Psycho-Babble Medication Thread 295706

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DESPERATE: depression, weight gain and BPII meds

Posted by JaybeeTee on January 2, 2004, at 10:34:49

has anyone else on lamictal or other nmood stabilizers felt that the lack of mental clarity they bring hinders the very thought processes that lead to motivation, specifically, with regard to exercise and committing to weight-loss eating?

i've been visiting this site for years...this is my first post. i am seeking the benefit of others' experience with BPII treatment.

i've struggled with major, episodic depressions with suicidal ideation (no attempts) for decades (i'm now 44). i've tried virtually every anti-D on the market, largely with temporary success. as a compulsive overater, wellbutrin has proven my truest friend over the years, but it has stopped working. now, it seems just to make me angry and irritable and i'm still overeating.

i've been doing talk therapy for decades, too. this time, i stuck with interpersonal psychoanalysis for 6 years, but recently terminated treatment in frustration that it's not helping - the major depressions and obsession with suicide have continued to come back time and again. my weight has been fairly steady for a few years, but i start to compulsively overeat when i am depressed.

when i terminated treatment, i contacted a psychiatrist i met with a few years back for a med evaluation. she diagnosed me (then and now) as BPII, a diagnosis i never accepted, and i started treatment with a different psychologist, who i've not yet really bonded with yet.

my last analyst had always said he "wasn't impressed" with my manic moods. but i came to believe the shoe fit, stopped the anti-Ds, and started depakote. the weight gain was immediate and substantial and i became a zombie. couldn't get off the couch or away from the fridge.

a few weeks ago, i started lamictal at 25 mgs and am titrating up slowly. a week ago, i went up to 50 mgs. i still can't stop eating. against my p-doc's recommendation, but with her consent, i have been experimenting with adding back 150 mg/day wellbutrin for its appetite suppressing affects. we also tried a tiny bit of ritalin over a few days to get me moving. nothing's helping, and i am increasing despair.

i an't connect with the new therapist, am increasingly frustrated with my p-doc and am plunging back into despair. i can't stop eating and am horrified about it. it's possible i used to use my hypo-manic moods for weight control. maybe this is just how "normies" feel. dunno. i get myself up to exercise (i used to be a marathon runner) and can't get out the door. when i do, i have no energy.

where's my old zeal? must i sacrifice that? at this point, i am considering discontinuing all talk therapy and all meds. i know that this is plain "crazy." obviously, someone who has major depression several times a year needs treatment. i know i experience euphoria at times, too, and certainly have mixed states. but i honestly don't think i'm just unwilling to let go of my hypo-mania (which i do like, i admit). i'd gladly give up those occasional highs if i could just feel "ok." but i am despairing of ever, EVER feeling "ok." i have perpetual brain fog on the mood stabilizers...i'm deperate to think clearly and to have that clarity that propels me to connect the dots of my life that motivate me. i have some effexor at home that i never tried and am contemplating taking it, again, against p-doc's recommendations. she keeps telling me to be patient - hard to do when i have quite literally outgrown everything in my closet and have nothing to wear...where is that svelte marathoner who used to enjoy going to the gym.

i know this is lengthy and not very specific...i guess i'm just in despair and flailing about for any bits of support, advice or experience...this is about as depressed as i have ever been without suicidal ideation, which may not be far off...



Re: DESPERATE: depression, weight gain and BPII meds

Posted by JohnFromCalifornia on January 2, 2004, at 12:16:21

In reply to DESPERATE: depression, weight gain and BPII meds, posted by JaybeeTee on January 2, 2004, at 10:34:49

Your state of mind reminds me of ex-Beach Boy Brian Wilson, who ended up with a somewhat shady live-in psychologist giving him advice that Wilson maintains has saved his life, and even permitted him to have the stable life he has today.

His psychologist was a strict behaviorist: If you act a certain way, you can't help but feel a certain way. So if you indulge in food and other escapes, you're bound to feel lousy.

He put Wilson on a regimen of diet and exercise and whenever Wilson stayed on the regimen, his life was fine. He could perform, enjoy his family, and so on. Over they years he has become more and more stable.

If you used to be a runner you know how beneficial exercise is to state of mind. You also know that even if overweight, you can get right out there and start walking. It's free and self-regulating. And your feelings of hopelessness will dissipate after a good walk - it proves you can control your life.

You might want to try Phentermine for weight loss and energy, but for me it's too speedy. I get along with Lexapro and "Stay Awake" caffeine pills to combat the somnolence Lexapro sometimes brings on. Believe it or not, those caffeine pills provide just the amount of boost I need.

