![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 23 to 47 of 54. Go back in thread:
Posted by DL on November 1, 1998, at 17:30:47
In reply to Re: Speech, posted by Toby on October 29, 1998, at 8:51:27
I posted a reply last night and it got lost in the transition between months.....Oh, well..
> Did you see that Klonopin has been used for the jaw clenching with good results? You may need to go back to it at night
After 2 years of being told it is not good to take benzos & that they are addictive & more, I wonder about starting again? I realize .25 or .5 mg at bedtime is not much, but at this point I am sleeping without waking (hooray!) with just the Remeron. No Klonopin for about 3 wks I think. If I give it a trial to see if it helps the oral motor and clenching problem, am I likely to find it hard to stop again? It used to be the only thing that let me sleep some so it was hard to give up till I found the Remeron worked better.
Would I take the same dose as before?
I now have a "bruxism appliance" to wear at night. When I wake my jaw is spasmed around it! I can hardly get a toothbrush in in the morning until I massage my jaw...So even though it protects my teeth from more fractures, it is not helping the clenching.
> Also, it sounds like you are having problems getting your words SPOKEN, not LOSING the word in your brain, like a memory problem, is that right?
Definitely. I do have concentration problems that plague me still, but at the time this is happening I know exactly what I want to say, but the jaw muscles seem to have a short circuit. I have found that when it happens I have better luck finding a way to say it with other words than if I just keep trying to get the original word out. Once it has started it just seems to keep getting worse so I try to lead the conversation to the other person. Perhaps it is muscle spasms. I have always had a problem with tooth grinding and clenching since I was small (at least to some degree) but the word problem only showed up 2 1/2 yr ago along with the other depression/anxiety symptoms. And it did seem to be less of a problem with the klonopin. The times I remember it a lot, other than now, were when I was trying to go without the klonopin at MD request.
I think I have always clenched with stress and probably even when on theklonopin. But the speech part seems definitely connected to the times I have been off the klonopin for a few days.
--Is there any difference between the generic clonazepam and klonopin? Once about 2 years ago I was given the generic and had trouble sleeping again. So the MD has written 'medically necessary' on the scripts since. But I wonder if it was just me and my sleep problem. It is less expensive I know, but with the degree of sleep problem I was afraid to try again.
---Are there any things that interact with Remeron? Is klonopin OK with it? I remember the info about Remeron and bone marrow problems......If I take it for a while should I be tested for those problems?
--I LOVE being able to sleep and dream. BUT the appetite and weight thing is sure there. I have definitely gained weight and find myself hungry all the time--even at times when I never used to think about food (driving, typing etc). I will be already into something to eat and then wonder after why I was even hungry at that time. Any more suggestions?
__Also, another thing I notice is that my lips and nose seem to always be dry. I think you told me the Remeron is related to antihistamines and my experience is that they do the same thing. Is this common with Remeron?
> Regarding the preferred medications: The MD's do need to contact the insurance company and appeal for the Remeron and for the natural hormones. You have a history of adverse reactions to the others and that is a criteria for most companies to approve off-formulary medications.
I see the psychiatrist tomorrow (Mon). That means it has been about 6 weeks--about 4+ wks on the 30mg of Remeron. Ins Policy switch will probably be towards the middle or end of Dec. (coinciding with divorce hearing). I will talk to them before that.
I will ask MD about the klonopin tomorrow and get a new prescription for Remeron since the one I struggled so hard for had no refils! Should I continue on this dose of Remeron? In your experience is it effective at this dose?
After I told the therapist about Remeron's drowsiness decreasing with increased dose, she was able to use the info with another person who was starting on Remeron and ready to give it up due to drowsiness. Thanks for the help.
Posted by DL on November 2, 1998, at 22:20:13
In reply to Lost Message, posted by DL on November 1, 1998, at 17:30:47
Had my drive by visit today! MD appologized for problems with Remeron script and called pharmacy while I was there to order new script and see if it was in stock.
I asked about the speech problem and the klonopin. He offered to write another script for klonopin--wish more in depth listening happened before the prescription pad popped out! I told him I was still in awe of the restorative properties of real sleep--and how much I looked forward to going to bed because I have dreams now. Even if they are sometimes scary, it's something I was missing for close to 3 years... He told me if I take the klonopin I may lose the dreams since benzos alter the sleep cycle. Would the klonopin override the Remeron? Would taking it in the morning for the day be better?
I asked what else I could do for the muscle spasm problem and he suggested I try meditation and relaxation. I tried all those type of things a few years ago and found that you really should learn them while you are well--then the method and structure is part of you and you can draw upon it more easily when you need help. Right now I am so busy and stressed with all the changes I think it would be hard to make those techniques work, but I am open to suggestions.
