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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by sweetmarie on August 11, 2001, at 10:48:46
hi
I`ve just got back home after being discharged from hospital, where I`ve been for 4 months now.
I was started on Mirtazapine/Venlafaxine/Lamotragine after 3 weeks in hospital. So, in total, I`ve been on this combination for 13 weeks. However, I`ve only been on `top dose` Venlafaxine (375 mg - as high as my consultant wants to take it) for 8 weeks. Over the time that I`ve been in hospital, my mood has been gradually improving from rock bottom (what I describe as `0 out of 10`) to better than that - i.e. about 3 out of 10 average (I find it easier to `log` my mood in numerical terms). Last w/end was a bit of a `breakthrough`, I felt, and I actually woke up 2 days in a row feeling O.K. as opposed to totally cruddy and wanting to stay in bed all day.
However, this past week has been very difficult, and my mood has been very low. Today is hideous.
There`s lots going on for me, though, not least leaving the `safety` of hospital, where I was being monitored and talked to on a regular basis (the nurse/patient contact is quite intense there). Obviously, I`ve left behind friends that I have made over the past months.
Also, I now have the prospect of going back to living alone again - I`ve been staying at my parents` place on my `home leaves`. I am also aware that I need to motivate myself to do things now - I won`t have nurses/doctors/parents to do this for me. If I don`t keep up some kind of activity/social contact, I am more likely to find myself `back` where I was. My flat is where I was when my illness was at it`s worst, and I associate it with those times. To be quite honest, I`m feeling VERY scared and anxious about the whole thing.
So, I`m facing `the rest of my life`, if you see what I mean. Nightmare.
Could this be the reason behind my drop in mood? I felt that I was actually getting somewhere prior to this last week.
I was told by the consultant treating me that some people experience a `sudden` lift in mood, whereas others experience a more gradual shift (especially where the illness has been severe and protracted). I know from experience that medication can take quite a while to `work` fully, and would be reluctant to alter things just now. My consultant feels the same way.
So, I suppose that I`m after some reassurance ...
... if anyone can help me out here I`d be most grateful. I`m experiencing a *real* loss of faith, and feel totally discouraged.
Please help if you can.
Thanks,
Anna.
Posted by SalArmy4me on August 11, 2001, at 10:58:38
In reply to Help ! Rocky patch ..., posted by sweetmarie on August 11, 2001, at 10:48:46
What dosage of the other two medications are you on?
Posted by susan C on August 11, 2001, at 13:22:29
In reply to Help ! Rocky patch ..., posted by sweetmarie on August 11, 2001, at 10:48:46
Hi sweetie,
If you were me and I were you, i would be feeling the same things. I have noticed 'triggering' or 'kindling' by my environment. Does your hospital/coverage have a social worker to check in on you regularly so you can make a 'transition' back to home? Be kind to your self. Pick somethings that are special to recreate a good atmosphere for you in your old place. Pat your self on the back for all the very hard work you have done. I know this things don't make any difference to what is going on in your brain, but, a hot bubble bath is a real nurturing thing. If the hospital isn't set up for monitoring you after you leave, is the doctor? are your parents? You know 'we' are always here...at least I am here, checking in each day. Fill your place with flowers, pull the shades, open the windows, pet the cat, turn on the music, loud, dance with happy feet, even if you aren't happy, demand attention. Eat a piece of the most delectiable thing you can find...chocolate? cheese cake? A very ripe tomato? a peach?
A wave and cyber hug from the western hemisphere.
-s
> hi
>
> I`ve just got back home after being discharged from hospital, where I`ve been for 4 months now.
>
> I was started on Mirtazapine/Venlafaxine/Lamotragine after 3 weeks in hospital. So, in total, I`ve been on this combination for 13 weeks. However, I`ve only been on `top dose` Venlafaxine (375 mg - as high as my consultant wants to take it) for 8 weeks. Over the time that I`ve been in hospital, my mood has been gradually improving from rock bottom (what I describe as `0 out of 10`) to better than that - i.e. about 3 out of 10 average (I find it easier to `log` my mood in numerical terms). Last w/end was a bit of a `breakthrough`, I felt, and I actually woke up 2 days in a row feeling O.K. as opposed to totally cruddy and wanting to stay in bed all day.
