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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 45. This is the beginning of the thread.
Posted by g_g_g_unit on August 1, 2009, at 1:41:20
excuse my fickleness, but i was reading thru the SSRI's HAVE DESTABILIZED ME thread and am rethinking seeing a psych now; anyway, i have a few questions first.
after reading thru symptoms, i think that on the surface, i probably present mild bipolar symptoms at the moment - i've never had a manic episode (though i used to get easily addicted to stuff, which im guessing is a coping mechanism in any anxiety disorder?) poor sleep, pain, compromised cognitive functioning (attention + learning difficulties), mood swings (rock back-and-forth between anhedonia and feeling suicidal).
what's been most difficult for me is chicken-and-the-egg stuff: am i depressed cos am i pain (which has a legitimate basis in just completely abusing my body thru computer overuse) or visa versa? ditto with concentration issues, etc.
i have always been anxious & OC, but most of these symptoms presented themselves AFTER going on SSRI's. no SSRI has helped me. i couldn't handle Nardil. my cognitive functioning is/was my most prized asset and i'd happily trade everything else to have that back. since no one will prescribe stims, the only thing left seems to be Parnate, but i am scared about the insomnia since my sleep sucks already.
i know it's not up to others to decide for me, but i was wondering if maybe people here who have been on meds for a long time or received a misdiagnosis for bipolar would suggest i hold off for a little bit, cos i feel a bit trapped at the moment. i also see a lot of my symptoms mirrored in other stuff like endocrine issues, but no GP will test my hormone levels b/c they think i'm a hypochrondriac. i consulted a Naturopathic Doctor yesterday who is going to arrange for more thorough blood testing (possibly heavy metal as well if i can afford it), but it's costly, and i will have to take the process slowly.
i am doing everything to get my pain levels down - fish oil, borage, curcumin - last night i found out glycine works really well for restful sleep. i am thinking of maybe just going on SJW for the time being to help with stress. i have no real responsiblities like school, i'm 23 and live with my parents, so time is on my side for now- i stopped working as a writer until i can get this all sorted out, and have a part-time job to help me. what scares me though is how terrible my congition is (i can barely follow movies, and just forget books as i read them), so if something is genuinely wrong, i dont wanna delay it ...
Posted by morganpmiller on August 1, 2009, at 2:14:03
In reply to damned if you do, damned if you don't, posted by g_g_g_unit on August 1, 2009, at 1:41:20
I would go for a trial with SJW at the moment. Make sure you get the right brand at the right dosage that suits your needs.
You are very young to be dealing with the pain issues. If a medical doctor cannot find anything physically wrong with you, I would guess that your pain issues are a result of your depression and anxiety.
In today's day of diagnoses, you probably are bipolar. You may benefit from a low dose of a mood stabilizer like lithium(lithobid would be my first choice). Lithium may also enhance the efficacy of SJW.
You are taking some good supplements that anyone may consider taking for life. That's great that glycine helped for sleep. You may also want to consider adding pycnogenol and grapeseed extract, both can help with inflammation.
SSRIs did not help at all? Hmm..that sucks.
Why not try Parnate if SJW does not help? If you do get the insomnia, it might go away over time. Plus, if Parnate works right away and you are not sleeping good, at least you are functioning at a higher level and feeling better. I think it's worth a shot if SJW does not help.
Have you ever thought about some form of therapy? If you are having these issues, they are most likely rooted in something related to childhood. You don't have to go through the long and arduous psychodynamic route, there are other options like CBT and EMDR.
Are you exercising(neurogenesis, promotes serotonin/dopamine) and stretching(promotes GABA)
Sounds like intense exercise may be of some benefit to you.
Posted by g_g_g_unit on August 1, 2009, at 2:49:34
In reply to Re: damned if you do, damned if you don't, posted by morganpmiller on August 1, 2009, at 2:14:03
thank you for your thoughtful reply
> I would go for a trial with SJW at the moment. Make sure you get the right brand at the right dosage that suits your needs.
I have heard that Perika is more dopaminergic so was thinking of tying that.
