![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 9 to 33 of 33. Go back in thread:
Posted by Noa on December 17, 1999, at 6:40:10
In reply to Re: Marplan and insomnia (or something), posted by Adam on December 17, 1999, at 3:27:56
A psychiatrist who specializes in biological rhythms, sleep, jet lag, depression, etc. is Dan Oren, at Yale University. When he was at NIH, his research focused on melatonin. He has also done work on light therapy. You can look him up at the Yale University site or the Yale-New Haven Hospital site.
Posted by Adam on December 17, 1999, at 14:53:36
In reply to Re: Marplan and insomnia (or something), posted by Noa on December 17, 1999, at 6:40:10
Thank you, Noa.
I don't want to dilute or detract from this thread (I do that all the time eslewhere and am trying to quit), so I think I will take questions about melatonin to the INSOMNIA thread.
> A psychiatrist who specializes in biological rhythms, sleep, jet lag, depression, etc. is Dan Oren, at Yale University. When he was at NIH, his research focused on melatonin. He has also done work on light therapy. You can look him up at the Yale University site or the Yale-New Haven Hospital site.
Posted by Scott L. Schofield on December 18, 1999, at 19:13:19
In reply to Marplan and insomnia (or something), posted by Elizabeth on December 15, 1999, at 21:47:11
> I'm having something really odd going on. I'm taking Marplan 40mg, lithium 300mg b.i.d. (now trying to d/c it - switching to 300 q.d. tomorrow), and pindolol 5mg b.i.d. I have the worst insomnia-or-something I've ever had when not depressed!Did the insomnia begin immediately after adding pindolol?
> It gets weirder. I'm getting food cravings starting at night and through the middle of the night. (Not overeating or gaining weight, but they are usually cravings for sweets.) I feel more awake and alert in the middle of the night than in the day...I feel like I should be asleep in the daytime, and sometimes I do sleep in the day, but I've been trying not to do this and I still have lots of trouble getting to sleep at night (often can't at all). Has anyone experienced this (especially the day-night reversal thing), and if so do you have any idea what causes it?
Insomnia has seemed to be a good-prognosis side-effect for me.
If an MAO-inhibitor is going to work for me, I develop insomnia early on.I have had this type of insomnia along with the day-night reversal with three different MAOIs. It was very frustrating, and the lack of sleep really affected cognition. I used benzo sleeping pills a few times (Ativan and Halcion combination), but found that it can be counterproductive in the long run. I felt like I would go through some sort of mini-withdrawal syndrome every day. I guess this could have been due to the short half-life of the Halcion. I found that Ambien wasn't strong enough to do the job.
I did try to keep my behavioral day-night cycle even though my biological cycle was out of whack. I went to bed at 11:00 PM and remained in bed until 7:00 AM, regardless of how wide-awake I was. I found that short naps during the day were O.K., but definitely not for more than 45 minutes. I remember hearing something about 20 minutes being ideal.
> My pdoc wrote me a script for some more Ambien (20mg/night) today; I hope it works again this time (I used it the whole time I was on Nardil, but the insomnia wasn't as bad that time).
I'm sure you thought of using trazodone. Is there some reason you are avoiding using it?
- Scott
Posted by Elizabeth on December 19, 1999, at 10:26:31
In reply to Re: Marplan and insomnia (or something), posted by Scott L. Schofield on December 18, 1999, at 19:13:19
> Did the insomnia begin immediately after adding pindolol?
No, I've had insomnia for a long time. It got worse when I started Marplan and pindolol (I started them simultaneously).
> Insomnia has seemed to be a good-prognosis side-effect for me.
> If an MAO-inhibitor is going to work for me, I develop insomnia early on.It is working. All the MAOIs have caused increased insomnia for me, and all that I have tried except selegiline have worked.
> I have had this type of insomnia along with the day-night reversal with three different MAOIs. It was very frustrating, and the lack of sleep really affected cognition. I used benzo sleeping pills a few times (Ativan and Halcion combination), but found that it can be counterproductive in the long run. I felt like I would go through some sort of mini-withdrawal syndrome every day. I guess this could have been due to the short half-life of the Halcion. I found that Ambien wasn't strong enough to do the job.
I need 20mg (2 pills) of Ambien. It seems to be working okay.
> I did try to keep my behavioral day-night cycle even though my biological cycle was out of whack.
This has been a long-term problem for me. I have tried a lot of behavioral and sleep-hygeine methods.
> I went to bed at 11:00 PM and remained in bed until 7:00 AM, regardless of how wide-awake I was.
I don't think you're "supposed" to do this (CW is that you should get up and go in another room and do something relaxing if you're awake more than 20 minutes or so), but hey, whatever works for you.
> I found that short naps during the day were O.K., but definitely not for more than 45 minutes. I remember hearing something about 20 minutes being ideal.
I don't nap during the day. Mostly I'm just not sleeping.
> I'm sure you thought of using trazodone. Is there some reason you are avoiding using it?
Yeah, 'cause it didn't do anything for me even when I took it (up to 400mg at h.s.) without an MAOI!
Posted by Scott L. Schofield on December 23, 1999, at 21:26:28
In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 19, 1999, at 10:26:31
> > Did the insomnia begin immediately after adding pindolol?
> No, I've had insomnia for a long time. It got worse when I started Marplan and pindolol (I started them simultaneously).
> > Insomnia has seemed to be a good-prognosis side-effect for me.
> > If an MAO-inhibitor is going to work for me, I develop insomnia early on.
> It is working. All the MAOIs have caused increased insomnia for me, and all that I have tried except selegiline have worked.
Did you say it *is* working?Alright! :)
Would you mind telling me about it?
Sincerely,
Scott
P.S. Why did you discontinue the other MAOIs?
Posted by Elizabeth on December 24, 1999, at 0:28:58
In reply to Re: Marplan and insomnia (or something), posted by Scott L. Schofield on December 23, 1999, at 21:26:28
> Did you say it *is* working?
Yuppers.
> Alright! :)
>
> Would you mind telling me about it?Sure thing, what would you like to know?
> P.S. Why did you discontinue the other MAOIs?
Nardil: poop-out - also massive weight gain (unfortunately, weight gain looks like it's becoming a problem with Marplan too).
Parnate: it causes spontaneous hypertensive crises (i.e., not drug-drug or food-drug interactions) at relatively low doses, so I couldn't get past 30mg/day, which really wasn't enough.
Posted by Phillip Marx on December 24, 1999, at 12:52:21
In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 24, 1999, at 0:28:58
Hi Elizabeth.
