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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by therock on March 17, 2008, at 12:34:41
I am seeing my pdoc on 4/1. All neuroleptics make me worse, SSRI's make me a little loopy and benzo's work but not "enough." Lamictal, Depakote & Trileptal all helped a tiny bit but also not enough.
Noone knows what my issue is. Some doctors say its anxiety, some say anxiety and depression. My diagnosis is atpyical mood disorder.
my pdoc basically knows that I react weirdly to most medications (been on a lot more than i listed above) and he tells me that my greatest hope for recovery is via long term therapy. either way, i need something to help me with anxiety like now.
thanks.
Posted by Phillipa on March 17, 2008, at 13:00:11
In reply to What med should I ask my doctor for?, posted by therock on March 17, 2008, at 12:34:41
Know the feeling a benzo used to work for me. Maybe someone has a better suggestion. Phillipa
Posted by Polarbear206 on March 17, 2008, at 13:19:52
In reply to What med should I ask my doctor for?, posted by therock on March 17, 2008, at 12:34:41
can you explain more in detail your symptoms. Age of onset, family history, sleep patterns, etc... Have you tried any SNRI's besides the SSRI's? How much lamictal did you take and was it in combination with an AD?
Posted by therock on March 17, 2008, at 14:09:23
In reply to Re: What med should I ask my doctor for?, posted by Polarbear206 on March 17, 2008, at 13:19:52
mostly chest pain, heart palpiations, derealization, deprsonalization. age onest was 21. was always anxious as a kid but managed it. smoked pot from ages 15-21 daily. tried LSD. then symptoms appeared. was panic stricken, thought i fried my brain.
today, cant focus, always thinking "something is wrong, something is wrong." its kind of like ocd/panic. many doctors have said there is nothing wrong and i believe them in sense but still am parnaoid often.
Posted by amyaub on March 17, 2008, at 15:30:09
In reply to Re: What med should I ask my doctor for?)polarbea, posted by therock on March 17, 2008, at 14:09:23
Not a doctor obviously, but could it be panic attacks? I feel like that when I have a panic attack. For me at least, I find it to be a bit different from an anxiety attack in that instead of just being in my head (anxiety) it actually affects my body (panic). I went to the ER one night thinking I was having a heart attack.
I found Klonopin if taken at the first sight of the anxiety growing often helps me. Havent' had an attack in quite some time. Thankfully.
Posted by amyaub on March 17, 2008, at 15:35:13
In reply to Re: What med should I ask my doctor for?)polarbea, posted by amyaub on March 17, 2008, at 15:30:09
oops last post meant for therock (nm)
Posted by Sigismund on March 18, 2008, at 17:00:12
In reply to Re: What med should I ask my doctor for?)polarbea, posted by therock on March 17, 2008, at 14:09:23
>today, cant focus, always thinking "something is wrong, something is wrong." its kind of like ocd/panic. many doctors have said there is nothing wrong and i believe them in sense but still am parnaoid often.
So there is the feeling that something is wrong?
But when you ask yourself what it is that is wrong you can get no answer?
It might not be such a wrong thought.
As for focus, I never found anything to help with that.
Posted by therock on March 18, 2008, at 17:03:46
In reply to Re: What med should I ask my doctor for? » therock, posted by Sigismund on March 18, 2008, at 17:00:12
i do get an answer. the answer is "i am damaged. there is something wrong with me. i did too many drugs (smoked pot for several years). drugs damaged me." that is the answer i get but if i ask what is wrong, nothing happens and then when i connect with the emotion, that is what comes out.
i have been told by many therapists that nothing is wrong and nothing is broken. i just dont know.
Posted by Sigismund on March 18, 2008, at 17:38:29
In reply to Re: What med should I ask my doctor for?))sig, posted by therock on March 18, 2008, at 17:03:46
> have been told by many therapists that nothing is wrong and nothing is broken.
Self evidently, something is wrong.
You will never know for sure whether it was the drugs or not.
In any case, apart from giving you something to regret, nothing in the way of treatment really follows from it if it was the drugs.
It is in the nature of depersonalisation that there is a lot of rumination.
If that book I posted a link to is right, and there is currently no pharmacological treatment for depersonalisation, as opposed to treating the depression and/or anxiety resulting or causative......what then?
Oddly enough, I think the initial (very initial!) effect of amphetamine is against depersonalisation. IMO, benzos make it worse.
Posted by therock on March 18, 2008, at 17:57:12
In reply to Re: What med should I ask my doctor for? » therock, posted by Sigismund on March 18, 2008, at 17:38:29
good question. so what then? any ideas?
Posted by Phillipa on March 18, 2008, at 19:24:57
In reply to Re: What med should I ask my doctor for?))sig, posted by therock on March 18, 2008, at 17:57:12
No idea at all. Phillipa
Posted by Sigismund on March 18, 2008, at 19:55:59
In reply to Re: What med should I ask my doctor for?))sig, posted by therock on March 18, 2008, at 17:57:12
No pharmacological ones.
What about Provigil?
Maybe you mentioned that?
Posted by undopaminergic on March 19, 2008, at 17:41:25
In reply to Re: What med should I ask my doctor for? » therock, posted by Sigismund on March 18, 2008, at 17:38:29
> It is in the nature of depersonalisation that there is a lot of rumination.
Really? When I'm particularly depersonalised, there's just pure apathy - a vacant, unfocussed stare at nothing in particular and thinking about nothing at all. Indeed, it's one of the few times there's nothing on my mind.
