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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 32. This is the beginning of the thread.
Posted by ed_uk on April 2, 2005, at 7:26:49
I often feel that people are rejecting me- even when they are probably not. I tend to over-react and 'make a mountain out of a molehill'. My reactions to percieved insults are often extrenely vicious and way out of proportion. I usually get very upset if I feel that I'm being rejected- sometimes I go into a rage. I am very sensitive to what my friends say to me, I often interpret their words as criticism.
Sometimes I think that people are angry with me, or that they think I'm stupid. If I am feeling rejected, I often spend all day thinking about it, I cannot get it out of my mind.
I am very easily disappointed. I over-react to setbacks and often feel that I cannot cope, I am very easily overwhelmed. A have very little motivation and am not doing well with my studies. I often 'give up before I have even started'.
I sleep a LOT- sometimes because I am tired and other times as an escape. I react to stress in an escapist fashion, often by sleeping. I often feel extremely weak and lethargic.
I want to try an MAOI. What do you think? SSRIs do not help me very much although they do reduce my anxiety and OCD. SSRIs increase my hypersomnia and lack of motivation. I do not have any OCD symptoms at the moment.
Ed x
Posted by ed_uk on April 2, 2005, at 7:36:48
In reply to Rejection sensitivity and MAOIs, posted by ed_uk on April 2, 2005, at 7:26:49
PS. I have upset my friends on many occasions. I often accuse people of not caring enough, not calling, not texting, not liking me, rejecting me, insulting me, laughing at me, being angry with me, ignoring me..........................................................
BEWARE: I am NOT an easy person to be friends with!
I feel quite overwhelmed at the moment. My exams are approaching and I've not even started revising. I don't want to think about how much work I have got to do, I can't cope. I find it very difficult to concentrate on revision, my mind wanders every two seconds.
I am not a morning person, I rarely even get up in the morning. I am a night person. The night is quite and peaceful, I can cope: there are no demands.
Ed x
Posted by Maxime on April 2, 2005, at 8:10:30
In reply to Re: Rejection sensitivity and MAOIs, posted by ed_uk on April 2, 2005, at 7:36:48
((( Ed ))) Now I know where all your questions have been coming from. You think you have BPD? Since you haven't found a med yet trying an MAOI would be beneficial. Have you been "allowed" to try any stimulants?
Also, you should look into DBT based on the work of Marsha Linehan. I did 20 weeks of intensice DBT and it helped. I wanted to help myself conquer my feelings of worthlessness and not deserving of any pleasure. But I think it would be more helpful for the feelings you described. Have you read "I Hate You, Don't Leave Me" ? I think you would be able to relate to a lot in the book.
Anyhow I wouldn't reject or abandon you. You have been too kind to me. :)
xoxo
Maxime
Posted by SLS on April 2, 2005, at 8:28:41
In reply to Re: Rejection sensitivity and MAOIs, posted by ed_uk on April 2, 2005, at 7:36:48
Hi Ed.
For what it's worth, rejection sensitivity is no longer considered a necessary symptom in the diagnosis of atypical depression.
Do you have explosive episodes of acting-out?
- Scott
Posted by ed_uk on April 2, 2005, at 8:43:25
In reply to Re: Rejection sensitivity and MAOIs, posted by Maxime on April 2, 2005, at 8:10:30
Hi Maxi :-)
((((Maxi)))) xxxx !!!!
>You think you have BPD?
I don't have BPD but I do have some borderline personality traits. My symptoms are better described as 'atypical depression' w/ rejection sensitivity.
>Have you been "allowed" to try any stimulants?
LOL no!
>"I Hate You, Don't Leave Me"
Have you read it? Do you think it would be in the local library?
>Anyhow I wouldn't reject or abandon you..........
:-)
Ed xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Posted by ed_uk on April 2, 2005, at 8:50:44
In reply to Re: Rejection sensitivity and MAOIs » ed_uk, posted by SLS on April 2, 2005, at 8:28:41
Hi Scott,
>Do you have explosive episodes of acting-out?
It has been known :-S
Ed.
Posted by ed_uk on April 2, 2005, at 9:09:28
In reply to Re: Rejection sensitivity and MAOIs » ed_uk, posted by SLS on April 2, 2005, at 8:28:41
PS.
