![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by BRC on August 13, 2004, at 17:32:44
Hi, I have been posting here for a number of months asking alot of questions about medications and responding to alot of other people's questions. I have found this site very informative and the people very helpful.
I have posted numerous questions about medications, side effects, and such. I have been trying to educate and learn as much as I can about what I am going through. But I cannot get a grip here lately.
I need some advice or help as to what I should do. I don't mean to be so personal by telling this information, but here it goes.
I have been diagnosed with panic attacks, GAD, and severe OCD. It all started about four years ago when I had my first panic attack. I didn't know what had happened and literally spent years going to doctors and specialists looking for answers to complex symptoms. I have had every medical test known to modern science.
Before I was a very active and normal 24 year old male with not too much to worry about. Just trying to finish up college and what I was going to do on the week ends.
But now my life is totally transformed. I suffer everyday from horrible unwanted thoughts and physical symptoms that paralyze me. I suffer from tremors, feeling like I am going to pass-out, aches and pains, and terrible headaches. I know there is nothing biologically wrong with me because all the medical tests come back negative--(I have been to the hospital so many times I am embarressed to go anymore). But the symptoms really make you feel like you are about to die.
I have been to a in patient psyche hospital four times hoping for relief to my problems. But each time was a failure. I have tried every medication combination you can think of with no help.
My symptoms are what they call OCD thoughts in which I experience awful, unwanted intrusive thoughts that repulse me and cause me significant anxiety. Thoughts such as thoughts against my religous beliefs, inopropriate sexual thoughts, etc.
I just wish I didn't have to think any more at all. I can't believe I have went from having it "all together" to not even being able to leave my house.
I see a psychiatrist on a regular basis. He is one of many I have seen. He is supposed to be one of the top in my state. This entire illness has taken a hard toll on both me and my family. For one there is the fincancial burden it has created. The other is my family watching me struggle with this illness and not getting much better. I do not let them know how bad it gets sometimes because they have been through so much with me I don't want to upset them anymore.
My doctor has me on 60mg of Lexapro to help with the OCD thoughts, but they do not stop. I take 4mg of Klonopin for the anxiety and that does seem to help. I take 1,200 mg of Trileptal as a mood stabilizer but I don't know if it works or not. And I take 30mg of Remeron mainly to sleep.
I have tried counseling and support groups but they just don't seem to work. It is like I don't control my mind or emotions anymore. I can't help but feel so guilty for my thoughts. And the pysical symptoms scare the "hell" out of me. I can't control my thoughts, so I don't trust myself anymore. I can't sit still because I feel the pounding of palpatations in my chest and the tremors and jerks in my body. I am no longer able to drive. I just can't believe this has gotten so bad.
I have never done drugs and I do not drink.
I am very sorry for anyone who reads this long personal post. But if anyone has any input as to what I should do or any alternative that can be done PLEASE feel free to respond. I am soooo tired of being sick!!!!. I am 28 now and I don't want to have to live like this another day. THANKS
Posted by sooshi on August 13, 2004, at 21:18:16
In reply to I Really need some Help or Advice?, posted by BRC on August 13, 2004, at 17:32:44
Hi BRC,
I was in the exact same boat as you when I was in my 20's. I was having daily (if not hourly) panic attacks, and eventually became agoraphobic, not leaving my home for 2 years. I have been hospitalized numerous times.
I can honestly tell you, that the only thing that helped get my thoughts under control was Cognitive Behavior Therapy. After starting on meds (I think at the time it was Xanax and a tricyclic, which DID help to some degree), I went to many a therapist, and got very little relief, except on megadoses of the Xanax. Luckily in my city at the time (Dallas) there was a place called "Phobia Centers of the Southwest" (I don't know if it still exists), which I found by desperately looking through the yellow pages for some place to get help. It was the best call I ever made. It was a center run by agoraphobics, panic-attackers, etc., from the receptionist to the doctors. They used CBT and Biofeedback, and through a lot of hard work learning the techniques, I became panic and anxiety free within a relatively short period of time (with the help of my meds, too, I might add).
