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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 Ihatemylife on October 29, 2010, at 1:53:57
I've had severe depression and extreme social anxiety for over 10 years, and I've tried many different medications, therapy and they've all just made me feel even worse. Everyday I just think about killing myself all the time and hate everything.
So what hope is there once you've tried all the medications your psychiatrist can give you and he gives up on you? Everyone I've talked to says that ECT is a bad choice for me and won't help me, and I really don't know what to do.
There are two kinds of treatment I mentioned that my psychiatrist rejected, buprenorphine and stimulants. Would it be worthwhile to seek out these treatments before ECT? It would probably be impossible to find someone willing to prescribe me buprenorphine or other opiates, and everyone keeps telling me they are not effective in the long run and that opiate dependency will make me want to kill myself even more (if there's still room for that). And I do not understand stimulants very much, on one hand I understand that ADHD children who have a hard time sitting in their seat or being still benefit from psychostimulants, but I would not like it if it made my racing thoughts, headaches and anxiety get worse like I did on bupropion. I've also seen people say that adderall gave them ringing in the ears, if mine were made any louder I probably wouldn't be able to hear anything at all, though if it doesn't cause permanent damage it might be worth the risk. My appetite is also sh*t, I can't stand the sight of food and I'm underweight.
If anybody has any other unconventional treatments that might fit me or thoughts on ECT I'd appreciate it a lot. One thing I haven't factored in is the cost, I've spent thousands of dollars on meds but right now there isn't any money left to spend, so if ECT costs a fortune I guess I'm pretty much screwed anyways. I'm just tired of considering suicide as the only viable option.
Posted by ed_uk2010 on October 29, 2010, at 12:55:39
In reply to Is it time for ECT?, posted by Ihatemylife on October 29, 2010, at 1:53:57
I assume you've tried Nardil?
Posted by Tomatheus on October 29, 2010, at 13:44:08
In reply to Is it time for ECT?, posted by Ihatemylife on October 29, 2010, at 1:53:57
Ihatemylife,
Have you ever talked to your psychiatrist about whether you might be bipolar? I ask this because you mentioned racing thoughts, which are typically considered to be a symptom of bipolar disorder. Bipolar disorder is usually treated with mood stabilizers, which include lithium, Depakote, Lamictal, Tegretol, Trileptal, and antipsychotic medications. Have you tried any of these medications? I personally think that they might be worth trying before going ahead with ECT.
I'm sorry that you've had so little success with the treatments that you've tried so far for your depression, and I hope that you do find something that brings you some relief. Another option that you might want to consider is trying some dietary supplements. Fish oil, St. John's Wort, and SAMe are the first three that come to mind for depression, but there are actually a lot more that may be useful in reducing depressive symptoms. Also, if you are bipolar, you may want to be cautious about taking SAMe, as it can exacerbate manic symptoms.
So, even though I don't know a whole lot about your treatment history, it would be my guess that you probably have some more options that you can exhaust before going ahead with ECT. As you probably know, there are some people who've undergone ECT who have a lot of good things to say about it, but the treatment also carries a lot of risks, such as long-term memory loss.
Good luck finding a treatment that works, and welcome to Psycho-Babble.
Tomatheus
Posted by Phillipa on October 29, 2010, at 16:35:44
In reply to Re: Is it time for ECT?, posted by Tomatheus on October 29, 2010, at 13:44:08
Great suggestions and well written as well. How are you feeling now? Please explore all the options available to you. And again welcome to babble Phillipa
Posted by Tomatheus on October 29, 2010, at 18:25:20
In reply to Re: Is it time for ECT? » Tomatheus, posted by Phillipa on October 29, 2010, at 16:35:44
> Great suggestions and well written as well.
Thanks, Phillipa.
> How are you feeling now?
I'm not sure if you were asking me or the original poster this question, but I've had some mild-to-moderate depressive symptoms to contend with as of late. Unfortunately, the negative and cognitive symptoms that I experience as part of my psychotic disorder have been pretty unrelenting, but I may be trying some supplements for those symptoms in the near future. I also experience some mild positive psychotic symptoms (occasional residual hallucinations and ideas of reference), but those don't bother me a whole lot. What has been bothering me a lot has been the apathy and cognitive blunting that I experience from taking my antipsychotic (I know that some of the apathy is from my illness, but my antipsychotic makes it worse).
