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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 28. This is the beginning of the thread.
Posted by kara lynne on January 8, 2003, at 22:46:13
Hi everyone. I just feel really, really, really, really bad most of the time. And today I just wanted to cry the entire day no matter what I did, and I have to carry on and get through the day and deal with very stressful things, and wish I could at least come home to someone who cares about me. But I'm in a bad relationship, giving up the last of my childbearing years, giving up yet another dream of something I thought I would always have, but never came true. I have a pit in my stomach and a lump in my throat that won't go away. I'm just so damn sad. I'm just so sad.
Posted by kara lynne on January 8, 2003, at 23:36:47
In reply to This is a sucky lifetime for me., posted by kara lynne on January 8, 2003, at 22:46:13
Posted by Pfinstegg on January 9, 2003, at 0:12:03
In reply to This is a sucky lifetime for me., posted by kara lynne on January 8, 2003, at 22:46:13
Hey, this does sound really sad. Are you treatment-resistant despite a lot of different AD's? I wonder if considering ECT or TMS would be a smart idea?
As to the real life issues, the one that jumps out at me is the awful sadness of reaching the end of your child-bearing years without having had a child. I know that you will have to keep fighting until you find really effective help for the depression. But after you do, why not work on getting a really good support system in place, and either bear a child or adopt one? I know several women who have done this on their own, and they are all so glad they did it. Each one of them says that the joy and fulfillment of having a child far outweighs the difficulties. The one I know best is just about to adopt her third child from a Ukrainian orphanage- she is 58, twice-divorced, working- and so happy! (tired, too!) I can't be sure from your post, but if this is what you care about most deeply in life, why couldn't this be you, setting your course and then just following it step by step?
wishing you the very best,
Pfinstegg
Posted by kara lynne on January 9, 2003, at 0:59:33
In reply to Re: This is a sucky lifetime for me. » kara lynne, posted by Pfinstegg on January 9, 2003, at 0:12:03
Thank you so much for your kind response. Yes, I am treatment resistant and have tried most meds, and have tried for a long time. I will be trying a couple of more things in the next couple of months. It just gets so exhausting after a while, and hard not to feel hopeless, feeling that deep ache, alone late at night. You're suggestions are good ones, even though I always thought I would bear my own child, and the idea of giving that up feels like such a profound loss. But if I don't make it out of this depression and my current life circumstances until that's just not a possibility anymore, I guess I would consider other alternatives. Of course in this state nothing seems possible, so yes, that is what I have to keep fighting right now. Thank you for responding, I know this was the wrong board to bring up the childbearing issue, but it was so nice to hear from you.
Posted by Pfinstegg on January 9, 2003, at 3:40:39
In reply to Re: This is a sucky lifetime for me. » kara lynne, posted by Pfinstegg on January 9, 2003, at 0:12:03
Hi Kara- thank you for your warm reply. Don't overlook that I included bearing your own child as one of the possibilities! It sounds like you have been struggling unsuccessfully for so long, and that time is starting to press in on you- you do need a good solution now. I don't know whether this will seem relevant to your situation or not, but I spent 8 years on AD's and got completely exhausted and discouraged, like you. Now I am in the 8th day of daily TMS treatments, and my (unipolar) depression has gone from very severe to non-existent. I have 7 more treatments to go, at least, and possibly as many as 17. I am so thrilled I'll just do whatever my doctor says! As for follow-up, I will continue to maintain some contact with my own psychiatrist at home, may take an atypical AP such as Abilify in low doses, and may also return for booster TMS sessions- all depending on whether I need anything at all.
From what I have learned, people can get at least equal results from ECT. ECT has always been scary to me, but now that I have spent 10 days with technicians who perform both, I think my former fears were essentially groundless. The most that happens to anyone on ECT these days is temporary short-term memory loss. Unfortunately, it doesn't work for everyone, just as TMS doesn't. When it does, however, which is about 3/4ths of the time, it is just amazing. It's not like a drug making you somewhat better, you feel completely well!
