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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Fivefires on April 14, 2008, at 11:46:27
Well ... I've never had this as a diagnosis, though maybe should have many years ago. Now has it become typical? I mean, it's not just about bad incidents anymore. I think it's changed me; my brain chemistry, as bad incidents seem to be chronic in my life. My two support peeps just ditched me, even knowing I very well may fall through the cracks of poverty in this mental health system. Lithium? Nardil? No $ for alternatives. I'm spiraling downward at a high rate of speed since lost my support peeps; told me last night to go to a hospital or something. This is the absolute worst I've ever felt, w/ exception of father passing away 4yrs ago. My own fam' is letting go of me. I wouldn't let go of them. One said she'd never let go, but she did ... last night. Her marriage I think was the reason. Usually it is $, but I think hers was for her husband.
lifelessw/olove, 5f
Posted by Phillipa on April 14, 2008, at 12:52:13
In reply to Atypical depression is now a chemical imbalance?, posted by Fivefires on April 14, 2008, at 11:46:27
Not sure but sleeping a lot is one symtoms and I think eating a lot although not sure on that. I hope someone post the true definition. I'd like to know too. So sorry about family. Love Phillipa
Posted by Phillipa on April 14, 2008, at 13:00:22
In reply to Re: Atypical depression is now a chemical imbalance? » Fivefires, posted by Phillipa on April 14, 2008, at 12:52:13
FF maybe this will help Love Phillipa
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Psychiatric News October 17, 2003
Volume 38 Number 20
© 2003 American Psychiatric Association
p. 20--------------------------------------------------------------------------------
Clinical & Research News
Atypical Depression: Whats in a Name?
Mark Moran
The existence of a subgroup of atypical depressed patientsdistinguishable in terms of symptoms, drug response, and possibly even underlying neurobiologysuggests that "depression" is less a disease than a description, encompassing a variety of subtypes.Twenty-five years ago a depressed patient told researchers at Columbia University College of Physicians and Surgeons, "You know those people who run around the park with lead weights? I feel like that all the time. I feel so heavy and leaden [that] I cant get out of a chair."
The statement graphically portrayed a symptom peculiar to a subset of depressed patients first described by English psychiatrists a generation earlier as "atypical." The Columbia researchers, seeking to define the group more rigorously, incorporated that symptomwhich they called "leaden paralysis"into the criteria that currently serve as the basis for a diagnosis of "depression with atypical features."
That diagnosis depends on the presence of "mood reactivity"depressed mood that can brighten readily at a positive turn of eventsin conjunction with any two of the following: hypersomnia, hyperphagia, leaden paralysis, and interpersonal rejection sensitivity.
But while experts agree that the definition roughly describes a subgroup of people who are different from those with classic melancholic depression, much about the description, including the centrality of mood reactivity, is debated.
Even researchers involved in developing the original Columbia University criteria agree that the diagnosis requires refinement.
"There is something out there that we can call atypical depression, but the problem is that the DSM criteria are too broad," said Jonathan Stewart, M.D., a professor of clinical psychiatry at Columbia and a research psychiatrist at the New York State Psychiatric Institute.
"Its clear to me that even though it captures most of the people who have the disorderwhatever it isit probably captures a lot who have something else."
Not Like Melancholic Depression
As Stewart recounted, almost 50 years ago the English psychiatrists West and Dally first described a subset of patients who were depressed but whose clinical symptoms differed from those of classic melancholic depression. Moreover, while this group did not respond to tricyclic antidepressants, it did respond to monoamine oxidase inhibitors (MAOIs).
Stewart said the Columbia research in the 1980s confirmed the latter, identifying a group of depressed patients who preferentially responded to the MAOI phenelzine sulfate. The treatment studies also validated criteria for atypical depression that originated with published observations by the English group and by the American Donald F. Klein, M.D., with reactivity of mood as the basic distinguishing characteristic.
"If you are depressed and something nice happens, you feel better for a while," Stewart explained. "In contrast, the quintessential melancholic is an emotional rock. The melancholic is not going to have any reaction at all."