It is good that you are researching the chemistry in such detail. I did the same thing after I realized how easy it was to learn more than my HMO knew, their ratio of negative success to zero positive success should have tipped me off sooner, except they had turned me into a revenue patient who couldn't remember how to complain. That struggling to think while under sedation will strengthen your mind and it's determinations to the point that you will seem like a manic rocketship when the sedative restraints fall off for any reason. Just like a runner would even use resistance training to build muscles that run faster, you are inadvertently using chemical mental resistance training that is building you and your concentration up for some really fast and clear thinking that will likely look like something worse. See my other posts here as I have just recently discovered this forum. I have found that using 1/2 to a full 0.25mg halcion=triazolam WITH 50-150mg Serzone=nefazodone gets me to very restful sleep in just a couple of hours or less unless I take too little which then takes longer, and the drop-off to sleep point is mostly at my discretion so that I CAN finish watching the climax endings of some TV shows the first time now. Benefit, alarms do make me conscious, there is very little paralysis, and the wake up hangover is only a sluggish period of at most 1/2 hour and I am clear thinking all day afterwards. Sometimes I wake up before the sluggish period is over and sometimes it is completely gone by the time I wake up and I can go right to the treadmill and do a quarter mile at 10 miles an hour without stumble, this treadmill won't go any faster. Not bad, it amazes me, I am 51 years old. The Physicians' Desk Reference says that Serzone makes the Halcion 1.7 times stronger and last 2.8 times longer. This is a perfect profile for those like me who are immune to Halcion by itself. Dosage might be less for you if you aren't yet. Most other medications effects and side effects are dependent on timed out serum metabolic conversion and renal (kidney) clearance. This means the wear-off time is somewhat logarithmic. The binary combination I'm suggesting times out and clears quickly, more like the desperately desired [square - rectangular -trapezoidal] step function every one wants. It has been working so well for me for two years now that I am not fearful of getting the word out to those who sound like they are otherwise starting a long terrible journey through multiple depressing expirations of medical efficacies. The Rx profession tried a lot of things on me and only this one rates my thanks. Another benefit of Halcion that encourages hope is that tolerances reverse with as little as a week of medicine holiday, and can then work for another couple of years. I haven't regained efficacy on any of the others I've used.I don't know what brought you to this forum first, but you sound not only very intelligent, but not driven yet to abandon hope. I lasted almost two years on increasing strength, increasingly crippling medications before they took me totally down. I was on state disability over a two-year period which www.DrJensen.com fixed in only his first week. The first medication got me through the next few months in a recovery mode that quit working when that brain chemistry system "healed" enough so that I had to work on the next most "not-yet-healed" brain chemistry exhaustions (workaholism does catch up, I've never heard of anyone who was working harder than I was in peacetime, I'd be afraid to meet her). I am now getting the 1st or 2nd top grades in some career transistion classes I'm taking into work that should be impossible to overwork in, which shows the medicine is working, though it makes people nervous how fast I finish the tests. Having gotten so sick and fat from the metabolic crippling of accumulated sleep medicines forced me to do as you are doing and re-learn from scratch how to take care on my normally self-negligent self. Now the weight is gone and skin shrinking back, though slower than I would wish. My body itself is a little afraid that it's not safe yet to get off emergency mode. I can now do more (sometimes twice) the weight and reps as the physical trainers at the gym half my age, I can't do free weights well at high weights because of my carpal tunnel issues since the tendons also grew in channels that didn't (oversize tendons are stronger and don't hurt as long as they aren't rubbed together until they swell even further under high loads, the weight machines "hold" alignments preventing such tendon sliding) as I got my strength back after a muscle-wasting three months stuck almost totally in bed from a desperately overdue, but temporary medication success. It's bizarre and baffling, but if I wouldn't have gotten so sick, and made even worse by the HMO, I wouldn't be alive today from the stress I was under back then. Now, I'm an otherwise very healthy looking person mistaken for 10-20 years younger than reality, I have to carry around transistion pictures to convince old friends that I am Me. Anyway, look up those two medications. They are synergistic and so are functional at doses so low that I haven't had any negative side effects. Dr. Jensen does telephone diagnosis and prescriptions world-wide.
Phillip Marx
PhilMarx@net999.com
> Did you say it *is* working?
>
> Yuppers.
>
> > Alright! :)
> >
> > Would you mind telling me about it?
>
> Sure thing, what would you like to know?
>
> > P.S. Why did you discontinue the other MAOIs?
>
> Nardil: poop-out - also massive weight gain (unfortunately, weight gain looks like it's becoming a problem with Marplan too).
> Parnate: it causes spontaneous hypertensive crises (i.e., not drug-drug or food-drug interactions) at relatively low doses, so I couldn't get past 30mg/day, which really wasn't enough.
Posted by Scott L. Schofield on December 25, 1999, at 11:56:24
In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 24, 1999, at 0:28:58
In Re: Marplan
> > Did you say it *is* working?
> Yuppers.
> > Alright! :)
> >
> > Would you mind telling me about it?
> Sure thing, what would you like to know?
How does it feel?
Sincerely,
Scott
P.S. I'm sorry that I keep forgetting about your experiences with Parnate. It must be my hippocampus fighting mental health again.Keep going.
Posted by Elizabeth on December 25, 1999, at 22:31:35
In reply to Re: Marplan and insomnia (or something), posted by Scott L. Schofield on December 25, 1999, at 11:56:24
> How does it feel?
Can you be a little bit more specific? I'm not sure how to answer this one.
> P.S. I'm sorry that I keep forgetting about your experiences with Parnate. It must be my hippocampus fighting mental health again.
It's okay, mine does that too. :)
Posted by Elizabeth on December 25, 1999, at 22:45:16
In reply to Re: Marplan and insomnia (or something), posted by Phillip Marx on December 24, 1999, at 12:52:21
Phillip,
Serzone is contraindicated with MAOIs. I can't use it. I tried it for depression a while back with no success -- and furthermore it caused multiple nighttime awakenings (where without Serzone, at the time, I had just been waking up early in the morning.
I've tried a number of benzodiazepines for insomnia; I develop tolerance to them rapidly, so they aren't terribly useful to me. I've also tried trazodone, atypical antipsychotics, thioridazine (Mellaril), clonidine, tricyclics, diphenhydramine, hydroxyzine, gabapentin, chloral hydrate, and probably some I'm forgetting.
I started using Ambien 20mg this week had used it before with Nardil, with some success). It's not perfect (wears off in a few hours -- not enough), but it's better than nothing.
Take it easy.
Posted by Phillip Marx on December 26, 1999, at 1:16:27
In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 25, 1999, at 22:45:16
Hi Elizabeth
The Serzone didn't do anything the tiniest bit noticeable on me by itself. "Only" concurrent with Halcion did the miracles start (synergy). I think I'll only be able to use binary medications in the future since all the single medications were used until they timed out. My curing doctor is world famous, look at his site @ www.DRJENSEN.com where he explains how he has taken people who have been to 50-100 doctors and has 30%-60% of them much better in less than two weeks. He did it for me twice. He will characterize the 10 main brain chemistry systems and see if the failure to cure is due to the failure to fix more than one imbalance simultaneously. That ambien will be as useless to you as it is now to me if you keep using it consistently for long due to tolerance increase up to virtual immunity (futility point). You have to think ahead now before the deficits build back up as they will soon when that ambien efficacy times out in known unavoidable ways. If you find an alternate before you are totally immune to ambien, you will still be able to use ambien later as a backup. Ambien is a crutch, not a fix for whatever is really causing the insomnia. I have no short half-life meds left still usable to me. Ativan still works a little because I talked the early doctors out of it early on since it so destroyed my memory, especially my short-term memory, so my tolerance to it hasn't been all used up yet. I wish I had jumped meds earlier so that I would have a short one available if I wasn't very tired and a long one for when I did need more sleep or one that I could add if I needed a couple of more hours sleep after an early wake-up. These meds are not tied into the sleep regulation systems, they replace them and over-ride them, they don't work with the regulation and feedback systems. Now I have to regulate (limit) how tired I get to match how much sleep I get per per med night, even the best medications in the world won't let me get back to how hard I was working, and I've lost most of the years of driven acquired endurance that enabled me then. Oh, also, I had a neck injury back in '79 that made me mostly numb. I acquired about a ten degree tilt in my atlas at the skull joint. MRI wasn't good enough for anything back then and I was forced to take a year of biofeedback (eventually worked well, now I can walk and run around in cold snow barefoot without freezing, though before that I could waterski in February) to control/ignore pain. The skull deformities, bone spurs and tendon deformations now show quite well when I had a skull x-ray taken to look for premature pineal calcification, none though. I think that is why I could work so much without feeling hardly tired, I think fatigue sensations need functioning Schwann cells to report fatigue level to the brain as well as pain levels. About three years ago the neck started to heal (maybe from so much bedridden immobility) and now I feel more naturally tired much more like before I hurt my neck. Meds regulate kind of like a heart pacemaker that doesn't have a blood Ox sensor built in. If you don't have a backup ready as soon as a known drug fails, you will have to experiment till you find one, and experiments hurt the most when they are started too late, especially if it's one that takes long to try (trial period). A second trial drug has an even tougher time since more systems are exhausted. It feels like multiple systems failures as the persisting problem failure causes many other dependent systems to exhaust and crawl along with crippled functions. If I would have rotated through that whole series of benzodiazepines instead of sticking each one out until there weren't any "work"able medications that could keep me working, I wouldn't have been forced to divorce my job. I just read somewhere that these can actually "cause" the insomnia.
