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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Saragram on October 2, 2002, at 14:03:11
I tried this before but got hung up in the registration process and lost the post -- my apologies if it turns up twice.
My 32-year-old daughter sought help about 6 months after the birth of her first child 2 1/2 years ago because she felt depressed. Her primary physician put her on Zoloft. Although this and counseling (individual and with her husband) helped, she kept talking for months afterward about divorce and said she felt like a "single parent." This struck me as creepily irrational since her husband is extremely solicitous to her, has ALWAYS done all the shopping and cooking, and is far more involved in child rearing (diapers, feeding, baths, general nurturing) than any man I've ever seen (and I have a son and friends that are exceptional fathers). At the time I was doing most of their dishes and laundry and she did virtually no housework: She claimed her job as a Registered Nurse in invasive cardiology was so much more important and stressful than his job or my job that it was insulting for us to expect her to do anything but spend time with the baby on her 4 days per week off.
She got pregnant again and seemed delighted. About 2 months ago when her second baby was 6 months old she went to her gyn complaining of dry vagina and mood swings. He decided it was a hormone imbalance and PMDD and put her on estrogen and Prozac (labelled as Sarafem). At about the same time she was complaining of a lot of pain from pinched nerve problems in her back and had stopped breast-feeding so she could take Vioxx.She sought counseling with a different practitioner because she said the one from 2 years before "sided with" her husband. They are seeing yet a third counselor as a couple, and at first things looked better: She was sharing cooking chores with him instead of sitting in the living room waiting to be served, folding more laundry, and telling friends they were working their problems out. They now have had 3 of the 8 couples meetings they are entitled to under a charity program (They have good incomes but lots of credit card debt). It has been about 6 weeks since she started the Prozac and she suddenly threw her husband out, told him she doesn't love him anymore, and that she is determined to get a divorce.
He says that as recently as Father's Day and their anniversary in late June, she was writing him very tender love notes on her greeting cards to him and being quite affectionate, although she did express frustration at his 2-month period of unemployment (which ended shortly thereafter). He says she was affectionate, although a little distant, until the day before she threw him out. She also has an IUD (copper) and her husband says she's been bleeding for 2-3 weeks each cycle and having worse cramps.
I suspect a bipolar element here, especially because her mood swings are, if anything, worse since the Prozac and estrogen than before. Also, her expressed feelings of superiority to her husband and her sudden borrowing of $3,000 against her 401K to set herself up in a new apartment seem to have an element of grandiosity. She's taking a sudden renewed interest in a creative hobby (drawing) that she hasn't done in years. Isn't this a sometimes a sign of a manic episode coming on?Since early adulthood she has been short tempered, difficult to please, and critical of others, and for many years has tended to sit or lie and read or watch TV for most of her non-working, non-sleeping hours. She has left at least 4 jobs (both before and since becoming an RN) because of interpersonal problems with co-workers or supervisors: She was fired once, was asked to quit once, quit on her own once, and requested a transfer once. She has episodes of inertia and hopelessness/helplessness: She never could make up her mind on how to find a good babysitter, so 5 times in 2 years I have had to do all the networking, phoning, and pre-screening for her: She checks references, interviews and makes final decisions: She doesn't seem to trust anyone else's judgment. Whenever she job-hunts she seems to have exaggerated reactions to getting, or especially NOT getting, call-backs.
Her husband is distraught at losing her, and at losing the day-to-day relationship he's enjoyed with his children. I was afraid he was suicidal for the first few days. Now he is going to AA and to church and reading a lot about depression and drug reactions and his mood is much improved because at least he's doing something proactive. As for the AA, he averaged probably less than 2 beers a day, occasionally smoked marijuana, and I have NEVER seen him intoxicated. She convinced him he is an addict. She also became furious when he sought help for his pain at her rejection at the same church they had attended as a couple -- claimed he was "violating her sanctuary."
