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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by fluffy on October 26, 2002, at 15:16:11
Wow.
I just read a really long thread about Cyclothymia on this BB. And just finished a really, really tearful conversation with my father over lunch.
For the past couple of months, I have been struggling with a really MAJOR bout of depression. To make a long story short...
I have been put on Lexapro for this particular bout, and have gotten WORSE! I have been really, really agitated and crying all the time. I have been having a hard time understanding how I can be so depressed and brain-dead for two months, when only a few months before I was so active and creative--solving all kinds of problems.
This morning, I read a description of Cyclothymia, and it made so much sense. After having a long discussion with my father, it turns out that he has also suffered from the same creative bursts and depressive jags.
Not only that, but my father's mother was given shock treatment for some type of mental disorder in the fifties, and was never diagnosed, and never recovered.Suddenly, I'm realizing that I need to be really straight with my Psychiatrist...I never wanted to be called BP, because I never had DANGEROUS upswings. But the downswings have seemed increasingly more dangerous for me...thoughts of hurting myself and/or suicidal thoughts.
I am an artist as well as many of the people who chimed in about cyclothymia on this BB. I'm a bit afraid about losing the creative side, but I'm also feeling afraid of my down moods.
Has anyone else has similar experiences? I could use some support.
Posted by Tabßitha on October 26, 2002, at 16:31:09
In reply to Recognizing / Treating Cyclothymia, posted by fluffy on October 26, 2002, at 15:16:11
Hi Fluffy,
Just persist in getting the depression under control. The diagnosis isn't that important. I'm not clear on the distinction between cyclothymia and bipolar II, but I have to agree "cyclothymia" sounds a bit less scary. I've been in the weepy/agitated state you describe and it's truly horrible. Antidepressants always worked to pull me out of it, but never as fast as I wanted. Now that I've been on meds consistently I never get that low anymore.
There was a thread about creativity and meds, I'm not sure if that's the one you saw, but I came away with the impression that most of the artistic folks felt their creativity was improved by the meds.
Posted by fluffy on October 26, 2002, at 16:53:11
In reply to Recognizing / Treating Cyclothymia, posted by fluffy on October 26, 2002, at 15:16:11
Thanks Tabitha (sorry I don't know how to make the German double 's' on this keyboard)
I guess that part of the problem is that this particular AD doesn't seem to be helping. i have been on it for 4 weeks....having trouble sleeping, feeling agitation, and tingling hands and what-not. Paxil seemed to help the last bout of depression, but I tried it this time and couldn't stay awake. My psychiatrist asked if I wanted to switch, but I resisted for fear of more side effects.
Now I think that I should switch and tell him about my other more hypo-manic phases so that I can get a proper diagnosis. Problem is, I've been feeling so blind from the depression, that I was having trouble putting anything into words--and afraid of being hauled away in a paddy wagon.
Now that I have some more info about my family history, I feel I could benefit from talking about it to him. It' s been a long, painful journey with my therapist in discovering these patterns, though.
I'm hanging in there...
Posted by polarbear206 on October 26, 2002, at 22:55:37
In reply to Re: Recognizing / Treating Cyclothymia, posted by fluffy on October 26, 2002, at 16:53:11
> Thanks Tabitha (sorry I don't know how to make the German double 's' on this keyboard)
>
> I guess that part of the problem is that this particular AD doesn't seem to be helping. i have been on it for 4 weeks....having trouble sleeping, feeling agitation, and tingling hands and what-not. Paxil seemed to help the last bout of depression, but I tried it this time and couldn't stay awake. My psychiatrist asked if I wanted to switch, but I resisted for fear of more side effects.
>
> Now I think that I should switch and tell him about my other more hypo-manic phases so that I can get a proper diagnosis. Problem is, I've been feeling so blind from the depression, that I was having trouble putting anything into words--and afraid of being hauled away in a paddy wagon.
>
> Now that I have some more info about my family history, I feel I could benefit from talking about it to him. It' s been a long, painful journey with my therapist in discovering these patterns, though.
>
> I'm hanging in there...Hi Fluffy,
Welcome from a fellow cyclothymic. This board has well educated people and will offer great support to you. You need to get on a mood stabilizer to even you out. Antidepressants used alone and in higher doses will just exacerbate your mood cycling. The mood stablizer should be the MAIN medication with a lower dose of an antidepressant if possible. I know EXACTLY what your going through!! My great grandmother was sent away to a mental institution when she was in her 30's. She died there. It's sad that there were no medications back then to help her. I have some web sites for you to explore about cyclothymia. This is a "softer" version in the bipolar spectrum.
Laura.
http://www.psycom.net/depression.central.html
Scroll down the page to cyclothymia
http://psycheducation.com/depression/frameset.htmlHere is a good book to check out too!