>
> You are very young to be dealing with the pain issues. If a medical doctor cannot find anything physically wrong with you, I would guess that your pain issues are a result of your depression and anxiety.well, a sports physician detected that i have wrong muscle-activation patterns which is placing excess stress on my shoulders (due to really weak abs). i guess it is tied to my mental issues in a way because i am a perfectionist, and would kill myself w/stress over writing assignments, and not take enough breaks. i have been given exercises to do every night to retrain my muscles, and am also seeing a personal trainer. there also seems to be an issue w/ circulation because my hands are constantly freezing, and i am starting to get tingling in my feet and hands. i am seeing a neurologist for the latter soon; but i think my pain issues are legitimate enough to declare that they aren't a side-effect of depression. what's more, anything lowering inflammation (sauna, ibupofren) has a great effect on my mood.
>
> In today's day of diagnoses, you probably are bipolar. You may benefit from a low dose of a mood stabilizer like lithium(lithobid would be my first choice). Lithium may also enhance the efficacy of SJW.i was thinking of trying lithium orotate. would it have a blunting affect, i.e. no lows but no highs either? because i don't want to exacerbate the anhedonia
>
> You are taking some good supplements that anyone may consider taking for life. That's great that glycine helped for sleep. You may also want to consider adding pycnogenol and grapeseed extract, both can help with inflammation.you don't know if glycine is neurotoxic at higher doses do you?
>
> SSRIs did not help at all? Hmm..that sucks.
>
> Why not try Parnate if SJW does not help? If you do get the insomnia, it might go away over time. Plus, if Parnate works right away and you are not sleeping good, at least you are functioning at a higher level and feeling better. I think it's worth a shot if SJW does not help.
>
> Have you ever thought about some form of therapy? If you are having these issues, they are most likely rooted in something related to childhood. You don't have to go through the long and arduous psychodynamic route, there are other options like CBT and EMDR.i am in CBT, and have been for a few months. i put it on hold for financial reasons, but will resume once i can afford it again.
>
> Are you exercising(neurogenesis, promotes serotonin/dopamine) and stretching(promotes GABA)i walk for exercise, but was told that was not enough to promote endorphin-release, so maybe begin biking (running hurts my back); and i do stretch yes, but am still getting the hang of it, because i will often overstretch
>
> Sounds like intense exercise may be of some benefit to you.
>
i started swimming vigorously after depression first hit. it calmed me; wasn't a cure-all, but definitely a part of the puzzle, yes
Posted by Phillipa on August 1, 2009, at 12:06:59
In reply to Re: damned if you do, damned if you don't, posted by g_g_g_unit on August 1, 2009, at 2:49:34
That's when my panic attacks begain age 24 almost same age. At that time 40 years ago 5mg valium three times a day with can you believe miltown 400 was better in a few weeks and ran five miles daily plus a lot of other stuff. I have pain at my age so now bike ride with binder. It helps but your're so right you have time to figure this out. I don't know about bipolar. This is just me but my deceased ex father in law was bipolar and he literally was a classic manic and then deep depression. SSRI's weren't out when I got the panic attacks. Phillipa
Posted by floatingbridge on August 1, 2009, at 13:54:42
In reply to damned if you do, damned if you don't, posted by g_g_g_unit on August 1, 2009, at 1:41:20
Hi ggg,
How frequent are the mood swings? All in a day, a week, a month? Bipolars often spend the majority of their time at the depressed end of the mood scale, and feeling that ad's de-stablize can also point to bipolar.
It's terrible to have health issues along side mood issues--I'm sorry. Keep posting and don't even worry about being fickle!
fb
Posted by g_g_g_unit on August 1, 2009, at 19:05:58
In reply to Re: damned if you do, damned if you don't » g_g_g_unit, posted by floatingbridge on August 1, 2009, at 13:54:42
> Hi ggg,
>
> How frequent are the mood swings? All in a day, a week, a month? Bipolars often spend the majority of their time at the depressed end of the mood scale, and feeling that ad's de-stablize can also point to bipolar.
>Usually in a day - but they're often triggered by some external event, or negative thought pattern/behaviour on my behalf. does that make any difference? i mean - wouldn't anyone in a state of stress experience mild mood swings anyway?
i am interested in having a sleep study done because these physical issues have made my breathing so bad, that when i awake i am literally gasping for air. i'm not trying to get out of a Dx, but i know sleep disorders can often mimic sleep issues. i also have a really low B12 level from a few years spent on proton pump inhibitors.
anyway, does a bipolar Dx significantly change how treatment would proceed? from what i've read on here, mood stabilizers don't sound like the most pleasant drugs. would i still be ok trying something like SJW?
