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Dr. Bob is Robert Hsiung, MD,
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Posted by silvercoin on August 10, 2006, at 16:38:44
In reply to Bipolar? Self diagnosis..., posted by jealibeanz on August 10, 2006, at 15:04:26
It's quite possible you might have just developed tolerance to the Lunesta. I also think this is a relatively poor drug for a depression patient to take for sleep, as GABA drugs have been linked to depression. I would suggest another course, perhaps trazodone or Seroquel for sleep. It doesn't really sound to me that you are BP.
Todd
Posted by jealibeanz on August 10, 2006, at 17:04:41
In reply to Re: Bipolar? Self diagnosis..., posted by silvercoin on August 10, 2006, at 16:38:44
You don't think so at all? What makes you say so? I've read that many unresponsive, chronic anxiety/depression patients are misdiagnosed, especially since there's now such a wide spectrum for BP consideration.
I'm definitely not hoping to be, no offense to those w/the disorder, since it requires lifelong treatment. However, I don't want to live in denial, ignoring some "red flags" that I've noticed.
The sleeping issue isn't normal. I don't feel like I should be able to function as well as I do. Also, people who are BP are prone to concurrent seasonal disorders, anxiety disorders, and ADHD. My initial onset of insomnia started when I can home from studying abroad. Can this be some sort of trigger?
I've actually heard my mother say one time I "cycle" about every 3 years. While I'm not sure about her accuracy with time intervals, an outsider's perspective of this occurence is noteworthy, especially since I don't really see that myself (I just notice the major depressions), which would be common to BP patients to block out or ignore such instances or patterns.
Posted by jealibeanz on August 10, 2006, at 17:40:09
In reply to Re: Bipolar? Self diagnosis..., posted by silvercoin on August 10, 2006, at 16:38:44
In my doc's defense, I don't have the formal diagnosis of depression at the moment, only anxiety/ADHD/insomnia. I did perviously develop a lack of response to Lunesta when I began taking Straterra. However, after going on Ambien for a week, then switching back to Lunesta, it worked better than ever.
Posted by Phillipa on August 10, 2006, at 18:29:54
In reply to Re: Bipolar? Self diagnosis..., posted by jealibeanz on August 10, 2006, at 17:40:09
Did you try switching the two again? Often someone close to you recognizes things others don't. Have you talked to you doc about the possiblilty. I could never feel well on 2-3 hours sleep. Love Phillipa
Posted by jealibeanz on August 10, 2006, at 19:27:01
In reply to Re: Bipolar? Self diagnosis... » jealibeanz, posted by Phillipa on August 10, 2006, at 18:29:54
I have tried Ambien again. I quickly remember why I didn't like it in the first place. I'm one of those who experienced the nightmares, weird actions during semi-awake states, sleepwalking, driving in the middle of the night, ect.
Haha, no I haven't mentioned this to my doc. I'm the one who keeps posting about not being able to breech the topic of depression. Now bipolar? Nope definitely don't know how to just yell that one out!
Besides, it's always a fleeting idea in my head, I'm not confident in it enough to bring it up even if I were comfortable with idea. I can easily be sure that I experience depression, but Bipolar is more ambiguous. It's much more difficult to grasp and diagnose, for me and doctors.
My physical is in a week! Ahhh!!! The only thing I'm really comfortable with is telling him the Lunesta doesn't work now. I'm due for a refill on the Straterra, but I probably need to confess that I stopped it for five days to see if I could sleep better. Since then my moods have been less stable, more crying, more depression. Ughhh... don't think I can do this! Why can't I just have a normal brain?!
However, I find out Monday whether or not I being allowed to stay in school. If I get asked to leave, there's no way I'm going to my doctor appointment because I will be way too embarrassed and ashamed to tell them I wasn't smart enough and couldn't handle school. I'll just end up going off all meds in that case and never seeing a doctor again. (crossing my fingers that I don't fail out!)
