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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by sar on August 1, 2001, at 1:54:59
before i started taking meds, i was diagnosed with social phobia, generalized anxiety disorder, and major depression.
i've never stuck with one pdoc (bad, i know).
and now that i'm on meds, i've been diagnosed as borderline, histrionic (MOI< HISTRIONIC?!! JE NE SAIS PAS!!!), and bipolar II (mixed states).
in my mind, i've always been liberal, outspoken wild crazy etc...in the past, it took alcohol to bring this out in me...now that i'm much more relazed on meds (prozac + klonopin) I feel more free to be me. Add a lot of alcohol to the mix, and i do become quite dramatic.
what am i to make of all these diagnoses? can a social phobic be histrionic or borderline? can a unipolar experience a mixed state?
i am thoroughly confused.
thanks,
sar
Posted by kazoo on August 1, 2001, at 2:25:44
In reply to diagnosis debacle, posted by sar on August 1, 2001, at 1:54:59
You have a flare for the dramatic, my dear, and confusion becomes you; therefore, seek your fame and fortune in Hollywood, California.
If one of those quacks told you that you were turning into a hairless, chicken-lipped Japanese transvestite with one leg and no finger nails, would you believe them?
It's okay to have multiple doctors. Just be sure they're not "multiples" themselves. Knowledge is power.
Above all, be kind to yourself.
kazoo
Posted by Wendy B. on August 1, 2001, at 5:21:54
In reply to diagnosis debacle, posted by sar on August 1, 2001, at 1:54:59
> before i started taking meds, i was diagnosed with social phobia, generalized anxiety disorder, and major depression.
>
> i've never stuck with one pdoc (bad, i know).
>
> and now that i'm on meds, i've been diagnosed as borderline, histrionic (MOI< HISTRIONIC?!! JE NE SAIS PAS!!!), and bipolar II (mixed states).
>
> in my mind, i've always been liberal, outspoken wild crazy etc...in the past, it took alcohol to bring this out in me...now that i'm much more relazed on meds (prozac + klonopin) I feel more free to be me. Add a lot of alcohol to the mix, and i do become quite dramatic.
>
> what am i to make of all these diagnoses? can a social phobic be histrionic or borderline? can a unipolar experience a mixed state?
>
> i am thoroughly confused.
>
> thanks,
> sar
Sar,Kazoo's a hoot, no?
I agree that the diagnosis turntable/windmill/turnstile (?) is a weird one. Makes you dizzy to think of yourself in all these different ways.
Kazoo is wrong, though, that these guys (girls) are all quacks... I know you've had a really bad experience lately with the female shrink. But they're not all like that, and we shouldn't, IMHO, lump them all together as incapable clods. I've had two excellent therapists so far, with only one bad experience.. but that's another story.
By the way, histrionic isn't a dx, it's just a label, and a nasty one at that, very sexist in my opinion. When's the last time you ever heard of a MAN being called histrionic? You don't. That's because even the root of the word (Hyst-) is greek or whatever for womb. So a man's not likely to get that, right?I freaked out when I went from thinking I was just chronically depressed with anxiety and a history of panic attacks (was on Zoloft, but it pooped out, and Xanax for the anxiety) to being dx'ed with BPII. My end of the spectrum veers toward being low most of the time, but I do get charged up at other times. So it's probably mixed states, or maybe cyclothymic.
Check the response I gave on the neurontin thread on the regular babble board. I think BPII is right - borderline is different. It's when you hate other people, scream at everybody all the time, or feel like it, and everybody seems to you to be either all bad or all good, with no in between. Or this is my understanding, others may disagree...
You don't seem to have a problem relating to people (I like the other post in another thread where you talk to the man in the store with the t-shirt screaming "Hit your kids..." etc.) I think that's pretty social behavior, even though you were asking him what it meant. Looking for a fight, maybe? But then that's BPII again.
Like I said in the other post, there's a lot of reading to be found on Psycho-Babble tips, so read on, girl, and maybe some of the diagnosis questions will be answered for you...More anon,
Wendy
Posted by mila on August 1, 2001, at 10:09:05
In reply to diagnosis debacle, posted by sar on August 1, 2001, at 1:54:59
Hi sar,
the before starting meds diagnosis is right.