Merry Christmas and God bless you
Phillip Marx
PhilMarx@net999.com> Phillip,
>
> Serzone is contraindicated with MAOIs. I can't use it. I tried it for depression a while back with no success -- and furthermore it caused multiple nighttime awakenings (where without Serzone, at the time, I had just been waking up early in the morning.
>
> I've tried a number of benzodiazepines for insomnia; I develop tolerance to them rapidly, so they aren't terribly useful to me. I've also tried trazodone, atypical antipsychotics, thioridazine (Mellaril), clonidine, tricyclics, diphenhydramine, hydroxyzine, gabapentin, chloral hydrate, and probably some I'm forgetting.
>
> I started using Ambien 20mg this week had used it before with Nardil, with some success). It's not perfect (wears off in a few hours -- not enough), but it's better than nothing.
>
> Take it easy.
Posted by Phillip Marx on December 26, 1999, at 2:48:33
In reply to Re: Marplan and insomnia (or something), posted by Phillip Marx on December 26, 1999, at 1:16:27
I just found an online interview transcript, check it out.
http://www.concernedcounseling.com/ccijournal/conference/jensendepression.htm
pm> Hi Elizabeth
>
> The Serzone didn't do anything the tiniest bit noticeable on me by itself. "Only" concurrent with Halcion did the miracles start (synergy). I think I'll only be able to use binary medications in the future since all the single medications were used until they timed out. My curing doctor is world famous, look at his site @ www.DRJENSEN.com where he explains how he has taken people who have been to 50-100 doctors and has 30%-60% of them much better in less than two weeks. He did it for me twice. He will characterize the 10 main brain chemistry systems and see if the failure to cure is due to the failure to fix more than one imbalance simultaneously. That ambien will be as useless to you as it is now to me if you keep using it consistently for long due to tolerance increase up to virtual immunity (futility point). You have to think ahead now before the deficits build back up as they will soon when that ambien efficacy times out in known unavoidable ways. If you find an alternate before you are totally immune to ambien, you will still be able to use ambien later as a backup. Ambien is a crutch, not a fix for whatever is really causing the insomnia. I have no short half-life meds left still usable to me. Ativan still works a little because I talked the early doctors out of it early on since it so destroyed my memory, especially my short-term memory, so my tolerance to it hasn't been all used up yet. I wish I had jumped meds earlier so that I would have a short one available if I wasn't very tired and a long one for when I did need more sleep or one that I could add if I needed a couple of more hours sleep after an early wake-up. These meds are not tied into the sleep regulation systems, they replace them and over-ride them, they don't work with the regulation and feedback systems. Now I have to regulate (limit) how tired I get to match how much sleep I get per per med night, even the best medications in the world won't let me get back to how hard I was working, and I've lost most of the years of driven acquired endurance that enabled me then. Oh, also, I had a neck injury back in '79 that made me mostly numb. I acquired about a ten degree tilt in my atlas at the skull joint. MRI wasn't good enough for anything back then and I was forced to take a year of biofeedback (eventually worked well, now I can walk and run around in cold snow barefoot without freezing, though before that I could waterski in February) to control/ignore pain. The skull deformities, bone spurs and tendon deformations now show quite well when I had a skull x-ray taken to look for premature pineal calcification, none though. I think that is why I could work so much without feeling hardly tired, I think fatigue sensations need functioning Schwann cells to report fatigue level to the brain as well as pain levels. About three years ago the neck started to heal (maybe from so much bedridden immobility) and now I feel more naturally tired much more like before I hurt my neck. Meds regulate kind of like a heart pacemaker that doesn't have a blood Ox sensor built in. If you don't have a backup ready as soon as a known drug fails, you will have to experiment till you find one, and experiments hurt the most when they are started too late, especially if it's one that takes long to try (trial period). A second trial drug has an even tougher time since more systems are exhausted. It feels like multiple systems failures as the persisting problem failure causes many other dependent systems to exhaust and crawl along with crippled functions. If I would have rotated through that whole series of benzodiazepines instead of sticking each one out until there weren't any "work"able medications that could keep me working, I wouldn't have been forced to divorce my job. I just read somewhere that these can actually "cause" the insomnia.
>
> Merry Christmas and God bless you
> Phillip Marx
> PhilMarx@net999.com
>
> > Phillip,
> >
> > Serzone is contraindicated with MAOIs. I can't use it. I tried it for depression a while back with no success -- and furthermore it caused multiple nighttime awakenings (where without Serzone, at the time, I had just been waking up early in the morning.
> >
> > I've tried a number of benzodiazepines for insomnia; I develop tolerance to them rapidly, so they aren't terribly useful to me. I've also tried trazodone, atypical antipsychotics, thioridazine (Mellaril), clonidine, tricyclics, diphenhydramine, hydroxyzine, gabapentin, chloral hydrate, and probably some I'm forgetting.
> >
> > I started using Ambien 20mg this week had used it before with Nardil, with some success). It's not perfect (wears off in a few hours -- not enough), but it's better than nothing.
> >
> > Take it easy.
Posted by Scott L. Schofield on December 26, 1999, at 14:16:16
In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 25, 1999, at 22:31:35
In Re: Elizabeth's responding to Marplan
> > How does it feel?
> Can you be a little bit more specific? I'm not sure how to answer this one.
The question was designed specifically to be anything but specific. Please feel free to answer it whichever way you like. You can, of course, decline to answer it at all. It is sort of personal.Oh yeah - Happy Belated Holidays!
Sincerely,
Scott
Posted by Scott L. Schofield on December 26, 1999, at 14:39:13
In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 25, 1999, at 22:45:16
> I've tried a number of benzodiazepines for insomnia; I develop tolerance to them rapidly, so they aren't terribly useful to me. I've also tried trazodone, atypical antipsychotics, thioridazine (Mellaril), clonidine, tricyclics, diphenhydramine, hydroxyzine, gabapentin, chloral hydrate, and probably some I'm forgetting.