He told me to come back in 2 months and call if I want more klonopin. At 10 min and $50 for a "medication check", he made $5/min...
Posted by Toby on November 3, 1998, at 14:08:40
In reply to MD visit, posted by DL on November 2, 1998, at 22:20:13
You might want to try the Klonopin in the morning or in the early evening so that it isn't associated with "sleep" but instead may help the speech and jaw clenching. If he gave you the 0.25 or 0.5mg strength, cutting it into halves or quarters to see what dose will stop the problems would be the best route. It may be that a very tiny dose during the day will be OK, but the jaw clenching may need a slightly higher dose. Again, the problem for you would not be "addiction" because you don't have a penchant for taking more and more (exactly the opposite) but with your body's sensitivity to meds, physical dependence is probably going to happen again. However, to paraphrase an old saying, "If it's fixed, don't break it;" in other words, if the medication works, don't get rid of it just because somebody wants to try and tell you it's an addictive medication. The very small dose of Klonopin you take should not override the Remeron in terms of sleep. For the eating, perhaps buying some crunchy things specifically for the munchies and making yourself go to them rather than the fattening things will help. To decide whether you need to increase the Remeron dose, talk to your therapist and go over what improvements you've made and what still needs improving in terms of how you feel emotionally and then talk about which of those things can be addressed in therapy and which she feels may need further medication adjustment. It sounds like (from afar) that improvements in mood, etc could still be made, but if things are still getting better even now (no matter how slowly), I probably wouldn't increase it until you have been at this dose for a total of 6-8 weeks and then evaluate again. I forget what else you asked in the posting from yesterday. I will look and write again if I missed something.
Posted by janey on November 3, 1998, at 22:52:05
In reply to Re: MD visit, posted by Toby on November 3, 1998, at 14:08:40
DL,
What works for me most of the time in terms of relaxation, bruxism and sleep problems is listening to one of my two relaxation tapes.
One was created by a doctor at the day treatment program I attended and incorporated deep muscle relaxation. Tense a muscle up, then relax; tense again, relax again and notice the difference, etc. The tape was about 20 minutes in length and the doctor suggested listening to it at least once a day for a few weeks. Eventually, when I find myself clenching my teeth or tensing up, I can do these deep muscle exercises and relax now. I still listen to the tape off and on.
Another tape was created for my a hypnotist my therapist referred me to. It's more for insomnia. While I take a horse's dose of trazodone every night, sometimes I still have trouble sleeping. I turn on this tape which done with me right there and "going under," and I usually fall asleep before the body relaxation exercise is done and I "go to my special place" on the tape.
These are just a couple of the tools I'm lucky to have to get me through the rough times. Maybe they can work for you? Good luck.
janey
Posted by janey on November 3, 1998, at 22:54:51
In reply to Re: MD visit, posted by Toby on November 3, 1998, at 14:08:40
DL,
What works for me most of the time in terms of relaxation, bruxism and sleep problems is listening to one of my two relaxation tapes.
One was created by a doctor at the day treatment program I attended and incorporated deep muscle relaxation. Tense a muscle up, then relax; tense again, relax again and notice the difference, etc. The tape was about 20 minutes in length and the doctor suggested listening to it at least once a day for a few weeks. Eventually, when I find myself clenching my teeth or tensing up, I can do these deep muscle exercises and relax now. I still listen to the tape off and on.
Another tape was created for me by a hypnotist my therapist referred me to. It's more for insomnia. While I take a horse's dose of trazodone every night, sometimes I still have trouble sleeping. I turn on this tape which was created with me right there and "going under," and I usually fall asleep before the body relaxation exercise is done and I "go to my special place" on the tape.
These are just a couple of the tools I'm lucky to have to get me through the rough times. Maybe they can work for you? Good luck.
janey
Whoops! Please excuse the double posts! I thought I could go back and correct my posts before they were actually submitted! I'll be more careful in the future.
Posted by DL on November 5, 1998, at 22:54:55
In reply to Re: MD visit, posted by Toby on November 3, 1998, at 14:08:40
I posted a message here on 11-4 and it acted just like it had been posted, but when I came back today it was gone.
I have decided to try other methods to deal with the speech/clenching problem before I go back to the klonopin. I remember the dentist said I should not chew gum since it tenses and tires the jaw muscles. I have sugarless gum in my car and use it for alerting while driving (started when I had excessive drowsiness on low dose Remeron). So to start I will stop the gum. I will also try to be more conscious of the clenching and practice relaxing neck and jaw muscles. If the spasms continue to get worse I will try a quarter tablet of klonopin during the day.
Real sleep continues to leave me awestruck. I just can't believe that I can have sleep with dreams, relaxation and depth. I think my focus on work may be a little bit better because of it. People who have never had a persistent, intractable sleep problem take this state of mind for granted. I never will. This sleep is the best present I could ever have...
