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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 12 to 36 of 36. Go back in thread:
Posted by floatingbridge on June 26, 2011, at 15:40:20
In reply to Re: more thougts on social phobia » floatingbridge, posted by sigismund on June 26, 2011, at 15:26:19
Hi sigi.
Sorry about the teenage thing if I am completing a half thought correctly.
I'm just literally lying around waiting to see if a script is coming through or if I need to dress and present at the clinic.
Very good point about the coach. I think
that little semantic switch opens some windows. Helpful. Thanks.Amazing how another little semantic switch can close tons of doors.
But where is the owners manual?
There is such an immensity to what I don't know, I often forget the little I do.
Posted by jms600 on June 26, 2011, at 15:44:04
In reply to Re: more thougts on social phobia » jms600, posted by floatingbridge on June 25, 2011, at 19:02:08
> So jms, how are you treating your disorder? It sounds like you are not satisfied with the results. (And thanks for your input. I am 100% unsure as what to do.)
>
> I have spent so much time reading and thinking about depression, I seems absurd given my ptsd, but I don't even understand the basic theoriea of anxiety disorder. What do you think, if I may ask you, as someone living this dx?
>
> fbI was on a whole host of meds - 150mg Effexor, 600mg lithium, 40mg buspirone, 600mg Lyrica, 10mg Zyprexa. I still had anxiety and depression, so my doctor decided to cut down the meds that I was taking as they weren't help 100%. Now I'm just taking 225mg Effexor and 600mg lithium. I think he wants a clearer picture on what's working and what isn't. I've been on a lot of meds over the years and most haven't helped a lot. I'm also taking 15mg Valium on an as needed basis.
The best SSRI I found for anxiety was Seroxat. It didn't treat my anxiety completely but it did help a little. Trouble is out of all the SSRIs I've tried Seroxat had by far the worst side effects. Terrible weight gain, total loss of libido, and excessive day time drowsiness (which started to effect me at work).
I do not know what your full symptoms are or what you have tried in the past, but you could also give consideration to atypical antipsychotics (or low dose typicals e.g. haloperidol) as well as looking at anticonvulsants.
Posted by sigismund on June 26, 2011, at 16:03:16
In reply to half thoughts » sigismund, posted by floatingbridge on June 26, 2011, at 15:40:20
Some people just give you the jerks, and some people don't.
(Does thinking of yourself as you mean you are borderline?)
That's about all I know.
After all this time I should be able to say something more profound about it all.
Posted by floatingbridge on June 26, 2011, at 16:06:45
In reply to Re: more thougts on social phobia » floatingbridge, posted by jms600 on June 26, 2011, at 15:44:04
Oh. Yeah. I see what you're doing, I think. Where is an maoi in your treatment map with you and your doc? Does he want to wait a little more? And how are you with that?
I have only tried to AP's to date with very negative results. In desperation I brought the class up again, like risperdal, only to have my doc shoot it down.
I hesitate to retry an snri or that sort
now because after 12 years (the last three dedicatedly) they haven't helped much, and the sides are not worth the
trade today. And I have finally withdrawn. Withdrawing from medication is usually difficult, so I am trying to keep my treatment possibilities open to maoi's while I have it.
Posted by floatingbridge on June 26, 2011, at 16:22:52
In reply to Re: half thoughts » floatingbridge, posted by sigismund on June 26, 2011, at 16:03:16
Yes about the inability to sum up anything profound to say. But there is something to be said about refraining from speaking.
Or dashing about words like borderline. It can indicate a severity or trend, but maybe like that old Zen thing about pointing at the moon.
No trip to the clinic today. They just called and cannot dispense emsam. I understand. But since my husband and I have now discussed all this very openly and 'relapse' has been officially declared, what difference would a patch make tonight? So the big hospital organization which is how meds are often done will clear away a spot for me tomorrow with a primary there. I don't have to go trotting out any emergency terms since there is no harming of anyone involved.
Is it difficult for folks to get treated for things of any sort where you live? Where I am, it's impacted and spilling over.
Posted by sigismund on June 26, 2011, at 18:15:47
In reply to Re: half thoughts » sigismund, posted by floatingbridge on June 26, 2011, at 16:22:52
>Is it difficult for folks to get treated for things of any sort where you live?