> I started using Ambien 20mg this week had used it before with Nardil, with some success). It's not perfect (wears off in a few hours -- not enough), but it's better than nothing.The first time I tried a combination of tranylcypromine (Parnate) and desipramine (Norpramin), I was unable to sleep at all for the first week or so. At this point, my doctor decided it was time to intervene using sleeping medications. He chose Halcion (triazolam) and Ativan (lorazepam) to be taken in combination at bedtime. The strategy was to take advantage of the potent effects of the Halcion to initially induce sleep, and then have the Ativan carry me over until morning. The dosages were tweaked a bit and resulted in little, if any, hangover the next morning.
If Ambien (generic name?) works well enough to put you to sleep, perhaps you can find something else to carry you the rest of the way through the night (trazadone, clonazepam, lorazepam). I found chloral hydrate to be hell on the stomach.
For some reason, I find myself waking up at 2:00 AM and then at 5:00 AM when using either Nardil or Parnate. I was told by WZ Potter that this was a function of time after the initiation of sleep. I guess this is possible since I have pretty much gone to bed around the same time for years (10:30 - 11:00 PM). As far as the 5:00 AM awakening, I get the feeling that this might be more a function of circadian rhythm. I have never bothered to look into it.
Does the fact that you experience early-morning awakenings indicate that you suffer from typical (melancholic) unipolar depression?
- Scott
Posted by Elizabeth on December 26, 1999, at 20:13:28
In reply to Re: Marplan and insomnia (or something), posted by Phillip Marx on December 26, 1999, at 1:16:27
> My curing doctor is world famous, look at his site @ www.DRJENSEN.com where he explains how he has taken people who have been to 50-100 doctors and has 30%-60% of them much better in less than two weeks.
I've read his website; I think he tends to oversimplify people's problems in a way that I think is unlikely to work in many cases (though obviously because of nonspecific effects I don't doubt that he has good luck sometimes). I think perhaps his "method" relies a lot on expectation effects.
> That ambien will be as useless to you as it is now to me if you keep using it consistently for long due to tolerance increase up to virtual immunity (futility point).
Uh, no. Some people develop tolerance to Ambien (probably behavioral tolerance, as occurs with alcohol), but that isn't the rule. For example, I used it every day for a year or more without needing to increase the dose. Your experience doesn't generalize.
Also, benzodiazepines cause cross-tolerance; if you're tolerant to one, you will be at least somewhat tolerant to another.
BTW I wonder if perhaps your memory problems may be due to chronic sleep deprivation as well as overuse of high-dose benzodiazepines; your loss of motivation might be caused by partial remission from mania. (Why do you feel such a need to insist that you are not manic? Mania is defined by observed symptoms, which I think you know you have.)
Posted by Elizabeth on December 26, 1999, at 20:19:59
In reply to Re: Marplan and insomnia (or something), posted by Scott L. Schofield on December 26, 1999, at 14:39:13
Scott....
> If Ambien (generic name?) works well enough to put you to sleep, perhaps you can find something else to carry you the rest of the way through the night (trazadone, clonazepam, lorazepam). I found chloral hydrate to be hell on the stomach.
(zolpidem)
My main problem has always been staying asleep, not getting to sleep, though now with the Marplan it's both, so I know that most other drugs don't help me to stay asleep. Something I'd thought of was perhaps using Sonata (a shorter-acting Ambien-like pill) when I wake up in the middle of the night when the Ambien wears off. Suboptimal, but could be worse.
> Does the fact that you experience early-morning awakenings indicate that you suffer from typical (melancholic) unipolar depression?
Well, that is the type of depression I have, but the insomnia is chronic, whereas the depression is episodic (it remits, then comes back). So, uh, I dunno!
About your question: I don't know how to answer it! But if you'll ask several specific q's instead of one broad one, I will try to answer those. :)
Posted by Phillip Marx on December 27, 1999, at 0:08:44
In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 26, 1999, at 20:13:28
Elizabeth
> > My curing doctor is world famous, look at his site @ www.DRJENSEN.com where he explains how he has taken people who have been to 50-100 doctors and has 30%-60% of them much better in less than two weeks.
>
> I've read his website; I think he tends to oversimplify people's problems in a way that I think is unlikely to work in many cases (though obviously because of nonspecific effects I don't doubt that he has good luck sometimes). I think perhaps his "method" relies a lot on expectation effects.Logic is simpler than ill-logic. Would you prefer he chose his most complex cases? His protocols are designed to rule out non-specific effects. He gets treatment resistant failures from other doctors, mostly by referrals like mine and his television programs, which keep him saturated, he doesn’t have to advertise. He gets people with totally defeated expectations. I guess maybe defeated expectations can get people to follow protocols without rebellion sometimes, but I wouldn’t expect such to be reliable. He isn’t keeping his protocols to himself. He wants to help more people than he can help all by himself. He’s devoting a lot of time to making sure other doctors can imitate his success. His protocols clone! Why? Because they really do have better success statistics.
>
> That ambien will be as useless to you as it is now to me if you keep using it consistently for long due to tolerance increase up to virtual immunity (futility point).> Uh, no. Some people develop tolerance to Ambien (probably behavioral tolerance, as occurs with alcohol), but that isn't the rule. For example, I used it every day for a year or more without needing to increase the dose. Your experience doesn't generalize.
I know my experiences don’t generalize, that’s why my first step into this forum was to ask if there were any atypicals like me around, since all other types of atypicals were begging for clues for help. I am phil’santhropic enough to try to offer help to all those here medically stalled like I was for so long. How else could I respond to reading all this? I have a long history of trying to help people more than is good for me, I keep getting called co-dependent. I used to be reluctant to admit how much my own happiness depended on helping others, que sera. Trying to rescue everyone and everything on a sinking ship is not wise when the ship isn’t really sinking. I probably shouldn’t get my mission mixed up with my missionary inclinations again here or I’ll wear out again. Your experience expectations don’t generalize well, which doesn’t bode well for future depression avoidance. You are at least going to use up your endurance and get exhaustion tolerant (wouldn’t that be interpreted (read) like depression, mental rather than physical) if you learn to settle for the short sleeps you get with Ambien. Your daily work output will decline and decay to the level you can recover nightly. Is your work output depressed? I couldn’t work much on Ambien, and I’m the worst workaholic I’ve ever met, sort of. Maybe you are retired and don’t need much sleep for your days.
Ambien (zolpidem tartrate), is a non-benzodiazepine hypnotic of the imidazpyrodine class…GABAx subunit modulator…chemical structure unrelated to benzodiazepines…deep sleep stages 3&4 factors…During nightly use for an extended period, pharmocodynamic tolerance or adaptation to some effects of hypnotics may develop. …’Transient and chronic insomnia use’ clinical tests listed in the PDR are for 5 weeks max. … no objective insomnia rebound evidenced…. INDICATIONS AND USAGE: Ambien is indicated for the short-term treatment of insomnia. Hypnotics should generally be limited to 7 to 10 days of use, and re-evaluation of the patient is recommended if they are taken for more than 2 to 3 weeks. Ambien should not be prescribed in quantities exceeding a 1-month supply….The failure of insomnia to remit after 7 to 10 days of treatment may indicate the presence of a primary psychiatric/medical illness which should be evaluated…. It is important to use the smallest possible effective dose…
Sounds like a professional warning of potential tolerance to me by the PDR. I wish you more than luck is usually statistically good for.