>
> However, this past week has been very difficult, and my mood has been very low. Today is hideous.
>
> There`s lots going on for me, though, not least leaving the `safety` of hospital, where I was being monitored and talked to on a regular basis (the nurse/patient contact is quite intense there). Obviously, I`ve left behind friends that I have made over the past months.
>
> Also, I now have the prospect of going back to living alone again - I`ve been staying at my parents` place on my `home leaves`. I am also aware that I need to motivate myself to do things now - I won`t have nurses/doctors/parents to do this for me. If I don`t keep up some kind of activity/social contact, I am more likely to find myself `back` where I was. My flat is where I was when my illness was at it`s worst, and I associate it with those times. To be quite honest, I`m feeling VERY scared and anxious about the whole thing.
>
> So, I`m facing `the rest of my life`, if you see what I mean. Nightmare.
>
> Could this be the reason behind my drop in mood? I felt that I was actually getting somewhere prior to this last week.
>
> I was told by the consultant treating me that some people experience a `sudden` lift in mood, whereas others experience a more gradual shift (especially where the illness has been severe and protracted). I know from experience that medication can take quite a while to `work` fully, and would be reluctant to alter things just now. My consultant feels the same way.
>
> So, I suppose that I`m after some reassurance ...
>
> ... if anyone can help me out here I`d be most grateful. I`m experiencing a *real* loss of faith, and feel totally discouraged.
>
> Please help if you can.
>
> Thanks,
>
> Anna.
Posted by sweetmarie on August 11, 2001, at 14:36:06
In reply to Re: Help ! Rocky patch ... » sweetmarie, posted by SalArmy4me on August 11, 2001, at 10:58:38
> What dosage of the other two medications are you on?
Sal,
I`m on 30 mg Mirtazapine, and 250 mg of Lamotragine.
The next `stage` is to turn the two around, i.e. decrease the dosage of the Venlafaxine and increase the dosage of the Mirtazapine. However, this will not be reviewed until late September when I see my own psychiatrist again.
I don`t really have a `say` in how the medication is regulated - as I`ve probably mentioned before, I`m being treated by a `treatment resistant depression` specialist. He`s a prof/consultant who will be overseeing my treatment from now on.
What I was really getting at was - could `situational` things be influencing my mood? I`m completely terrified about the future, and was wondering whether this could be a reason for this `dip`.
Anna.
Posted by sweetmarie on August 11, 2001, at 14:47:40
In reply to Re: Help ! Rocky patch ..., posted by susan C on August 11, 2001, at 13:22:29
If you were me and I were you, i would be feeling the same things. I have noticed 'triggering' or 'kindling' by my environment. Does your hospital/coverage have a social worker to check in on you regularly so you can make a 'transition' back to home?
- I will be seeing what is called a `community psychiatric nurse` (CPN). At least I think I will - I go for an assessment the week after next. If I do `qualify` (the hospital has been setting it up for me, and they say that it`s pretty much certain that I will), then I will probably see her either weekly or fortnightly. I think that she will just check me out, see how I am and report back to whoever - my psychiatrist I think. Also, she will have knowledge about other community support.
Be kind to your self. Pick somethings that are special to recreate a good atmosphere for you in your old place. Pat your self on the back for all the very hard work you have done. I know this things don't make any difference to what is going on in your brain, but, a hot bubble bath is a real nurturing thing. If the hospital isn't set up for monitoring you after you leave, is the doctor?
- my GP will be seeing me regularly to sort out my prescriptions etc. She`s dead nice, and very supportive.
are your parents?
- Yes, Mum and Dad are nearby, but I don`t really want to `lean` on them any more than I have to as it can be counter-productive. Still, they are there and will be available for practical stuff.
You know 'we' are always here...at least I am here, checking in each day.
- I know, and you are very supportive indeed. I don`t know what I`d do without this site.