Oh yeah sure. Something like you have, yes.
Of course you can get a doc to prescribe Nardil or Parnate but to find out what is really wrong and do something about it is really hard.
This bloke helped me more than anyone else....
http://www.nutritionmedicine.org/index.php?id=46
Posted by Phillipa on June 26, 2011, at 20:05:39
In reply to Re: half thoughts » sigismund, posted by floatingbridge on June 26, 2011, at 16:22:52
FB oh shoot!!!! Got something for sleep tonight? Love Phillipa
Posted by floatingbridge on June 26, 2011, at 20:56:32
In reply to Re: half thoughts » floatingbridge, posted by Phillipa on June 26, 2011, at 20:05:39
Yes. Ambien, which works. I look forward to sleep. Today slept 7 hours, but pain woke me up.
I figured out why the pain is so wicked and everything is worsening. It's been one week today that I removed my last patch.
Please remind me not to do things like
that. I mean just flat out say:dear fb, don't f*ck with your meds. They are helping you with pain and cognition
more than you know.
No need to be polite about it. It's pretty official and can go down into the infinite hyper-googlable cross-indexed search engines of Dr Bob and infinity until the Armageddon and we all lose power and rediscover the grand invention of paper.
Posted by Phillipa on June 26, 2011, at 21:38:48
In reply to Re: half thoughts » Phillipa, posted by floatingbridge on June 26, 2011, at 20:56:32
FB well now you know and that's the most important fact but a cyber smack will be in order if you even mention stopping again!!!! Love Phillipa
Posted by floatingbridge on June 26, 2011, at 22:05:37
In reply to Re: half thoughts » floatingbridge, posted by sigismund on June 26, 2011, at 18:15:47
sigi, I didn't see this post before. Thank you.
Posted by morgan miller on June 27, 2011, at 1:52:47
In reply to Re: more thougts on social phobia » morgan miller, posted by floatingbridge on June 26, 2011, at 15:18:00
Maybe we need to be blocked emotionally some, seems like everyone else walking around is.
I'm still doing better. Tweaking meds, trying to hit the gym or run outside, and sticking with my paleo-ish diet. I have bad days, like laying on the couch and napping bad days, but I don't think they are a biproduct of depression. I still need to figure out what is mysteriously going on with my mind and body. It could just simply be whacked out neurotransmitters and maybe an impaired hypothalamus/pituitary/adrenal axis. I'm actually hoping adding sertraline back into the mix(i'm taking it along with lexapro) will further help to restore HPA axis function, that is, if it has been impaired as a result of chronic stress/depression/anxiety.
I just decided to come back here and see what was going on. I admit, when I'm doing better, I tend to want to spend less time on the computer.
I really hope you find some relief soon FB.
Morgan
Posted by floatingbridge on June 27, 2011, at 11:53:39
In reply to Re: more thougts on social phobia, posted by morgan miller on June 27, 2011, at 1:52:47
> Maybe we need to be blocked emotionally some, seems like everyone else walking around is.
>: J
> I'm still doing better.
Yay(!). Glad to hear this.
>Tweaking meds, trying to hit the gym or run outside, and sticking with my paleo-ish diet. I have bad days, like laying on the couch and napping bad days, but I don't think they are a biproduct of depression. I still need to figure out what is mysteriously going on with my mind and body. It could just simply be
whacked out neurotransmitters and maybe an impaired hypothalamus/pituitary/adrenal axis. I'm actually hoping adding sertraline back into the mix(i'm taking it along with lexapro) will further help to restore HPA axis function, that is, if it has been impaired as a result
of chronic stress/depression/anxiety.
>Thanks for the update. I am interested in how you are working with your situation. I'm glad you are taking good care of yourself.
> I just decided to come back here and
see what was going on. I admit, when I'm doing better, I tend to want to spend less time on the computer.
>Yes!
> I really hope you find some relief soon FB.
>
> MorganThanks Morgan. I will. I am now out of the bedroom and in the living room. Sometimes progress seems small, but it's there.
: J
Posted by floatingbridge on June 27, 2011, at 13:53:26
In reply to Re: half thoughts » floatingbridge, posted by sigismund on June 26, 2011, at 18:15:47
Well, sigi, yeah. My husband called my ex pdoc. It's come to that, someone having to discuss my treatment. So pdoc calls back and says Nardil. So, yes, the prescibing can be done. But remind me to look at my practice kindness wallet card because I could just smack that man after 2 years or more asking him for a maoi. It's a bit late.
