![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 38. Go back in thread:
Posted by Maxime on May 19, 2005, at 22:44:31
In reply to Re: Why are evenings worse?, posted by vivi on May 19, 2005, at 20:13:59
I just saw my pdoc. I only take 10 mg of Dexedrine a day which isn't much. I don't think my pdoc will be much help. He will tell me to find something fun to do at night. I think the dexedrine does make me crash.
Maxime
> > Hello.
> >
> > I find that my depression takes over in the evening. I try to keep myself distracted by reading or writing, but still I feel a wave of sadness come over me. If I call a friend, I still feel very alone.
> >
> > Is there a biochemical reason for this? Would it have anything to do with cortisone levels?
> >
> > Sometimes I work on CBT exercises from the Feel Good Handbook to see if it will help, but so far it hasn't.
> >
> > It really is a significant drop in my mood. When I can cry .... I do. Right now I can't cry. I don't feel any anxiety or anything just EXTREME sadness.
> > This has always been the case for me. It's like my anti-depressant just stops working.
> >
> > Anyone have any input? Sometimes I don't feel very safe at night and I end up having to call a hotline. A few nights ago I went to the hospital, only to be sent home and feeling even worse.
> >
> > Help?
> >
> > Maxime
> >
> I feel worse at night too. But I think it might be because I am coming off the Dex. It is starting to make me depressed when it wears off. I then end up taking an Ambien to go to sleep. How much Dexedrine do you take? I remember you mentioning that you have taken it. Do you still? Keep calling your friends, you do not need to be alone. Are you going to be seeing your Doctor soon? Call and schedule an appointment:)
> ViviLeigh
>
>
Posted by Maxime on May 19, 2005, at 22:49:26
In reply to Re: Why are evenings worse? » Maxime, posted by Jakeman on May 19, 2005, at 21:59:25
My blood sugar. I bet that is part of the problem. I must start taking my chromium pills again and see if that helps. I'll let you know. :-)
Maxime
> For me, mood and energy starts to decline in mid-afternoon and gradually gets worse. It's almost as if an invisible hand is pushing down on me. I've tried adjusting the times I take meds and vitamins with a small bit of success but I feel something bigger is going on. Maybe something's out of wack hormonally or with glucose metabolism. Drinking a Coke picks me back up for a short time. I have trouble getting any doctor to take me seriously about this though.
>
> best wishes- J
Posted by Declan on May 19, 2005, at 23:22:15
In reply to Re: Why are evenings worse?, posted by Maxime on May 19, 2005, at 22:44:31
Hi
I suppose 10mg isn't much but its not surprising you should feel worse as it wears off, just as you feel better when it works.
Declan
Posted by FredPotter on May 20, 2005, at 0:14:17
In reply to Re: Why are evenings worse?, posted by Declan on May 19, 2005, at 23:22:15
I think you might be wrong to blame biochemistry for this. Although biochemistry will alter with mood, it may not be the cause. We're biochemical and we're social. We're physical *and* we're spiritual. But thanks Maxime for bringing this up because I have it too. I'm 58 and have only recently discovered that people are basically friendly (perhaps it's because I now live in NZ!). What's more I need to be around people. So when I'm at work I'm motivated, social and happy, broadly speaking. I go home happy too.
But I live alone since my wife left 4 years ago(with the kids). Every evening at first I enjoy the freedom but gradually a dread builds up. A dread and hopelessness that I'm not necessary to anyone and I'm all alone, washed up. Damn this nuclear family age. If I have to go out to play in my band I really come to life.
I believe for me that this is a simpler explanation than talking about drugs and biochemical imbalance. I take Celexa but suspect it doesn't do much. Xanax is powerless over "the evening feeling" too. I sometimes have a compulsion to prove that I can go it alone in life. However I suspect none of us can, because we're social animals. Perhaps even hermits pay a high emotional price for their freedom. Or perhaps the pain of feeling alone and un-needed is less than the pain outside in the world.