Well. one thing that isn't quite normal as yet- here it is the middle of the night, and I am so thrilled and excited by what has happened that I am wide awake!
Pfinstegg
Posted by Eddie Sylvano on January 9, 2003, at 9:04:50
In reply to This is a sucky lifetime for me., posted by kara lynne on January 8, 2003, at 22:46:13
>wish I could at least come home to someone who cares about me. But I'm in a bad relationship, giving up the last of my childbearing years, giving up yet another dream of something I thought I would always have
-------------------Why stay with someone that you describe as not caring about you? I know that the longer you stay in an unsatisfying situation, the harder it gets to break free, but consider the alternative. You've got to actively make things happen the way you want, or they typically won't happen.
Posted by kara lynne on January 9, 2003, at 13:30:38
In reply to Re: This is a sucky lifetime for me. » Pfinstegg, posted by Pfinstegg on January 9, 2003, at 3:40:39
Hi Pfinstegg,
Yes, it is very relevent to my situation. ECT treatment has always seemed really scary to me; even joking about it with my therapist made me feel suicidal (when he indicated I might be a good candidate for it-- *that* shocked me!). The idea of losing memory really bothers me-- it's been something I couldn't consider while going through school, but also it puts me into panic when I can't remember certain things that I always could. It makes me feel like I'm losing my mind, and I'm not OK until I can remember whatever bit of ridiculous minutae I've started obsessing about. Once I couldn't remember a song for about two months and couldn't let go of it until it finally came back to me. You sound so good though that it's encouraging, maybe I'd feel better and those things wouldn't bother me. Or of course there's the old joke about not remembering what you're unhappy about from the ECT. At any rate, I will be trying a few more things within the next couple of months, and I'll see where I am after that. But it is really nice to hear that you're doing so well-- it's hard to get those barbaric images out of my head about ECT. I'd love to hear how things progress for you. Thanks again.
Posted by kara lynne on January 9, 2003, at 13:34:53
In reply to Re: This is a sucky lifetime for me. » kara lynne, posted by Eddie Sylvano on January 9, 2003, at 9:04:50
You're right, and I'm working on that. My hope is to get some major things dealt with (in my own life) within the next couple of weeks and then I'll have the time and energy to devote to getting out. I'm struggling to be able to support myself, and it has been difficult financially as well as emotionally (with debilitating states of fear and depression) to make the break and find an affordable place to live.
Posted by Jumpy on January 9, 2003, at 15:25:05
In reply to Re: This is a sucky lifetime for me., posted by kara lynne on January 9, 2003, at 13:34:53
Hey Kara,
I truly believe there is a definate point in someone life when ECT should be considered. ECT definately cause retrograde amnesia ... the loss of memory of events surrounding the period of ECT and the few months before and after. For very few, some lose several years of memory. There is also anterograde amnesia ... basically forgetfulness or difficulties with concentration ... this is suppose to only last 4 to 6 weeks. Studies by Sackeim show *NO* learning difficulties and actually improved cognition at 6 months after ECT. But once again, a handful of patients will report persisting learning impairment.
I agree with the above poster that ECT improvement feels "clean" in a way. Like all the heaviness is lifted and what is left is just your motivated, calm, friendly old self. But you also still have that terrible cognitive impairment too!
So, I think you should get ECT if your obsessively suicidal or psychotically depressed/manic that is refractory to meds or in a catatonic depression. Aside from that, only after you have failed multiple drug trials with combos (including TCAs and lithium augmentation) should you consider ECT. And remember, ECT in general is just temporary .... not a permenant solution. Most patients relapse after ECT and fairly quickly if not medicated soon after.
