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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by ed_uk on May 15, 2005, at 11:21:31
Hi,
I am very avoidant.... if there is anything that I don't want to do, anything which I will find broring, anything which will cause anxiety etc.... I will not do it. I will put it off, I will procrastinate... it will never get done... ever. SSRIs seem to increase this avoidance.
Has anyone found that their avoidance was decreased by medication? If so, which medication was effective and what sort of avoidance is a problem for you.
Perhaps I'm expecting too much. I guess I'm just inadequate.
Ed.
PS. An unrelated bit of info....... I'm having ectopic beats every few seconds. I guess they're probably PACs. I'm going to the doc on Monday.
Posted by Nickengland on May 15, 2005, at 11:32:51
In reply to Million dollar question, posted by ed_uk on May 15, 2005, at 11:21:31
Hi Ed : )
I found my avoidance greatly increased when I tried SSRI's years ago - cipramil and prozac
Have you ever tried a low dose mood stabiliser/anti-convulsant?
From experience ssri's dont seems to work long-term, but with anti-convulsants there doesn't seem to be a poop out (if you disregard gabapentin and lamotrigine)
Kind regards
Nick
Posted by ed_uk on May 15, 2005, at 12:47:47
In reply to Re: Million dollar question, posted by Nickengland on May 15, 2005, at 11:32:51
Hi Nick!
>Have you ever tried a low dose mood stabiliser/anti-convulsant?
No.... I don't think they'd be effective for my symptoms.
Kind regards,
Ed.
Posted by The Resistance on May 15, 2005, at 13:07:36
In reply to Re: Million dollar question » Nickengland, posted by ed_uk on May 15, 2005, at 12:47:47
Hey Ed
I know what you mean about avoidance, I've just spent my one day off work sitting around.
Theres so much I could be doing!Dexedrine deffinetly made me less aviody (is that a word :) at the right dosage.
To much just made me anxiousI know that stimulants are a real tease, because its all but impossible to get them prescribed in the UK!
Posted by Racer on May 15, 2005, at 13:16:48
In reply to Million dollar question, posted by ed_uk on May 15, 2005, at 11:21:31
:^P
Seriously, though, the best I ever found for it was a combo of Effexor XR 225 and Prozac 10mg. The problem with that was that the anti-avoidance effects wore off after the first few months and never came back.
Second to that, Provigil seemed to help, when I took it alone, and it brightened my mood more than a little. Not quite enough to work on its own.
Cymbalta is a real drag for me, although maybe that's improving -- new med change yesterday, and yesterday it wasn't quite as bad, but necessity is a real taskmistress: my aunt is coming to criticize me on Monday, and the house is a mess. Something MUST happen today, or I will have to go sleep in the car so that I don't have to hear it.
Wellbutrin might give me the energy to do some of those things, but it also adds to the restlessness that interferes with getting it done...
I know all the steps and all the variations on the AvoiDance, but I can't tell you how to stop dancing. The only thing I can tell you from my own experience is that there's a sort of a vicious circle -- well, a kind circle? -- where if I feel better, I'll get something done that helps me feel even better and then I'll get more done. That cycle helps break me out of a pattern of avoidance, but when the things that I'm avoiding are impossible -- which, realistically, they sometimes are -- that saps my strength even more, and I start the AvoiDance again...
Ha. Not so helpful, huh? But it's well meant, and I hope you find an answer -- and pass it on to me...
Posted by ed_uk on May 15, 2005, at 13:41:44
In reply to I get a lot of exercise AvoiDancing... » ed_uk, posted by Racer on May 15, 2005, at 13:16:48
Hi Racer!
>I know all the steps and all the variations on the AvoiDance, but I can't tell you how to stop dancing.
LOL.... that's good! Perhaps I should take up dancing. The exercise might boost my energy!
Ed xx
Posted by ed_uk on May 15, 2005, at 13:42:31
In reply to Re: Million dollar question, posted by The Resistance on May 15, 2005, at 13:07:36
Hi!
>I know that stimulants are a real tease, because its all but impossible to get them prescribed in the UK!
Tell me about it!
Kind regards,
Ed.
Posted by Ritch on May 15, 2005, at 16:09:43
In reply to Million dollar question, posted by ed_uk on May 15, 2005, at 11:21:31
> I am very avoidant.... if there is anything that I don't want to do, anything which I will find broring, anything which will cause anxiety etc.... I will not do it. I will put it off, I will procrastinate... it will never get done... ever...Ed, that's an interesting complexity of two different issues. One would be avoidance of everyday tasks that have to get done (sooner or later), which could be explained by ADD or depressive stuff. A lack of interest thing.. or inability to focus thing/followthrough issue. The other is avoidance of anxiety-provoking situations. I've got a mix of both a lot of times.. no interest or motivation and worry that I won't get something *perfect* (I'll botch it up). SSRi's have helped in the past by making me not *care* whether I botch something up or not and "thaws" my thinking allowing it to flow and multi-task, but they tend to make me buzzy and over-activated. I'd say probably the best combo I've tried was Effexor+Adderall .. gabapentin+dexedrine worked pretty good too.