Stewart and colleagues also found the opposite to be true of the patients with atypical depressionthat they had an extreme reaction to negative events, particularly interpersonal rejection that others might just brush off. In contrast to the insomnia and loss of appetite usually seen in patients with melancholic depression, the patients with atypical depression were prone to overeating and oversleeping.
Since the development of the Columbia criteria, however, the uncertainty about how exactly to characterize these patients has become apparent, with some researchers and clinicians emphasizing some aspects over others.
Linda Carpenter, M.D.: "As we learn more about the biology of depressionnot just the phenomenology, but the biological markerswe will be able to lump less and split more."
"The original criteria were adopted on the basis of nonresponse to tricyclic antidepressants, not on the basis of a biological or genetic finding," said Linda Carpenter, M.D., chief of the mood disorders program at Butler Hospital in Providence, R.I., and an assistant professor of psychiatry at Brown University School of Medicine.In this way, she said, people with atypical depression are a subgroup that has been defined by researchersand the definition is still in the making. Carpenter added that the picture is complicated by the fact that patients with bipolar disorder, anxious depression, and personality disorders share some of the features of atypical depression.
So, even a reasonable estimate of prevalence is elusive, depending on what criteria are used to identify the atypical patient.
"The term atypical depression makes it sound like some rare thing," said Frederick E. Miller, M.D., Ph.D., chair of the department of psychiatry at Evanston Northwestern Healthcare in Evanston, Ill.
"Of the patients I see, its a common minority, depending on how much you stress the requirements in the DSM criteria. But it is not uncommon to see someone whose chief complaint is lethargy, who says [he or she] can sleep a thousand hours, but who also doesnt eat a lot.
"Are we making rational distinctions?" Miller wonders. "Or are we just sort of splitting certain symptoms that are part of a more general condition?"
Reverse Vegetative Symptoms Give Clue
A recent analysis of depressed patients with atypical features emphasizing the reverse vegetative symptomsovereating and oversleepingsuggest that those two symptoms alone might serve as important markers of atypical depression for primary care physicians who might not otherwise look for the disorder.
The study, appearing in the September Archives of General Psychiatry, used the two symptoms to identify 836 patients with major depression, 304 of whom had atypical features and 532 who did not, in the National Comorbidity Survey.
Study author Louis S. Matza, Ph.D., told Psychiatric News that the analysis suggests that the simpler criteria emphasizing overeating and oversleeping could be readily used by primary care physicians to identify depressed patients who are liable to have a different clinical course and possibly a different response to treatment.
He noted that the study found that the patients who fit the criteria had an earlier onset of illness. They also reported higher rates of depressive symptoms, suicidal thoughts and attempts, psychiatric comorbidity, drug dependence, and a history of paternal depression, childhood neglect, and sexual abuse.
Matza is with MEDTAP International of Bethesda, Md. MEDTAP is a research organization specializing in health outcomes research.
Stewart, a co-author of the study, noted that the earlier age of onset found among the patients identified by the NCS is "exactly what we see in patients with atypical depression as diagnosed according to the full DSM-IV criteria."
Experts React
Experts who reviewed the study for Psychiatric News found compelling the use of the reverse vegetative symptoms to identify atypical depression in such a large national sample.
Carpenter agreed that hypersomnia and hyperphagia are prominent. "A person with atypical depression is usually slowed down, as opposed to agitated and moving around a lot," she said. "They will tell you they are oversleeping and overeatingthat is sort of a classic characteristic. If you had to say what jumps out when you see these patients, that would be it."
But she and others expressed surprise, and some skepticism, about the finding of an increased-risk profile for suicide and comorbid psychiatric disorders among people with atypical depression.
"There have been plenty of typically melancholic depressed patients who are significantly ill," said Mark Frye, M.D., director of the bipolar research program at the University of California, Los Angeles. "The idea that [atypical patients] have more drug use is remarkable as well. I am not sure I have seen that. It makes me think that many of these patients are covert bipolars."
Miller, too, expressed surprise at the finding andunderscoring the complicated picture of atypical depressionwondered whether the increased risk found among the sample could reflect the confluence of personality disorders.