Wish you the best of luck
Jumpy
Posted by Anna P. on January 9, 2003, at 20:28:02
In reply to When to go for ECT » kara lynne, posted by Jumpy on January 9, 2003, at 15:25:05
Hello everyone,
It has been one year since my treatment with ECT. I did it after failing trials of multiple medications and severe medication poop-out. Today I live with no meds, and I can tell that ECT "reset" my brain back to work. Don't be affraid. It is much safer for you than some meds.
It can save your life.Anna P.
Posted by Pfinstegg on January 10, 2003, at 1:16:03
In reply to Re: One year ECT anniversary, posted by Anna P. on January 9, 2003, at 20:28:02
I am inclined to agree more with Anna's general view, rather than Jumpy's. As I have been having my daily TMS treatments, I've had a chance to talk at length with the technician, who also does ECT. She said that they are just not seeing cognitive deficits from ECT treatments the way it is given now- just temporary and fairly minor short-term memory loss- and often not even that. Patients don't lose any important long-term memories- the ones that give you a sense of continuity and of who you are. My doctors here, who have had many years of experience with ECT, consider it an excellent and underused treatment for resistant depression. Some people may need maintenance ECT, like Chloe on the board here, some may need ongoing medication, like Geezer, also on the board, but some, like Anna, may not need anything further. Whatever happens, you are likely to be in such a better position emotionally that you will have the energy and confidence to make much better life decisions.
I chose TMS, because of the ease of administration, but I believe TMS and ECT basically do the same thing. The electric or electromagnetic current helps your neurons and neurotransmitters return to a pre-illness level and manner of functioning. It really helps your brain get healthy again! And there just isn't much else about the treatments to worry about!
Pfinstegg
Posted by Jumpy on January 10, 2003, at 5:55:16
In reply to Re: considering ECT, posted by Pfinstegg on January 10, 2003, at 1:16:03
So let me get this straight. I essentially said to consider ECT if you had failed multiply medication regimens and combos. So do you feel that a person should consider ECT after failing one maybe two medication trials? Where I received ECT, there were people who had fail wellbutrin and that is it and were there for ECT. I think that is premature. And Sackeim's study has shown that up to 80% of patients relapse within 6 months after ECT. So for most, ECT is just temporary.
I personally would try more than one drug before going to ECT. But I am sure many would disagree with me and that this is just my humble opinion. Take Care.
Jumpy
Posted by Pfinstegg on January 10, 2003, at 9:00:27
In reply to Re: considering ECT » Pfinstegg, posted by Jumpy on January 10, 2003, at 5:55:16
Hi Jumpy... I'm not advocating ECT or TMS after one or two drug trials, We were talking about Kara Lynne, who has failed numerous drug trials, and whose own doctor has suggested ECT. The big difficulty for Kara is that she is so fearful of it.
Did you have persisting long or short term memory loss when you were given ECT? Do you feel that it resulted in any long-term cognitive losses? And just in general, how would you evaluate your ECT treatment in terms of effectiveness for you?
Pfinstegg
Posted by JESSsMom on January 10, 2003, at 14:54:46
In reply to Re: considering ECT » Jumpy, posted by Pfinstegg on January 10, 2003, at 9:00:27
I just wanted you to know you are not alone. I know I am just an anonymous person writing you a message but I am a real person, a 37 yr old single mother in PA. Please believe that I am going to say a special prayer for you.
I already pray for everyone with mental pain on this board but there's a special one going out to you today.
JM
Posted by Pfinstegg on January 10, 2003, at 15:35:26
In reply to Re: considering ECT » Jumpy, posted by Pfinstegg on January 10, 2003, at 9:00:27
While having my TMS treatment today, I inquired further about the down-side of ECT. The doctor treating me said that he advises patients and their families that they will have short-term memory loss during and for two weeks after their treatment- not longer. The temporary memory loss involves things like forgetting telephone numbers and where you have put things. You can't drive during the treatments, and not until two weeks after the last treatment.
Pfinstegg
Posted by kara lynne on January 10, 2003, at 16:12:29
In reply to Re: Kara and others, posted by JESSsMom on January 10, 2003, at 14:54:46
Thank you so much. To read your message makes you more than an anonymous person, and gives me a connection I would have otherwise gone through the day without. You have no idea how much that means to me right now.