Please let me know what you think. I would hate to see this 12-year marriage with a toddler and an infant go down the tubes because of a long-undiagnosed problem, wrong diagnoses and/or wrong medication. I really worry about the babies: the 2-year-old seemed so fragile when her father had her for visitation last weekend, and her mom has been increasingly impatient with her, too lately. I also saw a mention of light exposure being related to bipolar: her current work schedule in surgery (a pretty bright area of the hospital) involves two 12 hour shifts until nearly midnight each week.
Posted by BrittPark on October 2, 2002, at 18:09:43
In reply to Help, please! PMDD, cyclothymia, Prozac? (long), posted by Saragram on October 2, 2002, at 14:03:11
It certainly seems that your daughter could be BP, and your concern about prozac is well founded. ADs without a mood stabilizer tend to send bi-polars into hypo- or full blown mania. The first priority as I see it is to get her to see a psychiatrist, not the family GP. If he's any good he should be able to help her a lot. I imagine that convincing her to see a specialist may be difficult for you. That's the difficulty with manic or hypomanic people, they tend not to respond to reason very well. I know this from experience. My wife had a hypomanic episode several years ago and it was more than a little difficult to reason with her. Happily she didn't have BP; she was just reacting to an insanely high dosage of paxil prescribed by an incompetent psychiatrist.
I hope this helps some if only from my sympathy which you, your daughter, and your son-in-law have.
Britt
P.S. Keep checking the board, there are many people more knowledgable about BP than me, who will have good advice.
P.P.S. Don't forget to take care of yourself.
Posted by polarbear206 on October 2, 2002, at 20:04:39
In reply to Help, please! PMDD, cyclothymia, Prozac? (long), posted by Saragram on October 2, 2002, at 14:03:11
> I tried this before but got hung up in the registration process and lost the post -- my apologies if it turns up twice.
>
> My 32-year-old daughter sought help about 6 months after the birth of her first child 2 1/2 years ago because she felt depressed. Her primary physician put her on Zoloft. Although this and counseling (individual and with her husband) helped, she kept talking for months afterward about divorce and said she felt like a "single parent." This struck me as creepily irrational since her husband is extremely solicitous to her, has ALWAYS done all the shopping and cooking, and is far more involved in child rearing (diapers, feeding, baths, general nurturing) than any man I've ever seen (and I have a son and friends that are exceptional fathers). At the time I was doing most of their dishes and laundry and she did virtually no housework: She claimed her job as a Registered Nurse in invasive cardiology was so much more important and stressful than his job or my job that it was insulting for us to expect her to do anything but spend time with the baby on her 4 days per week off.
>
> She got pregnant again and seemed delighted. About 2 months ago when her second baby was 6 months old she went to her gyn complaining of dry vagina and mood swings. He decided it was a hormone imbalance and PMDD and put her on estrogen and Prozac (labelled as Sarafem). At about the same time she was complaining of a lot of pain from pinched nerve problems in her back and had stopped breast-feeding so she could take Vioxx.
>
> She sought counseling with a different practitioner because she said the one from 2 years before "sided with" her husband. They are seeing yet a third counselor as a couple, and at first things looked better: She was sharing cooking chores with him instead of sitting in the living room waiting to be served, folding more laundry, and telling friends they were working their problems out. They now have had 3 of the 8 couples meetings they are entitled to under a charity program (They have good incomes but lots of credit card debt). It has been about 6 weeks since she started the Prozac and she suddenly threw her husband out, told him she doesn't love him anymore, and that she is determined to get a divorce.
>
> He says that as recently as Father's Day and their anniversary in late June, she was writing him very tender love notes on her greeting cards to him and being quite affectionate, although she did express frustration at his 2-month period of unemployment (which ended shortly thereafter). He says she was affectionate, although a little distant, until the day before she threw him out. She also has an IUD (copper) and her husband says she's been bleeding for 2-3 weeks each cycle and having worse cramps.
>
> I suspect a bipolar element here, especially because her mood swings are, if anything, worse since the Prozac and estrogen than before. Also, her expressed feelings of superiority to her husband and her sudden borrowing of $3,000 against her 401K to set herself up in a new apartment seem to have an element of grandiosity. She's taking a sudden renewed interest in a creative hobby (drawing) that she hasn't done in years. Isn't this a sometimes a sign of a manic episode coming on?
