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Anxious Depression (maybe) - Medication Advice?

Posted by MixedState66 on March 13, 2013, at 0:33:56

This is my first time ever reaching out for advice online. I read some of the posts, and it is amazing how familiar many of you are with your symptoms. I have such a hard time identifying and pinpointing my constant distress that has consumed me for years.

First off, I have been on meds since the age of 18 as a senior in high school. Initially my mom took me in to get diagnosed for ADD so I could take medication for SAT's. It was at that point when the psychiatrist began asking questions relating to my worry, fear, anxiousness, paranoia, inability to concentrate, where I realized I have serious problems. If you are reading and can possibly give advice, please stay tuned and I will get into my symptoms, but I think it is important to inform you when it all happened.

I am a male, and I recall having OCD related symptoms beginning at a young age where I would pull out my eyelashes and eyebrows constantly and also had a phase where I was paranoid about getting sick and exposing myself to germs. I had a lot of energy, and then in the 8th grade when I hit puberty my OCD symptoms continued, but I developed an atypical type of depression where I would get down on myself for minor failures and was extremely irritable to my friends and family, blowing up at them and losing some friends in the process. Those symptoms healed temporarily as a freshman where I was social, confident and making a lot of friends and able to concentrate for the most part.

Somewhere along the line freshman year, something happened (possibly smoking pot occasionally) where I have fallen into a dark depression that I cannot snap out of. I am 26 now and have tried many different meds starting with lexapro which minimally helped my anxiety and racing thoughts, however gave me fatigue a zombie like feeling. Freshman year in college my doc put on a combo of 10mg lexapro, 0.5 mg risperdal, and 150 mg of welbutrin. Looking back at it, that may have helped but my self esteem and anxiety toward taking medication made me very pessimistic about treatment with meds and I thought I could get better through cognitive therapy. Mid freshman year my doctor took me off risperdal and lexapro and I was only on 300mg of welbutrin. My obsessions came back and it was about a girl that I lost and I was rejected by after being mean to her at one point. I Couldn't get her off my mind and would dwell about how I screwed it up and ways I could make it better (obsessed and couldn't get her off my mind for hours a day).

He then thought I was bipolar and put me on lithium which was a disaster. I was more depressed, slept the majority of the day, gained a ton of weight and woke up with racing thoughts and zero motivation - only energy from anxiety would get me through the day. I tried paxil about two years ago which helped the anxiety but did not relieve the depression at all. I had extreme fatigue still, slept a lot, my speech was slow, and anhedonia where I cannot get stimulated by positive events. Combination of wellbutrin and paxil didn't help either, maybe gave a minor boost but not much. I tried celexa, which didn't make me as fatigued as paxil, didn't do much for anxiety and I still am depressed.

I have been depressed now for years, unable to experience happiness or get stimulated by something good that happens like getting a new job, going on vacation, having a girlfriend, I cannot get excited. My sex drive is gone, and although I can get an erection and perform with girls, I cannot get excited or horny. (It has been like this since Freshman year in high school). I have had a pattern of obsessing over certain girls excessively (I've counted 5 since the age of 18) in an unhealthy manner. I pull out my eyebrows and eyelashes and I have zero motivation of going out and being with friends. Even with alcohol, when I get drunk you would think it would ease my anxiety and induce happiness, but the opposite - I get irritable, cranky and still don't have excitement. Cocaine as well, it gives me a boost but my anxiety skyrockets. I wake up with no motivation, everything is in a fog if that makes sense? It used to sensitize me for instance on a summer day to hang out with friends and watch a baseball game, that would put me in a good mood. I don't have anything but a negative mood and I am very self absorbed in my issues and cannot describe how miserable I am.

I am now calling the shots with my psychiatrist and he lets me make the decision on drugs. I have now been on my first TCA (nortriptyline) for 2 months which has helped anxiety somewhat but still not the depression and some of my obsessive ruminating thoughts. Yesterday, he prescribed me risperdal to augment it, and I took my first dose at .25 mg last night, soon to build up to 0.5.

Does anyone think this is a good combination since the risperdal may have helped when I first went on it freshman year? Should I give another drug a shot? I am open to any suggestions, and I apologize that this may be the longest thread on this website. I promise next thread I post will be more to the point, but as you can see I am having difficulty identifying my symptoms and trying to somehow inform you of how awful i feel.


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poster:MixedState66 thread:1040186
URL: http://www.dr-bob.org/babble/20130308/msgs/1040186.html