Posted by kara lynne on January 10, 2003, at 16:33:03
In reply to Re: considering ECT- Kara, posted by Pfinstegg on January 10, 2003, at 15:35:26
Pfinstegg,
Thank you for asking and passing on the info. Had you gone through years (in my case 10) of failed drug trials before you finally did the TMS? And did you try MAOI's? My next attempt was going to be Nardil-- I didn't do well on either Parnate or Moclobemide, but as you know people seem to have pretty dramatic results with Nardil. Of course I am so very sensitive to all side effects that it would be a miracle if I could tolerate it, but we'll see. It sounds like you are having a dramatic response with the TMS, and still feeling lucid and like "yourself", which is comforting to hear. It helps to chip away at that huge block of fear I have about ECT, even though I still don't feel ready to try it. Truthfully, I (thought I was) joking when I ran it past my doctor, and I was just crushed when he suggested it might be appropriate for me. So it's good to hear from people like you that are doing well with it; it takes the edge off the stigma. Thanks again, I really appreciate the updates and hearing about how things are going for you.
Posted by Pfinstegg on January 10, 2003, at 17:35:48
In reply to Re: considering ECT- Kara Pfinstegg, posted by kara lynne on January 10, 2003, at 16:33:03
Hi.. for me it was eight years of multiple drug trials- most of which worked only partially and briefly. I was actually quite scared of the side effects of the MAOI's, which were next in line, and so elected TMS instead. But, as you know, there are a number of posters to the board who feel stable and well on them.
The TMS worked very dramatically. I went from severely depressed to normal in 7 days- I can still hardly believe it! I am going to have an additional week of treatment as a sort of "insurance". Best of all, I will be followed by the doctors here, and can receive booster treatments, or even another course, if I need it. It is such a new and wonderful experience to know that there is actually a really effective treatment for me out there after all the years of struggling with ineffective AD's.
wishing you the very best!
Pfinstegg
Posted by Jumpy on January 10, 2003, at 20:12:35
In reply to Re: considering ECT » Jumpy, posted by Pfinstegg on January 10, 2003, at 9:00:27
> Hi Jumpy... I'm not advocating ECT or TMS after one or two drug trials, We were talking about Kara Lynne, who has failed numerous drug trials, and whose own doctor has suggested ECT. The big difficulty for Kara is that she is so fearful of it.
As I mentioned, after one has failed multiple drug trials, ECT should be considered.
> Did you have persisting long or short term memory loss when you were given ECT?
I fit the classic description of an ECT patient. Had anterograde amnesia for about 4 weeks ... diffuculty with concentration, learning, etc. I might have some very mild retrograde amnesia ... difficulty with remembering events surrounding ECT and the few weeks before that. And I relapsed back into depression as most patients do after ECT.
>And just in general, how would you evaluate your ECT treatment in terms of effectiveness for you?
I think that I felt as close to "normal" in terms of my emotions immediately after ECT. As you mentioned, there was no drug effect twisting or shaping my feelings. I was simply the "Old Me". I also had cognitive dysfunction and learning impairment .... which was temporary. But as I mentioned, I met a few ECT patients who lost years of memory, had flat personalities, very severe cognitive dysfunction and where physically slow in there movements. They had received high dose shocks and between 18 and 20 treatments.
So, in summary, I think ECT works for most people. And people return to as close to their normal personality as can be with the availible treatments for depression. The downside is that studies prove that relapse after ECT is typical. And that some people do have memory loss ... althought that is very few. So why risk memory loss and relapse after a few months if you have only tried a couple of medication trials? I think ECT should be considered after several medication trials, including a TCA and lithium augmentation.
