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Re: Shelli are you ok? » shelliR

Posted by Lorraine on September 20, 2001, at 10:00:40

In reply to Re: Shelli are you ok? » Lorraine, posted by shelliR on September 19, 2001, at 11:12:05

Hello, Shelli


> > > It is so horrible to say this but I feel like I'm ready to give up. But I could not do that to my parents, and my sister has been so clear in how much I mean to her.

I'm sorry you are in this place. Are you still seeing your talk therapist? Remember that feelings come and go even the really awful ones.

> > > Yesterday I faxed my pdoc (he's left today for five days), asking if I could increase my morning dose of oxy and even though I talked to his office staff and they promised me they would get back to me by the end of the day, they didn't. So I have upped the oxy in the morning by 10mg. If he has a problem with that, too bad.

You are doing what you need to do to survive. Is the Oxy working otherwise? What is your current dose? The lack of responsiveness is normally irritating but when you are feeling desparate becomes very upsetting. I have an almost panic reaction if my meds aren't working and I need an adjustment and it's Friday.

> > >As I said in the last post I am rethinking nardil and lamictal, my best combo, if my pdoc can plan out a way to cut at least half of the water weight gain. (I cannot accept adding 15 lbs, and it was also very uncomfortable weight). Last time I weighed myself I had lost 10.5 lbs since May, so I have 20 more to go until I feel comfortable in my body. (I'm 5'6, just to give you an idea that with twenty extra pounds I am not obese or anything, just not me, or more of me than I can tolerate!)

Have you tried Topamax or thought of augmenting with it? It is reputed to help with weight loss. Woman at my NDMDA meeting swore by it.

> > > It is so hard to work with my pdoc; he keeps ignoring me when I want to talk about buprenorphine over oxy or try to talk about lamictal. He says I'm changing enough at the moment, and as you truely understand, it works better for me to always have one eye to the future, to what's next. So eventually, I think he will let me try it, but I'm not sure how I will react to it anyway. I'm not sure what the answer is for me.

I guess this is why I decided to stay with my pdoc--he does let me lead the charge so to speak while he "consults" with me. It helps me feel more in control. I suppose if these guys haven't been depressed they don't know how frantic we become looking for a solution. Even if our solution is the wrong one (doesn't work), there is some piece of mind in crossing it off our list. At least that is how it is for me.

> > >In addition, in the middle of this I have gotten my period three times in the last seven weeks. I have an appointment next week to see my gyn but I think she's pretty much thinking the depression has been there too long for me to treat exclusively through hormones, but I definitely know that is the reason, everything got thrown off in the last year and a half.

I think you are right, shelli. This is why I am focusing on getting my hormone mix right--although you know it's another complication. You might look at www.mhsource.com/hy. In their journal devoted to women and mental health they note:

"As women reach their 30s to 50s, there begins an increase in sensitivity to the change in estrogen and progesterone levels that leads to a cluster of symptoms now called the premenstrual dysphoric disorder. Many women who suffer depression often have these symptoms preceding their actual onset of depression. The underlying mechanism may be the neurodynamics of the individual losing its constraints, shifting the balance towards a more chaotic mood state.

This is also a time when many women with bipolar disorders notice an increase in symptoms, including a shift to more rapid cycles of mood change and even mixed states of both mania and depression. Researchers have found that estrogen and progesterone directly influence the balance of other neurotransmitter systems whose function, in part, may be to minimize excessive swings in mood. Estrogen increases the activity of the glutamate system, which helps keep memory functioning. Increased activity in this system may also lead to hypomanic behavior. Progesterone is crucial to keeping the neuroreceptors for GABA operational. When progesterone levels drop, the ability for GABA to tone down neuronal activity decreases dramatically. This can lead to sleep disturbances, increased agitation, irritability and anxiety."

Shelli, I have no doubt that it is the changes in your hormones that destabilized you. That is what precipitated my depression. So you may need to work with both hormones and meds to find your footing again.

> > >It is so frustrating because before that, things in my life were finally feeling really managable and I was willing to move into "new" areas regarding relationships. Actually it will be two years ago this Christmas that nardil was no longer able bounce me back from short depressions, as it had for years and years.

Shelli, I have been mourning the disruption in my life lately. It's like just recently I have understood that this is a chronic illness, that it doesn't "go away" and that I will need to be able to manage it, through it's ups and downs when the meds are working and when they are not. What I mean is that I need to reclaim my life and stop waiting for a cure before I resume my old life. The truth is that my old life died and I need to move on from there. I was reading a quote about the difference between religiousness and spirituality that said essentially that religion is for those who want to avoid going to hell and spirituality is for those who have been to hell and don't want to go back. I have been feeling like no matter how hokey group meetings can be, no matter how unintellectual spirituality feels to me, I have to add things to my support system to help keep me afloat. I'm not saying you should do this because you should do what works for you--nothing more, nothing less. At one of the hospitals here they have a day program as well as an in-patient program for people with mental illness. Could this be a possibility for you? All you are trying to do is make the time pass between now and when meds start working--any tricks can help.

> > > So that's good that you aren't having any side effects with nardil.

Well, I increased my dose to 15mg 2x day. Let's see what that does. I was dipping in the afternoon. I am having some hyperventilating and back aches. I have also been having hot flashes like made (really worse than I have ever had them) so I have restarted the estrogen and added some progesterone. This on my own pretty much. I see the doctor tomorrow re hormone mix.

> > > Please don't worry. I have good friends, healthy parents, a sister, and a therapist to support me. And if I lose faith in mypdoc I would probably go to Boston and check myself into either McLean or Mass General.

Shelli, I'm concerned, not worried I guess. I hate to see you go through this. I hadn't realized it has been two years since you were stabilized. That's a long time--that's more or less my time frame too. I know how awful it can be to do the survival mode thing and wait for something to work.

> > > I hate writing bad news. Again that damn shame thing comes into play. Have a lot of work to do on that even if/when this depression lifts

I don't know--is it shame? I always want to be "competent" and this illness robs me of that. Continue to write please. What do you do to add structure to your days when you can't work?

Taking extra special care of yourself---


Lorraine



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