>For what it's worth, rejection sensitivity is no longer considered a necessary symptom in the diagnosis of atypical depression.
In DSM-IV-TR, mood reactivity (ie feeling temporarily better in response to good things) is required for the diagnosis of atypical features but as you said, rejection sensitivity is not required- it's one of the four criterion B symptoms. AFAIK, there's been some recent debate about removing the requirement for 'mood reactivity' from the criteria set.
Current 'official' criteria for the atypical features specifier.........
A. Mood reactivity.
B. Two or more of the following.........
1. Weight gain or increased appetite.
2. Hypersomnia.
3. Leaden paralysis.
4. Chronic interpersonal rejection sensitivity.C. Doesn't fit criteria for melancholic or catatonic features.
Regards,
Ed.
Posted by ed_uk on April 2, 2005, at 9:29:18
In reply to Re: Rejection sensitivity and MAOIs » SLS, posted by ed_uk on April 2, 2005, at 9:09:28
Of course, it's quite possible for people to be severely rejection sensitive without being mood reactive (in response to positive events). The reverse also applies..............
Ed.
Posted by TamaraJ on April 2, 2005, at 10:02:34
In reply to Re: Rejection sensitivity and MAOIs, posted by ed_uk on April 2, 2005, at 7:36:48
((((Ed))))
>
I am sorry that things are overwhelming for you right now :-( I don't know enough about MAOIs to say whether you would benefit from taking one. I seem to recall reading that Parnate is pro-social, so it may be a good med for what you are experiencing. And, I agree with Maxime - some type of therapy, other than CBT, could well help you deal with the feelings you have (which I would imagine are experienced by many, many more people than we would all realize).> BEWARE: I am NOT an easy person to be friends with!
~~ Well, I like you, so, I'll take my chances. To me, you are a wonderful, caring, bright person - so there! It takes a lot to scare me away (too bad eh? :-))
>
> I am not a morning person, I rarely even get up in the morning. I am a night person. The night is quite and peaceful, I can cope: there are no demands.
>
~~ I agree Ed, the night is a wonderful and peaceful time of day. I love the night too. I especialy like going for long drives or even long walks, in the dead of night, when it is quiet and still and dark. That is one of the most comforting and relaxing things for me. The world just does not accommodate night people well enough < sigh >.I know it seems impossible right now, but try to hang in there Ed. My thoughts are with you. Take good care.
Tamara
xxx
Posted by Emily Elizabeth on April 2, 2005, at 10:04:32
In reply to Rejection sensitivity and MAOIs, posted by ed_uk on April 2, 2005, at 7:26:49
Hi Ed,
I don't really know about MAOIs, but after I read your post, I just had to send you some support. I know that the babble world thinks you are an amazing and very important member. You never hesitate to offer support or advice to us. Hope that it helps (a least a little) to know that we care about you!
((Ed))
Take care,
EE
Posted by ed_uk on April 2, 2005, at 10:14:54
In reply to Re: Rejection sensitivity and MAOIs » ed_uk, posted by TamaraJ on April 2, 2005, at 10:02:34
Hi Tamara!
Thank you for your kind words and support :-)
>Well, I like you, so, I'll take my chances.
I like you too :-D
>I especialy like going for long drives or even long walks, in the dead of night, when it is quiet and still and dark. That is one of the most comforting and relaxing things for me. The world just does not accommodate night people well enough < sigh >.
Ah yes, long drives........ I love long drives. I can't drive but it's nice to go with a friend!
Ed xxxxxxxxxxxxx
Posted by ed_uk on April 2, 2005, at 10:16:03
In reply to Re: Rejection sensitivity and MAOIs » ed_uk, posted by Emily Elizabeth on April 2, 2005, at 10:04:32
Hi EE!
Thank you for your kindness and support :-)
Ed xx
Posted by SLS on April 2, 2005, at 10:34:48
In reply to Re: Rejection sensitivity and MAOIs » SLS, posted by ed_uk on April 2, 2005, at 9:09:28
> AFAIK, there's been some recent debate about removing the requirement for 'mood reactivity' from the criteria set.
