Psycho-Babble Medication Thread 827

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Re:

Posted by Toby on October 8, 1998, at 14:12:11

In reply to Another day, posted by DL on October 7, 1998, at 22:11:08

Didn't you start the 30 mg on Sunday? A good response is characterized by improved mood, better coping ability, fewer tears, no thoughts of being better off dead, "seeing colors again," better energy, laughing at good jokes, better sleep, being able to get your mind off worries or at least worry "appropriately," hope for the future, feeling worthwhile, on and on. It's a gradual, but distinct, process and others notice before you do.

Don't try to tough out the sleep thing too much. If you need the kava or klonopin, take it. Pick one and stay with it for at least 3 days running and if you feel you need to switch to the other one to see if it's better, do so.

I don't know if the EMDR people will respond by mail or not. Couldn't hurt to try since you are having to wait abit while you get the basic necessities of life in order.

 

A few degrees

Posted by DL on October 8, 1998, at 21:35:22

In reply to Re: , posted by Toby on October 8, 1998, at 14:12:11

> Didn't you start the 30 mg on Sunday?

I counted back and it was Sat night I started 30mg. So I will keep going till it hits 2 wks. (If pharmacy comes through). Is Remeron expensive per pill? I know some of the AD's are.

> A good response is characterized by improved mood, better coping ability, fewer tears, no thoughts of being better off dead, "seeing colors again," better energy, laughing at good jokes, better sleep, being able to get your mind off worries or at least worry "appropriately," hope for the future, feeling worthwhile, on and on. It's a gradual, but distinct, process and others notice before you do.

I think I am less anxious. I don't notice the pounding heart and tightness in my muscles as much. Even though it is still hard to concentrate, I think it is getting better. And I seem to be able to more easily put aside worries. And if I take a little bit of something for sleep along with the Remeron, I sleep better than I did before. It is strange on some mornings to wake up with the alarm! I would always set it and then turn it off in the morning before it went off. It is actually a bit scarey since noises still make me jump! A few degrees of progress?

> Don't try to tough out the sleep thing too much. If you need the kava or klonopin, take it. Pick one and stay with it for at least 3 days running and if you feel you need to switch to the other one to see if it's better, do so.

OK....Perhaps I will go with this and try to d/c it after the 2 weeks on Remeron?
___________________________________

Some of the time life seems a little less scarey. And, I feel as if I am not taking any meds--no side effects. Sometimes a little heavy headed in the afternoon but that could be from just not enough sleep. Perhaps a little less fragile...We will see.

Thanks for hanging in there for me.
Dotty

 

Progress?

Posted by DL on October 11, 1998, at 21:43:41

In reply to A few degrees, posted by DL on October 8, 1998, at 21:35:22

This is Sunday night. One week on 30mg Remeron. It's hard to look at yourself and be objective (impossible?).
--Good----That feeling of being on guard, sort of like walking in a dark alley and knowing something terrible is about to happen to me---seems to be fading some. This is the only way I can describe it. Do you know what I mean? I think I have felt that way for a long time-even during sleep. I have been able to set aside some worries that I know I can't deal with right now. For instance, after 20 years I must find an apartment and I don't have much money. Our house sold quickly and my standard of living will plummet. Some of the places I saw today would have tumbled me into the dark hole not too many days ago. But I just kept on looking and surprised myself by enjoying talking to some of the people I met. Feels strange.
---Not so good------I noticed today that I have been snacking more. Actually I seem to feel hungry even when I am full. Since I have denied myself so many things in life I enjoyed the cravings and being able to do something gratifying for myself. But I remembered today that one of the side effects of REmeron is weight gain! So I raced to the scale and sure enough 4-5 lbs added! So, I need to use my brains and will power to stop this. Any suggestions? It is hard to keep good stuff since our refigerator died and we are using a tiny dorm type one that holds very little. And, I have not had the energy or time to plan, shop, and cook good meals. Any suggestions?
Also, when I get up in the morning it takes a long time to get that groggy feeling out of my head. And when I drive a strange thing happens to me. If I concentrate on something I am thinking about I lose track of the road. It's almost as if I can't do 2 things at once. It's scarey sometimes when I seem to lose a few seconds at a time--enough to cause a problem if I had to react quickly. Perhaps it happens in reverse--that I "lose" a few seconds and then can't remember what I was supposed to be concentrating on. Maybe you can make some sense of this. I'm having a hard time explaining it. I still have trouble concentrating and take longer than I should to do things because I have to read things over and over. Any ideas here?
Also, that hair trigger startle reflex of mine is worse than ever. Any loud noise or sudden sensory stim feels like powerful electriciy coursing through me--sort of like someone is using those "paddles" on me that are used when your heart stops. Why is it getting worse? Perhaps because I have not been using the klonopin? (which is what started to calm it 2 years ago). I have been able to sleep with one Kava tablet and will try soon again to d/c that.