Fill your place with flowers, pull the shades, open the windows, pet the cat, turn on the music, loud, dance with happy feet, even if you aren't happy, demand attention. Eat a piece of the most delectiable thing you can find...chocolate? cheese cake? A very ripe tomato? a peach?
- thank you VERY much for your reply and kind words - I really appreciate it.
A cyber hug to you, too!
Anna.
Posted by susan C on August 11, 2001, at 17:45:29
In reply to Help ! Rocky patch ..., posted by sweetmarie on August 11, 2001, at 10:48:46
Hi again,
I wander around of this board and the social section occasionally and came across this and immediately thought of you. I didn't see if you had responded, so don't know if you read it, but it is one I want to save and re-read for times I have feelings like you are having now. Hope a dose of philosphy is helpful
Ta Ta,
-s
http://www.dr-bob.org/babble/social/20010731/msgs/8663.html >hi
>
> I`ve just got back home after being discharged from hospital, where I`ve been for 4 months now.
>
> I was started on Mirtazapine/Venlafaxine/Lamotragine after 3 weeks in hospital. So, in total, I`ve been on this combination for 13 weeks. However, I`ve only been on `top dose` Venlafaxine (375 mg - as high as my consultant wants to take it) for 8 weeks. Over the time that I`ve been in hospital, my mood has been gradually improving from rock bottom (what I describe as `0 out of 10`) to better than that - i.e. about 3 out of 10 average (I find it easier to `log` my mood in numerical terms). Last w/end was a bit of a `breakthrough`, I felt, and I actually woke up 2 days in a row feeling O.K. as opposed to totally cruddy and wanting to stay in bed all day.
>
> However, this past week has been very difficult, and my mood has been very low. Today is hideous.
>
> There`s lots going on for me, though, not least leaving the `safety` of hospital, where I was being monitored and talked to on a regular basis (the nurse/patient contact is quite intense there). Obviously, I`ve left behind friends that I have made over the past months.
>
> Also, I now have the prospect of going back to living alone again - I`ve been staying at my parents` place on my `home leaves`. I am also aware that I need to motivate myself to do things now - I won`t have nurses/doctors/parents to do this for me. If I don`t keep up some kind of activity/social contact, I am more likely to find myself `back` where I was. My flat is where I was when my illness was at it`s worst, and I associate it with those times. To be quite honest, I`m feeling VERY scared and anxious about the whole thing.
>
> So, I`m facing `the rest of my life`, if you see what I mean. Nightmare.
>
> Could this be the reason behind my drop in mood? I felt that I was actually getting somewhere prior to this last week.
>
> I was told by the consultant treating me that some people experience a `sudden` lift in mood, whereas others experience a more gradual shift (especially where the illness has been severe and protracted). I know from experience that medication can take quite a while to `work` fully, and would be reluctant to alter things just now. My consultant feels the same way.
>
> So, I suppose that I`m after some reassurance ...
>
> ... if anyone can help me out here I`d be most grateful. I`m experiencing a *real* loss of faith, and feel totally discouraged.
>
> Please help if you can.
>
> Thanks,
>
> Anna.
Posted by Janelle on August 11, 2001, at 18:09:52
In reply to Help ! Rocky patch ..., posted by sweetmarie on August 11, 2001, at 10:48:46
Hi there,
I've not had to go to the hospital, but I can TOTALLY relate to your facing the prospect of going back to living alone again - I had also been staying at my parents` place while I was at my worst.
I had anxiety and fear about moving "back home" and being there alone, just me and my thoughts, but I've stabilized enough to the point where I'm actually okay there! And YOU will be too! I will pray for you.
I'm also facing `the rest of my life`, as I now have to find employment again and return to finish school. It is indeed scary.
I would think that these kinds of issues could indeed be factors in your feeling more "down", and do not "push" yourself until you feel ready. My pdoc said that when I was ready, I would automatically start doing more, be able to face more things in my life, be back home, etc., and she is RIGHT!
I can understand your "loss of faith" and discouragement, as I have been there, felt that. Try to hang in there, and things WILL turn around for you.
Good luck and keep us posted.
