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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 PhoenixGirl on February 23, 2001, at 18:12:05
I'm 23 and female, and I have suffered from depression and social phobia since I was 12. The social phobia has subsided some, but ADs have never knocked out the depression.
I've never had sex or had a relationship with a guy, and I feel like I'm missing out on life. Matters are made worse by the fact that I have little sex drive or physical sensation. I used to have more in the first few years of my depression (I was on imipramine), but since then I've gone through a lot of other ADs, and they killed my sexual functioning. Recently I've switched to an AD that is very much like imipramine, but have had only a slight improvement.
Every time I see couples, or sexual things on tv, etcetera, I feel so sad. I don't know what to do. Life is a struggle, not a joy. I can't stop taking ADs because the depression becomes utterly crippling when I try to stop. I hope people here can give me some feedback. Thanks.
Posted by ShelliR on February 23, 2001, at 19:25:31
In reply to 23, never had sex or relationship, sad about it, posted by PhoenixGirl on February 23, 2001, at 18:12:05
Phoenix Girl. I sorry that you have suffered from depression for so long. But you are still quite young and have lots of time left in your life for relationships. When I remember back to that age, it was hard to visualize that I would not always feel the way I was feeling and that good things would happen a bit later in life to me (when I got on an antidepressant which helped me enormously).
I wouldn't worry so much about not having sexual feeling right now; since your social phobia has subsided some, I would focus my attention there. If you develop a relationship, then you can work on changing to a medication that doesn't take away your sexual drive. But first you have to develop a relationship.
You are still struggling with depression. I would focus both on therapy, as well as continuing the search for medications which may not be the traditional ADs to help with the depression. Have you tried MAOIs with augmentation? How about tricyclics? Do you feel you have a good pdoc that is committed to finding the right combintion to help your depression? I hope so.
p.s. I think it was very brave to talk about this.
shelli
Posted by PhoenixGirl on February 23, 2001, at 20:58:35
In reply to Re: 23, never had sex or relationship, sad about it » PhoenixGirl, posted by ShelliR on February 23, 2001, at 19:25:31
Thank you shelli for your reply. I just moved to a new town (Atlanta), and will probably get a doctor from Emory University. My insurance covers them, and they are world famous, so I have hope. I will get a therapist too.
Right now I take desipramine, which causes somewhat less sexual dysfunction than others I've tried, like celexa, clomipramine, and remeron. I may try augmenting it with something that may help dysfunction, like a stimulant, yohimbine, or a dopamine drug like mirapex. I'm scared of MAOIs, and think they would probably cause sexual dysfunction too.
So things look good for the future, since I finally have health insurance and can see a good doctor.> Phoenix Girl. I sorry that you have suffered from depression for so long. But you are still quite young and have lots of time left in your life for relationships. When I remember back to that age, it was hard to visualize that I would not always feel the way I was feeling and that good things would happen a bit later in life to me (when I got on an antidepressant which helped me enormously).
>
> I wouldn't worry so much about not having sexual feeling right now; since your social phobia has subsided some, I would focus my attention there. If you develop a relationship, then you can work on changing to a medication that doesn't take away your sexual drive. But first you have to develop a relationship.
>
> You are still struggling with depression. I would focus both on therapy, as well as continuing the search for medications which may not be the traditional ADs to help with the depression. Have you tried MAOIs with augmentation? How about tricyclics? Do you feel you have a good pdoc that is committed to finding the right combintion to help your depression? I hope so.
>
> p.s. I think it was very brave to talk about this.
>
> shelli
Posted by niborr on February 23, 2001, at 21:51:20
In reply to 23, never had sex or relationship, sad about it, posted by PhoenixGirl on February 23, 2001, at 18:12:05
You've probably heard this before, but it would be good for you to try to find some pleasure in your life even without a relationship. If you can do some work getting that to happen that will be better for you. When you expect a relationship with a guy to be the thing that will bring you joy, that can put too much pressure on one thing or person.
I hope you find a therapist you can work with. My heart goes out to you--you are the same age as my children (21 and 24) and I give them the same advice about expectations from relationships.
