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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Sophronia on April 10, 2008, at 21:20:02
Hi folks:
Its been awhile since I've here but in the last 6 months I've taken a huge depressive nose-dive. Meds I'm currently on:
Lamictal, 100mg
Zoloft, 50mg
Trileptal, 1200mg
Trazodone, 50mg
Clonapin, 1mg
Zyprexa is being replaced with Abilify (currently on 2.5mg of Z. and 2mg of A)I just keep getting more and more depressed and am having anxiety attacks. I'm wondering if I need to go into a hospital; don't want to but I'm a bit scared by how lost I feel. Pdoc is, of course, trying everything to keep me out of hospital, including seeing me a couple times of week and now she wants me to see a therapist a couple times of week. I just started to see a "dialectal behavior therapist" at pdoc's suggestion; the shrink I saw for years--I don't know what happened but things turned bad in the fall and trying to fix things just made them worse. I've called him to see him--though he doesn't have a regular time for me and definitely can't see me twice a week. the new "dbt" person isn't sure she can help me....
I don't know...does anyone here have any encouragement or insight to give me? I've never been in a hospital before. My pdoc has told me where to go if I end up wanting to check myself in--it is a place that is very pro-active and she feels confident it is the best place to go in the city where I live. Part of me wants to let go and check myself in; part of me is scared I'll lose a part of myself if I do that.
I know you all can't make my decision for me. Or even really give me advice. But if you are willing to talk about your experiences, I'm looking to listen to them.
Sophie
Posted by Phillipa on April 10, 2008, at 21:38:31
In reply to CrossPost--Complex Med/Hospital Querie, posted by Sophronia on April 10, 2008, at 21:20:02
Hi S I'm so sorry you are feeling so miserable. Know the feeling. But seriously if you pdoc thinks that hospital may be a safe place for you maybe reconsider as have been in one myself years ago and wasn't bad. Lots of therapy and others to be with. You mention DBT? Not thinking of hurting yourself are you? You know we are all here for you. And remember Phycology might be a good place to also post as you are trying to decide if therapy for now with the frequent seeing of pdoc. Good luck. Phillipa
Posted by Sophronia on April 10, 2008, at 22:07:17
In reply to Re: CrossPost--Complex Med/Hospital Querie » Sophronia, posted by Phillipa on April 10, 2008, at 21:38:31
thanks phillipa...not thinking of hurting myself, just scared, really scared. have a history of serious trauma and that is why the dbt--amazing someone else has heard of it; it was new to me. not sure what that other thing was you referred to--Phycology? Pdoc wants me to be in therapy 2x a week, immediately...or its the hospital. thanks for your impressions about the hospital. part of the difficulty for me is i teach and i missed the end of the fall semester b/c i had surgery and now its looking like i'll miss the end of spring semester b/c of this. i've been stable for about 3 or 4 years....seems like the surgery and lead up to it got me off kilter. i had a total hysterectomy....guess that'll do it to just about anyone.
thanks again for your generosity; you give so much to so many on this site.
sophie
Posted by Phillipa on April 10, 2008, at 22:27:07
In reply to Re: CrossPost--Complex Med/Hospital Querie, posted by Sophronia on April 10, 2008, at 22:07:17
S boy do I know what you mean surgery myself seven weeks ago. I've taken a serious backwards spiral. So you had problems too? Mine was different but same area. No fun. I'm on your side. Thanks for the compliment. I was just thinking that if you also posted the theraphy part on the psychology board others there have experiences to share. Love Phillipa
Posted by Sophronia on April 10, 2008, at 22:35:39
In reply to Re: CrossPost--Complex Med/Hospital Querie » Sophronia, posted by Phillipa on April 10, 2008, at 22:27:07
So sorry to hear you had surgery too P--gees it is no fun...and it sent you back too, huh? i've been wondering how much of this is hormone-related (well, i know it is all chemical...but how much is directly related to having the ovaries removed...).... I did sort of forget about the psych board...will post there tomorrow probably...too tired tonigt...dear G*d I hope I sleep tonight...it's been over a week of nightmares and restless legs and night sweats and you name it...doesn't help the depression.
