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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 59 to 83 of 94. Go back in thread:
Posted by SLS on February 6, 2014, at 5:11:39
In reply to Re: It all makes sense, posted by poser938 on February 5, 2014, at 23:37:05
Bipolar? I am not convinced that you are now dealing with a condition that lies along the bipolar spectrum, but it might not hurt to consider the possibility that there is some bipolar stuff going on that was triggered by antidepressants. It would allow you to explore a drug like Trileptal, which often helps people with bipolar disorder who have irritability, agitation, aggression, or impulsivity while in a mixed-state. However, these symptoms occur with major depressive disorder, too, although they are more prevalent during adolescence.
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http://archpsyc.jamanetwork.com/article.aspx?articleid=1737169
Interpretation on Medscape:
* "The most important finding in this paper is that it confirms...that the majority of people with irritability and depression do not have bipolar disorder," Roy H. Perlis, MD, director of the Bipolar Clinical Program at Massachusetts General Hospital and associate professor of psychiatry at Harvard Medical School in Boston, who was not involved in the study..."
"Symptoms of irritability and anger during a major depressive episode (MDE) appear to be clinical markers for a significantly more complex, chronic, and severe form of major depressive disorder, a new study indicates.
Results from the longitudinal observational investigation of patients with unipolar MDEs showed that those with current overt irritability/anger were significantly more likely to have increased depressive severity, longer duration of the index MDE, poorer impulse control, and a more chronic and severe long-term course of illness.
Overt irritability and anger were also associated with higher rates of lifetime comorbid substance abuse and anxiety disorder, more antisocial and personality disorders, greater psychosocial impairment, reduced life satisfaction, and a higher rate of bipolar II disorder in relatives.
The study findings strongly suggest that "concurrent anger/irritability symptoms are important indicators of increased severity, chronicity, and complexity of unipolar major depression," the authors, led by Lewis L. Judd, MD, University of California, San Diego, write. Symptoms of irritability and anger during a major depressive episode (MDE) appear to be clinical markers for a significantly more complex, chronic, and severe form of major depressive disorder, a new study indicates.
Results from the longitudinal observational investigation of patients with unipolar MDEs showed that those with current overt irritability/anger were significantly more likely to have increased depressive severity, longer duration of the index MDE, poorer impulse control, and a more chronic and severe long-term course of illness.
Overt irritability and anger were also associated with higher rates of lifetime comorbid substance abuse and anxiety disorder, more antisocial and personality disorders, greater psychosocial impairment, reduced life satisfaction, and a higher rate of bipolar II disorder in relatives.
The study findings strongly suggest that "concurrent anger/irritability symptoms are important indicators of increased severity, chronicity, and complexity of unipolar major depression," the authors, led by Lewis L. Judd, MD, University of California, San Diego, write."
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The list of drugs I gave you was based upon the criteria you set for treatment using your theory. Some are good tools for depression, but would not really address bipolarity per se. You don't have to display mania to have a bipolar diathesis (underlying predisposition). Lamictal might help with the depression aspect, as might adding low dosages of lithium to Prozac. At this point, polypharmacy is probably what is going to get you better. The permutations of combinations of drugs are virtually endless. It is hard to lose hope when so many treatments are left untried. I chose to take lithium at 300 mg/day indefinitely because it does so many things that protect the brain from further damage by my bipolar depression and stress. It turned out that going to 450 mg/day sparked an improvement in depression. Minocycline is another drug with neuroprotective properties which has the potential to treat bipolar depression.
Would you really prefer to have electrodes routed through a hole drilled into your skull rather than taking a mood stabilizing drug?
Let's say that you do not have any family history of bipolar or schizoid illness, and that you are not truly bipolar. Bipolar drugs might still help when so many antidepressant drugs have not. I would consider using Abilify or Latuda in combination with antidepressants before going with DBS. I would also consider adding minocycline. You might actually avoid traditional antidepressants altogether by combining Abilify, Lamictal, and minocycline. I have seen it work very well.
My mind is open, otherwise I would not have produced that list of drugs in one of my previous posts. I hope your mind is just as open to the idea that your current condition includes bipolar features.
