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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by socialdeviantjeff on February 17, 2004, at 20:13:32
I've ben diagnosed with: Atypical Depression with psychotic features, (auditory and visual hallucenations)Generalized Anxiety Disorder and OCD.
I'm musing over my diagnosis. There seem to be some overlaps with other disorders such as: Bipolar 2 (Dysphoric hypomania), Borderline Personality Disorder, (Less the attachment issues) Schitzoaffective Disorder and Schizotypal Personality Disorder.
As far as paranoia, I have it in spades. I experience delusional thinking, but I can rationalize over time that it's not the appropriate reality. That diesn't change the fact that the delusion exists in my mind on some level, but I can usually diffrientiate between my delusions and reality. I do have issues with believing that others can read my thoughts and/or I can read theirs. Despite this, I have a firmer foothold on reality than a true schitzophrenic or psychotic. These thoughts are most predominant during a depressive episode.
On Hallucenations, I hear constant music, footsteps, doors opening and closing, I think I'll hear me being discussed in a bad light. I also have a voice that will say derisive things to me, about me or others around me. These occur regardless of mood.
On mood, When I'm not in a depressive episode my mood is still dark. Suicidal ideation occurs. Lots of hotility and irritation. Significant emotional swings but only between dysphoria and emotional flatness and apathy.
I guess I'm just wondering how correct or how incorrect my diagnosis is and why....
I also just started Abilify, 5 mg in the morning. Considering I react so badly and paradoxically to most meds I hope this works out.
Posted by jdgjdg on February 18, 2004, at 10:32:57
In reply to My diagnosis, started Abilify today, posted by socialdeviantjeff on February 17, 2004, at 20:13:32
It sounds like you have OCD and possible bipolar to me. Of course I'm not a doctor, but I have OCD and bipolar I. I can see prescribing the meds for the bipolar, but I'm not sure what it can do for the OCD. It can be hard to destinguish bad obsessions from delusions. Especially if you are very, very compulsive. Do you really hear things or are you worried that you are hearing things. Sometimes my mind tricks me if I am very afraid do to the OCD. Do you sleep a lot and have difficulties wanting others approval? I was mis diagnosed with atypical depression when I am in fact bipolar. You might want to get a second opinion or ask you doctor to look into this further. Jdgjdg
Posted by utopizen on February 18, 2004, at 17:16:32
In reply to Re: My diagnosis, started Abilify today, posted by jdgjdg on February 18, 2004, at 10:32:57
I think it's great you guys are dosing at low doses to begin with... it may help you avoid the anxiety and akathasia so common for the atypicals, especially Abilify, that you may notice a couple of weeks on what I was starting on, 7.5mg/day.
The first few days, it'll knock you out, so take it before bedtime. Then skip the next dose and the following day, take it in the AM, unless you continue to feel sleepy.
My target dose was going to be 15mg/day, if not higher, after the first month. Most side effects go away after a month, so simply introducing your body to it for a month at a low dose is a good idea...
But don't expect too much the first month, if not second, especially if you're under 15 or higher mg. But be glad, because you don't want to feel restlessness too much.
I took it for social anxiety disorder, so an ultra low-dose was considered 15mg. Maybe you're sensitive to doses, but psychotic features typically require psychotic dosing after you're adjusted to the med's side effects.
Posted by utopizen on February 18, 2004, at 17:24:36
In reply to Re: My diagnosis, started Abilify today, posted by jdgjdg on February 18, 2004, at 10:32:57
Augment with an SSRI, and, after letting your body adjust to your super low dose, I'd think about upping it to 15-30mg a couple of months down the road.
SSRIs+Antipsychotics, according to my GP even, appear to synergize, or "boost" the effect of the SSRI when it doesn't work alone... (in fairyland, apparently there's cases where SSRIs do work alone).
I failed Abilify because at the time i wasn't yet on Klonopin daily, and I believe had I had that I wouldn't feel restlessness (akathasia, think of it like comuplsive pacing). I don't have OCD, but given what lines I can recall from the movie K-PAX, "An Obsessive-Compulsive Doesn't Just Stare Out the Window All Day."
