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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 29. This is the beginning of the thread.
Posted by scatterbrained on October 10, 2003, at 19:35:57
I guess I've been depressed or whatever this is for 4 years since 17. It progressively seems to get worse. First it started out as just a mood thing but now it's effected my cognition to such a degree that my internal monologue has completly fragmented and disapeared. I have to write down my thoughts just to think them and I used to be SOOO articulate; that was my thing. The drugs don't seem to help. This is my experience. I have tried all the SSRI and the same thing seems to happen every time. The drugs work vaguely well, nothing substancial, but then within the next few days they make me completly delerious;to the point that I can't even understand what people are saying to me as if they are speaking a different language. I've tried effexor, worked moderatly well at first then I got sooo anxoius and just plain STRANGE feeling.Tried wellbutrin which made me paranoid and delerious. I feel as if there is something else going on, I am constantly confused, not just depressed.I can't even concentrate enough to drive a car, or have a conversation. I don't know what to do, I've tried everything and nothing works.I have such high asperations, asperations that were realistic until this debilitating whatever it is started to happen.Please someone help me.
Posted by DSCH on October 10, 2003, at 23:00:29
In reply to depression or something else, posted by scatterbrained on October 10, 2003, at 19:35:57
You may want to look for a neurologist or clinical neuropsychologist who can get some functional imaging done of your brain as it seems your cognitive troubles are quite severe and your reactions to SSRIs so odd. I would look for such professionals who have access to fMRI or conventional MRI plus SPECT.
Posted by scatterbrained on October 10, 2003, at 23:36:33
In reply to Re: depression or something else » scatterbrained, posted by DSCH on October 10, 2003, at 23:00:29
Thank you
I had a speck scan a few months ago. Strangely,the Nuropsychiatrist who order the test concluded that there were these sort of spotty portions of my left cerebral something or other that indicated some kind of "Brain Damage". He said that this was most likely something inate however if it was inate why all of a sudden would I start to have these debilitating symptoms? It just doesn't make sense and I'm going to go to another nurologist. I had asked the Dr. if the vast amounts of psychotropic drugs that I've tried including anti-psychotics could have caused this and he got very defensive and said "no,no,no not the this extent".So you can get brain damaged to an extent from these psychotropics?In any case he went on to say that my speck was not consistent with clinical depression. He also said the part damaged is the part of the brain that regulates mood; said nothing about cognition and memory which are my main symptoms. So, i'm in the dark, don't know what to do and need as much advice as possible because I'll fight to the bitter end, I'll never give up, I WANT MY LUCIDY BACK!!!!! PLEASE SOMEONE HELP. WHAT COULD THIS BE?
Posted by Searchlight on October 11, 2003, at 0:24:54
In reply to WHAT COULD THIS BE?, posted by scatterbrained on October 10, 2003, at 23:36:33
Scatterbrained, I am very concerned for you. By all means keep going to the neurologists and the psychiatrists without fail. Take as many tests as are necessary to find out what is going on. You are on the right track. Don't take no for answer- push for the tests and treatment. Please know that your posts are articulate and have indicated you are in pain and need help. Please feel confident in your abilities to express yourself as you have done a great job on this board. And please come back for support and let us know what is going on! I am sure many people are worried about you and want the best treatment/advice for you. I know I do.
I know you can find something to help you, make those docs listen carefully to all your symptoms and concerns!!! Shout if you have to!!!
Searchlight
Posted by Liligoth on October 11, 2003, at 1:17:50
In reply to Re: WHAT COULD THIS BE?, posted by Searchlight on October 11, 2003, at 0:24:54
hey Searchlight, I dont have any answers or ideas for you Im sorry but I do have similar concerns & fears. Often I wonder if I have some progressive degenerative condition along with the depression. What gives me hope that it is *just* the depression is that when the depression lifts so does my cognitive ability again. Also, given enough time our ways of thinking & 'internal monologue' become habituated so it may seem that there is a decline.
