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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 blueberry1 on February 4, 2007, at 6:31:56
Just found out I am so in debt cannot see a psychiatrist. Even if I could, there are no good ones in my State. Must stick with $45/hour nurse practioner. Who probably, along with me, could use some diagnosis help. YOU make the diagnosis. Let me know what you think. You all are smart.
Family history. Great great grandmother had severe depression treated with insulin shock therapy which eventually killed her. Grandmother had a 7 year postpartum depression. No others in the family seem to have had any probs.
Hypomania? I think so, not sure. Example. When younger I got into fast cars. Skipped entire semesters of college to just build engines and race. I was consumed by it. Not sure if just pure passion for it or whether it was excessive behavior. As I look back, it does seem quite irresponsible and excessive. Example. Bedroom needed a lot of work. Old dilapidated walls and ceiling. With lots of enthusiasm I ripped out all the walls and ceiling, brought in new material and redid the whole room. The problem was that near the finish, all the enthusiasm and energy was gone. I barely was able to force myself to finish. Started feeling very alone, insecure, and...doc said depressed. That began my medication journey.
Depression? All through childhood. At child summer camp counselors would pull me aside to ask what was wrong. I didn't know anything was wrong. They said I looked sad all the time. I thought I enjoyed activities but actually I didn't much. In teens a girlfriend left me. Plunged into a severe crying depression that lasted months. More than what would be expected from a breakup. It lifted as I got into new lovers and race cars. Parents moved me to Hawaii years later. Imagine, totally depressed, withdrawn, unable to experience pleasure, in paradise of all places.
Marriage. Spouse took a job for the first time. I found myself very insecure, jealous, paranoid, absolutely positive spouse would have an affair and fall in love with someone else. Totally unfounded. Marriage is actually one of the best one could ever hope for. Went to counseling for 6 months. Discovered the core problem...abandonment. Was literally abandoned as an infant and up to age 2. In my bones. Counseling did not help. Counselor eventually said it was a chemical imbalance and I needed to see a doctor.
Paxil worked ok for a year. 6 months after stopping it, bad shape again...depressed, insecure, abandoned, fearful. Next decade was prozac+zyprexa. Decent years. The usual ssri blahness flatness. At about 8 years started getting strange new symptoms...upon waking there was a totally engulfing feeling of dread and of butterflies in the stomach. It would go away in about 2 hours and then the day was fairly ok. Horrible way to wake up day after day. Over time zyprexa and prozac were dropped, replaced with many other things, most of which made me WORSE.
Best combos in the last two years:
20mg prozac+5mg zyprexa (except for that terrifying way to wake up...I wonder what it was and what could have treated it).
25mg zoloft + 500mg depakote + 2.5mg zyprexa. Decent, very little depression, very little anxiety, no morning dread or butterflies, just overall very blah and flat, no interest.Now. Quite depressed with anxiety. While on cymbalta those paranoid jealous feelings of spouse falling in love with someone else have returned. Again, totally unfounded.
I couldn't venture a diagnosis. As I look at descriptions of different things, I would say it is Bipolar II but also some Borderline Personality Disorder, Major Depression, Anxiety, and something in the Schizoaffective vein...where does that unfounded paranoia come from? And why did cymbalta spark it?
Am thinking of returning to one of the med cocktails mentioned above. Probably the zoloft/depkote/zyprexa one. Just get to a place of stableness and blahness and then go from there.
Sorry so long. What are your thoughts?
Posted by Squiggles on February 4, 2007, at 7:58:00
In reply to Help With Diagnosis (long), posted by blueberry1 on February 4, 2007, at 6:31:56
I agree with you that bipolar is a possibility.
Whatever the psychological state, matching the
right drug with it, is the bottom line. Some aspects of your experiences in life suggest mania and depression. But these two states can come with a variety of diagnostic categories. Have you tried any mood stabilizers? Mood stabilizers are good for targeting both anxiety and depression.Squiggles
Posted by Phillipa on February 4, 2007, at 12:00:44
In reply to Re: Help With Diagnosis (long), posted by Squiggles on February 4, 2007, at 7:58:00
Trileptal? just been prscribed for me but haven't started as the luvox upping it is depressing me and upping my anxiety which it didn't used to do. Love Phillipa
Posted by chiron on February 4, 2007, at 15:22:41
In reply to Re: Help With Diagnosis (long), posted by Phillipa on February 4, 2007, at 12:00:44
Sorry for your pain. This pain sucks.
