![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 29. This is the beginning of the thread.
Posted by chocamine on November 22, 2008, at 11:03:47
Hi guys,
After a very euphoric bout of hypomania lasting 3 months, I fell into the deepest, darkest melancholic depression you can think of. I am in a vegetative state, pretty much. Non-stop ruminating thoughts about this traumatizing experience (the bipolar appeared out of NOWHERE so I can't help thinking about it constantly). I cannot be cheered up by anything.. basically.. textbook case of severe MELANCHOLIC depression.
Prior to the hypomania, I had never had any mood swings and my life was pretty damn good. Just some minor depression here and there. I am 20 years old.
Unfortunately, my psychiatrist and I have had no luck in getting relief from my depression. I have been in this state for 4 months.
Here is what I am on so far with no success.
Lamictal 150mg 10 weeks
Lithium 1200mg 5 weeks
Zoloft 50mg 4 weeksI've had great success with 300mg Welbutrin XL in the past (2 years ago) but because of the severity of the depression I have now (nothing like I've ever experienced before) I could not even tolerate 150mg due to anxiety and chest pain when we tried adding it.
The depression is seriously the worst thing I have ever experienced in my life. I think due to the extremely prolonged and euphoric nature of the hypomania I had, the depression is especially as bad versus someone who had a more irritable type of mania. More neurotransmitter depletion or whatever.
Does anyone have any suggestions? I was thinking about trying a TCA but my psychiatrist wants to see if the SSRI will work first. I'm 99% convinced it won't... it's like... look at the studies... common.
I'm especially worried about the lamictal because it is a first line treatement for bipolar depression and I noticed nothing from it except cognitive impairement. Is it even worth it to keep using it?
I 100% know that something is severely chemically impaired in my brain. There is just no debating it. It feels like I got a lobotomy and the reward centers in my brain are just shut OFF.
Does anyone have any suggestions?
Posted by Jimmyboy on November 22, 2008, at 12:13:51
In reply to Treatement resistant bipolar depression..., posted by chocamine on November 22, 2008, at 11:03:47
Did anything induce this bout of mania? Were you doing any drugs/lots of alcohol? Any major changes in your life/traumatic experiences?
Don't be too quick to label yourself "bipolar' yet. Many things can lead to hypomanic episodes and you may never have one again. I find labeling yourself with a lifelong terrible disorder and feeling like "there is something wrong with you" can make you pretty depressed too. Many people I know ruminate on the fact they are now "bi-polar' and see the world throuogh that filter.
Anyway, I have two suggestions, although they are not prescrition meds. Borage Oil ( high in GLA) - I have a similar pattern of depression ( bipolar -like) and it has helped me immensely and there are a couple of other posters on the alternative board who have bipolar type depression who say Borage Oil has helped them. It may not be helpful, but its not going to hurt you or have any sides either. Also, as hard as it is, get out and get some exercise, it doesn't help fast, but it eventually really does help and if you can make it a part of your life it can really keep you level over the long term so you can get on with your life.
Posted by Justherself54 on November 22, 2008, at 12:38:58
In reply to Treatement resistant bipolar depression..., posted by chocamine on November 22, 2008, at 11:03:47
I had the same thing happen to me. Prolonged mania (I just thought I was having the time of my life for the first time in 40 some odd years)..then the horrible depression followed.
Increasing the Zoloft could do the trick. It worked well for me at 100 mg. Has your pdoc suggested an increase. He/she may be waiting to see if you are having a partial response to it before raising the doseage.
Zoloft no longer works for me but it was the one drug that I felt good on.
I have not had luck with mood stabilizers, but that's me. I have to keep a rigid sleep schedule which helps.
Work closely with your doctor. It may take some time to find the right combo of meds.
Looking back on my life I can see that I suffered from BP for a long time, but I only sought help in the depressive phases. It wasn't until the prolonged mania and crash that I was properly diagnosed. Perhaps if I had been diagnosed and treated earlier I could have made better decisions and life may have been easier. Who knows?
Learn all you can about this disorder. Ask you friends and loved ones to educate themselves, so they can help. Sometimes my family and friends can see me getting in trouble before I'll fess up to it. Pay attention to any changes in your mood. Listen to that inner voice that tells you when you're heading for trouble and report it to your pdoc.
