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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by Susan on December 4, 1998, at 12:43:27
Toby, your response to my questions regarding EMDR were very helpful. Thank you. I am waiting for the list to arrive and have a few more questions before pursuing that method of treatment. I feel that most of my symptoms (crying, lack of appetite, ruminations about past offenses, procrastination, anxiety, etc.) could possibly be eliminated if I could get "good sleep" (by good I mean more than 4-5 hours.) I am doubting my present diagnosis of "bipolar cyclothymia" because of my research on the illness. Is it possible to have cyclothymia and not have irritable moods, impulsivity, talkativeness, creativity or racing thoughts, expressed anger, inflated self-esteem, etc.? Could my wonderful family and friends think that I am the most loving, patient, even tempered, giving person they know if I truly had a bipolar disorder ? I am aware that the previous question smacks of an inflated self esteem but those are the facts and I know that my religious faith keeps me steady in spite of this illness and the credit goes to God. Four years ago I sought treatment for unexplained physical symptoms and was given Xanax for stress and two years ago was diagnosed with major depression. I was given hope that "this soon would pass." Against the advice of many Christians I took antidepressant medication (zoloft 200mg, Sinequan 10mg, and Xanax .50mg for one year until it stopped helping, a short trial of up to 30mg Remeron which worked GREAT but made my hands swell and gave an incredible craving for sweets, and for the last year Effexor XR 150-225mg and Xanax .5mg for sleep and/or .25 for anxiety.) I am still suffering from chronic insomnia (waking up many times and usually 4am with headache.) It seems to me that it is the insomnia that causes the fatigue and resulting unable to cope feelings. Sleep problems have been present since childhood and have caused headaches and crying. I am in my late 50’s and would like some relief but question whether starting a mood stabilizer (Dr. said wait a couple of months), trying EMDR, continuing present medications, trying different or more medications or discontinuing all and going back to trusting God alone is the best answer. Two years ago I was convinced that my Dr. was a gift from God and wanted to "educate" others about mood disorders. But now that time has passed and the same symptoms persist I question the wisdom of my decision in regard to medication. Could Xanax be causing the continuing depression and could Effexor XR be causing the insomnia and a vicious cycle? I am in a position in which my experience can influence many on the issue of mental illness/treatment and I do not want to give a harmful example. Because of my incomplete recovery I am questioning my own decisions and suffering in silence. Please help.
Posted by Toby on December 4, 1998, at 15:35:02
In reply to EMDR/Meds, posted by Susan on December 4, 1998, at 12:43:27
> Is it possible to have cyclothymia and not have irritable moods, impulsivity, talkativeness, creativity or racing thoughts, expressed anger, inflated self-esteem, etc.? Could my wonderful family and friends think that I am the most loving, patient, even tempered, giving person they know if I truly had a bipolar disorder ?
Pretty much no. I question a diagnosis of bipolar or cyclothymia that begins in a person's 50's; although it can happen, it isn't common. Your symptoms are more in keeping with depression than mania, it sounds like. Especially if you (and your family/friends) look at the symptoms of cyclothymia and don't feel that it describes you, perhaps the diagnosis was made during a time in your depression when you were agitated or irritable.
> I am still suffering from chronic insomnia (waking up many times and usually 4am with headache.) It seems to me that it is the insomnia that causes the fatigue and resulting unable to cope feelings. Sleep problems have been present since childhood and have caused headaches and crying. I am in my late 50’s and would like some relief but question whether starting a mood stabilizer ... is the best answer.
Two questions: Are you on hormone replacement? Unless there is a compelling reason not to be, estrogen may help with some of the depressive symptoms. If you are already on it and have seen no benefits with regard to mood, I still would not stop it on the off chance it may be keeping you from getting worse. Also, has your doctor told you that he thinks you have manic-depression, or do you assume that is your diagnosis because he suggested the mood stabilizer? Sometimes a mood stabilizer is used to augment or boost the effects of an antidepressant without manic-depression being present. I don't find that it is extremely helpful for depression alone, but many doctors do use it and sometimes it helps (usually due to an unrecognized bipolar illness).
> Could Xanax be causing the continuing depression and could Effexor XR be causing the insomnia and a vicious cycle?
Xanax is known to be a central nervous system depressant and can contribute to depression if anxiety is not strongly present. Do not, however, stop it on your own since you have been taking it a long time your body will be physically used to it and abrupt withdrawal can cause seizures. Effexor can cause insomnia in some people although in others it causes sedation.
Have you tried Serzone? It is used often for people with insomnia and depression. It is commonly prescribed as a twice a day medication which makes some people sedated during the day, but it now has been approved to take the whole dose at bedtime which improves sleep and takes away the daytime sedation. Also, please look back at a posting from 12/3 from me on various medications used to boost antidepressants. Write down the list and take it to your doctor and discuss if any of these might be reasonable to try for you considering your insomnia.
In addition, please do consider seeing a therapist about the EMDR. These folks are genuinely concerned with relieving suffering, not just making a buck, and will evaluate you carefully as to whether it is likely that EMDR would be able to help your insomnia and other symptoms. If not, they will not subject you to it, wasting your time and money.
Good luck.
This is the end of the thread.
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