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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by kamikazi_ladybug on November 21, 2002, at 13:37:39
thats what I was told by my psychologist about 5 years ago...I hated going in for therapy, didn't really feel that it benefited me, but my pdoc is not wanting me to try again. I don't think its worth it. I have severe panic and agoraphobia..I am just happy at HOME. Anyone have any suggestions?
KL
Posted by Pfinstegg on November 21, 2002, at 14:22:03
In reply to Sorry I can't help you anymore.., posted by kamikazi_ladybug on November 21, 2002, at 13:37:39
Do you have depression as well as social phobia and agoraphobia? Do you get anxious, irritable or angry about little frustrating things at home? Did you feel it was a poor fit between you and your previous shrink? Do you have difficulty sleeping? Do you have suicidal thoughts? Can you list the medications you have taken, with a note about which ones were helpful, and to what degree? I feel confident that your situation can be much better than it is right now, and that there are people here who will have excellent suggestions if you give us a bit more information. Hoping to hear from you more fully...
Pfinstegg
Posted by kamikazi_ladybug on November 21, 2002, at 16:41:16
In reply to Re: Sorry I can't help you anymore.. » kamikazi_ladybug, posted by Pfinstegg on November 21, 2002, at 14:22:03
Sometimes I feel like such a baby whineing about my problems. My dad keeps telling theres not a "damn thing wrong with me" .
Yes, I have depression as well. I feel no matter what I do I am always anxious, irritable, and frustrated, but at home I am safe. My dx is somewhat confusing to me, but it is Agoraphobia w/severe panic and depression OCD and I tend to hurt myself when things get overwhelming but I have only vaguely mentioned that to my pdoc.
In the past I have taken..Paxil, Zoloft, Lithium, Welbutrin, Xanax, Geodon, Depakote, thats all I can remember right now (I've been being treated since 1994). Right now I am taking Prozac (since 1995), Topamax, Seroquel, and Adderall. I do have difficulty sleeping, at first when I started taking the seroquel it would knock me out, now even on 300 mgs. its not as good as it was, I can stay awake and still function.
Thank you,
KL
Posted by Pfinstegg on November 21, 2002, at 18:58:05
In reply to Re: Sorry I can't help you anymore.., posted by kamikazi_ladybug on November 21, 2002, at 16:41:16
Hi KL, No, it's not "nothing"- it's a very difficult and challenging illness. Because of the range of medications you've tried, the length of time you've been suffering from such disabling symptoms, and the lack of benefit from the therapy you tried, would it be worthwhile looking at the physical aspects? I have in mind checking your TSH, T3 and T4, and,even if these are all normal(they probably are), taking a low dose of Cytomel(T3) for its anti-depressant effect. It was helpful for Chloe after ECT and has been helpful for me. There is an article about using it for depression in the NEJM, 1999, which I can cite more definitely if you want. The other thing which might be worth checking is your 24-hour cortisol and whether you suppress or not on the Dexamethasone Suppression Test- not suppressing is a marker for treatment-resistant depression. There aren't yet good treatments for cortisol abnormalities, but there will be soon, as it is an area of intense research interest. Being a non-suppressor myself, I felt better just understanding why all the medications I took didn't really work. I have what sounds like a similiar situation to yours- mainly depression, which gets better when I live very quietly, spending time at home, snuggling with the dog, etc., but which gets worse when I try to live a fuller, more people- and accomplishment-oriented life. I. too, have social phobia, although it is better since I have been having psychotherapy.
One thing I really believe helpful are vitamins-all of them, A,C,D and E in normal amounts, and all of the B vitamins. To help a stressed brain, it is not too much to take 100 mcg. of B12 and 400-800 mg. of folic acid, for at least a while. I've been taking them at those doses for several years. Also, I do think the fish oils are worth taking- maybe 2-3 grams a day.
Then-about psychotherapy. You sound like a warm and intelligent person who could form a meaningful relationship with a therapist and benefit from psychotherapy, provided you found the right person. Do you feel like giving it another try? Is it the going out part that is the most difficult?
I don't feel able to comment usefully on meds, as I never found any that worked, other than just a little. But there are a number of people on the board who have struggled through many med trials and have found the right ones, and they are in a much better position to suggest ADs which might really help.
I do hope you will keep posting and let us know how things are going- you know, it never sounds even remotely like whining on this board, as we are all going through variations of the same thing.
Pfinstegg
Because my endocrinologist and I have come to the conclusion that we need to focus on correcting the hormone abnormalities, I am taking tianeptine, a European drug which protects the brain from cortisol, and an scheduled for TMS in January- when it's successful, it lowers the cortisol and normalizes the DST test.(ECT does the same thing). In a few years, I hope to be able to take mefipristone, which dramatically lowers cortisol- it is being intensively studied as an AD at Stanford and NIH now.
This is the end of the thread.
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