And do you think I want to take a single thing today? I cannot abide the thought of another medication. I have my tiny norco pile and my once a day ambien. I am exhausted.
The corporate med place called today. That's good I guess, but I've gone into hiding from doctors. Yeah. I'll get there this week. Show up. Get looked at, checked off, record complete. I just don't see how I can ever start anything. It's like thinking about touching a distant galaxy.
I still have an appt at Stanford for their anxiety clinic. I will make that as much out of curiosity as 'hope'. Maybe curiosity is a better stance to cultivate.
I am very glad you received (and found) some effective care. I had a good tcm person. I really don't know anymore. You sound like you've walked the line w/ some success.
> >Is it difficult for folks to get treated for things of any sort where you live?
>
> Oh yeah sure. Something like you have, yes.
>
> Of course you can get a doc to prescribe Nardil or Parnate but to find out what is really wrong and do something about it is really hard.
>
> This bloke helped me more than anyone else....
> http://www.nutritionmedicine.org/index.php?id=46
Posted by sigismund on June 27, 2011, at 14:14:39
In reply to Re: half thoughtsn » sigismund, posted by floatingbridge on June 27, 2011, at 13:53:26
That doc I mentioned was good on lots of things, but not with sleep.
I don't know...it's just my impression from reading your words.....but it is that you are not so much depressed or socially phobic as sick. I don't know what sort of sick. What are we talking about? Pain, fatigue, anxiety, insomnia? And the results of drug treatment, the damage it does. That too, I suppose.
Looked at that way Nardil does not sound like such a good idea. If I had to take a decent AD, I'd take that though. So I dunno.
My feeling about depression is squewed/scewed/(sp?) by the fact that for me it is despair. The idea that you could have depression without despair was news to me.
Posted by floatingbridge on June 27, 2011, at 14:42:55
In reply to Re: half thoughtsn » floatingbridge, posted by sigismund on June 27, 2011, at 14:14:39
sigi, I dunno. For me and treatment, all of the above. Anxiety first? It is awful. For you? Sleep most intractable?
Umm. The term existential depression. It was used once. Is that useful to you? The doc looked kinda' sad and sober when he said it. Said maoi's were the best. But I think there are some things for some people that science can't really touch. At this point. Hence the sober look, like, sorry lady, my very good science no longer provides a map.
Wow. A spelling question. I know the word, but not the spelling.
Posted by floatingbridge on June 27, 2011, at 14:48:58
In reply to Re: half thoughtsn » floatingbridge, posted by sigismund on June 27, 2011, at 14:14:39
Skewed?
I don't like thinking you know despair. I am sorry if that's true. Why do you think some hold up under it better than others?
>
> I don't know...it's just my impression from reading your words.....but it is that you are not so much depressed or socially phobic as sick. I don't know what sort of sick. What are we talking about? Pain, fatigue, anxiety, insomnia? And the results of drug treatment, the damage it does. That too, I suppose.
>
> Looked at that way Nardil does not sound like such a good idea. If I had to take a decent AD, I'd take that though. So I dunno.
>
> My feeling about depression is squewed/scewed/(sp?) by the fact that for me it is despair. The idea that you could have depression without despair was news to me.
Posted by sigismund on June 27, 2011, at 15:19:13
In reply to Re: half thoughts » sigismund, posted by floatingbridge on June 27, 2011, at 14:48:58
I don't know why some can bear it and others can't.
Despair is a perfectly valid philosophical position.
If nothing matters, then it doesn't matter if you despair.
So there's the no God to put a floor under everything problem, just for a start.
Despair and me are old friends. I don't like to be separated too long from it. I get irritable when people try to offer me hope. I must be a pain to live with.
Posted by sigismund on June 27, 2011, at 15:26:09
In reply to Re: half thoughtsn » sigismund, posted by floatingbridge on June 27, 2011, at 14:42:55
>For you? Sleep most intractable?
After too long on 3 hours sleep a night I relented and decided to take 300mg gabapentin at bedtime.
For something that feels mild when you are awake, it is pretty good for sleep maintenance. Better than temazepam. I get 5 hours now, which is good enough.