Prozac triggers hypomania in you, it did in me, although I am not a bipolar, borderline or histrionic, you would easily confuse me with one when I am on prozac.Prozac will eventually cure your major depression, you seem to respond to SSRI, but social phobia and GAD do not go away without therapy. SSRI masks their presence but doesn't cure them. when you'll try to go off the meds the depression might not return, but these two suckers will. and the vicious cycle will begin again. Social isolation brought by social phobia is very depressing, and GAD is as well.
your problem is not that prozac leads to mistakes in diagnosis, but that it will interfere with therapy. First, your therapy will be geared towards dealing with the consequences of taking prozac instead of dealing with real stuff. Second, it influences your thinking and doesn't allow for the change in beilefs and new behaviors to take place (it will make you therapy resistant, so to speak).
hope this helps
mila
Posted by Ted on August 1, 2001, at 11:42:47
In reply to Re: diagnosis debacle » sar, posted by kazoo on August 1, 2001, at 2:25:44
Sar & Kazoo,
>seek your fame and fortune in Hollywood, California.
As a CA resident I take exception to this.
ANYWHERE in CA would be appropriate. Don't limit it to Hollywood. :-)Ted
> You have a flare for the dramatic, my dear, and confusion becomes you; therefore, seek your fame and fortune in Hollywood, California.
>
> If one of those quacks told you that you were turning into a hairless, chicken-lipped Japanese transvestite with one leg and no finger nails, would you believe them?
>
> It's okay to have multiple doctors. Just be sure they're not "multiples" themselves. Knowledge is power.
>
> Above all, be kind to yourself.
>
> kazoo
>
Posted by Wendy B. on August 1, 2001, at 12:30:36
In reply to Re: diagnosis debacle, posted by mila on August 1, 2001, at 10:09:05
Mila,
> Hi sar,
>
> the before starting meds diagnosis is right.Why? I think that you're right, the Prozac probably did push Sar into a hypo-manic state, but if you read the literature, it doesn't do that to people who are simply depressed. It does it to people who have mania hiding in the background, it *reveals* the mania.
This is why I think neurontin or another mood stabilizer makes sense, although it's of course a non-medical opinion. Sar says she was offered depakote, but I think the neurontin at a relatively high dose would help A LOT.
> Prozac triggers hypomania in you, it did in me, although I am not a bipolar, borderline or histrionic, you would easily confuse me with one when I am on prozac.While I really appreciate most of your posts, her reaction to Prozac and yours may NOT be the same, Mila.
> Prozac will eventually cure your major depression, you seem to respond to SSRI, but social phobia and GAD do not go away without therapy. SSRI masks their presence but doesn't cure them. when you'll try to go off the meds the depression might not return, but these two suckers will. and the vicious cycle will begin again. Social isolation brought by social phobia is very depressing, and GAD is as well.
>
> your problem is not that prozac leads to mistakes in diagnosis, but that it will interfere with therapy. First, your therapy will be geared towards dealing with the consequences of taking prozac instead of dealing with real stuff.What? I don't get this at all... The consequences of taking prozac are that she'll be able to think about and understand the issues in therapy...
>Second, it influences your thinking and doesn't allow for the change in beilefs and new behaviors to take place (it will make you therapy resistant, so to speak).
I totally disagree with this statement. Meds taken concurrently with therapy is still the standard of care. The meds make you able to accept the therapy, because of what they're doing biologically and chemically to your brain. If you don't fix the reuptakes, etc., you can't get the most out of therapy. All IMHO. Sorry, but I couldn't disagree more with what you're saying...
Wendy
Posted by mila on August 1, 2001, at 14:07:38
In reply to Re: diagnosis debacle » mila, posted by Wendy B. on August 1, 2001, at 12:30:36
Hi Wendy,
I know I should've inserted IMHO after each sentence and used 'seems to be's instead of 'is's. All of the above is my opinion and i tend to see in sar what i had since I feel sympathy. The good thing here is that we all offer different perspectives on it for sar to choose what rings true in her case.
to keep the conversation going, here are some replies to your replies:)
mania (as I had been taught this spring in the abnormal psych course which by no means make me an expert) doesn't hide to be revealed by the antidepressants. It should be present prior to the beginning of the treatment in order for the person to be dxed as a bipolar. Of course, there is a debate going on about bipolar III diagnosis for people like me who go hypomanic while on meds. this had been discussed recently on PB.
of course, neurontin could be added, or the antidepressant changed to see whether the mania was clearly caused by the specific SSRI.
sar's reaction to prozac might be different from mine, agree. again, I only noticed the similarities and was amazed at the radical shift in diagnosis before and after.
