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Barb, Re: Should BP II's nix the AD's? - Depends

Posted by McPac on June 6, 2003, at 14:50:49

In reply to Re: Should BP II's nix the AD's? - Depends nmk, posted by Barbara Cat on June 6, 2003, at 11:42:06

Hi Barb,
As I've told you before, your symptoms have always so closely seemed to resemble mine. Your posts so eloquently and vividly explain in CLEAR detail so many of the same symptoms that I've felt. I often wish that I could type faster (instead of the one-finger, 'pecking' method that I employ.....I don't respond as often or as lengthy as I would if I could just sit down and type out a long post in no time....also, a crazy work schedule often keeps me from posting too). Anyway, I'm going to respond to different points you made in your last response to Nicole (below)....see what you think.

Happy to answer. You can scroll to the bottom for my dose info and skip the following if you want. I'm including my med history cause it puts my thoughts in order. I've had infrequent but very bizarre depressions all my life. Was on Elavil for a short time mid-70s but hated the side effects. Went on Zoloft and other SSRI's in 1984. They worked pretty good, but would always poop out after a few months and I had to keep going to higher doses. As time went on the depressions were cycling more rapidly with truly awful terror and angst mixed in. Nothing helped, and I had a 'breakdown' in 1999 and was hospitalized and off work for 5 months. The rest helped, no doubt, and I eventually felt better but still very shaky. Then 'it' started up again and I was put on Remeron 2 years ago. Worked great then same pattern. I also developed severe fibromyalgia during this time so had to deal with bad somatic pain as well. I was working in a very stressful high-tech job and falling apart. Things got so bad I truly in despair and stopped working. It was really, really baaaaad. I applied for disability and am currently on the last round in the process. I am very blessed to have a wonderful loving husband who was my rock of support during this time.

>>>>>>>>>>Barb, for 20 YEARS I have not been able to quite figure something out....here is what happened.....20+ yrs. ago I was diagnosed with terrible ocd/anxiety/depression. I was eventually put on Nardil which worked very well (not AS good for ocd as the depression/anxiety, but it was a HUGE improvement). I was young (in my teens). Didn't want to be a 'mental case' on psych drugs (all these yrs. later and the 'stigma' is still there just the same). Anyway, I wasn't on the Nardil long....took it and chucked it down the toilet one day...wouldn't go back to the shrink either....got away with it for a few months. Stress and anxiety started getting worse... started feeling very nervous, anxious....then, TERRIBLY nervous.....I knew something was terribly wrong. I had been getting more and more steadily nervous for some time. Then, one night while w/ my girlfriend at her house (playing cards)I was EXTREMELY nervous---that was the biggest thing of all---my nerves were falling completely apart, not a little nervous like on a first date but it was as if my actual nerves were chaotically 'dancing' in my body....it was a physical sensation which felt like my nerves were actually 'breaking down' (LITERALLY a nervous breakdown!) It wasn't like a spur-of-the-moment panic attack...it had been building for quite some time, slowly getting worse and worse as days and weeks went by. I felt unbearable dread and agitation...that night was pure hell....more than ANYTHING it was my NERVES! The next day, back to shrink. He tried to put me on tofranil and something for nerves. It wasn't strong enough. I took it briefly, day or two, but the incredible, unbearable F'ing NERVE problem worsened again...I BEGGED him to put me in hospital, even though I HATED that idea, I NEEDED FAST relief! In the hospital, I was 'knocked out' on meds (THANK GOD!!!)....I was heavily sedated the whole time (probably didn't even know what I was taking). Within one week, I was FINE! He had put me on lithium, xanax and something else. The xanax was cool---it 'chilled' me out and helped my nerves settle down. And the lithium mellowed me out, smoothed me out...things that bothered me before didn't bother me at all (or at least NOT like before). AND, perhaps most importantly, I believed that the lithium had a tremendous effect on that agitation and that NERVE-JANGLING feeling! (YEARS later UNFORTUNATELY I had an anti-dep. added to the mix...I always KNEW I needed THAT!)
Anyway, I ALWAYS wondered what the H@ll that unbearable agitated/nervous/dreadfully panicky feeling was---was that a mixed-state thing? When I tried to go off my lithium recently, I noticed after a while that that 'feeling inside' was creeping back...I tell you the worst part for me is this nerve-jangling feeling. I started the lithium again and that feeling went away (it's different somehow that regular nervousness). Anyway, JUST a few short months ago I was reading Dr. Amen's book....in it he mentioned that aside from lithium being used for mood control that it was also very good for some people as a NERVE STABILIZER....THAT is what it seems to do for me SOOO WELL...it keeps that nerve-jangling feeling away! It also works great for me in the mood-control department too. But I've never really read many posts here describing this 'nerve-jangling breakdown' feeling....(maybe I have and just didn't know others were describing the same feeling)...I know many here have terrible anxiety but this seems like a 'variation' of regular bad nervousness...this is nervousness to an incredibly bad degree.