Life's a bugger really
Fred
Posted by jerrympls on May 20, 2005, at 1:33:57
In reply to Why are evenings worse?, posted by Maxime on May 19, 2005, at 15:30:09
> Hello.
>
> I find that my depression takes over in the evening. I try to keep myself distracted by reading or writing, but still I feel a wave of sadness come over me. If I call a friend, I still feel very alone.
>
> Is there a biochemical reason for this? Would it have anything to do with cortisone levels?
>
> Sometimes I work on CBT exercises from the Feel Good Handbook to see if it will help, but so far it hasn't.
>
> It really is a significant drop in my mood. When I can cry .... I do. Right now I can't cry. I don't feel any anxiety or anything just EXTREME sadness.
> This has always been the case for me. It's like my anti-depressant just stops working.
>
> Anyone have any input? Sometimes I don't feel very safe at night and I end up having to call a hotline. A few nights ago I went to the hospital, only to be sent home and feeling even worse.
>
> Help?
>
> Maxime
>
HI MaximeI'm the same way. But I get more anxious and lonely than sad. Part of it for me, I think, is that my Dexedrine has worn off - but I also think that cortisol levels have some impact as well. If I am not mistaken, cortisol production/release? is *supposed* to taper down at night staying at lower levels throughout the night and then gradually tapering back up in the morning. I THINK?? But I wouldn't blame it all on cortisol - medication timing, hormones, melatonin function, etc all come into play. I had my cortisol levels checked pretty thoroughly a while back and they found that my levels were consistently LOW! Which kinda makes sense - since my depression is more anhedonic/lethargic, etc.
I know scientists are looking at meds that stabilize the cortisol system - otherwise known as the HPA axis. My pdoc think that my HPA system is out of balance - but haven't found any suitable meds to try to get it back on track.
I also notice that I get more lethargic and depressed in the spring/summer months. Exact opposite from usual SAD. Not sure why that would be? But I can certainly feel a bit of mode improvement in the Fall & Winter months.
Anyway, hope this helps..
Jerry
Posted by jerrympls on May 20, 2005, at 1:40:20
In reply to Re: Why are evenings worse?, posted by FredPotter on May 20, 2005, at 0:14:17
> I think you might be wrong to blame biochemistry for this. Although biochemistry will alter with mood, it may not be the cause. We're biochemical and we're social. We're physical *and* we're spiritual. But thanks Maxime for bringing this up because I have it too. I'm 58 and have only recently discovered that people are basically friendly (perhaps it's because I now live in NZ!). What's more I need to be around people. So when I'm at work I'm motivated, social and happy, broadly speaking. I go home happy too.
>
> But I live alone since my wife left 4 years ago(with the kids). Every evening at first I enjoy the freedom but gradually a dread builds up. A dread and hopelessness that I'm not necessary to anyone and I'm all alone, washed up. Damn this nuclear family age. If I have to go out to play in my band I really come to life.
>
> I believe for me that this is a simpler explanation than talking about drugs and biochemical imbalance. I take Celexa but suspect it doesn't do much. Xanax is powerless over "the evening feeling" too. I sometimes have a compulsion to prove that I can go it alone in life. However I suspect none of us can, because we're social animals. Perhaps even hermits pay a high emotional price for their freedom. Or perhaps the pain of feeling alone and un-needed is less than the pain outside in the world.
>
> Life's a bugger really
>
> FredFred- very well said. I agree completely. The loneliness and dread at night doesn't respond to anti-anxiety meds - it's something you can't put your finger on - but know it's there. Part of being human - if not the most important part/goal is to be intimate with other humans. We need intimacy just like we need food to survive. Without it, the loneliness eats away at us like severe hunger. At work, I'm more social and don't feel dread. But when I come home it starts sinking in - or creeping in. It doesn't help either to have friends who have abandoned you because of your mental illness as mine have done.
Thanks for the post Fred--you raised a VERY important point.
