![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 57 to 81 of 101. Go back in thread:
Posted by not exactly on February 8, 2003, at 13:00:09
In reply to Re: hey Bob heres a theory !! » not exactly, posted by LAURA777 on February 8, 2003, at 7:20:49
> I have a theory...
> do you think that my brain converts dopamine right to norepinephrineAn interesting theory. I wonder if the source of this theory is my recent post [http://www.dr-bob.org/babble/20030204/msgs/140070.html] when I suggested: "One possibility is an overzealous enzyme that's converting every bit of dopamine it can find into norepinephrine."
> i remeber in a previous post you had mentioned that cocaine has little to do with NE .. i disagree .. the stimulant effect is directly related to NE .. don't you think ..
I didn't say (or intend to imply) that. Cocaine is a potent dopamine reuptake inhibitor, and a somewhat less potent (tho nevertheless still fairly strong) norepinephrine reuptake inhibitor. Its stimulant effect results from both of these actions. The way I stated it in my previous post [http://www.dr-bob.org/babble/20030204/msgs/139371.html] was "...cocaine has no direct effect on serotonin (it is generally understood to be a reuptake inhibitor of dopamine, and to a lesser extent NE)..."
> also cocaine is a NE agonist , and my suspicion is it quickly converts to epinephrine , hence the paranoia , because they say the epinephrine is in invovled in fight or flight
Cocaine is not really an "NE agonist" in the strict sence of the term. An NE agonist would directly stimulate NE receptors instead of (even in the absence of) actual NE. This is not how cocaine affects NE receptors. It only blocks NE reuptake, resulting in higher NE levels. The receptors are then stimulated by this additional NE, not by the cocaine itself.
But this "excess" NE in the brain synapses would not be "convered" to systemic (outside the brain) epinephrine. Systemic epinephrine is synthesized and released by the adrenal gland (hence the name "adrenaline") [see http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/adrenal/medhormones.html].
> any addiction in your family ???
Just me. I had an alcohol problem many years ago when I started drinking excessively in response to a very stressful job situation. Fortunately, my abusive boss got the axe and I was able to wean myself off. I don't drink at all now.
- Bob
Posted by LAURA777 on February 8, 2003, at 16:44:16
In reply to Re: hey Bob » LAURA777, posted by not exactly on February 8, 2003, at 13:00:09
hey , well i think there may be truth to your theory . and the only reason i stated that cocaine was an ne agonist is because i read it on a nuerotransmitter synthesis site . they used it as an example that it was a good ne agonist but not a good anti-depressant ..
did you read that article about the opioids and genetics .. ??
i read about the crf factor in depression ,, cortisol levels and all .. hyper hypothalmic pituitary ..
can you explain this to me better , and what roll anti-depressants play . ?? it seems that they say that snri , helps with this ,?? i don't know , it was all pretty complicated ..
does norepinephrine have any thing at all to do with the amount of epinephrine in our systems ??
could there be a screw up some where where too much of this gets produced??? or could it possible be that a person can be super sensitive to it ????
are parkinsons drugs effective in raising the dopamine in the nucleus accumbens ?? do parkinsons drugs raise dopa throughout the brain or just in certain areas ???
sorry if you told me already , but did you try any of these ???
why does maoi's taken on long term have a likelyhood of causing high blood pressure ??? or was that tca's ??? sorry can't remember..i know i read somewhere that taking maoi's and tca's long term can cause problems .. ???
do you think that having a fast metabolisim and being very sensitive to stims have anything to do with the anhedonia ?? or how the nuerotransmiters work ??
what do you think ??
sorry for all the numerous questions .. i promise next time i will keep it down to only 4 questions !!! thanks for your time .. laura
Posted by not exactly on February 8, 2003, at 18:36:55
In reply to Re: hey Bob i got a question???? » not exactly, posted by LAURA777 on February 8, 2003, at 16:44:16
Well, the desipramine is finally starting to kick in. Only trouble is, it seems more like an ANTI-antidepressant. I've been feeling irritable and annoyed, and the WHY BOTHER syndrome is in full gear. I had planned to go to a party tonite, but now the thought of showering, getting dressed, and driving to it seem like far too much trouble. And what could I possibly enjoy at the party anyway? I don't want to be with people, or eat, or drink, or hear music. I just want to crawl in a hole somewhere. But I don't even feel like resting or sleeping. I don't know WHAT I want, and if I knew, it wouldn't be worth the effort.