It is a hypothesis of mine that mood reactivity might be useful in differentiating atypical unipolar versus bipolar depression. Bipolar depression is generally not mood-reactive while mood reactivity is common in atypical depression. It might be a good idea to continue to use mood reactivity as a criterion.
- Scott
Posted by ed_uk on April 2, 2005, at 11:07:40
In reply to Re: Rejection sensitivity and MAOIs » ed_uk, posted by SLS on April 2, 2005, at 10:34:48
Hi Scott!
This may be of interest...........
Eur Arch Psychiatry Clin Neurosci. 2002 Jun;252(3):135-40.
Should mood reactivity be included in the DSM-IV atypical features specifier?Benazzi F.
BACKGROUND: The definition of atypical depression is still an unsolved issue. DSM-IV atypical features specifier criteria always require mood reactivity, but why mood reactivity should be included is unclear. The study aim was to test whether mood reactivity should be included in DSM-IV atypical features specifier. METHODS: Consecutively, 164 unipolar and 241 "soft" bipolar II major depressive episode (MDE) outpatients were interviewed with the Structured Clinical Interview for DSM-IV. The DSM-IV criteria for atypical features specifier were strictly followed. Associations were tested by univariate logistic regression. RESULTS: MDE with atypical features was present in 41.4 % of patients. Bipolar II disorder was significantly more common in patients with atypical features. MDE with atypical features was significantly associated with bipolar II, female gender, lower age of onset, more axis I comorbidity, fewer psychotic features, and more depressive mixed states. In the whole sample, mood reactivity was significantly associated with all the atypical symptoms, apart from leaden paralysis, and all the other atypical symptoms were significantly associated with each other. In the bipolar II sub-sample, mood reactivity was associated with many, but not all, atypical symptoms, while in the unipolar sub-sample it was associated with no atypical symptom. Atypical symptoms were significantly more common in mood reactive than in non-mood reactive patients, apart from leaden paralysis. Bipolar II disorder and mood reactivity were strongly associated. CONCLUSIONS: Results may support the inclusion of mood reactivity in the DSM-IV atypical features specifier for bipolar II disorder, but not for unipolar depression.
Posted by banga on April 2, 2005, at 11:26:06
In reply to Re: Rejection sensitivity and MAOIs, posted by ed_uk on April 2, 2005, at 11:07:40
Hi Ed!
I am sorry things are difficult lately, as Ive said I know all too well about interpersonal sensitivity!! There are all kinds of ways to help oneself to work through it, as people mentioned Linehan's work among others...some are very simple ways to check in with yourself and working in a direction to help escape the tyranny of these thoughts. You once mentioned therapy I think--did it help at all at the time?
I hesitate to recommend any medications, as you have studied them in such depth..is there a more stimulating TCA than lofepramine in the UK? I have found that desipramine has switched me from oversleeping to normal hours of sleep, even getting out of bed at ??6:30, being a night person I didnt think it even possible...
Take care of yourself!!! And you are needed and appreciated here, you wont be abandoned here!!
Banga
Posted by banga on April 2, 2005, at 11:35:46
In reply to Re: Rejection sensitivity and MAOIs, posted by banga on April 2, 2005, at 11:26:06
Ed,
Have you ever considered a small amount of an AP for yourself? It at times helps me at least with the rumination part...or is that hard to receive in the UK too?
It is a beautiful country, so sad it has such an unresponsive, rigid mental health system. Things sound much more complex and difficult there....starting with those unreasonably long telephone numbers you have there!
Posted by SLS on April 2, 2005, at 12:12:37
In reply to Re: Rejection sensitivity and MAOIs, posted by ed_uk on April 2, 2005, at 11:07:40
I think they got it 180° wrong.
- Scott
Posted by ed_uk on April 2, 2005, at 12:36:08
In reply to Re: Rejection sensitivity and MAOIs, posted by banga on April 2, 2005, at 11:35:46
Hi B!
>You once mentioned therapy I think--did it help at all at the time?
I was once assessed by a clinical psychologist who specialised in CBT- he said he couldn't help me and he wouldn't see me again!
>is there a more stimulating TCA than lofepramine in the UK? I have found that desipramine...............