- Scott
Posted by Bob on February 6, 2014, at 14:04:09
In reply to Re: Scott (pretty long post) » poser938, posted by SLS on February 4, 2014, at 23:02:58
>
> Any nausea?
>
> Have you ever tried nortriptyline (Pamelor) or mirtazapine (Remeron)?
>
>
> - Scott
>Scott... are you saying that nortriptyline and mirtazapine are particularly well suited for treating autonomic dysregulation?
- Bob
Posted by Bob on February 6, 2014, at 14:08:48
In reply to Re: Scott (pretty long post) » poser938, posted by SLS on February 5, 2014, at 21:46:20
> * Nefazodone (Serzone)? It combines 5-HTc receptor antagonism and weak serotonin reuptake inhibition.
>>
> - Scott
Wasn't Serzone discontinued almost 10 years ago?-Bob
Posted by phidippus on February 6, 2014, at 16:38:20
In reply to Re: It all makes sense, posted by poser938 on February 5, 2014, at 23:37:05
Well...You've been trying to treat the wrong disorder. Everytime you took antidepressants you succumbed to manic-like symptoms.
Of course you felt raped. Try something that might really help this time: a mood stabilizer.
Eric
Posted by phidippus on February 6, 2014, at 16:47:19
In reply to Re: Scott (pretty long post) » SLS, posted by poser938 on February 5, 2014, at 23:26:06
>...a few days ago I switched to Prozac) and so far, no manic reactions
Is the dose therapeutic and have you been on the dose for at least 4 weeks?
Absence of affect? There's seem to be plenty of emotional undertow inn your writings.
Eric
Posted by phidippus on February 6, 2014, at 17:54:55
In reply to Re: Scott (pretty long post) » phidippus, posted by SLS on February 5, 2014, at 21:57:15
Receptor/Transporter Protein antagonistBinding affinity (Ki[nM]) towards cloned human receptors unless otherwise specified[31]
SERT 4100 (RC)
NET 290 (RC)
5-HT1A 59
5-HT2A 1.67
5-HT2B 1.54
5-HT2C 2.23
5-HT3 228 (MN)
5-HT6 142
5-HT7 123.01
M1 12
M2 7
M3 12
M4 8
M5 11.8
D1 117
D2 112
D3 8
H1 0.06
H3 >10000
H4 201.5
Posted by phidippus on February 6, 2014, at 17:56:10
In reply to Re: It all makes sense » phidippus, posted by SLS on February 5, 2014, at 21:52:57
I'd like to see him try a mood stabilizer.
Eric
Posted by poser938 on February 6, 2014, at 18:15:00
In reply to Re: Scott (pretty long post) » poser938, posted by phidippus on February 6, 2014, at 16:47:19
> >...a few days ago I switched to Prozac) and so far, no manic reactions
>
> Is the dose therapeutic and have you been on the dose for at least 4 weeks?
>
> Absence of affect? There's seem to be plenty of emotional undertow inn your writings.
>
> Eric
It doesn't matter to you what dose I was on. You'd still find some way to explain it away.And there you go again, taking into account some things I write and ignoring others. I wrote "near" absence of affect. One of my psychiatrists used the words "essentially an absence of affect" to describe it.
I can close my eyes while I'm driving and keep them closed and feel as comfortable as I am sitting on my living room couch. With music, I feel a very tiny fraction of it that I used to. Much of the way it sounds, I am oblivious to. There is a high-speed sweeping curve on the interstate close to my town that, before having meds mess me up, I felt a strong g-force when going around it at 80mph. I no longer feel that. I also no longer get an effect from many meds ive tried. Such as AdderlalI . And i tried Yohimbine a few weeks ago, i had tried it before in the past and it made me feel extreme,y anxious and made my heart beat fast. This time, zero effect from it. could go on and on. But the emotions I do express and feel are on a much, much smaller scale than they used to be. But as I continue regressing back to my pre-cyproheptadine state, it will develop into a complete absence of affect.And I have tried a couple of different mood stabilizers, lamictal and a couple of different Atypical Antipsychotics. I got zero effect from them. And yes, I took them in therapeutic doses.