I saw the therapist on Sat. She didn't mind that I called her about the script. When I asked she said the reason it was confusing for them was the MD never wrote in my chart that he had given me the Remeron script! So with him gone, none of the other MD's there would write out the script. Apparently they got ahold of him wherever he had gone for M--Th and he had to call the pharmacy and the insurance co. This makes me feel bad and a little nervous about seeing him in a month.

Maintaining those few degrees?

Have a nice weekend. I work on Monday but I know a lot of people don't. The foliage is really pretty now--even if some of it is on the ground.

I will check in tomorrow to see if you are in.

Dotty


 

Re: Progress?

Posted by Toby on October 12, 1998, at 8:06:56

In reply to Progress?, posted by DL on October 11, 1998, at 21:43:41

The increase in the startle reaction sounds like what I've heard other people with PTSD describe when they get on an antidepressant and it starts to work: part of them is waking up and as the world starts to get more "real," i.e., not in a fog anymore or blotted out by the depression, some of the need to be "on alert" picks up, and in other ways the concentration wanders, making one less sure of oneself for awhile which may increase that feeling a little. They do tell me also that once the world has reached a peak of being "solid," and they feel grounded again, that that feeling fades to a manageable level (or at least back to what it was before the antidepressant) and they can start working on whatever needs working on.
I've had several patients tell me that the best thing for the increased hunger on Remeron is a banana and a rice cake (one that is flavored with cinnamon seems to be the most satisfying to the hunger, but maybe other flavors would work,too). I recall rice cakes tasting like styrofoam, but my patients tell me it's not so anymore with the new flavors. Since I heard about it I've been recommending that and checking with patients about it and those that try it are telling me it works and they aren't gaining weight.
I wouldn't worry about having offended your doctor or anything just because the office had to track him down to correct his own error. Doctors are used to that (hopefully not the error part, but the being called part) and he will probably have forgotten it by the time you see him, unless you remind him of it. And when you tell him 'how good you are doing on this medicine he was so good to give you,' all should be well.

 

A step backwards?

Posted by DL on October 13, 1998, at 19:24:57

In reply to Re: Progress?, posted by Toby on October 12, 1998, at 8:06:56

For some reason I couldn't connect with this site the last few days.

For a while I seemed to be feeling more sturdy and less affected by everything. It was nice. But today I was back in the mode of high muscle tension, tense shoulders and chest and that inner feeling of being vulnerable and anxious at the same time. It makes me feel like I can't handle my work and plans for the future--very unsure of myself. I could not get anything done at work today--felt like I was only half there during evaluations with a family. NOT GOOD!

No coffee/stimulants either. -- Makes me feel like I want to scream and just go off and hide somewhere. I catch myself constantly holding my breath again.

I forgot to take the tiny dose of estrogen I have been taking in the morning, but I don't think that was the trigger. The natural progesterone I take at night has sleepy side effects and that is OK. Only other change is that I was taking a really good grade multi from at natural pharmacy and ran out 2 days ago. I DON'T LIKE THIS FEELING! Now I know I can feel otherwise it is hard to take.

I continue to feel really groggy in the morning. And today the fog followed me--causing that lack of concentration and also motivation. Why is this happening? Was the improvement fake? Or do people slip back like this? Tension underneath fog is not fun.

