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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 28. This is the beginning of the thread.
Posted by linkadge on April 27, 2006, at 16:22:00
Does anyone ever feel that their medications are making them functionally better, Ie, they can go back to work etc, but that they do not actually feel better, or that they would never really report actually feeling much better?
I'm just wondering how common that is. I may need to return to some medications, but I am thinking that I cant really remember feeling all that much better on them.
Linkadge
Posted by zeugma on April 27, 2006, at 16:38:54
In reply to Functionally better vs. Actually better, posted by linkadge on April 27, 2006, at 16:22:00
for some thoughts that touch on this problem, look at this site: http://www.psychotropical.com/
for whatever reason, some of the most interesting research on antidepressants seems to be coming from Australasia.
my own opinion is that I don't always know the difference between being functionally better and actually being better, and maybe I never do. The only thing I know is that one can be functionally better relative say to the size of your paycheck, or relative say to your ability to wake up at a reasonable hour, or relative to your ability to stay awake long enough to eat a meal. These are all in my opinion valid functional criteria. But obviously some here may find them trivial, or conversely find them a distant dream.
And maybe being able to say, earn a larger paycheck means you are actually better (it depends on your values). The one thing I know for absolutely certain is that there is no such thing as being better than well.
-z
Posted by Crazy Horse on April 27, 2006, at 16:45:13
In reply to Functionally better vs. Actually better, posted by linkadge on April 27, 2006, at 16:22:00
> Does anyone ever feel that their medications are making them functionally better, Ie, they can go back to work etc, but that they do not actually feel better, or that they would never really report actually feeling much better?
>For me it is both. Parnate definitely makes me feel better, and yes i am functionally improved as well. To be totally honest though, after 25 years of this sh*t i don't trust any medications. I'm just trying to enjoy one day at a time, because i know or at least fear that this could end any day..nothing has ever had a lasting effect on me. I hope this is different, but realistically i have my doubts.
Monte
Posted by linkadge on April 27, 2006, at 16:59:56
In reply to Re: Functionally better vs. Actually better » linkadge, posted by zeugma on April 27, 2006, at 16:38:54
For "actually better", I suppose the question would be "do you feel better?"
Sure, some drugs got me back to doing what I do, but I would never actually tell anyone, I feel ok. Kindof like the drugs were just strings pulling me around like a marionette dall.
Linkadge
Posted by Glydin on April 27, 2006, at 17:19:56
In reply to Re: Functionally better vs. Actually better » linkadge, posted by Crazy Horse on April 27, 2006, at 16:45:13
Mine is also both.
Motivation and drive were a problem for me and staying on tasks and keeping to responsibilities was a problem. Feeling sad, anxious, panic, agoraphobic and irritable was awful in addition to accomplishing NOTHING. The best change I have seen is the ability to accomplish those tasks and have a level of contentment with my life. There has also been a huge change in outlook overall.
I think it's very individualistic how people measure wellness and wellbeing. For some, I think one improved trait can be the starting point for another.
Functional and miserable is possible but I would not see that as feeling better. I need both for a decent quality of life and I have, gratefully, achieved that for now and that change happened with my AD.
I hope you find a workable treatment for you, Link.
Posted by UgottaHaveHOPE on April 27, 2006, at 17:26:45
In reply to Re: Functionally better vs. Actually better, posted by Glydin on April 27, 2006, at 17:19:56
How long have yoou been on Parnate and what do you take it for? What does it do for you?
Posted by bassman on April 27, 2006, at 18:11:42
In reply to Functionally better vs. Actually better, posted by linkadge on April 27, 2006, at 16:22:00
I have Panic disorder and when I was on Paxil and Xanax, I went from a 24-hour a day nightmare to feeling self confident and probably faced some of the biggest changes of my life without being scared silly.
Now I'm taking Wellbutrin, Prozac, and Klonopin and spend a lot of time feeling fearful/depressed, but I am just as functional. So I do know what you mean about the difference.
Which, of course, asks the question, "what is feeling well enough?" when it comes to meds. At least functional, IMO.
Posted by blueberry on April 27, 2006, at 18:19:46
In reply to Functionally better vs. Actually better, posted by linkadge on April 27, 2006, at 16:22:00
I've been both functionally better and actually better at different times.
Paxil or zoloft or remeron...functionally better but not well.
Lexapro...not functionally well or actually well.
Prozac...functionally better and closer to well, but still not there.
Prozac zyprexa combination...functionally much better and very close to actually well. Lasted almost 5 years.
Prozac zyprexa st johns wort combination...95% completely well. Awesome. The metabolic effects of sjw screwed up the other meds and I just couldn't retain the good effects. Lost it.
