![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by utopizen on May 3, 2004, at 15:00:34
I seem to write garbage unless I tweak my circadian rythms, take my stims, and do an all-nighter for a paper. I don't know if it's the motivation, or the sense of "well, you've already sacrificed sleep, you may as well get this finished" or the circadian rythms getting tricked, or what, but I've written every paper as an English major as an all-nighter.
It doesn't work as well during finals week when you have multiple papers and need to "come down" and have no Klonopin or anything because you've run out... sigh... hence my incompletes from last semester....
Anyway, seems that after trying every stim available, I can only work in this condition. Keuroac did it, but then again, he was found dead with Dexedrine causing a cereberal hemeroge in his brain and alcohol causing his liver to be screwed up while watching a cooking show one day.
(Probably the interaction of the alcohol and amphetamines... why does everyone think anything can be mixed with alcohol? It's like the worst drug interaction wise!)
Okay, so his doses were triple digits, as were many back then, but still, I want to know if anyone's tried like Straterra, supposedly it's suppose to equalize your sense of sleep and energy and let you focus in the daytime and feel tired when you're suppose to at night....
rambling on stims.... heh
Posted by Anthony Quest on May 3, 2004, at 20:48:05
In reply to Anyone a writer, all-nighter, ADDer?, posted by utopizen on May 3, 2004, at 15:00:34
I am new to this board. I have never been an internet poster before, and the only reason I chose to sign up is because the people who wrote posts here seemed intelligent and well, aware of what they don't know. The posts were also humble - and demonstrated an self-awareness of limitations and problems. It was a degree of honesty I didn't see much in my own life from friends or others.
So I thought I would start sharing my thoughts in cyberspace even if they would only be answered by other dots of light on my computer screen. It was more of a response that I was getting from actual people in my life. It seemed too that I wouldn't be thought of as odd for being able to talk about applied psychopharmocology. In the course of my life, I have had just about all that there is to have and taken all there is to take with the exception of atypical neuroleptics which always scared me. I never took barbituates for sleep either. I never used illicit drugs either.
I learned not to trust doctors or anyone else with my health, and while a little knowledge is a dangerous thing, I'd rather apply a little knowledge to what I know about myself than delegate to others the task of applying a lot a lot of knowledge about drugs to me about whom they knew next to nothing. I found being honest with doctors was rather counterproductive as well with only a few exceptions.
I chose to write to this post because it mentioned a few things I have been feeling and thinking about.
I seem to be doing my best work late at night too and my circadian rhythyms are totally screwed up. I have about a one hour window when I could fall asleep each night and if I don't lie down during that window I will easily simply stay up the entire night. I don't take any stimulants in the afternoon. I think the lack of going to sleep must trigger some sort of hypomania in me because I am wide awake at 1 am more so than when I am on 50 mg of dexedrine sustained release.
Regardless of whether or not, I've grown use to having to function in the world totally exhausted all of the time. It's been a damper on the social life I must say.
AS an aside, I don't have an ADD diagnosis. I started falling alseep in class. I am in my twenties and law student. I've been a straight A type my whole life and never had a sleep problem during the day - of course I lived on diet coke and barely slept at night but I could always make it through the day without falling asleep.
This year I finally couldn't do it anymore. I couldn't fall asleep at night which was not new. When I did I felt no more rested. But then I started to fall asleep in the day and in the car, at work, anywhere. I also got some interesting auditory hallucinations and then paralysis before sleep. I went to a sleep specialist who quickly identifies narcolepsy.
I thought it's too good to be true in the sense that I have always had medical problems totally elusive of diagnoses. But I seemed to have every single symptom of narcolepsy except cataplexy.
Now I am not sure. Since I started taking stimulants as prescribed by the sleep doctor no more sleep paralysis, no more hallucinations. I still get excessively sleepy and I wonder if I don't have idiopathic hypersomnia - a more appropriate diagnosis in that it is the catchall diagnsosis for those who have narcolepsy without the key clinical feature. It's also frustrating that the stimulants worked well for about 8 weeks and quit.
The reason I typed all this out is because I had two close friendsm but I don't consider them friends anymore. I wasn't getting my calls returned. I wrote both of them to ask for an explanation. I am sensitive about people returning phone calls.
One friend wrote that he simply wasn't feeling like we were friends; such is life. It just happens. I could appreciate his honesty and I knew already we were not friends. I just wanted to know why and that there was no reason was adequate.
Another friend - psychology phd, no less - wrote me to say that he was disappointed in me as a friend because I hadn't been fun to spend time with lately.