I barely had the energy/motivation to send this post out. But I thought there was a chance ("hoping" is too "up" a word for now) that somebody might have an idea why I feel this way and what I could do about it. Any feedback would be appreciated, although I can't promise I'll be motivated to respond.
thanks,
bummed-out Bob
Posted by LAURA777 on February 8, 2003, at 19:22:25
In reply to BUMMED OUT BIG TIME, posted by not exactly on February 8, 2003, at 18:36:55
hey , i am so sorry , it sucks .. i usually sit and read books , so this computer has been a distraction and i also hope i will find an answer ..hope is everything ,, but i have been in that place where hope is even illusive . so i sleep .. but that gets really depressing .. i do not know what to say .. except that i think you are extremely intellegent and articulate and i admire your tenacity .. did you know a trait of having high NE is vigilance ... lol !! i am sorry ... i will talk with you soon , laura
Posted by fachad on February 8, 2003, at 19:37:40
In reply to Re: dysphoric hypomania? » fachad, posted by LAURA777 on February 8, 2003, at 6:24:25
Luara777,
I'm glad you did not take offence at my suggestion.
> My theory is that my brain or body converts all my dopamine very quickly into norepinephrine .. this is very simplistic and i need to look into it ..
My original theory from the cocaine experience was that my MAOI was just "overactive". I thought it broke down catecholamines too fast.
I cooked that one up based on my experience of coke wearing off so much faster for me than anyone else, and the feeling that the coke induced good mood was "melting" or "dissolving" right before my inner eyes.
In retrospect that seems really simplistic, but it did help me get a handle on my experiences. And that is real the purpose of theories - to make sense of experiences.
>i enjoy your posts by the way , and i see that you like philosophy , i do too .. can you tell me about the philosophy that you mentioned in previous posts ???
Yes, I have been thinking philosophically as long as I can remember. When I discovered philosophy as a formal discipline in high school, I was hooked. I completed a B.S in philosophy, with full intent of going to graduate school, but alas, the need to be gainfully employed got in the way.
Most of the posts I have done that have waxed philosophical have been on Psycho-Babble Faith, and have been a (civil, per Dr. Bob) statement of my rationalism and skepticism toward religious dogma and revealed religion.
There have been a few probes into epistemology in service of that end. Epistemology has always seemed to me to be the core concern in philosophy.
I've also done a few posts on philosophy of mind. I think that while there is much validity in the biochemical theory of mental disorders, it is very easy to take the implicit reductionism to extremes and end up with a view of human beings as merely so chemicals and cells.
I also think that the biochemical perspective can detract from the genuine need to focus on the behavioral, characteriological, and existential issues that factor into the human experience of emotional misery.
The need for medication in psychiatry could be compared to the need for cholesterol lowering drugs in primary care. Yes, there are some folks who have a strong genetic predisposition to high cholesterol, but there are others who just need to lay off the cheeseburgers. And the existence of a drug to lower cholesterol removes the motivation for some to observe a healthy diet. I think you can see where that analogy is going.
In addition to biological vs. behavioral etiologies of mental/emotional distress, I think there are also characterological and existential considerations. I think that biological treatments can go so far and no further; behavioral techniques and good behavioral hygiene can go so far; and beyond that there is a certain amount of emotional suffering that is just part of the human condition...
Posted by LAURA777 on February 8, 2003, at 20:58:57
In reply to Simplified Theories and Philosophical Musings » LAURA777, posted by fachad on February 8, 2003, at 19:37:40
> Luara777,
>
> I'm glad you did not take offence at my suggestion.