I hope other posters who've had success with mood stabilizers and AD's will chime in. There are lots of very informed posters here that can give you wonderful advice. Keep posting!!
Posted by ricker on November 22, 2008, at 16:15:33
In reply to Re: Treatement resistant bipolar depression..., posted by Justherself54 on November 22, 2008, at 12:38:58
I've experienced similar cycles. The worst in 1988 when 2 courses - 6 treatments of ECT helped with the depression.
My current meds are zoloft 50 mg, clonazepam 0.5mg tid and just added zyprexa 10mg.
Recent failures due to physical side-effect with lamictal and lithium, hence the zyprexa. I'm feeling quite well at the moment so I must credit the zyprexa, perhaps a possible option for you?If need be, I would consider ECT again. I don't know why so many people view it as some barbaric treatment? The very same people that would sooner trial hundreds of various med combo's, with zero therapeutic gain? Because meds are the safer route? I'm not so sure, maybe because it's much more convienent to pop a pill? Sometimes short-term pain for long-term gain rings true?
Regards, Rick
Posted by desolationrower on November 22, 2008, at 16:37:15
In reply to Re: Treatement resistant bipolar depression..., posted by Justherself54 on November 22, 2008, at 12:38:58
In general there isn't much evidence that antidepressants help bipolar depression. Maybe maois. If bupropion helps you, I'd go on that, with a benzo to keep the anxiety down.
here is a great website that has a lot of detail on treatments for bipolar.
http://www.psycheducation.org/The other things i'd recommend is makes sure sleep is regular, excercise and seeing a therapist, and nutrition, including fish oil, vitamin D, magnesium & zinc, b vitamins especially folate and b12, and a multivitamin.
Two other things to try: N Acetyl-Cysteine, maybe h elp with bipolar depression. otc.
Lecithin has a bit of evidence it helps with bipolar, but there is also some evidence that choline-boosting supplements can worsen depression; its worth a try but i'd put it at the bottom of the list of things to try.
-d/r
Posted by Maxime on November 22, 2008, at 17:16:47
In reply to Treatement resistant bipolar depression..., posted by chocamine on November 22, 2008, at 11:03:47
I'm sorry that you are going through this.
I know that your psychiatrist wants to fix everything with an SSRI, but I think that you should try an MAOI. Or maybe an SSRI with an atypical anti-psychotic like Zyprexa.
I wish you the best of luck and I hope you recover quickly.
Posted by bleauberry on November 22, 2008, at 17:39:43
In reply to Treatement resistant bipolar depression..., posted by chocamine on November 22, 2008, at 11:03:47
I am extremely sorry you are feeling so bad. Believe me though, we are all either there in the same place or have and may be again. While friends or family might not be able to relate, we can.
A few comments I hope might be helpful.
You may or may not be bipolar, and it doesn't matter anyway. What ends up helping you feel better has nothing to do with the manmade term used to describe a certain cluster of symptoms. Bipolar is just a broad term that includes all kinds of physical and mental illnesses. I've known a few people who were called bipolar when in fact it was silver fillings in their teeth causing chronic longterm mercury intoxication. That is just one of many possible examples.
In any case, as your instincts tell you, there is something definitely wrong in the nervous system. What exactly, who knows. When the correct bridge is found that bypasses whatever the problem is, you'll feel a lot better.
For med suggestions, here are some. With your doctor's help, eliminate the lamictal. It isn't helping in any way, as you said. Lower the lithium to a maintenance antidepressant augmentation dose of 300mg-600mg. Like lamictal though, if it isn't providing any benefit, you kind of have to re-assess whether it is worth taking at all.
For a mood stabilizer to replace the ones that haven't worked, consider a switch to zyprexa 5mg-10mg. There is a med FDA approved for bipolar depression, and it is also pretty good for treatment resistant depression. That is, the combination of Prozac+Zyprexa. I am surprised this combo is not more popular than it is. It served me well for almost a decade when pretty much everything else was not helping much. Another combo in that same vein is Lexapro+Risperdal or Lexapro+Zyprexa.
In any case, Lexapro in metastudies was shown to be superior to all other SSRIs by a small margin. It might be worth having that on your side. Personal opinion, but I think Prozac is one of the best SSRIs. Whatever, Zoloft aint cutting it. Just because one ssri doesn't work does not mean another won't work brilliantly.