Posted by g_g_g_unit on August 1, 2009, at 19:06:53
In reply to Re: damned if you do, damned if you don't, posted by g_g_g_unit on August 1, 2009, at 19:05:58
> i'm not trying to get out of a Dx, but i know sleep disorders can often mimic sleep issues.
sorry i meant mimic Bipolar symptoms, at least according to a book on sleep i'm reading.
Posted by Phillipa on August 1, 2009, at 21:05:56
In reply to Re: damned if you do, damned if you don't, posted by g_g_g_unit on August 1, 2009, at 19:06:53
Mood stabalizer if start low weren't bad for me trileptal and lamictal. I'd suggest the trileptal. Interesting about the sleep do you feel you literally stop breathing and then panic? Or an I totally off base? Phillipa
Posted by morganpmiller on August 1, 2009, at 21:33:15
In reply to Re: damned if you do, damned if you don't, posted by g_g_g_unit on August 1, 2009, at 19:05:58
I'm bipolar and I took Zoloft for seven years. I would have benefitted from staying on it and maybe adding a low dose of depakote and lithium or both. Or, I should have just stayed at my 100mg dose, kept taking fish oil(btw, take your fish oil!!!), kept exercising, and kept up with therapy. Instead I got off it and opened up pandora's box.
Give SJW a try, maybe it helps, maybe not.
You might get mood stabilizing effects and some protection from a low dose of depakote and lithium(take extended release forms of both). I'm not crazy about Lamictal but many have success with it.
The key for you, if you are bipolar, is protection. You want to do whatever it takes to never ever have a major episode.
Posted by morganpmiller on August 1, 2009, at 21:36:09
In reply to Re: damned if you do, damned if you don't, posted by g_g_g_unit on August 1, 2009, at 19:06:53
Why not go somewhere and see a doctor that could maybe give you a good solid diagnosis?
And, of course, find out if you have some type of sleep disorder, like you said you are going to do(i think??).
Posted by g_g_g_unit on August 1, 2009, at 22:05:42
In reply to Re: damned if you do, damned if you don't » g_g_g_unit, posted by Phillipa on August 1, 2009, at 21:05:56
> Mood stabalizer if start low weren't bad for me trileptal and lamictal. I'd suggest the trileptal. Interesting about the sleep do you feel you literally stop breathing and then panic? Or an I totally off base? Phillipa
no, i sleep on my side, and when i wake up, i'm kind of crushing my rib cage, and have to like manually take over my breathing - every inhalation feels really laborous. i'm going to try sleeping on my back to see if it makes a difference.
Posted by morganpmiller on August 1, 2009, at 22:29:36
In reply to Re: damned if you do, damned if you don't, posted by g_g_g_unit on August 1, 2009, at 22:05:42
Find the right kind of pillow for back and side sleeping. I think it might make a difference.
Posted by g_g_g_unit on August 1, 2009, at 22:46:31
In reply to Re: damned if you do, damned if you don't, posted by morganpmiller on August 1, 2009, at 21:33:15
> I'm bipolar and I took Zoloft for seven years. I would have benefitted from staying on it and maybe adding a low dose of depakote and lithium or both. Or, I should have just stayed at my 100mg dose, kept taking fish oil(btw, take your fish oil!!!), kept exercising, and kept up with therapy. Instead I got off it and opened up pandora's box.
>
> Give SJW a try, maybe it helps, maybe not.
>
> You might get mood stabilizing effects and some protection from a low dose of depakote and lithium(take extended release forms of both). I'm not crazy about Lamictal but many have success with it.
>
> The key for you, if you are bipolar, is protection. You want to do whatever it takes to never ever have a major episode.i'll give SJW a shot, possibly in combination with lithium orotate - a combo i saw someone on another board using successfully for mood issues. i think part of the problem is i spent too much time ruminating over the 'right' option; my thinking's very B&W in that way. i guess if i were being logical, then SJW should be the first thing i try, because if that works it would save me a lot of hassle w/meds! are there many s/e's with low doses of mood stabilizers?
Posted by g_g_g_unit on August 1, 2009, at 22:48:59
In reply to Re: damned if you do, damned if you don't, posted by morganpmiller on August 1, 2009, at 21:36:09
> Why not go somewhere and see a doctor that could maybe give you a good solid diagnosis?
>
> And, of course, find out if you have some type of sleep disorder, like you said you are going to do(i think??).i would love to, but i'm so broke at the moment - i'm reckless with my money (not in the sense that i buy luxury stuff, but spend it on health stuff .. sigh). i'm looking for another job at the moment so i can start seeing a psych; unfortunately, my family's health insurance doesn't cover mental health stuff.
ditto with the sleep study .. you can only get one through the public system if you're falling asleep at the wheel! going private's gonna cost me a lot.
