer Briggs? I am a INTJ. I'm guessing that my therapist is a ETNJ or a ENTJ. All my past therapists have been feeling types and I have gotten very frustrated much of the time. This therapist has taught me a lot about staying on track

> > > > Well if you take the neurotin and adderal, will you be able to tell when the nardil kicks in? Because that is probably an easier option for you, to take that route, rather than the purity route. Actually it is the way my doctor wanted to handle things in the hospital and I resisted, then gave in after one day. I wanted to try selegiline for a while before I added the oxy, because I really did feel that the oxy made me feel so good, that I wouldn't be able to see if the selegiline was working. But my pain was too great, and we decided that I could always take away the oxy, in other words I guess it would be called the subtraction method, rather than the addition method.
> I'm a believer in the subtraction method too. I'm so sorry I'm off the selegiline in a way. I loved what it did cognitively for me. Really felt like I was back to my old self in term of being able to think. I read some of my posts from back then, it shows.

It may be possible to add a very low dose of seligeline, while it's still a reversible MAOI. Have you done any research on this?

> > > > I've heard that there are a lot less interactions with nardil and other meds vs. parnate and other meds. Is adderal time release? If so, is it a capsule that can be split? Is it a capsule and a pill? JUST KIDDING. See we already have a history :-)
> And, you're funny...Well I am taking my second dose of Nardil at 4 pm and if I have a dinner party at 5 pm because otherwise I crash. I don't understand you or elizabeth with this steady state stuff and "it doesn't matter when you take your dose"--it matters a great deal to me. I really feel the doses kick in and then I feel myself crash or come down off the dose--in the evening, it's like coming down off an amphetamine.

That's so strange to me. I literally took 45mg for weeks and felt nothing, and than it totally kicked in. But that's true, it never made any different when I took it, still same side effects (around waking up every few hours at night, and afternoon fatigue.)
> >
> > > > Lorraine, I really don't know what to say. I can only say for me that it took a full five weeks of 45mg, and it changed my life. You haven't even done one week at 45mg.
> I didn't know there was a "whining" license competancy requirement:-)
:-). Hey, my statement was intended to give you support and encouragement. :-) To say that you've been on too low a dose to feel discouraged yet. (Oh, yes, I am also the president of the discouragement committee. I get to assess at what points you are allowed to feel discouragement < g > Very powerful roles, I have).

> > > > I also have to say that nardil alone wasn't enough. I also used a benzo throughout my whole adult life, sometimes more, sometimes none. It allowed me more or less to lead a normal life. And if I could have tolerated a stimulent, I would have been on that also.
> I'm being difficult with this, I know. The valium I could take at night (b/4 bed) and it actually might work throughout the day (I know it shouldn't with half lives and so on but I think it might have when I was taking it to sleep). But I also think I felt sexual impairment on it--which, by the way, I think Neurontin is also contributing to. When I was on Nardil alone, surprisingly, I had no impairment so I actually felt things normally for a week or so.

Well, now you are on a higher dose, so that's going to be hard to separate that out based on one week several weeks ago. It sounds like you are experiencing ony partial impairment. If that is true, then a little serzone or a bit of wellbutrin might help.

You might want to do some searches to se if klonopin or neurotin actually affects sexaul impairment. I've known a lot of people on both, and haven't heard much said about that. Nothing like the SSRIs, etc.

BTW, I think you are testing this impairment possiblity a bit more than is truely neccesary for a fair trial. < g >.
I don't think I've heard of sexual impairment on valium. Didn't affect me at all that way. Now if you want to talk about impairment, the codiene I think has quite a factor. But I have not participated in any trials lately. It could be very frustrating because it is actually very sensual, but full release is difficult.

I'm reluctant to try Klonopin (??) b/c I have heard it has some sexual impairment plus I have also heard that while it helps with anxiety it can actually worsen depression. I'm also very sensitive to cognitive impairment caused by these drugs.

Most people who have a dissociative disorder are both on an AD and klonopin. I don't think there are many complaints about it worsening the depression. I would say valium would have a greater tendency than klonopin to cause depression. I also haven't read much about it causing sexual disfunction. As for cognitive impairment, I actually think valium helps me with that, because it stablizes me and grounds me and that adds to my cognitive abilities.