I know this sort of excellent response to CBT doesn't happen to everyone, but I just wanted to give you my experience, since your story sounded so similar to mine. If you haven't given CBT a try, you might want to consider it? Also, David Burn's "Feeling Good: The New Mood Therapy" is a great book to start with.
For now, I deal with my BPII, but have not had a "full-blown" panic attack in years. I just know it could be this way for you too!
Good luck to you, and let me know if you have any more questions,
Sooshi
Posted by alesta on August 13, 2004, at 22:00:18
In reply to I Really need some Help or Advice?, posted by BRC on August 13, 2004, at 17:32:44
Hi, BRC,
I’m so sorry you’re going through this. I know how hard it is to have an anxiety disorder and have the burden of worrying about its impact on your family. First of all, I think you should congratulate yourself for the extraordinary strength you possess.
That is some great advise from Sooshi concerning CBT!! Sounds like a great idea, especially considering you aren’t having success w/ medications.
I’ll try and help you out on the OCD end. I posted a while ago on this board concerning natural remedies for OCD to try. I’ve pasted them below. (Please check with your doctor if you decide to try any of them in case they don’t interact well w/ your meds.) here's the post:
there are 3 great things to try. Fish oil (i like carlson's lemon-flavored, which is just as high quality as omegabrite and cheaper), probably around 5 grams (5,000 mg) a day. you can get a great price at iherb.com. See if lower amounts work first, due to cost. here is a web site about this: http://www.omega3.20megsfree.com/about.html
2nd thing is morphine. i read a promising article about taking a small dose 1 or 2 times a week, and a post elsewhere on psychobabble. maybe find a doctor who will prescribe it. our brain has natural morphine, which you may be deficient in or something. sounds very promising. (i think the fda is testing a similar drug called tramadol for ocd.) here is the psychobabble post:
“New treatment to ocd and social phobia:
There are several studies that indicate that morphine provides relief from ocd taken orally only once a week! Studies indicate that it acts on the caudate nucleus which the area of the brain that is implicated with ocd.
Check out this info.
Exciting evidence recently published in the Canadian Journal of Psychiatry suggested morphine as an efficacious drug that showed dramatic effects in cases in which SSRI's, behavior therapy, and psychosurgery failed (Warnecke 1997). The author referenced several imaging studies showing a concentration of opioid receptors in the caudate nucleus, an aforementioned important region in the pathogenesis of OCD (Murin et al. 1980; Woo et al. 1985). Notably, none of the patients reported a euphoric response after each dose of morphine, which suggests that the mu subclass of opioid receptors may not be involved and the risk of addiction should be very low. Oral doses of morphine were given with doses ranging from 20 to 40 mg. Surprisingly, therapeutic effects lasted for at least 5 days following a single dose.
Does anyone have any experience with morphine for ocd? I can see why this can be true, b/c I recently received morphine when I had my wisdom teeth taken out. For several days I had complete relief from my ocd and social phobia.”The third thing is inositol, at a very high dosage (i think 18 g, not sure).
Hope I might have been of some help. Good luck to you! :)
-Amy
Posted by HappyGirl on August 13, 2004, at 22:54:11
In reply to I Really need some Help or Advice?, posted by BRC on August 13, 2004, at 17:32:44
Hi:
I truly understand your 'endless' struggle brought by mental illness you've been carrying for so long.In my suggestion, ... Anti-psycho. med., such as 'Seroquel,' 'Zyprexa,' 'Geodon,' and 'Risperdal' could alleviate your symptoms as reading all of those 'traditional' psycho. meds. have NO effect on your problems. Besides this, ... it sounds to me like you have some 'Bipolar' trace, for which your pdoc. rxed Trileptal, one of reputable mood-stabilizers.
In my knowledge from the reading/hearing, dual dxes such as yours is VERY complex M.I. for most of pdocs. to deal with. I have no idea at which state you live, ... but my pdoc. is one of the *best* pdocs. in the region where I live, ... one of the biggest cities in U.S.A. I too have complex form of Bipolar illness, 'ultra-rapid cycler' with Bp II. For this form of Bp, most of pdocs. do NOT have a good clue to rx appropriate med. combo. in the first place. In this regard, I feel I am VERY lucky to find my current pdoc. I went through four different pdocs. until I bumped into my current pdoc. I highly recommend my pdoc. if you live close-by.