-Janelle
Posted by shelliR on August 11, 2001, at 20:51:36
In reply to Help ! Rocky patch ..., posted by sweetmarie on August 11, 2001, at 10:48:46
Hi Anna.Getting out of the hospital is a major major transition, up there with changing jobs,divorce, moving, etc. About six years ago I was in the hospital for almost six weeks, and I totally flipped out when I got out, so I ended up going back into another part of the hospital (a much less supportive unit for a week) ; then I really *did* want to go home.
The problem was that no one had worked with me on the transition. I had a new outpatient therapist and pdoc, but that was not enough. Later they developed a partial hospitalization program where you could go either everyday, all day, or pick a shorter schedule, like three days a week. Is there anything like that in the UK? Or more importantly, a program near where you live?
Also, there is any equivalent to what we call here community colleges? They are relatively inexpensive community based programs where you can go for the first two years of college, while creating a very flexible schedule for yourself. I had already gone to both college and graduate school and just went there to get some structure; I took art courses. It was very relaxing, non-competitive, and there were people of all ages--right out of college, also a lot of retired and folks on disabililty, because they were offered classes free.
Would something like that be available to you? If not, are there any other places which offer relaxing type classes, just to get you out everyday, or at least a few times a week. Structure is so important to create because you are used to a structured environment, where the structure was set up for you. And as you mentioned, the social aspect.
I think you are probably having a let down from having to face a scary situation, and I would think that the good you were getting from the meds will come back, once you are acclimated to the world again. And I think it was Susan who said to do nice things for yourself--maybe change things enough in your apartment that it doesn't trigger your prior feelings. Are you allowed to paint the walls? If so, maybe you could get a friend or family member to help, and pick out a wonderful color for you. In most apartments here you are allowed to paint the walls as long as they can put the same basic offwhite over it when you leave. I wish I knew more about the UK, so I could offer more ideas.
Feel free to reject any or all of my suggestions. I want you to know that I do understand, and that creating structure was the thing that helped me through it.
Take care,
Shelli
Posted by sweetmarie on August 12, 2001, at 11:47:40
In reply to Re: Help ! Rocky patch ..., posted by susan C on August 11, 2001, at 17:45:29
> I wander around of this board and the social section occasionally and came across this and immediately thought of you. I didn't see if you had responded, so don't know if you read it, but it is one I want to save and re-read for times I have feelings like you are having now. Hope a dose of philosphy is helpful
>
> Ta Ta,
> -s
> http://www.dr-bob.org/babble/social/20010731/msgs/8663.html >hi again susan
I`ve just read that message and it`s really quite inspirational.
Thanks for thinking of me and posting it.
love,
Anna.
Posted by sweetmarie on August 12, 2001, at 11:49:44
In reply to Re: Help ! Rocky patch ..., posted by Janelle on August 11, 2001, at 18:09:52
> Hi there,
>
> I've not had to go to the hospital, but I can TOTALLY relate to your facing the prospect of going back to living alone again - I had also been staying at my parents` place while I was at my worst.
>
> I had anxiety and fear about moving "back home" and being there alone, just me and my thoughts, but I've stabilized enough to the point where I'm actually okay there! And YOU will be too! I will pray for you.
>
> I'm also facing `the rest of my life`, as I now have to find employment again and return to finish school. It is indeed scary.
>
> I would think that these kinds of issues could indeed be factors in your feeling more "down", and do not "push" yourself until you feel ready. My pdoc said that when I was ready, I would automatically start doing more, be able to face more things in my life, be back home, etc., and she is RIGHT!
>
> I can understand your "loss of faith" and discouragement, as I have been there, felt that. Try to hang in there, and things WILL turn around for you.
>
> Good luck and keep us posted.
> -JanelleJanelle,
Thanks for replying and posting your own experience. It`s definitely encouraged me.
Love
Anna.
Posted by sweetmarie on August 12, 2001, at 12:15:12
In reply to Re: Help ! Rocky patch ... » sweetmarie, posted by shelliR on August 11, 2001, at 20:51:36
> Getting out of the hospital is a major major transition, up there with changing jobs,divorce, moving, etc.This is true ...
