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Dr. Bob is Robert Hsiung, MD,
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Posted by vic80 on February 27, 2010, at 14:07:47
I am in severe distress. Please forgive me for putting up such a badly written question - (I would have done a much better job any other day)
On jan 8 2010 I was diagnosed with anxiety and depression.
I am on Escitalopram 10mg for the past 8 weeks, and 0.25 mg clonazepam for the past 4 nights. I had abruptly stopped escitalopram on 13th (along with 15mg 9 days mirtazapine) after feeling mind-numbed one evening and suspecting this combo to do this. On my doctor recommendation I restarted escitalopram on 20th and have been taking it regularly till date.I want to know if
is it normal for one to feel mind-blanked...? like unable to think anything spontaenously - no thoughts coming on their own - only when I get aware I am thoughtless I try to populate my mind with thoughts. this has been happening since yesterday. It started with lying in my bed in the afternnon yesterday - feeling agitated over my doubts that I have gotten emotionally-numbed/blunted plus apathetic and motivation-less because of my anti-dep medicine. Then suddenly i had a vague recollection of a panic attack I had in nov 2009 when I (during this attackfelt 'everything is gone, everything is over' and went into a void for a a minute or two - along with severe distress)..
After this recollection yesterday afternoon - I felt very strange - vey detached - very lost and dazed out... After this I started feeling very very edgy anxious and overwhelmed scared and vigilant I felt like a shock has entered my mind and suddenly I started making plans perhaps superficially- about what I want to do in life I started fearing what if I go into a void... this fear also made me aware that I am not thinking as much as I usually do - I must also mention that past 3 months my mind has been only occuppied with HOW I AM FEELING/SUFFERING - this has made me disconnect with normal life - I have little interest in things - very apathetic and indifferent - though I do have emotions - I feel them quite less - this too I am not very sure of - I have psyched myself by reading too much on anti-dep side effects and tragic stories of people on anti-dep medicines, plus an unending internet research into mental-disorders and brain chemical mechanisms.
since yesterday as I mentioned above, today too felt that same feeling unreal empty - numb etc its as though I psyched myself into believing that I am not able to think while all along in my mind I am thiking about things I might ask some psychiatrist/psychologist about me being mind numbed the feeling I can describe is as below:
Since yesterday I have felt mind blanked like when walking the dogs I was looking around but not thinking anything this freaked me out I was devoid of thoughts then I returned back home I frantically started surfing the internet I was lapping up everything I read or felt all along trying to avoid the numb-feeling or perhaps the fear of it that was manifesting itself in my inability to think like some placebo effect of the fear I went to watch a movie I the evening which I partially enjoyed but in between I was constantly checking on myself am I able to think or not ? then I even tried to observe myself thinking etcwhich I have begun to do keep watch of what I am thinking I am feeling like I am fading away.
wonder if this Could it because of the anti-dep medication escitalopram 10mg I have been taking since past 8 weeks. It is said to have emotion-numbing effect plus past 3 nights I have been on 0.25 mg clonazepam too.Could it be that I am just depressed without any melancholia utterly apathetic and disinterested in anything and this is making my mind go blank?
do u think my fear of going blank is so severe/pronounced that it manifests in my subconscious actually not letting my mind have spontaenous thoughts?
Also I must mention that I have suicidal ideation once in a while - which is restricted to thoughts and never to impulse or feeling like doing so .... and very strangely I tend to shock myself out of a stupor of blankness/emotional-numbness by thinking about this negative ideation. My family is around to keep check on me and my doctor thinks this is to do with depression. My mood is not bad - but I notice that just without any apparent reason I slip into a down mood these days. ANd sometimes I have bad dysphoria and agitation when I obsess that something is wrong with me.
Could it be possible that my subconscious mind harbours pain/unreleased emotions/fear that play havoc over my mood/feelings without my conscious knowledge?
And how do I deal with these apparent feelings of blankness- are they my fear or are they real - how should I manange them?
How do I stop constantly being on a vigil over what or how I am thinking .... like I am 'thinking/observing how I am thnking'Am I losing control? should I blame escitalopram and/or clonazepam?
I am again very sorry for my clumsy and hap-hazard way of asking this question... (when I started typing I was constantly feeling I might lose the ability to even write soon)"
Posted by bleauberry on February 27, 2010, at 17:14:36
In reply to Mind-numbing/emotional numbing, posted by vic80 on February 27, 2010, at 14:07:47
Well, if these symptoms of mind-numbness and blankheadedness were not there before escitalopram, then yeah, that's it.
These kinds of feelings are fairly common with all of the ssri medications. Lack of motivation and anhedonia (inability to experience pleasure) are components of depression itself, can also be separate syndromes without depression, and are also medication induced by certain drugs. The most guilty ones are SSRIs (celexa and lexapro, paxil, luvox, zoloft, and to a lesser extent prozac), the benzos (xanax, klonopin, lorazepam, valium), and the antipsychotics if their doses are more than very low.
The best bet is to take medications that target a broad spectrum of neurotransmitters...the inhibitory ones as well as the excitatory ones. Right now you are taking two medications that are inhibitory, drowning out anything excitatory.
I guess if lexapro were to help your depression greatly, but leave you numb, the next step would be to add a medication like ritalin, nortriptyline, wellbutrin, anything that targets the norepinephrine/dopamine circuits. But since you say suicidal thoughts are still present at times, then that doesn't speak well for lexapro doing much good for you.
You should probably call the doctor and tell him how badly the meds are changing you, and then see what he does.
Posted by Phillipa on February 27, 2010, at 20:11:03
In reply to Re: Mind-numbing/emotional numbing, posted by bleauberry on February 27, 2010, at 17:14:36
Sounds a bit like panic attacks to me with some OCD. I feel luvox is a good med as sedating. Klonopin can cause depression in some so I'd try another benzo for the anxiety. Phillipa
Posted by linkadge on February 27, 2010, at 20:46:09
In reply to Mind-numbing/emotional numbing, posted by vic80 on February 27, 2010, at 14:07:47
For having no thoughts thats a pretty detailed post! I recomend lowering the escitalopram to 5mg. 5mg can still be very potent and should still help anxiety. Whatever you do, make changes slowly!
You might try adding a little folic acid (400mcg) and perhaps some omega-3 to boost dopamine production.
An occasional cup of coffee can be a good medication adjunct.
I am also taking escitalopram - I take between 2.5 and 5mg and this seems to keep the blunting effect to a minimum.
Take care,
Linkadge
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