>
> > My theory is that my brain or body converts all my dopamine very quickly into norepinephrine .. this is very simplistic and i need to look into it ..actually the above theory is Bobs ,,
>
> I also think that the biochemical perspective can detract from the genuine need to focus on the behavioral, characteriological, and existential issues that factor into the human experience of emotional misery.
But shouldn't the emotional misery be tempered with joy , fun , and just basic happiness once in awhile ??
i used to like to go trail hiking ,i love the trees nature ect ect ,, and i have done many things that i see others are enjoying and i do not see it .. it is like everything is DULL . i know that it is not me physchologically . i am very aware . i have been self examing and focusing for years , and as a result of that i am pretty healthy .. but still a work in progress just like everyone else .. but what is this Dull thing .. gotta be biological .. i remember going out in snowstorms and it being so enchanting . truly , now it is dull , i have no answers ...> In addition to biological vs. behavioral etiologies of mental/emotional distress, I think there are also characterological and existential considerations. I think that biological treatments can go so far and no further; behavioral techniques and good behavioral hygiene can go so far; and beyond that there is a certain amount of emotional suffering that is just part of the human condition...
hey i can get with that , but again i say i live a life where there is no temperance ,, everything feels like a push to do ..
I am no intellectual Giant in philosophy , i am just interested in it because i think alot.. about alot of things and i find this interests me ...but there has to be more .. i see people enjoying a smattering of things and i know i used to also , now it is dull , why is this ??be easy with me on the philosophy terms because i do not know them ,so explain some of these things to me ... i will try and find some of your posts in the religion section , thanks , laura
Posted by fachad on February 8, 2003, at 23:41:29
In reply to Re: Simplified Theories and Philosophical Musings » fachad, posted by LAURA777 on February 8, 2003, at 20:58:57
Laura777,
> actually the above theory is Bobs ,,
Oops, I missed that. For a layman, I think I'm fairly versed in neuro-anatomy and neurochemistry, but I got lost somewhere in that thread between you and Bob.
> But shouldn't the emotional misery be tempered with joy , fun , and just basic happiness once in awhile ??Well sure, it should, but there's the rub - reality is not obligated to follow our ideals of how things ought to be.
That does not mean we should stop trying to make things better, or give up on our ideals, just that we need to have a certain amount of stoicism about the results of our efforts.
> i used to like to go trail hiking ,i love the trees nature ect ect ,, and i have done many things that i see others are enjoying and i do not see it .. it is like everything is DULL . i know that it is not me physchologically . i am very aware . i have been self examing and focusing for years , and as a result of that i am pretty healthy .. but still a work in progress just like everyone else .. but what is this Dull thing .. gotta be biological .. i remember going out in snowstorms and it being so enchanting . truly , now it is dull , i have no answers ...
I would like to share a few snippets from literature with you...things I've found to be very expressive of this anhedonia. But we're already way off topic, and Dr. Bob is gonna redirect us soon to Psycho-Social-Babble,
http://www.dr-bob.org/babble/social/
so if you're interested come over and look for the "anhedonia" thread.
> I am no intellectual Giant in philosophy , i am just interested in it because i think alot.. about alot of things and i find this interests me ...but there has to be more .. i see people enjoying a smattering of things and i know i used to also , now it is dull , why is this ??
No answers here, but I do think you'll like the snippets over in Social...
> be easy with me on the philosophy terms because i do not know them ,so explain some of these things to me ... i will try and find some of your posts in the religion section , thanks , lauraOops, sorry, I feel like a dork babbling on in jargon. It's just that philosophy, both in the general sense of wonder about why things are, and in the formal sense of the academic discipline, are really excing to me, and I do get carried away.