But see, this is why I keep replying. I want to feel more suicidal. I want to have the motivation to follow through with it. Me hearing more and more misunderstanding from people, helps increase my suicidal thoughts. Some time ago I figured I would have followed through with it by now. But, I'm still here!
Write some more back to me, Eric.
Posted by Phillipa on February 6, 2014, at 18:28:14
In reply to Re: Scott (pretty long post), posted by poser938 on February 6, 2014, at 18:15:00
Poser I am writing and truly want to see you get better. Think a short stay inpatient might help? Just a suggestion. I like you and want to see you remain here. One time I took a low very low dose of trileptal. Felt nothing on it. But was the suggestion of pdoc. Phillipa
Posted by poser938 on February 6, 2014, at 18:36:03
In reply to Re: Scott (pretty long post) » poser938, posted by Phillipa on February 6, 2014, at 18:28:14
Thank you, Phillipa. I'm trying everything I can. The main thing keeping me alive right now are my animals. But before too much longer I won't even be able to bring myself to pet the :(
Its part of my absence if affect.I'll look up Trileptal. If it looks like it has potential, I will try it.
Posted by phidippus on February 6, 2014, at 18:50:28
In reply to Re: Scott (pretty long post), posted by poser938 on February 6, 2014, at 18:15:00
Eric,
> It doesn't matter to you what dose I was on. You'd still find some way to explain it away.I just wanted information.
> And there you go again, taking into account some things I write and ignoring others.
I ignored those things I felt unimportant.
>One of my psychiatrists used the words "essentially an absence of affect" to describe it.
What does this mean to you?
> I can close my eyes while I'm driving and keep them closed and feel as comfortable as I am sitting on my living room couch.
Are you trying to crash?
>With music, I feel a very tiny fraction of it that I used to. Much of the way it sounds, I am oblivious to.
Does it matter what kind of music?
>There is a high-speed sweeping curve on the interstate close to my town that, before having meds mess me up, I felt a strong g-force when going around it at 80mph. I no longer feel that.
So you now have a vestibular disorder from the meds you took?
>I also no longer get an effect from many meds ive tried. Such as AdderlalI .
What affect should it have?
>And i tried Yohimbine a few weeks ago, i had tried it before in the past and it made me feel extreme,y anxious and made my heart beat fast. This time, zero effect from it.You may have been nervous the first time around you tried it. You may have been accustomed to
its effect the second time around.>it will develop into a complete absence of affect.
"Brains!" - Zombie
> And I have tried a couple of different mood stabilizers, lamictal and a couple of different Atypical Antipsychotics. I got zero effect from them. And yes, I took them in therapeutic doses.
Great,did you get agitated and anxious on them?
> But see, this is why I keep replying. I want to feel more suicidal.I spend hours a day thinking about suicide, whether I reallly want to or not.
>Me hearing more and more misunderstanding from people
What do you want from us?
Eric
Posted by poser938 on February 6, 2014, at 18:57:29
In reply to Re: Scott (pretty long post) » poser938, posted by phidippus on February 6, 2014, at 18:50:28
I want everyone to know what I experienced was real. I want them to know the reason why I parked my car on the side of the interstate and jumped in front of a big truck going 70 MPH.
Posted by SLS on February 6, 2014, at 19:24:34
In reply to Re: Scott (pretty long post) » phidippus, posted by poser938 on February 6, 2014, at 18:57:29
It doesn't matter who is right and who is wrong. It appears to me that everyone is trying to help you, Poser. The thing is, each of us has a different way of doing this. I am not Phiddipus and Phiddipus is not me. However, I am certain that we both want to see you feel well.
I am listening to you.
- Scott
Posted by SLS on February 6, 2014, at 19:41:47
In reply to Re: Scott (pretty long post) » SLS, posted by Bob on February 6, 2014, at 14:04:09
> > Any nausea?
> >
> > Have you ever tried nortriptyline (Pamelor) or mirtazapine (Remeron)?> Scott... are you saying that nortriptyline and mirtazapine are particularly well suited for treating autonomic dysregulation?