Sincerely,
Jumpy
Posted by Dave1 on January 11, 2003, at 0:22:42
In reply to Re: considering ECT- Kara Pfinstegg, posted by kara lynne on January 10, 2003, at 16:33:03
Hi,
I have some follow up questions for several people that posted here - Pfinstegg, Jumpy, and Anna.
Pfinstegg - I'm glad the TMS has helped you. I talked to a researcher at NIMH and he said that the problem with TMS was that you couldn't get follow up treatments. I was wondering where you are getting your treatments where they do follow ups, if you don't mind me asking.
Jumpy - I'm sorry you relapsed after your ECT. I had a similiar experience. I had an incomplete course of ECT and had no follow up. I got partially better, but then relapsed after about a month. I was wondering if you had any maintenance to try to prevent a relapse.
Anna - I'm happy that your ECT lasted. What follow/maintenance did you receive.
Thanks very much
Dave
Posted by Pfinstegg on January 11, 2003, at 1:03:21
In reply to Re:considering ECT- Follow up questions for people, posted by Dave1 on January 11, 2003, at 0:22:42
I am receiving TMS at North Atlanta Psychiatric Associates with Dr. Mark Hutto. Even though I am feeling great now, I fully expect to need continued monitoring, and am prepared in case I require retreatment with TMS and/or medications- I can obtain all of that here.
Pfinstegg
Posted by Jumpy on January 11, 2003, at 7:33:44
In reply to Re:considering ECT- Follow up questions for people, posted by Dave1 on January 11, 2003, at 0:22:42
> Jumpy - I'm sorry you relapsed after your ECT. I had a similiar experience. I had an incomplete course of ECT and had no follow up. I got partially better, but then relapsed after about a month. I was wondering if you had any maintenance to try to prevent a relapse.
Hey Dave,
Yeah, I wanted to start pamelor during ECT and lithium augmentation right after ECT to prevent relapse. Unforunately, I was in a study and they did not allow for meds to be started for 1 week after ECT. So I have yet to begin any medications. But the only study of medications post ECT is Sackeim's study in JAMA showing pamelor and lithium combo to be the most effective. I have also heard that effexor and lithium combo is good as well as a maintainance med. I think more research has to be done to determine what the best treatment option is. We will see what "STAR*D" turns up as far as the best treatment approach to treatment resistant depression ... but that won't be finished til 2004 and who knows when the data will be published.
Sincerely,
Jumpy
Posted by denise528 on January 11, 2003, at 12:22:54
In reply to Re: One year ECT anniversary, posted by Anna P. on January 9, 2003, at 20:28:02
Hi Anna,
I'm so glad to hear that you are doing well after having ECT. Did you used to post on this board under the name of Sweetmarie?
Can I ask you what drugs you had tried prior to having ect and for how long and also what kind of depression you were suffering from?
>
Denise
Posted by Dave1 on January 11, 2003, at 14:09:29
In reply to Re:considering ECT- follow-up » Dave1, posted by Pfinstegg on January 11, 2003, at 1:03:21
Thanks for the response, I thought TMS was still only being done experimentally, but I can see I was wrong. Maybe I'll consider trying TMS before ECT since I really hate ECT.
Dave
Posted by Dave1 on January 11, 2003, at 14:21:00
In reply to Re:considering ECT- Follow up questions for people » Dave1, posted by Jumpy on January 11, 2003, at 7:33:44
Jumpy,
I was supposed be in a study too. It was at Columbia using a new machine to induce seizures with a magnet. Its supposed to cause much less side effects than ECT. Anyway, they scheduled me to come in but I told them I had to reschedule because of personal problems and now they won't let back in. They had the same protocol. You can't start the Pamelar + Li for a week after the final treatment. It really should be started before your treatment ends. My Pdoc says you can take LI during treatments, you just have to hold it the day before.
Regarding the Pamelar +LI, my pdoc said you can't tell what type of antidepressant to put with the Li. So, maybe the best thing to do would be to use several different types with LI to cover all the bases.
By the way where was your study?
Dave
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