Posted by mayzee on August 10, 2006, at 21:56:02
In reply to Re: Bipolar? Self diagnosis..., posted by jealibeanz on August 10, 2006, at 19:27:01
Dear Jealibeanz,
Please,please,please ask your doctor for a referral to a pdoc that he knows & respects. Commit to finding a pdoc you can relate to and then commit to working with that pdoc to determine your diagnosis and treatment plan; knowing that the pdoc (*any* doc) can't do his/her best for you if you are not open & honest.
You sound very smart. It also sounds like you are torturing yourself with all the possible diagnoses and treatments that you so very capably determine. Please collaborate with a trained medical professional. I feel so strongly that you are doing yourself a disservice, thinking that you can't just walk into your doctor's office and tell him the truth about what you've been going through, and what you think might help. If he's the caring man you have portrayed, he won't freak out; you won't be letting him down. But he can't read your mind. Please write it down and mail it to him before your appointment. You can do it! You deserve good medical care! Please let yourself get it!
Crossing my fingers for you that all goes well with your staying in school,
Warm regards,
mayzee
Posted by Racer on August 10, 2006, at 22:42:41
In reply to Re: Bipolar? Self diagnosis..., posted by jealibeanz on August 10, 2006, at 17:04:41
> You don't think so at all? What makes you say so? I've read that many unresponsive, chronic anxiety/depression patients are misdiagnosed, especially since there's now such a wide spectrum for BP consideration.
I'd also say you don't sound bipolar to me. And there are a fair number of psychiatrists out there who don't believe that the new broadening of the bipolar spectrum is actually helpful -- some say that a lot of people with comorbid anxiety and depression are being put into a new category, without nearly enough evidence to support it.That said, what it sounds like to me is anxiety, not bipolar. Maybe OCD. You wanna know why I feel as though I can say that? Because I have done the same thing: "Oh no! Maybe this means I'm bipolar." It's taken up a lot of energy for me, and I've even brought it up with my T, in hopes she'd refer me for psychological testing. She didn't, said she never would, and that it's a manifestation of my anxiety/OCD. And that it was something better explored in therapy, rather than having testing done.
>
> The sleeping issue isn't normal. I don't feel like I should be able to function as well as I do. Also, people who are BP are prone to concurrent seasonal disorders, anxiety disorders, and ADHD. My initial onset of insomnia started when I can home from studying abroad. Can this be some sort of trigger?While all of that is true, as far as it goes, none of it means you're bipolar. Many people are prone to concurrent seasonal disorders, anxiety disorders, and ADHD. Guess what? Those are all part of my dx -- which is not bipolar. Sleeping too little and being able to get by with some coffee? That pretty well describes an awful lot of students in this world, many of whom are able to get pretty good marks.
Do I remember correctly that you also have a history of anorexia? That would certainly go far towards explaining the ability to get by with less sleep. It would also support the idea of OCD, you know...
Stopping Strattera made things worse? I found it a pretty friendly little A/D, for whatever that's worth. It might be worth trying it again.
>
>(I just notice the major depressions), which would be common to BP patients to block out or ignore such instances or patterns.Again -- it's also common that people with anxiety disorders who haven't yet started obsessing about whether they're bipolar... ;-)
I know, I'm teasing you. I remember very well how hard it is, though. Heck -- I called GG the other morning, on my way to school, with one of those obsessional "OMG! Do I have this? Or is it that?" questions. (GG is a great friend to have, and I'm very fortunate she likes me, too. Are you reading this?) It's horrible to feel that way, and it's hard for me to accept that this really is OCD, that it's really about anxiety, etc.
As for mood stabilizers, and A/Ds, and weight gain -- how long have you actually been on any one drug or combo? And were you actively eating disordered at that time? Those things will make a difference, you know.
I'm too tired to make any sense. I just wanted to tell you that I don't think you sound bipolar, that it's worth talking to your doctor, you're not alone, and to wish you luck.
Posted by Phillipa on August 10, 2006, at 22:49:08
In reply to Re: Bipolar? Self diagnosis..., posted by Racer on August 10, 2006, at 22:42:41
Racer for what it's worth I totally agree with you. That pdoc I had here tried to say that tx resistant depression was Bipolar and that there were new categories. Wonder what the new DSM will say? Will be interesting. Love Phillipa
Posted by jealibeanz on August 10, 2006, at 23:16:23
In reply to Re: Bipolar? Self diagnosis... » jealibeanz, posted by mayzee on August 10, 2006, at 21:56:02
I'm not really sure a pdoc is an option. I've been only to one, the one my insurance would cover. He was horrible. Made me feel worthless, incompetetent, and completely to blame for any unhappiness in my life. He told me I was perfectly fine and refused to help with any type of medication whatsoever.