All the clinicians interviewed by Psychiatric News agreed that reverse vegetative symptoms cannot be used as criteria to start patients on MAOIs as a first-line treatment.
"Why force someone into following an MAOI regimen with its side-effect problems until you have demonstrated that less problematic treatments are not going to work?," Stewart asked.
Distinct Biological Disorder?
Stewart told Psychiatric News that he and colleagues have refined their definition of atypical depression, focusing on early onset and chronic course as critical features.
"If you sort the patients who meet the criteria [for atypical depression] into those who have early-onset chronic illness and those who have later-onset or nonchronic illness, those two groups look entirely different," he said.
Moreover, the "true" atypical patients with early onset and chronic course differ from both late-onset nonchronic patients and from patients with classic melancholic depression on cortisol testing and auditory perceptual processing, as well as on their response to tricyclic antidepressants.
"The patients with melancholic depression and late-onset atypical depression lie on the same side of normal controls on cortisol testing and perceptual processing, while these early-onset chronic patients lie on the opposite side of normal controls," Stewart said. "This demonstrates to me that they have biologically different disorders. It argues against the notion of depression as a continuum and in favor of the idea that these categorical distinctions make some sense, that they are biologically distinct disorders."
More generally, experts said, the stubborn existence of a subgroup of atypical depressed patientsdistinguishable in terms of symptoms, drug response, and possibly even underlying neurobiologypoints to the possibility that "depression" itself is less a disease than a description, encompassing a variety of subtypes.
"As we learn more about the biology of depressionnot just the phenomenology, but the biological markerswe will be able to lump less and split more," Carpenter said. "The nosology will reflect more subtypes as we have greater understanding of the biological, genetic, and psychosocial contributions."
An abstract of the study, "Depression With Atypical Features in the National Comorbidity Survey: Classification, Description, and Consequences," is posted on the Web at http://archpsyc.ama-assn.org/cgi/content/abstract/60/8/817?.
Arch Gen Psychiatry 2003 60 817[Abstract/Free Full Text]
Posted by Phillipa on April 14, 2008, at 13:01:48
In reply to Re: Atypical depression is now a chemical imbalance?, posted by Phillipa on April 14, 2008, at 13:00:22
Have to scroll down til study don't know why. Phillipa
Posted by dbc on April 14, 2008, at 14:55:00
In reply to Re: Atypical depression is now a chemical imbalance?, posted by Phillipa on April 14, 2008, at 13:01:48
Whats a chemical imbalance? Theres no such thing as neurotypical brains. Mental illness is just an umbrella statement that means someone who's functionality is impaired by a psychiatric/psychological problem.
Posted by Phillipa on April 14, 2008, at 19:00:40
In reply to Re: Atypical depression is now a chemical imbalanc, posted by dbc on April 14, 2008, at 14:55:00
DCB I like your description. Seriously. Phillipa
Posted by Fivefires on April 14, 2008, at 19:36:52
In reply to Re: Atypical depression is now a chemical imbalanc, posted by dbc on April 14, 2008, at 14:55:00
Why do you say this dbc?
You know there is such a thing as a chemical imbalance, right?
I think it is sarcasm you are using in the statement re: no such thing as neurotypical brains. Am I correct? Pls explain.
I'm going downhill quickly and have no one to lend a hand in any way.
The support I had from family has just been withdrawn.
I have no IRL peer support.
I've been on everything BUT an MAOI w/ little success. I mostly have had worsening of my problem in the form of exacerbation of anxiety, which then causes me to feel more depressed re: the inability to interact socially and take care of the NADLs.
I lie in bed a lot, and, 'I do feel like dead weight as I lie there; like I am very heavy', but only weigh 110lbs.
I can snap right out of feeling depressed when something positive occurs in my life.
I can't say I overeat. Part of this is being unable to afford to overeat. If I had a bag of Mothe*'s Taff& cookies right now, I'd probably mow down a row of 'em.
Appreciate if you would respond dbc, and tks to Phillipa as well.