> To decide whether you need to increase the Remeron dose, talk to your therapist and go over what improvements you've made and what still needs improving in terms of how you feel emotionally and then talk about which of those things can be addressed in therapy and which she feels may need further medication adjustment.
I see her on Sat and can try to do this. I'm not quite sure exactly which "non improvements" would be on the therapy list and which would be on the medication list.
> It sounds like (from afar) that improvements in mood, etc could still be made,
Tell me why you have this sense--it might help me decide where I am on the improvement scale. Unfortunately I have been in such a low/anxious/stressed mental state for so long I find I just don't have a "feel" for normal anymore. I have forgotten what that's like. So I may be there or not--I just don't know.
> but if things are still getting better even now (no matter how slowly), I probably wouldn't increase it until you have been at this dose for a total of 6-8 weeks and then evaluate again.
I will have been on the 30mg 5 weeks on this coming weekend. As I said it is hard for me to judge my improvement. It would be easier for someone living with me to evaluate. But my son is at college and my husband is angry and distant and passive aggressive especially now. He is not interested in helping me out in any way. I do definitely feel the sleep is even getting better. This surprises me because last week I didn't think it could get better. I thought that was pretty great then. Any suggestions?
Hope this one posts and stays.
Posted by Toby on November 6, 1998, at 11:50:41
In reply to Lost Message, posted by DL on November 5, 1998, at 22:54:55
It sounded like you are still not feeling "content" yet with how things are going, so that's why I said it would be helpful to talk with your therapist since that may be a good place to put things in perspective and see which things are symptoms of clinical depression and which are "situational" and can still be addressed in therapy (she should be able to help you with distinguishing these).
Regarding "not knowing what normal feels like," you'll know when you get there, kind of like the realization that comes with finding "normal" sleep again... you just know when you feel it. So, if you don't "feel" OK yet, aren't "sure" you are there yet, then you aren't. And that just means it will take more time and investigation to reach. And don't worry too much about figuring out an exact time to increase the remeron; if in 3 weeks or so you are still on an upslope of the recovery curve, there's no hurry to go up on the dose just because it's there (I think the mountain analogy just got out of hand). The time to think about raising the dose is when the improvement has leveled off but you feel that you haven't reached "feeling really good and/or normal" yet.
Posted by janey on November 7, 1998, at 15:55:52
In reply to Re: Lost Message, posted by Toby on November 6, 1998, at 11:50:41
Hi DL.
I know what you mean about what a wonderful present
sleep is. I've been a chronic insomniac all my
life and a good night's sleep is just the absolutely,
totally wonderful best thing in life... yep, even
ahead of chocolate and maybe good sex. The jury
is still out on that one. ~laughing~Feeling normal... There were days, weeks, months,
years even when I wondered if I'd ever feel "normal"
again. Sometimes it takes a while of feeling "normal",
or I prefer to call it "yourself" before you realize
you do feel normal.This week I had a "bad" week, depressed and down,
didn't want to get out of bed (I missed some of my
medicine doses - I have to get better about that!).
It is reversible, and you can feel like your old self
again. When I finally did get off of my butt and take
my medicine like I'm supposed to, I'm good. I treat
myself often -- it could be just staying in on a Friday
night and wearing warm snuggly sweats, making sinfully
delicious hot chocolate, playing my favorite music on
the stereo and reading a trashy novel (that's what I
did last night! How positively selfish! ~big smile~)Sometimes it's a bubble bath with a glass of wine; or a
manicure. Othertimes it could be flirting outrageously,
telling jokes or even petting my animals. When I treat
myself, indulge myself, I'm taking care of me, and
it helps maintain/achieve/whatever that feeling of
normalness, happiness, selfness.Take care of you, hon, and good luck.
janey
Posted by DL on November 8, 1998, at 20:41:43
In reply to Re: Lost Message, posted by Toby on November 6, 1998, at 11:50:41
I know I wanted things to change, but everything is changing so fast now. Found a nice place to live and have been packing and trying to get things over there evenings and weekends. My husband is getting angry at everything now. If I pack half the dishes he wants the ones I have, he counts the towels to see if i took one too many. When he found out i had washed and packed a set of little bedroom curtains he got so mad he ripped the phone out of the wall and threw it. Of course I went into that scared and protective mode and found my heart racing and my insides in turmoil....
Spoke with my therapist this weekend. She said she thought it would be a good idea to wait to reassess the situation after I am moved out of the stressful situation and into my aparment. She said she would help me separate the situational from the medication issues then. I will be totally out of this situation probably by the 20th, The closing on our house is the 27th.