So just my own doctor isn't OK? Do they at times treat tx resistent or bipolar patients? I do forget that others can't read my mind or know all my history without me telling them. He actually doesn't know I have recurrent episodes, which is significant. I just never thought to come out and say it because to me it's very apparent.
Posted by Phillipa on August 10, 2006, at 23:32:26
In reply to Re: Bipolar? Self diagnosis..., posted by jealibeanz on August 10, 2006, at 23:16:23
Write down notes so you don't forget anything. And I don't think a regular doc unless they're extremely good knows as much as a pdoc for treating tx resistant depression. But there are a lot of good docs out there. Love Phillipa
Posted by jealibeanz on August 10, 2006, at 23:33:30
In reply to Re: Bipolar? Self diagnosis..., posted by jealibeanz on August 10, 2006, at 17:04:41
That makes sense about OCD/anxiety like manifestation. While I don't think I have clinical OCD, I do get fixated on ideas, especially since this matter is a huge part of my life.
No,thankfully no history of anorexia (how does that translate to being able to get less sleep anyway?), I just happened to respond to one of the posters, and in curiosity followed a few of her posts to the eating board. My issues about weight are totally concerning the abnormal response my body has had to meds, otherwise I completely fine about my body/food when not on the topic of side effects of medication.
Like I said I stopped the Straterra for 5 days, meaning I'm back on it, for a couple of weeks now, which has just exacerbated my depression. I think I did notice a weird increase in anxiety the very first time I began it. Now it's hard to say b/c I'm used to that level. I don't know how much AD properties it has with me. Actually I think none at all.
I was only on Paxil and Buspar for 2-3 weeks each. Wellbutrin for 4 months. Effexor for 6-7 weeks.
BTW, it is my experience that anyone I've dealt with in the mental health field- psychiatrists, PHD's, psychologists, therapists, ect. are condescending, sketptical, and demeaning. They treat my like less than a person. Which is why is prefer my GP, who makes me feel like an equal who deserves to get better.
Posted by jealibeanz on August 10, 2006, at 23:35:26
In reply to Re: Bipolar? Self diagnosis... » jealibeanz, posted by Phillipa on August 10, 2006, at 23:32:26
Luckily it's a physical and not a recheck, so I have time. Yet i have a number of issues... depression, the insomnia, straterra. I always forget pertinent ideas, so writing things down is good, but I don't really want to be reading from a list.
Posted by Phillipa on August 10, 2006, at 23:35:59
In reply to Re: Bipolar? Self diagnosis..., posted by jealibeanz on August 10, 2006, at 23:33:30
Then that's who you should see. You have trust and that's important. Love phillipa
Posted by Racer on August 11, 2006, at 1:34:33
In reply to Re: Bipolar? Self diagnosis..., posted by jealibeanz on August 10, 2006, at 23:33:30
> I always forget pertinent ideas, so writing things down is good, but I don't really want to be reading from a list.
You wrote that to Phillipa, but it made me laugh: I have a spreadsheet that I take along if I see a new psychiatrist, with all the meds I've been on, how long, what results, what side effects, etc. Yeah, I know, I'm nuts, but your comment still made me laugh. Mostly at myself.
> That makes sense about OCD/anxiety like manifestation. While I don't think I have clinical OCD, I do get fixated on ideas, especially since this matter is a huge part of my life.