Lifestyle...as mentioned, heavy exercise a few times per week or daily. Purified water and lots of it. Heavy on proteins and raw or slightly cooked veggies, cut way back on sugars and caffeine. Cod liver oil or fish oil, and borage oil daily. Of the vitamins, I would start with Vitamin D3 in a dose of 400iu-1000iu per day. As for any other vitamins, do them one at a time individually to see what helps or what harms. Big mistake to just start popping B complex pills or taking a handful of vitamins by pure guess. You won't know what is doing what and can shock an already traumatized system. On the alternative board check out Lao's posts on his creative artistic way of discovering which vitamins help him.
ECT is a lot of hype. I know it was mentioned favorably by another poster, but honestly, that kind of experience is rare. ECT has a high percentage of relapse even when it does work. Some people escape the memory loss/brain trauma effects from it, but not many, and the risks of permanent memory loss and congitive dulling are very real. I and others can attest to that from personal experience. Someone else may recommend ECT, but I am strongly against it. It ruined my life more than the depression did, not to mention it cost $20,000 for 12 shocks.
Prozac+zyprexa, or some antipsychotic with Lexapro, would be my first choices for you. Get off the stuff that aint working.
Posted by ricker on November 22, 2008, at 18:29:49
In reply to Re: Treatement resistant bipolar depression..., posted by bleauberry on November 22, 2008, at 17:39:43
> ECT is a lot of hype. I know it was mentioned favorably by another poster, but honestly, that kind of experience is rare. ECT has a high percentage of relapse even when it does work.That would be me. Sooo, medication has a "LOW" percentage of relapse?????
> Some people escape the memory loss/brain trauma effects from it, but not many, and the risks of permanent memory loss and congitive dulling are very real. I and others can attest to that from personal experience. Someone else may recommend ECT, but I am strongly against it.Sorry to hear of your negative experience, but to use such a broad brush is simply.... not fair... nor accurate. It saved my life and perhaps many many more. I do not know what the statistics would indicate...so I won't comment as to it's effectiveness for others, just "myself"!
> It ruined my life more than the depression did, not to mention it cost $20,000 for 12 shocks.
I'm not sure what to make of that statement?
My treatments cost me 0 Canadian dollars.
Posted by desolationrower on November 22, 2008, at 18:36:09
In reply to Re: Treatement resistant bipolar depression..., posted by bleauberry on November 22, 2008, at 17:39:43
> I am extremely sorry you are feeling so bad. Believe me though, we are all either there in the same place or have and may be again. While friends or family might not be able to relate, we can.
>
> A few comments I hope might be helpful.
>
> You may or may not be bipolar, and it doesn't matter anyway. What ends up helping you feel better has nothing to do with the manmade term used to describe a certain cluster of symptoms. Bipolar is just a broad term that includes all kinds of physical and mental illnesses. I've known a few people who were called bipolar when in fact it was silver fillings in their teeth causing chronic longterm mercury intoxication. That is just one of many possible examples.
>
> In any case, as your instincts tell you, there is something definitely wrong in the nervous system. What exactly, who knows. When the correct bridge is found that bypasses whatever the problem is, you'll feel a lot better.
>
> For med suggestions, here are some. With your doctor's help, eliminate the lamictal. It isn't helping in any way, as you said. Lower the lithium to a maintenance antidepressant augmentation dose of 300mg-600mg. Like lamictal though, if it isn't providing any benefit, you kind of have to re-assess whether it is worth taking at all.
>
> For a mood stabilizer to replace the ones that haven't worked, consider a switch to zyprexa 5mg-10mg. There is a med FDA approved for bipolar depression, and it is also pretty good for treatment resistant depression. That is, the combination of Prozac+Zyprexa. I am surprised this combo is not more popular than it is. It served me well for almost a decade when pretty much everything else was not helping much. Another combo in that same vein is Lexapro+Risperdal or Lexapro+Zyprexa.
>
> In any case, Lexapro in metastudies was shown to be superior to all other SSRIs by a small margin. It might be worth having that on your side. Personal opinion, but I think Prozac is one of the best SSRIs. Whatever, Zoloft aint cutting it. Just because one ssri doesn't work does not mean another won't work brilliantly.