I got so worked up today that I had a glass of wine. I couldn't stand the worked up, on edge, feeling. It has increased the sort of drowsy feeling I have had the last few days. Any take on what is causing this? I may regret the wine since past experience is that I wake up around 12-3 AM and can't get back to sleep but I felt a GREAT need to settle the agitation.
I want to thank people for suggestions to help me. I wish I could use imagery and relaxation to help myself. It is not that i haven't tried, but that it is hard to learn those techniques on my own.
Drowsiness seems to be creeping somewhat back into mylife now. Any suggestions?
Posted by Toby on November 9, 1998, at 14:41:16
In reply to Confusion/life moving too fast, posted by DL on November 8, 1998, at 20:41:43
Packing and moving are very energy draining even if you don't feel you are overdoing it. Add to that the emotional drain of moving away from a longstanding home and getting the third degree from a vengeful spouse, and you've got a recipe for tiredness, hopeless feelings, and an innate desire to withdraw from the world. Don't forget to take care of your physical self during this time. Enlist friends to help with the move (or just to be "around" when your ex is there to provide a buffer). When things have been bad a long time, it is hard to tell when depression is slipping back in vs. when you are having a normal stress reaction. Pray alot (which can be a form of meditation and relaxation itself) and focus on the future (what you want to be and do, not necessarily how to get there... that may be too much for now).
Posted by DL on November 9, 1998, at 21:10:59
In reply to Re: Confusion/life moving too fast, posted by Toby on November 9, 1998, at 14:41:16
You know, I haven't gone to church for many years. But when you mentioned praying it brought up images of a church years ago with high stained glass windows with sun coming through and that big empty quite/peaceful feel. I don't know where it was or when because my experiences with church have not been peaceful.
Church is another part of my life touched by my father. Haven't thought about it in a long time. We were told we had to go to church as children. Everytime we moved it was a different type of church. When I was in high school he made us walk to churchschool. I was the oldest in the Sunday school and kids in highschool made fun of me because I still went. Then we had to wait and go to church after. The minister was terrifying--fire and brimstone type. His voice thundered out and scared me and always talked of what sinners humans were. When I had to be alone with him once at choir practice I was terrified--also when we left church and I had to shake his hand I would be shaking. He adopted a teenager who was scarred from a facial burn injury--he went to school with me. One night the boy went after them with a knife, set a fire at the house and raced away in their car. He was found and sentenced to jail. I never forgot that.
I never went to church after I left home and went to college. But if I could give up some of my troubles to someone else to take care of it would be nice.
I remember now where that chruch was--about 2 1/2 years ago a friend's teenaged son died of bone cancer. I went to a beautiful church to his memorial ceremony. I think I was building up to the depression level that sent me for help. I remember that when it was "OK" to cry at the service I started and could not stop for hours after I had come home. I had not cried for ages and was pretty desperate inside. I could not understand why I couldn't stop. It was not until I had almost given up on life and went in for help that I was able to cry. I think I thought if I did let go and cry I would fall apart and end up in a hospital....
My family has been helping me. I feel bad letting them pay for things. My mother offered to get new tires for my car (no tread left) and my sister offered to get a new mattress for my bed in the new place. I have slipped back some into the shroud of anxiety/depression. At first I felt triumphant and powerful and in charge when I signed the apartment lease. Then as the reality of costs and giving away/throwing out so many things that are a part of my role as "mom" in the past hit I started to run in the fear mode again. I am feeling a lot of mood swing.
Sorry to write so much. It is helping me. I learn about myself if I just take off with the keyboard and then read back.
Even though I still sleep well, I am feeling some of the drowsiness I felt when the Remeron dose was smaller. I never changed the timing of the dose. It was easier to take it at night but maybe I could try that. Also the prescription company for Health Ins (Maxor Plus) had a mix up and the compounded hormone script was not refilled. I have been working on it by phone but it ran out so I was taking half the dose and now it has run out. So that may be playing into this too.
I have thought about what I want to do. I have never had a vacation....When I am on my own I want to save up and go somewhere beautiful....
Thank you for your ideas. Perhaps I will quietly join a chruch service. I find myself tearing up thinking about it and I don't know why. I think I might break down there like I did before....There are still a lot of things about me I can't see into and understand.
When I am on the downswing I picture myself wanting to be in a place like the beautiful church--all alone--no sound--safe--peaceful--no anxiety--no yelling--no fear--drifting off and floating..(does this sound like I'm crazy?--because it sounds that way to me)
Posted by janey on November 9, 1998, at 21:30:10
In reply to A good idea, posted by DL on November 9, 1998, at 21:10:59
DL,
Sometimes it's hard for us to accept help from
others -- family, friends, strangers -- whether
that help be emotional, financial, spiritual.