when i said that it will be interfering with therapy i meant that she would be offered therapy geared to clear off thinking, feeling, and behavioral patterns typical for histrionics, bipolars, and borderlines, not anxiety/depressive patterns which are very different.
as far as difficulties with beliefs change while sar is on prozac (not just ANY medication) and behing hypomanic goes, i referred to the general fact that happy people do not change toward moderately happy, because happiness reinforces person's belief that what they beileve is all right. Hypomania makes people refractory to suggestions. were it any other side effect, i wouldn't have uttered that statement in the previous post.
thanks for talking to me, Wendy. hope you are doing alright yourself. yes I was tested for the pancreatic cancer.
best
mila
Posted by Kingfish on August 1, 2001, at 19:24:23
In reply to diagnosis debacle, posted by sar on August 1, 2001, at 1:54:59
IMHO, you sound like a Bipolar diagnosis. (It would be BPII, because of lack of hallucinations, etc.).
Your "symptoms" seem similar to mine, especially when I was younger (I'm 30 now). Isn't it interesting that they sound similar to Mila's, too, though, who has a different diagnosis.
Remember that diagnoses change all the time, anyway, so keep reading up and contemplating. Eventually, something will sound right to you. And keep searching for the right doctor. You've had a hard time finding someone you can trust.
Depakote seems too strong to me. I personally would try an anti-convolusant first (except they mess up your ability to spell, case in point).
I don't feel anywhere near 100% yet, but I do feel better. Topamax has allowed me to make better decisions, to think more literally. It's worth a try. My mind is not as "mixed up". Neurontin did not help me on its own, but does help with the Topamax. But Topamax is sedating for me (I seem to be one of few), so I'm adding Lamictal.
Keep posting!
- K.
Posted by sar on August 3, 2001, at 0:57:14
In reply to Re: diagnosis debacle » sar, posted by kazoo on August 1, 2001, at 2:25:44
well i've been to hollywood babe, and i felt so shy! my hair wasn't blonde enough, and i'm already 5'9" so no need for 6" platforms. no money for fringey suede $400 outfit. felt v. homely and undramatic.
HOWEVER, i did grow up watching 90210 during my high school yrs, which may have influenced me in a negative way. lets blame it all on the telly, mmmmkkay?
sar
Posted by sar on August 3, 2001, at 1:07:28
In reply to Re: diagnosis debacle » sar, posted by Wendy B. on August 1, 2001, at 5:21:54
dear wendy,
thank you. your brief summation of borderline helped put things in perspective--i do exhibit the impulsive behavior, the "i hate you, don't leave me" crap, but i'm very easy to get along with, v. ammenable and accepting. rarely overtly angry.
i've been hesitant to take on the BP II diagnosis because i feel like--may i give you a metaphor? say someone is depresst for a month but still functioning--they've got the "blues," and then somehow the blues go away but that's what they think depression feels like. blues=5 pounds, depression=1000 pounds. i'm hesitant to call myself BPII because i don't want to discount the extremity of it.
i've never been manic, but 2 of my docs think they've seen me in "mixed states." most of that time though, i was drunk.
i'm shyly sociable on the whole, not-at-all a bitch (is that what makes a borderline?) so i don't know what to think.
i've never experienced mania, though...and how would you describe hypomania? i *wish* i could have some of that mania, but i think maybe i'm just a drunken unipolar woith weird side-effects (explained in next message).
thanks Wendy!
love,
sar
Posted by sar on August 3, 2001, at 1:17:58
In reply to Re: diagnosis debacle, posted by mila on August 1, 2001, at 10:09:05
> Hi sar,
>
> the before starting meds diagnosis is right.
> Prozac triggers hypomania in you, it did in me, although I am not a bipolar, borderline or histrionic, you would easily confuse me with one when I am on prozac.
>i don't know that i qualify for "hypomania," per se. as i said before, i've always been this way *menatlly,* it's just that the relaxation brought by prozac + klonopin has allowed me to be more true to myself/
> Prozac will eventually cure your major depression, you seem to respond to SSRI, but social phobia and GAD do not go away without therapy. SSRI masks their presence but doesn't cure them. when you'll try to go off the meds the depression might not return, but these two suckers will. and the vicious cycle will begin again. Social isolation brought by social phobia is very depressing, and GAD is as well.i did try CBT for 1.5 yrs for social phobia and it helped a bit with rumination/paranoia; however, it never quelled the physical symptoms: throat closing, tunnel vision, dissiness, sweating or extreme coldness, stiffness, delayed response, trembling, etc.