Yeah, and the fixation is a big part of the OCD stuff. (I'm too tired to write properly. If I get to "Whosamawhatsit," though, I'll stop and finish in the morning, I promise.) I wouldn't have thought I had it, although I knew that I was a little weird about some things. One day I was telling my T something, just as an aside, and she started laughing and said, "That's because you have OCD!" We've talked about it since then, and I guess it's fairly official, although it doesn't impair my life much. (Unless you count telephone calls to a friend for diagnostic consults...) Mostly, I get some sort of idea in my head that I can't really get out. Sometimes it's something silly but understandable -- I can't stand having sticky hands. Dirty hands? Yeah, I can kinda handle that, but sticky? Get the heck out of my way and hold that bathroom door -- I *need* to wash my hands. Sometimes it's something that used to be semi-adaptive, but no longer is -- used to be that an A reduced my anxiety, now I have huge anxiety about the possibility that I might NOT get an A. And sometimes it's just kinda stupid -- I've started taking some classes, and find I'm spending all too much time considering what classes I'll be taking next year, and what that means in terms of other classes I might take instead or as well as, and whether I should take class [x] next summer or wait until the fall term since summer classes are so intense or -- it's nothing more than energy being wasted. (Energy I could use to post here! lol) There's very little of what many people think OCD is about.
>
> No,thankfully no history of anorexia (how does that translate to being able to get less sleep anyway?),Sorry, I get confused about who's who sometimes. Part of anorexia is hyperactivity. Sometimes that means early wakening, or restless sleep, and then getting through the day with less sleep. (And good that you don't have that history.)
>
> I was only on Paxil and Buspar for 2-3 weeks each. Wellbutrin for 4 months. Effexor for 6-7 weeks.Other than the WB, that's not really long enough to know if anything would have worked. It's worth another try, especially of Lexapro or maybe Zoloft or Celexa. Paxil is actually the most anxiolytic, but if you had trouble with it, that's probably not a good one.
>
> BTW, it is my experience that anyone I've dealt with in the mental health field- psychiatrists, PHD's, psychologists, therapists, ect. are condescending, sketptical, and demeaning. They treat my like less than a person. Which is why is prefer my GP, who makes me feel like an equal who deserves to get better.
>
>
>Yeah, some of them can be [insert derogatory term/phrase here], but they do know more about medications than GPs do. And I wouldn't say you're treatment resistant, either. I think you posted that somewhere else. TRD generally means adequate trials at therapeutic doses of at least two classes of meds.
Good luck.
Posted by jealibeanz on August 11, 2006, at 4:20:55
In reply to Re: Bipolar? Self diagnosis..., posted by Racer on August 11, 2006, at 1:34:33
Well I can relate to your story about planning/worry about classes, ect. I'm overanalytical like that and do waste a lot of energy just worrying about everything and every possibility!
Yeah I know I haven't tried enough SSRI's, but one of the main reasons I stopped is because of the major weight gain with all of them(the reason for switching off Paxil/Buspar so soon). I know Wellbutrin shouldn't cause this, but it did. So I'm completely opposed to any medication with serotonin reuptake, no matter what the claims of potential side effects may be.
Too bad b/c everyone's answer to everything these days is SSRI's. There are so many to try, they can just keep throwing them out at you. I haven't experienced this with my doc actually, since I haven't pursued depression enough, but thats the way most practices run now.
Posted by SLS on August 11, 2006, at 6:14:51
In reply to Bipolar? Self diagnosis..., posted by jealibeanz on August 10, 2006, at 15:04:26
I would just add that there is a difference between reduced sleep and a reduced need for sleep. You do not function as well with the reduced sleep. People who are manic function just fine on 4 or less hours of sleep. They just don't need any more than that.
I tend to agree with the others. You don't appear to be bipolar. Perhaps there were periods of time in the past when your depression was less severe or in remission that you are now looking at with suspicion as being possibly manic episodes.
Your self-reporting is excellent.
- Scott
Posted by jealibeanz on August 11, 2006, at 7:03:14
In reply to Re: Bipolar? Self diagnosis... » jealibeanz, posted by SLS on August 11, 2006, at 6:14:51
Right, I don't function well on 2 hours of sleep. I can't even begin to measure the extent of my impairment, though. It's been sooo long since I regularly got 7-8 hours of sleep. When I read articles warning people that 6 hours isn't enough I just think-- wowww those 6 hour people don't know how good they have it!