Posted by LAURA777 on February 9, 2003, at 8:26:31
In reply to Re: Simplified Theories and Philosophical Musings » LAURA777, posted by fachad on February 8, 2003, at 23:41:29
hey fachad , here is a post that i stumbled across that is very much true , and that is why this problem of discomfort is so complicated ..
anyway here is the post i am refering to ...
http://www.dr-bob.org/babble/faith/20020527/msgs/405.html
Posted by LAURA777 on February 9, 2003, at 9:22:00
In reply to BUMMED OUT BIG TIME, posted by not exactly on February 8, 2003, at 18:36:55
hey bob, i have thought alot about this , and from what i can see , is that some people are born with a deficet in both D2 receptor in the nucleus accumbens and a deficet in the endorphins . I believe this area has been looked into but very cautiously because of the addiction factor .. in fact there are meds that block like naltexone . opiate blocker ..
but this only addresses the issue of making the person stop the behaviour , not why they intiated the behavior in the first place ..
i also believe that it is an incompleteness in them that causes this behaviour .. there are many factors invovled and i will just give you a link to where fachad described these factors so very well .. here it is below
http://www.dr-bob.org/babble/faith/20020527/msgs/405.htmlWhat if a person takes care of the spiritual end , the phsycological end and even the behavioural end but is still is suffering ..
this is the place that i am at .. truly ...
Now i think it is very strange to me that when i ingest some form of opiate, this state in my being begins to change ... this is imperical proof to me that there is something amiss in this area of my biochemistry ..And even though they create drugs that stop addicts from feeling this , because addiction is a horrible state , they need to address what it is that started the whole process in the first place , What makes this complicated is all the factors in fachads post must be considered because they are all very important ... Some people it may be just a screw up in there physcological , hence thearpy is sucessful.. the person is free now .. some it may be a combo of behavioral issuse which in my opinion is directly tied to phsycological .. and the spriritual thing in conjuction with this as well..
Then there is the biological end , could this be the reason why so many fail at alcoholics anonymous or the narcotics anonymous ???i am not stating here that one should continue an addiction to any substance because it breeds a vicious cycle and exasberates the problem .. Sort of like hitting a broken leg with a hammer in hopes that it will heal ...
But this incompleteness that so many feel that lead them to these substances is very real.. and i guess it depends on wheather it's phsychological, or behavioral only ...is directly connected to wheather you become a sucess at being substance free and and content in your life ..
the word content is very operative here .. i am in a state of discontent .. even though i have taken care of all the factors mentioned in fachads post .. i am mentally healthy .. what i mean to say is that i was able to change dysfunctional patterns and perceptions ..
So now here i am stuck at the biological end ...i wonder if the d2 receptor has any link to endorphins ????
i keep going back to endorphins because one of thier properties is that they cause a sense of well being completeness , contentment .. and if you read the article i gave you about the experiment with the alcohol and non alcoholic mice you can see the connection , And wheather a person reaches this state of discontentment because of substance abuse or because they were born with it , or because of tramatic shock is really moot!!!! the point is ... is that it is a very real and profound issue that effects every area of my life .. your thoughts ???
thanks , laura
Posted by LAURA777 on February 9, 2003, at 9:25:16
In reply to Simplified Theories and Philosophical Musings » LAURA777, posted by fachad on February 8, 2003, at 19:37:40
hey Fachad please read this post and i would love to here your thoughts ..
http://www.dr-bob.org/babble/20030208/msgs/140275.html
i do appreciate you time and input , laura
Posted by fachad on February 9, 2003, at 17:38:31
In reply to Re: Fachad please read and give thoughts !! » fachad, posted by LAURA777 on February 9, 2003, at 9:25:16
I'm digesting that post, but as I'm thinking through the reply, I realize that it is somewhat off topic.
Dr. Bob has set up guidelines about only medication related stuff being posted here, and he would eventually redirect this thread over to social.
I admit I think it's a bit awkward, because we are talking about both medication and non-medication issues, but I can also see the reason for segregating the discussions.
So give me a bit of time to come up with something, and I'll reply over there...
> hey Fachad please read this post and i would love to here your thoughts ..
>
> http://www.dr-bob.org/babble/20030208/msgs/140275.html
>
> i do appreciate you time and input , laura
Posted by fachad on February 9, 2003, at 19:16:48
In reply to Re: Fachad please read and give thoughts !! » fachad, posted by LAURA777 on February 9, 2003, at 9:25:27
> hey Fachad please read this post and i would love to here your thoughts ..