What is existential depression? That life is pointless and painful? I feel better just saying it. Very funny indeed.
Posted by floatingbridge on June 27, 2011, at 16:23:38
In reply to Re: half thoughtsn » floatingbridge, posted by sigismund on June 27, 2011, at 15:26:09
> >For you? Sleep most intractable?
>
> After too long on 3 hours sleep a night I relented and decided to take 300mg gabapentin at bedtime.
>
> For something that feels mild when you are awake, it is pretty good for sleep maintenance. Better than temazepam. I get 5 hours now, which is good enough.
>Very good. You take it at bedtime, as needed? The 'mild when awake' part is difficult with medication.... Sleep is cornerstone, imo.
> What is existential depression? That
life is pointless and painful? I feel better just saying it. Very funny indeed.:D oh good. I dunno. Had to google a bit to cobble together a meaning. Nothing I particularly hold to.
I thought about your last post re: philosophy. I remembered this therapist, and how much comfort she brought to the moment with her certain candor. She has a structure. Philosophy is being able to build something out of...thought/experience? Anyways, she wasn't in a rush to say this is or you are. She offered no hope other than that life
can feel better with less anxiety and a
cure wasn't possible, but less was definitely attainable. Warm but very
neutral. She didn't seem to be shaken by
despair, but, yeah, had made friends with it. She wasn't even particularly Buddhist which is the vogue here.I was cruising wiki and found 'New Wittgenstein'. I can't read one sentence of philosophy, but liked the entry. That philosophy was therapeutic, and words are tools.
O.K. my boy is home now. Thanks always for talking, sigi.
Posted by floatingbridge on June 27, 2011, at 16:29:15
In reply to Re: half thoughtsn » floatingbridge, posted by sigismund on June 27, 2011, at 15:26:09
Do your readings in history provide structure or context for you?
Posted by sigismund on June 27, 2011, at 17:09:07
In reply to Re: half thoughts » sigismund, posted by floatingbridge on June 27, 2011, at 16:23:38
>New Wittgenstein'
I enjoyed this book about him......
Posted by morgan miller on June 27, 2011, at 17:10:16
In reply to Re: half thoughtsn » floatingbridge, posted by sigismund on June 27, 2011, at 14:14:39
I hear you sigi on the depression with despair thing, but as you know there are many depressed people walking around without despair.
Posted by sigismund on June 27, 2011, at 17:12:23
In reply to Re: half thoughts » sigismund, posted by floatingbridge on June 27, 2011, at 16:29:15
>Do your readings in history provide structure or context for you?
Not a comfortable one, but yes, I think they have.
(It's so recent too. It's not ancient history, even though it feels like it. Just in the decades before I was born.)
And more confidence in my judgement.
Posted by sigismund on June 27, 2011, at 17:19:07
In reply to Re: half thoughtsn, posted by morgan miller on June 27, 2011, at 17:10:16
>but as you know there are many depressed people walking around without despair.
Well, I find myself wondering why you wouldn't (to take an instance) call it chronic fatigue if it was a question of energy.
I don't understand a thing about why these things are grouped together the way they are.
It feels like a linguistic tangle saying things like 'disturbed sleep is a symptom of depression'.
I don't (of course) understand TCM either, where all sorts of odd things are grouped together.
Posted by floatingbridge on June 27, 2011, at 19:37:04
In reply to Re: half thoughts » floatingbridge, posted by sigismund on June 27, 2011, at 17:09:07
I might be able to manage this some day.
That would be improvement.
I see the author has a forthcoming novel.
Being able to sustain reading seems such a boon. Honestly.
I think I really will look at the whole she-bang relapse as anxiety-driven. Even the depression part, more physical this
time around. That might be most helpful. The despair is very deep but intermittent. As Morgan suggested, maybe a 60% med. Who knows? I am glad to be less driven. I think I have reached the bottom on this, and it's back to digging out.Being able to post here has helped me out alot. Thinking things through. Being too exhausted to talk but full of thoughts is, well, I was going to say, unbearable at times. Like too exhausted to project my voice. Plus it spares my family. Sigi, I can't imagine you are painful to live with. We are all pests in one way or another.
Thanks.
> >New Wittgenstein'
>
> I enjoyed this book about him......
>
> "The World As I Found It"
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