well, listen, p, you take good care of yourself. 7 weeks is still not that long after surgery--do good things for yourself, okay?
sophie
Posted by CareBear04 on April 11, 2008, at 0:55:09
In reply to CrossPost--Complex Med/Hospital Querie, posted by Sophronia on April 10, 2008, at 21:20:02
hi sophie--
sorry to hear that you're having a hard time. i have definitely been where you are; in fact, i've rather in a similar place now.
anyway, i have had plenty of stays in the hospital, so i can speak to that a bit. i've had both good and bad experiences, and whether it's the right decision for you really depends on what you need right now. looking back, i think in general, the hospital has mostly just served to take me out of my everyday reality and give me a little break for however long. like phillipa said, it can be nice to be among people who understand what you're experiencing. if you're like me, life requires a big effort to maintain appearances, to pass as normal. taking all my meds every day is a constant reminder of being sick. in the hospital, i guess i've felt like i can let my guard down. the other patients are also there for reason, and nothing you say or do or don't do can really surprise the staff. despite what tv and movies show psych units to be, they are not really a scary place (except maybe if you're committed involuntarily). there are usually a few requirements like attending a few groups or activities and taking your meals in the common area, but you can be as social or withdrawn as you want. i think hospital stays mostly serve to allow me to avoid the realities of my life, which helps me regain some perspective. doing things like ping pong, coloring, reading, crafts... i forget to enjoy these kinds of things unless i'm reminded. it's also nice to forget about things like cooking and cleaning and be taken care of. the drawback of all this for me is the disparity between the hospital world and my real world. when i was in for around three weeks having ect, it was a huge shock to return to find the outside in the same state as it was when i went in. maybe you can avoid this if you take a more gradual approach to returning to your normal everyday stuff.
as far as inpatient v. outpatient treatment, i'm not sure what to say. it sounds like you're in a tough place right now as far as therapy goes. what do you and your pdoc do during your sessions? is it all meds? i've usually done best with one person doing both meds and therapy. at bad times, i've found it useful to see the pdoc often, especially since it gives us opportunity to make med changes whenever needed. in this way, inpatient is really good because the drs can be more aggressive with treatment since they can monitor you and intervene if anything bad develops. i've not ever really committed to it, but i haven't found cbt/dbt that useful; my impression is that, at least for me, the process is oversimplified. it's good to identify something like a recurring irrational thought, but knowing something cognitively is different than believing and feeling it.
therapy/interaction with the doctors seems to vary with the patient and the doctor. some people feel like all they get is a five-minute perfunctory check-in every morning. i've generally had good experiences in this respect, especially at teaching hospitals. some people don't like having residents and students managing their care, and it's true that they are the ones you'll mostly deal with. but they are also usually the ones who are willing and interested in talking to you. particularly if they perceive you to be generally high-functioning, as you seem to be, they will usually do a pretty good job of helping you feel like there's hope, both by the treatments they suggest and through the extent to which they are invested in your care and outcome. i don't think the hospitalizations have ever produced remarkable insights or anything, but sometimes it is nice to just have people to talk to when you feel like it.
i hope this helps, and i hope you feel better.
cb
Posted by Sophronia on April 11, 2008, at 7:59:54
In reply to Re: CrossPost--Complex Med/Hospital Querie » Sophronia, posted by CareBear04 on April 11, 2008, at 0:55:09
Oh Carebear, you really are a carebear!
Your post is so very helpful, especially your description of your experience of the hospital. One of the reasons I've been sort of leaning towards checkin myself in is that decision making has become such a burden to me--should I go to work? when should I leave work? what should i make for dinner? do i have the energy to go grocery shopping? etc.... luckily (in this arena anyway) i live alone and don't have to take care of anyone else--don't know how those of you who do that, do it. really. showering is a big deal for me these days.
when i see my pdoc, our visits are sometimes 15 minute med check-ins and maybe once a week, she does an hour with me--but she has kind of made it clear that she really isn't a therapy person. she is a great doctor--a former acupuncturist--who also has me on supplements (7-Keto, Rosavin and Flax Seed Oil); she thought the cbt/dbt person would help give me skills for the anxiety, saw it as short term, etc. I was pretty skeptical--but when I met her I kind of liked her and after the 2nd visit I thought, well I'll give this a chance and asked if I could see her every other week. Well the pdoc wasn't happy to hear that--she wants me in therapy 2x a week, as I said.