There are some articles on Practicing Joy in the Living Well section of my website at http://www.undoingdepression.com. Perhaps you will find something helpful there.
niborr
Posted by ksvt on February 23, 2001, at 21:54:07
In reply to Re: 23, never had sex or relationship, sad about it, posted by PhoenixGirl on February 23, 2001, at 20:58:35
> Phoenix Girl - I agree with Shelli. You shouldn't worry about the sexual dysfunction until you've found someone you really care about. It sounds like you have enough to deal with depression-wise without adding to your burden with worries about sexual performance. I know you probably don't feel this way, but 23 is unbelievably young. Also I know this is not necessarily true, but I believe that the development of close relationships can help you get over your depression. I went through my first depression when I was in my mid-20,s. Developing a relationship with my now-husband had alot to do with my recovery. Largely because of some pretty bad experiences I had been through, ours was a very non-sexual relationship for quite awhile. Hang in there and give yourself some time and space. Atlanta is a great town. Have fun there. K
> >
BTW, my sister lives in Atlanta very close to Emory. She has a couple of friends who have gone through pretty bad depressions. It's possible one of them used an Emory doc. Do you want me to try to come up with some names or do you have a good referral already?
Posted by Noa on February 24, 2001, at 12:57:02
In reply to Re: 23, never had sex or relationship, sad about it » PhoenixGirl, posted by ksvt on February 23, 2001, at 21:54:07
I agree--you are young, and because you are doing something about your depression, social phobia, etc., you have lots of time to work toward being ready for a relationship. Take one step at a time, in terms of learning to enjoy yourself and make friends and find out what you like in life. The pressure of feeling like you HAVE to be in a relationship would only add to the anxiety, I think. Instead, take one day at a time, and set small achievable goals regarding how you feel about yourself, and developing more social confidence. BTW, moving to a new city is hard--be kind to yourself about the adjustment process.
Posted by PhoenixGirl on February 25, 2001, at 18:16:59
In reply to Re: 23, never had sex or relationship, sad about it » PhoenixGirl, posted by ksvt on February 23, 2001, at 21:54:07
Hi ksvt,
Thank you for your response. I would like to hear what your sister's friends say about emory docs. One that I have been told is good is Dr. Ninan, who is an expert in treatment-resistant depression like I have. Thanks,
PG
> Phoenix Girl - I agree with Shelli. You shouldn't worry about the sexual dysfunction until you've found someone you really care about. It sounds like you have enough to deal with depression-wise without adding to your burden with worries about sexual performance. I know you probably don't feel this way, but 23 is unbelievably young. Also I know this is not necessarily true, but I believe that the development of close relationships can help you get over your depression. I went through my first depression when I was in my mid-20,s. Developing a relationship with my now-husband had alot to do with my recovery. Largely because of some pretty bad experiences I had been through, ours was a very non-sexual relationship for quite awhile. Hang in there and give yourself some time and space. Atlanta is a great town. Have fun there. K
> > >
> BTW, my sister lives in Atlanta very close to Emory. She has a couple of friends who have gone through pretty bad depressions. It's possible one of them used an Emory doc. Do you want me to try to come up with some names or do you have a good referral already?
Posted by Mark H. on February 25, 2001, at 21:47:41
In reply to for ksvt (also thanks everyone for your thoughts), posted by PhoenixGirl on February 25, 2001, at 18:16:59
Everyone has given you such good advice already, so I'll limit my comments to what has not been mentioned.
A new edition of "Screaming to Be Heard" was recently published, and it is available from Amazon.com for about $25 (or perhaps the library will have a copy). Written by a female OB/GYN, it is the most intelligently researched and comprehensive reference on hormonal balance considerations for women that my wife and I have been able to find anywhere.
The author notes that some women have too little serum testosterone (yes, women produce "male" hormones, in much smaller amounts than men, of course). For women whose blood tests indicate such a deficiency, supplementation with tiny amounts of testosterone may help. The serum testosterone blood test is likely to cost $150 or more (at least here), but it might be worth it to you to eliminate that as a possibility.
