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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 26. Go back in thread:
Posted by ed_uk on December 3, 2004, at 11:17:59
In reply to To the point where I don't mention suicidiality, posted by linkadge on December 3, 2004, at 11:09:17
Hello,
I know you had problems with Parnate, but was it more effective against your depression than any of the other ADs that you've taken? Perhaps you could combine Nardil with an AP. I know I've suggested this before. Perhaps you could encourage your pdoc to consider it
Perhaps it is time to consider Nardil or Lamictal.
Posted by linkadge on December 3, 2004, at 11:39:24
In reply to Re: To the point where I don't mention suicidiality, posted by ed_uk on December 3, 2004, at 11:17:59
Docs here in Canada are different. Is soon as I start doing the suggesting, they automatically thing that I am not depressed.
I understand what you mean but, If I "ask" by doctor for a specific AD, then he says something like Or "YOu always want to change your medicaction, it won't work if you keep changing it!"
And I feel like saying "it won't work unless I change it"
Linkadge
Posted by ed_uk on December 3, 2004, at 11:43:57
In reply to Re: To the point where I don't mention suicidiality, posted by linkadge on December 3, 2004, at 11:39:24
I suppose you'll have to emphasize that you have given previous medication adequate time to work, but it hasn't. Doctors don't like being told what to do so you'll need to be very subtle when making suggestions.
Regards,
Ed.
Posted by linkadge on December 3, 2004, at 11:49:49
In reply to Re: To the point where I don't mention suicidiality, posted by ed_uk on December 3, 2004, at 11:43:57
You're right they don't like being told what to do.
Linkadge
Posted by Larry Hoover on December 3, 2004, at 11:57:47
In reply to To the point where I don't mention suicidiality, posted by linkadge on December 3, 2004, at 11:09:17
> It's come to the point where I don't even mention suicidiality when I go to the doctors office.
>
> They can't do anything, they also don't want to hear that after all this time they havn't made progress. They also just think I'm faking it, so I don't even bother to mention it anymore.
>
>
> LinkadgeI had extended periods of time when I was overwhelmed with suicidal ideation. Do you have a counsellor to talk to? You should have access via your Student Health Services, as part of your tuition.
Lar
Posted by ed_uk on December 3, 2004, at 12:08:28
In reply to Re: To the point where I don't mention suicidiality » linkadge, posted by Larry Hoover on December 3, 2004, at 11:57:47
..........after all, medication alone is rarely (if ever) adequate to bring about recovery in the absence of additional help......
Posted by linkadge on December 3, 2004, at 13:57:34
In reply to Re: To the point where I don't mention suicidiality » Larry Hoover, posted by ed_uk on December 3, 2004, at 12:08:28
They've labled me as bipolar and in this case, asking for a specific medication is never taken seriously in bipolar disorder.
Doctors always think bipolar individuals are up to something.
I tried counselling, but it just goes in circles. They ask whats wrong, I say I don't know.
They ask why you want to kill yourself, I say why would I not want to kill myself?
They ask if anthing has been on your mind recently, I say I don't know.
They ask why you can't concentrate, I say I don't know.
They ask if you look forward to anything,
I say yes, the day I die.They ask if I have any friends, I say no.
I just get irritated when people are around me, so I go to my room.They ask if there is any trouble at home, I say no.
They ask if I have any hobbies or anything I enjoy, I say no.
Then they get really, inventive. If they can't try and will me into living, they start making me feel guilty about wanting out. They say
"have you ever thought of the people you'd be hurting if you left this earth?"Thats just about when I've had enough. When they start making me feel guilty for being in the state I am in.
The only thing that works is sleep deprivation. When I don't sleep one night, I can actually say to myself "I want to live" But we all know that I can't go on like that forever.
Linkadge
Posted by linkadge on December 3, 2004, at 13:58:42
In reply to Re: To the point where I don't mention suicidiality » Larry Hoover, posted by ed_uk on December 3, 2004, at 12:08:28
I'm genetically programmed to kill myself. I am like a human lemming.