>
> Also, benzodiazepines cause cross-tolerance; if you're tolerant to one, you will be at least somewhat tolerant to another.I don’t know if tolerance ever wears off, but they put me on longer and longer half-life versions as time went on and sleep decreased to insufficient with each one. I’ll have to look up cross-tolerance somehow and see how wide it’s definition is.
>
> BTW I wonder if perhaps your memory problems may be due to chronic sleep deprivation as well as overuse of high-dose benzodiazepines; your loss of motivation might be caused by partial remission from mania. (Why do you feel such a need to insist that you are not manic? Mania is defined by observed symptoms, which I think you know you have.)Sleep deprivation hurt more than my memory, it hurt everything ever listed as effect from affect. Medicinal related memory problems were only significant for me on Ativan in therapeutic doses. Ativan is one of the anesthesiologist’s choices to keep us from waking up and remembering surgery. Even Halcion can cause memory dysfunction, even amnesia, but I can’t remember any??? Halcion is what made President Bush throw up on the Japanese ambassadors and what caused Sally Field’s boyfriend in that bootlegger movie series look like he had AIDs. I never took an overdose of BDs that I know of, though I think they have been somewhat overused on me. I can’t remember all the technical reasons why they chose original diagnoses that far back since I have overwritten it with much better information in the since-time, and I didn’t like it then, but they promised me they wouldn’t change to something else unless it didn’t work, I would really have balked if I had know how long they would take to give up first diagnosis, but the earliest diagnoses were Insomnia (NOS) being not otherwise specified by professionals trained better than I ever want to be to call it mania if it is mania. My lo-pro call is manic-like but not manic-exact, conceding mania-standard too easily will put everyone back on a malevolent treadmill I don’t think I should have been run on the first time. Suspicions of mania-standard cost me an extra couple of years of recovery. Mania-like, fine, lithium just wasted a lot (years) of my time. Mania-standard treatments failed which indicates non-mania-standard. I’m different in some ways, thanks, and I’m different in some other ways, sorry. Mania as cause/source and mania as result require different treatments. Lack of sleep is not always preceded by or indicative of mania-standard, if you have enough endurance you can sure test positive for increasing exhibited panic. If you split the mania definition right, you get more appropriate treatment, otherwise it will cost years by honest people who will never know they were wrong, even if you die. What you may be referring to as loss of motivation is really deferred motivation as I learned I had to put everything on hold until, if ever, promises of recovery ever came true. It would take years to complete all the projects I have preserved for such a time. I’m still reluctant to commit to much from the trauma of so much helpless powerlessness, I know how fast it overtook me completely against my will without any cooperation with convenient timing, there was no putting it off with a reschedule-please notice. My motivations are easiest to sustain for short, easy-to-complete quickly projects to this day still from sedative conditioning. I don’t understand how loss of motivation can be caused by partial remission from mania, unless they were manic-only motivated projects, which I don’t think any of mine are. The tree that kept filling my house downwind with its dirt I took down. Manic? I have to fix the garage fascia board it destroyed on the way down. Manic? I have to get the garden in the back yard replanted and the above-ground pool removed. Manic? I’ll have to mull over the rest. I’m willing to purge anything not belonging.
Phillip Marx
PhilMarx@net999.com
Posted by Scott L. Schofield on December 27, 1999, at 16:26:34
In reply to Re: Marplan and insomnia (or something), posted by Phillip Marx on December 27, 1999, at 0:08:44
I would not presume to diagnose you, but there are a few facts you may want to take note of.
I know the missionary position can be appealing at times.> > That ambien will be as useless to you as it is now to me if you keep using it consistently for long due to tolerance increase up to virtual immunity (futility point).
Perhaps this is true of Ambien, but it is not true of all the benzodiazepines in all individuals. A combination of Halcion and Ativan did a real good job for me over the course of three years while taking Parnate or Nardil in combination with Norpramin. There was no decrease in efficacy once the dosages were titrated and later tweaked.
> > Uh, no. Some people develop tolerance to Ambien (probably behavioral tolerance, as occurs with alcohol), but that isn't the rule. For example, I used it every day for a year or more without needing to increase the dose. Your experience doesn't generalize.> I know my experiences don’t generalize, that’s why my first step into this forum was to ask if there were any atypicals like me around, since all other types of atypicals were begging for clues for help. I am phil’santhropic enough to try to offer help to all those here medically stalled like I was for so long. How else could I respond to reading all this? I have a long history of trying to help people more than is good for me, I keep getting called co-dependent. I used to be reluctant to admit how much my own happiness depended on helping others, que sera. Trying to rescue everyone and everything on a sinking ship is not wise when the ship isn’t really sinking. I probably shouldn’t get my mission mixed up with my missionary inclinations again here or I’ll wear out again. Your experience expectations don’t generalize well, which doesn’t bode well for future depression avoidance. You are at least going to use up your endurance and get exhaustion tolerant (wouldn’t that be interpreted (read) like depression, mental rather than physical) if you learn to settle for the short sleeps you get with Ambien. Your daily work output will decline and decay to the level you can recover nightly. Is your work output depressed? I couldn’t work much on Ambien, and I’m the worst workaholic I’ve ever met, sort of. Maybe you are retired and don’t need much sleep for your days.
> > BTW I wonder if perhaps your memory problems may be due to chronic sleep deprivation as well as overuse of high-dose benzodiazepines; your loss of motivation might be caused by partial remission from mania. (Why do you feel such a need to insist that you are not manic? Mania is defined by observed symptoms, which I think you know you have.)
One of the most effective treatments for severe mania is to combine a neuroleptic with a benzodiazepine. I imagine clonazepam would be the best choice for this. There are reasonable grounds for Elizabeth’s ponderings.
> Sleep deprivation hurt more than my memory, it hurt everything ever listed as effect from affect.
Sleep deprivation can also precipitate mania as well as being a symptom of it.
> I probably shouldn’t get my mission mixed up with my missionary inclinations again here or I’ll wear out again.
> I’m the worst workaholic I’ve ever met, sort of.
Not to be a hard-on, but I think Elizabeth may be right. The previous passage you wrote resembles very closely some of the psychodymamics I experienced during a manic state. Whereas you seem to think of your "mission" as being an effort to help the mentally ill, my mission was to save the world by ridding it of the devil. I was a courageous sole to take on the devil single-handedly, considering that the rest of the world had demonstrated its impotency in that pursuit. I don't know - I guess it was pretty grandiose, but there was no chance in Hell that I was going to be able to recognize it at that time.
> Medicinal related memory problems were only significant for me on Ativan in therapeutic doses. Ativan is one of the anesthesiologist’s choices to keep us from waking up and remembering surgery. Even Halcion can cause memory dysfunction, even amnesia, but I can’t remember any??? Halcion is what made President Bush throw up on the Japanese ambassadors and what caused Sally Field’s boyfriend in that bootlegger movie series look like he had AIDs
I did not experience any memory problems while taking Halcion, nor did I suffer a significant hangover or memory deficit the next day while taking Ativan. Of course the reaction profile will differ between individuals.