All kinds of add-ons like lamictal, depakote, pindolol, buspar, etc...not help at all, or very short lasting help.
Zyprexa mini-dose cymbalta xanax combo...functionally totally well and nearly actually well...but only did it for 4 days in an emergenecy, doubt it would have kept up.
When I read about the 32% to 44% of people in clinical trials that reached remission, I have to ask myself, where are they?
Posted by linkadge on April 27, 2006, at 19:41:56
In reply to Re: Functionally better vs. Actually better, posted by bassman on April 27, 2006, at 18:11:42
I guess I feel that life should be about oneself too. Theres a difference between having to do things, and being able to find some enjoyment in doing things.
So I may be functionally better, ie eating/sleeping working, but still really feel miserable on the inside.
Its like my doctor always asks questions like, "are you sleeping ok", not, "are you suicidal".
Linkadge
Posted by SLS on April 27, 2006, at 19:59:25
In reply to Functionally better vs. Actually better, posted by linkadge on April 27, 2006, at 16:22:00
> Does anyone ever feel that their medications are making them functionally better, Ie, they can go back to work etc, but that they do not actually feel better, or that they would never really report actually feeling much better?
Sounds like residual anhedonia or dysphoria.
Parnate treats me that way. It gives me more mental and physical energy to function better, but not much else. On the other hand, when it works for me, Nardil increases my sense of wellbeing and allows me to experience reward.
A friend of mine found that Wellbutrin alone helped with energy, but left her feeling empty and unmotivated. Adding Effexor brought her the motivation and desire to do things and enjoy her activities. She later switched from Effexor to Lexapro. She likes the Lexapro better.
- Scott
Posted by Phillipa on April 27, 2006, at 20:21:11
In reply to Re: Functionally better vs. Actually better, posted by SLS on April 27, 2006, at 19:59:25
Link what were you on last summer we E-mailed a lot and you seemed to be doing well. Love Phillipa
Posted by Caedmon on April 28, 2006, at 0:40:42
In reply to Re: Functionally better vs. Actually better, posted by Phillipa on April 27, 2006, at 20:21:11
Interestingly, I have experienced the opposite: "feeling" better but actually functioning worse. SSRIs tend to do this. I feel less depressed, it's true: but I also stop socializing, caring about myself and others, etc. So functionally I take a crash dive. I've found that non-SSRI AD's work better in that regard.
- C
Posted by bassman on April 28, 2006, at 5:18:12
In reply to Re: Functionally better vs. Actually better » bassman, posted by linkadge on April 27, 2006, at 19:41:56
I don't think any of us are asking to sing a song from the Sound of Music every morning; sometimes it bothers me that once in awhile (God, not right now) I'll have a 15-30 minute period of "happiness"...and then I read that 70% of Americans feel they are that way most of the time (?) The emotional feeling of meaning or content adds so much more to just working, eating, sleeping, etc. I know I've had the those feelings in the past.
Good topic, Link.
Posted by Crazy Horse on April 28, 2006, at 9:02:41
In reply to Re: Crazy Horse, posted by UgottaHaveHOPE on April 27, 2006, at 17:26:45
> How long have yoou been on Parnate and what do you take it for? What does it do for you?
I've been one Parnate for just about 3 months now. My diagnosis is chronic major depression w/some atypical features, GAD, Social phobia and OCD (no rituals). Parnate helps with all of these for me. My Depression is relieved at this time, i'm not anxious, and ocd and sp are not reaking havic at this time. I feel pretty good most of the time. The insomnia is the biggest problem for me. Just hope it lasts(the good effects)..don't mean to be negative, but meds usually don't keep their effectiveness for me...or for most everyone for that matter.
Monte
Posted by UgottaHaveHope on April 28, 2006, at 10:39:14
In reply to Re: Crazy Horse » UgottaHaveHOPE, posted by Crazy Horse on April 28, 2006, at 9:02:41
Do you mind sharing your whole story? I think I may have some things in common, and I would love to hear what all you have experienced, if you dont mind that is. Thanks.
Posted by naughtypuppy on April 28, 2006, at 12:22:30
In reply to Functionally better vs. Actually better, posted by linkadge on April 27, 2006, at 16:22:00
I think a lot of pdocs and researchers confuse a lack of negative symptoms with remission. Can't we all atest to meds that cause apathy and lack of motivation. It's like a cognitive deadening of youre emotions. You can go on with life because youre not as upset as before, but it's just because you are dead to the world. I hope that makes sense.
