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Dr. Bob is Robert Hsiung, MD,
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Posted by b2chica on June 12, 2015, at 0:01:20
In reply to Re: I'm just so tired of the same fight... » b2chica, posted by phidippus on June 11, 2015, at 1:20:17
i'm on it (latuda) at 60mg... i cry about every day and have worsening harmful and intrusive thoughts...
Posted by b2chica on June 12, 2015, at 0:03:36
In reply to Re: I'm just so tired of the same fight... » b2chica, posted by stan_the_man70 on June 11, 2015, at 4:35:45
sounds like things are going well STM, i am quite pleased to hear that. ... it gives me a little hope.
sleep: too much
exercise: barely get off the couch
food: i hate it all.need pharmacological intervention asap...
Posted by b2chica on June 12, 2015, at 0:09:04
In reply to Re: I'm just so tired of the same fight... » b2chica, posted by SLS on June 11, 2015, at 19:42:15
started Fetzima yesterday. saw T today.
extra crappy is my mood.I'm trying scott, i really am. i try to distract pretty much all day now that i'm home with the kiddos. i have about 3 craft projects going. i try to clean and bake often, but about the last 2 weeks my energy level is in the toilet and don't even want to move.
i have terrible agitation/irritability when I'm not on my adder all (yes people i said when i'm Not on it... i am a walking paradox ok, deal with it). and i'm not up to 900-1200 gabapentin/day to help with intrusive thoughts, agitation, thoughts of self harm, urges to self harm... etc.
my T and i are very flustered with pdoc... but my old pdoc is still unavailable. and i don't trust anyone else in this stupid town.
Posted by SLS on June 12, 2015, at 0:57:56
In reply to Re: I'm just so tired of the same fight..., posted by b2chica on June 12, 2015, at 0:09:04
> started Fetzima yesterday.
Fetzima (levomilnacipran) is kind of a "purified" version of Savella (milnacipran). It's like comparing Lexapro to Celexa.
> extra crappy is my mood.
Latuda made me feel much worse. I am not unique in this regard. I have yet to see a success story on Psycho-Babble. I was hoping for more with Latuda. You might consider asking your doctor to temporarily discontinue Latuda to see if it is responsible for your further deterioration.
Did you feel worse with Remeron or Buspar?
I forget - What happened with Lamictal? I have seen a combination of Lamictal and Trileptal work well to treat bipolar disorder. Do you think you might need something for ruminating or intrusive thoughts? In fact, I have seen a combination of Wellbutrin + Lamictal + Trileptal help someone with a mixed-state hypomania. He also had trouble with anger management, irritability, and impulsivity. It helped with weepiness, too.
It is not rare that amphetamine can smooth things out for some people. Have you tried Vyvanse? Some people like it much better than Adderall. That's not a universal endorsement, of course.
> I'm trying scott, i really am.
I know.
Just trying is a success. You deserve kudos for this. Like it or not, you are a true survivor. Let's hope that you soon enjoy more from life than merely surviving.
I think you have plenty of fight left in you. I may need to borrow some. :-)
- Scott
Posted by SLS on June 12, 2015, at 1:27:56
In reply to Re: I'm just so tired of the same fight..., posted by b2chica on June 12, 2015, at 0:09:04
Oh. Before I forget. Lamictal works well with Abilify. Do you think Abilify and Trileptal might work to control Lamictal-induced hypomania? Wasn't that the problem with Lamictal - mania?
I forgot to ask you why you are taking Latuda in the first place. On paper, it looks like a good drug for bipolar depression. I imagine the clinical trials demonstrated efficacy. I never reviewed them. Sometimes, the only clinical trial that is worth paying attention to is your own. You never know.
Risperidone?
If you haven't yet tried a MAOI, you really need to explore that. I would ask your doctor about Parnate. You can combine it with nortriptyline, which might take care of intrusive thoughts, ruminations, and hypophagia. Of course, you would want to be on some sort of antimanic drug. There is NO WAY you can combine a MAOI with a serotonin reuptake inhibitor like Fetzima. These include SSRIs, SNRIs, and certain TCAs (imipramine, and clomipramine).