I'll take the therapy piece over to the other forum. This is my third day on Abilify--don't like how it is making me feel--kind of revved up inside my head but not in my body. Weird. Don't like it.
Thanks so very much, CB!
Sophie
Posted by undopaminergic on April 11, 2008, at 17:16:25
In reply to Re: CrossPost--Complex Med/Hospital Querie, posted by Sophronia on April 10, 2008, at 22:35:39
> So sorry to hear you had surgery too P--gees it is no fun...and it sent you back too, huh? i've been wondering how much of this is hormone-related (well, i know it is all chemical...but how much is directly related to having the ovaries removed...)....
>The steroids do have effects on the mind. I assume you're taking replacement estrogen? You may wish to experiment with progesterone and testosterone as well.
Posted by Sophronia on April 11, 2008, at 17:24:17
In reply to Re: CrossPost--Complex Med/Hospital Querie, posted by undopaminergic on April 11, 2008, at 17:16:25
Nope, not on any replacement hormones--pdoc wanted a "clean slate" as she put it to do her "magic" with meds. the gyn. agreed with that assessment. i'm on enough meds to als be on hrt. i do take 7-keto, a derivative/better form of dhea because my dhea level was so depleted. evidently normal is 180-240 and my number was 42--this was gotten by a blood test.
sophie
Posted by bleauberry on April 11, 2008, at 18:33:25
In reply to CrossPost--Complex Med/Hospital Querie, posted by Sophronia on April 10, 2008, at 21:20:02
While all psych drugs can help people feel better, they can also make people feel really really bad. Even drugs that start out good can end up making someone much worse many months later.
My hunch is that there is a mix of two things happening:
1. The ongoing illness.
2. One or two of the meds are bad for you and are over riding anything good the others are doing.Instead of adding to the mix or increasing doses, you might consider whittling the mix down, eliminating some that you suspect, and replacing with new fresh ones, hopefully fewer than you are on now.
Too many drugs. Can't tell what is doing what. My bet is that one or two are doing you a lot of bad right now, and that no other improvements can be made as long as they are running the show.
Posted by Phillipa on April 11, 2008, at 19:22:08
In reply to Re: CrossPost--Complex Med/Hospital Querie, posted by Sophronia on April 11, 2008, at 7:59:54
Sophie my guess don't know your age or if you've been through menopause but replacement estrogen, progesterone and as dopamanergic said maybe testosterone if young and haven't been through the change. Just my thoughts. And also agree with blueaberry. Love Phillipa
Posted by Phillipa on April 11, 2008, at 20:00:56
In reply to Re: CrossPost--Complex Med/Hospital Querie, posted by Phillipa on April 11, 2008, at 19:22:08
OOps!!!! Sorry undominergic. Love Phillipa got name wrong
Posted by Sophronia on April 11, 2008, at 21:38:42
In reply to Re: CrossPost--Complex Med/Hospital Querie, posted by Phillipa on April 11, 2008, at 19:22:08
We are all different; I'm 48...was well on my way to menopause when I had the hysterectomy. I really trust both my gyn and my pdoc and they both agree on the no hrt for me. i had lots of gyn complications leading up to the surgery...so it was a complicated decision to make...to have the surgery, to remove the ovaries, to not do hrt.
as i say we are all different and this hrt thing is very tricky stuff for lots of reasons, in all kinds of ways. i've talked it over, read all sorts of stuff, and i think i'm right in not doing the hrt.
thanks for your concern and thoughts, though. they help, even when i don't agree. :) they help me remember how complicated all of this is, how complicated the past 7 months have been in particular.
s.
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