>
> your problem is not that prozac leads to mistakes in diagnosis, but that it will interfere with therapy. First, your therapy will be geared towards dealing with the consequences of taking prozac instead of dealing with real stuff. Second, it influences your thinking and doesn't allow for the change in beilefs and new behaviors to take place (it will make you therapy resistant, so to speak)that makes a lot of sense, except that i've always been a rather unusaul social phobic. i experience all of the classic symptoms and fear, but my "impulsivity" has existed nearly always. i've always nervously been a bad girl! next time i see my pdoc i'm going to tell him that my root prpblem is social anxiety (which he might not believe, because i don't feel it as much one to one with the opposite sex; on the contrary, i become flirty.
when i'm not parlayzed-shy, i'm extraverted-sexy. does that make any sense?
thanks mila,
sar
> hope this helps
> mila
Posted by sar on August 3, 2001, at 1:19:22
In reply to Re: diagnosis debacle, posted by Ted on August 1, 2001, at 11:42:47
ha ha ho ho and hee hee.
Posted by sar on August 3, 2001, at 1:44:44
In reply to Re: diagnosis debacle » mila, posted by Wendy B. on August 1, 2001, at 12:30:36
> Mila,
>
>
> > Hi sar,
> >
> > the before starting meds diagnosis is right.
>
> Why? I think that you're right, the Prozac probably did push Sar into a hypo-manic state, but if you read the literature, it doesn't do that to people who are simply depressed. It does it to people who have mania hiding in the background, it *reveals* the mania.
> This is why I think neurontin or another mood stabilizer makes sense, although it's of course a non-medical opinion. Sar says she was offered depakote, but I think the neurontin at a relatively high dose would help A LOT.
it's difficult to tell because i drink to excess everyday (a depressant).
> > Prozac triggers hypomania in you, it did in me, although I am not a bipolar, borderline or histrionic, you would easily confuse me with one when I am on prozac.
even when i'm not on meds, you could dx me either borderline/histrionic when i'm drunk/sad.writing in my diary etc. prozac + klonopin allows me to act the way i would if i weren't socially phobic. i *do* have dramatic flair, but ppl generally seem to appreciate the humorous aspect of it (what? am i speaking positively of myself????).
>
> While I really appreciate most of your posts, her reaction to Prozac and yours may NOT be the same, Mila.
my reaction to prozac: near-elination of ruminating thoughts (a lifesaver), great reduction in social phobia...those are the main ones. i've been anit-meds before but after prozac, man...social anxiety is an overwhelmingly physical/ruminating-thoughts illness for me, and prozac has blown it all away....and i say as an anti-med/qus=asi-buddhist--I'd raher be on prozac/klonopin than not.
the reason i get up in the morning is to take my meds with a nice glass of OJ. i would *never* forget to take my meds. i forget appoint,ments, work schedules, dates, names, seasons--but NEVER my meds.
>
> > Prozac will eventually cure your major depression, you seem to respond to SSRI, but social phobia and GAD do not go away without therapy. SSRI masks their presence but doesn't cure them. when you'll try to go off the meds the depression might not return, but these two suckers will. and the vicious cycle will begin again. Social isolation brought by social phobia is very depressing, and GAD is as well.
> >
> > your problem is not that prozac leads to mistakes in diagnosis, but that it will interfere with therapy. First, your therapy will be geared towards dealing with the consequences of taking prozac instead of dealing with real stuff.
right now i'm wonderinmg if the near-anxiety-free social interaction is any sort of natural med for sp. when someone says, "how are you?" i say "good" and smile, instead of thinking, omigaw they know i'm such a loser they must be making fun of me!!!!i feel like i'm getting some cognition out of this. social phobia is an odd beat. i've had it all my life. it has frustrated me that i think like janis joplin but must live like emily dickenson. after 23 yrs i am *extremely* grateful that drugs have hel[ed to significatnlty reduce my sp. Unfortunately, i don't think any amount of CBT would have had the same effect.
thanks mila,
sar
Posted by mila on August 3, 2001, at 10:47:34
In reply to Re: diagnosis debacle mila, posted by sar on August 3, 2001, at 1:44:44
Dear sar,
i am glad to hear that you appreciate prozac+kloponin. That is great!
I was alarmed though when you mentioned 1.5 years of CBT. Something is not right here. It should've only lasted 10 sessions or so. Are you sure you counselor knew what they were doing? If they were incompetent, then no wonder you got no results to brag about.
best wishes, and sorry for whatever wrong I might have been when I jumped into this thread.
mila
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