Halcion is not on the top of most doctors’ lists of hypnotics. It is extremely potent and has a very short half-life (3-5 hrs). It has been blamed for episodes of severe amnesia, a side-effect that I believe motivated Upjohn to cut the recommended dosages by half and produce lower-dose pills. I can’t help but to wonder if the use of Halcion alone as a hypnotic might actually produce a mini benzo-withdrawal once the blood levels have dropped precipitously. Perhaps this was the reason why President Bush found it necessary to bring-up certain issues.
> My lo-pro call is manic-like but not manic-exact, conceding mania-standard too easily will put everyone back on a malevolent treadmill I don’t think I should have been run on the first time. Suspicions of mania-standard cost me an extra couple of years of recovery. Mania-like, fine, lithium just wasted a lot (years) of my time. Mania-standard treatments failed which indicates non-mania-standard. I’m different in some ways, thanks, and I’m different in some other ways, sorry. Mania as cause/source and mania as result require different treatments. Lack of sleep is not always preceded by or indicative of mania-standard, if you have enough endurance you can sure test positive for increasing exhibited panic. If you split the mania definition right, you get more appropriate treatment, otherwise it will cost years by honest people who will never know they were wrong, even if you die. What you may be referring to as loss of motivation is really deferred motivation as I learned I had to put everything on hold until, if ever, promises of recovery ever came true. It would take years to complete all the projects I have preserved for such a time. I’m still reluctant to commit to much from the trauma of so much helpless powerlessness, I know how fast it overtook me completely against my will without any cooperation with convenient timing, there was no putting it off with a reschedule-please notice. My motivations are easiest to sustain for short, easy-to-complete quickly projects to this day still from sedative conditioning. I don’t understand how loss of motivation can be caused by partial remission from mania, unless they were manic-only motivated projects, which I don’t think any of mine are. The tree that kept filling my house downwind with its dirt I took down. Manic? I have to fix the garage fascia board it destroyed on the way down. Manic? I have to get the garden in the back yard replanted and the above-ground pool removed. Manic? I’ll have to mull over the rest. I’m willing to purge anything not belonging.
Recently, there has been a bit of a revision in the conceptualization of affective illness. Terms like "affective-spectrum" and "soft-affective illness" as well as “soft-bipolar” have been used to help place people for whom the classical “hard” standards do not apply well. The motivation for such a “liberalization” of diagnostic criteria and the inclusion of quasi-affective presentations is to try to get more people better. What other motivation could there be? I think the missions of our researchers and clinicians seem philanthropic enough to forgive them for any of their mistakes.
My sincerest wishes for the attainment of your mental health.- Scott
Posted by Elizabeth on December 27, 1999, at 23:09:55
In reply to Re: Marplan and insomnia (or something), posted by Phillip Marx on December 27, 1999, at 0:08:44
Phillip,
The PDR isn't a very good source of information on drug side effects -- its source is the pharmaceutical companies, and so it tends to be alarmist.
That said, you're just wrong about Ambien. There are a number of studies of long-term use of Ambien that show no significant tolerance, whereas you will find only isolated case reports of tolerance. I was not generalizing from my experience; I was offering it as a specific example of a general fact that can be obesrved.
> I don’t know if tolerance ever wears off,
It does. You need to abstain from the drug (and similar drugs) for a while in order for it to become effective again, though.
BTW, like others, I'd appreciate it if you'd be more concise and less rambling. I have attention problems (improved since I started Ambien again, though) and it's hard for me to read your long and not-always-entirely-coherent posts.
Posted by Scott L. Schofield on December 30, 1999, at 14:08:20
In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 27, 1999, at 23:09:55
(Not meant to be a flaming of Elizabeth).
> Phillip, …> BTW, like others, I'd appreciate it if you'd be more concise and less rambling. I have attention problems (improved since I started Ambien again, though) and it's hard for me to read your long and not-always-entirely-coherent posts.
I wanted to say something, but I can’t find the right words.I am still fairly new here, and have “made-ass” a few times early on (I’m sure there will be more to come). I think it was due to a combination of my need to be heard (end the feelings of isolation) and the need to feel smart (boost self-esteem), both of which are directly attributable to the bipolar depressive state I find myself in. But is that the real me?
I have not been here long enough to have a feel as to the many ways that people interact with one another in different situations. If this issue has already been dealt with, I apologize. Also – for Elizabeth – please don’t take any offense that I chose your post to reply to. It just seemed to hit me at that moment.
Is it more compassionate to understand and avoid reacting to the behaviors and words of one whose mental state has been compromised by illness, or to be reactionary in such a way as to disregard the contribution of that illness to the resultant psyche? Is it one’s fault that they are mentally ill – regardless of diagnosis? Is it within their control to change without any help and of their own volition? Perhaps it is the honest knee-jerk reaction of others that helps one to recognize that something is not right. Would this not be the more compassionate choice, as it might lead to an improvement in their quality of life?
I dunno.
- Scott
Posted by Elizabeth on December 31, 1999, at 4:38:51
In reply to Re: Marplan and insomnia and tolerance, posted by Scott L. Schofield on December 30, 1999, at 14:08:20
> Is it more compassionate to understand and avoid reacting to the behaviors and words of one whose mental state has been compromised by illness, or to be reactionary in such a way as to disregard the contribution of that illness to the resultant psyche? Is it one’s fault that they are mentally ill – regardless of diagnosis? Is it within their control to change without any help and of their own volition? Perhaps it is the honest knee-jerk reaction of others that helps one to recognize that something is not right. Would this not be the more compassionate choice, as it might lead to an improvement in their quality of life?
I don't know the answer to that, Scott, and it's an interesting question. I don't know that it's particularly uncompassionate to say that one thinks someone is manic, though (unless it's being used as a way to devalue that person's opinions). As to whether it's in one's power to change, I think help is required, but practically speaking, you have to seek out that help first. And in order to do that, you have first to realize that something is wrong!
Several people have tried to point out to Phillip that he comes across as manic or psychotic (not just in the length and disorganization of his posts, but also in some of his odd ideas and unusual turns of phrase), but he denies that he is. Of course he might just lack insight into his condition, as many manic (or otherwise psychotic) people do.
I sort of think it would be interesting to write up and post a mental status exam of Phillip's posts, but I have resisted doing so. :-}
BTW a particular issue with this is whether a less-than-honest "therapist" might take advantage of the impaired judgment of such individuals to offer less-than-sound treatment. Not that this is necessarily happening here, but it's something that *could* happen.
Posted by Scott L. Schofield on December 31, 1999, at 10:08:58
In reply to Re: Marplan and insomnia and tolerance, posted by Elizabeth on December 31, 1999, at 4:38:51
> > Is it more compassionate to understand and avoid reacting to the behaviors and words of one whose mental state has been compromised by illness, or to be reactionary in such a way as to disregard the contribution of that illness to the resultant psyche? Is it one’s fault that they are mentally ill – regardless of diagnosis? Is it within their control to change without any help and of their own volition? Perhaps it is the honest knee-jerk reaction of others that helps one to recognize that something is not right. Would this not be the more compassionate choice, as it might lead to an improvement in their quality of life?
> I don't know the answer to that, Scott, and it's an interesting question. I don't know that it's particularly uncompassionate to say that one thinks someone is manic, though (unless it's being used as a way to devalue that person's opinions). As to whether it's in one's power to change, I think help is required, but practically speaking, you have to seek out that help first. And in order to do that, you have first to realize that something is wrong!Perhaps this is a topic that should be started as a new thread.