>
> Since early adulthood she has been short tempered, difficult to please, and critical of others, and for many years has tended to sit or lie and read or watch TV for most of her non-working, non-sleeping hours. She has left at least 4 jobs (both before and since becoming an RN) because of interpersonal problems with co-workers or supervisors: She was fired once, was asked to quit once, quit on her own once, and requested a transfer once. She has episodes of inertia and hopelessness/helplessness: She never could make up her mind on how to find a good babysitter, so 5 times in 2 years I have had to do all the networking, phoning, and pre-screening for her: She checks references, interviews and makes final decisions: She doesn't seem to trust anyone else's judgment. Whenever she job-hunts she seems to have exaggerated reactions to getting, or especially NOT getting, call-backs.
>
> Her husband is distraught at losing her, and at losing the day-to-day relationship he's enjoyed with his children. I was afraid he was suicidal for the first few days. Now he is going to AA and to church and reading a lot about depression and drug reactions and his mood is much improved because at least he's doing something proactive. As for the AA, he averaged probably less than 2 beers a day, occasionally smoked marijuana, and I have NEVER seen him intoxicated. She convinced him he is an addict. She also became furious when he sought help for his pain at her rejection at the same church they had attended as a couple -- claimed he was "violating her sanctuary."
>
> Please let me know what you think. I would hate to see this 12-year marriage with a toddler and an infant go down the tubes because of a long-undiagnosed problem, wrong diagnoses and/or wrong medication. I really worry about the babies: the 2-year-old seemed so fragile when her father had her for visitation last weekend, and her mom has been increasingly impatient with her, too lately. I also saw a mention of light exposure being related to bipolar: her current work schedule in surgery (a pretty bright area of the hospital) involves two 12 hour shifts until nearly midnight each week.
I cant't begin to tell you how much of that story above reminds me of my journey to the right diagnosis. I am a geri-psych nurse. I have a soft form of bipolar (cyclothemia). You daughter needs to see a good Psychiatrist for proper diagnosis and treatment. Antidepressants used alone and in high doses will exacerbate mood cycling. My depression started after the birth of my son. Many bipolar women will cycle worse after child birth. I had this before I got pregnant, but it was so subtle. My mood cycling just escalted after taking and trying different antidepressants. I had a 4 month affair and left my husband after I got hypomanic on 40mg of Paxil one summer. I accused him of being and alcoholic and thought the reason I was unhappy and depressed was because of my marriage. This is what this illness can do to the mind. I'm happy to say that we got back together shortly after all this. Just educate yourself as much as possible about this illness. A good book for you to read is "Why Your Depression Isn't getting better", br Dr. M. Bartos. This is an excellent book about the epidemic of undiagnosed bipolar disorders. There is a very broad spectrum to this illness. I'll post some good web sites for you to check out too. Good luck. I hope this helps you.Laura.
Posted by Roo on October 3, 2002, at 8:59:37
In reply to Re: Help, please! PMDD, cyclothymia, Prozac? (long), posted by polarbear206 on October 2, 2002, at 20:04:39
Laura--
Please do post the websites...I wrote down the name
of the book...your situation sounds like mine...I am
cyclothymic too...it can really destroy relationships
when you don't know what it is. I was engaged and I didn't
know I was cyclothymic. I went back and forth, back and forth....
breaking up with my fiance' convinced there was some problem, that
he wasn't the one, something wasn't right...my moods about him
would vacillate greatly...it caused me a great deal of shame...I never
felt so "flakey" in my life. After the relationship ended, I noticed
I _still_ didn't feel right...that _he_ wasn't really the problem. I got
diagnosed with cyclothymia and put on a mood stabilizer. It's still new
to me and I'm still learning about this disease. So I'm going to read the
book you recommended and check out the websites...thanks....