Posted by floatingbridge on August 1, 2009, at 23:52:00
In reply to Re: damned if you do, damned if you don't, posted by g_g_g_unit on August 1, 2009, at 19:05:58
Hi ggg,
I didn't know that sleep disorders can mimic bipolar symptoms. Interesting. May I ask you what your previous Dx was for? It sounds like you've tried numerous meds.... If you're feeling like you're safe and somewhat stable, I don't see why you should rush into a drug trial. And it sounds like a sleep study might be nessesary to get a more definitive diagnosis. However, mood changes can be a rough ride, esp on a daily level--I know. It's a tough call. I'd like to hear from some of the other babblers here.
Do you have babble mail? You can e-mail someone whose name shows up in blue on the left hand top of the post. I forget how one signs up for babble mail. Maybe on the babble mail page?
fb
Posted by morganpmiller on August 1, 2009, at 23:53:23
In reply to Re: damned if you do, damned if you don't, posted by g_g_g_unit on August 1, 2009, at 22:46:31
It appears that some have had success with low doses of lithium orotate.
Make sure you get the right brand of SJW. Some take pure hyperforin for depression. Just do your research. It may help to see a naturopath.
When it comes to your mental health, some hassle is worth it in the end.
Posted by morganpmiller on August 1, 2009, at 23:59:17
In reply to Re: damned if you do, damned if you don't, posted by g_g_g_unit on August 1, 2009, at 22:48:59
It really sounds like you may be bipolar. There is a fairly large umbrella for diagnosis and it is not uncommon these days for people with symptoms like yours to fall under it. Bipolar is not an easy diagnosis to make.
I would get a hold of some lithium orotate if you can. Take 2 or 3 tablets a day.
Try SJW and give it at leas 4 to 6 weeks. Give it time to work and to find the right dose.
Posted by g_g_g_unit on August 2, 2009, at 0:26:37
In reply to Re: damned if you do, damned if you don't » g_g_g_unit, posted by floatingbridge on August 1, 2009, at 23:52:00
> Hi ggg,
>
> I didn't know that sleep disorders can mimic bipolar symptoms. Interesting. May I ask you what your previous Dx was for? It sounds like you've tried numerous meds.... If you're feeling like you're safe and somewhat stable, I don't see why you should rush into a drug trial. And it sounds like a sleep study might be nessesary to get a more definitive diagnosis. However, mood changes can be a rough ride, esp on a daily level--I know. It's a tough call. I'd like to hear from some of the other babblers here.
>
> Do you have babble mail? You can e-mail someone whose name shows up in blue on the left hand top of the post. I forget how one signs up for babble mail. Maybe on the babble mail page?
>
> fbmy original Dx was GAD comorbid with Obsessive Compulsive Personality Disorder.
i do have babblemail i believe .. were you wanting to contact me privately?
Posted by sam K on August 2, 2009, at 0:31:03
In reply to Re: damned if you do, damned if you don't, posted by g_g_g_unit on August 1, 2009, at 2:49:34
you cant get prescribed stimulants? i know how it feels. It makes me sick... The first day I went in the the doctors office I said, Ive taken adderall before and it helped tremendously, and I think amphetamines are the answer for my depression.
He says ill gain "tolerance" over time. So I end up trying every med available, every ssri, abilify, seroquel, all bipolar meds, then after like a year he perscribes adderall. I have been on it for the longest out of any med and its just what i expected and Im not depressed anymore.
it makes me sick that i was right about it and went on this crazy med train when it couldve been avoided.
Posted by g_g_g_unit on August 2, 2009, at 0:32:14
In reply to Re: damned if you do, damned if you don't, posted by morganpmiller on August 1, 2009, at 23:59:17
> It really sounds like you may be bipolar. There is a fairly large umbrella for diagnosis and it is not uncommon these days for people with symptoms like yours to fall under it. Bipolar is not an easy diagnosis to make.
>
> I would get a hold of some lithium orotate if you can. Take 2 or 3 tablets a day.
>
> Try SJW and give it at leas 4 to 6 weeks. Give it time to work and to find the right dose.
