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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Francisco on July 14, 2002, at 8:44:10
Hello, I want to share my problems with depression in hopes someone can help me out. I was first diagnosed with clinical depression when I was about 15. Now I am 25 and I still suffer from depression. I had a somewhat traumatic experience in my adolescence due to my family crisis (parents + financial) and I think that started my depression. However I believe, and my parents agree that a lot of it is from genetics. When I was first diagnosed, they tried to put me on prozac but I suffered too much side effects, mostly the jitters and gave up on it within the first week. Thinking back, I was probably given too much dosage and that is what my current doctor thinks too. She thinks one day I should give prozac another try, once we discovered I was super sensitive to meds.
Anyways, although I had hard time in high school due to depression, I was able to get enough studying done and go to a great university. In my college years, I found marijuana and fell in love with it. I eventually started abusing it to get me through when a breakup with a girlfriend caused me to become very depressed. I used the weed to get me through college and it helped me a lot with depression. I know abusing it is bad but I wasn't taking any meds and in college and being high all the time (just about every day for few years), I never really felt my depression was bad enough to seek out more help.
Later in my college years, I started noticing that I have symtoms associated with ADD. I was curious whether I had ADD and my mother suggested I see this brain therapist she knew. Well that doctor told me I do have ADD and that is what is causing depression. Anyways, I was put on some ECG(?) therapy (the brainwave calibration thing) but that didn't seem to help me at all. Anyways, I graduated college and when I found my self unable to find work in my field, I got somewhat depressed again. I was even more unmotivated, lazy, thanks to the weed I was smoking daily to supposedly help me with depression. The dependency to weed was something I wasn't willing to give up because I still think it has helped me with depression so much.
When I told my mother last year that I still have depression, she asked me to see a doctor and told me there are so many new medicines out there for depression now. I went to see the doctor who told me that the ADD was a mis-diagnose and I have dysthymia, and put me on paxil. Paxil helped me feel better but I was getting strong side effects. Even on minimal dosage, my sensitivity to meds caused me daily diarreah, excessive sweating, jitters. I changed to celexa for its weaker side effects and that went ok. I told my doc that the side effects weren't too bad on celexa but she urged me to try Remeron. I noticed remeron is nothing like the SSRI's. It worked great at first and helped me with my decade old insomnia. But I started noticing my mind was getting too affected by the drug. I noticed I was getting too messed up, especially when I combined it with marijuana. In fact, when I first combined it, I was so torn up that I had what I believe was my first panic attack. My vision was totally affected and my visual perception of depth was fading. I got used to this, since I couldn't quit marijuana and actually I started enjoying the different high in the remeron+pot combo. However, during this time, I had two terrible episodes of depression, anxiety, panic both coming after I had partied with the drug ecstasy. I noticed that mixing all these drugs started making me a bit psycotic and trip out for no reason. After going through such low times, now I feel permanently vunlerable to frequent depression, anxiety, and panic. I felt the lows of emotions I never knew existed, and my increased range of emotion, in both extremes is something I am having a hard time handling. I concluded that the depression that followed the usage of ecstasy was not worth it and I decided to never use the drug again.
Well here I am now, I am not taking any meds and I haven't seen my doc for a while. I am seeing a new doc this month though. Last time, when my old doc recommended Remeron, she told me if that doesn't work, its wellbutrin next. Since then, I had those crazy episodes and now I don't know I want to try medications. In retrospect, I think Remeron messed me up for good, while it could have been the ecstasy, or the prolonged use of marijuana, I am leaning more towards Remeron because everything bad started when I started it. Before remeron, I never had serious problems with usage of ecstasy and marijuana, I never knew how a panic attack felt like, I never knew how bad depression can be. I have a sample bottle of WB here at home, but I found out theres a warning that mixing WB and pot can cause psycotic episodes. So I am putting it off for now and contemplating stopping weed for a while so I can try WB.