My unprofessional opinion would be to go back to what has been the most helpful so far as a starting point.Question about Depakote - I just started it two days ago & am sooo tired. Did it have this affect on you & did it go away?
Have you tried Topamax? If there are any more drugs you have tried, list them out along with your reactions.
Posted by UgottaHaveHope on February 4, 2007, at 16:34:39
In reply to Re: Help With Diagnosis (long), posted by chiron on February 4, 2007, at 15:22:41
Blueberry: I am sorry you are not doing well at the present moment. My heart goes out to you after reading your story, sounds like you have been through a lot of pain. It's such a bummer that things which affected you as a child, when you had virtually no control over the situation, come back on you decades later.
Have you tried any of the MAOIs? I think you have but I am not sure. If not, one of those combos would at least stabalize you. Have you ever had any extensive therapy? Thats hard to do if you are not calmed down. Thoughts and prayers go out to you, Michael
Posted by polarbear206 on February 5, 2007, at 10:49:23
In reply to Help With Diagnosis (long), posted by blueberry1 on February 4, 2007, at 6:31:56
> Just found out I am so in debt cannot see a psychiatrist. Even if I could, there are no good ones in my State. Must stick with $45/hour nurse practioner. Who probably, along with me, could use some diagnosis help. YOU make the diagnosis. Let me know what you think. You all are smart.
>
> Family history. Great great grandmother had severe depression treated with insulin shock therapy which eventually killed her. Grandmother had a 7 year postpartum depression. No others in the family seem to have had any probs.
>
> Hypomania? I think so, not sure. Example. When younger I got into fast cars. Skipped entire semesters of college to just build engines and race. I was consumed by it. Not sure if just pure passion for it or whether it was excessive behavior. As I look back, it does seem quite irresponsible and excessive. Example. Bedroom needed a lot of work. Old dilapidated walls and ceiling. With lots of enthusiasm I ripped out all the walls and ceiling, brought in new material and redid the whole room. The problem was that near the finish, all the enthusiasm and energy was gone. I barely was able to force myself to finish. Started feeling very alone, insecure, and...doc said depressed. That began my medication journey.
>
> Depression? All through childhood. At child summer camp counselors would pull me aside to ask what was wrong. I didn't know anything was wrong. They said I looked sad all the time. I thought I enjoyed activities but actually I didn't much. In teens a girlfriend left me. Plunged into a severe crying depression that lasted months. More than what would be expected from a breakup. It lifted as I got into new lovers and race cars. Parents moved me to Hawaii years later. Imagine, totally depressed, withdrawn, unable to experience pleasure, in paradise of all places.
>
> Marriage. Spouse took a job for the first time. I found myself very insecure, jealous, paranoid, absolutely positive spouse would have an affair and fall in love with someone else. Totally unfounded. Marriage is actually one of the best one could ever hope for. Went to counseling for 6 months. Discovered the core problem...abandonment. Was literally abandoned as an infant and up to age 2. In my bones. Counseling did not help. Counselor eventually said it was a chemical imbalance and I needed to see a doctor.
>
> Paxil worked ok for a year. 6 months after stopping it, bad shape again...depressed, insecure, abandoned, fearful. Next decade was prozac+zyprexa. Decent years. The usual ssri blahness flatness. At about 8 years started getting strange new symptoms...upon waking there was a totally engulfing feeling of dread and of butterflies in the stomach. It would go away in about 2 hours and then the day was fairly ok. Horrible way to wake up day after day. Over time zyprexa and prozac were dropped, replaced with many other things, most of which made me WORSE.
>
> Best combos in the last two years:
> 20mg prozac+5mg zyprexa (except for that terrifying way to wake up...I wonder what it was and what could have treated it).
