Posted by brynb on June 27, 2015, at 12:06:58
Hi All-
I haven't been on here in quite some time. I'm doing ok-ish, though I'm at a bit of an introspective stand still and have had a decent amount of ups & downs (many more downs!) the past year, and feel like I need to rethink or address certain issues and questions I have. I'd love the community's feedback.
First, I use a pdoc in Manhattan who does IM Ketamine & TMS in office, as well as med management. I've been with him for about 3.5 years (my longest relationship ever w/ a pdoc) & while I have issues w/ him, he knows me very well, did my disability, and understands using "non psych" meds and thinking outside of the box for psych issues.
To be clear, I no longer do Ketamine treatments unless I'm really down, in a slump and need a kick start (imo that's what it's best for).
Here are some of my issues/questions:
-I never had a definitive diagnosis, tho' it seems I lean toward TRD, MDD w anxiety, or possibly some sort of Bipolar 2 w/ the prominent symptom being major depressive episodes.
While he never suggested it, other psych professionals over the years have asked if I've been dx'd with a personality disorder (borderline or histrionic), something that's crossed my mind many times too. Neither my doc nor I are too concerned w/ my DX (good, bad...?) but rather with the therapies & meds that work.After dealing (and not treating/dealing) with my illness for over 20 years, I've found less and simple goes much further for me with meds.
I'm currently doing my best (as far as functioning daily w few side effects) on Lexapro, Tramadol & Ativan. Lexapro & benzodiazepines have been in the picture forever & help depression & anxiety w the least side effects, tho' I'm at a high dose of Ativan and have started to very slowly lower the dose bc it's leaving me exhausted. Tramadol has been in my regimen for 4 years; it's a wonderful AD for me & helpful for inexplicable (horrible) leg and (sometimes) arm pain. It's considered fibromyalgia by omission. I've been tested for everything and I'm negative on every imaginable fronts.
As far as the DSMV goes & a bipolar 2 diagnosis, I believe I fit in the "hyper from certain meds" criteria. Several examples (and yes, I know some of the following are NOT psych meds):
-Neurontin: makes me manic in every definition of the word (speeding, over talking, hyper sexual, over spending, crying one minute over nothing...it continues).
-All pain meds, including sometimes my Tramadol, make me very up and talkative.
-AAP: I've been all over the board w/ unsavory reactions (anxiety, depression, exhaustion, etc.)
-Stabilizers: severe depression and anxiety
-Stimulants: very allergic to the entire group of meds & they all induce severe melancholia.(That's just a cursory, quick med rundown.)
Clearly, many meds are out of the picture, whic, as said, is fine bc less is more with me, but as much as I have improved quite a bit, if I simply miss a little over one day of my meds, I'm thrown into a tizzy; I become nasty, sick and have something akin to a blackout. I also become bed-bound.
That's why I'm sticking to the less is more approach and trying to incorporate some physical activity, yoga, meditation and being social if possible. That said, I still have a good many days where I'm too tired/unmotivated/depressed to leave home or my bed.
As far as rapid cycling goes, I suppose I can be hyper manic (irritable, anxious) and I absolutely have times when I don't or can't sleep, and I definitely have been having at least 4 or more severe depressive episodes where I'm home bound for at least a week. As I said, it seems like "rapid cycles."
Thus my questions and feeling like I could be doing better. I'd like to incorporate different therapies (perhaps a therapist, starting yoga & being physical, etc.). But, as much as I know what I can and *should* do to get better, I still often lack motivation, interest and have these episodes that hit me out of nowhere and I fear my world will be upside down w/ no warning on any random morning.
I guess I'd like feedback/responses/etc. re: what my dx might be according to the above, my reactions to meds, the rapid cycling, bipolar vs depression vs both w a personality disorder, etc., etc., etc. I feel I should be doing a lot better & I'm often sabotaging myself. I'll be 41 in a few days and am lonely since it's been a long time I've been in any serious relationship. And I just can't deal with my roller coaster of emotions. There seems to be no middle ground. Can anyone relate?
One last thing: I used to take klonopin. Not certain really egg I take Ativan instead now, but, if I'm not mistaken, can't klonopin provide mood stabilization? I vaguely remember being more social or motivated while on it, but that was years ago.
Thanks in advance, sorry for the novella, and I hope you're all faring well.
-b
Live in the sunshine, swim the sea, drink the wild air. - Ralph Waldo Emerson
poster:brynb
thread:1080019
URL: http://www.dr-bob.org/babble/20150520/msgs/1080019.html