>
> Lifestyle...as mentioned, heavy exercise a few times per week or daily. Purified water and lots of it. Heavy on proteins and raw or slightly cooked veggies, cut way back on sugars and caffeine. Cod liver oil or fish oil, and borage oil daily. Of the vitamins, I would start with Vitamin D3 in a dose of 400iu-1000iu per day. As for any other vitamins, do them one at a time individually to see what helps or what harms. Big mistake to just start popping B complex pills or taking a handful of vitamins by pure guess. You won't know what is doing what and can shock an already traumatized system. On the alternative board check out Lao's posts on his creative artistic way of discovering which vitamins help him.
>
> ECT is a lot of hype. I know it was mentioned favorably by another poster, but honestly, that kind of experience is rare. ECT has a high percentage of relapse even when it does work. Some people escape the memory loss/brain trauma effects from it, but not many, and the risks of permanent memory loss and congitive dulling are very real. I and others can attest to that from personal experience. Someone else may recommend ECT, but I am strongly against it. It ruined my life more than the depression did, not to mention it cost $20,000 for 12 shocks.
>
> Prozac+zyprexa, or some antipsychotic with Lexapro, would be my first choices for you. Get off the stuff that aint working.
>
>The dose of lamotragine he's on isn't very high, he should increase it to 200 at least because that could get a response; especially since it takes a while to titrate lamotrigine, you shouldn't waste the time already spent if you are close to a dose that would cause a response.
I don't think b vitamins are nearly so powerful; getting the necessary amount is only necessary because few people eat the 15 servings of vegetables you'd need otherwise.
And ECT is quite effective; if you have insurance that covers it its something to think about. And of course some people need maintenance treatment. And current ect technique doesn't cause as much memory problem as it used to. So if you do go for ECT, just make sure to look into what kind they will be giving you.
-d/r
Posted by chocamine on November 22, 2008, at 23:27:55
In reply to Re: Treatement resistant bipolar depression..., posted by desolationrower on November 22, 2008, at 18:36:09
Wow! Thanks for all the replies, guys! I REALLY appreciate it.
I've been doing heavy exercise, supplementing with vitamins and high-dose fish oil for years now so that's not a variable.
The thing that worries me the most is that even though I "fit" the textbook model of a bipolar patient there are 2 things that don't make sense;
1) I have absolutely no family history of mental illness on either side going back as far as we can trace.
2) I never had mood swings of any kind until my first hypomanic episode.However, to counter that, my hypomanic episode was DEFINITELY textbook mania. I had massive delusions of grandeur. I basically thought I was a messiah. I felt like I was on a special mission sent by God and I felt at one with the universe. IT wasn't just the burst of energy, creativeness and good mood... it was sooo much more. I didn't think anything was wrong with me. I thought I was some sort of "chosen one".
So now it is as bad as that was good... if it makes any sense. I feel the complete opposite of that.
It was a blaunt trauma when the depression hit because my life was going perfectly. Job, girfriend, social life, etc. I felt like all my problems were over.
Then I Started getting severe migraine headaches above my left eye that lasted a week and after that the crash came in. It is like day and night.
In any case, at least I've had the privilege to lead 20 happy years of a normal life. I sort of feel like I'll never get back to that state again but maybe it's just the depression talking.
I just hope I find a med that works. I see a lot of people are recommending antipsychotics but do they really work for depression ?
Posted by desolationrower on November 23, 2008, at 0:45:45
In reply to Re: Treatement resistant bipolar depression..., posted by chocamine on November 22, 2008, at 23:27:55
They aren't the best for depression; they have mixed results and serious side effects. But bipolar depression is a lot harder to treat: there is less evidence that antidepressants help, and some evidence that antidepressants can cause mania and increase cycling between mania and depression. Antipsychotics reduce mania so they are less risky in that way. If you click on that site i linked earlier, it goes through antipsychotics as well as other treatments and gives a nice overview of the evidence on how well they work. If you have any further questions ask us or there is scholar.google.com for research too.
One thing I hope you can keep in mind is that you were able to live quite well before. So you know that its something thats possible for you, once you get over yoru illness. I know sometimes i wonder if i can ever be normal so I guess I'm saying its something good you can keep in mind that you know how to be normal so remember your past might be something to give you hope that you'll be able to get there again.
-d/r
Posted by azalea on November 23, 2008, at 0:56:05
In reply to Re: Treatement resistant bipolar depression..., posted by chocamine on November 22, 2008, at 23:27:55
Perhaps consider trying Lamictal at 200mg for 4-6 weeks before concluding that it's not helping. You could also try Provigil (modafinil).