> Several people have tried to point out to Phillip that he comes across as manic or psychotic (not just in the length and disorganization of his posts, but also in some of his odd ideas and unusual turns of phrase), but he denies that he is. Of course he might just lack insight into his condition, as many manic (or otherwise psychotic) people do.
It strikes me that the way you responded to Phillip’s post was constructive. I think it helps to illuminate what I feel is an important perspective. I believe we have a bit of a “catch-22” here. The fact that someone who is mentally ill fails to recognize that he has a problem and therefore does not seek help is the manifestation of the illness itself. Since this person will not be treated (because he does not recognize or accept his illness), his errant judgement regarding his illness will be perpetuated. Thus, he never receives the help he needs. Even if one recognizes that something is wrong does not guarantee that they will have the good judgement or energies to do anything about it.
> BTW a particular issue with this is whether a less-than-honest "therapist" might take advantage of the impaired judgment of such individuals to offer less-than-sound treatment. Not that this is necessarily happening here, but it's something that *could* happen.
Hmmm…
Wishing you a happy new year... Let's hope it's a good one.- Scott
Posted by Phillip Marx on December 31, 1999, at 19:50:18
In reply to Re: Marplan and insomnia and tolerance, posted by Scott L. Schofield on December 31, 1999, at 10:08:58
OK, Elizabeth, Scott, jamie and all. I'll take this bait. Get your thoughts together, and so will I. The following will give you a head start.
I'll respond soon, point by point, to what is already written, in a separate post I have already begun composition of. I will come short of full compliance to the APA Publications Guidelines. Resort to such expense of time and backup editor proof-reading “would” uncontestably look manic and psychotic here (no offense intended to the APA, maybe I should micro-debate-proof for this community too). Quit comparing what I write to what the APA can afford to write. My present aversion to such now unprofitable detail is financially responsible ($=time: net + net , or red time plus red money feels like red squared dot product time&money). Such exposition perfection would require a couple of weeks’ displacement of priorities I can't justify, classes restart soon, and nothing here would justify slipping a semester. I know structure will be debated more than the sub-contents of the overall content (medicinally forgivable, all of you are in some kind of treatment too). I shouldn’t be embarrassed by that, nor you. I’m sure already that my next discourse length will bait some brevity-compression-compromises appreciation from you. Since I detect opposition due to pre-bias “fog” I will resort to massive repetition, using multiple perspectives to dislodge foregone (really gone) conclusions and pry open some open-forum-mindedness. I think all institutes of learning grant that repetition is “the” best lowest common denominator teaching method. Calling that manic too, well…. that’s a disorder in and of itself.
I'll use the DSM-IV, Fourth edition (paperback) for objectivity control. I wish to point out that “the” Note, the “only” note to manic episode criteria, points out the criteria for exceptions to a manic episode diagnosis (p. 332). The exact term to consider is it's first one: "Manic-like" to which I have referred from my first post. Manic-like means NOT actually manic, it concedes similarity only, while conceding not really manic. Some of the semantic difference of opinion may lie in the thought of manic as mania-ic. Pun-ishly, manic-like=mania-ic-ic, which would always look like a typo. It does looks like what looks like mania, fully conceded, double-talk sounding, but not double-talk meaning, just an officially acknowledged APA disorder sub-category in double-nested (embedded) disguise. Don’t be embarrassed for confusion, my frequent emphasis is only driven by frustration aversion to help you detour your own confusions you don’t yet recognize. Someday you’ll realize this is an “I told you so” situation. You don’t have to believe me, or the APA, too bad for everybody. I really, really, really told you so, over and over and over. I know only once doesn’t work from much experience, neither does thrice. Thrice is usually my limit. Do your best and let God do the rest in action. I solicit alternative constructive suggestions for a non-manic-looking description technique. "I" have always conceded mania similarity, else I’d sue somebody for malpractice. I am Atypical, which means NOT typical. I am not in denial of illness, I am on medication I can’t live without because of it. I am not failing to seek treatment. I am seeking it at a significant cost that is still an especially bargain cost compared to all the years of unfruitful treatment. I am deliberately failing to seek more false treatment, based on false ideas of what the treatment is for. I know what doesn’t work. People and doctors who think lithium will always work, if you take enough, long enough, have a reality comprehension disorder. I came here seeking any help from others better off than I, and offering help to anyone less well off than I. REAL professionals, ALL of them, have given up the diagnosis your lay intuition suspects, just as reluctantly as you might. I hope you will catch on to reality here. Don’t feel bad. Better-trained professionals didn’t get it right for a long time either. Some of them never will. However, I will correct you for impugning the only Doctor who restored functionality to me, in spite of having to overcome a presenting history of a long series of reversed (counter-indicative) medicine responses. I have very visible, massive physiological improvements to show for it. My strength is back. I am over 50-years old. I can pick up 100 pound kids with just my index finger and love proving it, so do the kids, so I can live just fine without your approval. My (dis)trust of diagnosis is not paranoid, but is educated by the school of really hard involuntary knocks. A prayer to God once asking why he let me take so much karate resulted in an impression it was so I could learn how to take punches. I had an understandable mixed good/bad impression of that. These types of knocks I don’t have a mixed good/bad feeling about. Most of you show signs of the same feelings about conventional diagnosis state-of-the-art. My Dr. and I have a way to go. I’ve never claimed complete restoration from so many derivative effects. I haven’t given him enough trials to deal properly with so many sub-problems since I am hoping for as much natural healing in the meantime as possible, all of which take their own long times. I haven’t forfeited all hope though. Several medication trials are scheduled for future, longer class breaks. I like when trial stress subsides. I’m not in a rush for more. Such procrastination may catch up with me again, but it won’t be my Doctor’s fault. Watch out, sympathy and pity can be symptoms of end-stage responsibility for thinking clearly. Treatment for typical mania is DE-generative and COUNTER-therapeutic for me, a total failure, as is such diagnosis. Anyone with intellectual bi-focals can see that. Please get that or surrender to the opinion I’ll have of you and the end-stage teachability of “your” diagnostic skills. Some of you aren’t treatment-resistant, you are really “proper diagnosis”-resistant. Your presence here indicates you are consciousness of this, maybe vividly. Historically, ME TOO. You sound like dim, ringing echoes that trigger traumatic memories of medicinally forced helplessness(es) that trigger fight or flight instinct bio-chemical response poisonings. If I were to give your recommended treatment for such a long-failed diagnosis any credence, my life and functionality would again be at stake. We are designed to learn from painful experiences to avoid unpleasant encores. Consensus, when proven wrong, needs to be abandoned. If it doesn’t work, call Sherlock Holmes, the Hardy Boys or Nancy Drew if you need someone to help you decide if that might mean it is wrong. Any response not understanding that is essentially non-responsive due to deficits of diagnostic skills I should have abandoned far sooner in order to get un-bedridden sooner. But I have to dig through just such a shroud of patient turfing to find more like me. Manic treatment for manic-like symptoms is serious maltreatment. It hurts everything more than mania does. Death might have hurt less than what I went through.