>
>thanks, i'll add lithium and st john's wort to my next iherb order. call me dumb, but i still don't understand the difference between bipolar and plain ol' depression, or even atypical depression.. i mean, when i say mood swings, there might be like a couple hours a day where i feel okay, but i'm not exactly all over the place .. i just feel consistently crappy
Posted by g_g_g_unit on August 2, 2009, at 0:33:48
In reply to Re: damned if you do, damned if you don't, posted by sam K on August 2, 2009, at 0:31:03
> you cant get prescribed stimulants? i know how it feels. It makes me sick... The first day I went in the the doctors office I said, Ive taken adderall before and it helped tremendously, and I think amphetamines are the answer for my depression.
> He says ill gain "tolerance" over time. So I end up trying every med available, every ssri, abilify, seroquel, all bipolar meds, then after like a year he perscribes adderall. I have been on it for the longest out of any med and its just what i expected and Im not depressed anymore.
> it makes me sick that i was right about it and went on this crazy med train when it couldve been avoided.
>they are heavily restricted in the southern hemisphere .. reserved for ADHD and narcolepsy. when i asked my psych for ritalin, he almost threw me out his office.
Posted by Phillipa on August 2, 2009, at 18:18:48
In reply to Re: damned if you do, damned if you don't, posted by g_g_g_unit on August 1, 2009, at 22:05:42
GGG what do you mean by manually take over your breathing? Phillipa
Posted by morganpmiller on August 2, 2009, at 20:33:32
In reply to Re: damned if you do, damned if you don't, posted by g_g_g_unit on August 2, 2009, at 0:32:14
That's why BP is so tough to diagnose. I was just throwing it out ther as a possibility. Just something to consider.
Hey, I have four unopened bottles of Relentless Improvement lithium orotate, I have no problem sending you one just to get you started. I know you are struggling for some cash right now. It would take a week to get there.
Google Relentless Improvement, they are a legit very reliable supplement company.
If anything, the lithium orotate may help with reversing some damage done to the brain by chronic depression/anxiety. Lithium may increase neurogenesis in the hippocampus, where much of the damage takes place.
Posted by g_g_g_unit on August 2, 2009, at 22:41:29
In reply to Re: damned if you do, damned if you don't, posted by morganpmiller on August 2, 2009, at 20:33:32
> That's why BP is so tough to diagnose. I was just throwing it out ther as a possibility. Just something to consider.
>
> Hey, I have four unopened bottles of Relentless Improvement lithium orotate, I have no problem sending you one just to get you started. I know you are struggling for some cash right now. It would take a week to get there.
>
> Google Relentless Improvement, they are a legit very reliable supplement company.
>
> If anything, the lithium orotate may help with reversing some damage done to the brain by chronic depression/anxiety. Lithium may increase neurogenesis in the hippocampus, where much of the damage takes place.hey - i would appreciate that so much, but feel guilty at the same time! i mean my parents can technically afford to help me, but i think they have already contributed a lot, and are just running out of patience (which i understand, since there seems to be a generational difference in how depression is comprehended).
i still think B12 is an issue; i started experiencing neurological symptoms, which have cleared a bit since starting methyl-b12. my doctor said my serum b12 and homocysteine levels were fine, but according to an expert on a site i use, the readings were in fact approaching danger level.
if you can honestly afford to spare a bottle, and think it may be of some benefit, then i would hugely appreciate you sending it.
i think i will go through with the psych visit, just be completely honest about my whole history (often i go in with some preconceived idea about treatment which often creates hostility), but i just don't know where that will get me. i hate the SSRI's, SNRI's, TCA's i've tried. Nardil was a trip, but left me feeling airheaded. all signs point to Parnate i guess, unless i could get a way with a low dose of a mood stabilizer. i keep thinking about the quote Hemingway made before he killed himself regarding electroshock treatment and about how the cure was worse than the disease. obviously i don't wanna conflate my talent with his, but the creative question complicates things so much. i feel like i'm way worse off for ever beginning psychotropic treatment, hence the title of this thread
Posted by morganpmiller on August 2, 2009, at 23:23:03
In reply to Re: damned if you do, damned if you don't, posted by g_g_g_unit on August 2, 2009, at 22:41:29
>i feel like i'm way worse off for ever beginning psychotropic treatment, hence the title of this thread.
Maybe you are, maybe you are not. I would try to give the former too much attention. I mean, you obviously needed some help to begin with, otherwise you would not have tried medication in the first place.
I have no problem sending you a bottle if you are sick of asking your parents for money. Really, it is not a problem at all.
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