This makes me feel a little better about not bringing up bipolar. I just wanted to make sure for myself that I truely wasn't ignoring a major issue, since it's something I've considered. I don't want to be kicking myself 10 yrs from now because I didn't get help.
Thanks, I guess! (about the self-reporting) I've been that by almost every doctor/counselor I've seen. (although not by my current one). I suppose I hold back way too much with him, despite the fact that I like him. I try to please him with the idea that all is well, or at least better than it really is.
My mother reminds me sometimes that I can't feel bad about bringing up my concerns, making appointments, or calling about prescriptions b/c I know they're busy. Other patients shouln't take priority, we're all equal. He's working for me and it's his job! I really don't know why I feel this way because when I'm in his office, with him or any employee, I'm treated like I'm the most important person evvver!
Posted by Jost on August 11, 2006, at 12:00:40
In reply to Re: Bipolar? Self diagnosis..., posted by jealibeanz on August 10, 2006, at 23:16:23
> I'm not really sure a pdoc is an option. I've been only to one, the one my insurance would cover. He was horrible. Made me feel worthless, incompetetent, and completely to blame for any unhappiness in my life. He told me I was perfectly fine and refused to help with any type of medication whatsoever.
>---That pdoc must have been unusual. Maybe of an old school, where pdocs were more therapists than writers of prescriptions.
If you go to most pdocs now, they see their primary role as evaluating appropriate medications, and I can't imagine any uptodate and competent one who would refuse to give you any AD at all, if you told him what you've written here.
> So just my own doctor isn't OK? Do they at times treat tx resistent or bipolar patients? I do forget that others can't read my mind or know all my history without me telling them. He actually doesn't know I have recurrent episodes, which is significant. I just never thought to come out and say it because to me it's very apparent.Jealibeanz,
---You say you trust the GP and he's caring and respectful, but you also say you can't bring yourself to tell him that you're depressed.
If it's hard to say that to him in person, what about sending an email, or, if not email, writing a short letter explaining your experiences, recurrent depressions, and current emotional state.
You've also said you're on good terms with other professionals in his office-- nurse, assistants, etc. Is there one of them whom you feel particularly trusting of? Maybe you could tell him/her and ask that they relay the information to the GP for you. (Or write an email, or letter, to him/her.)
Maybe if you turn it around, you'll feel a little better:
What if someone came to you, as a professional, with the problems that you've described: Wouldn't you want to help? You would be respectful and helpful.
Contrary to your expectations, that might be exactly how your GP, and others in his office will react.
Maybe take a couple of messages from this board, and send those, if you can't face writing the letter/email. Sometimes I put off writing hard emails, or letters-- but you've described how you feel very well, here.
Maybe time to take the next step in being able to do what you want in life. Step out of the self-analytic, self-questioning feedback loop that we all get stuck in, in a half self-protective,/half self-defeating way-- at times.
Jost
Posted by Racer on August 11, 2006, at 12:21:28
In reply to Re: Bipolar? Self diagnosis..., posted by jealibeanz on August 11, 2006, at 4:20:55
>
>
> Yeah I know I haven't tried enough SSRI's, but one of the main reasons I stopped is because of the major weight gain with all of them(the reason for switching off Paxil/Buspar so soon). I know Wellbutrin shouldn't cause this, but it did. So I'm completely opposed to any medication with serotonin reuptake, no matter what the claims of potential side effects may be.
>Buspar isn't an SSRI, and Paxil is the SSRI most known for weight gain. Have you had any trials lasting two months or more of any other SSRIs?
Also, Wellbutrin is not serotonergic.
I'm sorry you're struggling so much. I'm also sorry to say that I need to back out of this thread, because it's beginning to upset me enough I'm afraid I'll write something inappropriate.
Good luck.
Posted by jealibeanz on August 11, 2006, at 14:28:14
In reply to Re: Bipolar? Self diagnosis... » jealibeanz, posted by Racer on August 11, 2006, at 12:21:28
Upset? About something I wrote? Sorry if I offended you. I definitely mean no harm and apologize if I unknowingly stepped on your toes.