I wish I knew what would help us get well. I don't. I'm just throwing out some ideas that are rather aggressive.
Msybe the oral ketamine-type drug being developed by Naurex will eventually come to market. It should work as well as ketamine, but without dissociative cognitive side effects and a wider therapeutic window.
Would you consider things like intranasal ketamine or low-dose naltrexone (LDN)? Maybe higher dosages of memantine would be helpful. It may take several months to work, though.
- Scott
Posted by stan_the_man70 on June 12, 2015, at 7:22:18
In reply to Re: I'm just so tired of the same fight... » stan_the_man70, posted by SLS on June 11, 2015, at 9:25:53
> > ----------------------------
> > no pills, no pills, no pills
> >
> > ------------------------------
>
> Are you that sure?
>
> This might be good advice. However, if you are wrong, the consequences might be more dire than just a little indigestion.
---------------------
I meant I was not taking pills at the time I got good sleep
----------------
The one observation I had based on an exercise routine -
if you wake up every morning and try to exercise early, you will notice things that affect you very clearly...and if you didn't get good sleep the night before it will be immediately observable...
if you didn't take a healthy diet the previous day, it could affect your exercise routine immediately...
if you added a pill, you will understand its effects better...
if you are trying to reduce/taper a pill, it will help calm you down easier...
any good social activity or any mental workouts and it will help you focus on the exercise routine better...hope you can appreciate this... thanks !
>
>
> - Scott
Posted by SLS on June 12, 2015, at 11:38:27
In reply to Re: I'm just so tired of the same fight... » SLS, posted by stan_the_man70 on June 12, 2015, at 7:22:18
> > > ----------------------------
> > > no pills, no pills, no pills
> > >
> > > ------------------------------
> >
> > Are you that sure?
> >
> > This might be good advice. However, if you are wrong, the consequences might be more dire than just a little indigestion.
> ---------------------
> I meant I was not taking pills at the time I got good sleep
> ----------------
> The one observation I had based on an exercise routine -
> if you wake up every morning and try to exercise early, you will notice things that affect you very clearly...
>
> and if you didn't get good sleep the night before it will be immediately observable...
> if you didn't take a healthy diet the previous day, it could affect your exercise routine immediately...
> if you added a pill, you will understand its effects better...
> if you are trying to reduce/taper a pill, it will help calm you down easier...
> any good social activity or any mental workouts and it will help you focus on the exercise routine better...
>
> hope you can appreciate this... thanks !Yes I do. My apologies.
I thought you were suggesting that this person discontinue their medication in favor of diet and exercise in order to treat a severe affective disorder. I didn't realize you were speaking only of sleep. Certainly, making dietary changes and initiating exercise can help improve sleep hygeine. However, severe depression can preclude performing regular exercise routines. It might even prevent one from eating healthy as this often takes too much energy to prepare meals. Each case is, of course, unique.
- Scott
Posted by Tomatheus on June 12, 2015, at 11:55:14
In reply to Re: I'm just so tired of the same fight..., posted by SLS on June 12, 2015, at 1:27:56
> Sometimes, the only clinical trial that is worth paying attention to is your own.
Scott, I think that this statement of yours is so true and so well put. You definitely seemed to express yourself well here.
And to B2chica, I don't have any real treatment suggestions for you, but I hope that you've found what's been written here so far to be helpful. You might find the battles that you're fighting to be tiring, but all I can say is to hold out some hope that you'll continue to persevere and that you'll possibly even make some significant gains against your disorder in the time ahead.
Tomatheus
Posted by b2chica on June 12, 2015, at 12:38:36
In reply to Re: I'm just so tired of the same fight... » b2chica, posted by SLS on June 12, 2015, at 0:57:56
remeron i was on for sleep only about a week, stopped cuz it wasnt helping.
Buspar i gradually got worse on.Lamictal i started having problems breathing, when i called pdoc she told me to immediately stop.
T thought it could be some form of SJS.Trileptal i had such a severe reaction from it was lucky i was in the hospital at the time. So i cant go back on that one or carbazapine (related).
this pdoc picked Fetzima because i had such a positive result when i was on wellbutrin. (i eventually had to stop because it pooped out on me, a few years later i tried it again (brand and 2 generics) and never worked.