Linkadge
Posted by ed_uk on December 3, 2004, at 14:05:41
In reply to Re: To the point where I don't mention suicidiality, posted by linkadge on December 3, 2004, at 13:58:42
Hello,
'They ask if I have any hobbies or anything I enjoy, I say no.'
You seem to enjoy learning, especially about the brain.
I'm sure you will find an effective treatment in the future....... perhaps in the near future.
Ed.
Posted by linkadge on December 3, 2004, at 14:08:02
In reply to Re: To the point where I don't mention suicidiality, posted by linkadge on December 3, 2004, at 13:58:42
I don't think that people understand how primitive the brain really is.
It doesn't need tangable, logical, rational reasons to want to kill itself. Nothing really has to be wrong externally for things to go wrong internally. I know because, after one night of sleep deprivation, everything is normal again almost as quick as it takes to snap my fingers. Thats how I know its got nothing to do with some external factor I've been continually beating myself up over finding.
"Oh, but you've got to wait for things to kick in" - I've waited long enough. Like somebody in chonic pain, it doesn't just go away.
Linkadge
Posted by ed_uk on December 3, 2004, at 14:16:44
In reply to the worst part, posted by linkadge on December 3, 2004, at 14:08:02
Hi,
I remember when I was depressed and people tried to cheer me up it really didn't seem to help. Their efforts felt so superficial and lacking in impact.
It would make sense for you to do the sleep deprivation thing as often as you can. I know you can't do it every night though.
What treatment does your pdoc want you to try next. Does s/he have any suggestions?
Regards,
Ed.
Posted by linkadge on December 3, 2004, at 15:07:34
In reply to Re: the worst part, posted by ed_uk on December 3, 2004, at 14:16:44
Well when I increase the celexa, my mind races. I tell him this and so he takes it as futher evidence of my "bipoliarity" so he reduces the dose and I have a psychiatrist apointment in a month.
The idea that "if antidepressants agitate you or make you anxious = bipolar" is wrong.
Antidepressants don't calm everybody down and make them happy. They make me anxious, agitated, and worried. They're supposed to help you let things go, but the more I take the more my mind repeats things over and over.
Linkadge
Posted by cherylann on December 3, 2004, at 16:17:01
In reply to Re: To the point where I don't mention suicidiality » Larry Hoover, posted by ed_uk on December 3, 2004, at 12:08:28
Perhaps it's time for a new doctor?
The doc I see is always happy to hear my suggestions and my experience with alternatives. There must be others out there like that.
Like anything else, you gotta shop around.
Best wishes,
cherylann
Posted by simcha on December 3, 2004, at 16:49:11
In reply to To the point where I don't mention suicidiality, posted by linkadge on December 3, 2004, at 11:09:17
> It's come to the point where I don't even mention suicidiality when I go to the doctors office.
IMHO it might be time to start playing hard-ball with this doc. All psychologists/psychiatrists in Canada must belong to the College of Psychology in their Province. If you start mentioning that you might go to the College (which is their licensing board who WILL do disciplinary action if needed) with your complaints. There is such a thing as negligence and failing to listen to key symptoms of a client.
Start mentioning that if he does not believe your suicidality and you actually do the deed, he would be liable. I know that even in your country you can sue the doctor and that the doctor's license can be taken away.
I've seen doctors perk up when they realize just how educated clients are about their licensing and disciplinary actions.
Simcha
>
> They can't do anything, they also don't want to hear that after all this time they havn't made progress. They also just think I'm faking it, so I don't even bother to mention it anymore.
>
>
> Linkadge
Posted by linkadge on December 3, 2004, at 17:29:44
In reply to Re: To the point where I don't mention suicidiality » linkadge, posted by simcha on December 3, 2004, at 16:49:11
I come to the docotors because I've given up on life. Learned helplessness. I need help because I can no longer help myself. When people propose that I start doing all these things, I just don't have the energy. Its enought to make it out of bed and to the computer.
These guys need a patient or two to commit suicide just to let them know that they are dealing with real people and real emotions.