My pdoc suggested lithium as an augmentor since Remeron was fizzling out and I resisted for months.
I then began to recall times of intense hyperactivity all my life that I never associated with bipolar symptoms because it was such fun and so very productive. Plus the hyperactivity and depressions were separate. The hyperactivity unfortunately started getting jangled and intense, meshing with my garden variety major depression as I got older.

>>>>>>Sounds SOOOOOO familiar!

It turned into what I think is bipolar mixed states, agitated and horrible symptoms that were fast becoming my predominant state.

>>>>>>>>Again, sounds soooo familiar! Only, how is it a 'happy-sad collision' at the same time? For me, it's all shitty feelings---agitation/irritability/nerves/anxiety/stress/depressed/flustered, etc.

So I thought, OK, I believe I have classic bipolar signs and agreed to try lithium, 600mg a day.

>>>>>>>Barb, I'm a big guy and I'm only on 300 mg/day! My level is probably around .03 right now---downright puny and sub-therapeutic....I'm sure I'd feel better by taking 600 mg/day...that would be all I would need though....just enough to mellow me and keep me feeling fine...I've never needed the higher dosage and higher blood levels....

Within 1 week it felt like a black veil had lifted.

>>>>>>>lithium rules, lol,....I think MANY here would feel 100% better on it.....

I was tapering off Remeron and still feeling a little weird even at 7.5mg, so went off it completely and only then felt great. Hated the weight I put on from inactivity and Remeron and tried Topomax for 1 month. Hated it, felt pissed off all the time.
Sure enough, major depression returned only thank God without the mixed states component

>>>>>>>>lithium will keep those mixed-states away, keep taking your lithium BarbCat!

so my pdoc added lamictal which seemed to help at first at 75mg (couldn't go any higher without anxiety). It was very nice, energetic and sparkly happy. Then it of course started pooping. I was holding my own until my Mother died in very tragic circumstances last fall and I fell apart and was really at the edge. My pdoc said "OK, let's go to good old tricyclics". I said ANYTHING! So I've been on nortryptiline at 75mg since January and am feeling very good.

>>>>>>>>>I'd LOVE to be able to take the good ol' TCA's!! (They don't work on my ocd as well as the ssri's though....that's my DOWNFALL! I have to take these ssri's! Great for my ocd but the side effects---MUCH WORSE than the old TCA's for me! (Don't believe the marketing/hype about ssri's having less side effects....ssri's have the worst s/e's by far!!!!!!!!!They BLOW....but I have no choice)

This is the longest I've ever gone feeling stable.

>>>>>>Keep doing just what you're doing Barb! The lithium will be very GOOD to you!!

So my doses are:

lithium 600mg (very low dose but working)
lamictal 75mg
nortriptyline 75mg
ambien 10mg to sleep
10-12 grams liquid fish oil

>>>>>>I'm also on a mood stabilizer(lithium)/AD(Zoloft)/sleep-aid (Remeron)combo, & fish oil....Barb, 10-12 grams of liquid fish oil daily? GOOD for you! I take liquid fish oil too, have been for some time now, it seems to help...at 10-12 grams a day, that can be expensive right? Are you growing gills yet, lol?
I also take lots of supplements.

Not many side effects from this low lithium dose, but when I added the nortriptyline I had annoying tremors and cotton mouth that lasted about 2 months and then decreased enough to not be so annoying.
I think the fish oil helps alot, as well as numerous 'state of the art' supplements.

Yep!

My thyroid medication had to be raised because lithium does clobber the thyroid. This is the major objection I have to it cause I already was hypothyroid. But being at the right level of thyroxine has made a HUGE difference.

>>>>>I wonder about my thyroid level....was tested at TSH: 3.126...Thyroxine (T4): 6.1 about 6 months ago....

Whew, what a diatribe.

>>>>>>I've never written so much in a post! Probably won't ever do it again, lol....I've got to go and rest my "finger" now, lol....TAKE CARE!

- BarbCat


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poster:McPac thread:229544
URL: http://www.dr-bob.org/babble/20030604/msgs/231943.html