Vyvanse i got way worse mood wise on, crying all the time major depressive episode. it seems that the DRIs dont work for me, it needs to be the DA stimulants. specifically adderall.
i read something last night (believe it or not from a graphic novel) that said You wont know the meaning of success without knowing how it feels to fail How you recover from these trials is what really matters.
sometimes its the little things that gives me a bit more to continue on
i would love to share with you any of what i have Scott... anytime..
Posted by b2chica on June 12, 2015, at 12:39:45
In reply to Re: I'm just so tired of the same fight..., posted by SLS on June 12, 2015, at 1:27:56
i would consider (and have) ketamine itself and pot at this point...
Posted by SLS on June 12, 2015, at 13:50:20
In reply to Re: I'm just so tired of the same fight..., posted by b2chica on June 12, 2015, at 12:39:45
> i would consider (and have) ketamine itself and pot at this point...
Oral ketamine?
Oral ketamine is all but impossible to administer. The blood level of ketamine for treating depression is very narrow, and requires precision to dose. That's why it is best administered intravenously for maximal effect. Intranasal ketamine can work, too, but it takes awhile to find the right dose and dosing frequency.
Medical science is deconstructing marijuana and evaluating the actions of its components in the brain. For example, intractable epilepsy can sometimes be controlled with marijuana, but only if the strain of marijuana contains a high ratio of CBD to THC. If it is CBD that helps with anxiety, it would be nice to have a well-metered oral pill to take (Epidiolex). The same would apply to appetite and THC and its prescription synthetic derivative (Marinol).
I know you are desperate. I would drink elephant piss if I thought it would cure me. I would drink in moderation, of course. I bet my memory would improve, though.
- Scott
Posted by phidippus on June 12, 2015, at 14:47:06
In reply to Re: I'm just so tired of the same fight..., posted by b2chica on June 12, 2015, at 0:01:20
so you're mood bottomed out on it.
what antidepressants have you tried? (remind me, I know I've probably asked before)
Eric
Posted by b2chica on June 12, 2015, at 17:31:18
In reply to Re: I'm just so tired of the same fight..., posted by SLS on June 12, 2015, at 1:27:56
Abilify gee me Extreme anger/aggitation doc took me off it right away. Trileptal had terrible reaction to lucky i was in hospital, risperidone when i tried it did absolutely nothing for me
have Not tried MAOI, i have suggested numerous times to this pdoc a couple (especially Nardil) but she wont comment on them.
nortriptyline and impipramine. she just said no to them.sorry, ive been on so many its hard to guess with me.
but have not been on MAOIs. or TCA i think. but every time Ive suggested them to a doc they dont go there. i was told at two different times by on pdoc that he wouldnt put me on a TCA due to the current state i was in of depression, he was too afraid of my actions regarding the meds. (since i had a history there).anyway. thanks
Posted by b2chica on June 12, 2015, at 17:35:09
In reply to Re: I'm just so tired of the same fight... » b2chica, posted by SLS on June 12, 2015, at 13:50:20
can't believe you actually got a laugh out of me Scott. Though i did just wake from a nap. i must be delirious. but i chuckled for sure. and agree 100%.
> I know you are desperate. I would drink elephant piss if I thought it would cure me. I would drink in moderation, of course. I bet my memory would improve, though.
>
>
> - Scott
Posted by b2chica on June 12, 2015, at 17:42:35
In reply to Re: I'm just so tired of the same fight... » b2chica, posted by phidippus on June 12, 2015, at 14:47:06
> so you're mood bottomed out on it.
>
> what antidepressants have you tried? (remind me, I know I've probably asked before)
>
> Erici can't hardly remember them all, but i've tried a list full of SSRI's, DRI's, Stimulants, AAP, AP, SNRI's, older meds, new ones.
i have Not been on any MOAI's or TCA's (which as i mentioned above i have suggested them to a couple pdocs at various times and for whatever reason was never tried on them.i guess i've been on most of the 'standard' AD's... and for some reason it seems to be the 'odd' ones that tend to help me the most. like Adderall and Gabapentin.
i have a list somewhere of the meds i've tried and i think its up to 33 now if i include the Fetzima... i think, its something like that.
