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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by jerrympls on September 15, 2003, at 21:53:20
Hi everyone. I'm on 75mg of Nardil - have been for a couple months. At first it was like a miracle med - my depressed got better so quickly. Now, I've crashed and am afriad of having to go back in the hospital. What else can they do in the hospital? More ECT? NO!!!!!! I've been on everything! I've even been thinking more and more about suicide - but I'm NOT suicical.
I've been missing more work and feel like I just want to quit my job and move home. I know that's not practical - but I'm at a loss. If I miss anymore work, my JOB is protected under the Family Medical Leave Act - but I don't get paid when I use up all my sick and/or vacation time. How do I pay my bills then?
I'm just a basket case. My apartment is a disaster and I dread coming home to it each day. I've thought of hiring a maid service to come in a clean it just like a once time thing. I dunnno?
I need a coach or something....I need more than a psych doc. I have my sister - who's REALLY supportive - so I'm lucky about that. My doc it hooking me up with a therapist - but who knows how long that will take.
I see my doc on Thursday and I'm losing faith in any kind of treatment. Help....God I need help.......help......
And words of wisdom and/or support would be greatly appreciated
Jerry :-(
Posted by clay on September 15, 2003, at 23:40:55
In reply to Nardil is pooping out...need advice and support, posted by jerrympls on September 15, 2003, at 21:53:20
Been on Nardil for years.
It has been like a miracle drug but that does not mean that it worked quickly.
On 60mg it took months and months of continual gradual feeling better until life came back to complete normal.
If I taper back over a period of time, atypical depression creeps back. When I return to normal dose, it takes time to get back to normal.
Posted by cubbybear on September 16, 2003, at 0:27:43
In reply to Nardil is pooping out...need advice and support, posted by jerrympls on September 15, 2003, at 21:53:20
>
> I've been missing more work and feel like I just want to quit my job and move home. I know that's not practical - but I'm at a loss. If I miss anymore work, my JOB is protected under the Family Medical Leave Act - but I don't get paid when I use up all my sick and/or vacation time. How do I pay my bills then?You said something about moving home. Are you living in a foreign country? If so, where?, If not, where are you situated anyway? The support system available where you are can be crucial at a time like this. I went through a severe depression last year while living in Thailand (I'm still there) and my pdoc at the hospital became more of a problem over time--especially when I needed him most. (I am presently taking Parnate for depression, which i must obtain in the U.S.) So I can relate well to your terrible fears. As far as augmenting your Nardil, other people on this board are better qualified to help you out.
>
Posted by Bob on September 16, 2003, at 4:22:54
In reply to Re: Nardil is pooping out...need advice and support » jerrympls, posted by cubbybear on September 16, 2003, at 0:27:43
You're living in Thailand with major depression? That's impressive, especially when you have to do things like get your own Parnate from the U.S. I live right here at home in the good ole US of A, and due to my illness/anxiety, I really don't think I'd do well in some foreign country halfway around the world.
My hat goes off to you.
Posted by Bob on September 16, 2003, at 4:29:25
In reply to Nardil is pooping out...need advice and support, posted by jerrympls on September 15, 2003, at 21:53:20
Jerry:
You are the one who recently had the VNS explanted, right? The Nardil problems must have been somewhat abrupt, as I thought you just said Nardil was working quite well. I think I have seen other posts here where people go higher than the 75mg with Nardil. You might want to do a search. The previous post in this thread that mentioned the drug taking a long time to work properly may be true. I have taken Lithium and a small dose of Celexa for about a year and a half now. For about a year of that, I had serious, life-threatening depression. I came very close to going in for ECT, but decided against it. Very, very, very slowly, the suicidal aspects have faded for the most part. On the down side, I am less funtional than you, and am on disability. The fact that you're going to work, etc is much more than I can currently hope for. Anyway, maybe you should ask about a higher dose, or possibly another MAOI, i.e. Parnate?
Just curious, you seem to be quite down on the ECT. Did you have a bad experience with it, or did it just not work for you?
Bob
Posted by Ron Hill on September 16, 2003, at 15:05:23
In reply to Nardil is pooping out...need advice and support, posted by jerrympls on September 15, 2003, at 21:53:20
Jerry,
I’m very sorry that you are having trouble. Hang in there, Jerry; it will get better.
> Hi everyone. I'm on 75mg of Nardil - have been for a couple months. At first it was like a miracle med - my depressed got better so quickly.