In my opinion, ... your case must be handled with a right med. combo. rather than CBT, due to the severity of your M.I. about which you're describing almost on every sentences in your post.
H.G.
Posted by BRC on August 14, 2004, at 8:58:55
In reply to Re: I Really need some Help or Advice? » BRC, posted by sooshi on August 13, 2004, at 21:18:16
Hi, I just wanted to thank you so much for taking the time to respond to my post. Thanks for being kind and understanding.
I did try CBT therapy for a while but gave up on it because my mind was going through so much I could not grasp the concepts. With the thoughts and anxiety I would totally forget what I had learned and could not concentrate on what I needed to read and study.
But you are right I have read and researched where CBT therapy combined with medication is perhaps the best change for control over anxiety and OCD.
I want to thank you so much for your information and replies. THANKS
Posted by BRC on August 14, 2004, at 9:06:26
In reply to Re: I Really need some Help or Advice?, posted by alesta on August 13, 2004, at 22:00:18
Hi, I just wanted to thank you for your response to my post and your concern.
I do take various vitamins and supplements. I do take fish oil and/or Flaxseed oil daily.
I think I read a while back where instonol (don't know if I spelled it right) helped with OCD. If I am not mistaken it is a vitamin or mineral? I remember purchasing some but I never new how much to take.
Thanks again for all your information. I will print it out and keep it.
Posted by BRC on August 14, 2004, at 9:11:32
In reply to Re: I Really need some Help or Advice?, posted by HappyGirl on August 13, 2004, at 22:54:11
Hi, I first want to thank you for responding to my post. My doctor did suggest trying a atypical anti-psychotic and even gave me some samples. But I was scared to use them because of the amount of medication I was already taking and the potential long term permanent side effects the medications they could cause.
I would love to hear from you if you have tried any of these meds with success. Thanks again for your concern and information. THANKS.
BRC
Posted by HappyGirl on August 14, 2004, at 10:19:16
In reply to Re: To Happy Girl. » HappyGirl, posted by BRC on August 14, 2004, at 9:11:32
Hi:
In the beginning of Zyprexa tx, around the fall of 2001, I took the 2.5 mg. Zyprexa mainly for my utltra-rapid cycler, dysphoric manic(rageous form of manic phrase once awhile) and my 'super' sensitivies to the words and noise(even chirping of birds in my backyard). In the beginning of Zyprexa tx., I experienced VERY sedative feelings next day even I took around 10 p.m. before the bed. But, this 'zombi' feeling went away about 2-3 wks.(I can't remember the exact time-phrase due to the length of time). I kept taking a 'tiny' amount of Zyprexa for about one year, ... but I changed its dosage to the 5 mg. as my system started to accustomed to the Zyprexa. This time on the 5 mg., I didn't feel 'zombi' next day. BTW, I've been on Lithium 900 mb. t.i.d. from breakfast to the bed-time and working well as mood-stabilizer along with A.D.s.As for a weight-gain, I never got any pounds from taking the Zyprexa, but only problem I got for the first few months on the Zyprexa was 'sleepiness/sedation' that went into, some days, until noon-time. But, one 'GOOD' benefit I got from the Zyprexa was my 'main' BP II problems went away with time. I'd say it took,... however about one and a half year or even two years when I felt 'good/functionability' about myself.
In my expereince, most of those psycho.meds. particularly, Anti-psycho.med. seems to need 'time' to get a satisfactory result. Then, needs 'patient,' 'faith' and 'trust' on the meds. which you're taking. Particuraly, you need to work with your pdoc. persistently, but in amicably way in order to find a right med. comb. Because, keep in mind, even an expert pdoc. doing a tough job on rx. a right med. combo. We are not only one who is frustrating on this regard but even the pdoc. doing a tough job in helping, 'tough' M.I. cases, like us.