Posted by Searchlight on October 11, 2003, at 1:27:58
In reply to Re: WHAT COULD THIS BE? » Searchlight, posted by Liligoth on October 11, 2003, at 1:17:50
Liligoth, thank you for the concern but it is not me who is having these painful issues, it's a poster named Scatterbrained. I must admit I am really worried about this person. I just hope this person knows that there is definitely a way somehow to find out what is happening medically and can hopefully get treatment asap! As for depression, you are absolutely right, it can feel as if your cognitive abilities are very impaired when you are in the evil clutches of it.
I hope Scatterbrained can find a diagnosis and help soon!
Searchlight
Posted by pixygoth on October 11, 2003, at 3:57:05
In reply to WHAT COULD THIS BE?, posted by scatterbrained on October 10, 2003, at 23:36:33
Scatterb. - serotonin (the mood regulating chemical) *does* affect cognition and memory to some degree. Doctors seem to think that the brain is split into discrete bits like stomach, lungs and so on, all for separate things. It's not like that, the brain runs as a whole. So if there's *one* problem, it will almost certainly "leak" into areas not expected by medical science.
I'm totally with the stuff about getting into habits of thinking- you're much more together sounding than you clearly think you are.
Keep strong and good luck. Just take a small pinch of salt with doctor opinions, and keep thinking for yourself even if it feels like you can't
S x
Posted by DSCH on October 11, 2003, at 7:57:50
In reply to WHAT COULD THIS BE?, posted by scatterbrained on October 10, 2003, at 23:36:33
> Thank you
> I had a speck scan a few months ago. Strangely,the Nuropsychiatrist who order the test concluded that there were these sort of spotty portions of my left cerebral something or other that indicated some kind of "Brain Damage".SPECT can be a little lacking in the ability to resolve fine detail. It also shows only the metabolic side of the picture. In my outsider/non-professional opinion the NP should have gone on to MRI to confirm if this was available, as this will show structural details. (fMRI and PET will show both degree of activity and structural detail IIRC, but are still uncommon)
>He said that this was most likely something inate however if it was inate why all of a sudden would I start to have these debilitating symptoms?
I didn't want to alarm you, but the possibility of a tumor cannot be discounted without having a look. A carcinogenic tumor would likely show up as a hot spot rather than an inactive spot, though.
>It just doesn't make sense and I'm going to go to another nurologist. I had asked the Dr. if the vast amounts of psychotropic drugs that I've tried including anti-psychotics could have caused this and he got very defensive and said "no,no,no not the this extent".
Well, you only started on these after the symptoms arose. Is that correct?
>So you can get brain damaged to an extent from these psychotropics?
The older anti-psychotics do have some severe syndromes resulting from chronic use such as tardive dyskinesia and neuroleptic malignant syndrome, but these are more motor-related than cognitive. I think the "damage" is in the wrong place for him to HAVE to consider the posibility of it being iatrogenic. (You touched a nerve there with that question!)
>In any case he went on to say that my speck was not consistent with clinical depression. He also said the part damaged is the part of the brain that regulates mood; said nothing about cognition and memory which are my main symptoms. So, i'm in the dark, don't know what to do and need as much advice as possible because I'll fight to the bitter end, I'll never give up, I WANT MY LUCIDY BACK!!!!! PLEASE SOMEONE HELP. WHAT COULD THIS BE?
Until you find a second neurodoc it might be best to keep working on this with the one who ordered the SPECT. Make sure you he hears you out on details regarding mood and cognitive ability in a sort of timeline (what came first? what was the order of drugs taken and their effects). Going into self-diagnosis or blaming the medications will likely turn on his defensive/oppositional/"I am the professional here" mode rather than therapeutic/medical detective mode you need.
Posted by tealady on October 11, 2003, at 8:10:51
In reply to Re: WHAT COULD THIS BE? » scatterbrained, posted by DSCH on October 11, 2003, at 7:57:50
Dsch, What's the diff between an fMRI and a MRI?
I'm scheduled for an MRI next week. Didn't know there are supposed to be different kinds.