So I'm guessing you'd be prone to this. It's okay, there's a drug called... something your doc would remember... it's not controlled... easy to get. And it should go away, so hopefully you won't need to take that extra drug forever.
I've never tried Zoloft. Tried all the others, except Zoloft. I think I'd like to try that. I've been on Klonopin since April, and it only really helped for like 3 months, but still far better than nothing.
Posted by socialdeviantjeff on February 18, 2004, at 18:18:21
In reply to Re: My diagnosis, started Abilify today, posted by jdgjdg on February 18, 2004, at 10:32:57
thanks for your reply. I've wondered about Bipolar for a while. My pdoc really doesn't think I would be. I haven't had a manic or hypomanic episode in the euphoric sense, however I strongly suspect that I've had episodes of mixed/dysphoric hypomania lasting maybe one day to a week at a time."Do you really hear things or are you worried that you are hearing things. "
Insofar as hearing things, there is no doubt I do actually hear things. I have for a long time, at least since Junior High 13 years ago. Sometimes it's disconcerting, but I can usually rationalize that the sounds are not real.
"It can be hard to destinguish bad obsessions from delusions. Especially if you are very, very compulsive."
True. Right now I'm trying to deal with a fixation I have on a former boss who was very bad to me.
"Do you sleep a lot and have difficulties wanting others approval?"
When it comes to sleep, I have a delayed-phase problem that despite major pharamcotherapy. Considering a light box. I also have CFS. I usually get 7-9 hours but if that's disturbed in the slightest it really messes me up. I'm not to sure if I understand the approval thing. I desire approval but once I get it I'm completely uncomfortable. I am also very sensetive to disapproval.
Posted by socialdeviantjeff on February 18, 2004, at 18:31:56
In reply to Re: My diagnosis, started Abilify today, posted by utopizen on February 18, 2004, at 17:16:32
Thanks for your reply.
Yes, I'm not expecting much, if anything from Abilify. If I can even take the psychotic dose, it might take months for me to get there. I am exquisitely sensetive to meds. I think it's some sort of toxic encephalopathy. I've seen 3 docs and none of them can explain why I react to a broad spectrum of psych meds so badly. I haven't been able to even hit a theraputic dose on anything. Because of my past with SSRI's, they are out. I can't tolerate any one of them. I also can't take SNRI's, TCA's, Lithium, anticonvulsants, Wellbutrin, etc. Kinda sucks. Havent's tried MAOI's yet due to concerns of a possible underlying neuropathy.
I can only take 2 mg of Perphenazine (another antipsychotic) which doesn't do much but seems to help a little.
Posted by Ilene on February 19, 2004, at 10:06:27
In reply to Re: My diagnosis, started Abilify today » utopizen, posted by socialdeviantjeff on February 18, 2004, at 18:31:56
I am exquisitely sensetive to meds. I think it's some sort of toxic encephalopathy. I've seen 3 docs and none of them can explain why I react to a broad spectrum of psych meds so badly. I haven't been able to even hit a theraputic dose on anything. Because of my past with SSRI's, they are out. I can't tolerate any one of them. I also can't take SNRI's, TCA's, Lithium, anticonvulsants, Wellbutrin, etc. Kinda sucks. Havent's tried MAOI's yet due to concerns of a possible underlying neuropathy.
>
> I can only take 2 mg of Perphenazine (another antipsychotic) which doesn't do much but seems to help a little.
>
>
How are you doing today? I'm feeling somewhat better.For a person with psychotic depression and delusions you seem pretty reasonable. I like to read your posts.
What are your cfs symptoms? I discovered there's an interaction between my sleep and cfs--when I had a very bad cfs flare-up in October my sleep was terrible, including one night where I didn't sleep at all.
Sleep is so nice.
Because my cfs is triggered by my dysautonomia, I kept it under control for a couple of years by avoiding triggers. Current problem is that anxiety is a trigger, and my GAD has gotten much worse. I think Risperdal is good for my anxiety (see my "Marplan Diary" thread).
I'm not sure what you mean by an underlying neuropathy preventing you from taking an MAOI. Most of the problems are with drug and food interactions.