Posted by linkadge on April 28, 2006, at 12:39:54
In reply to Re: Functionally better vs. Actually better, posted by naughtypuppy on April 28, 2006, at 12:22:30
I just remember some of my responces to drugs. I guess people just assumed that when I started to resume "normal behvior", that I was actually feeling better. Nobody ever asked me, are you feeling better? It was always, "how are you sleeping etc". Sometimes I wondered exactly what it was that I was being treated for. Am I just taking pep pills?
Linkadge
Posted by bassman on April 28, 2006, at 12:51:47
In reply to Re: Functionally better vs. Actually better, posted by naughtypuppy on April 28, 2006, at 12:22:30
Makes perfect sense. It would be like if you were under anesthesia, you wouldn't be anxious...but you wouldn't be aware, either. I sometimes wonder if depression and anxiety are being TOO realistic about life, and having it scare/sadden you until it takes over your life...
Posted by linkadge on April 28, 2006, at 13:00:39
In reply to Re: Functionally better vs. Actually better, posted by bassman on April 28, 2006, at 12:51:47
Yeah, reality can be depressing. I often find myself lured by the whole chemical imballence thing because it gives me a more positive way to frame my problems. In reality, life could very well just suck.
Linkadge
Posted by Jay on April 28, 2006, at 13:13:34
In reply to Functionally better vs. Actually better, posted by linkadge on April 27, 2006, at 16:22:00
> Does anyone ever feel that their medications are making them functionally better, Ie, they can go back to work etc, but that they do not actually feel better, or that they would never really report actually feeling much better?
>
> I'm just wondering how common that is. I may need to return to some medications, but I am thinking that I cant really remember feeling all that much better on them.
>
>
> LinkadgeYes Linkadge, I do remember being on a great combo of meds that not only made me 'functional', but I would say 'normally' content and happy. The reason I think many fail with a med or two, is because their doctors don't give them access to the most variety of combinations of drugs. Like, two a.p.'s..two a.d.'s...a mood stabalizer plus a benzo plus a stim...all of the above at once. As you know, the single or even double...or even TRIPLE monoamine uptake theory is really child's play. You want to hit the right number of various receptor sites, as far and wide as can do, then start to close down and use deductive logic. This also means the monoamine pathways in the brain get shifted around, reconditioned, in a safe but powerful way a single or dual med couldn't do. Add in vitamins, exersize, journaling, doing something creative, and you have a great success of what the combo of polypharmacy(mostly) and (helps maintain)non-drug treatments can do. I am living proof (knock on wood..heh..)..and I will take up the fight anyday with any psychiatrist about the issue. We just *don't* treat mental illness aggressively enough!
Jay
Posted by Crazy Horse on April 28, 2006, at 14:10:55
In reply to Re: Crazy Horse, posted by UgottaHaveHope on April 28, 2006, at 10:39:14
> Do you mind sharing your whole story? I think I may have some things in common, and I would love to hear what all you have experienced, if you dont mind that is. Thanks.
No problem. Please read my Thread from April 15th entitled: "Unfortunately, I am a Lifer." This is pretty much my story. If you have any further questions don't hesitate to ask, i don't mind at all. :)
Please share your story with me as well. Have a good day.
Monte
Posted by ed_uk on April 28, 2006, at 14:48:35
In reply to Re: Functionally better vs. Actually better, posted by Caedmon on April 28, 2006, at 0:40:42
>Interestingly, I have experienced the opposite: "feeling" better but actually functioning worse. SSRIs tend to do this. I feel less depressed, it's true: but I also stop socializing, caring about myself and others, etc. So functionally I take a crash dive. I've found that non-SSRI AD's work better in that regard.
That's just what I was going to say Caedmon!
Ed
Posted by linkadge on April 28, 2006, at 15:31:35
In reply to Re: Functionally better vs. Actually better » Caedmon, posted by ed_uk on April 28, 2006, at 14:48:35
One of the best combinations I took was actually lithium and ritalin. I don't know if a doctor would prescribe that again, seems like a longshot.
Linkadge
Posted by zeugma on April 28, 2006, at 15:37:50
In reply to Re: Functionally better vs. Actually better, posted by linkadge on April 28, 2006, at 15:31:35
> One of the best combinations I took was actually lithium and ritalin. I don't know if a doctor would prescribe that again, seems like a longshot.>>
why? because it worked???
-z
>
> Linkadge
Posted by linkadge on April 28, 2006, at 18:49:01
In reply to Re: Functionally better vs. Actually better » linkadge, posted by zeugma on April 28, 2006, at 15:37:50
Yeah, doctors have something against using stimulants to treat depression. Not sure whats up with it.
Linkadge
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