Thanks, Jan
Posted by DSCH on October 11, 2003, at 10:22:24
In reply to Re: WHAT COULD THIS BE? » DSCH, posted by tealady on October 11, 2003, at 8:10:51
MRI/fMRI (f = "functional")
http://vuiis.vanderbilt.edu/~nins/MRI_FAQ.htm
Highly technical...
http://www.eecs.umich.edu/~dnoll/primer2.pdf
Posted by scatterbrained on October 11, 2003, at 15:41:11
In reply to Re: WHAT COULD THIS BE? » tealady, posted by DSCH on October 11, 2003, at 10:22:24
Thank you everybody for all your support and advice. I'm not going to give up and I'm going to DEMAND as many tests as possible; my survival depends on it. I'm sorry if I hinted at any sort of psychotropic induced brain damage and scared anybody. I have no idea what this is and the neurologist who I saw was just very quick, only saw me twice(once before speck,once after) and really had no advice to give me except to possibly take a neuropsych test that would determine what job would best "fit" me. I know there are good doctors out there, I have nothing against psychiatry or neurology but I do have something against doctors who are insensitive, pressumptuous and stupid. Does anybody know the best way to find a GREAT neurologist and psychiatrist?Also, aside from a tumor, what other sorts of things could cause these debilitating symptoms?
Posted by DSCH on October 11, 2003, at 16:14:54
In reply to Re: WHAT COULD THIS BE?, posted by scatterbrained on October 11, 2003, at 15:41:11
> Thank you everybody for all your support and advice. I'm not going to give up and I'm going to DEMAND as many tests as possible; my survival depends on it. I'm sorry if I hinted at any sort of psychotropic induced brain damage and scared anybody. I have no idea what this is and the neurologist who I saw was just very quick, only saw me twice(once before speck,once after) and really had no advice to give me except to possibly take a neuropsych test that would determine what job would best "fit" me. I know there are good doctors out there, I have nothing against psychiatry or neurology but I do have something against doctors who are insensitive, pressumptuous and stupid. Does anybody know the best way to find a GREAT neurologist and psychiatrist?Also, aside from a tumor, what other sorts of things could cause these debilitating symptoms?
OK, since mentioning the word tumor didn't cause you to panic... ;-)
This is a stretch possibily: small strokes? small hemorages?
Is there a history of strokes, embolisms, or other vascular weaknesses in your family?
Posted by scatterbrained on October 11, 2003, at 16:24:36
In reply to Re: WHAT COULD THIS BE? » scatterbrained, posted by DSCH on October 11, 2003, at 16:14:54
I don't think I have a history of strokes in my family and wouldn't that be odd considering I'm only 21? However, my grandfather had a heart attack @ age 30. How do you test for these things?Any other possibilities?Thanks
>
> OK, since mentioning the word tumor didn't cause you to panic... ;-)
>
> This is a stretch possibily: small strokes? small hemorages?
>
> Is there a history of strokes, embolisms, or other vascular weaknesses in your family?
Posted by DSCH on October 11, 2003, at 16:34:52
In reply to Re: WHAT COULD THIS BE?, posted by scatterbrained on October 11, 2003, at 16:24:36
Well, I omitted the obvious: head trauma.
One other suggestion and that does it for me: Have you used drugs not RXed by your doctor? MDMA ("Ecstacy") in particular?
> I don't think I have a history of strokes in my family and wouldn't that be odd considering I'm only 21? However, my grandfather had a heart attack @ age 30. How do you test for these things?Any other possibilities?Thanks
> >
> > OK, since mentioning the word tumor didn't cause you to panic... ;-)
> >
> > This is a stretch possibily: small strokes? small hemorages?
> >
> > Is there a history of strokes, embolisms, or other vascular weaknesses in your family?
>
Posted by scatterbrained on October 11, 2003, at 16:43:44
In reply to Re: WHAT COULD THIS BE? » scatterbrained, posted by DSCH on October 11, 2003, at 16:34:52
> Well, I omitted the obvious: head trauma.
> No head trauma
> One other suggestion and that does it for me: Have you used drugs not RXed by your doctor? MDMA ("Ecstacy") in particular?
>
No I haven't
Thank you for all your suggestions
if you or anybody else can think of any more PLEASE!!!!
> > I don't think I have a history of strokes in my family and wouldn't that be odd considering I'm only 21? However, my grandfather had a heart attack @ age 30. How do you test for these things?Any other possibilities?Thanks
> > >
> > > OK, since mentioning the word tumor didn't cause you to panic... ;-)
> > >
> > > This is a stretch possibily: small strokes? small hemorages?