5f
Posted by Phillipa on April 14, 2008, at 20:25:00
In reply to Re: Atypical depression is now a chemical imbalanc, posted by Fivefires on April 14, 2008, at 19:36:52
Maybe because there is no way to accurately measure that or a test to say what med may work? Not sure but don't feel it was sarcasm. How do you measure brain serotonin, norepenephrine, dopamine, or the other host of neurotransmitters? Now there is another google question be back. Phillipa
Posted by Phillipa on April 14, 2008, at 20:36:06
In reply to Re: Atypical depression is now a chemical imbalanc » Fivefires, posted by Phillipa on April 14, 2008, at 20:25:00
Quick search heres one theory. Love Phillipa
Biology and Mental Illness
The most honest answer to this questions is "No one really knows for sure." However, this is not an answer your apt to hear very often. On this page, I'll briefly discuss both sides of the issue. First, let me talk briefly about the relationship between biology, mental illness, and emotions.Biology, Mental Illness, and the Emotions
Most emotional states occur in connection with certain processes in the brain which can be measured in terms of electrical activity and the presence of certain chemicals. For example, when a person is depressed, we can predict that there are lower levels of a neurotransmitter called Serotonin in the brain. We also can predict that increasing the level of serotonin in the brain will decrease the emotions related to depression. Similarly, we can predict many other activities occurring in the brain based on different emotions or mental illness diagnoses.
What this tells us is that there is a correlation between what is occurring in our brain and our conscious experience. This does not necessarily tell us anything about the cause of this pattern.
The Case for a Biological Bases of Mental Illness
Based on what is stated above, it seems quite obvious why many people would say that mental illness is biologically based. If by examining what is occurring in the brain we can predict a person's experience with a high degree of accuracy, it seems logical to assume that biology is the cause of these experiences. Additionally, research has suggested that people with a family history of mental illness are more likely to have the same or a similar mental illness. This appears to suggest that mental illness has its roots in genetics and biology. But let's take a look at the other side of the story...
Alternative Views on Mental Illness
One of the first things that you'll learn if you take a research class is that correlation doesn't mean causation. In other words, just because two things routinely occur together does mean one is causing the other. Let's take an absurd example to illustrate this point. Imagine that every time it snows outside you have difficulty sleeping because its too warm in your bed. Does this mean that snow outside causes your bed to be warm? Obviously the answer is "no." It could be that when it snows you turn up the heat, put on your flannel pajamas, and put an extra blanket on the bed. In your mind, you associate snow with being cold so you overcompensate by doing several things to keep you warm. It is the extra layers of clothing and blankets along with the higher setting on the thermostat that are causing you to be warm, not the snow!
In response to the argument that biology causes our emotions and mental illness, some will state that our biology is at least partially determined by our consciousness, our thoughts, or other things which are under our control. For example, if you were to spend 10-minutes concentrating really hard on the most painful experiences in your life, you'd probably start to feel at least a little more sad or anxious. Additionally, you would have just changed the biology of your brain in terms of chemical and electrical activity! Similarly, if you were to spend 10-minutes relaxing, watching a funny sitcom, or exercising, you would have just changed your brain in a different way.
A good deal of theory which is supported by research suggest that things which bother us that we don't deal with may change our biology. For example, say that you are really mad at your spouse. However, you don't want anyone, including your spouse, to know. So you pretend everything is fine. This may lead to an ulcer, lower back problems, or a variety of other physically experienced symptoms. In psychology, we often refer to these as somatic symptoms. In other words, not dealing with emotional and relational issues also changes your biology!
Third, we could question whether genetics is the only way mental illness could be passed from one generation to another. While biology is one possible cause, another is learning. We learn ways to act and deal with things from our family. We learn patterns of interaction and coping strategies. These patterns we learn could play an important role in the development of mental illness.
A final point in the case against biological determined mental illness is the success of talk therapy. Various approaches to therapy have been shown to be very effective in treating depression, anxiety, and other painful experiences or mental illnesses. In doing so, they also change your brain and biology.
Pulling it Together
Below three main hypotheses are discussed. With each of these hypotheses, you can find many professionals who agree with them and many that challenge them. You can also find research supporting and contradicting each of these. In other words, don't get sucked in too easily when you hear research support or experts advocating for one or another of these hypotheses. Please note that these are not the only three hypothesis, but they are three of the more common.