In my case, ... he's a GREAT pdoc. with terrific personality, but he wants me to *listen* to him. I normally comply with my pdoc., but sometimes it's NOT easy emotionally when I want to get other form of med. However, I always show a great respect, admiration and first of all, *trust and faith* on his practice. That works out very well, thus I believe my pdoc. keeps helping me in every possible way he can.
H.G.
Posted by cpallen79 on August 14, 2004, at 22:03:15
In reply to I Really need some Help or Advice?, posted by BRC on August 13, 2004, at 17:32:44
Hi there, I have read your post and am very concerened for you. I sincerely hope that you get better. I have some ideas!
1) Try a different SSRI. Lexapro may not be the one for you. There's a million of them out there. If your PDOC refuses, move on.
2) Keep the trileptal or try a different mood stabilizer... Perhaps lithium or Depakote may be in order (don't be scared of them- they may be just what you need). Perhaps Lamictal will work too. take this with your SSRI. Another option if meds jsut aren't workign is ECT... Don't be scared of it! It's much mroe humane and has brought people out of absolute despair.
3) Perhaps try a different benzo... Xanax XR perhaps?
4) Happy Girl's advice of trying an atypical AP is also excellent! I may try adding in Zyprexa myself if my current meds don't work out.
5) Keep the remeron, it's a good sleep med. Perhaps alternate it /w a benzo to keep it doing it's job.
6) You are NOT your ocd, meaning you are not a sexual deviant, a violent person, nor a sacriligious person (note that these are all common OCD fears)... what you are is someone who happens to have OCD. There is a book called "Brain Lock" by Jeffrey Schwartz... I highly recommend that you read it. Again, even if CBT has failed you in the past, you must go back to it... you have to come out of the OCD shadows and be open and confront your fears, you have the power.
7) Have you had any manic or hypomanic episodes induced by your medications or without medications? I had to dig back thorugh my history and also recently endured a really interesting hypomanic episode as a result of upping my SSRI for me to see the obvious, that I was bipolar. Have you looked at a BP diagnosis?
I have had OCD since I was about 11 years old, and I am 25 now so I've had quite the rollercoaster with it. I take Luvox to control it... does it work? a bit I suppose but I haven't been on it long. I also take Trileptal for my BP II and ativan occasionally as a "treat" for anxiety attacks. I can relate to you and understand the pain and anxiety that you are suffering. I want to say this... I firmly belive that once you get your med situation under control that you will once again be thinking about what to do on weekends with your friends and not thinking about OCD or panic attacks. I believe that for all of us because new things are constantly on the way and there's so many things to try.
I wish you the very best and know that everything will work out.
Chris
> Hi, I have been posting here for a number of months asking alot of questions about medications and responding to alot of other people's questions. I have found this site very informative and the people very helpful.
>
> I have posted numerous questions about medications, side effects, and such. I have been trying to educate and learn as much as I can about what I am going through. But I cannot get a grip here lately.
>
> I need some advice or help as to what I should do. I don't mean to be so personal by telling this information, but here it goes.
>
> I have been diagnosed with panic attacks, GAD, and severe OCD. It all started about four years ago when I had my first panic attack. I didn't know what had happened and literally spent years going to doctors and specialists looking for answers to complex symptoms. I have had every medical test known to modern science.
>
> Before I was a very active and normal 24 year old male with not too much to worry about. Just trying to finish up college and what I was going to do on the week ends.
>
> But now my life is totally transformed. I suffer everyday from horrible unwanted thoughts and physical symptoms that paralyze me. I suffer from tremors, feeling like I am going to pass-out, aches and pains, and terrible headaches. I know there is nothing biologically wrong with me because all the medical tests come back negative--(I have been to the hospital so many times I am embarressed to go anymore). But the symptoms really make you feel like you are about to die.
>
> I have been to a in patient psyche hospital four times hoping for relief to my problems. But each time was a failure. I have tried every medication combination you can think of with no help.