The problem is not that I'm not depressed, but that I react terrably to their antideressants.
Exercise helps my depression, does it make my mind race ? No. Sleep deprivation helps my depression, does it make me agitated ?? No.
Opiates help my depression, do they make my suicidiality increase? No. But yet somehow they think that because I don't react well to their SSRI's/SNRI's that I'm not really depressed.For once I'd like a docotor to say to me, yes you're depressed as hell, I don't know why, and I don't know why standard antidepressants don't help.
But, no because I don't respond properly, I can't really be depressed. Docotor's definition of depression these days is people who feel better when given an SSRI.
Linkadge
Posted by simcha on December 3, 2004, at 17:37:54
In reply to Re: To the point where I don't mention suicidiality, posted by linkadge on December 3, 2004, at 17:29:44
Linkadge,
My heart goes out for you. I'm fortunate in that my Major Depressive Disorder with Recurrent Features is in remission due to psychotherapy and proper pharmacological treatment. Apparently my type of depression is treatable.
It hurts to hear that there is no way that you can feel better. I hope that you have the energy to advocate for yourself in finding treatment where you are honored as the wonderful person you are. I know you are wonderful because I've been on this board for a few years with you and I can tell that you are intelligent, kind, and caring.
I wish it would be appropriate for you to fly down here to California so that I could be your therapist. It sounds like you need someone to REALLY listen to you and to take what you say seriously.
This is where the DSM falls short. My diagnosis and your diagnosis are probably similar, yet, my depression responds to the treatment I'm on currently. I would think that your depression is of a different quality. So it would be vital, in my opinion, to have a therapist who would see you as a unique individual and treat you as a unique individual rather than a DSM code.
Please stick around and stay with us. Things are developing every day for those of us with these conditions. I have hope that one day, you will find some answers.
Blessings, and Shalom,
Simcha
Posted by linkadge on December 3, 2004, at 17:45:40
In reply to Re: To the point where I don't mention suicidiality » linkadge, posted by simcha on December 3, 2004, at 17:37:54
Thats for your concern
Linkadge
Posted by jujube on December 3, 2004, at 18:34:56
In reply to Re: To the point where I don't mention suicidiality » simcha, posted by linkadge on December 3, 2004, at 17:45:40
Linkadge,
For what it is worth, at the end of August when I felt that I was having problems with being "heard" by the pdoc I had been seeing for medication, I called his office and asked his secretary how I could send an e-mail to him. In the e-mail, I laid out how I was feeling, how I felt the medication I had been prescribed was working and the options I wanted to pursue/discuss. He actually called me back the next day, discussed the options I had put forward, and called in a new prescription for me.
I guess what I am getting at is perhaps what you need to do is try to change the tone of your relationship with your current pdoc, and try to focus the pdoc on the fact that he/she works for you. As a first step, you could sit down at the computer and start working on a "paper" of sorts to present (either by e-mail in advance of your next appointment or hand it to doc at appointment) your current state of mind, what helps you to some degree (i.e., exercise, sleep deprivation), your understanding of why these things help you and your brain chemistry, how your current medication affects you (both positively and negatively, physically and mentally), what medication options you have become aware of through your own research, and how you want to proceed with your treatment. You are not a child, and this doctor needs to stop treating you like one. You need to be an active participant in your treatment, and feel like you are being heard. Putting your thoughts on paper or in an e-mail may help you focus the pdoc and may make the pdoc realize that you are serious about your treatment and that you expect to be listened to and taken seriously.
Just a thought.
Tamara
Posted by linkadge on December 3, 2004, at 19:58:13
In reply to Re: To the point where I don't mention suicidiality » linkadge, posted by jujube on December 3, 2004, at 18:34:56
Thanks for the advice.
Linkadge
Posted by Dr. Bob on December 3, 2004, at 23:32:43
In reply to Re: To the point where I don't mention suicidiality, posted by linkadge on December 3, 2004, at 17:29:44
> These guys need a patient or two to commit suicide just to let them know that they are dealing with real people and real emotions.