Jerry
Posted by ed_uk on May 20, 2005, at 5:25:02
In reply to Re: Why are evenings worse? » FredPotter, posted by jerrympls on May 20, 2005, at 1:40:20
Hi Jerry,
>Part of being human - if not the most important part/goal is to be intimate with other humans.
Well said!
Warm regards,
Ed.
Posted by Maxime on May 20, 2005, at 6:14:20
In reply to Re: Why are evenings worse?, posted by FredPotter on May 20, 2005, at 0:14:17
Hi Fred *hugs*
I think you are right. I am trying to find things to do at night. To go OUT and do. I have to take it slow though. I am only just coming out of my depression right now. Wish I could pop over to NZ and we could and do something together!
I will work on it. I also have myself tied up in volunteer work that involved a lot of writing and ties me to the computer. I look for jobs during the day, and work on my volunteer stuff at night. So I need to get out more period. I am going hiking on Sunday ... that should help. :-)
But I do agree with you, yet a part of me thinks some of it is biochemical. It could also be a bit of PSTD as I was attacked (badly)at night once. There are so many variables.
You are a sweetie!
Maxime
> I think you might be wrong to blame biochemistry for this. Although biochemistry will alter with mood, it may not be the cause. We're biochemical and we're social. We're physical *and* we're spiritual. But thanks Maxime for bringing this up because I have it too. I'm 58 and have only recently discovered that people are basically friendly (perhaps it's because I now live in NZ!). What's more I need to be around people. So when I'm at work I'm motivated, social and happy, broadly speaking. I go home happy too.
>
> But I live alone since my wife left 4 years ago(with the kids). Every evening at first I enjoy the freedom but gradually a dread builds up. A dread and hopelessness that I'm not necessary to anyone and I'm all alone, washed up. Damn this nuclear family age. If I have to go out to play in my band I really come to life.
>
> I believe for me that this is a simpler explanation than talking about drugs and biochemical imbalance. I take Celexa but suspect it doesn't do much. Xanax is powerless over "the evening feeling" too. I sometimes have a compulsion to prove that I can go it alone in life. However I suspect none of us can, because we're social animals. Perhaps even hermits pay a high emotional price for their freedom. Or perhaps the pain of feeling alone and un-needed is less than the pain outside in the world.
>
> Life's a bugger really
>
> Fred
Posted by Maxime on May 20, 2005, at 6:22:53
In reply to Re: Why are evenings worse? » Maxime, posted by jerrympls on May 20, 2005, at 1:33:57
Jerry, I am the same way re. the summer months! Wow, I have never found anyone like me before. And it's strange because I have a harsh Canadian winter to face after the fall! But I liven up a lot. I think because it reminds me of going back to school which I always enjoyed and will be returning once again to change careers in a year. I was always happy in university, even during my graduate programme which was tough.
I also cut at night sometimes as well(ashamed). And I am anorexic so my blood sugar and energy is depleted in the evening even though I do eat around 5 pm. (nothing after 6pm is allowed).
I will be seeing a neuroendocrinologist who will be testing my hormones etc. and hopefully my cortisone levels. I think the corticosteroid I was taking for asthma for well over ten years has done some damage, but I don't know for sure. Now that I am off it, I feel much better (thanks to CK1). Although now my asthma is starting to get worse. Sigh. MY GP is going to be so angry with me for stopping, but my mood and health has improved so much.
Thanks again Jerry, as usual you are a wealth of information. :-)
Maxime
> > Hello.
> >
> > I find that my depression takes over in the evening. I try to keep myself distracted by reading or writing, but still I feel a wave of sadness come over me. If I call a friend, I still feel very alone.
> >
> > Is there a biochemical reason for this? Would it have anything to do with cortisone levels?
> >
> > Sometimes I work on CBT exercises from the Feel Good Handbook to see if it will help, but so far it hasn't.
> >
> > It really is a significant drop in my mood. When I can cry .... I do. Right now I can't cry. I don't feel any anxiety or anything just EXTREME sadness.