Posted by linkadge on May 15, 2005, at 19:51:06
In reply to Re: Million dollar question » ed_uk, posted by Ritch on May 15, 2005, at 16:09:43
The only medications that have helped my avoidance are the ones that make me too dumb to complete what I am avoiding.
Ie, clomipramine helped me at least sit down and look at work I was afraid of, but when I did sit down It took 10 times longer to understand it.
Ie they reduced the dopamine and made me less fearfull, but at the same time the reduced dopamine made me dumb.
So all in all no gain.
Linkadge
Posted by stresser on May 15, 2005, at 20:33:21
In reply to Re: Million dollar question, posted by linkadge on May 15, 2005, at 19:51:06
Wellbutrin, Wellbutrin, Wellbutrin...I really can't say anything good about that medication alone, or with a mood stablizer for me. Topamax, Zoloft, and Adderall XR are working very well at the moment to keep me from putting off everything I have put off, since before taking the combo. I have actually started get my life together, and stop watching it go by. I just hope it can stay that way. -L
Posted by Phillipa on May 15, 2005, at 21:24:47
In reply to Re: Million dollar question, posted by stresser on May 15, 2005, at 20:33:21
Ed, I wish there was a drug. I say "just do it". I force myself to do it even though I'm scared and my heartrate is very high. This includes even going to the gym. I have to give that fair on Saturday, and I wake up every morning after having real nightmares about not doing it good or fast enough. I sympathize with you. Fondly, PJ O
Posted by FredPotter on May 15, 2005, at 23:30:10
In reply to I get a lot of exercise AvoiDancing... » ed_uk, posted by Racer on May 15, 2005, at 13:16:48
Spot-on racer. I'm on Cipramil (Celexa). I often wondered if it was the cause. People make me come to life I've found though, but not at parties, I mean being part of a common effort. And as you say, once something starts the ball rolling you feel better and that makes one do more. I guess it's about inertia and momentum
Fred
Posted by pro_social_soon on May 15, 2005, at 23:56:20
In reply to Million dollar question, posted by ed_uk on May 15, 2005, at 11:21:31
> Has anyone found that their avoidance was decreased by medication? If so, which medication was effective and what sort of avoidance is a problem for you.
What worked for my avoidance?Tramadol (only from time to time)
Amphetamine (also from time to time)
GHB (always)
Xanax (tolerance went way up VERY FAST)
Posted by banga on May 16, 2005, at 10:08:41
In reply to Re: Million dollar question » ed_uk, posted by pro_social_soon on May 15, 2005, at 23:56:20
Hi Ed!!
I am so sorry you are having such a tough time.
Avoidance is also the bane of my life. It is awful--if it is not my apathy, it is most commonly because I get tired that every single thing--big or little--washing a dish or writing a dissertation--it all means fighting irrational fear. You get so tired saying "feel the fear and do it anyways." Lately I have lived by "feel the fear and RUN AWAY!" As someone said, sometimes doing something small can help the intertia.The atypicals (ziprasidone and Abilify) helped initially with this *immensely*--I almost felt driven to get things done! but it did fade with time. However the 2-month jump-start helped get out of a rut. With all other meds, specifically SSRIs- it is difficult to say if they made avoidance worse for me.
Cognitive-behavioral therapy is often worth trying....helps you reset your perspective on events and tasks.....
Hang in there,
Banga
Posted by FredPotter on May 16, 2005, at 21:48:37
In reply to Re: Million dollar question, posted by banga on May 16, 2005, at 10:08:41
I've suspected this might be so. Apathy to some degree is a normal human experience. So what do people feel? Does prolonged SSRI use aggravate this trait?
Posted by ixus on May 18, 2005, at 1:42:02
In reply to Million dollar question, posted by ed_uk on May 15, 2005, at 11:21:31
> Hi,
>
> I am very avoidant.... if there is anything that I don't want to do, anything which I will find broring, anything which will cause anxiety etc.... I will not do it. I will put it off, I will procrastinate... it will never get done... ever. SSRIs seem to increase this avoidance.
>
> Has anyone found that their avoidance was decreased by medication?Hi Ed,
I think Nardil is a gold standard for avoidant personality.
/ixus
Posted by ixus on May 18, 2005, at 1:46:20
In reply to Million dollar question, posted by ed_uk on May 15, 2005, at 11:21:31
Hi again,
maybe you will find it useful:http://www.acnp.org/G4/GN401000152/CH148.html
/ixus
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