Hypothesis 1: Biological Determinism: This is the position discussed above which believes genetics and biology are the primary causes of mental illness.
Hypothesis 2: Personal and Environmental Factors: This is the position discussed above which advocates a variety of personal factors including thoughts, behaviors, the way we deal with problems, our relationships, and our environment all contribute to mental illness.
Hypothesis 3: Multiple Causes: This is the most complex position and there are many variations to it. Two major variants would be that 1) personal, environment, and biological factors contribute to mental illness and 2) that for some people/illnesses biology is the primary cause while for others personal and environmental factors are the primary cause.
Conclusion
So what does all of this mean in terms of the causes of mental illness and biology? In the end, it states we don't know for sure what causes mental illness. What a mental health professional believes about these answers will impact the way he or she approaches treatment. If you have strong beliefs in terms of one of these positions, it may be wise to find a therapist who shares your beliefs.
The place where caution is likely warranted is with professionals who present one of these positions as accepted by the field or who seem to be unaware of other viewpoints. These professionals often may be so immersed in one viewpoint that they are not even aware of other important research and theories in the field or they may have other vested interest in one position being seen as the correct position. A professional who knows where they stand, but are aware of differences in the field and respects these differences often will be the better choice to work with.
Posted by Fivefires on April 14, 2008, at 20:37:21
In reply to Re: Atypical depression is now a chemical imbalanc » Fivefires, posted by Phillipa on April 14, 2008, at 20:25:00
> Maybe because there is no way to accurately measure that or a test to say what med may work?>
>Prob' not.
>Not sure but don't feel it was sarcasm.>
Oh dear ... dbc I hope you didn't take that the wrong way. I meant friendly sarcasm, like sarcasm between friends ? o_o
>How do you measure brain serotonin, norepenephrine, dopamine, or the other host of neurotransmitters? Now there is another google question be back.>
You move faster than my dial-up pute Phillipa!
Tks for trying to help.
And hey, dbc, sorry if you feel the way I hope you don't re: mention of sarcasm. Not need more enemies. Way not! Please come back.
5f
Posted by dbc on April 14, 2008, at 22:43:40
In reply to Re: Atypical depression is now a chemical imbalanc, posted by Fivefires on April 14, 2008, at 20:37:21
Because of neuroplasicty no brain is ever the same so therefore theres no such thing as neurotypical people. Our brains are as unique as finger prints or an eye iris. So in reality chemical imbalances dont exist. Theres no normal brains theres just ones that predispose you to certain problems that inhibit various levels of functionality, we call it mental illness.
That doesnt mean you dont have depression because of neurochemical problems, no one doubts that people have bad depression. I've been doing this whole psych drugs thing for years and years and i know how depression grinds you down. I went through drug after drug after drug without success untill a trial of lamictal.
And no i wasnt being sarcastic i just didnt explain myself well enough.
Posted by Fivefires on April 15, 2008, at 0:57:40
In reply to Re: Atypical depression is now a chemical imbalanc, posted by dbc on April 14, 2008, at 22:43:40
Tks dbc. Understand.
5f
Posted by Jedi on April 15, 2008, at 1:53:04
In reply to Atypical depression is now a chemical imbalance?, posted by Fivefires on April 14, 2008, at 11:46:27
Hi 5f,
"According to the DSM-IV, as opposed to major depression, the patient with atypical features experiences mood reactivity, with improved mood when something good happens. In addition, the DSM-IV mandates at least two of the following: increase in appetite or weight gain (as opposed to the reduced appetite or weight loss of "typical" depression); excessive sleeping (as opposed to insomnia); leaden paralysis; and sensitivity to rejection."Source: http://www.mcmanweb.com/atypical_depression.html
Atypical Depression: This form of depression is actually very common.I'm sorry you're feeling so bad. If your symptoms sound similar to the above, your depression is probably atypical. If several of the SSRIs have not worked, the irreversible MAOIs (Nardil, Parnate, Marplan) are the gold standard treatment for this condition.