I'm not really sure. :-(
- Scott
Posted by Phillipa on February 6, 2014, at 19:46:55
In reply to Re: Scott (pretty long post) » Phillipa, posted by poser938 on February 6, 2014, at 18:36:03
Poser I do want to help. I may not have the psychiatric knowledge to do so but I can emotionally support you. As I do care. Please stick around. I have no idea what a diagnosis or treatment is for you. But keep trying. I've seen you this way before and you have rallied back. Routing for you. Phillipa
Posted by phidippus on February 6, 2014, at 21:29:04
In reply to Re: Scott (pretty long post) » phidippus, posted by poser938 on February 6, 2014, at 18:57:29
Whether it was real or not isn't important. What matters most is that you move forward and continue to try and treat your illness.
Eric
Posted by baseball55 on February 6, 2014, at 23:01:33
In reply to Re: Scott (pretty long post), posted by poser938 on February 6, 2014, at 18:15:00
> But see, this is why I keep replying. I want to feel more suicidal. I want to have the motivation to follow through with it. Me hearing more and more misunderstanding from people, helps increase my suicidal thoughts. Some time ago I figured I would have followed through with it by now. But, I'm still here!
>
> Write some more back to me, Eric.This is a very disturbing post. So the more people respond and fail to completely validate your perception, the more you become depressed and want to commit suicide? And you keep posting to elicit what you see as unhelpful responses to make yourself more depressed so as to increase your motivation to commit suicide?
Well, I, for one, opt out of this game. If you want to commit suicide, I can't stop you and I hope, for your sake, that you don't make this decision. But I'm certainly not going to participate in a conversation in which you perceive yourself as constantly misunderstood and driven by others' misunderstanding to commit suicide.
Posted by SLS on February 7, 2014, at 5:56:11
In reply to Re: Scott (pretty long post), posted by baseball55 on February 6, 2014, at 23:01:33
> > But see, this is why I keep replying. I want to feel more suicidal. I want to have the motivation to follow through with it. Me hearing more and more misunderstanding from people, helps increase my suicidal thoughts. Some time ago I figured I would have followed through with it by now. But, I'm still here!
> >
> > Write some more back to me, Eric.
> This is a very disturbing post. So the more people respond and fail to completely validate your perception, the more you become depressed and want to commit suicide? And you keep posting to elicit what you see as unhelpful responses to make yourself more depressed so as to increase your motivation to commit suicide?
>
> Well, I, for one, opt out of this game. If you want to commit suicide, I can't stop you and I hope, for your sake, that you don't make this decision. But I'm certainly not going to participate in a conversation in which you perceive yourself as constantly misunderstood and driven by others' misunderstanding to commit suicide.It is hard for me to know what is best for Poser. I think he is frustrated, demoralized, tired, weak, and getting desperate. I remember being in a similar place myself. I don't completely understand the dynamics, but I wanted to blame the world (all of existence; God) for my unrelenting pain. I wanted the pain to end. Suicide might be one way to accomplish this. It felt good to consider the relief that suicide would bring. However, I didn't want to be responsible for pushing myself over the edge so as to actually do it. I wanted to be pushed by someone else so that I don't take the blame. Perhaps I wanted to hurt someone else - maybe even God - because I was hurt by the world (God). It was not fair to be born this way. I wanted everyone else to pay for my misery.
I guess one could look at what Poser is doing as playing a game of sorts. I see it as being a call for help. He might want us to know that he is nearing the precipice. He doesn't know what else to do. Actually, he did verbalize an intention to keep fighting. Poser can't help himself but to keep trying. Poser is a survivor. In his mind, this could be a blessing and a curse.
- Scott
Posted by Phillipa on February 7, 2014, at 18:47:42
In reply to Re: Scott (pretty long post) » baseball55, posted by SLS on February 7, 2014, at 5:56:11
Scott I agree and do hope Poser is reading your post. If so Poser you can do it I know you can. And you can't anger me. I will sit with you if needed. Phillipa
Posted by SLS on February 8, 2014, at 7:33:15
In reply to Re: Scott (pretty long post) » phidippus, posted by poser938 on February 6, 2014, at 18:57:29
So, Poser, what's the deal?