Given your initial positive response to Nardil, do you think it might be worthwhile to bump it up to 90 mg/day to see what it does?
> I've been missing more work and feel like I just want to quit my job and move home.
Do what you need to do to keep your job. I know it is very difficult for you right now, Jerry, but you can make it through this because you are tough. You've done it before and you can do it again!
> I'm just a basket case. My apartment is a disaster and I dread coming home to it each day. I've thought of hiring a maid service to come in a clean it just like a once time thing. I dunnno?
Absolutely! Call the maid service today. You deserve it!
-- Ron
Posted by cubbybear on September 16, 2003, at 21:59:42
In reply to Re: Nardil is pooping out...need advice and support » jerrympls » cubbybear, posted by Bob on September 16, 2003, at 4:22:54
> You're living in Thailand with major depression? That's impressive, especially when you have to do things like get your own Parnate from the U.S. I live right here at home in the good ole US of A, and due to my illness/anxiety, I really don't think I'd do well in some foreign country halfway around the world.
>
> My hat goes off to you.Thanks Bob, but I guess I somehow misled you about the sequence of events. I moved back here in '99, was taking Parnate up until the winter of 2002 (returning each year to the U.S. to get a new supply), but decided to try Remeron (to avoid the necessary trips for the Parnate) in Jan. 2002. It pooped out later, I switched to Zoloft, which I didn't like, then tried Moclobemide, which did nothing, and plunged into the severest depression ever by the end of last year. I had to return to the U.S. in March of this year to obtain a new supply of Parnate. It kicked in after 3 weeks, and I feel as good as new. Thank God, I survived the trip back to the U.S. and back here again, and got my happy life back, after re-starting the Parnate.
But as you implied, life ain't no barrel of fun in Bangkok when you're suffering from major depression.
Posted by jerrympls on September 16, 2003, at 22:02:33
In reply to Re: Nardil is pooping out...need advice and support, posted by cubbybear on September 16, 2003, at 21:59:42
Can one switch from nardil to Parnate rather quickly?
Posted by cubbybear on September 16, 2003, at 22:07:10
In reply to Re: Nardil is pooping out...need advice and support, posted by jerrympls on September 16, 2003, at 22:02:33
> Can one switch from nardil to Parnate rather quickly?
I'm not sure, but I think I once read that at least 1 week's wait is required after stopping the Nardil. Better get the professional advice on this one from other people. Sorry I can't be more helpful.
Posted by Bob on September 16, 2003, at 23:11:17
In reply to Re: Nardil is pooping out...need advice and support, posted by cubbybear on September 16, 2003, at 21:59:42
Well, I'm still impressed. If I tanked in Bangkok, a trip home would be extremely daunting to me, considering getting out of bed alone is almost out of the question. Plus, I can't imagine the support structure would be as good in Thailand, unless you are fluent in Thai. I think if I had to spend time in a mental health facility, I'd rather it be in the U.S. Maybe I'm just too wimpy.
Posted by jmackie on September 17, 2003, at 15:05:49
In reply to Re: Nardil is pooping out...need advice and support » cubbybear, posted by Bob on September 16, 2003, at 23:11:17
A couple MAOI augmentation meds that may not seem obvious are lamictal or T3 (thyroid).
The lamictal can be effective if the "poop out" is a kind of drug-induced hypomania/depression cycle. This helped me when Parnate pooped out. Also, T3 (of a T3/T4 combination) can help reactivate the benefits of pooped out meds even for those who test normal for thyroid. Good T3 augmentation info in the "psychopharmological tips" section of this web site.
Let us know what happens with your meds.
Posted by jerrympls on September 17, 2003, at 20:53:14
In reply to Re: Nardil is pooping out...need advice and support, posted by jmackie on September 17, 2003, at 15:05:49
> A couple MAOI augmentation meds that may not seem obvious are lamictal or T3 (thyroid).
> The lamictal can be effective if the "poop out" is a kind of drug-induced hypomania/depression cycle. This helped me when Parnate pooped out. Also, T3 (of a T3/T4 combination) can help reactivate the benefits of pooped out meds even for those who test normal for thyroid. Good T3 augmentation info in the "psychopharmological tips" section of this web site.
> Let us know what happens with your meds.I've been taking a small dose of Synthroid for about a little over a month now. I don't know how much it has helped or not. But my doc increased my Nardil to 90mg. Tomorrow, I see her again and I'm gonna ask her about adding a small amount of stimulant. I know it's contrainticated - but I've heard so many stories about people being on small amounts of Ritalin or dexedrine and it has behlped augment the Nardil wonderfully with the hypertensive crisis.