It's a learning experience to learn how to accept
help and it is a good thing.I can't think of a safer place to cry than church.
Find yourself that pretty church where you felt
safe and loved and go in and pray or cry or just
be... You don't have to limit it to just Sunday.A lot of churches in my area have their doors
unlocked during the day for people who want or need
to come in and connect with God.A vacation... what a wonderful thing to plan for.
Think about where you might like to go. Surf the
Internet for those places. Cut out pictures from
magazines or such and keep those on your fridge
or your bathroom mirror or your bedside and
believe it's possible to go there.Good luck. My thoughts are with you.
janey
Posted by DL on November 14, 1998, at 1:52:06
In reply to Re: Confusion/life moving too fast, posted by Toby on November 9, 1998, at 14:41:16
> Packing and moving are very energy draining even if you don't feel you are overdoing it.
It's 2:30 in the morning. I'm up packing. Partly moved. I'm starting to feel what it might be like to disconnect from this long trapped life. When I am at the new place and thinking about the future.
Sleep is still good. I've stopped wondering each day if I might go back to the terrible old sleep pattern. And I hardly ever dissolve into those tears that float me down the hill. Anxiety is improving and frequently my concentration seems to be better.
But, the weight/appetite is a problem I don't want. It seemed to come over me just after I had finally had a week or two of good sleep. I know intellectually I should be able to control it, and I can't understand since I have always had an iron will (it's what kept me alive). Within minutes of thinking about losing the weight I have put on I suddenly notice I am eating something. I never felt hungry so much before. Perhaps when I am all moved and alone I can deal better with it.
But, if I still have trouble gaining should I try to stop the Remeron and see if I am OK without it?
>Focus on the future (what you want to be and do, not necessarily how to get there... that may be too much for now).
I want to go on a vacation somewhere beautiful and peaceful--even if it's only for a few days. It always seemed that everyone had them and I never did. When I build up some vacation time I want to do this. I also want to get more training in infant movement facilitation and feeding issues. I'm not even going to try to figure out how.
Should be all moved out by the 21st.......
Posted by janey on November 14, 1998, at 14:29:27
In reply to Re: Confusion/life moving too fast, posted by DL on November 14, 1998, at 1:52:06
DL,
Janey here, not one of the docs. Congratulations!!
It sounds like you are doing so well!Boy, that weight gain is a pain, isn't it? I'm
right there with you! This summer after my bad
depressive episode, I was wanting to lose my weight
and LOSE IT NOW! I was in a similar situation as
you. Moving into a new apartment, a healthy
environment for me, but I stuck on losing weight!I was talking to my psychiatrist about it and she
put my STOP SIGN out there for me. She helps me
focus on one thing at a time. My medicine was
working excellently for me, and she said that's
one thing we weren't going to screw up.She asked me to focus on moving. Getting the utilities
established/transferred, packing and unpacking,
learning about my new neighborhood - exploring and
to go to work. She gave me "permission" to be
overweight for a while; and let me tell you, what
a relief that was! I had permission from someone
not to worry about losing weight!And so, for a month I did not worry about losing
weight -- AT ALL! Funny thing... I didn't GAIN
any weight during that time; I remained at the
weight I was.Well, then the weight worry returned. There I was
at an appointment bitching about losing weight
again. Again she reminded me that my medicine
was working well and I was doing well, and we
weren't going to mess with that.So, I was to focus on these things: If I skipped
the gym, then I was to walk 30-45 minutes that evening.
I was to avoid eating out (that will pack it on like
gangbusters!). I was to buy healthy snacks to
munch on during my "munch" phases, and try to prepare
more healthy foods for myself. If I prepare any
carbs for dinner, I try to balance it with chicken
or fish (salmon is great!), and a vegetable and
a fruit. The snacks I keep in the house are
low-fat microwave popcorn (and I dump Molly McButter on it!)
and my favorite fruits -- even canned fruit!I make smoothies when I want an ice cream fix.
I put some ice in a blender, chop up some fruit
(whatever I want), pour in a little bit of low-
fat evaporated/condensed milk (the kind in a can)
and blend away! I pour it in a glass or bowl
and eat away. Note -- If I use apples as my fruit,
I put a little cinnamon in it. YUM. It's healthy
and sinfully delicious!I keep my hands busy -- writing, crocheting, needle
point, jigsaw puzzles. I taught myself how to knit.Again, indulge yourself, too. Go to the mall and
get a makeover at one of the makeup/perfume counters.
Who says you have to buy their stuff? Keep an eye
on the colors they use and buy Mabelline! ~laughing~
Get a day or half-day of beauty at a day spa -- new
haircut/hairdo, massage and manicure? Or, just get a
manicure!Pick up travel brochures at travel agencies, or surf
the net? Start planning that really cool vacation
you've always wanted. Begin investigating how
you can learn more about infant movement facilitation
and feeding issues. I bet you're active in La Leche
League, aren't you? Do some web searches on infant
movement and facilitation.Congratulations, DL, you are such a good role
model and you keep me on my toes! Thank you.