Nevertheless, I agree with everything the other responders have written, so don't put too much emphasis on this. However, I thought you might want to know about it.
Best wishes,
Mark H.
Posted by ksvt on March 5, 2001, at 13:06:27
In reply to for ksvt (also thanks everyone for your thoughts), posted by PhoenixGirl on February 25, 2001, at 18:16:59
>
> Phoenix Girl - I didn't want you to think that I had forgotten you. I emailed my sister days ago and since she doesn't use email anywhere near as frequently as I do, she only just got back to me. The person she wants to ask for info is out of town until sometime next week. This friend of hers uses a woman psychiatrist both for meds and for therapy. Hers is not the name you mentioned, and may not be an Emory affiliated doc, but this friend of my sister's is also an information gatherer by nature and may know something about the doc you mentioned. I'm sure my sister will get back to me after her friend returns. I hope all goes well - have you made the move yet? Ksvt
Posted by PhoenixGirl on March 6, 2001, at 16:14:50
In reply to Phoenix Girl - I haven't forgotten about you, posted by ksvt on March 5, 2001, at 13:06:27
Hi ksvt,
I haven't chosen a doctor yet. At this point I think that I want to get an Emory-affiliated doctor, because I want a doctor who is willing to experiment, try "controversial" things like stimulants, rather than one who is "by the book" and tries to play it safe. I've already tried practically all the by-the-book things, and they haven't been sufficient. One that was recommended to me was Dr. Philip Ninan, an expert on treatment-resistant depression at Emory, but he may not be taking new clients. By the way, I also want one who will take my sexual side effects and fatigue seriously, because for years doctors have been letting my suffering in those areas linger. I don't think they are unconquerable, but so many doctors like to give you the standard depression treatment and just send you on your way. For years I had extreme fatigue, and none of these bastards tried me on Wellbutrin or a stimulant or anything to help it. I insisted on trying Wellbutrin a few months ago, and it has helped considerably with my fatigue. All these years a doctor could have tried Wellbutrin or something with me, but they didn't, and the only reason I'm benefitting from it now is that I researched it myself and insisted on trying it. This is just one example of the ways pdocs have let me down. Anyway, thank you for investigating for me. I hope your sister or someone has some information.
> > Phoenix Girl - I didn't want you to think that I had forgotten you. I emailed my sister days ago and since she doesn't use email anywhere near as frequently as I do, she only just got back to me. The person she wants to ask for info is out of town until sometime next week. This friend of hers uses a woman psychiatrist both for meds and for therapy. Hers is not the name you mentioned, and may not be an Emory affiliated doc, but this friend of my sister's is also an information gatherer by nature and may know something about the doc you mentioned. I'm sure my sister will get back to me after her friend returns. I hope all goes well - have you made the move yet? Ksvt
Posted by Mary Ann on March 11, 2001, at 13:14:08
In reply to 23, never had sex or relationship, sad about it, posted by PhoenixGirl on February 23, 2001, at 18:12:05
Hi PhoenixGirl,
I think I was somewhat in your situation several years ago, where I thought I had to be in a relationship to be a "real" person, and none of my relationships were healthy. Jumping into a sexual relationship (which I almost always did) was the worst thing I could do, especially because most women put more feelings into a sexual relationship than most men do (Note that I said MOST, not ALL).My husband, who has the patience of a saint (most of the time), could not fill and did not want to be expected to have to fill that void in my life. So after I went for depression treatment almost three months ago, I have felt this void in my live becoming filled, but just a little. Since you have social phobia (something from which I suffered for years!) you might want to just take small steps. Get involved with a church group if you are religious, or book clubs, or reading to kids at the library, volunteering at nursing homes (older people are wonderful!), an animal shelter, or join a bowling league (which I did), or do anything in which you are interested that helps to get you out of the house. These types of things, done in groups, usually help to make you feel safe, because there is usually one or two people that you can feel that you really relate to. These types of groups can also be the basis for developing lasting realtionships. I feel I have control over my life much more so than I felt years ago.