Yeah, I know Buspar isn't an SSRI. Neither is Wellbutrin SR (but not regular), however, it <may> have some modification on the rate of serotonin release, it's just not that main intent of the drug. I can actually say that I believe it did on me due to the well know serotonin-induced apathetic feeling I had while on it. I say that I don't want an SSRI because that's about all that's left of the "safe" medications, since I've already taken the alternative "safe" drugs (Effexor, Buspar, Wellbutrin).
Posted by jealibeanz on August 11, 2006, at 14:35:17
In reply to Re: Bipolar? Self diagnosis..., posted by Jost on August 11, 2006, at 12:00:40
You know what he was actually a fairly young pdoc, definitely not old school, but seemed totally against medications for the majority of people who experience depression or anxiety. Weird.
Yes, you're right I do need to make that next plunge and talk to my doctor! I just like to overanalyze first!:) It does make me feel a little more apt to bring up the subject when I am more active in discussions such as this though. I feel a little more normal.
Seeing stats about the percentages of people who every day go to their physician for mental health is quite a wake up call. You walk around thinking everyone you run in to in public is perfectly healthy and happy. I suppose we all just like to give that impression.
In some ways it seems like I shouldn't be dwelling by researching and interacting with other people with problems. But if I were to ignore these resources on the internet I would never have known about the possibility of getting help and what options exist.
Posted by nickguy on August 11, 2006, at 17:41:43
In reply to Re: Bipolar? Self diagnosis... » jealibeanz, posted by Racer on August 11, 2006, at 12:21:28
> I'm sorry you're struggling so much. I'm also sorry to say that I need to back out of this thread, because it's beginning to upset me enough I'm afraid I'll write something inappropriate.
>
> Good luck.
I think what he meant is that your situation is getting frustrating even for other people. You've written so many threads talking about how your depressed and you love your GP but won't tell him. I think people just want you to get on with it already ( I don't mean that in an offensive manner, it's just that it's either one way or the other...tell him or talk to a different PDOC ((there are some great, friendly, non-condescending ones out there)) or stop asking for ways to get help.
Posted by jealibeanz on August 11, 2006, at 19:21:59
In reply to Re: Bipolar? Self diagnosis..., posted by nickguy on August 11, 2006, at 17:41:43
Well, yes, I'm am offended that people don't like that I've had a lot of posts recently. This is not directed at you, Nickguy. If you look at the boards at any given period of time, they are always dominated by a select few people, often in small spurts of a matter of weeks, who are going through an unusually difficult time or having acute problems with illness or medication. I've never seen any complaints about this happening in the past, even though it's very apparent that it occurs.
There's the option of not reading certain member's post, which I do from time to time when a particular person has been posting an unusual amount. I always respected this board for the large wealth or knowledge and treatment options presented by its members, however, I clearly am not welcome any longer. Hopefully nobody else who needs help and support will be made to feel uncomfortable... Signing off...
Posted by Phillipa on August 11, 2006, at 20:00:02
In reply to Re: Bipolar? Self diagnosis..., posted by Racer on August 11, 2006, at 1:34:33
Racer seems like we're similar. I hate dirt on my hands and just won't put them in dirt. But my understanding was you consistently washed your hands for no reason for it to be OCD? Well I also add up license plates and assign a number as to where they appear in the alphabet to the letters and add them all together. Do you pick you cuticles too? And when in school or even not that I'm not in school I drive my husband nuts changing from one thing to the other . Almost like thinking outloud. So luvox maybe helps it. But most of the time when I preform this ritualistic behavior is to relieve anxiety. Doesn't always work but sometimes it does. And I used to keep daily notes of the times I took my meds, what I did that day, and how I felt. I threw them away when we moved. I had a stack of around l5 legal pads. But Jost Maybe just write down the most important things? And I just don't know about which type of doc is better. It depends on whether they read journals and keep up on meds. I know a pdoc only does med checks for around l0minutes after the first time. That's my experience and sometimes a good GP will spend more time. You could always see both? Love Phillipa
Posted by Phillipa on August 11, 2006, at 20:01:38
In reply to Re: Bipolar? Self diagnosis... » Racer, posted by Phillipa on August 11, 2006, at 20:00:02
Sorry that was to jealibenz sp? Sorry Love Phillipa
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