Don't let the weight rule your life right now. There
are too many positives already happening. Take
small steps in order to maintain it or begin to
lose it slowly. Weight is a nightmare to live with
sometimes. It seems like it comes on overnight
and takes forever to lose.Good luck!
janey
Posted by DL on November 15, 1998, at 22:59:36
In reply to Re: Confusion/life moving too fast, posted by janey on November 14, 1998, at 14:29:27
Toby,
Can you give me some help on these questions?1. How long does one usually take Remeron? Is this related to how old you are or how long you have been depressed, or how many times you have been depressed?
2. What do you predict would happen if I stopped the Remeron now to deal with the weight gain? Would the sleep problem stay fixed? Would the weight go down?
3. Speech problem may be a little better. I have stopped chewing gum while driving. I notice it most when I need to talk fairly quickly without stopping for a while. Have not tried the klonopin even though I still have some here. I won't unless it gets worse. Would the klonopin and the Remeron together turn me into a slow moving cloud during the day?
4. Would increasing the Remeron decrease the weight problem? (have gained 12 lbs).
5. If I stay on the Remeron and sleep is OK and anxiety decreases, would you still recommend EMDR? I am coming to the point where I will transfer to another health policy and could switch therapists.
6. If I am receiving therapy sessions with one insurance co., does the new one have to continue--or could they refuse me?
I am about 1/2 moved. Should be mostly all done this coming weekend. Appts with CPA to talk about taxes and what to do money wise, and with mediators to sign final agreements. I need to send all the paperwork in and wait for a court hearing date. Hopefully this will be all done by the end of the year. Then I will be free of some of my worries (but with new ones like finances).
Haven't heard from you in a while. You are a point of stability from me.--You got me through some tough times in the last few months when my MD was not coming through for me. Thanks.
Posted by Toby on November 16, 1998, at 14:30:00
In reply to Remeron questions, posted by DL on November 15, 1998, at 22:59:36
1. They used to think depression could be treated for a year and then stop the medication and all would be well. Now, however, we know that depression tends to recur over and over. Now we say in general that if it's a first episode that fully responds to medication, that a person CAN stop it after about a full year's recovery. If it comes back (even years later) then the person should stay on an antidepressant forever.
2. You may lose weight if you stop the Remeron but you can't predict what would happen to the sleep or depression, but I would bet they would both return, especially if stress is still high in the environment.
3. Many people take Remeron and Klonopin together and do fine. Remember you are sensitive to medications and probably especially combinations of medications, so you would want to take tiny doses of Klonopin during the day for the speech problem if you did decide to try it again.
4. The higher the Remeron dose, the less drowsy and the less weight gain you get.
5. Yes, on the EMDR. The past is still there. If you want to someday decrease the need for meds and therapy and all that, you still need to put the past where it belongs... in the past. My goal is always to get the patient away from psychiatry if they can. I don't feel that people have a "psychiatry deficiency." I don't want repeat business (especially if it's something we could have fixed and just didn't) and I don't think psychiatrists should just treat the symptoms without treating the underlying problems, too. You need to address those abuse issues and once and for all send them packing and then if you need medication because you've got a chemical imbalance, then fine. If the chemical imbalance resolves along with the past, then better.
6. I suppose the new company could refuse therapy if they don't provide for it, but if the policy provides for it, I don't see why or how they could refuse medically necessary treatment.
I'm glad some things are coming together for you. Hope the other things resolve quickly and to your benefit so you can move on to actually living life in the present, rather than haunted by the past or worried to death by the future. Hang in there.
Posted by DL on November 16, 1998, at 23:34:26
In reply to Re: Remeron questions, posted by Toby on November 16, 1998, at 14:30:00
> If it comes back (even years later) then the person should stay on an antidepressant forever.
Wow! That sort of shook me up....to think I might be on a medication forever.....Does my history put me in that category?-
> 2. You may lose weight if you stop the Remeron but you can't predict what would happen to the sleep or depression, but I would bet they would both return...... The higher the Remeron dose, the less drowsy and the less weight gain you get.
Thanks for putting up with my see-sawing. I guess I knew such was the case. This is the only time in the last 3 years that I have been able to sleep consistently well. And, I am noticing that I am able to let some things bounce off me that would have lingered with me for a long time. I don't feel as anxious all the time and seem to be concentrating a little better. I don't want to lose that (especially the sleep).
