Psycho-Babble Medication Thread 1024750

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My place of relaxation is a place of dysfunction

Posted by Chris O on September 3, 2012, at 3:55:31

I don't know if others here feel this way about their anxiety or depression. But I have found that my place of relaxation (whatever tepid relaxation I can manage to eek out each day) is a place of dysfunction, anxiety, depression. In other words, when I "let go" or "stop trying" I go to an even worse place than I do when I am exerting effort to fight against my anxiety disorder and depression. It feels like what I need in an antidepressant is something to "lift the veil" or "pull down the wall" so that I can come out from inside a place of deep pressure and pain. Another unfortunate byproduct of this condition is that those that stay with me in relationships (my faux place of relaxation) tend to be abusive and controlling (my perception). This, of course, is the same environment I grew up in with my mother (in retrospect). I don't really know how to get out of this pattern. I am completely crippled by it. I know that I need to change my brain chemistry because it feels that the cause is very physical. After failing all of the SSRIs, I am thinking of trying nortriptylene.
I am really getting desperate. If I wasn't with my wife, I would most surely be skirting homelessness or (god forbid) living with my mother. I do not want to be this way. I want to function and take care of myself. Yet, I am unable to due to the inability to exert control over my life. I am sick of trying so very hard and feeling like giving up each moment. The struggle is too great. Any feedback on notrip would be useful. Thanks,

Chris

 

Re: My place of relaxation is a place of dysfunction Chris O

Posted by Phillipa on September 3, 2012, at 9:52:00

In reply to My place of relaxation is a place of dysfunction, posted by Chris O on September 3, 2012, at 3:55:31

I don't know what the answer is do you know what originally began your anxiety and depression? I only know that took pamelor which I think is nortriptaline and couldn't wake the next day at l0mg. So for me never again. Phillipa

 

Re: My place of relaxation is a place of dysfunction Chris O

Posted by phidippus on September 3, 2012, at 23:13:24

In reply to My place of relaxation is a place of dysfunction, posted by Chris O on September 3, 2012, at 3:55:31

Depression is one of those things that get worse if you sit still and don't do anything, especially if anxiety is involved. All you end up doing when you're trying to relax is ruminate, which always spirals down.

You don't need to feel desperate because you failed the SSRIs, there are plenty of other antidepressants you can take. There are also many other drugs that can augment treatment with ADs.

How long were you on the SSRIs you've tried?

Eric

 

Re: My place of relaxation is a place of dysfunction phidippus

Posted by Chris O on September 4, 2012, at 14:42:55

In reply to Re: My place of relaxation is a place of dysfunction Chris O, posted by phidippus on September 3, 2012, at 23:13:24

Eric:

Thanks for responding, and thanks for the hope!

In terms of the SSRIs I've tried and for how long:

During the 1990s (after I graduated from college), I basically tried therapy, yoga, tai-chi, supplements, "faking it until I make it" to deal with my GAD and depression. In retrospect, it really didn't work very well. (In college, I was in therapy much of my last two years 1988-1990 to control panic attacks and anxiety. Still living with my mom, a big cause of all this stuff.)

In 2000 (the year), I was on 20mg of Celexa/150mg Wellbutrin. It worked, but it wasn't strong enough, I think. I lost my job as a high school teacher even while on it.

From 2001-2004, I was basically medicationless and insurance-less. Brief trial of Effexor (10 days). Made me wired even at 37.5mg but probably too brief a trial to determine anything.

2004: Took Lexapro 40mg for a year after a massive panic attack/anxiety/depersonalization event. Went to ER for that. The Lexapro didn't seem to do anything, in my opinion.

2007-2011: Failed year-long trials of Paxil (75mg/day), Prozac (80-100mg/day), Luvox (300-450mg/day), Serzone (1200mg/day), Vibryd (40mg (or whatever a high dose is)/day), Klonapin (3mg/day--the stuff does nothing except make me slightly sleepy; could easily take a Stevie Nicks dosage, I think).
I also took Neurontin for a week or two, but it just gave me a headache. Not a long enough trial, I know.

So, now, I was going to move onto either a TCA, such as nortriptylene, or an MAOI, such as Nardil. I was preparing to take Nardil about 8 months ago, but just ... decided against it due to fears.

On the plus side, I've lost a solid 10 pounds of SSRI weight with exercise. Not excited about taking another med that just makes me gain weight and does nothing. But I am definitely not able to work or function in the world the way that I am.