Anyway, I know that it sounds like I've got a lot of symptoms to contend with, but on a more positive note I am feeling pretty stable and doing better depression wise than I have in the past.
I hope that life has been treating you well, Phillipa.
Tomatheus
Posted by Phillipa on October 29, 2010, at 20:20:17
In reply to Re: Is it time for ECT? » Phillipa, posted by Tomatheus on October 29, 2010, at 18:25:20
Are you stable enough to work? I give you so much credit for being able to handle psychosis. Phillipa trying to stay sane? Me that is.
Posted by Tomatheus on October 29, 2010, at 21:16:48
In reply to Re: Is it time for ECT? » Tomatheus, posted by Phillipa on October 29, 2010, at 20:20:17
> Are you stable enough to work?
Not at this time. Between my depression, my negative symptoms, my cognitive symptoms, and my cognitive blunting (from the medication), the amount of functional impairment that I experience is too high.
> I give you so much credit for being able to handle psychosis.
Thank you. I know that this isn't the case of everybody who has a psychotic disorder, but for me my positive symptoms have become more bearable with time. Of course, my medication helps too. I think it's the insight that I have into my illness that has helped me deal with my positive symptoms better. In other words, recognizing that what I'm experiencing are symptoms of a psychotic disorder instead of messages from God (which is what I used to think my hallucinations and ideas of reference were) has helped prevent me from becoming delusional again.
Tomatheus
Posted by bleauberry on October 29, 2010, at 21:33:41
In reply to Is it time for ECT?, posted by Ihatemylife on October 29, 2010, at 1:53:57
Take it from me, an ECT survivor, your options for buprenorphine and stimulants blow ECT in the weeds. Stimulants would need to be in combo with an ssri low dose.
TCA SSRI combo? Done that?
Prozac Zyprexa combo? Done that?
Lexapro Abilify combo? Done that?
Despite what you may read, ECT is not all that successful and has an extremely high relapse rate within a short time. Not to mention the potential for severe memory loss. Which might not be a bad thing....to me it was kind of like starting a new chapter. The new chapter was just as bad as the old, but at least it was a new one and I didn't remember much of the old one.
I like the idea of buprenorphine because it hits the neurotransmitters missed with everything else. For a quick test, you could take Hydrocodone or Codeine for a day or so and see what happens. If positive, you know you are in the right direction.
The sad part though is that pdocs never look for what is causing it all. There is likely a medical biological cause. I talk about them here all the time. People get well from longterm chronic resistant severe depression with such things as antibiotics.
Posted by floatingbridge on October 30, 2010, at 0:38:06
In reply to Is it time for ECT?, posted by Ihatemylife on October 29, 2010, at 1:53:57
Personally, I had dramatic results from dexedrine. I do have add inattentive, so I suppose my doc used that as an excuse to take a chance. To date, it is the only medication that has brought me close to my pre-breakdown state. It's problematic, and a weird headtrip for me accepting my usage.
I would say that if you haven't tried it, it
is certainly not a crazy idea. I don't know why your doc rejected the possibility--what was his or her reason? You could try a 5mg short acting tablet to test your response.I'm not familiar with the other drug you mention.
Best to you.
Posted by Zyprexa on October 30, 2010, at 23:58:24
In reply to Is it time for ECT?, posted by Ihatemylife on October 29, 2010, at 1:53:57
I don't recomend ECT, as a past user of it. I had probably 30 of them in 6 months. They did nothing good except make me forget everything I knew. 12 years later and I'm slowly getting pieces of my memory back. By the way ECT is very expensive. I've heard of prices like $20,000 each.
One thing I've thought about trying (but won't because I'm stable now) is Fluphenazine. It is very cheep in the US, about $20 a month. Its an old AP, that is supposed to be very powerfull. I currently take a simmilar one, perphenazine.
I do belive that if I took my meds before the ECT, I may not have needed the ECTs.
This is the end of the thread.
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