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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 uncouth on December 29, 2009, at 21:02:54
Hi,
I posted a few days ago about 'rejection sensitivity' and I guess this is just more of the same. I'm curious as to what medications help with resilience. I have climbed, every so slowly, from a prolonged, suicidal depression (23 sessions of ECT didn't help) over teh past year, and I finaly feel like i'm back to my baseline level of dysthymia (out of the pit but into the muck so to speak). But I've found that the smallest things are just destroying me, and brining back even suicidal thoughts.
It is incredibly hard to function. I am applying to business schools, waiting to hear back from a job, in the middle of a move, trying to quit smoking, so things are very stressful and nothing is pinned down in any part of my life, which doesn't help, but being pummeled by every little thing doesn't help things at all! Today I got back some comments on my business school essays (for Wharton), and I could hardly even read them. It's not like I'm a terrible writer (but the lithium certainly doesn't help things) but I could barely even read the constructive criticism, I just felt like sh*t, like I did a bad job. I've got over a week to finish them up before deadlines, so I need to revisit them, but this lack of resilience is really making thing sdifficult.
I've found this recently in other parts of my life too, social, relationship, etc. I pray, and that helps, sometimes. But the sheer anxiety that comes upon me and the inability to shrug things off is so destructive. Like I said, I feel like i've made good progress from wanting to die for months to where I am now, but how do I get rid of this *sensitivity* to everything.
I will accept comments on my mess of a drug regime too :) but please note that I'm seeing my pdoc in a week or two so maybe he'll have some adjustments. I thought Antipsychotics were supposed to help with this kind of thing?
I guess the whole point of this post is to ask whether an SSRI, specifically serotonin related med, is what i'm "missing" (that's my intuition right now).
Wellbutrin 600mg (brought me out of the depths and made me functional)
Zyprexa 5mg (eliminated the throbbing pain, and suicidal ideation, and ruminative thoughts)
Abilify 5mg (attenuates Zyprexa appetite increase quite well!)
Agomelatine 25mg (because i'm an agomelatine psychonaut...and helps with sleep. not sure about it's a/d effect though)
Tianeptine 50mg daily (on it for a little over 2 weeks. not sure about it. as i said in previous post, i am enthralled by it's theoretical actions)
Memantine 10mg daily (tapering slowly off...not necessary for me to be on and hasn't helped anything as far as I can tell)I've been off of 300mg of lithium for about two weeks, as well. Not sure it was doing anything for me and was making me a bit cloudy and made it hard to write well. Killed creative thoughts too.
Anyway. I know that more is not always best, so I don't need another lecture about excessive medication (I get it, i get it), but I do want to know if it would be worth adding an SSRI or switching from Zyprexa to Symbyax. I'm going to talk to pdoc about this idea at next meeting but would be curious to hear from others.
My diagnosis is Bipolar 2. High dose SS/NRIs make me hypomanic and I haven't been on one in 5 months.
I just could *DEAL* with so much more, and have such a better life, if I was just more resilient!
Thanks as always. Thanks.
-Sad Uncouth
Posted by Phillipa on December 30, 2009, at 0:20:24
In reply to Resilience, posted by uncouth on December 29, 2009, at 21:02:54
Uncouth first wow Wharton is the top of the line business school. Have to extremly intelligent to be accepted into this prestigious school. I'd say wait til you see the doc and don't knock yourself as you say you've climbed out of suicidal depression that alone is a great accomplishment. Give yourself some time to recover. Love Phillipa
Posted by bleauberry on December 30, 2009, at 16:52:04
In reply to Resilience, posted by uncouth on December 29, 2009, at 21:02:54
Well, no way to know for sure obviously, but I feel you hit it right on target when your gut instincts told you serotonin is the missing link.
Julia Ross describes symptom clusters that are associated with certain neurochemical deficiencies. Obviously there is no proof of anything in psychiatry, but what she says makes a lot of sense, and she has a good deal of success in her practice.
Your symptoms fall into the category of serotonin deficiency, with a possibility of a secondary deficiency being endorphins. It appears to be exaggerated norepinephrine and dopamine, perhaps not that they are actually exaggerated, but rather they don't have enough counterbalance...serotonin, endorphins, gaba.
I have experienced the same kind of emotional sensitivity you describe. Cymbalta did not help it and made it a little worse...I think the last thing I needed was any more NE, even though Cymbalta's NE isn't much. But within several days of switching straight to Zoloft, wham, that emotional sensitivity stuff was completely gone.
Posted by floatingbridge on December 30, 2009, at 23:07:10
In reply to Resilience, posted by uncouth on December 29, 2009, at 21:02:54
Uncouth,
I like what both Phillipa and BB wrote. I don't know what you should add or take away--I hope you get what you need from your pdoc and get yourself stable. Being kind to one's self is hard to do when depressed. You deserve lots of kindness and also acknowledgement of what you've done and will be able to do
again.Meanwhile, eat as well as you can, guard your sleep, post and reach out to friends who treat you kindly. Please stay away from ketamine (is that the spelling?).
kind regards,
fb
Posted by inanimate peanut on December 31, 2009, at 16:30:44
In reply to Re: Resilience, posted by bleauberry on December 30, 2009, at 16:52:04
Do you have any articles, etc. by this Julie Ross? It sounds like she has some interesting theories and I would like to read more.
Posted by floatingbridge on December 31, 2009, at 17:32:01
In reply to Re: Resilience » bleauberry, posted by inanimate peanut on December 31, 2009, at 16:30:44
peanut,
I'm curious, too.
best new year to you, uncouth, and BB, and every one else on this thread,
fb
Posted by janejane on January 1, 2010, at 5:24:58
In reply to Re: Resilience » bleauberry, posted by inanimate peanut on December 31, 2009, at 16:30:44
Hi Peanut & FB,
I'm not Bleauberry, but I'm familiar with Julia Ross. She wrote a book called "The Mood Cure" which I think is definitely worth reading. (Despite the fact that the title makes it sound like pop psychology, which was a turn-off to me, it is actually packed with lots of interesting ideas.) I have read quite a few books on alternative treatments for depression and I have to say that it's one of my favorites. I got my copy from amazon (there are a lot of reviews there), but she has a website here if you want to find out more before buying:
http://www.moodcure.com/index.html
Of course, as with anything, you'll want to read it with a critical eye.
This is the end of the thread.
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