Especially the motivation thing is becoming big. It is hard to make myself do more than the essentials, even going to grocery store. Just managing work and basic survival is hard enough. Is this all related to stress and my turned over life? Or what?

> I've had several patients tell me that the best thing for the increased hunger on Remeron is a banana and a rice cake

Thank you. I will try this.
The raised level of anxiety today blocked the appetite.

Have not taken klonopin in a week. Have not been taking the kava either. THe natural progesterone seems to help me sleep some perhaps along with Remeron. Still not the best sleep ever, but not as bad as it was before--so some improvement lingers.

I want the sturdy, level, grounded feeling back....


 

Re: A step backwards?

Posted by Toby on October 14, 1998, at 14:22:52

In reply to A step backwards?, posted by DL on October 13, 1998, at 19:24:57

Perhaps moving the dose of remeron up a few hours will banish the morning grogginess, say 8 pm or even up to 6 pm. Perhaps that would also improve the overall quality of the sleep since you are now at the higher dose (smoother loading into your system). Even more, perhaps diving the dose up into 15 mg in the morning (or afternoon) and 15 mg in the evening would take away the grogginess and improve the anxiety (I saw a patient earlier this week that a previous doctor had put on that regimen and she said it helped greatly). Who knows why these strange tweakings of the dose makes such a difference?

 

Hangin on

Posted by DL on October 14, 1998, at 19:56:23

In reply to Re: A step backwards?, posted by Toby on October 14, 1998, at 14:22:52

> Perhaps moving the dose of remeron up a few hours will banish the morning grogginess, say 8 pm or even up to 6 pm. Perhaps that would also improve the overall quality of the sleep since you are now at the higher dose (smoother loading into your system). Even more, perhaps diving the dose up into 15 mg in the morning (or afternoon) and 15 mg in the evening would take away the grogginess and improve the anxiety

I will try this and see--1/2 at night and 1/2 in morning and see. But I thought the reason to take it at night was to maximize the sleepy side effects during nighttime?

Did not sleep well last night--sort of like before--about 5 hrs sleep and wake before the alarm feeling tired. Still really hard to concentrate at work. This morning, with the tension still there in my muscles, I took one of the kava tabs. Perhaps it helped some since I did not have as much tension as yesterday. I also took a multi and restarted the B-50complex I had been taking for the past few months but stopped 2 days ago. Is all the stuff I read about B vits helping nerves true?

Just a thought.--Director at work is very controlling and sometimes downright unethical/unprofessional. Perhaps some of the backsliding is due to how this feeds into my past unresolved issues......But, then I have been working there since mid August and that part has not changed recently--only that my case load has increased.

Pretty discouraging looking at apartments after living in a house with nice land for 20 years! Up here in the cold a 2 bedroom apt that is safe and clean costs around $700/mo! Looking at places that are tiny/cramped/noisy/etc. is very sad/depressing for me. But I sense that if things were OK inside I would be rejoicing at least in part at the release from a bad situation....

If things are staying about like this and Sunday rolls around (2 wks on 30mg), what would be a good course of action?
1. Keep it up and wait longer to see if more progress?
2. Go back to using klonopin? or some other anxiolytic?
3. Stop Remeron?
4. Try to transfer the 6 therapist visits just granted by health ins to a cog beh therapist (hopefully with EMDR training)? Don't know if ins will allow this
5. Other suggestions?

Hope there is someone who listens to you too---if only psychiatrists knew they could effect more change in the right direction if they just listened closely to their clients, perceived what is most important to the person, and worked in a focused way toward that--things would be much better.-------


 

Update

Posted by DL on October 21, 1998, at 22:05:30

In reply to Hangin on, posted by DL on October 14, 1998, at 19:56:23

Hello,
Glad you are back.

Sleep is evening out and has continued to be better. No side effects still. No klonopin in quite a long time. Still some bad days where I feel unglued and so scattered I can't concentrate or focus--I just bring work home and spend all night on it. I find myself reading things over and over.

Stress level is incredibly high. Mediator's computer broke down so it's been weeks since she said she'd have the agreement to me. Trying to find an apartment is so discouraging--after living in a house, going to an apartment with noise, less space and not so great areas is scarey. Not much out there and even less in my price category....