Would you suggest upping the Remeron dose (I think it has been 8 weeks?) If so, would the larger dose be apt to cause any of those problems associated with Remeron and blood disorders? Would I need to have any tests?
> 3. Many people take Remeron and Klonopin together and do fine. Remember you are sensitive to medications and probably especially combinations of medications, so you would want to take tiny doses of Klonopin during the day for the speech problem if you did decide to try it again.
Thanks. It's nice to know I have the klonopin here in case I need it. You are right about the combinations. Once years ago a Dr. had me taking 3 different over the counter meds for a sinus problem. By the first afternoon I thought I was going crazy. At least 2 of them had strong nasal decongestants. I thought I was truly going crazy (the shakes, racing heart, agitated inside) and all of this was under the foggy blanket of an antihistamine.
> 5. Yes, on the EMDR. I don't think psychiatrists should just treat the symptoms without treating the underlying problems, too. You need to address those abuse issues and once and for all send them packing and then if you need medication because you've got a chemical imbalance, then fine. If the chemical imbalance resolves along with the past, then better.
OK--will try to do this as a Christmas gift for myself. Too bad managed care and many psychiatrists don't feel the way you do. I will take this message from you and print it for my therapist on Sat.
> I'm glad some things are coming together for you. Hope the other things resolve quickly and to your benefit so you can move on to actually living life in the present, rather than haunted by the past or worried to death by the future. Hang in there.
When I read this I teared up for the first time in quite a while. It's that caring and understanding that shines through. It means so much and acts like braces on legs--it helps stand me up so I can get going.
Keep in contact. I look here most every day.
Posted by Toby on November 17, 1998, at 13:07:44
In reply to Re: Remeron questions, posted by DL on November 16, 1998, at 23:34:26
Regarding the length of time to be on medications: Since your history of depression and anxiety is a long one, yet at the same time has never been really relieved by any medications until recently, it would be premature to say whether you should be on medications for life. In addition, from my last post, remember I said I thought you should do the EMDR and then see what, if any, symptoms you are left with. I don't want to hang out a carrot that you can't reach, but a good portion of my patients have been able to stop their medications without recurrence of anxiety or depression after EMDR. Remember that "a good portion" doesn't mean "everybody" and some folks just have a chemical imbalance that needs correcting. Even so, some of those patients have been able to get rid of one or more medications (for sleep and nightmares and anxiety and flashbacks and hallucinations, etc) and just remain on an antidepressant for a (probably) inherited illness. That is a tremendous difference. For you, just on one or two meds, we will just have to wait and see. Onward, now!!
Posted by DL on November 17, 1998, at 21:56:13
In reply to Re: Remeron questions, posted by Toby on November 17, 1998, at 13:07:44
>> your history of depression and anxiety is a long one, yet at the same time has never been really relieved by any medications until recently.I sense that a good part of my life I have been in the anxious/depressed mode but since that was all I knew Ididn't realize it. Then when hormones (pregnancy/delivery/menopause) or physical and mental stress were contributing factors, I gradually fell into that place where I felt trapped, alone, scared and unable to move in any direction--hanging on by my fingernails over a cliff. I think that if someone like you had spent a few hours getting to know me and some time experimenting and watching closely--I might have found relief sooner. 19 yrs ago when I was teetering on the edge after giving birth, no one seemed to be available. An OB/GYN prescribed Dalmane to help me sleep and then refused to renew it after 3 months. It was the same as with klonopin--I slept enough to stay alive and made my self keep going, but life was empty and full of terror for at least a year. I never saw a psychiatrist or therapist until 2 1/2 yrs ago. At that point I was just as bad again. The psch told me I was a Pandora's Box waiting to be opened! After those AD trials I was led to believe I "didn't want to get better" or the drastic effects were just in my mind etc. I started to believe it. Both times the MD's resorted to sleeping meds and then stopped even considering other things. So, if someone tried the right med I might have responded?
>>EMDR.
CAn you tell I am a little nervous about this? I will finish moving first and get the legal stuff over with--then call some of the people on the list. Hopefully new insurance will cover it. Since I may have to pay the full price, I want to make sure the person is very experienced and that I won't be afraid with them. That list has 9 people on it--I wish there was someone local who could recommend one of them.What are your ideas on M or F for EMDR? I see a female therapist but was comfortable with a male therapist who did some couples therapy with us until my husband refused to go back. I was very comfortable with that male therapist.
I guess I am worried that I won' t feel safe enough or that my issues won't seem "big enough" to be bothered with. I myself don't feel them as much as I did a few months ago--they fade some when things are brighter for me.
>>
Will you be hanging around this site in the next few months so I know I will have someone to check in with during EMDR?Hey, thanks for being there......