"Why Your Depression Isn't Getting Better" by Dr, M. Bartos
Posted by JaneB on October 27, 2002, at 7:56:33
In reply to Re: Recognizing / Treating Cyclothymia, posted by polarbear206 on October 26, 2002, at 22:55:37
> > Thanks Tabitha (sorry I don't know how to make the German double 's' on this keyboard)
> >
> > I guess that part of the problem is that this particular AD doesn't seem to be helping. i have been on it for 4 weeks....having trouble sleeping, feeling agitation, and tingling hands and what-not. Paxil seemed to help the last bout of depression, but I tried it this time and couldn't stay awake. My psychiatrist asked if I wanted to switch, but I resisted for fear of more side effects.
> >
> > Now I think that I should switch and tell him about my other more hypo-manic phases so that I can get a proper diagnosis. Problem is, I've been feeling so blind from the depression, that I was having trouble putting anything into words--and afraid of being hauled away in a paddy wagon.
> >
> > Now that I have some more info about my family history, I feel I could benefit from talking about it to him. It' s been a long, painful journey with my therapist in discovering these patterns, though.
> >
> > I'm hanging in there...
>
>
>
> Hi Fluffy,
>
> Welcome from a fellow cyclothymic. This board has well educated people and will offer great support to you. You need to get on a mood stabilizer to even you out. Antidepressants used alone and in higher doses will just exacerbate your mood cycling. The mood stablizer should be the MAIN medication with a lower dose of an antidepressant if possible. I know EXACTLY what your going through!! My great grandmother was sent away to a mental institution when she was in her 30's. She died there. It's sad that there were no medications back then to help her. I have some web sites for you to explore about cyclothymia. This is a "softer" version in the bipolar spectrum.
>
> Laura.
>
>
> http://www.psycom.net/depression.central.html
> Scroll down the page to cyclothymia
> http://psycheducation.com/depression/frameset.html
>
> Here is a good book to check out too!
>
> "Why Your Depression Isn't Getting Better" by Dr, M. Bartos
>
"Why Your Depression Isn't Getting Better" by Dr, M. BartosJust testing to see if I understand the suggestion of double quotes to link to Amazon.
Posted by Dr. Bob on October 27, 2002, at 9:43:58
In reply to Re: Recognizing / Treating Cyclothymia, posted by JaneB on October 27, 2002, at 7:56:33
Posted by KathyA on October 29, 2002, at 11:27:51
In reply to Recognizing / Treating Cyclothymia, posted by fluffy on October 26, 2002, at 15:16:11
> Wow.
>
> I just read a really long thread about Cyclothymia on this BB. And just finished a really, really tearful conversation with my father over lunch.
> For the past couple of months, I have been struggling with a really MAJOR bout of depression. To make a long story short...
> I have been put on Lexapro for this particular bout, and have gotten WORSE! I have been really, really agitated and crying all the time. I have been having a hard time understanding how I can be so depressed and brain-dead for two months, when only a few months before I was so active and creative--solving all kinds of problems.
> This morning, I read a description of Cyclothymia, and it made so much sense. After having a long discussion with my father, it turns out that he has also suffered from the same creative bursts and depressive jags.
> Not only that, but my father's mother was given shock treatment for some type of mental disorder in the fifties, and was never diagnosed, and never recovered.
>
> Suddenly, I'm realizing that I need to be really straight with my Psychiatrist...I never wanted to be called BP, because I never had DANGEROUS upswings. But the downswings have seemed increasingly more dangerous for me...thoughts of hurting myself and/or suicidal thoughts.
>
> I am an artist as well as many of the people who chimed in about cyclothymia on this BB. I'm a bit afraid about losing the creative side, but I'm also feeling afraid of my down moods.
>
> Has anyone else has similar experiences? I could use some support.
>Hi,
I was diagnosed with cyclothymia about 15 years ago and can really relate to your experience. I was put on Lithium and tricyclics. The lithium helped and gave me relief for the first time in years, but eventually "flatlined" me. I dropped the tricyclics and switched to Tegretol which worked GREAT for me until I got married, moved across the country, took on two stepchildren, had 3 babies (for which I went off the Tegretol for 5 years, and really missed it), built a house and my husband and I own and run a small engineering firm (small businesses are VERY stressful) for which we remodelled an office building. Now the Tegretol isn't enough (surprise, surprise) and added AD's aren't doing the trick. However, I guess my point is that the Tegretol worked very well under previous circumstances and probably would've continued to do so if I hadn't taken on such a hectic lifestyle. The Tegretol really helped me feel "normal" without many side effects after the initial startup. As I was able to develop some coping techniques with my newfound stability I was able to decrease the amount I was taking and also decrease the "spaciness" it caused (although I did study for and pass my CPA exam while taking 400 mg a day). Also, no significant weight gain, and it did not interfere with losing weight via diet and exercise.