I'm sorry it's frustrating, but please don't suggest that anyone should harm themselves.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by SLS on December 4, 2004, at 7:53:36
In reply to To the point where I don't mention suicidiality, posted by linkadge on December 3, 2004, at 11:09:17
> It's come to the point where I don't even mention suicidiality when I go to the doctors office.
>
> They can't do anything, they also don't want to hear that after all this time they havn't made progress. They also just think I'm faking it, so I don't even bother to mention it anymore.
Hi Linkadge.If I were you, I would verbalize these concerns to your doctor. I have had to do this from time to time with my doctors in the past. Being ill with depression for so long, I have learned how to minimize its outward expression. I don't appear to be that ill. The other thing that might contribute to the underappreciation of the severity of your illness is the enormous amount of research and learning you have accomplished and the insight you display. A doctor might question how someone so severely affected by depression has the energy, motivation, and cognitive resources to accomplish so much. A doctor might even speculate that you are obsessively preoccupied with the neurobiology of mental illness and that you might be hypochondriacal. You should most surely express that you are worried that he might be thinking these things, and that you want to be clear as to what you are actually experiencing.
Your doctor will not treat you properly unless you talk to him.
- Scott
Posted by linkadge on December 4, 2004, at 10:44:43
In reply to Re: To the point where I don't mention suicidiality » linkadge, posted by SLS on December 4, 2004, at 7:53:36
Thats exactly it. It's in my chart that I know a great deal about medications. (Ie If I am asked to give a reason why I don't want to try remeron, I say the 2a/2c blocade makes me obsessive, and norepinephrine meds make me irritable)
They've got me labled as a hypochondriacal drug seeker. And that sticks! (Its in my chart which gets passed from doctor to doctor) And doctor shopping only makes it worse! You leave one doctor the chance is that the next one is going to think you are a drug seeker gets more likely.
And being young also strikes against me. All the old psychiatrtists I see are still harbouring false ideas that a young person can't really be depressed (and treatment resistant none the less)
No, no, it's all just too fishey for them. They write me off.
The last psychiatrist I went to, I waited 6 months suicidally for this (7min) aptment! I begged in the office to let me try Nardil, he asked me one question, "how's your sex life?" and then said he only prescribed SSRI's.
I've never felt more hopless in my life. I'm young, I'm suicidal, I have no money, I have to wait half a year to see a psychiatrist (who doesn't believe a word I say), sends down a dead end path, that I've been down before.
I just can't take it. Time is the one thing that a depressed person doesn't have.
Or, more aptly put, I just don't care anymore.
Linkadge
Posted by SLS on December 4, 2004, at 12:22:22
In reply to Wow you've hit the nail on the head, posted by linkadge on December 4, 2004, at 10:44:43
> I've never felt more hopless in my life. I'm young, I'm suicidal, I have no money, I have to wait half a year to see a psychiatrist (who doesn't believe a word I say), sends down a dead end path, that I've been down before.
>
> I just can't take it. Time is the one thing that a depressed person doesn't have.
>
> Or, more aptly put, I just don't care anymore.
Hang in there, Linkadge.I am confident that you will get to where you want to go. Just not tomorrow.
- Scott
Posted by Emme on December 4, 2004, at 13:31:14
In reply to To the point where I don't mention suicidiality, posted by linkadge on December 3, 2004, at 11:09:17
I know you had some reservations about continued use of your homemade rTMS contraption, but have you considered using it a bit now as a stopgap measure? If I recall correctly, it helped you feel better. I hope you get some relief.
em
Posted by linkadge on December 5, 2004, at 11:08:10
In reply to Your TMS machine...? » linkadge, posted by Emme on December 4, 2004, at 13:31:14
I'm thinking about a booster rTMS, but I really do believe that it has caused some neurotoxicity.
I have never been as profoundly, and hoplessly depressed since the effect has worn off.
It is almost as if, after being activated by the RTMS machiene, certain brain cells just won't activate under their own valition.
Linkadge
This is the end of the thread.
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