Consider also the somatoforms (p. 445+) for the reasons I use some physiological evidences as criteria for de-cloaking a response from those similar to me, who likely don't know it. I expect these criteria clues will sound discombobulated and unrelated to those with non-congruent disorders, too bad. I intend to use them to rule-out similar but otherwise unrelated problems and problem genesis(es). These are who I am seeking during my only recent useful week with any time for this. My time-investment/involvement estimator needs serious re-calibration after this. PMS and many other real physiological events used to be classified as merely “psycho”-somatic and those so afflicted were thought of as psycho because of it. It’s not my fault that history repeats since history teaches so mercifully. Honest neuro-psychiatry will someday accord EMF it’s due place too (http://www.google.com/search?q=emfrapid). EMF is my main suspicion, but I concede it’s only my main suspicion. It could be something else. If I knew what else it could be whose validity hadn’t already been ruled-out, I’d look there. Mania-typical doesn’t prove out, several years of benevolent attempts to prove so failed.
I am life-long pro-instrumentation towards the end that subjectivity can get more honestly objective. Indeed, such a project did me in. If a collective of experiences can be coordinated, treatment for future relapse treatments might achieve some therapy streamlining and misery reduction. Fore-thought should be higher on my priority list in at least token form. Guinea pig has not been my voluntary career transition choice, nor do I wish to be an anecdote.
If saying that so many times in so many ways doesn’t work, too bad, more for you than for me. So much emphasis isn’t intended to penetrate bullet-proof mindsets. I intend for you to walk away intact even if you disagree with me. It’s just emphasis for “your” sake, not mania. I’m more improved with my recent treatments than you are with yours. I appreciate your compassion, patience and sympathy, though I wish such were more mutually productive than merely diplomatic. I will try to tailor my more detailed response kindly in-kind while still leaning towards objectivity. Objectivity will be supported with emphasis where known to be needed. That’s a forewarning to recalibrate your input circuits to recognize emphasis as deliberate and legitimate language use, not involuntary mania. Again. If you still don’t get it, que sera.
Maybe the medicine profession hangs on to Latin to discourage argument fluency by patients in situations like this. Instead of this I should be monitoring my stocks. They rose over $4,000 today in half a day and an under-bid for 5,000 more shares barely fell through on the early market close. Drat! I need to schedule responses to off-critical hours.
> > > Is it more compassionate to understand and avoid reacting to the behaviors and words of one whose mental state has been compromised by illness, or to be reactionary in such a way as to disregard the contribution of that illness to the resultant psyche? Is it one’s fault that they are mentally ill – regardless of diagnosis? Is it within their control to change without any help and of their own volition? Perhaps it is the honest knee-jerk reaction of others that helps one to recognize that something is not right. Would this not be the more compassionate choice, as it might lead to an improvement in their quality of life?
>
> > I don't know the answer to that, Scott, and it's an interesting question. I don't know that it's particularly uncompassionate to say that one thinks someone is manic, though (unless it's being used as a way to devalue that person's opinions). As to whether it's in one's power to change, I think help is required, but practically speaking, you have to seek out that help first. And in order to do that, you have first to realize that something is wrong!
>
> Perhaps this is a topic that should be started as a new thread.
>
> > Several people have tried to point out to Phillip that he comes across as manic or psychotic (not just in the length and disorganization of his posts, but also in some of his odd ideas and unusual turns of phrase), but he denies that he is. Of course he might just lack insight into his condition, as many manic (or otherwise psychotic) people do.
>
> It strikes me that the way you responded to Phillip’s post was constructive. I think it helps to illuminate what I feel is an important perspective. I believe we have a bit of a “catch-22” here. The fact that someone who is mentally ill fails to recognize that he has a problem and therefore does not seek help is the manifestation of the illness itself. Since this person will not be treated (because he does not recognize or accept his illness), his errant judgement regarding his illness will be perpetuated. Thus, he never receives the help he needs. Even if one recognizes that something is wrong does not guarantee that they will have the good judgement or energies to do anything about it.
>
> > BTW a particular issue with this is whether a less-than-honest "therapist" might take advantage of the impaired judgment of such individuals to offer less-than-sound treatment. Not that this is necessarily happening here, but it's something that *could* happen.
>
> Hmmm…
>
>
> Wishing you a happy new year... Let's hope it's a good one.
>
> - Scott
Posted by Scott L. Schofield on December 31, 1999, at 22:15:00
In reply to Re: Marplan and insomnia and tolerance, posted by Phillip Marx on December 31, 1999, at 19:50:18
Dear Philip,
> OK, Elizabeth, Scott, jamie and all. I'll take this bait. Get your thoughts together, and so will I. The following will give you a head start.
> I'll respond soon, point by point, to what is already written, in a separate post I have already begun composition of.
I will not even begin to read beyond the first few sentences before replying.
This is not a war and I plan not to take part in one. As to my posts regarding these issues, I feel that they are both important and relevant. They apply not only to the one suffering from a mental illness, but also to those who he may interact with ( especially with those who genuinely care about him). They do not, however, necessarily apply to you. That is for you to discover – with or without help; with or without intervention. It is my hope that you end up walking the path that is right for you.
Bye the way, within this thread I chose to share with you something that is extremely personal. I felt somewhat embarrassed to describe the things that went on with me during a manic episode. Certainly, I was not bragging about how psychotic I was.
Why do you suppose I did that?
Take care of yourself.
Sincerely,
Scott
Posted by Phillip Marx on January 1, 2000, at 3:02:55
In reply to Happy New Year !, posted by Scott L. Schofield on December 31, 1999, at 22:15:00
Suits me. Que Sera. I had no intentions of a war. Sharpening "your" double-edged diagnostic sword with the rest of the truth is more my style. If you know all the truth, we lose our differences cheap. There are better and legitimate neuro-psychology teachers in better condition than me, but I'll wager not many as recovered. Unfortunately, my family took pictures and I can prove it.
I have had bio-medical electronics engineering for 20 years now. I'm planning to start certified formal deep stuff next week, now that formal deep stuff knows something that only has to be learned once. My present lack of ProP credentials is curable. My learning has been too self-centered thus far. I'd rather spend the next semester fixing that than proving I need to.
pmOnwards and backwards to my original search for similar atypicals through old posts.
Oh, Elizabeth, take care. I wish I had the confidence that my medications won't fail again, but I've played the brinkmanship game too close to the brink once too often, and it was very close to the death of me. I hope your confidence isn't the death of you.
re: Ambien - http://www.dr-bob.org/babble/19991212/msgs/17451.html> Dear Philip,
>
> > OK, Elizabeth, Scott, jamie and all. I'll take this bait. Get your thoughts together, and so will I. The following will give you a head start.
>
> > I'll respond soon, point by point, to what is already written, in a separate post I have already begun composition of.
>
> I will not even begin to read beyond the first few sentences before replying.
>
> This is not a war and I plan not to take part in one. As to my posts regarding these issues, I feel that they are both important and relevant. They apply not only to the one suffering from a mental illness, but also to those who he may interact with ( especially with those who genuinely care about him). They do not, however, necessarily apply to you. That is for you to discover – with or without help; with or without intervention. It is my hope that you end up walking the path that is right for you.
>
> Bye the way, within this thread I chose to share with you something that is extremely personal. I felt somewhat embarrassed to describe the things that went on with me during a manic episode. Certainly, I was not bragging about how psychotic I was.
>
> Why do you suppose I did that?
>
> Take care of yourself.
>
>
> Sincerely,
> Scott
This is the end of the thread.
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