> 25mg zoloft + 500mg depakote + 2.5mg zyprexa. Decent, very little depression, very little anxiety, no morning dread or butterflies, just overall very blah and flat, no interest.
>
> Now. Quite depressed with anxiety. While on cymbalta those paranoid jealous feelings of spouse falling in love with someone else have returned. Again, totally unfounded.
>
> I couldn't venture a diagnosis. As I look at descriptions of different things, I would say it is Bipolar II but also some Borderline Personality Disorder, Major Depression, Anxiety, and something in the Schizoaffective vein...where does that unfounded paranoia come from? And why did cymbalta spark it?
>
> Am thinking of returning to one of the med cocktails mentioned above. Probably the zoloft/depkote/zyprexa one. Just get to a place of stableness and blahness and then go from there.
>
> Sorry so long. What are your thoughts?Blueberry,
We have several things in common. My GG was placed in a mental institution after the birth of her 3rd child. She was there the rest of her life. I didn't learn about this until after my PPD. Family didn't talk about it. Everything was kept hush,hush. I felt a great sense of relief after my mom told me. So the history was there. I am the only one in my immediate family with depression. My brother went through a serious situational depression after a rough divorce, and required medication for a year. In childhood, I can remember having periods of feeling blue, esp. in the winter months. Went through depression when my high school sweetheart broke up with me. I have a long list of starting projects with great enthusiasm and not finishing. Early childhood symptoms are a red flag for bipolar depression. You definitely seem to have some BPD too. I also experienced chronic thoughts of past difficult events when depession was uncontrolled. This is a very common thing with depression. I'm so sorry about what all you have gone through. If I won the lottery, you would be on my list. The poster above mentioned an MAOI. Nardil with a mood stabilizer has a good track record for situations like yours.
Posted by polarbear206 on February 5, 2007, at 11:13:40
In reply to Re: Help With Diagnosis (long), posted by polarbear206 on February 5, 2007, at 10:49:23
> > Just found out I am so in debt cannot see a psychiatrist. Even if I could, there are no good ones in my State. Must stick with $45/hour nurse practioner. Who probably, along with me, could use some diagnosis help. YOU make the diagnosis. Let me know what you think. You all are smart.
> >
> > Family history. Great great grandmother had severe depression treated with insulin shock therapy which eventually killed her. Grandmother had a 7 year postpartum depression. No others in the family seem to have had any probs.
> >
> > Hypomania? I think so, not sure. Example. When younger I got into fast cars. Skipped entire semesters of college to just build engines and race. I was consumed by it. Not sure if just pure passion for it or whether it was excessive behavior. As I look back, it does seem quite irresponsible and excessive. Example. Bedroom needed a lot of work. Old dilapidated walls and ceiling. With lots of enthusiasm I ripped out all the walls and ceiling, brought in new material and redid the whole room. The problem was that near the finish, all the enthusiasm and energy was gone. I barely was able to force myself to finish. Started feeling very alone, insecure, and...doc said depressed. That began my medication journey.
> >
> > Depression? All through childhood. At child summer camp counselors would pull me aside to ask what was wrong. I didn't know anything was wrong. They said I looked sad all the time. I thought I enjoyed activities but actually I didn't much. In teens a girlfriend left me. Plunged into a severe crying depression that lasted months. More than what would be expected from a breakup. It lifted as I got into new lovers and race cars. Parents moved me to Hawaii years later. Imagine, totally depressed, withdrawn, unable to experience pleasure, in paradise of all places.
> >
> > Marriage. Spouse took a job for the first time. I found myself very insecure, jealous, paranoid, absolutely positive spouse would have an affair and fall in love with someone else. Totally unfounded. Marriage is actually one of the best one could ever hope for. Went to counseling for 6 months. Discovered the core problem...abandonment. Was literally abandoned as an infant and up to age 2. In my bones. Counseling did not help. Counselor eventually said it was a chemical imbalance and I needed to see a doctor.