As Brian Wilson said, "If I exercise and eat right I'm okay." It sounds simplistic but it really is that simple. That's behaviorism, the only branch of psychology that really accomplishes anything, in my view.

Good luck and Happy New Year!

- John in California


Re: DESPERATE: depression, weight gain and BPII meds

Posted by brussell on January 2, 2004, at 15:21:36

In reply to DESPERATE: depression, weight gain and BPII meds, posted by JaybeeTee on January 2, 2004, at 10:34:49

Dr. Eugene Landry was sued and lost his license to practice psychology due to his "treatment" of Brian Wilson, which included isolating him from his friends and controlling every aspect of Brian's personal life.


I also received a diagnosis of BPII on the basis of my terrible mood swings, and was advised to use mood stabilizers and possibly Depakote. I wouldn't touch Depakote due to the side effects you graphically described, but I did use Lamictal for several weeks. It seemed to have a mild AD effect, but mainly it stabilized me in a moderately depressed state, and it made me stupid.

I quit the Lamictal and tried Parnate, a MAOI antidepressant. It actually seems to be working. I describe the effects as similar to Welbutrin on steriods, but without the anxiety.

BP2 is a very fuzzy diagnosis. If you aren't hypomanic (like me) or if your hypomania is infrequent and does not have negative effects on your functioning I think it can be counterproductive to use BPI treatments.

Have any of the antidepressants you have tried made you manic or hypomanic? If not, I think you should treat your depression more aggressively with antidepressants. Your good reaction to Welbutrin and your more "atypical" depression (weight gain, difficulty in moving) makes me think you would be a good candidate for Parnate. It has one of the best side-effect profiles of any AD, in my opinion. It almost never causes weight gain and it has made me much more alert and motivated. I believe you can use Lamictal with it if you need a mood stabilizer, although you would need to check with your doctor.

Please don't give up; there are definitely more options out there. On a practical note, you might find it helpful to get rid of high-carb snacks. If the food isn't around; it's easier to avoid eating it!

Good luck, and once again, I think you should try a MAOI. They aren't magic, but have worked for many people when nothing else does. Don't give up on therapy, either. You may just need to find someone else. It probably can't cure your depression, but at least you won't be completely alone with these awful feelings.

Hang in there.


Re: DESPERATE: depression, weight gain and BPII me

Posted by JaybeeTee on January 2, 2004, at 15:45:43

In reply to Re: DESPERATE: depression, weight gain and BPII meds, posted by brussell on January 2, 2004, at 15:21:36

thanks to those who have responded to my post. brussel, you've identified the "stupidity" problem, which i also experienced with depakote. my job requires me to think clearly and analytically - and i can't. but i'm also really depressed, so i don't know the genesis of this particular bout of the "stupids" - can't thibnk of words, lose my train of thought mid-sentence. maddening. i know it may sound odd, but i think the lack of clarity defeats my genuine attempts to get my eating under control and to exercise. it's as though i can't hold a clear, motivational thought thought long enough to follow through. maybe i fixated too much in the past and this is just how it is for "regular" folks, but i miss those states that my p-doc would probably call hypo-manic: the ones that got me into my running shoes and out the door, the ones that let me focus on a project sufficiently to forget about food for more than 5 minutes.

thanks for the support here. it helps, it really does.


Re: DESPERATE: depression, weight gain and BPII me

Posted by JohnFromCalifornia on January 2, 2004, at 21:18:47

In reply to Re: DESPERATE: depression, weight gain and BPII me, posted by JaybeeTee on January 2, 2004, at 15:45:43

Once again, have you tried SSRIs? Like you I can't stand feeling muddle-headed. I also share your depression and tendency to go to food for comfort.

Paxil didn't work for me, and I'm just in the first weeks of Lexapro, but it seems promising. Not as a panacea of course, but it doesn't make me gain weight (as did Paxil) and I am less anxious, and not prone to those overwhelming surges of hopelessness that I was feeling just a few weeks ago.

And yet, my thinking is clear and lucid. No "dopiness" at all.

With your experience I'm sure you've done the rounds of SSRIs and have your reason for not using them. I'm a newbie to this board (though not to depression) and would like to know what they are, from your perspective.

(And yes, it's true Brian Wilson's psychologist overstepped his professional boundaries big-time and lost his license for it, but to the great benefit of all us Beach Boys fans, he gave Brian a life-saving regimen.)

Good luck! -- John

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