>
> My symptoms are what they call OCD thoughts in which I experience awful, unwanted intrusive thoughts that repulse me and cause me significant anxiety. Thoughts such as thoughts against my religous beliefs, inopropriate sexual thoughts, etc.
>
> I just wish I didn't have to think any more at all. I can't believe I have went from having it "all together" to not even being able to leave my house.
>
> I see a psychiatrist on a regular basis. He is one of many I have seen. He is supposed to be one of the top in my state. This entire illness has taken a hard toll on both me and my family. For one there is the fincancial burden it has created. The other is my family watching me struggle with this illness and not getting much better. I do not let them know how bad it gets sometimes because they have been through so much with me I don't want to upset them anymore.
>
> My doctor has me on 60mg of Lexapro to help with the OCD thoughts, but they do not stop. I take 4mg of Klonopin for the anxiety and that does seem to help. I take 1,200 mg of Trileptal as a mood stabilizer but I don't know if it works or not. And I take 30mg of Remeron mainly to sleep.
>
> I have tried counseling and support groups but they just don't seem to work. It is like I don't control my mind or emotions anymore. I can't help but feel so guilty for my thoughts. And the pysical symptoms scare the "hell" out of me. I can't control my thoughts, so I don't trust myself anymore. I can't sit still because I feel the pounding of palpatations in my chest and the tremors and jerks in my body. I am no longer able to drive. I just can't believe this has gotten so bad.
>
> I have never done drugs and I do not drink.
>
> I am very sorry for anyone who reads this long personal post. But if anyone has any input as to what I should do or any alternative that can be done PLEASE feel free to respond. I am soooo tired of being sick!!!!. I am 28 now and I don't want to have to live like this another day. THANKS
>
Posted by cpallen79 on August 15, 2004, at 0:00:51
In reply to Re: I Really need some Help or Advice? » BRC, posted by cpallen79 on August 14, 2004, at 22:03:15
BRC, I wanted to add a few more things... The objective with OCD is to control it, not eliminate it completely. Aknowedge it as a chronic condition that can be controlled, just like diabetes. Come out of the OCD closet and discuss it with friends and family...You may be causing yourself anxiety by expecting the meds to diminish all of your OCD thoughts. Don't drive yoruself crazy with that expectation... Not to be negative, but it really doesn't happen like that... what does happen is your response to these thoughts can be changed... the medication can "unhook" your obsessions so you can move on. Rather than ruminating about an OCD thought indefinetely, meds help to "change the channel" so to speak, as well as CBT. Don't torture yourself with expectations of complete success, you deserve to be able to relax. Look forward to the day where one of those yucky OCD thoughts hits you, and you can say, "that's not me, it's simply OCD." Finally, you may want to consider adding a beta blocker into your med mix. Beta blockers help with the physical symptoms of anxiety like palpitations, sweating, tremors, that stuff.
again, I wish you the best
Chris> Hi there, I have read your post and am very concerened for you. I sincerely hope that you get better. I have some ideas!
>
> 1) Try a different SSRI. Lexapro may not be the one for you. There's a million of them out there. If your PDOC refuses, move on.
>
> 2) Keep the trileptal or try a different mood stabilizer... Perhaps lithium or Depakote may be in order (don't be scared of them- they may be just what you need). Perhaps Lamictal will work too. take this with your SSRI. Another option if meds jsut aren't workign is ECT... Don't be scared of it! It's much mroe humane and has brought people out of absolute despair.
>
> 3) Perhaps try a different benzo... Xanax XR perhaps?
>
> 4) Happy Girl's advice of trying an atypical AP is also excellent! I may try adding in Zyprexa myself if my current meds don't work out.
>
> 5) Keep the remeron, it's a good sleep med. Perhaps alternate it /w a benzo to keep it doing it's job.
>
> 6) You are NOT your ocd, meaning you are not a sexual deviant, a violent person, nor a sacriligious person (note that these are all common OCD fears)... what you are is someone who happens to have OCD. There is a book called "Brain Lock" by Jeffrey Schwartz... I highly recommend that you read it. Again, even if CBT has failed you in the past, you must go back to it... you have to come out of the OCD shadows and be open and confront your fears, you have the power.