I would probably recommend the Tegretol, but I know there are some new mood stabilizers out there that may as good or better, such as Neurontin and Lamictal, that you might want to research , too.
Good Luck!
Kathy
Posted by Krysti on October 31, 2002, at 13:15:45
In reply to Re: Recognizing / Treating Cyclothymia » fluffy, posted by KathyA on October 29, 2002, at 11:27:51
Hi,
I can also relate. I was in your position about a year ago. I looked up cyclothymia and it pretty much described me, however, I chose to be in denial about it at the time. I also had extreme anxiety for 6 years. I finally decided to go on Paxil for the anxiety. I ended up becoming manic and was diagnosed with Bipolar Disorder. I initially went on Depakote which brought me down from the manic state, but ended up switching to another mood stabilizer (Gabitril) due to weight gain and the "flat" feeling. About a month ago, I also added on Lexapro for depression. So far, so good.
When I first realized I was probably cyclothymic, I was scared to death. I didn't want to have anything to do with "bipolar". I didn't want to be on medication (lithium - oh my!), be crazy, etc.
Now I am so glad I was diagnosed, being on medication has helped so much. I no longer feel like I'm going crazy.
The most important thing is to tell your doctor what is going on, sooner rather than later. From what I've read about it, it can get worse if not treated.
Good luck to you.
Krysti
Posted by fluffy on October 31, 2002, at 14:24:06
In reply to Re: Recognizing / Treating Cyclothymia, posted by fluffy on October 26, 2002, at 16:53:11
Thanks you guys.
I went away on a vacation to de-stress. (which kinda didn't work)
I called my doc this morning to make an appointment after another sleepless night. He wants to put me on a mood stabilizer and told me to STOP taking the Lexapro. It feels a little relieving already. I have been wondering for awhile now why I needed to achieve so much all of the time--thinking that I was just competative and a workaholic. It wasn't until depression and anxiety kept flooring me every couple of years that I had to wonder what was really happening. I just found out that my aunt is on a mood stabilizer and an antidepressant as well (gabepantin and zoloft). Maybe it isn't just a weird personality fluke after all.It has been so difficult to detect what the real problem is because of a history of abuse in my family...is it because of the abuse? Or did mental illness cause abusive patterns? My therapist has been trying to help me untwist all of this--god love him. It's quite the puzzle.
I'll keep you posted. And again--THANKS! I don't feel so abnormal now.
Posted by Ritch on October 31, 2002, at 22:27:31
In reply to Re: Recognizing / Treating Cyclothymia, posted by Krysti on October 31, 2002, at 13:15:45
> Hi,
>
> I can also relate. I was in your position about a year ago. I looked up cyclothymia and it pretty much described me, however, I chose to be in denial about it at the time. I also had extreme anxiety for 6 years. I finally decided to go on Paxil for the anxiety. I ended up becoming manic and was diagnosed with Bipolar Disorder. I initially went on Depakote which brought me down from the manic state, but ended up switching to another mood stabilizer (Gabitril) due to weight gain and the "flat" feeling. About a month ago, I also added on Lexapro for depression. So far, so good.
>
> When I first realized I was probably cyclothymic, I was scared to death. I didn't want to have anything to do with "bipolar". I didn't want to be on medication (lithium - oh my!), be crazy, etc.
>
> Now I am so glad I was diagnosed, being on medication has helped so much. I no longer feel like I'm going crazy.
>
> The most important thing is to tell your doctor what is going on, sooner rather than later. From what I've read about it, it can get worse if not treated.
>
> Good luck to you.
>
> Krysti
>
>
>
>
Krysti, How much Gabitril (and when) are you taking now? I am wondering because I was on a high dose of it as a trial a couple of years ago and had to stop it because of depersonalization/cognitive problems. My pdoc brought it up again a couple of visits ago, but I didn't want to retry it. Have you found it as effective as Depakote for your cycling? Thanks for any input--Mitch
Posted by BarbaraCat on October 31, 2002, at 23:47:56
In reply to Recognizing / Treating Cyclothymia, posted by fluffy on October 26, 2002, at 15:16:11
Dear Fluffy,
I second Polarbear's advice. If you even suspect you might fall within the bipolar spectrum, go with a mood stabilizer first and foremost, an AD second, or even skip the AD altogether and go with a benzo chaser. Antidepressants alone are bad news for bipolars, cyclothymics, or whatever, who cares what the moniker may be for our disorder. As a recently diagnosed bipolar, I finally understand why I've gone bezerk on SSRI's. They work for awhile, and then the manic agitated depression breaks through and the SSRI exacerbates the nightmare.My father and his whole family were classic bipolars, although never treated. I finally understand him and have utmost compassion and sorrow for his suffering while he was alive. As far as creativity, I'm a musician and dancer, as well computer geek (for a living, only for a living). I can say that the disorganization of a brain fry does not behoove creativity, unless you aspire to Hironimous Bosch or Edvard Munch-dom. The creative edge will always be there, as long as the motivation is kept alive. Move the energy by physical activity if you're able. I'd suggest Lamictal since it has the best antidepressant profile of all the anti-bipolar meds. Good luck and be very good to yourself.