> > This has always been the case for me. It's like my anti-depressant just stops working.
> >
> > Anyone have any input? Sometimes I don't feel very safe at night and I end up having to call a hotline. A few nights ago I went to the hospital, only to be sent home and feeling even worse.
> >
> > Help?
> >
> > Maxime
> >
> HI Maxime
>
> I'm the same way. But I get more anxious and lonely than sad. Part of it for me, I think, is that my Dexedrine has worn off - but I also think that cortisol levels have some impact as well. If I am not mistaken, cortisol production/release? is *supposed* to taper down at night staying at lower levels throughout the night and then gradually tapering back up in the morning. I THINK?? But I wouldn't blame it all on cortisol - medication timing, hormones, melatonin function, etc all come into play. I had my cortisol levels checked pretty thoroughly a while back and they found that my levels were consistently LOW! Which kinda makes sense - since my depression is more anhedonic/lethargic, etc.
>
> I know scientists are looking at meds that stabilize the cortisol system - otherwise known as the HPA axis. My pdoc think that my HPA system is out of balance - but haven't found any suitable meds to try to get it back on track.
>
> I also notice that I get more lethargic and depressed in the spring/summer months. Exact opposite from usual SAD. Not sure why that would be? But I can certainly feel a bit of mode improvement in the Fall & Winter months.
>
> Anyway, hope this helps..
> Jerry
>
Posted by Maxime on May 20, 2005, at 6:24:58
In reply to Re: Why are evenings worse? » FredPotter, posted by jerrympls on May 20, 2005, at 1:40:20
Amen to that Jerry. :-( I've lost so many friends. They don't bother to call me anymore or invite me anywhere. I don't blame them, but it hurts.
Maxime
> It doesn't help either to have friends who have abandoned you because of your mental illness as mine have done.
>
> Thanks for the post Fred--you raised a VERY important point.
> Jerry
>
Posted by 4WD on May 20, 2005, at 14:26:59
In reply to Re: Why are evenings worse? » Maxime, posted by jerrympls on May 20, 2005, at 1:33:57
> HI Maxime
>
> I'm the same way. But I get more anxious and lonely than sad. Part of it for me, I think, is that my Dexedrine has worn off - but I also think that cortisol levels have some impact as well. If I am not mistaken, cortisol production/release? is *supposed* to taper down at night staying at lower levels throughout the night and then gradually tapering back up in the morning. I THINK?? But I wouldn't blame it all on cortisol - medication timing, hormones, melatonin function, etc all come into play. I had my cortisol levels checked pretty thoroughly a while back and they found that my levels were consistently LOW! Which kinda makes sense - since my depression is more anhedonic/lethargic, etc.
Jerry,My depression is also anhedonic and lethargic. However, in the last couple of years, I have also begun to have problems with panic, anxiety and general lasting terror. My cortisol levels are consistently way way too high.
So since your levels are low and you are lethargic and feel bad at night, and my levels are high and I am scared and anxious during the day but feel good at night...doesn't it seem to follow that cortisol is possibly indeed the culprit. Or perhaps there is some other force at work which causes both effects - the type of depression AND the cortisol level.
>
> I know scientists are looking at meds that stabilize the cortisol system - otherwise known as the HPA axis. My pdoc think that my HPA system is out of balance - but haven't found any suitable meds to try to get it back on track.
Have you seen an endocrinologist?
Marsha
Posted by 4WD on May 20, 2005, at 14:35:57
In reply to Re: Why are evenings worse?, posted by Maxime on May 20, 2005, at 6:22:53
Maxime,
You might want to look at the thread "urine test to measure neurotransmitter levels" - there's a lot of stuff there about cortisol levels and depression and endocrinological testing and treatment.
I used to be anorexic (two years) and then bulimic (~30 years). I am now in recovery (for about 5-6 months). If you ever want to talk, I'm here.