>
> 7) Have you had any manic or hypomanic episodes induced by your medications or without medications? I had to dig back thorugh my history and also recently endured a really interesting hypomanic episode as a result of upping my SSRI for me to see the obvious, that I was bipolar. Have you looked at a BP diagnosis?
>
> I have had OCD since I was about 11 years old, and I am 25 now so I've had quite the rollercoaster with it. I take Luvox to control it... does it work? a bit I suppose but I haven't been on it long. I also take Trileptal for my BP II and ativan occasionally as a "treat" for anxiety attacks. I can relate to you and understand the pain and anxiety that you are suffering. I want to say this... I firmly belive that once you get your med situation under control that you will once again be thinking about what to do on weekends with your friends and not thinking about OCD or panic attacks. I believe that for all of us because new things are constantly on the way and there's so many things to try.
> I wish you the very best and know that everything will work out.
> Chris
>
>
> > Hi, I have been posting here for a number of months asking alot of questions about medications and responding to alot of other people's questions. I have found this site very informative and the people very helpful.
> >
> > I have posted numerous questions about medications, side effects, and such. I have been trying to educate and learn as much as I can about what I am going through. But I cannot get a grip here lately.
> >
> > I need some advice or help as to what I should do. I don't mean to be so personal by telling this information, but here it goes.
> >
> > I have been diagnosed with panic attacks, GAD, and severe OCD. It all started about four years ago when I had my first panic attack. I didn't know what had happened and literally spent years going to doctors and specialists looking for answers to complex symptoms. I have had every medical test known to modern science.
> >
> > Before I was a very active and normal 24 year old male with not too much to worry about. Just trying to finish up college and what I was going to do on the week ends.
> >
> > But now my life is totally transformed. I suffer everyday from horrible unwanted thoughts and physical symptoms that paralyze me. I suffer from tremors, feeling like I am going to pass-out, aches and pains, and terrible headaches. I know there is nothing biologically wrong with me because all the medical tests come back negative--(I have been to the hospital so many times I am embarressed to go anymore). But the symptoms really make you feel like you are about to die.
> >
> > I have been to a in patient psyche hospital four times hoping for relief to my problems. But each time was a failure. I have tried every medication combination you can think of with no help.
> >
> > My symptoms are what they call OCD thoughts in which I experience awful, unwanted intrusive thoughts that repulse me and cause me significant anxiety. Thoughts such as thoughts against my religous beliefs, inopropriate sexual thoughts, etc.
> >
> > I just wish I didn't have to think any more at all. I can't believe I have went from having it "all together" to not even being able to leave my house.
> >
> > I see a psychiatrist on a regular basis. He is one of many I have seen. He is supposed to be one of the top in my state. This entire illness has taken a hard toll on both me and my family. For one there is the fincancial burden it has created. The other is my family watching me struggle with this illness and not getting much better. I do not let them know how bad it gets sometimes because they have been through so much with me I don't want to upset them anymore.
> >
> > My doctor has me on 60mg of Lexapro to help with the OCD thoughts, but they do not stop. I take 4mg of Klonopin for the anxiety and that does seem to help. I take 1,200 mg of Trileptal as a mood stabilizer but I don't know if it works or not. And I take 30mg of Remeron mainly to sleep.
> >
> > I have tried counseling and support groups but they just don't seem to work. It is like I don't control my mind or emotions anymore. I can't help but feel so guilty for my thoughts. And the pysical symptoms scare the "hell" out of me. I can't control my thoughts, so I don't trust myself anymore. I can't sit still because I feel the pounding of palpatations in my chest and the tremors and jerks in my body. I am no longer able to drive. I just can't believe this has gotten so bad.
> >
> > I have never done drugs and I do not drink.
> >
> > I am very sorry for anyone who reads this long personal post. But if anyone has any input as to what I should do or any alternative that can be done PLEASE feel free to respond. I am soooo tired of being sick!!!!. I am 28 now and I don't want to have to live like this another day. THANKS
> >
>
>
This is the end of the thread.
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