> > >
> > > Is there a history of strokes, embolisms, or other vascular weaknesses in your family?
> >
>
>
>
Posted by John1022 on October 11, 2003, at 17:35:21
In reply to depression or something else, posted by scatterbrained on October 10, 2003, at 19:35:57
are you currently on meds when all of this is happening? or do you feel this way even when your system is clean of all meds?
I know that Effexor (worked once though, now having a paradoxal affect), Elavil and St. John's Wort all cause me to almost loss my mind, all concentration, slur my speech, have suidical thoughts where I have never had those in my life or when I am not on any meds, messes up my hearing and hearing songs in my head, when I only have mild depression to begin with. When I stop using the meds, all of these symptoms clear up (at least I hope they are this time with Elavil, still waiting)
I honestly believe it is the seretonin re-uptake properties in my circumstance that are causing this (although I know they help a lot of people) When I don't take them, I go back to almost normal with only mild depression.
I also know I can go to feeling as terrible as I felt above with all those terrible symptoms of SEVERE depression, to having almost all of those feelings lifted to some extent within hours of taking 5HTP.
I am sure everyone is different, but I honestly believe 5HTP to be my last hope for taking AD's and I BELIEVE it is going to work as I feel it work (just waiting for Elavil to fully clear out until I get on a regular regimine of it)
Hang in there brother. Be brave and try to stick it out. I will say a prayer for you tonight along with a prayer for myself before I go to bed. Good luck and be persistent with the tests and finding the right doctors (I too have had bad luck with doctors not believing the reactions I have had to meds)
Posted by Searchlight on October 11, 2003, at 18:02:39
In reply to depression or something else, posted by scatterbrained on October 10, 2003, at 19:35:57
Scatterbrained, have you had your thyroid levels checked - all of them? There are some very selective and sensitive tests for several types of thyroid levels to be checked (more than just what you would get tested for in just a regular physical). Also if you are female and are using an oral contraceptive, please be aware some of these can really effect different women very badly. If you are a male, have you had your testosterone levels checked? Hormones can and do play a huge role in cognition, emotions and behavior as well as many, many other biological things so I urge you to consider having your thyroid levels tested if you haven't already. I am concerned about you.
Best, Searchlight
Posted by scatterbrained on October 11, 2003, at 18:50:20
In reply to Re: depression or something else » scatterbrained, posted by Searchlight on October 11, 2003, at 18:02:39
> Scatterbrained, have you had your thyroid levels checked - all of them? There are some very selective and sensitive tests for several types of thyroid levels to be checked (more than just what you would get tested for in just a regular physical). Also if you are female and are using an oral contraceptive, please be aware some of these can really effect different women very badly. If you are a male, have you had your testosterone levels checked? Hormones can and do play a huge role in cognition, emotions and behavior as well as many, many other biological things so I urge you to consider having your thyroid levels tested if you haven't already. I am concerned about you.
> Best, SearchlightThank you for your kind and concerned words. I have had my thryroid levels checked but I don't know if I've had all of them checked.Do you know what the specific tests are exactly? I don't think I've ever had my testosterone level checked.If you or anybody else have any other suggestions please don't hessitate to respond. I need as much infomation as possible.Thanks again
Posted by Merci on October 11, 2003, at 18:54:28
In reply to depression or something else, posted by scatterbrained on October 10, 2003, at 19:35:57
Are you also always very tired?
After several years of trying many medication combinations (with some success) to treat my depression, I was diagnosed with sleep apnea. Sleep apnea causes all kinds of problems like memory loss and problems concentrating. Your symptoms sound so similar to mine - I would forget the names of people and streets I'd known for 20 years; I've been reading the same novel since March because it is so difficult to concentrate. I left grad. school because as hard as I tried, I could keep up with the reading or follow what the professors were saying. It was just too hard to concentrate on what they were saying and I no longer felt like the capable student that I once was.