> Wow! Thanks for all the replies, guys! I REALLY appreciate it.
>
> I've been doing heavy exercise, supplementing with vitamins and high-dose fish oil for years now so that's not a variable.
>
> The thing that worries me the most is that even though I "fit" the textbook model of a bipolar patient there are 2 things that don't make sense;
>
> 1) I have absolutely no family history of mental illness on either side going back as far as we can trace.
> 2) I never had mood swings of any kind until my first hypomanic episode.
>
> However, to counter that, my hypomanic episode was DEFINITELY textbook mania. I had massive delusions of grandeur. I basically thought I was a messiah. I felt like I was on a special mission sent by God and I felt at one with the universe. IT wasn't just the burst of energy, creativeness and good mood... it was sooo much more. I didn't think anything was wrong with me. I thought I was some sort of "chosen one".
>
> So now it is as bad as that was good... if it makes any sense. I feel the complete opposite of that.
>
> It was a blaunt trauma when the depression hit because my life was going perfectly. Job, girfriend, social life, etc. I felt like all my problems were over.
>
> Then I Started getting severe migraine headaches above my left eye that lasted a week and after that the crash came in. It is like day and night.
>
> In any case, at least I've had the privilege to lead 20 happy years of a normal life. I sort of feel like I'll never get back to that state again but maybe it's just the depression talking.
>
> I just hope I find a med that works. I see a lot of people are recommending antipsychotics but do they really work for depression ?
Posted by linkadge on November 23, 2008, at 6:20:37
In reply to Re: Treatement resistant bipolar depression..., posted by bleauberry on November 22, 2008, at 17:39:43
I don't know if I believe there is no evidence that AD's work in bipolar depression. This is a debated topic with other evidence suggesting that AD's do help and that early discontinuation puts BP at risk for relapse.
Anyhow, have you tried something like Mirapex? Small trials suggest it may be good for bipolar depression.
Linkadge
Posted by linkadge on November 23, 2008, at 6:23:09
In reply to Re: Treatement resistant bipolar depression..., posted by ricker on November 22, 2008, at 18:29:49
I don't think I'd recomend ECT. Yes it can work, but as mentioned most people relapse and there is the real possiblity that you will permanantly loose some of your faculties.
Linkadge
Posted by SLS on November 23, 2008, at 7:42:33
In reply to Treatement resistant bipolar depression..., posted by chocamine on November 22, 2008, at 11:03:47
Hi.
Bipolar depression.
I am currently having success with the following drugs:
Parnate 80mg
nortriptyline 150mg
Lamictal 200mg
Abilify 20mg
I highly recommend Abilify. It is known as a dopamine system stabilizer (DSS), and has produced a more robust antidepressant effect for me than the other atypical antipsychotics.Combining a TCA with a SSRI is currently gaining favor. I would recommend using either Lexapro or Effexor. If there is a serotonergic drug that you responded partially to, I would choose to revisit that first.
Wellbutrin is a drug thought by many clinicians to be well suited for bipolar depression. It generally has a lower rate of precipitating mania. It is often added to Zoloft and other SSRIs.
You have to prevent mania. If you don't, you will always wind up with the depression that follows, despite drug therapy. This will require a mood stabilizer other than Lamictal. I would definitely add Lamictal to the mix, anyway, as it acts as a good antidepressant augmentor. I think you might want to look into Trileptal as an antimanic.
Treatment might look something like this:
Wellbutrin + Zoloft + Lamictal + Trileptal + Abilify.
- Scott
Posted by linkadge on November 23, 2008, at 8:56:35
In reply to Re: Treatement resistant bipolar depression... » chocamine, posted by SLS on November 23, 2008, at 7:42:33
Was your manic episode invoked by the use of any substance ? ... chocamine ?
Linkadge
Posted by uncouth on November 23, 2008, at 10:37:16
In reply to Re: Treatement resistant bipolar depression... » chocamine, posted by SLS on November 23, 2008, at 7:42:33
Scott when did yous ee the A/D effect of abilify kick in. E.g. weeks, but also what dose. 20mg is pretty high for A/D augmentation, did you feel the a/d effects as low as 2 or 5? Or did you have to go up to 20 before you felt it really "kick in". Any side effects from abilify? Has it been stimulating or made you tired? What about hunger issues and weight gain on 20mg dose?