Chris

 

Re: My place of relaxation is a place of dysfunction Chris O

Posted by phidippus on September 4, 2012, at 16:09:00

In reply to Re: My place of relaxation is a place of dysfunction phidippus, posted by Chris O on September 4, 2012, at 14:42:55

Anxiety is a very difficult thing to treat. I'm surprised so many SSRIs didn't work for you.

I have a couple of suggestions for you:

Clomipramine or Amitryptaline instead of Nortryptaline-they have better indications for anxiety and depression.

Mirtazapine at 60 mg. I have taken Mirtazapine and it treated my anxiety/OCD very well.

Nardil - nothing to be afraid of. Can obliterate anxiety.

Here are some off label medications that could augment treatment with an antidepresant:

Prazosin - has shown efficacy in treatment of GAD, PD and PTSD

Gabitril - case reports show its efficacy in the treatment of PD.

Lyrica - the stronger version of Neurontin. Double the max dose and it might work well for you.

Keppra - has anxiolytic properties.

Buspar - augments treatment of anxiety and depression.

Pindolol - may help with your PD symptoms and depresssion.

The Klonopin didn't work for you probably because the dose wasn't high enough.

How long have you been battling anxiety and depression?

Eric

 

Re: My place of relaxation is a place of dysfunction

Posted by Chris O on September 6, 2012, at 16:16:54

In reply to Re: My place of relaxation is a place of dysfunction Chris O, posted by phidippus on September 4, 2012, at 16:09:00

Eric:

Thanks for responding and thanks for the list of meds. A great help. I'm surprised the SSRIs don't work for me, too. They did for about a year. Since I went off them and started four years later, it has been like they are nothing, a placebo, worse than a placebo because they don't give me placebo response.

You mention the TCAs clomipramine and amitryptaline instead of nortryptaline. I'll ask my psychiatrist his opinion. I suspect he'll say the side effects profile is better for notryptaline.

Remeron: I took that for a week last year. I was really going to give it a go. But then...I got this horrible rash on my face. Just complete flaking of the skin around my nose, chin. Redness. It was bizarre. I decided to stop the med due to that.

I will talk to my p-doc about prazosin. I think I mentioned it before.

The anti-seizure meds: I guess I haven't given those a long enough go. Neurontin just gave me a pressure- feeling in head. I'll have to consider them (the others you mentioned).

Buspar I did briefly try (3 weeks), perhaps not long enough, but felt like nothing.

Pindolol I know nothing about. High blood pressure med? My blood pressure doesn't really run high despite my issues.

How long have I been battling my anxiety and depression?

Let's see, about...since the time I was conceived. My mother was on and off antidepressants before I was born. She was raised in a severely alcoholic family (her father committed suicide when she was 6 or 7), though there is no dealing with that on her end. I don't think she can deal with it really. She is brain damaged from her environment. She can barely take care of herself. And I have inherited her condition. I tried everything to escape it, but now it is apparent to me that there is something severely broken inside of me. I just can't "keep up." Exhausted, feel like hiding. I've somehow managed to manage periods of employment in my 45 years of life, but right now, if I wasn't with my wife, I'd be looking at homelessness. She thinks I exaggerate, but I do not. So, I do need to take something that works. I exercise regularly which manages some of my symptoms, but just barely. Anyway, thanks for responding.

Chris

 

Re: My place of relaxation is a place of dysfunction Chris O

Posted by phidippus on September 8, 2012, at 15:04:33

In reply to Re: My place of relaxation is a place of dysfunction, posted by Chris O on September 6, 2012, at 16:16:54

>You mention the TCAs clomipramine and >amitryptaline instead of nortryptaline. I'll ask >my psychiatrist his opinion. I suspect he'll say >the side effects profile is better for >notryptaline.

Which is of greater concern? Side effects or your symptoms? Most side effects of TCAs wash out after awhile.

While were on TCAs, have you thought of Imipramine?

>Pindolol I know nothing about. High blood >pressure med? My blood pressure doesn't really >run high despite my issues.

Its prescribed psychiatrically to treat anxiety. Its effects as a blood pressure medication will be negatory if your blood pressure is normal. It could induce hypotension as a side effect.

I'm just thinking the right antidepressant will help you tremendously. In fact, you might respond to two antidepressants very well, Like Pristiq + Wellbutrin, or Parnate + Clomipramine. I'd be on two myself, but I'm bipolar and every time I try two antidepressnats I become manic.