I was completely surprised to find out that I had sleep apnea, but finding out certainly explained a lot. I'm being treated for sleep apnea now. It's been about 6 weeks and I'm starting to see some progress. Dealing with another disorder in addition to depression is difficult, but I'm thankful that I finally found a doctor who diagnosed me correctly.
There are a lot of symptoms of sleep apnea. One symptom is always being very tired. For an overview of sleep apnea, a good website is: www.sleepapnea.org
If you learn about sleep apnea and think that you have some of the symptoms, I urge you to talk to your doctor (or sleep specialist). Like I said before, I was shocked to find out I had sleep apnea. Often, sleep apnea and depression go hand in hand.
I hope that you can find a speedy resolution. Be well.
Merci
Posted by scatterbrained on October 11, 2003, at 19:20:57
In reply to Re: depression or something else - always tired?, posted by Merci on October 11, 2003, at 18:54:28
I DO always feel very tired but more than tired I feel like I'm in a dream like state;actually more like a never ending nightmare.There is no real fluctuation between feeling less tired one moment and more tired the next. I can awake and fall asleep at any moment. I fall asleep and wake up out of routeen,nothing else.What is the treatment for sleep apnea and what is the test?I don't snore; is this still a possibility? Again, any other ideas about what all this might be would be profoundly appreciated and I want to thank everybody again for their help.
Posted by John1022 on October 11, 2003, at 19:24:57
In reply to Can you have sleep apnea without snoring?, posted by scatterbrained on October 11, 2003, at 19:20:57
Do you feel like this when you are off meds, or only when you are on them? In other words, do you think the meds could be contributing to your problem?
Posted by scatterbrained on October 11, 2003, at 19:44:22
In reply to Re: Can you have sleep apnea without snoring?, posted by John1022 on October 11, 2003, at 19:24:57
> Do you feel like this when you are off meds, or only when you are on them? In other words, do you think the meds could be contributing to your problem?
I just have an odd and sort of horrific response to many of the meds I've tried, aside from the sedatives which don't tend to do anything special except sedate me,increase my appetite a bit, then I build a resistance to them and I don't even get those minimal effects anymore. In response to what you wrote; no, I don't believe the meds are contributing to my problems.This is the way I feel WITHOUT meds and it progressively gets worse;no fluctuation and no relief. If I could take a med and it worked I would gladly do so.Thank you for your concern.
Posted by Cybele on October 11, 2003, at 23:36:41
In reply to Re: depression or something else - always tired?, posted by Merci on October 11, 2003, at 18:54:28
Merci wrote "After several years of trying many medication combinations (with some success) to treat my depression, I was diagnosed with sleep apnea. Sleep apnea causes all kinds of problems like memory loss and problems concentrating. Your symptoms sound so similar to mine - I would forget the names of people and streets I'd known for 20 years; I've been reading the same novel since March because it is so difficult to concentrate. I left grad. school because as hard as I tried, I could keep up with the reading or follow what the professors were saying. It was just too hard to concentrate on what they were saying and I no longer felt like the capable student that I once was."
I had the memory loss and problems concentrating that you describe when I took Paxil for 6 weeks. Paxil screwed up my REM sleep pretty badly. I almost lost my job because I couldn't get anything done. My brain was a sieve and I could not stay at task more than 10 seconds. My mind would just drift off...
Posted by Liligoth on October 12, 2003, at 3:00:37
In reply to Re: WHAT COULD THIS BE?, posted by Searchlight on October 11, 2003, at 1:27:58
hehe sorry Searchlight. Just an unwitting example I suppose of a foggy brain
Posted by Liligoth on October 12, 2003, at 3:19:37
In reply to Can you have sleep apnea without snoring?, posted by scatterbrained on October 11, 2003, at 19:20:57
<snip>
I don't snore; is this still a possibility?
<snip>Scatterbrain, sorry if this is getting too personal but are you certain you dont snore? It usually comes as a shock to everyone when they find out. After all you're asleep. If you share your bedroom & if you havent already, ask this person to tell you honestly whether you snore.
If you usually sleep alone & someone sleeps in the next room ask them if they ever hear you snore. If there is no-one to ask apart from taping yourself I dont know how you would find out without attending a sleep clinic.just trying to help narrow things down.
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