Never done ECT or Lithium and they are both at the very ultimate bottom of my list. i tend to do terrible on mood stabilizers (anti-siezure).have dx of bipolar (mixed) or psychotic depression.
i have never had that 'high' of mood, it tends to go straight to agitation, irritability, then the negative intrusive thoughts which leads me to self harm or harmful behavior. then at times when severe it can lead to psychosis. i mostly have auditory illusions but can also have visual ones as well. some paranoia as well at different levels of depression.so... good luck me...
Posted by phidippus on June 12, 2015, at 18:16:11
In reply to Re: I'm just so tired of the same fight... » phidippus, posted by b2chica on June 12, 2015, at 17:42:35
>i have Not been on any MOAI's or TCA's
I think its time try one or the other. I recommend Clomipramine not only because its the gold standard for depression, but is a standard for the care of OCD, which you seem to have a slight case of: you often talk about intrusive negative thoughts that become obsessive and lead to self-harm (which is also a bit borderline).
>Adderall and Gabapentin.
Adderall works because it treats your depression and may treat an underlying ADHD.
Gabapentin helps because it is a glutamate inhibitor and helps with intrusive/recurrent thoughts
>Never done ECT or Lithium
ECT can be helpful, but I don't think its going to help with the intrusive thoughts. You don't need Lithium.
>i tend to do terrible on mood stabilizers
Probably because you don't need one and they just make you more depressed.
>have dx of bipolar (mixed) or psychotic depression.
i have never had that 'high' of moodYou are not bipolar. Please get a new diagnosis.
Psychotice depression? Maybe. Do you see things? Do you hear things? If you do, then its a better diagnosis. I'm not goingg to ask if you become delusional, mainly because you won't know if you are. Do you have strange thoughts? Who cares? You don't have to be psychotic to have strange thoughts.
You have more than one thing going on with you-maybe ADHD from your strong response to adderall. Definitely MDD as you fight depression contionuously. OCD or borderline-intrusive thoughts that lead to self harm. How was your childhood? Did you suffer from any abuse? Knowing this would tell me more.
Have you stopped the Latuda?
Eric
Posted by b2chica on June 12, 2015, at 18:55:28
In reply to Re: I'm just so tired of the same fight... » b2chica, posted by phidippus on June 12, 2015, at 18:16:11
i need to at least see if this fetzima works i need to give it a fair try. (though i dont want to waste that much time). the self-harm is usually a nice way to say i want to throw myself in a lake with a brick anklet although there are times where i actually have SI in mind, but that tends to only flair when my PTSD is kicked up. (answer to below, yes, abuse thus PTSD)
dx does included ADHD, and i DO know i have that. and adderall does most certainly make a Huge difference in my life. huge
gabapentin calms me down and relaxes me mentally so that im not so psychotically anxious (i have bad anxiety) which typically leads to ruminating thoughts and some paranoia.every mood stabilizer ive been on has made me worse (except this latuda well maybe)
i have dx of bipolar due to the severe reaction ive had to some SSRIs. i actually Have had true highs to the point of reality slipping away but i was in hospital during my worst episode thanks prozac.yes i can see, hear things, but i am usually aware they are not real (thats why its termed psychotic depression) because it is not usually delusional. i am aware and therefore took a long time before i admitted i had those episodes.
no have not stopped the latuda.
Posted by phidippus on June 12, 2015, at 19:19:04
In reply to Re: I'm just so tired of the same fight... » phidippus, posted by b2chica on June 12, 2015, at 18:55:28
OK I needed that info. Especially this bit:
"gabapentin calms me down and relaxes me mentally so that im not so psychotically anxious (i have bad anxiety)"This anxiety you're describing would be the extent of your mania. With some folk, severe anxiety along with a depressed state constitutes a mixed state, with the anxiety being the mania. Gabapentin works so well because it has some mood stabilizing properties and gets rid of pesky thoughts. How much do you take?