Specifically he said even though it wasn't my fault I had been so sleepy that he couldn't go out and enjoy himself in my presence. When I pointed out that friends should be there for each other and friendship is about more than simply providing mutual social stimulus, he wrote back -
" Yes I think that really good friends, the best of friends, are "there for each other through the good times and the bad." But herein lies the problem. Are we "really" good friends, the best of friends? Should you expect me to be there for you "through thick and through thin?". Would I expect you to be there for me as well? To me, the answer is no to both questions. I don't expect compassion and selflessness from you when it comes to me. I don't see our relationship that way. Perhaps you have and do? Perhaps you want me to be this important figure in your life, a really good friend. But that's not the way I see it. Now, would I be a better person if I could spend time with you when you are sick and be there for you when you are depressed, lonely, having physical ailments? Of course I would be. And if our relationship developed as such, I would. But it didn't"
I thought this an exceptionally cruel paragraph of prose. So esquisitely mean that I have been reading it almost daily to remind myself how I have a tendency to see what I want to see. I knew that guy for 1 1/2 years, and it's hard to imagine I wouldn't have identified the character trait that would have allowed him to write that. Then again, maybe I expect too much.
Then again, would I be friends with me? Probably not. Would I read my own emails? Probably not. Would I read my own posts. I wouldn't read my own actually; I bore myself.
I have no motivation to study and have two exams next week. I suppose this was just a way of procrastinating too. I would go to the psychiatrist if I thought I were depressed, but I don't think I am. I just think I am more honest with myself about the nature of human beings.
Is that wrong? Do I sound depressed.
P.S. Does anyone else feel like they are drunk when they are tired. I have never been a drinker but when I go without sleep and show up to work I find myself saying things that I wouldn't normally say. My inhibitions are gone. I don't think it has anything to do with Dexedrine or Adderall. I just will not have the willpower or the self-restraint to monitor thoughts before speaking outloud. I am well-respect but people are thinking of me as erratic. I am very hardworking well-composed most days. Then one day a week I will come in and say things that are true but not diplomatic; I'll just blurt things out, and then I can't explain things well at all. The stimulants keep me from falling asleep but they don't make me "sharp".
(I am working part-time in addition to grad school for a court. Since it's free, I don't worry so much about getting fired, but I'd like to think I can function as a professional when I graduate and if things don't change, I won't be able. Does anyone else have this fear, especially anyone who is going to have a professional license from the state?)
Posted by utopizen on May 5, 2004, at 13:56:09
In reply to The Sleepy Friendless Life » utopizen, posted by Anthony Quest on May 3, 2004, at 20:48:05
> Is that wrong? Do I sound depressed.
Don't ask yourself that. Instead, ask yourself if you're happy. If you can't honestly answer yes, you need to accept that there's something going on and you need to ask for help about it.
Believe me, I've been excessively sleepy for a year now, and while I use to be able to just take a 2 hour nap in the middle of the day and all was well, that just doesn't carry me over anymore for the remainder of the day.
It's not surprising that you would have depression. You have a lot going on, your friends have noticed a change in the way you behave around them, and even you have.
And as someone who's gotten both narcolepsy from one doc's dx and Idiopathic Hypersomnolence from another doc's, and four sleep studies, and seen 7 sleep docs, please try to think about this.
It's not uncommon for people with depression to deny themselves they have it. It's hard to accept. I was a really happy kid growing up, why would I suddenly feel different? I use to have so much energy when I was around my friends, but now I'm unstable, erratic, and withdrawn.
Don't focus on asking yourself if you're down. Ask if you're up. Do you have a reason to be happy at the moment, without changing somethings in your life? (Exercise, therapy, antidepressants, etc.)? Probably not. I'm in the same situtation. I can barely write right now, even with stimulants-- the same meds that once gave me a total boost in my energy/productivity just last year.
My roommate got mixed up, and I got placed with this depressing kid who's all sullen and likely has some kind of Asperger's Syndrome. It's a slob, he's grotesque, dirty, and depressing just to be around. I've remembered times where I have had bursts of energy (like I use to always, only now more rare) and just coming in the room, and him asking me some question about something in the most sullen voice, seemed to suck the life out of me instantly.
So here's my advice:
1. Depression often causes you to be sleepy. Accept this. I denied this for a year, thinking it was too "cliche" or some nonsense like that.
2. You may very well have a sleep disorder of some kind. Hopefully you've had sleep studies, and if not, try to get one... they're helpful in ruling out things like apnea, etc.
3. It's not impossible to feel depressed and have a sleep disorder at the same time. Don't think it's one or the other. The two may simply play off one another, making your sleepiness worse.
4. Think about the fact that, when you were around friends, you suddenly had energy out of nowhere-- a party, or something like that. Realize the signifigance of your energy levels having a strong relationship to your mood.
5. Reduce stress. We all have a finite, limited amount of mental energy we may use each day. Cut your work, if you think it's not the end of the world. It could be taking away mental energy you could transfer on your school work.