.Work is VERY stressful How do I learn to figure out where the balance is? I find myself responding to the director (controlling and manipulative) in that fright or flight mode. Hard to see where the line is at a new job so I allow her to overload me. How do I learn to get out of that mode?

Finding that even though I sleep better than before ( actually a great step forward) I have been isolating myself--working late at home to make up for decreased concentation-not finding time to go to exercise class, and not seeing friends. It takes all I have to manage a job and basic living activities.

How do I go about working this stuff out?

Should I ask for the same dose of Remeron when this script runs out?

Life hasn't brightened a lot, but perhaps it will after I find a place to live and get this drawn out legal stuff settled.

Thanks for keeping in touch.

 

Re: Update

Posted by Toby on October 26, 1998, at 16:18:11

In reply to Update, posted by DL on October 21, 1998, at 22:05:30

Glad you are hanging in there. Don't give up your exercise or friends -- need that outlet to work off boss frustration, clear your head, improve concentration, counteract weight gain risks with Remeron, keep the blood well oxygenated and going to your brain for all of the above and to fight the depression. Stick with the same dose until you return to the doctor.

Any possibility of not taking the work home? Or taking home just a few things as opposed to every last thing you didn't get done on the job? Pushing too hard makes it harder to settle down and concentrate on one thing, increases the anxiety and on and on.

Keep on keeping on.

 

Re: Update

Posted by DL on October 26, 1998, at 23:17:39

In reply to Re: Update, posted by Toby on October 26, 1998, at 16:18:11

Will respond tomorrow. It's late and I just struggled on a report--spending so long and getting little done. It's terrible. Wish I could change that part. Also having increasing trouble with not being able to get words out--embarassing. Has happened off and on over the last few years since I started into this depression/anxiety. Seems to be worse when I am completely off the klonopin. Strange feeling of the signals just not getting through to the mouth muscles. I seem to stop in the middle of a word--almost as if my speech is paralyzed off and on. Any thoughts? Is this just from anxiety?

 

Speech

Posted by DL on October 27, 1998, at 22:14:35

In reply to Re: Update, posted by DL on October 26, 1998, at 23:17:39

You are really very perceptive. I didn't actually say anywhere that I was bringing every last thing home with me!! But I do that. It is unrealistic to think I will have time to do it all, but I bring it home anyway. I guess some cog-beh therapy would be good. I have never experienced it but perhaps if someone helped me to look at what would happen if I didn't finish things I would see that the world wouldn't end. It is so strongly programed into me that it's hard to get around it. And I can't blame it ALL on the director.

The speech thing is really bothering me. I can tell others are noticing it. I don't think it is related to any medication because I remember it starting about the time I originally went for help (about 2 1/2 years ago) before I had any medication. But there have been times when I did not notice it much. I think that was when I routinely took the klonopin. It's almost like a short circuit or disconnection of messages from the brain. I have always had trouble with clenching and grinding my teeth (even as a little girl) --even that is getting worse. I had to have a bite guard made for when I sleep and when I get up my jaw is frequently "locked" shut in a muscle spasm. Are these part of the same thing? Is it just anxiety? Or could this be something I should have checked? It happens all the time now.

Thanks for being there and for respecting and supporting me. I see the MD next Monday. The Remeron will run out right after that. I think it is really helping with sleep since I am sleeping and not taking the klonopin.
Thanks again. Still hoping for EMDR etc.

 

Re: Speech

Posted by Toby on October 28, 1998, at 8:14:49

In reply to Speech, posted by DL on October 27, 1998, at 22:14:35

Reckon the nocturnal jaw clenching is related at all to the same thing that has caused you to grip the sheets at night and rigidly lie waiting for something scary to happen?

 

Re: Speech

Posted by DL on October 28, 1998, at 21:00:40

In reply to Re: Speech, posted by Toby on October 28, 1998, at 8:14:49

> Reckon the nocturnal jaw clenching is related at all to the same thing that has caused you to grip the sheets at night and rigidly lie waiting for something scary to happen?