Klonopin doesn't seem to worsen depression the way valium can for me. If I am really really depressed, I wouldn't take valium, but if I'm that depressed, I'm generally not that agitated or anxious so I don't need to take valium.
> Speaking of cognitive impairment, I have been in two accidents (very minor--backed into a parked car and solidly tapped the car ahead of me at a stop light). This plus losing some ability to concentrate. It's funny the accident where I hit the car at the stop light, it was actually as though I was "gone" for a moment. Then the other day, I had what I am convinced was a "smell" hallucination. In Beverly Hills on Rodeo, when I went to get into my parked car, I smelled marijuana very strongly. I looked around (it's not THAT uncommon in Beverly Hills after all) and saw no parked car with occupants, no car on the road that would explain the smell and no people in site. It was so odd that I actually stood there for about 3 minutes trying to figure out if there was a diner or restaurant that might be emitting exhaust that smelled like mj. Plus I am getting electric tingles on my arms or legs. Anyway, I think this may be temporal lobe seizure like stuff. I'm going to ask my pdoc. I'm wondering if Nardil might increase seizure like activity. I'm also wondering if I should add a different anticonvulsant.

Well, I got my masters on nardil, and I don't remember having any cognitive difficulties. And I supplemented with valium to keep me grounded. .
> > > > That’s why I mentioned subtraction above. That really may be easier. easier = better.
> Yes. I just need to move on this stuff I think. I am getting some mood support now I believe.

But then you feel that everything else is not going right. Maybe you can deal with the sideeffects after.
> > > >I have had the image of myself as fucked up, much more than depressed until two years ago. Lots of stuff to work on outside the depression which was managed by nardil.
> I had this image of myself as super-competent b/4 my depression. It's all nonsense. It's like we collect our moods roll them into a ball and call it "self".

Well, maybe you were super-competent before the depression? Do you look back and see great sex and clear mind, because those are the things that come up over and over for you , when wondering about what is being affected by the AD or mood stabilizer, other than the depression.
> >
> > > > When you find the right drug, then you will naturally put it into perspective.
> I know this is true, but I also know that I may not find the right drug and that I still need to be able to live a life to my fullest capability.

I think you will find the right drug. but you may have to prioritize what you are willing to live with, and work on the side effects after the success of the AD. I don't think I have the sublety of side effects that you do. Like I don't usually have to ask the questions, is this pill effecting something. I have such strong reactions to the drugs I can't tolerate, and there were many of them. On the other hand, it never occurred to me to go off of nardil because it was causing afternoon tiredness. Taking a 1/2 nap seemed a small price to pay, and when it didn't work anymore, in hindsight, an even smaller price to pay.
> > > > What is your next plan, if nardil doesn’t kick in. I know that one plan would be to go back to moclobernide with adjuncts, but is that next? I know you always have a next plan.
> I'm going to give the Nardil some more time and work on the anxiety and anticonvulsant side of the equation for right now.

> What was atarax like?
I take atarax to sleep and it also works the next day for me as an antihistamine. I sometimes adjust up and down depending on my drug trials. But I just use it for sleep, so I don't think too much about it. And I also have histimine which rises to the surface and makes me itch horribly (I think it's from grass) and now I don't have to worry about that anymore.
> You mean you took effexor successfully once and when you retried it, it didn’t work?
> Precisely. Ain't that a b****?

Well, you gave it up for pretty important reasons for you.
> > > > I remember that you said that you had quit work to be home with your kids, because that was something you had missed. Had you thought you’d stay home until the kids were a certain age, or just left it open-ended?
> I'm not sure what I'm doing with this. I don't think I can 9-5 anymore or assume my old 12 hour days. I don't think that I have the ability to withstand stress the way I used to. So I would need to do some sort of "home" work which I could transition into slowly.

If you can get away with it financially (and it appears that you can), I can't see working twelve hours a day, except for myself. And if I had kids, I probably couldn't see it at all.
> Shelli, I'm hoping you are progressing on your meds and feeling better, less sleepy. Let me know and let me know about that trade group meeting.

Group meeting was go crowded and it was totally open. I thought there was going to be a presentation. I learned a few specific facts about some plug-ins to photoshop, so it was worth it for me to go. I wouldn't go again, unless there was a speaker or demonstration that had to do directly with my work. I did see a young woman who did some freelance work for me, so that was fun--it's been about two years and she's been assisting and is ready to go solo if she can get some work. She'd like to do portraits and support that work by doing weddings. There were a bunch of people who have been converting to purely digital, but their commercial photographers which has very little relevance to my work. Still it was worth it for the few tibits I learned and also made me realize that I need to follow more closely what software is being put out by other companies to support photoshop. My digital pictures are coming out beautiful, although I can't find exactly the right thicknesss of paper. The big thing for me is going to be a huge change in marketing, selling myself and my decision to go digital, without seeming defensive. Once people see the work they'll know. Also my past clients have enough confidence in me to know that I woudn't change unless I thought the quality of my work would be equal. But it is harder to explain on the phone (not doing hand-prints anymore?) I think the first year will be rough, but I think it's absolutely a neccesary change for me to have a much better quality of life.





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