Posted by Toby on November 18, 1998, at 9:32:44
In reply to Meds/EMDR, posted by DL on November 17, 1998, at 21:56:13
Women with post partum depression (not just baby blues that go away in a few weeks) need antidepressants, not just sleep medications. Any woman with a history of post partum depression who starts getting the same symptoms again even when not pregnant needs to be evaluated for something stronger than sleep medications.
As long as the therapist has been properly trained in EMDR I don't think it matters whether the therapist is male or female. I think a Level II trained therapist would be best for you since the things you will be working on are "process" problems; i.e., lots of events over a lifetime rather than just one or two big traumas. A Level II trained person has more experience and can support you through the purging and reintegrating process better than a Level I trained therapist. Don't worry about whether your issues are "important" enough for EMDR. There's no such thing as an unimportant issue. If it bothers you, then it is important. The therapist will not judge you. In fact, some therapists don't even want to know what the problem is, they just go directly to the desensitization phase (the eye movements) and let your brain do all the work. It's not important that the therapist know all the details; it just wastes valuable processing time for the patient to talk to the therapist, so the therapist usually only stops long enough for the patient to say one or two sentences so that he/she can be sure processing is taking place and the patient is moving in some direction (any movement is good). Each therapist has his/her own technique, so just go in with an open mind and be prepared to be honest with yourself and allow yourself to feel everything. Many people get nervous about that part, feel that they can't handle it, but they forget that they've been feeling these things anyway for years and years and have handled it (sometimes well, sometimes not). In EMDR you feel the feelings all at once, cut them out like a surgeon cutting out a cancer and you are done with it. I've never had a patient who couldn't handle it; the brain is a resilient organ.
I'll be around for hopefully a long time; Lord willing and the creek don't rise.
Posted by DL on November 19, 1998, at 21:40:24
In reply to Re: Meds/EMDR, posted by Toby on November 18, 1998, at 9:32:44
I just have a need to keep this connection going....I feel unbelievably weighed down by all the things going on now. I can see a light far away at the end of the tunnel though. I can start to imagine being able to sit down in my own place without looking over my shoulder or wondering/worrying what might happen next. I think I will need an extended amount of time to go home from work and just absorb calm and peace--if indeed I find it. I am starting to feel a little bit of excitement about fixing up the apartment. But, I think something in me is holding back so I won't be disappointed in case it doesn't happen......It seems like I keep working so hard at making this new life and someone out there is testing me and making it hard.
Note about Remeron. It is very drying to my nose and lower lip. I have to keep chap stick nearby and often have dry skin peeling on my lower lip until I massage lots of moisturizer in. Is this because you said Remeron is in the antihistamine group? Have you noticed this before? But, I continue to have good sleep and less down times and less anxiety, so I won't stop it.
THANKS FOR THE SUPPORT. I won't let the creek rise............
Posted by Toby on November 20, 1998, at 15:11:35
In reply to Check in, posted by DL on November 19, 1998, at 21:40:24
Remeron is drying so that, plus having started it in the cold season is probably causing it. It may well go away after a while. Hard to predict.
Have a good weekend this weekend; you know, one day at a time...
Posted by janey on November 21, 1998, at 10:12:11
In reply to Re: Check in, posted by Toby on November 20, 1998, at 15:11:35
Hi DL,
I don't know if my posts do any good or not, but
here's some help for your dry nose and mouth, maybe.I have a problem with dry nose especially in the winter.
At night, I run a warm mist humidifier in my bedroom
and during the day I use "Ocean" nasal spray or
the drugstore's cheaper version. All it is is
a saline solution that helps keeps the nasal tissues
moist. It is NOT A DRUG.. so it won't interact
with any of your meds or treatment and you can't
get addicted to it.As for dry mouth and throat, I keep a glass of water
at the bedside and I have suckers (Dum-Dums) and Vitamin C
drops that I keep near.Good luck.
janey
Posted by DL on November 22, 1998, at 22:59:33
In reply to Re: Check in, posted by Toby on November 20, 1998, at 15:11:35
HEY I'M FREE!
Hey, guess what! All the cleaning, selling, dividing, moving is coming to an end! 2 of my sons helped this weekend and I have almost everything here. Best of all I love my place and I feel FREE here! It feels like I have burst out of a shell and I don't have to be "on guard" all the time. I think I can learn to relax now. I'm not crazy enough to think that everything is fixed now--but I will be able to start working on a healthier spirit, mind and body. I don't have much money for the holidays this year but I think my present to myself and my family and friends will be that I am coming alive again.......Wish me luck as I bravely step out into the world. And, thanks for the suggestions.
Posted by Sandra on November 24, 1998, at 0:58:39
In reply to FREE!, posted by DL on November 22, 1998, at 22:59:33
Congrats on having your own space to nurture yourself. I was just wondering what is EMDR?
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