Thanks, i'm on 5mg, actually thinking of going down to 2.5 becuase i feel a bit less creative on abilify. But i like the drug too.
Posted by Phillipa on November 23, 2008, at 13:00:18
In reply to Re: Treatement resistant bipolar depression... » chocamine, posted by SLS on November 23, 2008, at 7:42:33
Scott I didn't know that after a mania always a depression never baseline? Love Phillipa
Posted by SLS on November 23, 2008, at 14:28:10
In reply to Re: Treatement resistant bipolar depression... » SLS, posted by uncouth on November 23, 2008, at 10:37:16
> Scott when did yous ee the A/D effect of abilify kick in.
It took about a week or so. My starting dosage was 20mg. I had a doctor who knew exactly what he was doing. I did not experience any akathisia or other EPS. I dropped the dosage to 10mg for quite awhile. When I discontinued it entirely, I suffered a relapse. However, this gave me the opportunity to titrate again to find the best dosage. I discovered that I was better off at 20mg than at 10mg.
20mg is pretty high for A/D augmentation,
Perhaps, but it might be necessary to go higher for bipolar depression.
> did you feel the a/d effects as low as 2 or 5?
Definitely not. I am sometimes surprised at how low people go with Abilify. I just hope that people are not missing the target by stopping at 5.0mg. Abilify might be one of those drugs where the side effects are worse at lower dosages.
> Any side effects from abilify?
Not really. When I first started it at 20mg, I experienced a mild-moderate sense of restlessness which lasted about a week, but that's about it.
> Has it been stimulating or made you tired?
I found Abilify to help with energy and motivation.
> What about hunger issues and weight gain on 20mg dose?
I couldn't begin to tease out the relative contribution of Abilify to my current elevated body weight. Nortriptyline is the biggest offender for me.
> Thanks, i'm on 5mg, actually thinking of going down to 2.5 becuase i feel a bit less creative on abilify. But i like the drug too.I can't comment on your feeling less creative because of taking Abilify. Because of the way I experience the drug, I am surprised to here this. Just remember, if you were to respond favorably to a high dosage of Abilify, you would almost certainly end up being more creative while in a state of remission than you are now.
It is difficult for me not to generalize my own experiences to the majority of people. Mine is far from being a classic case. I would wish that the majority of people who are currently taking low-dose Abilify would feel much better at higher dosages as I do.
- Scott
Posted by SLS on November 23, 2008, at 14:33:41
In reply to Re: Treatement resistant bipolar depression... » SLS, posted by Phillipa on November 23, 2008, at 13:00:18
> Scott I didn't know that after a mania always a depression never baseline? Love Phillipa
Not always, but certainly for the majority of people who cycle, the pattern is:
Normal > Manic > Depressed > Normal > Manic > Depressed > etc.
Rarely, the cycle looks like:
Normal > Depressed > Manic > Normal > Depressed > Manic > etc.
It is my feeling that if you can prevent the mania in the more common pattern of cycling, you can also mitigate the depression.
- Scott
Posted by chocamine on November 23, 2008, at 15:43:23
In reply to Re: A question, posted by linkadge on November 23, 2008, at 8:56:35
No, it wasn't.
It is really strange actually because 2007 was a really great year for me. Then, in January 2008 it got even better in college (was doing surprisingly well and was socializing more than I ever have in school before). I was in the best shape of my life. Then finally things really kicked into high gear in May and that is when the mania and delusions started and I crashed at the end of August.
I gotta say though... if I have not said it already. Those 3 months that I was manic were the best 3 months of my entire life. Bar none. This could be a little dangerous for me since it a seductive thing.
I'll look into all your guys' suggestions especially abilify.
Unfortunately, my psychiatrist really wanted to try me out on an SSRI before a TCA or MAO so I sort of let it fly... he was very keen on an antipsychotic though, but I'm deathly afraid of the weight gain.
Is the lithium worth keeping?
My biggest problem right now is the stress. Even though 10mg Valium daily is keeping my anxiety somewhat at bay, the stress has already caused 25% of my facial hair to fall out. It's so depressing. Too high cortisol from the stress no doubt... it's a vicious cycle because unfortunately, I'm a bit of a nerd and I know what it is doing to my brain and hippocampus as every day goes by... so I worry that my brain is shrinking and I'll always have residual effects from this episode that will haunt me 'til the end of days.