>dx does included ADHD, and i DO know i have that. and adderall does most certainly make a Huge difference in my life.
I'm glad it works so well for you.
>every mood stabilizer ive been on has made me worse (except this latuda well maybe)
Latuda is an antipsychotic and not really a mood stabilizer. It should help with your mania/anxiety and keep you from becoming psychotic. It probably won't help with depression-I don't think it will pack enough punch.
>(thats why its termed psychotic depression) because it is not usually delusional.
If you are bipolar and experience psychosis in a depressed state, its just bipolar and not psychotic depression. Being bipolar kind of excludes the psychotic depression diagnosis. With bipolar you can become psychotic on both ends of the spectrum which seems to have happened to you.
>i need to at least see if this fetzima works i need to give it a fair try.
My concern is without a mood stabilizer an antidepressant is just going to destabilize you and either send you into a terrible funk or make you manic, with increased anxiety. Maybe the Latuda will keep you from going off the rails, but I wouldn't bet money on it. Gabapentin may help, but your dose would need to be pretty high.
I take back my statement that you do not need lithium.
I think you need to try it. No other mood stabilizers have worked for you, but lithium is completely different and might just be the only 'true' mood stabilizer.
Eric
Posted by baseball55 on June 12, 2015, at 19:54:46
In reply to Re: I'm just so tired of the same fight... » phidippus, posted by b2chica on June 12, 2015, at 17:42:35
You might want to consider lithium. I found it amazingly helpful for intrusive thoughts of suicide. It just stopped them. I only took 900mg, not enough to worry about side effects and blood levels.
Posted by Phil on June 12, 2015, at 21:48:44
In reply to Re: I'm just so tired of the same fight... » b2chica, posted by baseball55 on June 12, 2015, at 19:54:46
I had really bad tremors at 900mg. I couldn't write. If I had to use a check I had to ask them to fill it out and I would sign it. It was very noticeable. It can be a lifesaver though.
Posted by Lamdage22 on June 13, 2015, at 5:47:02
In reply to Re: I'm just so tired of the same fight... » SLS, posted by b2chica on June 12, 2015, at 17:35:09
What are your hobbies and how would you feel to go back out there and "just do it". Im not a Nike representative but i like the slogan.
They can be a nice distraction from your mental problems.
What did you like to do when you felt better?
Posted by Lamdage22 on June 13, 2015, at 6:19:09
In reply to Re: I'm just so tired of the same fight..., posted by Lamdage22 on June 13, 2015, at 5:47:02
thats what depression is. Lack of interest in things you once found enjoyable.
Posted by stan_the_man70 on June 13, 2015, at 9:41:21
In reply to Re: I'm just so tired of the same fight..., posted by b2chica on June 12, 2015, at 0:03:36
> sounds like things are going well STM, i am quite pleased to hear that. ... it gives me a little hope.
> sleep: too much
> exercise: barely get off the couch
> food: i hate it all.
>
> need pharmacological intervention asap...
>-------------
thanks for the reply....as an aside....
I used to visit http://www.lumosity.com/ when I felt tired. It's a website for brain exercises. You don't need to pay to subscribe to use the basic services. I found it very helpful - helps to focus and concentrate and it is not frustrating like video games !Another one I liked http://www.happy-neuron.com/
And there are many other similar websites too ...
btw, your sleep may not be natural sleep, so not sure how much it is helping you
Posted by stan_the_man70 on June 13, 2015, at 12:12:00
In reply to I'm just so tired of the same fight..., posted by b2chica on June 10, 2015, at 23:21:03
Three postings/articles on same website
the links are self explanatory...http://www.prevention.com/mind-body/emotional-health/13-healthy-foods-reduce-stress-and-depression
http://www.prevention.com/mind-body/yoga-poses-relieve-stress
http://www.prevention.com/mind-body/bizarre-mental-health-practices
Posted by b2chica on June 30, 2015, at 11:41:38
In reply to in case you have time to read » b2chica, posted by stan_the_man70 on June 13, 2015, at 12:12:00
thank you i like these very much.
i do two of the yoga poses, but the others seem very helpful too. Thank you STM
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