I feel the need to wake up. I think these meds while helped me with depression initially, totally changed me. While on meds, I stopped caring about things anymore. I felt like my mind is clouded and I seem to zone out frequently, and unresponsive. When my family started to tell me, "Howcome you never talk to us anymore?", I totally realized how true that was. I was rarely talk to my siblings and mother, who care deeply about, and since then have made efforts to change this. While I now want to experience emotions again that were incapacitated by meds, I am scared of the lows of emotions. But I have noticed a somewhat strange change in me. I am scared to be alone. I am too scared because I get more depressed when I am alone where I tend to just go into constant thoughts of depressing things. Before, I used to enjoy my solitude and wanted to be alone a lot. Now, if I'm alone, I think I'll go mad and can't stand it. I want to be with my friends more where before I tried avoiding them a lot. This is really confusing for me. Since wanting to be with friends and going out more is a good normal healthy thing, I feel maybe I am starting to feel normal. On the other hand, I feel these efforts are due to the fact that I am so scared to fall into another scary relapse. My friends provide me so much comfort and I feel so happy to be with them now that it is so unlike me. I was always the one that my friends had to force to come and hang out. It has been two weeks since my last Remeron was taken and I feel like I'm starting to wake up. I don't know if I want to go back to meds, and I have always been scared about dependency to meds. l I am not sure where to go from here. If anyone can provide any insights or help it'd be appreciated. Also I want to hear from people with dysthymia and how they cope with it. I am really sorry about this long post, but I feel better now letting everything out.
Posted by Shawn. T. on July 14, 2002, at 11:06:35
In reply to What is going on with me? Long story..., posted by Francisco on July 14, 2002, at 8:44:10
Posted by Shawn. T. on July 14, 2002, at 12:46:47
In reply to What is going on with me? Long story..., posted by Francisco on July 14, 2002, at 8:44:10
Posted by katekite on July 14, 2002, at 16:49:14
In reply to What is going on with me? Long story..., posted by Francisco on July 14, 2002, at 8:44:10
It sounds like there are a lot of issues: sleep, attention and cognitive things, depression, daytime energy, motivation, and whether or not your moods are overly extreme. Dysthymia sure doesn't sound like it explains most of that! I don't buy it as a solo diagnosis.
With the new doc, it is a psychiatrist right? It might be useful to do an MMPI or other mood/personality test to help them figure out what other classes of meds might help.
It's important to rule out ADD. I liked the quiz at www.mindfixers.com. Have you ever been prescribed ADD meds? like Ritalin or Adderall? It is important to get tested for ADD when on the smallest amount of meds possible. If you think the neurobrain guy you saw long ago could have been wrong, talk to the psychiatrist about getting a formal evaluation. In unclear cases a psychiatrist will most likely know an ADD specialist that could really figure it out once and for all.
It sounds like you've unfortunately had to deal with bouts of depression since you were a teenager. Something severe enough to make you need pot on a daily basis just to get by! That says a lot. It's reasonable to be scared of what happened with remeron or the side effects of prozac. There's no reason you need to tolerate those things (and no reason you have to live with pain itself). Almost everyone eventually finds a med or maybe a combination of two that really makes life livable again. It just takes time.
Can you elaborate on the extra range of emotion with remeron? Did that happen while you were on it, or after you stopped? When you say you had panic-like symptoms, how long did that last and what did it feel like, exactly? Are you sure it wasn't agitation, dysphoric hypomania or something else?
Kate
Posted by Noelle on July 14, 2002, at 22:06:30
In reply to Re: What is going on with me? Long story..., posted by katekite on July 14, 2002, at 16:49:14
Kate
I hope this doesn't confuse things, but why do you say rule out ADD first, I've always heard that its important to to rule out depression and treat it before ADD. I'm not sure If I agree but this psychologist that I have been working with seems to think that I've never really experience functioning in a non-depressed, non-anxiety state and this is what is contributing to my concentration problems and otherwise ADD-like symptoms, but I do agree that testing is the way to go. I'm definately not saying I agree but what do you think
Posted by katekite on July 15, 2002, at 9:23:10
In reply to Re: What is going on with me? Long story...Kate, posted by Noelle on July 14, 2002, at 22:06:30
I guess my thinking is this (and this does not apply to major depression, just dysthymia and less urgent problems):
1. anti-depressants can screw up ADD testing by working in a stimulant way (especially prozac, wellbutrin, maybe remeron in high doses, maybe serzone in high doses) and all ADs will reduce the behavioral problems of ADD so can mask it to some degree. If someone is on antidepressants and tests not ADD, are they really not ADD or are the antidepressants just masking it? Since we all mostly get evaluated for ADD just once or twice in our lives, it ought to at least be a fair evaluation.
