Posted by Viking on April 1, 2007, at 18:34:31
Hello babblers
I have followed this board for some time, but this is my first post.
First a little about myself. I am middleaged, male and live in northern Europe. I have been seeing a number of doctors and psyciatrists for the last 30 years, first for fatigue and stress and later on for depression. For many years i was not able to get any proper diagnosis, I was just told that nothinng was wrong with me. I spent lots of time and money on psycological therapy but it did not help very much.
Some 15 years ago it became so bad, I was for the first time referred to a pdoc. He did not put a name on my diagnosis, but hinted that my thoughts about being badly treated or harassed by my colleagues were delusional and I was prescribed an anti-psycotic drug. That definitely did no good. At the end I was fired from my job and could start to relax again.
Later I tried several times to get treatment for depression. I was first prescribed Cipramil which was later augmented with Buspar but it had very little effect. The only time when it really worked well was when I was supposed to have withdrawal symptoms, strange ! Today I realize that I have probably been somewhat hypomanic for 2 weeks during withdrawal, but it was nice.
Later on I was treated with Remeron + Mianserin (strange combo, but in those days I just did as the doc told as I did not know better). After several month and at a high dose I finally saw remission. But it was from one end of the scale to the other in one day. Suddenly all my rumination, anger, frustration and fatigue disappeared. On the other hand I did become rather aggressive and did a few stupid things. Furthermore it was a bit of a rollercoaster ride. most time I was "overspeeded" and when I relaxed I felt sedated (Remeron and Mianserin are both very sedating). I also gained a lot of weight. Medication was later changed to Cipramil + Mianserin but after one year it pooped out.
Later on I have tried a number of other meds including: Effexor, Modafinil, Adrafinil, Marplan, Amisulpride and Zyban. None of them did much good, and Remeron or Mianserin never worked again.
During the last couple of years I have read a lot aboout psyciatry in order to find an explanation. My last pdoc described my condition as "atypical depression/dysthymia and possibly social anxiety/phobia". He also hinted that it had some similarity with narcolepsy.
In order to sum up my symptoms were:
- excessive sleeping
- daytime sleepiness, difficult to stay awake
- mental slowdown
- rejection sensitivity
- stress sensitivity
- inability to exercise influence upon my life
- overeating
- always being accused of "sleepwalking" or "daydreaming"- endless compulsive rumination, anger, frustrations , complaints
- muscle tension, bruxism, headacheI chose to see the first grouop of symptoms as primary and the second group as a consequence of a frustrating live. I remember that I even as a kid was conscious about my lack of ability to have any influence upon things happening around me and I often fell victim to abusive behaviour such as mobbing. There were ups and downs but I believe these were due to external factors.
After a lot of reading I found a fair bit of evidence that stress can have a very damaging effect on the noradrenergic system. The consequences of this could be sleep disorders and increased sensitivity to stress and rejection. If I am to put this into one of those little boxes which doctors call a diagnosis, I would call it "atypical depression". It is possible that a US doc would call it "ADHD inattentive type", but that diagnosis is not used over here. Anyway, how do you distinguish that from a serious sleep disorder ?
To test my hypothesis I bought the most noradrenergic drug I could find: Reboxetine. I am now on week 3 and for the last week I have experienced almost full remission. I sleep easily, I feel fully awake and relaxed during the day and I suddenly find it surprisingly easy to talk to other people. It is very obvious that people treat me differently from what I am used to. I dont have any of the "speedy" feeling or the aggresiveness that Remeron gave me. All rumination etc is gone completely.
I must admit that my life is a mess. My somewhat uneven career has definitely hit the bottom and I am very much alone. But I have accepted it and I can think about it without getting upset. I am optimistic (at least cautiously) and I can think about the future in a constructive way.
Why did the doctors not give me proper treatment 30 years ago when all the evidence was there ? Why did I have to find out for myself ? Well never mind, that is part of the past.
My present medication is Reboxetine (Edronax) 4 mg a day. I did have some sideeffects in the beginning (constipation, restlessness, insomnia) but they are gone by now. I am surprised that such a low dose works so well as I normally need high doses to get any effect at all (I am a big guy). Maybe the bad reputation of Reboxetine is due to too high a dose recommendation ?
Miracles apparently still do happen.
I hope this can be of use to somebody else on this board.
Best regards.
poster:Viking
thread:746078
URL: http://www.dr-bob.org/babble/20070327/msgs/746078.html