No, I'm afraid not :-(
>And you are needed and appreciated here, you wont be abandoned here!!
:-)
>Have you ever considered a small amount of an AP for yourself?
Yes, I've tried chlorpromazine, it wasn't difficult to get a prescription. It didn't help though and the side effects were severe (akathisia). I could ask for Abilify... although I'd need PLENTY of diazepam on hand in case of akathisia because I don't want to end up in the emergency department like I did last time!!!!!
Love Ed xx
Posted by Colleen D. on April 2, 2005, at 12:44:45
In reply to Rejection sensitivity and MAOIs, posted by ed_uk on April 2, 2005, at 7:26:49
Ed,
Your description of how you feel is SO concise! I could swear that I'd written it. Please, if you do try nardil or another such med, keep us posted on how you're doing. Good luck!!!
Colleen
p.s. - What extactly is your dx?
Posted by banga on April 2, 2005, at 13:52:54
In reply to Re: Rejection sensitivity and MAOIs » banga, posted by ed_uk on April 2, 2005, at 12:36:08
Hi Ed!!
> I was once assessed by a clinical psychologist who specialised in CBT- he said he couldn't help me and he wouldn't see me again!
>
How very helpful and sensitive!! I am sorry to hear that, please dont get the message that you cannot be helped, that is ludicrous. It just amazes me to no end how some of these people manage to get licensure to work with patients. Clearly he is intimidated by the complexities of human beings. He should study and treat rocks instead. He and the rock, and the human race, would all be better off!And I could not disagree more with his assessment. You are such a nice person who not only deserves to be helped but *can* be helped. Please dont be so rough on yourself.
Posted by ed_uk on April 2, 2005, at 14:38:21
In reply to Re: Rejection sensitivity and MAOIs » ed_uk, posted by banga on April 2, 2005, at 13:52:54
Awww banga, you are soooo nice!
I am thinking about seeing a private psychiatrist or a private psychologist/therapist. I *will* have to encourage my parents to pay though because I cannot afford!!
Ed xxxxx
Posted by zeugma on April 2, 2005, at 17:11:36
In reply to Re: Rejection sensitivity and MAOIs » banga, posted by ed_uk on April 2, 2005, at 14:38:21
> Awww banga, you are soooo nice!
>
> I am thinking about seeing a private psychiatrist or a private psychologist/therapist. I *will* have to encourage my parents to pay though because I cannot afford!!>>That's the only way I was able to afford proper treatment. A lot of people fall through the cracks- not in need of hospitalization, but at the same time unable to work a proper job due to illness. After a while I was able to pay for treatment myself, but it took quite a while, and I would not have been able to make even the fragile progress I've made without the help of specialists, who are always more expensive. You definitely should encourage them to pay.
-z
>
> Ed xxxxx
Posted by Phillipa on April 2, 2005, at 17:27:00
In reply to paying for treatment » ed_uk, posted by zeugma on April 2, 2005, at 17:11:36
Ed, You can't drive? I guess you don't have a car since you take the train to school. But, no one but you would have Babbled back and forth with my husband the other night. When I read your Babbles I couldn't believe how concerned you were with someone you only know via Internet. You are a truly wonderful person who always takes the time to find relevent websites to send others to with their questions. I know Babble wouldn't be the same without you. Fondly, Phillipa, J OOOOOO
Posted by ed_uk on April 2, 2005, at 17:50:30
In reply to paying for treatment » ed_uk, posted by zeugma on April 2, 2005, at 17:11:36
Hi Z!
>That's the only way I was able to afford proper treatment.
Thank you Z :-) I think you are right, I will try to encourage them.
Kind regards,
Ed.
Posted by ed_uk on April 2, 2005, at 17:54:50
In reply to Re: paying for treatment » zeugma, posted by Phillipa on April 2, 2005, at 17:27:00
Hi Phillipa!
>You can't drive?
No, I did have a few lessons when I was 17 but I was REALLY BAD and I was always PANICKING. Also, I got NASTY because my instructor used to shout at me!!
>When I read your Babbles I couldn't believe how concerned you were with someone you only know via Internet.
I care about you :-)
Ed xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
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