Are you okay?
- Scott
Posted by AlexanderS on February 8, 2014, at 11:37:37
In reply to Wrong about mental illness., posted by phidippus on January 31, 2014, at 17:57:50
testing
Posted by poser938 on February 13, 2014, at 11:39:31
In reply to Re: Scott (pretty long post) » poser938, posted by SLS on February 8, 2014, at 7:33:15
> So, Poser, what's the deal?
>
> Are you okay?
>
>
> - ScottYeah Scott, I'm fine. These mental health sites just aren't for me. I'm just in a situation that the majority on sites like Babble can't relate to. Its like trying to describe ice cream to someone who has never eaten ice cream before.
And it just pains me to see people who think they have certain areas of psychiatry, and how these meds affect people figured out.
When they really do not.
I'm not trying to be rude. I just want Mental Health Care to be better for everyone. It would be amazing if millions demanded more from Psychiatry, in the same way they do our elected leaders. Instead of being complacent about it all, and turning a blind eye when someone does step forward to reveal the hell Psychiatry has caused them. All this has to do more with making money, than it does about Science.
And many feel informed enough, without actually being informed. They feel so informed that they feel they can tell me I'm wrong about my experiences.
No one had EVER questioned y descriptions of my experiences in life, until I stepped into the corrupt work of Psychiatry. Psychiatry corrupts minds, it leads so many innocent, sick people in the wrong direction. People such as Eric. He's well versed in nothing more than more than WebMD. I know this because of personal experience, not because of anything I've read.
Can a blind man lead a blind man? Will they not both fall into a pit? A student is not above his teacher, but everyone who is fully trained will be like his teacher. Luke 6:39-40
You're catching on, Scott. But as long as this we give praise tonthose who are wrong about the topic they give their 2 cents about, we will continue to just be fighting roadblocks that prevent people from getting the help they need.
I won't even be reading any replies to this post. I'm done with Babble. I do hope everyone on this site finds the relief they need. And thank you Phillipa for your impartial, objective words. I really appreciated them.
Anyway,it snowed like 7 inches here, so, I'm going to play in the snow!
Posted by poser938 on February 13, 2014, at 12:15:41
In reply to Re: Scott (pretty long post), posted by poser938 on February 13, 2014, at 11:39:31
Also, I would love to see Dr. Bob use this image for this image at the top of Psychobabble. It a drawing depicting the metaphor " the blind leading the blind.". Not to criticize anyone in a rude way, but in an instructive way., and to encourage people to open their eyes. To fully educate themselves. A little bit of knowledge can be dangerous. And passing on this little bit of knowledge can be dangerous. The more knowledge Babblers have, the better.,
I hope this link works on regular computers, since I'm on a mobile device. But if not, it is the picture from the Wikipedia page "the blind leading the blind"
Posted by Phillipa on February 13, 2014, at 19:58:10
In reply to Dr Bob, posted by poser938 on February 13, 2014, at 12:15:41
Poser sorry to see you leave. Anything I can do to help? Phillipa
Posted by phidippus on February 13, 2014, at 22:34:24
In reply to Re: Scott (pretty long post), posted by poser938 on February 13, 2014, at 11:39:31
>These mental health sites just aren't for me.
No, they are not. People with real illnesses post to this board.
>I'm just in a situation that the majority on sites like Babble can't relate to.
No one can relate to a factitious disorder that can be quantified.
>They feel so informed that they feel they can tell me I'm wrong about my experiences.
You're not wrong about your experiences, they just make no sense to us.
>Psychiatry corrupts minds, it leads so many innocent, sick people in the wrong direction.
I'd be in a state institution without psychiatry. You see, psychiatry is a whole made up of parts. Not every one of those parts, or individual psychiatrists has all the answers and some psychiatrists may be dead wrong. That does not mean everyone's experience with psychiatry is as harrowing as yours. I'm deeply sorry you took a bunch of pills and they caused damage to your brain. I hope you get that function back.
>People such as Eric. He's well versed in nothing more than more than WebMD.
You got me. Ow, the burn.
Eric
ps. you have factitious disorder
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