Be Well,
Jedi
> Well ... I've never had this as a diagnosis, though maybe should have many years ago. Now has it become typical? I mean, it's not just about bad incidents anymore. I think it's changed me; my brain chemistry, as bad incidents seem to be chronic in my life. My two support peeps just ditched me, even knowing I very well may fall through the cracks of poverty in this mental health system. Lithium? Nardil? No $ for alternatives. I'm spiraling downward at a high rate of speed since lost my support peeps; told me last night to go to a hospital or something. This is the absolute worst I've ever felt, w/ exception of father passing away 4yrs ago. My own fam' is letting go of me. I wouldn't let go of them. One said she'd never let go, but she did ... last night. Her marriage I think was the reason. Usually it is $, but I think hers was for her husband.
>
> lifelessw/olove, 5f
Posted by Phillipa on April 15, 2008, at 18:48:10
In reply to Re: Atypical depression is now a chemical imbalance? » Fivefires, posted by Jedi on April 15, 2008, at 1:53:04
Jedi great article. Love Phillipa
Posted by Fivefires on April 15, 2008, at 21:07:21
In reply to Re: Atypical depression is now a chemical imbalance? » Fivefires, posted by Jedi on April 15, 2008, at 1:53:04
I'm so confused and freaked, I'm moving from the bottom to the top.
Phillipa, I can't read that whole thing. I so appreciate all this info you've brought here, but in this depressed slow weary lazy state I'm in, my mind can barely get beyond the first paragraph :(.
I have every one of the symptoms of atypical, although am not eating a lot because there's nothing good to eat. I only get $10 a mo food stamps :(.
Think already told you all this.
I had T appt today and she shook her head in the 'no manner' the same way my pdoc had at mention of an MAOI months and months ago.
She confronted about borderline personality v. atypical, and looked at me like 'convince me you have one and not the other'. I mumbled about the symptoms of atypical. o_o (I love that face, but you all get that I'm sure. Are you getting sick of it yet? I hope not 'cuz it's me w/ that 'duh .. I dunno' look and right now, and these past few days of rejection by everyone in fam' and even ICMan, it's like stuck on my face.
T did send an email to my pdoc about my wanting to try an MAOI. Maybe if one worked that is proof I've atypical depression?
You're all being so helpful but my ability to be perceptive and cognitive is sort of snuffed out by these ruminating thoughts ... 'I give up ... No one likes me ... I don't know what I did wrong ... I kind of like me and don't get why no one else does ... Maybe fam is rejecting me to push me into the action which will get me into a hospital but then I'll be treated inproperly and don't they get that'.
I'll bet some one of you would like to reach through your pute and give me a slap to wake me out of this stupor. I don't think you could hurt me. I'm numb.
An important indicator may be its onset?
First experience w/ feeling sad for no reason, unless my subconscious knew something I didn't, was at age 20. I was married to someone who loved my bubbly personality. I was his 'laugh of the party'. I was so far from where I am today. After a year or so, at some point, this 'bubbly me' would go away for a while. I said maybe I should seek help. He said 'I'll not be married to anyone who needs to see a psych doc' and he left me.
I went into an immediate panic attack (couldn't breathe; didn't know what it was called) and parents rushed me to an ER. I was begun on Librium.
After a while I noticed (duh) this seemed to be happening at the same time every month. So, therein came the dx of PMS, as PMDD had not yet been thrown into the coding books.
I met someone who filled the void of my first husband's absence and was very happy for a couple years w/o a lot of downs .. in fact .. I barely remember any. UNTIL, he hurt me physically.
The 2wks up and 2wks down became more noticeable again, but at this time I was in 'fear of violence' every day too. So that period of time was just not ever good.
My PMDD was treated w/ everything a really good doc could think of, but w/ nothing being effective, including Prozac, I had removal of all organs responsible for fluctuating hormones. One reason for having the surgery was, I thought he was hurting me because of my downs. Anyway, after surgery, the ups and downs were gone, but there was still a daily melancholy feeling, but I'm still married to an abusive man w/ three children.
That's enough about the beginning of 'mental illness for me'.
Yes. I did stay in an abusive relationship too long.
Does this say anything to anyone about my diagnosis being borderline v. atypical?