2. For someone who is not bipolar, stimulants can be extremely effective antidepressants. So if ADD and depression co-exist, one drug sometimes can effectively treat both. Better to find out first than to by trial and error add a stimulant to a cocktail years later.
3. In order to make a diagnosis of ADD you have to report concentration problems that go back to childhood. Very few people who are depressed will have been depressed from childhood, so this can be a good way to differentiate. Most people who report concentration problems from childhood have primary ADD, not primary depression. ADD is much more common in childhood than depression. As an adult, if the primary problem is treated, the secondary ones may get better on their own. Why not at least test for ADD first?
So that's my reasons. One could argue against that order of treatment by saying that there is a risk of addiction with stimulants and this is certianly true. But in people who test as ADD addiction to stimulants is very rare. Also for people who may be bipolar, stimulants have risks (although antidepressants have as much or more risk).
I don't feel that the 'test for ADD first rule' applies to people in a major depressive episode. If someone is dangerously suicidal then waiting weeks to get properly evaluated for ADD is dumb, they should try standard antidepressants because they can't afford to mess around.
Also, stimulant trials should not be used for ADD diagnosis. Because stimulants help most people a little and will help the concentration issues of depression. They should only be used after a diagnosis is made.
kate
Posted by Francisco on July 16, 2002, at 10:44:22
In reply to Re: What is going on with me? Long story..., posted by katekite on July 14, 2002, at 16:49:14
> It sounds like there are a lot of issues: sleep, attention and cognitive things, depression, daytime energy, motivation, and whether or not your moods are overly extreme. Dysthymia sure doesn't sound like it explains most of that! I don't buy it as a solo diagnosis.
>
> With the new doc, it is a psychiatrist right? It might be useful to do an MMPI or other mood/personality test to help them figure out what other classes of meds might help.
>
> It's important to rule out ADD. I liked the quiz at www.mindfixers.com. Have you ever been prescribed ADD meds? like Ritalin or Adderall? It is important to get tested for ADD when on the smallest amount of meds possible. If you think the neurobrain guy you saw long ago could have been wrong, talk to the psychiatrist about getting a formal evaluation. In unclear cases a psychiatrist will most likely know an ADD specialist that could really figure it out once and for all.
>
> It sounds like you've unfortunately had to deal with bouts of depression since you were a teenager. Something severe enough to make you need pot on a daily basis just to get by! That says a lot. It's reasonable to be scared of what happened with remeron or the side effects of prozac. There's no reason you need to tolerate those things (and no reason you have to live with pain itself). Almost everyone eventually finds a med or maybe a combination of two that really makes life livable again. It just takes time.
>
> Can you elaborate on the extra range of emotion with remeron? Did that happen while you were on it, or after you stopped? When you say you had panic-like symptoms, how long did that last and what did it feel like, exactly? Are you sure it wasn't agitation, dysphoric hypomania or something else?
>
> Katei did take the ADD test at mindfixers.com and i believe it said probable ADD. but then i didn't have concentration problems until i first got depression during adolescence. i have never been prescribed ADD meds. as for the range of emotions with remeron, it came when i purposely stopped it for a day or two because i didnt want to mix it when i used recreational drugs. looking back, maybe what i went through was withdrawl or something. my current doc doesn't want me to mix meds, when i asked her of that possibility, she said that would only be necessary if the situation was desperate enough. the first so called panic attack came when i tried driving on the freeway after i smoked pot while on remeron. the second time i felt it was during the post-ecstasy depression phase. both times it only lasted part of one day though. perhaps it wasn't panic attack but i sure was panicking. can u tell me what dysphoric hypomania is?
i have been reading about dysthymia lately and the more i read about it, the more it is the correct diagnosis. however, i did and still do have certain periods of unbearable depression that feel like episodes of major depression. from what i know, a person with dysthymia is not supposed to have major depression?
Posted by cybercafe on July 16, 2002, at 15:04:16
In reply to Re: What is going on with me? Long story..., posted by Francisco on July 16, 2002, at 10:44:22
dysthymia is a mild form of depression.... however it is expected that most sufferers of dysthymia will suffer from major depressive episodes ... this is called a "superimposed episode of depression" or if you prefer the slang term "double depression" ...
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