Posted by polarbear206 on October 3, 2002, at 20:01:37
In reply to Re: Help, please! PMDD, cyclothymia,PolarBear, posted by Roo on October 3, 2002, at 8:59:37
> Laura--
>
> Please do post the websites...I wrote down the name
> of the book...your situation sounds like mine...I am
> cyclothymic too...it can really destroy relationships
> when you don't know what it is. I was engaged and I didn't
> know I was cyclothymic. I went back and forth, back and forth....
> breaking up with my fiance' convinced there was some problem, that
> he wasn't the one, something wasn't right...my moods about him
> would vacillate greatly...it caused me a great deal of shame...I never
> felt so "flakey" in my life. After the relationship ended, I noticed
> I _still_ didn't feel right...that _he_ wasn't really the problem. I got
> diagnosed with cyclothymia and put on a mood stabilizer. It's still new
> to me and I'm still learning about this disease. So I'm going to read the
> book you recommended and check out the websites...thanks....Glad to be of help Roo.
Here are some good sites.
www.psycom.net/depression.central.html
www.psycheducation.com/depression/frameset.html
www.bipolarworld.net/Phelps/phelpsask.htWhen you get to depression central site, scroll down to cyclothemia. Great info.!!
Laura.
Posted by Dinah on October 3, 2002, at 20:21:04
In reply to Re: Help, please! PMDD, cyclothymia, Roo, posted by polarbear206 on October 3, 2002, at 20:01:37
Posted by Saragram on October 4, 2002, at 15:59:09
In reply to Re: Help, please! PMDD, cyclothymia, Prozac? (long), posted by polarbear206 on October 2, 2002, at 20:04:39
Thank you all so much. We MAY have been on the wrong track about the AD's and bipolar, but things are certainly not getting better:
When her husband tried to bring up the subject of a possible bad reaction to Sarafem, she blew up at him and said she was not taking it – she denied having filled the prescription and said she had only taken a few of the doctor's free samples almost 6 weeks ago. Her brother's fiancee says this doesn't gibe with what she told her two weeks ago, so who can tell?
When her husband visited the children Tuesday night while she was working late (at the home of a couple who are friends of theirs with whom she's staying while she's making arrangements to rent an apartment), he left an article on cyclothymia and AD’s, a book on depression, and a "Daily Bread" religious booklet for her. Before he even got home, she had called him raging that he had to quit leaving stuff like that and that she sees it as a form of “stalking” and that she’ll get an injunction against him if he doesn’t stop!
He has been much lower again the past two days. He keeps repeating that he still loves her so much he’d do anything to save his marriage, and is nowhere near ready to accept that she’s determined to end it. He’s also sad that he has to give up the most compatible AA group he’s found because it’s an early AM one and his boss on his new job is complaining if he’s late. When a friend asked him if he thought he was really an alcoholic and, if so, why, he replied that if your alcohol use has a bad effect on your life then you’re an alcoholic, and his life was ruined so he must be. He seems willing to let her define himself to him.
She says he is to take the children every weekend, and she is unwilling to do any of the transporting – this means he has to drive 60 miles from work to get them, 32 miles to my house to keep them for the weekend (no baby furniture in his house) and then take them back to her Sunday night. Both last Friday and today she called all around trying to get him or me or a friend or her brother to pick the kids up early – today she first said she had a bad muscle spasm in her neck but later in the day the reason was that she needed to go buy a money order to make the deposit on her apartment.
As for taking care of myself, I’m trying but it’s not easy! I made an appointment with a therapist and when I went she said that she used to see my daughter (2 years ago) and so it wouldn’t be appropriate for me to be her patient so I’ve got to find another one. She said she thought I should be on an antidepressant, so I called my gynecologist about a prescription and she suggested Effexor. I had done a little reading and was leaning toward Celexa, partly because it’s supposed to help you stop drinking and since my daughter is defining everyone in the family as an alcoholic I guess I’ve got to give up my lite beer, too. I’m going to hold off on doing anything for a few days. I’ll have my hands full with all three granddaughters this weekend – the two little ones plus my son’s 10-year-old so maybe that will keep my mind off things until Monday.
This is the end of the thread.
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