I think you could fill several books with answers from different angles to these questions. But here is one preliminary thought - a way of seeing the question a different way.
>...i also believe that it is an incompleteness in them that causes this behavior ...What if a person takes care of the spiritual end , the physiological end and even the behavioral end but is still is suffering ..
I want to be careful here and state right from the beginning that I am only stating personal opinion, what works for me. I'm not implying that it's true for everyone, or judging anyone for interpreting things differently.
That being said, I think that part of "taking care of the spiritual end" includes finding a way to be at peace with things that are not as they should be, such as feelings of incompleteness and senseless suffering.
The need to understand and cope with those exact feelings are the driving factors behind spirituality.
If the problem (suffering, feelings of incompleteness, or whatever) is solvable by medication, or behavior, some known means, then it is just plain wrong to address it with spirituality. In that case you are evading reality and that is the real danger in a spiritual approach.
But on the other hand, I think that some kind of suffering, be it physical pain, or emotional pain, or emptiness, or boredom, or ennui, or existential dread or whatnot, is always going to be present to some extent, just a little ahead of whatever means our science has developed to relieve suffering.
So for me, taking care of the physical and behavioral components is an on-going lifelong process, and whatever suffering is left after I have done my best is the Prima Materia for the spiritual process.
Posted by fachad on February 9, 2003, at 19:22:45
In reply to Incompleteness and Residual Suffering » LAURA777, posted by fachad on February 9, 2003, at 19:16:48
The above post was supposed to go to Social. Oops.
I'll post a little more on that same line over there.
Posted by LAURA777 on February 9, 2003, at 19:48:15
In reply to The above post was supposed to go to Social, posted by fachad on February 9, 2003, at 19:22:45
hey Fachad , what i meant by incompleteness was the incompleteness of the full range of emotions , i can feel all the unpleasant feelings really well , but when it comes to the pleasant ones , ???? i guess i should have explained it better , . i am responsible for my happiness , i know this , but there is something amiss here and i have done alot of work on myself and know that i am a work in progress ,, but again this anhedonia ??? thanks laura
Posted by not exactly on February 9, 2003, at 20:56:29
In reply to Incompleteness and Residual Suffering » LAURA777, posted by fachad on February 9, 2003, at 19:16:48
"God grant me the SERENITY to accept the things I cannot change, the COURAGE to change the things I can, and the MEDS to move as much as possible from the first category to the second."
Posted by LAURA777 on February 9, 2003, at 21:35:38
In reply to Re: Incompleteness and Residual Suffering, posted by not exactly on February 9, 2003, at 20:56:29
hey check this link out , it is exactly what i have been talking about and its in great detail , it does not matter how the system got screwed up .. many things can cause it , and if you notice you are fully capable of feeling the unpleasant emotions ... but the pleasant ones seem to be illusive ,, why would we have receptors for opioid peptides in the area of emotion and learning .. opiate peptides are not just physical pain killers . anyway check it out and let me know what you think .//
Posted by fachad on February 9, 2003, at 21:48:09
In reply to Re: The above post was supposed to go to Social » fachad, posted by LAURA777 on February 9, 2003, at 19:48:15
>hey Fachad , what i meant by incompleteness was the incompleteness of the full range of emotions , i can feel all the unpleasant feelings really well , but when it comes to the pleasant ones , ????
Ok, so you are describing anhedonia as if it were a defect of perception, like color blindness. You can experience the full range of negative emotions, but not the positive ones. And you are hopeful that this defect is based in and remediable by chemical processes.
I was just suggesting an alternate perspective.
I think I mentioned in an earlier post that MAOIs have shown the most effectiveness for anhedonia, and the best solid scientific research I've seen to date is in a collection of articles edited by Fawcett and Clark, titled "Anhedonia and Affect Deficit States". It's now out of print, but you can find a copy thru abebooks.com or amazon.com used. It's in depth research and theory in anhedonia., and well worth the price.