(I know. I'm asking you to do all the work. I apologize. I'm just AFU and very tired and weary and sh*t!)
I'll keep all threads in inbox because I have literally no contact w/ my pdoc except for this email my T sent today. Maybe I'll hear something.
Maybe I won't tolerate an MAOI if given it.
I have lithium sloshing around in my thoughts too.
Tks for all this info and I will read it because you're trying to help me; you're my support.
My IRL support is becoming nonexistent. Bad thoughts? Yep. Butt, giving thought to these diff' alternatives is helping me from going there.
need rest & want to return asap, 5f
and: I know this 'isn't all about me'.
and: Does anyone here feel confident atypical is their dx? (You've prob' said and I've forgotten.)
and: I wonder where this dx falls if we were ... whoops, on second thought, best not go there. Anyone reading my mind?
Posted by Phillipa on April 15, 2008, at 21:34:53
In reply to Re: Atypical depression, posted by Fivefires on April 15, 2008, at 21:07:21
FF you know I know the rejection of children and family. So on the same wave length there. As far as an MAOI goes I feel that since you are alone that maybe the pdoc if he does prescribe them may not feel that you'd be safe. This is not a criticism but concern as a lot of side effects that can be dangerous. Also I don't think you could take your pain meds for your back. So this may be a huge factor. Can you ask you doc about that. As far as borderline goes I have no idea. That is an Axis II personality disorder. This goes along with a primary diagnosis. Like your depression and anxiety and chronic pain. Write and can discuss more. Love Phillipa ps I only understood the overeating, oversleeping.
Posted by Fivefires on April 16, 2008, at 11:42:26
In reply to Re: Atypical depression is now a chemical imbalance? » Jedi, posted by Phillipa on April 15, 2008, at 18:48:10
Read articles Jedi and Phillipa.
This leaden paralysis doesn't fit w/ me when I'm on my feet, only when I'm lieing down. It's then that I feel like a big huge dead weight.
And, sleeping a lot ... I have to take something to sleep; Soma currently.
I recall something about onset at a common age re: atypical depression, read somewhere, but don't remember the age. Was it age 30 maybe?
I had a dream I was with my family and we were getting ready to go somewhere to have fun and sort of jumped out of bed as if I was going to start getting ready, and didn't realize until 30seconds or so, I was only responding positively to this dream I'd had. I'll go back to bed now.
Been awakening during the night with stomachaches; new thing.
tks, 5f
Posted by Phillipa on April 16, 2008, at 19:32:41
In reply to Re: Atypical depression is now a chemical imbalance?, posted by Fivefires on April 16, 2008, at 11:42:26
So what's your pdoc decided to do? Have you talked with him today? Love Phillipa
Posted by Shadowplayers721 on April 17, 2008, at 0:34:57
In reply to Re: Atypical depression is now a chemical imbalance? » Fivefires, posted by Phillipa on April 16, 2008, at 19:32:41
I am so sorry you are going through this FF.
Posted by Fivefires on April 17, 2008, at 10:31:21
In reply to Re: Atypical depression is now a chemical imbalance? » Fivefires, posted by Phillipa on April 16, 2008, at 19:32:41
Only contact made w/ him, this week, (Last week I called and left messages w/ no result.) was an email sent to pdoc by T on Tuesday. Have heard nothing from pdoc and T is off today, Friday.
5f
Posted by Fivefires on April 17, 2008, at 10:42:11
In reply to Re: Atypical depression is now a chemical imbalanc, posted by Shadowplayers721 on April 17, 2008, at 0:34:57
It's good to hear from you Shadowplayers721.
tks, 5f
Posted by Shadowplayers721 on April 17, 2008, at 11:06:24
In reply to Re: Atypical depression is now a chemical imbalanc, posted by Fivefires on April 17, 2008, at 10:42:11
I am so glad to see you too my friend. I hope to give you some comfort and support during this trying time.
I know boards like this have helped me during my past crisis. Don't feel you are out there alone in this.
It's times like this we need each other more than ever. If nothing else, we just need some one to be there to listen. You know what I mean.
I am listening and an e-mail a way. :)
This is the end of the thread.
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