However, it may well be that I have a different idea of depersonalisation/derealisation, because the state of being disengaged, absent-minded, detached, and out of touch with reality and everything but abstract thought is the only state of existence I'm familiar with. This is in contrast to the temporary "attacks" or episodes of depersonalisation that most people seem to be referring to.
> Oddly enough, I think the initial (very initial!) effect of amphetamine is against depersonalisation.
My experience would seem to confirm that. The first time I took PEA, I was, perhaps for the first time in life (or at least over a decade), entirely present in - and focussed on - the external reality and the present moment rather on the internal thoughts and abstractions that usually preoccupy me. That reality was a most amazing and "unreal" experience to me, and I wondered if that's how "normal" people live their lives. Is it?
As for amphetamines - or stimulants in general, they seem to be highly neglected as treatment options for anxiety disorders, but it's my definite experience that methylphenidate does a lot more to relieve anxiety and instill confidence than sertraline or midazolam do.
Posted by Sigismund on March 20, 2008, at 1:44:14
In reply to Re: What med should I ask my doctor for?, posted by undopaminergic on March 19, 2008, at 17:41:25
>When I'm particularly depersonalised, there's just pure apathy - a vacant, unfocussed stare at nothing in particular and thinking about nothing at all. Indeed, it's one of the few times there's nothing on my mind.
However, it may well be that I have a different idea of depersonalisation/derealisation, because the state of being disengaged, absent-minded, detached, and out of touch with reality and everything but abstract thought is the only state of existence I'm familiar with. This is in contrast to the temporary "attacks" or episodes of depersonalisation that most people seem to be referring toI was walking through Woolworths today having a conversation with myself about this conversation I hope to have with you, and I missed not only the meat but also the milk.
My life for 50 years has been conversations about conversations.
30 years ago, when my mind was still sharp, this was a problem.My idea of depersonalisation (derived from "Feeling Unreal") may be different to yours.
You described it as vacant apathy (at its extreme).
My idea was more about going through the motions of life but with a sense of inner paralysis and alarm.Has your experience with PEA been positive long term?
My doctor advised that I take low dose deprenyl and eat lots of good dark chocolate.
Posted by undopaminergic on March 20, 2008, at 22:27:01
In reply to Re: What med should I ask my doctor for? » undopaminergic, posted by Sigismund on March 20, 2008, at 1:44:14
> I was walking through Woolworths today having a conversation with myself about this conversation I hope to have with you, and I missed not only the meat but also the milk.
> My life for 50 years has been conversations about conversations.Oh, I see. I do this kind of mental simulations of anticipated dialogues and events as well, and indeed, at times they take priority over less interesting activities such as driving, that are instead delegated to the autopilot, which does a good job most of the time, but sometimes misses details like old men crossing the street.
>
> My idea of depersonalisation (derived from "Feeling Unreal") may be different to yours.
> You described it as vacant apathy (at its extreme).Here's a good description of the extreme:
http://books-and-coffee.theglancetts.com/?page_id=142
(see "depersonalised schizoid")Fortunately, I rarely decline to that level.
> My idea was more about going through the motions of life but with a sense of inner paralysis and alarm.
I'm not sure I'm following.
> Has your experience with PEA been positive long term?
Not really positive, but certainly educative in several ways. My summary of long-term use is that it feels a lot better than it is. The good thing is that no matter how miserable and lethargic I felt, PEA (oral) would fix it every time in 15 minutes or less - nothing else has been so predictable and reliable. I quit it due to the almost total lack of results: PEA didn't produce long-term (or short-term, to a lesser extent) rational behaviour. It didn't help me achieve any goals, although it gave me the energy and stubborn determination to keep trying, and for longer than I'd like to admit, it kept me from noticing the futility of the situation, because it kept my spirits up. One day, while not being high on PEA and thus not feeling very well, the truth dawned on me and I decided not to take any more of it. That's one of the few times that my dopamine-deficiency - the anhedonia and lack of motivation - has been useful - it makes it so easy *not* to do things (such as take another dose of a drug) - a normal, healthy person wouldn't have been able to resist the temptation, which is what they call addiction.
I think that's a good real-world example of what is called perseveration in the litterature on (mostly) animal experiments. If it's not working, it's time to try something else - not harder.
Posted by Sigismund on March 21, 2008, at 3:56:09
In reply to Re: What med should I ask my doctor for?, posted by undopaminergic on March 20, 2008, at 22:27:01
Maybe the 'affectiveless schizoid' is Aspergers?
>a defect in the ability to understand the meaning of human communication. In contrast, the affectless variant combines the apathy of the schizoid with the emotional constriction and the formality of the compulsive, effectively eliminating all emotion expression. Like compulsives, they find structred settings comfortable and are more likely to be effective in adult roles than the basic schizoid pattern. But like schizoids, they express the basic conflict of the basic compulsive, autonomy versus obidience, only weakly if at
If I may so remark, these people do not know how to spell 'obedience'.
Depersonalised schizoid? It *sounds* like a very good thing.
>as if they were contemplating some peaceful vision that draws them more and more away from the existence of the mundane world. Like all the schizoids, they are extremely inattentive and disengage from the affairs of life. More than most, however, depersonalized schizoids have deteriorated into obliviousness. Although they appear preoccupied internally with something substantive, they are in fact preoccupied with nothing at all.
This is the end of the thread.
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