I won't be able to take Ultracet (contains Ultram/Tramadol) for the cfs pain now. Maybe I'll get lucky and the Marplan will dampen the anxiety enough so I won't have flare-ups. Tramadol has an effect on serotonin, I think, and it is effective for fibromyalgia & cfs pain, unlike otc pain meds.
Have you tried Tramadol or other opiates for depression? Opiates don't do it for me, but I'm sure you've read Babble threads on the subject.
How's the light box project?
Best wishes,
I.
Posted by Lazarus on February 19, 2004, at 17:47:44
In reply to My diagnosis, started Abilify today, posted by socialdeviantjeff on February 17, 2004, at 20:13:32
Ninety percent of the stuff in our heads is junk; only about ten percent is truly meaningful and useful. That said, the Abilify will cleanse your head of much of the junk that's in it now.
The best feature of Abilify is that it decreases, even eliminates, the conflicts in the mind. I have multiple personalities. They fight each other for dominance over the core personality and the Abilify suppresses them all.
Lazarus
Posted by socialdeviantjeff on February 20, 2004, at 1:34:20
In reply to Re: My diagnosis, started Abilify today » socialdeviantjeff, posted by Ilene on February 19, 2004, at 10:06:27
>>How are you doing today? I'm feeling somewhat better.
Ok I oguess, thanks for asking.
>>For a person with psychotic depression and delusions you seem pretty reasonable. I like to read your posts.
Thanks. I try to keep it down when I'm on this site. Plus, I've had a pretty good month delusion-wise. Now If I could do something about those pesky hallucenations
>>What are your cfs symptoms? I discovered there's an interaction between my sleep and cfs--when I had a very bad cfs flare-up in October my sleep was terrible, including one night where I didn't sleep at all.
Well, I get chronic muscle pain. Not usually too bad but I've had my flare-ups. It does keep me form woking to a large degree. So far though, I don't really recognize any triggers or connection with sleep. It feels more like fibro but given my tendancy towards delusions I don't want to give myself that dx..
>>Because my cfs is triggered by my dysautonomia, I kept it under control for a couple of years by avoiding triggers. Current problem is that anxiety is a trigger, and my GAD has gotten much worse. I think Risperdal is good for my anxiety (see my "Marplan Diary" thread).>>I'm not sure what you mean by an underlying neuropathy preventing you from taking an MAOI. Most of the problems are with drug and food interactions.
Some sort of abnormal brain tissue issues (hey, almost rhymes) are the current theory. Taking any large psych med dose creates all kinds of hell for me. With the hypertension issues I guess I'm just scared of the stuff.
>>I won't be able to take Ultracet (contains Ultram/Tramadol) for the cfs pain now. Maybe I'll get lucky and the Marplan will dampen the anxiety enough so I won't have flare-ups. Tramadol has an effect on serotonin, I think, and it is effective for fibromyalgia & cfs pain, unlike otc pain meds.
Sorry to hear that. I LOVE Ultracet. For me, it's worked better than most anything for pain. In facct I have to take it right now for my first attack ever of Pleurisy. It is not a recommendable experience.
>>Have you tried Tramadol or other opiates for depression? Opiates don't do it for me, but I'm sure you've read Babble threads on the subject.
Not yet on the opiates. Since ultracet contains Tramadol, I do think it could work if I got low doses of Tramadol solo. If course, I would be in la la land most of the time...
How's the light box project?
Stalled until I have more energy, but I think it's only gonna cost about $40-60. Gonna put a cool flame paint job on it too. :)
Posted by jdgjdg on February 20, 2004, at 23:23:11
In reply to Abilify- try higher doses (15-30mg) + SSRI, posted by utopizen on February 18, 2004, at 17:24:36
Does Abilify work to calm the manic episodes?
J
Posted by socialdeviantjeff on February 20, 2004, at 23:50:47
In reply to Re: Abilify- try higher doses (15-30mg) + SSRI, posted by jdgjdg on February 20, 2004, at 23:23:11
Well, I don't get manias per se, but there are times (althogh my pdoc doesn't agree) when I'm sure I've experienced dysphoric hypomania.
Right now my abilify dose is too low to tell and I'm a lot calmer right now.
This is the end of the thread.
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