YOu said you worry a lot. Is this rumination?

Eric

 

Re: My place of relaxation is a place of dysfunction phidippus

Posted by Chris O on September 8, 2012, at 18:41:52

In reply to Re: My place of relaxation is a place of dysfunction Chris O, posted by phidippus on September 8, 2012, at 15:04:33

Eric:

To be clear, I've never been on a TCA before. Obviously, symptoms would be of greater concern if I was living on my own. They have almost completely debilitated me. It's good to know that TCA side effects go away for most people.

Pristiq + Wellbutrin or Parnate + Clomipramine: I'm totally open to two meds at a time. Those combinations sound like they would be too activating for me. I'll figure out what I'm going to try in the next few weeks.

My worry is beyond anything conscious. It's just "on" terminally. It, I guess, is managed when I am under no stress. But put me under any stress and I cannot function. Basically, I feel like there is a weight of pressure around holding me back. Floating anxiety. It just moves around my body. It prevents me from being extroverted. In retrospect, I think this is how my mom shaped my brain chemistry with her controlling behavior and own bio-chemical issues perhaps brought on by being born of a woman who drank heavily while she was pregnant (my grandmother). All that I know is that I have been almost completely shut down by my anxiety disorder/PTSD/depression.

 

Re: My place of relaxation is a place of dysfunction Chris O

Posted by phidippus on September 9, 2012, at 15:44:34

In reply to Re: My place of relaxation is a place of dysfunction phidippus, posted by Chris O on September 8, 2012, at 18:41:52

How much have you done in the way of therapy? A big part of treating anxiety properly is having a good therapist.

I have had the same issues with anxiety-floating anxiety as you describe it is something I can relate to. It took me 4 years of trying every medication under the sun to get it under control.

Oh, yeah, I just wanted to mention another strategy for treating anxiety and that is with an antidepressant and an anti-psychotic. Invega/Risperidone and Seroquel are popular choices for treating anxiety. Seroquel also has the benefit of having antidepressant qualities.

Eric

 

Re: My place of relaxation is a place of dysfunction phidippus

Posted by Chris O on September 10, 2012, at 9:41:00

In reply to Re: My place of relaxation is a place of dysfunction Chris O, posted by phidippus on September 9, 2012, at 15:44:34

Eric:

I was in therapy for much of the 1990s--group and individual. Obviously (well, obviously to me), I could be therapy for life, if I could afford it. But at the same time, I almost feel that my main issue is so biochemical, or so brain-based, that if I could "correct" or deal with that part of the problem, my never-ending worrying would dissipate to the point where I wouldn't need therapy. Much of therapy to me is getting someone to listen to my worries. Many of my worries, I think, are irrational, or based on endlessly negative projections. Yet, they are not completely irrational in my current state because I truly am at risk for homelessness and complete collapse (not being able to take care of myself) in my current condition. Anyway, my psychiatrist suggested adding or trying Abilify several times (I still have the samples he gave me over a year ago), but I never did it. I just didn't want the risk of diabetes, high triglycerides, massive weight gain, and other worries for a 10% (or whatever) improvement. 80% miraculous improvement, maybe; 10-20% improvement with no job, no prospects of taking care of myself and more dependance, nope. Not doing that anymore. Anyway, glad to hear your anxiety is under control. Has yours been a lifetime (since young childhood thing) or is it more recent?

Thanks,
Chris

 

Re: My place of relaxation is a place of dysfunction Chris O

Posted by phidippus on September 10, 2012, at 13:06:22

In reply to Re: My place of relaxation is a place of dysfunction phidippus, posted by Chris O on September 10, 2012, at 9:41:00

My psychiatric journey began in childhood. I was a rambunctious child with ADHD. When I was a teenager I struggled with depression and then when I was 25 I had a full blown bipolar episode concurrent with OCD-harming thoughts. I stabilized on Depakote but was a total *ssh*l* until 2003 when I went on Lithium. In 2007 OCD began to rear its ugly head and I spent 4 years falling down a hole. It wasn't until 2011 that my OCD finally came under control with Clomipramine and Dextroamphetamine-and lots of ERP.

Anxiety disorders are difficult to treat. They often take a combination of drugs to treat successfully.

I don't know why your doctor recommended Abilify-it sometimes causes akathisia which can make anxiety unbearable. There are other antipsychotics that don't have a lot of the side effects Abilify has.

Eric


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