> >
> > Paxil worked ok for a year. 6 months after stopping it, bad shape again...depressed, insecure, abandoned, fearful. Next decade was prozac+zyprexa. Decent years. The usual ssri blahness flatness. At about 8 years started getting strange new symptoms...upon waking there was a totally engulfing feeling of dread and of butterflies in the stomach. It would go away in about 2 hours and then the day was fairly ok. Horrible way to wake up day after day. Over time zyprexa and prozac were dropped, replaced with many other things, most of which made me WORSE.
> >
> > Best combos in the last two years:
> > 20mg prozac+5mg zyprexa (except for that terrifying way to wake up...I wonder what it was and what could have treated it).
> > 25mg zoloft + 500mg depakote + 2.5mg zyprexa. Decent, very little depression, very little anxiety, no morning dread or butterflies, just overall very blah and flat, no interest.
> >
> > Now. Quite depressed with anxiety. While on cymbalta those paranoid jealous feelings of spouse falling in love with someone else have returned. Again, totally unfounded.
> >
> > I couldn't venture a diagnosis. As I look at descriptions of different things, I would say it is Bipolar II but also some Borderline Personality Disorder, Major Depression, Anxiety, and something in the Schizoaffective vein...where does that unfounded paranoia come from? And why did cymbalta spark it?
> >
> > Am thinking of returning to one of the med cocktails mentioned above. Probably the zoloft/depkote/zyprexa one. Just get to a place of stableness and blahness and then go from there.
> >
> > Sorry so long. What are your thoughts?
>
> Blueberry,
>
> We have several things in common. My GG was placed in a mental institution after the birth of her 3rd child. She was there the rest of her life. I didn't learn about this until after my PPD. Family didn't talk about it. Everything was kept hush,hush. I felt a great sense of relief after my mom told me. So the history was there. I am the only one in my immediate family with depression. My brother went through a serious situational depression after a rough divorce, and required medication for a year. In childhood, I can remember having periods of feeling blue, esp. in the winter months. Went through depression when my high school sweetheart broke up with me. I have a long list of starting projects with great enthusiasm and not finishing. Early childhood symptoms are a red flag for bipolar depression. You definitely seem to have some BPD too. I also experienced chronic thoughts of past difficult events when depession was uncontrolled. This is a very common thing with depression. I'm so sorry about what all you have gone through. If I won the lottery, you would be on my list. The poster above mentioned an MAOI. Nardil with a mood stabilizer has a good track record for situations like yours.
Blueberrycheck this out.
Posted by blueberry1 on February 5, 2007, at 18:45:07
In reply to Re: Help With Diagnosis (long), posted by polarbear206 on February 5, 2007, at 11:13:40
Excellent link you provided. I saw lots of me in that stuff.
Strange too, how earlier in this thread I said I did best with prozac+zyprexa, or with zoloft+depakote+zyprexa. So what were the preferred treatents for symptoms like mine? SSri+antipsychotic+mood stabilizer.
Hmmm.
What surprised me though was that he starts with the ssri and adds the others on as needed. I thought it would be the other way around.
Posted by elanor roosevelt on February 7, 2007, at 22:08:43
In reply to Re: Help With Diagnosis (long) » polarbear206, posted by blueberry1 on February 5, 2007, at 18:45:07
i tried to take a class in attachment theory and only was able to get through one session as i knew it would be too painful
Blueberry,
when a newborn is laying in a crib with nobody around and that baby is wet or hungry or lonely and cries and is picked up by a loving person with a soothing voice who will care for those needs, the infant is learning that needs can be met and life is good
however, if you are left to cry you are alone in the universe and develop expectations for disappointment -- you do not expect your needs to be met by the people in your life
this affects your loving and intimate relationships because you are pretty sure you don't deserve to be taken care ofYou do deserve to be loved and cared for.
Please find a way to believe that.
My best wishes for you
Posted by Phillipa on February 7, 2007, at 22:24:14
In reply to Re: Help With Diagnosis (long), posted by elanor roosevelt on February 7, 2007, at 22:08:43
Eleanor sounds like what my real first pdoc said about me that if a baby drops something and the Mother goes around the corner and child can no longer see her she thinks she's been abandoned. Mealanie Klein. Supposedly my fear of being alone. Love Phillipa
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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