I found stopping my work study helped a lot in focusing on my school work more, and realized a work study isn't why I go to college.
6. Seriously consider an antidepressant. Straterra+Provigil may be something to bring up, as it has antidepressant properties and the combo often helps patients with sleepiness. And if you are worried about adjusting your dose/side effects while you do school/work, think seriously about taking a semester off.
7. Now's the time to think about taking the fall semester off, or putting off work/school plans during the summer, and telling this to your school/work. Don't assume you need to get everything done in a set time, because it'll lead you to getting nothing done in a set time if you're not up to speed.
8. Don't, ever, ever, ever, do what I did with sleep docs/psychiatrists. Don't hide your mood from them. If you tell them your mood is low, they can help you with that. They're not going to stop you from staying awake, or anything like that. It's very common for patients with true narcolepsy/idiopathic hypersomnolence to also have depression, and they know this. The sleepiness you feel can make you depressed itself.
9. Listen to this. I just checked myself into a mental ward the other day for a night, just because I felt so hopeless I needed to. Don't let yourself get worse by hiding your feelings from your doctors, they're there to help. There's nothing to hide, and there's nothing to fear. You'd be surprised at how relieving it is to realize they're on your side no matter what, because they are there to help you.
Best of luck, and reduce that stress! If you think finals or work is going to be too much, now's the time for the doctor's note to get written and have it put off. Don't think the clock is ticking on these things. And also, don't ever fear checking yourself into a psych ward. It can be relieving to know that you can stop that clock in your head from ticking just when you are feeling hopeless.
Oh, and Straterra has been noted to help lots of people adjust their circadian rythms to normal, so they have energy in the morning/day and feel tired when they're suppose to-- I'd consider a 3 month trial of it + Provigil. If you want to talk, my email is utopizen54nospam@yahoo.com (remove "nospam").
Posted by utopizen on May 5, 2004, at 14:05:43
In reply to The Sleepy Friendless Life » utopizen, posted by Anthony Quest on May 3, 2004, at 20:48:05
Oh, I almost forgot to say, I've been off antidepressants for over a year now, and wish I didn't... I was taking them just for social anxiety at the time, which now I take care of with Klonopin.
But I'm going to try out Straterra, if not also an antidepressant as well, soon after finals.
I've been down the same road, but you need to just sort of hang in there, accept that these meds aren't magical, and try them out for a few months anyway before you think it's worthless/hopeless.
In any event, they might make you feel more tired in the beginning, but who cares? You're already tired! So am I! In the long run, they could help you become yourself again, and not force you to live feeling so hopeless in a relatively short time.
They really can't hurt. And I wouldn't be too afraid of some Abilify to add to an antidepressant or Straterra if it doesn't seem to work-- often the combo of an antipsychotic will help make it work after it seems to fail. I've been on Abilify for two weeks before, and after a couple of days of feeling tired, I had to switch to AM dosing because it was so energizing/motivating. Wouldn't you like to feel that way again? I sure would!
Posted by desufnoc on July 6, 2004, at 1:57:28
In reply to Anyone a writer, all-nighter, ADDer?, posted by utopizen on May 3, 2004, at 15:00:34
I don't know if I am ADD or not, but I can relate to a lot of what was said by both of you who posted on here. That's why I decided to share my two cents worth.
I have been going through a craziness that I can't define and hasn't been diagnosed in a satisfying matter. Depression and anxiety mostly, but there are days when things are clear and I'm not so miserable.
As a student, I was always doing all nighters. I think some friends thought is was odd, but it worked for me. I think it may have been because studying during the day brought up a lot of anxiety and I just felt more "in the zone" at odd hours of the night. I suppose that's still true...it's easier for me to focus late at night, I feel more alive, less constrained. Just a night owl I suppose. I don't really know.
I say as a student as though I am no longer one, but I am. I just feel at odds with my academic career at the moment. I have been a successful student my whole life with very little studying, and upon dealing with my current psychological mess, my academic standing has steadily decreased. I have/had aspirations to obtain a law degree, a PhD in psychology, or both, but now I doubt my capabilities of making it through my final 2 semesters of undergrad.
Being a person of high ambition, high sociability for the greater part of my 21 years, most of those around me support my desire of such high achievements. However, I am plagued with extreme doubts. I am no longer very social; instead I am very self-conscious, always lacking a contribution to the conversation rather than being the main mouth. The thought of succeeding in a graduate program seems like a bad joke to me.
I'm not sure how cohesive any of this was, but I wanted to write something. I'm at a place where I don't really know what to do, or if my future can ever be as bright as other people seem to think it can be.
This is the end of the thread.
Psycho-Babble Students | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.