Regarding your meds, I was originally on Prozac, which killed my sex drive, and my doctor switched me to Serzone, which has given me back my sex drive and restored many of the feelings that Prozac turned off, but I am having trouble sleeping with it. I would not recommend taking Yohimbe, because even though it is a "natural" product, it can raise blood pressure to astoundingly high levels and can cause stroke or even death. It's kind of like ephedra in that respect.
Good luck to you, please keep in touch.
Mary Ann
Posted by ksvt on March 12, 2001, at 21:41:11
In reply to Re: Phoenix Girl - I haven't forgotten about you, posted by PhoenixGirl on March 6, 2001, at 16:14:50
>
> >PhoenixGirl - I finally heard from my sister's friend. She has not heard of Philip Ninan, but she did give me a couple of names of people who can perhaps refer you or who might be able to give you the scoop on Ninan. The first is an Emory-trained pdoc named, Dr. June Serravezza, who's number is 404-378-8907. I'm told that she is very approachable and probably would be more than willing to help steer you in the right direction. She is my sister's friend's pdoc and therapist. The other name she gave me is that of Dr. Beth Seelig who is at Emory. My contact only knows her by reputation. She thinks she might be a psychoanalyst and thus not what you're looking for, but there again, maybe someone who can tell you about Ninan or other Emory docs who have some expertise in treatment resistant depression. You said you might have a difficult time getting into see Ninan. Have you tried, or have you tried to at least talk to him? I think if he won't see you, maybe he'll talk to you on the phone and help set you up with someone else who might be appropriate for your purposes. If you want to come at him more indirectly then maybe you should call one of these women and sound her out about Ninan, and whoever else might be good for this. I'm sorry I can't be of more help. Good luck, and I'd love to hear who you ended up with and how you got there. If you think I can help, please don't hesitate to ask. K
Posted by PhoenixGirl on March 13, 2001, at 16:51:03
In reply to Re: Phoenix Girl - I haven't forgotten about you, posted by ksvt on March 12, 2001, at 21:41:11
Hi ksvt,
Thanks for your advice. What I've found out is that doctors who actually work at Emory are very difficult to see because they do so much research, that they do not have many patients. It's easier to see a doctor who was trained at Emory. I spoke to one who works at Emory, a doctor Andrew Miller, and he said he would help me find a doctor. I have an appointment with one named Dr. Joseph Berger. Dr. Miller can tell me who's a really "bio" psychiatrist, but he said that I will have to actually visit a doctor before I can decide whether we're a good match. See, I'm looking for a doctor who is ok with a pro-active patient. I'm also looking for a doc who is willing to experiment with unconventional treatments, but I forgot to ask Miller about that. Thank you for your help! My appointment with Berger is in about two weeks, so we'll see how it goes.
> >
> > >PhoenixGirl - I finally heard from my sister's friend. She has not heard of Philip Ninan, but she did give me a couple of names of people who can perhaps refer you or who might be able to give you the scoop on Ninan. The first is an Emory-trained pdoc named, Dr. June Serravezza, who's number is 404-378-8907. I'm told that she is very approachable and probably would be more than willing to help steer you in the right direction. She is my sister's friend's pdoc and therapist. The other name she gave me is that of Dr. Beth Seelig who is at Emory. My contact only knows her by reputation. She thinks she might be a psychoanalyst and thus not what you're looking for, but there again, maybe someone who can tell you about Ninan or other Emory docs who have some expertise in treatment resistant depression. You said you might have a difficult time getting into see Ninan. Have you tried, or have you tried to at least talk to him? I think if he won't see you, maybe he'll talk to you on the phone and help set you up with someone else who might be appropriate for your purposes. If you want to come at him more indirectly then maybe you should call one of these women and sound her out about Ninan, and whoever else might be good for this. I'm sorry I can't be of more help. Good luck, and I'd love to hear who you ended up with and how you got there. If you think I can help, please don't hesitate to ask. K
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