Yes, perhaps to some degree. I know the clenching is related to the old stuff (father and husband) and the high degree of stress. I find myself doing it driving and at the computer

But what is bothering me more is the speech problem I tried to describe. If you read my last 2 posts you will see what I am trying to explain. (Update/26 and Speech 27). It is really hard to explain. I will be talking and in the middle of a word my brain seems to interrupt the signal and I can't get the rest of the word out. Then it keeps happening and I have to hesitate and sometimes just stop and try again. It feels sort of like some of the people I worked with in rehab after a stroke where they understand everything but can't get the words out.--Not like stuttering- just like something pulls the plug for the muscles required to say the word. It is embarassing with families I work with and other staff members. It is increasing lately and others are starting to notice it.

I noticed it first 2 and 1/2 years ago when I knew I had to go for help. It was only one of many disruptions (no sleep, weight loss, racing heart, anxiety and tears and hopelessness ). It scared me then-I thought I was having some kind of blockage like a TIA. Over the last few years it has receded then re-emerged. As I said in the other post, it seems that it is much worse when I do not take the klonopin. It has been a number of weeks since I have taken the klonopin and I notice the "signal disconnection" more and more.

1. Is this just a symptom of anxiety? (related to muscle tension)? Or can it be something else? And what can I do about it? It is sure not a confidence builder!

Will probably be changing health insurance to HealthSource and the Remeron is a "non-preferred drug" for them. Only Prozac, Paxil and Zoloft are "preferred". So it will cost me $25/mo for it. Since I have been taking natural hormones (progesterone and estradiol) and only the synthetic ones are "preferred" that means $75/mo for these. I don't really have the money to do that now that I will be paying rent, utilities etc etc.

2. How would I go about trying to get this requirement changed? CAn the MD talk to them and explain I can't take those SSRI's?

3. Thanks for checking in. It means a lot to me. You probably have a skewed picture of what I am like. All you hear is the stuff most other people don't know about me. You have gotten to know me from the inside out--in some ways backwards to what one would normally see when meeting me....

4. Good stuff--I do not find myself crying in the car now-like I used to. And I do not feel myself on the verge of crying as much in general. Whether that is related to sharing more of me with people around me etc, or the Remeron--I don't know.

5. Bad stuff--the speech stuff and the concentration problem interfering with my work. I wish my brain could keep on track so I can get the work done more expediently.

6. Thank you for giving me some peace inside.

 

jaw clenching and speech problem

Posted by Dr. Bob on October 29, 1998, at 0:01:13

In reply to Re: Speech, posted by DL on October 28, 1998, at 21:00:40

I don't remember all the specifics here, in
particular, which medications are involved, so this
might not apply, but...

> I know the clenching is related to the old stuff
> (father and husband) and the high degree of
> stress.

It may be related, but it can also be a side-effect
of medications. See:

http://www.dr-bob.org/tips/split/Bruxism-from-SSRIs-and-sti.html

> I will be talking and in the middle of a word my
> brain seems to interrupt the signal and I can't
> get the rest of the word out.

This, too. See:

http://www.dr-bob.org/tips/split/Word-finding-difficulties-.html

Bob

 

Re: Speech

Posted by Toby on October 29, 1998, at 8:51:27

In reply to Re: Speech, posted by DL on October 28, 1998, at 21:00:40

I looked at Dr. Bob's posts that he recommended. 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 since I think I remember from your other posts that this started before you started on medications; so it sounds like an independent problem, not particularly related to the medications. 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? In that case, it may also be related to anxiety, or in some way related to the jaw clenching, like the muscles spasm sometimes. If the Klonopin also has helped that in the past, it sounds even more like the two are related and you may need the Klonopin for both problems.

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.

 

Lost Message

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.

 

MD visit

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...

 

Re: MD visit

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.

 

Relaxation, sleep problems

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

 

Relaxation, sleep problems

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.

 

Lost Message

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.

 

Re: Lost Message

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.

 

Sleep and feeling "normal"

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

 

Confusion/life moving too fast

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?

 

Re: Confusion/life moving too fast

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).


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