Posted by Krysti on November 1, 2002, at 10:54:45
In reply to Re: Recognizing / Treating Cyclothymia » Krysti, posted by Ritch on October 31, 2002, at 22:27:31
Hi Ritch,
When I first went on the Gabitril, I was supposed to take one 4mg pill in the morning and two 4mg pills at night. I started having abdominal pains right away so my doctor was going to switch me to something else at my next appointment. I ended up just taking 4mg at night and the pains went away. I remained stable on that dose so we never switched. However, I did end up feeling "flat" (which I felt on the Depakote also). Then I got depressed and then started having crying spells. That's when I added the Lexapro (10mg). I've felt good since then (I started the Lexapro about a month ago).
I was hoping just the mood stabilizer would do the trick, obviously - who wants to take a bunch of stuff? But, from everything I've read, that "flat" feeling happens to a lot of people on mood stabilizers alone so I decided to just go ahead and add on an anti-depressant. It's worked so far :)
Do you remember how much you were taking? Have you tried adding an anti-depressant to your stabilizer?
Krysti
Posted by Ritch on November 1, 2002, at 13:47:21
In reply to Re: Recognizing / Treating Cyclothymia, posted by Krysti on November 1, 2002, at 10:54:45
> Hi Ritch,
>
> When I first went on the Gabitril, I was supposed to take one 4mg pill in the morning and two 4mg pills at night. I started having abdominal pains right away so my doctor was going to switch me to something else at my next appointment. I ended up just taking 4mg at night and the pains went away. I remained stable on that dose so we never switched. However, I did end up feeling "flat" (which I felt on the Depakote also). Then I got depressed and then started having crying spells. That's when I added the Lexapro (10mg). I've felt good since then (I started the Lexapro about a month ago).
>
> I was hoping just the mood stabilizer would do the trick, obviously - who wants to take a bunch of stuff? But, from everything I've read, that "flat" feeling happens to a lot of people on mood stabilizers alone so I decided to just go ahead and add on an anti-depressant. It's worked so far :)
>
> Do you remember how much you were taking? Have you tried adding an anti-depressant to your stabilizer?
>
> Krysti
Oh, I was taking a LOT. I started out at 4mg at bedtime and then added an additional 4mg/day every week. I got up to 12mg twice daily and I just zonked out totally. I had just taken 12mg all at once and went to work and just got lost... I almost didn't know who I was or what I was doing there. I felt kind of panicky because of that. It was that jamais vu feeling of strangeness in a familiar place, except it didn't really feel familiar! Also, I got an intense facial/forehead numbness from it as well-an anesthetic feeling. I always have to take a *tiny* dose of a serotonergic antidepressant (nowadays 12.5mg of Effexor). I was on 1.25-2.5mg of Celexa every day for a couple of years before that. Any more than that and I start getting very hypomanic. I've also got ADHD and take Ritalin (at a fairly common dosage, however). It doesn't seem to cause that type of problem that AD's seem to cause.
Posted by Krysti on November 4, 2002, at 8:17:10
In reply to Re: Recognizing / Treating Cyclothymia » Krysti, posted by Ritch on November 1, 2002, at 13:47:21
Wow, why would they put you on that high of a dose?
Posted by Ritch on November 4, 2002, at 9:26:05
In reply to Re: Recognizing / Treating Cyclothymia - Ritch, posted by Krysti on November 4, 2002, at 8:17:10
> Wow, why would they put you on that high of a dose?
Hi, I was seeing a neurologist/psychiatrist who also treated a lot of adults and children with seizures. The dosage of Gabitril for treatment-resistant partial seizures (it's indicated as an add-on AED) ranges from 24mg-40mg/day from what I can recall (if you don't take other AED's that speed up its elimination). It was a trial as a switch from Depakote. We were experimenting and he wanted to see how I would react with continuing steady titration. Taking *any* of the stuff during the daytime while I was trying to work was similar to taking a benzo (which I don't do if I have to think). It did clearly have a mood-elevating effect, however. I did sleep fairly well on the stuff. I might reconsider 4-8mg, but ONLY at bedtime.
This is the end of the thread.
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