Marsha
Posted by Maxime on May 20, 2005, at 16:20:57
In reply to Re: Why are evenings worse? » Maxime, posted by 4WD on May 20, 2005, at 14:35:57
Thanks Marsha ... I may very well do that. Congratulations of your 5-6 months of recovery.
Maxime
> Maxime,
>
> You might want to look at the thread "urine test to measure neurotransmitter levels" - there's a lot of stuff there about cortisol levels and depression and endocrinological testing and treatment.
>
> I used to be anorexic (two years) and then bulimic (~30 years). I am now in recovery (for about 5-6 months). If you ever want to talk, I'm here.
>
> Marsha
Posted by jerrympls on May 20, 2005, at 17:33:59
In reply to Re: Why are evenings worse? » jerrympls, posted by 4WD on May 20, 2005, at 14:26:59
> > HI Maxime
> >
> > I'm the same way. But I get more anxious and lonely than sad. Part of it for me, I think, is that my Dexedrine has worn off - but I also think that cortisol levels have some impact as well. If I am not mistaken, cortisol production/release? is *supposed* to taper down at night staying at lower levels throughout the night and then gradually tapering back up in the morning. I THINK?? But I wouldn't blame it all on cortisol - medication timing, hormones, melatonin function, etc all come into play. I had my cortisol levels checked pretty thoroughly a while back and they found that my levels were consistently LOW! Which kinda makes sense - since my depression is more anhedonic/lethargic, etc.
>
>
> Jerry,
>
> My depression is also anhedonic and lethargic. However, in the last couple of years, I have also begun to have problems with panic, anxiety and general lasting terror. My cortisol levels are consistently way way too high.
>
> So since your levels are low and you are lethargic and feel bad at night, and my levels are high and I am scared and anxious during the day but feel good at night...doesn't it seem to follow that cortisol is possibly indeed the culprit. Or perhaps there is some other force at work which causes both effects - the type of depression AND the cortisol level.
>
>
> >
> > I know scientists are looking at meds that stabilize the cortisol system - otherwise known as the HPA axis. My pdoc think that my HPA system is out of balance - but haven't found any suitable meds to try to get it back on track.
>
>
> Have you seen an endocrinologist?
>
>
> Marsha
>
>
Hi MarshaYes I have seen an endocrinologist. He was puzzeled that my cortisol levels were low knowing my history with depression & anxiety. My testosterone levels were a bit low as well. He put me on a small dose of oral hydrocortisone and testosterone replacement therapy. After months on them, I didn't notice any improvement. Eventually he said "Well, I'm not sure what else we can do." and sent me back to my pdoc - who later thought that my testosterone dosage may have been too low. Something worth investigating I think.
But yes - cortisol levels play a HUGE role in our balance of moods. HUGE HUGE HUGE!
Posted by fires on May 20, 2005, at 18:44:57
In reply to Why are evenings worse?, posted by Maxime on May 19, 2005, at 15:30:09
Something similar to "sundowning"? (I'm not implying that you are demented).
Posted by Jakeman on May 20, 2005, at 19:05:57
In reply to Re: Why are evenings worse? » Jakeman, posted by Maxime on May 19, 2005, at 22:49:26
Yes, let me know if you notice anything.
Actually I just took some chromium before reading your post, the first time in a while. I guess I should add it to my regimen but I'm not sure.> My blood sugar. I bet that is part of the problem. I must start taking my chromium pills again and see if that helps. I'll let you know. :-)
>
> Maxime
>
>
> > For me, mood and energy starts to decline in mid-afternoon and gradually gets worse. It's almost as if an invisible hand is pushing down on me. I've tried adjusting the times I take meds and vitamins with a small bit of success but I feel something bigger is going on. Maybe something's out of wack hormonally or with glucose metabolism. Drinking a Coke picks me back up for a short time. I have trouble getting any doctor to take me seriously about this though.