So, I'll hope for the best.....
Jerry
Posted by cubbybear on September 18, 2003, at 0:53:35
In reply to Re: Nardil is pooping out...need advice and support » cubbybear, posted by Bob on September 16, 2003, at 23:11:17
> Well, I'm still impressed. If I tanked in Bangkok, a trip home would be extremely daunting to me, considering getting out of bed alone is almost out of the question. Plus, I can't imagine the support structure would be as good in Thailand, unless you are fluent in Thai. I think if I had to spend time in a mental health facility, I'd rather it be in the U.S. Maybe I'm just too wimpy.
Thanks for the compliment. . .most definitely, having to haul myself onto a plane in the depths of depression, fly 17 hours, then endure jet lag on top of it was the most difficult and painful thing I ever did, but it was a matter of either getting that Parnate or maybe being confined to a Bangkok institution for the mentally ill, which I didn't even want to contemplate. And I couldn't extend my trip in the U.S. until the Parnate kicked in, since I had only the support of my mother and step-father (in Phoenix) and they are well past retirement age and were/are in no physical condition to provide lodging beyond a couple of weeks. So the trip back to Bangkok was hardly any easier.
As for the mental health support scene here, there are several fine hospitals that have therapists who vary in their qualifications, as would be true in the U.S. I have no evidence of there being any group therapy or support groups for ex-pats who go through severe anxiety and depression. I could write loads about my experiences with the various therapists I consulted, but unfortunately don't have the time right now. One good thing about living here is that the prices of doctor visits and ALL medications are just a fraction of what they are in the U.S. For example, Zoloft sells for exactly half of what you'd pay in Walgreens, and a .5 mg. tab of name brand Klonopin costs 6 baht, which equals about 1/7 of a dollar (you'll have to use your calculator to figure that one out). The bottom line is that the medical treatment itself is a great bargain compared to the U.S., but this city is so intense, and the natives can be so unsympathetic, naive, and provincial, that it's perhaps the last place one would want to be when depressed or anxious.
Posted by Bob on September 18, 2003, at 1:03:29
In reply to Re: Nardil is pooping out...need advice and support » Bob, posted by cubbybear on September 18, 2003, at 0:53:35
Your fear of being institutionalized in Bangkok would provide enough anxiety for me to get the hell out. That's what I was talking about. I guess my situation is different, because I've not found anything which would even allow me to contemplate living abroad. I think that would be stressful to say the least. In my situation, I would also worry about the level of expertise available in the field of psychiatry in SE Asia. I doubt they're involved in any cutting edge treatments, and obviously don't even have Parnate. That having been said, Thailand might be one of the best countries to be in if you're going to be in SE Asia. I have a Cambodian girlfriend, as well as Vietnamese and Phillipino friends. It's obvious to me from knowing them that you wouldn't want to be in those countries. I mean, they have a very limited concept of even the existence of mental illness. It, to me, shows how humans have addressed mental illness in centuries past. "It doesn't really exist".
Posted by cubbybear on September 18, 2003, at 2:18:17
In reply to Re: Nardil is pooping out...need advice and support » Bob » cubbybear, posted by Bob on September 18, 2003, at 1:03:29
What you say is "right on"-- mental illness is definitely stigmatized here, and I read that mental health care workers are given funny looks when they talk about their work. The ratio of psychiatrists to patients (existing patients and those in need) is extremely wide. The whole situation reflects the cultural fact of life here that "problems" don't exist, and if they do, they should be ignored and they'll go away by themselves. God knows how many Thais I've met would benefit from counseling of some sort, although few would ever admit it. Although I can speak the language halfway fluently, I've found time and again that the language barrier rears its ugly head whenever I found myself in any kind of emergency medical situation, whether it was food poisoning or severe depression and panic. Fortunately,the therapist I had been seeing for nearly a year was fairly fluent in English, but even then, the differences between his conception of an emergency and mine was so so different that it caused me a great deal of confusion and disillusionment. When he ultimately decided to rush me through a Klonopin withdrawal program rather than a (necessary) gradual phaseout, this was the cue for me to bail out--it was the Thai way of saying, "I don't want to deal with you and your problems any more." I'll have to stop here and get back to work. Good talking to you.
This is the end of the thread.
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