About six years ago I was in the hospital for almost six weeks, and I totally flipped out when I got out, so I ended up going back into another part of the hospital (a much less supportive unit for a week) ; then I really *did* want to go home.
> The problem was that no one had worked with me on the transition. I had a new outpatient therapist and pdoc, but that was not enough. Later they developed a partial hospitalization program where you could go either everyday, all day, or pick a shorter schedule, like three days a week. Is there anything like that in the UK? Or more importantly, a program near where you live?
I would be able to attend hospital on a `partial` basis if I actually lived in Newcastle (where I was in hospital). As I live `out of area` (in Leeds, 200 miles away) I can`t do this. However, I will hopefully be seeing a community nurse on a regular basis - although I`m not sure how regularly I`ll actually see her.
> Also, there is any equivalent to what we call here community colleges? They are relatively inexpensive community based programs where you can go for the first two years of college, while creating a very flexible schedule for yourself. I had already gone to both college and graduate school and just went there to get some structure; I took art courses. It was very relaxing, non-competitive, and there were people of all ages--right out of college, also a lot of retired and folks on disabililty, because they were offered classes free.
>
> Would something like that be available to you?Yes, there ARE colleges where I could do a course - these usually only offer evening classes though. I`m not sure whether I would be able to cope with this at this stage, but you are spot on when you mention `structure`. It`s one of the main things that hospital offers, and it`s *crucial* (I think) for people recovering (or, trying to recover) from major depression. I have a place at a day centre, which I am intending to go to. It`s not a `typical` mental health day centre (grim surroundings, basket weaving (!) etc.), and really quite pleasant (even ambient) with various different groups. I DON`T want to go there - I`m completely terrified - but, I think that I`ll go however crappy I feel.
> I think you are probably having a let down from having to face a scary situation, and I would think that the good you were getting from the meds will come back, once you are acclimated to the world again. And I think it was Susan who said to do nice things for yourself--maybe change things enough in your apartment that it doesn't trigger your prior feelings. Are you allowed to paint the walls? If so, maybe you could get a friend or family member to help, and pick out a wonderful color for you.
It`s funny you should mention this ... last year (April), all the flats in our estate were given new kitchen fittings, new front doors, and double glazing. At the same time, the Housing Association gave all tenants £200 to decorate their places (I don`t know whether you have these in the States - they are charitable organisations which own properties and rent them out to people who are on the `lower` income brackets. They charge very reasonable rent, and are responsible for most of the repair work that`s needed). Anyway, I went out and bought a fitted carpet and bought paint (bright yellow) for the bathroom and kitchen. They stipulated that the work was to be carried out in 2 years, which leaves me approx 8 months to do it. So, I think I`ll actually do it. Thanks for the suggestion - I`d forgotten all about it ...
In most apartments here you are allowed to paint the walls as long as they can put the same basic offwhite over it when you leave. I wish I knew more about the UK, so I could offer more ideas.
You`ve been great ... have you never been to the UK? If not, you should - it`s good (honestly!).
> Feel free to reject any or all of my suggestions. I want you to know that I do understand, and that creating structure was the thing that helped me through it.
You`ve been wonderful - all your suggestions were helpful, and you hit the nail on the head when you talk about `structure`.
Thank you.
love,
Anna.
Posted by shelliR on August 13, 2001, at 11:52:52
In reply to Re: Help ! Rocky patch ... » shelliR, posted by sweetmarie on August 12, 2001, at 12:15:12
Hi Anna
> You`ve been great ... have you never been to the UK? If not, you should - it`s good (honestly!).
>
I was actually in London many years ago, but I know that is just a small part of the UK.
I think if I come back it will have to be after my depression is resolved :-)
judging by the board, the UK is rather unsophisticated when it comes to mental health and I
am having a hard enough time here in the states!I'm glad you're going to try a partial program; I hope it works for you unti it is time to move
on to something that you are interested in.take care, and do use that yellow paint :-)
Shelli
This is the end of the thread.
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