> >
> > best wishes- J
>
>
Posted by FredPotter on May 22, 2005, at 16:55:40
In reply to Re: Why are evenings worse? » FredPotter, posted by jerrympls on May 20, 2005, at 1:40:20
Thanks Jerry I've got friends who abandoned me when I got ill as well. I was disgusted with them. But most don't thankfully. I met a really old bloke the other night at a Theosophical meeting ( I won't expand on that). He invited me round to talk about Life etc. I really like him and it's very helpful to me to be able to connect with someone who's obviously lonely. So I'm being selfish really. But as they say, "everything you give you give to yourself"
Fred
Posted by FredPotter on May 22, 2005, at 17:04:40
In reply to Re: Why are evenings worse?, posted by Maxime on May 20, 2005, at 6:14:20
Thanks Maxime I think I might be a bit old to do the town with you. I agree that there is a biochemical side to all this too. I suppose you can attack it from a social/intimate angle or by using drugs. One problem I have is there are important creative things I need to do in the evening for which I need to be alone. I don't want to rush around being social all the time. I can't afford it for one thing. And we don't have to be intimate all the time do we? Please note that I don't mean sexual by the word intimate (although it might mean that). So what I mean is all this "keep moving or it will get you" is not a good way of living. Any advice?
kia ora
Fred
Posted by Maxime on May 23, 2005, at 16:37:41
In reply to Re: Why are evenings worse? » Maxime, posted by FredPotter on May 22, 2005, at 17:04:40
> Thanks Maxime I think I might be a bit old to do the town with you.
Well I didn't say anything about getting married. :-) I don't think there are any age difference restrictions when going out for some drinks and live music.
Maxime
Posted by Declan on May 23, 2005, at 17:16:40
In reply to Re: Why are evenings worse? » jerrympls, posted by 4WD on May 20, 2005, at 14:26:59
Hi rhere
I hope this isn't too much off the thread. My hormone results came back yesterday and my progesterone was 30 something, perhaps almost 40, and the right level for men is below, I think, 1.9. I've been reactive, moody, and depressed, (I guess), so maybe its like I've got PMT?? Things though are not worse in the evenings for me. (after 2 scotches). My doctor could not explain how this could be and is having the test redone.
Declan
Posted by FredPotter on May 23, 2005, at 18:54:53
In reply to Re: Why are evenings worse?, posted by Declan on May 23, 2005, at 17:16:40
My evenings used to be free of anxiety in the evenings when I used to drink, but I can't do that anymore
Posted by Phillipa on May 23, 2005, at 19:09:51
In reply to Re: Why are evenings worse? » Declan, posted by FredPotter on May 23, 2005, at 18:54:53
Hey Fred, Mine too! Fondly, Phillipa
Posted by lola_prime on May 25, 2005, at 21:22:52
In reply to Re: Why are evenings worse? » FredPotter, posted by jerrympls on May 20, 2005, at 1:40:20
Fred and Jerry. I really appreciate your thoughts on loneliness. It's comforting for this 23-yr old hermit, who can't stop wallowing in depression, to hear. It's true, some things are essential--intimacy with other humans probably should be forced sometimes...I should go SOMEWHERE tonight. My friends don't call anymore, my f*cked-up self-damaging behavior has scared them off, or maybe I'm too much of a downer. Or maybe I'm overdramatizing. Yup. Most likely. Anyway, 7:30pm, the sun is going down. Time to rock out in the shower and go to the bookstore or something.
Posted by FredPotter on May 25, 2005, at 23:59:35
In reply to Re: Why are evenings worse?, posted by lola_prime on May 25, 2005, at 21:22:52
It sounds pathetic but I can get high just going to the supermarket. We could analyse it in terms of dopamine and opiates I expect, but "human contact" is shorter. And remember Lola, they need you as much as you need them
Fred
Posted by lola_prime on May 28, 2005, at 1:10:58
In reply to Re: Why are evenings worse?, posted by FredPotter on May 25, 2005, at 23:59:35
That's true, and easy to forget, that they need us too, we all need each other.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.