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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 28. Go back in thread:
Posted by Lamdage22 on January 4, 2016, at 13:30:09
In reply to Re: chronic suicidality, posted by rjlockhart37 on January 4, 2016, at 13:27:27
yes i have to grow.
Posted by SLS on January 4, 2016, at 14:06:05
In reply to chronic suicidality, posted by Lamdage22 on January 4, 2016, at 0:35:35
> What a fun way to live.
>
> Yet i am not doing it.
>
> I am thinking to add 5htpC_E makes a good point.
Suicidality is not an easy thing to categorize as being either biological or psychosocial. Things get real dangerous when there is a combination of the neurobiological suicidal state and psychosocial triggers producing negative thinking.
It is very important to try to minimize anxiety and anger. Both of these can bring one closer to suicide. You really need to recognize these emotions and avoid anything that causes you to become impulsive.
People can become suicidal for no reason (biogenic).
People can become suicidal over real issues (psychogenic).
To remain alive when the two types of suicide are combined is an extraordinary feat.
To be able to choose life over death despite living in a suicidal state is an achievement. You do this very bravely. This is true of a great many people who post on Psycho-Babble.
- Scott
Posted by Guy on January 4, 2016, at 18:49:38
In reply to chronic suicidality, posted by Lamdage22 on January 4, 2016, at 0:35:35
I don't think 5HTP is going to do anything given the long list of meds you are currently taking. From personal experience, I would say that anxiety is the main driver of suicidal thoughts. Anything to escape the pain! Are you currently experiencing severe anxiety? I have found that antidepressants make me batshit crazy with anxiety, and that is why I am wondering if the culprit in your mix might be the Effexor. You would know best if your anxiety started with the Effexor. You have to think back. Zyprexa is widely recognized as the med that brings (most) people back from the brink of suicide as it helps people calm down and sleep. Seroquel also helps with sleep, but it made so sick all I wanted to do was jump off a cliff. Hang in there and try to put your finger on any med that made you worse. Also, get to the ER if you are starting to feel impulsive.
Posted by linkadge on January 4, 2016, at 19:08:29
In reply to Re: chronic suicidality, posted by Guy on January 4, 2016, at 18:49:38
Sometimes I find that serotonergic agents actually make my suicidiality (when I have it) worse.
To be honest, you sound more like rapid cycling bipolar to me....in which case you might try a reduction in Effexor and prescription lithium.
I am currently taking lithium only, and to be honest, am doing fairly well. I do have Effexor and Ritalin as prescriptions but rarely take them.
Linkadge
Posted by Lamdage22 on January 5, 2016, at 4:10:38
In reply to Re: chronic suicidality, posted by linkadge on January 4, 2016, at 19:08:29
you got that wrong. if i dont take the Effexor i REALLY am suicidal.
Posted by Lamdage22 on January 5, 2016, at 5:34:25
In reply to Re: chronic suicidality, posted by Guy on January 4, 2016, at 18:49:38
yes i have anxiety. Anxiety that i cant take care of myself anymore and anxiety what will happen when my parents are dead.
Posted by Lamdage22 on January 5, 2016, at 5:49:50
In reply to Re: chronic suicidality, posted by Lamdage22 on January 5, 2016, at 5:34:25
i am scared of hights because some impulsive part of me wants to jump down
Posted by SLS on January 5, 2016, at 7:20:32
In reply to Re: chronic suicidality, posted by Lamdage22 on January 5, 2016, at 5:49:50
I know that things are exceedingly difficult for you right now.
How can you be sure that you would not commit suicide this time? I am not challenging you per se, but I think it would be helpful to note when your suicide prevention mechanisms break down. Do you think there are any behavioral or psychological/emotional red flags that would indicate that your safety is an issue? One must be very resilient in order to fight chronic thoughts and feelings of suicidality and reject them.