You know that SSRI and stimulants don't help. As far as things to try, there are TCAs, MAOIs, and lithium and the newer anticonvulsants. Some have even reported success with the newer antipsychotics, citing similarities between anhedonia and the "negative symptoms" of schizophrenia. If you can find a special pdoc, you may be able to get a BUPRENORPHINE trial.
Using these meds for anhedonia is really a trial and error process. It’s not nearly as well researched as treating conventional depression or anxiety. I also share the desire to understand the underlying physiological mechanisms that produce anhedonia, but I would caution you that in my personal experience, the correlation between theoretical considerations and the practical effects of these meds is not always there.
Posted by LAURA777 on February 9, 2003, at 22:01:58
In reply to Incompleteness and Anhedonia » LAURA777, posted by fachad on February 9, 2003, at 21:48:09
hey Fachad , i know what you mean about being careful , but i have to try .. if there can be things wrong with our insulin , if we can have a sero problem or a norepinephrine problem , we can have an opioid peptide problem .. i know this is very simple , our brains are fantastic and each and every one of us are different that is why it is such a crap shoot with the meds .. buprenorphine is something i may consider ,, and it is something that i will talk about with the pdoc when i see him on the 21st of febuary ..
the brain is so complicated and while they know alot , they still don't know a whole lot .. in my searches i have been reading about autism , schiz , parkinson disease ,( fist thing that comes up when you mention dopamine) .. these maladys are all so sad ..
laura
Posted by not exactly on February 9, 2003, at 23:10:05
In reply to Re: Incompleteness and Residual Suffering, posted by not exactly on February 9, 2003, at 20:56:29
"God grant me the SEROTONIN to accept the things I cannot change,
the NOREPINEPHRINE to change the things I can,
and the DOPAMINE to care which is which."
Posted by LAURA777 on February 9, 2003, at 23:46:36
In reply to another version (for Laura), posted by not exactly on February 9, 2003, at 23:10:05
> "God grant me the SEROTONIN to accept the things I cannot change,
> the NOREPINEPHRINE to change the things I can,
> and the DOPAMINE to care which is which."
>VERY GOOD !! that is a good one .. you feeling better ?? laura
Posted by fachad on February 10, 2003, at 0:52:16
In reply to Re: Incompleteness and Residual Suffering, posted by not exactly on February 9, 2003, at 20:56:29
That is EXACTLY what I was thinking.
I was actually thinking about the Serenity Prayer when I wrote that post! But thanks for the fantastic revision of that classic, which says as much in one sentence as I said in a whole page.
> "God grant me the SERENITY to accept the things I cannot change, the COURAGE to change the things I can, and the MEDS to move as much as possible from the first category to the second."
>
Posted by not exactly on February 10, 2003, at 2:46:20
In reply to Yes, Exactly! » not exactly, posted by fachad on February 10, 2003, at 0:52:16
> That is EXACTLY what I was thinking.
>
> I was actually thinking about the Serenity Prayer when I wrote that post! But thanks for the fantastic revision of that classic, which says as much in one sentence as I said in a whole page.Glad you liked it. I'm not going to claim it was mental telepathy, but reading your insightful post reminded me of that old prayer. I quickly came up with that parody as a humorous way of paraphrasing what I thought was your essential concept.
- Bob
Posted by not exactly on February 10, 2003, at 3:18:18
In reply to Re: another version (for Laura) » not exactly, posted by LAURA777 on February 9, 2003, at 23:46:36
> you feeling better ??
Yes, thanks. Much better. For at least 3 reasons.
1) I finally finished a large unpleasant task that I had been procrastinating. So I feel good that I did it, that I did it well, and that it's no longer hanging over my head. And maybe the desipramine is finally helping my motivation.
