Posted by Racer on March 20, 2007, at 1:52:22
In reply to Re: Another perspective » Racer, posted by Jeff Smith on March 20, 2007, at 1:08:48
You asked how my depression/anxiety affected my life, and what meds I'm on. So, I'll give you the short answer to those, although I don't want to go into too much detail.
First, I'm on disability, because of severe depression/anxiety and anorexia nervosa. My depression is the melancholic sort, and when it's bad, it leaves me lying on the sofa, unable to do much of anything. Anxiety is a big problem, too, mostly physical, with some OCD type aspects to it. I'll get intrusive thoughts that I just can't get away from, guilt over past events, shame, etc. The anorexia is chronic, although my weight is near normal range right now.
I take Wellbutrin XL, Prozac, Ritalin, and my pdoc just had me add SAMe. He's also just prescribed a new B complex vitamin, a new prescription formulation, but my pharmacy hasn't gotten that in yet, so I don't know if it will be helpful or not. I have a lot of paradoxical reactions to medications, and a few more common adverse effects, so it's hard to treat either depression or anxiety. Benzodiazepines, like Valium or Xanax, often increase my anxiety a great deal. When I take Ritalin, I often need an afternoon nap. Right now, though, the side effects seem benign enough, and I guess I'm getting back to being pretty OK with this combination. It's early days, though.
And when I was without insurance, I experienced a series of nightmares with trying to get treatment. I won't go into details, but some of it was very, very bad. The most recent horror story is only a couple of years old, and it's here in the archives. Basically, though, I lost a third of my body weight, telling the "therapist" that I had lapsed back into anorexia, and was ignored. The pdoc's notes continued to call me "well nourished" as my BMI dropped below 14. I know that there are horror stories out there. I really do. There are also some good stories, though. It's just hard to find them when you need them.
Abilify may not have been the right drug for you, but there are others like Seroquel and Risperdal that might be a better fit for you. Even Buspar is great for some people. Wellbutrin is a nice drug if it works for you, but it often isn't enough on its own. Adding a low dose of one of the SSRIs is often a good adjunct to it, providing a more robust response. There really are a lot of options out there. And you really do sound as if you're in so much pain right now.
As for the bipolar, it doesn't necessarily mean "highs" and "lows." Many people don't have full blown mania at all -- just hypomania, or mixed states. Hypomania is not quite mania, it's like mania lite. Mixed states, though, can present as depression with rage, or with agitation or anxiety. That sounds a bit like what you're describing, and a lot of the mood stabilizers are also used to augment antidepressants. Lamictal is one that a lot of people have a lot of good luck with. Even Lithium is used successfully to augment antidepressants. You really can get a better response than you're getting right now.
I hope Columbia works out for you. I know a few people there, and they're all good folks. My mother's life was saved there, years ago, and a few people there did a big favor for me by providing second (and third) opinions for me when I wasn't able to access adequate health care a few years back. You're lucky to live close enough to access them, and I truly hope it works out for you.
If it doesn't, for some reason, check with the universities in your area which offer doctoral programs in psychology. Psych candidates have to do some internship work, and often you can get pretty good care from an intern. It's not the most experienced care, but sometimes the students are older, and have more experience of the world. It's certainly worth a shot.
Good luck.
poster:Racer
thread:742135
URL: http://www.dr-bob.org/babble/psycho/20070309/msgs/742382.html