On the bright side, I'm not feeling very tired and despite my lack of motivation, I have the energy to do most things if I absolutely had to do them. I find this rather strange because I'd expect myself to be sleeping all day in a situation like this.
Blah.. I'm worried about so many things I don't think it's worth listing it all. Stuff like residual cognitive loss... PTSD (the depression traumatized the sh*t out of me), etc.
I had to cut off all contact with my friends and isolate myself at home when this all started because my behavior went from a charismatic party animal to a vegetable (literally). They probably think I'm dead or something.
I tried once going out with a few friends and I just felt terrible. I know everyone recommends going out and having social support but I HATE being around people right now. It just makes me feel worse, no matter who I'm with.
As a last note, I was never even remotely suicidal in my entire life but the first week the depression hit me, I was already considering it. Like I said, it was just so traumatizing because my brain was functioning in a way that I never could fathom. I never thought a human being could feel that way. I thought I would not make it past a week but here I am at month 4. If the meds have done anything it is probably that I am no longer suicidal or maybe I've just come to terms that this is it... this is what it is and I can't do anything about it.
I don't know if this is a typical symptom of severe depression but I get a jolt of anxiety whenever I think of something positive. Like when I think of the incredibly fun time I had with my friends in the months prior it instantly makes me panic because I feel like I'll never get to experience that again. The feeling of pleasure feels so foreign and inconceivable and yet I have a deep longing for it. There's just no way to explain it but it is the deepest pit of hell that I would not wish on my worst enemy.
> Was your manic episode invoked by the use of any substance ? ... chocamine ?
>
> Linkadge
Posted by Jimmyboy on November 23, 2008, at 17:29:52
In reply to Re: A question, posted by chocamine on November 23, 2008, at 15:43:23
Hey Choc,
Reading your response reminded me of one of the hardest things to come to terms with after a manic or hypomanic episode. After coming down from a manic period- you isolate yourself b/c you don't feel like you can " live up to the standard" you set when you were manic. This has happened to me both times ( once full manic and another hypo manic) - so I can definitely understand this.
But, at least in my case, I did not have a realistic view of what I was like during those times. I looked back on them fondly. I was so witty and quick and self-confident, full of energy.. but according to people i talked to about it later -they considered me to be annoying, obnoxious, hostile and the fact that I was acting so bizarre really freaked some of them out. So, things may be different with you, but just becaue you remeber those times fondly doesn't mean the outside world felt the same way about your behavior. Plus, lets face the truth, the majority of people out there ( new acquaintences -not old friends) don't think about others that much anyway, they are too busy with their own lives to worry too much about others - so my point is - forget about feeling like you have to live up to any expectations of others- your true friends will accept you for who you are depressed or not - you don't have to be the life of the party.
Try not to romanticize the manic period. Its hard to do, its a powerful f'ed up experience - as you know ... but, you don't want to be there again. The high is always followed by a dark nasty depression that usually lasts a hell of a lot longer than the high.
Good luck
JB
Posted by chocamine on November 23, 2008, at 19:51:13
In reply to Re: A question » chocamine, posted by Jimmyboy on November 23, 2008, at 17:29:52
Thanks for the reply JB.
It's really great to get feedback from other guys who have been there as it is very different for us males
You're definitely right that I'll have to come to terms with the reality of mania.
What I really liked about it is the way I felt... its indescribable. At the time I thought it was what is called a "spontaneous Kundalini awakening" so I thought I reached natural enlightenment. A buddha coming back to earth to help others...
Can you tell me about your manias and depressions? How long did they last? Characteristics of these episodes, age of onset, etc.
I really appreciate it bro.
Posted by Jimmyboy on November 23, 2008, at 21:23:23
In reply to Re: A question, posted by chocamine on November 23, 2008, at 19:51:13
Sure , I will drop you a babble mail..
Posted by chocamine on November 23, 2008, at 23:19:57
In reply to Re: A question, posted by Jimmyboy on November 23, 2008, at 21:23:23
I had "babblemail" turned off... but I turned it on now. Just wanted to let you know just in case.
Thanks.
> Sure , I will drop you a babble mail..
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