2) I had made the mistake of changing 2 variables at once. I was trying to wean myself off of Neurontin [see http://www.dr-bob.org/babble/20030125/msgs/137900.html] at the same time I was waiting for the desipramine to kick in. The really bad WHY BOTHER syndrome hit the day after I had finally cut the Neurontin to zero. Later that evening, I realized that it might be relevant, and went back to taking a teeny bit of Neurontin. Within a day I felt much better. So I'll stay at this low level for a while longer before going cold turkey again.
3) Humor. No matter how low I'm feeling, if I can somehow laugh about something, it helps pull me out. The Serenity Prayer parodies were a successful exercise in humor therapy.
- Bob
Posted by Dr. Bob on February 10, 2003, at 9:18:09
In reply to Re: Simplified Theories and Philosophical Musings » LAURA777, posted by fachad on February 8, 2003, at 23:41:29
> I would like to share a few snippets from literature with you...things I've found to be very expressive of this anhedonia. But we're already way off topic, and Dr. Bob is gonna redirect us soon to Psycho-Social-Babble ... so if you're interested come over and look for the "anhedonia" thread.
Here's a link:
http://www.dr-bob.org/babble/social/20030208/msgs/36701.html
Bob
Posted by rayww on February 12, 2003, at 0:16:15
In reply to Re: BUMMED OUT BIG TIME » not exactly, posted by LAURA777 on February 9, 2003, at 9:22:00
I understand what you are saying about the different layers of depression. From my experience you can have every one of your issues resolved. You can be physically fit, spiritually secure, emotionally cozy, but when it hits, it hits. The psychosis affects all the layers at once. you become spiritually wierd, emotionally warped, physically ill, socially inept. I really don't think you become just spiritually depressed or just emotionally crashed, or physically down.
I was labelled bipolar about three years ago. Before that I thought I just had issues to deal with, so I went from one issue to the next, and as soon as that was resolved, another would surface, until it seemed never ending. There was always another emotional issue to work out, dating back to my father's death, surgery, moving countries, shyness, relationships, at the same time managing a large family and business.
I used various methods of "working" my way into areas of work that needed done, and became the chart master, and I survived all right. I have a chart for every mood possible. But it seemed like the psychosis kept getting worse instead of better, even though my life's issues had eased up.
I was spiritually minded, making sure I scheduled time for daily prayer, scripture study, meditation, and journal writing. I was committed to community service, church service, physical exercise, and family. I have never had a substance addiction, but every time "it" hit me I went psychotic behind the scenes in my mind and would almost betray my family, but I never did.
Each time whatever it was hit me, it was a little worse, and finally my concerned family decided I needed an evaluation. I had two, a spiritual evaluation from my clergy leader, and a medical/mental evaluation from my doctor.
My year of hell was the one spent on medication. I felt emotionally shut down, couldn't get my words out, and yet I had to keep going in the positions I held. I didn't know enough about meds to know how to shop around, and epival and topomax was what I ended up with.
I guess the meds served their purpose because I was able to go off them after about a year. (who watches time any more?) My issues decreased in severity, but still kept surfacing until I tried some nutritional supplements, which seemed to take the edge off and bring me back around to a relatively normal state, if there is such.
Most of what surfaces I let out here on PB (like this right now) and comparing what I write now to how I was writing back then, it is very mild.
I am going on here, and I'm not quite sure if I'm still on topic, but I guess my main point of this was to say, about the layers of depression, my opinion is that even when every layer is problem free, biological depression can still strike for no apparent reason, other than your own mis-perception of what is going on in your life. Like for instance, I am bipolar and rotate around in moods, including sexual ones. When I'm off the sexual swing and my partner is on his, which is very predictable and regular, I can have a nervous break by just thinking about it. If he becomes determined I can feel raped, abused, and worthless, because I absolutely cannot and there is nothing I can do to make him understand I still love him and my love is not expressed by sex. (You can tell I've been there and done that again and again). It would be easy to blame the whole bipolar problem onto sex, and justify it, but in reality I know the problem was the psychosis and the warped perception. Actually, I wish someone could evaluate this and tell me, is it possible for sex to bring on a psychotic reaction and a nervous melt down?
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Dr. Bob is Robert Hsiung, MD,
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