Right now, my resilience is the lowest that I can remember. It doesn't take much to get me thinking about suicide. So far, I have felt confident that I would not self-terminate. However, there was one time when a bad drug reaction caused me such an increase in depression with anxiety that I began to make out a will and began to get my finances in order. My family did not take me seriously. I was serious and had given it a great deal of thought. My family thought that the whole thing was drama and that I would never follow through with my plans. That type of thinking has resulted in many deaths. Thankfully, the suicidal state disappeared within 36 hours of discontinuing the offending drug.
I believe that it can make sense for some people to end their lives. I call it "autoeuthanasia" It is a very complicated issue.
In any event, I think everyone would like to see you get through this bad time without you hurting yourself.
I'm not one to so quickly recommend benzodiazepines, but perhaps Klonopin to be taken every day would help. Lyrica could be an alternative. I would also look to evaluate your need for Seroquel. If you are not sure that it is adding significantly to your treatment, I would replace it. You could either increase the Zyprexa, or add Risperdal. As with many APs, Risperdal can produce akathisia. However, this is not the same as anxiety. Risperdal might produce anxiety and insomnia for a few days before exerting its antipsychotic/anxiolytic (anti-anxiety)/antidepressant therapeutic effects. I tried low-dosage Risperdal and experienced anxiolytic and antidepressant effects. I experienced no side effects except some sedation for the first 3 days. Unfortunately for me, the antidepressant effect lasted for less than a week.
- Scott
Posted by Lamdage22 on January 5, 2016, at 7:30:32
In reply to Re: chronic suicidality » Lamdage22, posted by SLS on January 5, 2016, at 7:20:32
Hi Scott,
I am dropping the Seroquel to 600 probably tomorrow. However i still have a little bit psychotic thoughts. There was someone on the radio saying "a therapist or an exorcist". I had an idea of reference that they were talking about me although i know they did not. Also someone on the street said "too lazy to work" and i also had an idea of reference. This was yesterday.
I think Lyrica can still be addicting. I would favor Neurontin as needed in the place of Lorazepam.I have built up a tolerance to Lorazepam and iam not exactly happy about it.
I have good experiences with Neurontin.
Posted by SLS on January 5, 2016, at 8:22:40
In reply to Re: chronic suicidality, posted by Lamdage22 on January 5, 2016, at 7:30:32
> Hi Scott,
>
> I am dropping the Seroquel to 600 probably tomorrow. However i still have a little bit psychotic thoughts. There was someone on the radio saying "a therapist or an exorcist". I had an idea of reference that they were talking about me although i know they did not. Also someone on the street said "too lazy to work" and i also had an idea of reference. This was yesterday.I am glad that you understand your illness(s) so well.
I experienced ideas of reference during my manic attacks. I needed full doses of Zyprexa or valproate 1000-1500 mg/day to make the psychotic symptoms disappear entirely. However, I am truly bipolar.
> I think Lyrica can still be addicting.
In theory. It does happen, though. I just don't know how often. I would start a new thread and ask who has become addicted to Lyrica; being sure to differentiate between true addiction with cravings versus physiologically dependence with withdrawal syndrome. Lyrica tends to work better for GAD than Neurontin. I guess you should try Neurontin first. Let's hope it works for you. However, unless substance addiction has been an issue with you in the past, you could then switch to Lyrica. Any "high" that you might experience with Lyrica wears of very quickly - within a few days. For me, the high was not at all euphoric. It was more of a feeling of being slightly drunk with less anxiety. I felt in some way lighter and less apt to ruminate. "Horse" would be a good person to talk to about Lyrica.
You are a hard worker. You probably read and learn stuff faster than I do, and I try to check in with you so that I can learn things. I also like to help when I can.
- Scott
Posted by Lamdage22 on January 5, 2016, at 9:03:23
In reply to chronic suicidality / winning the chronic battle » Lamdage22, posted by SLS on January 5, 2016, at 8:22:40
> > Hi Scott,
> >
> > I am dropping the Seroquel to 600 probably tomorrow. However i still have a little bit psychotic thoughts. There was someone on the radio saying "a therapist or an exorcist". I had an idea of reference that they were talking about me although i know they did not. Also someone on the street said "too lazy to work" and i also had an idea of reference. This was yesterday.
>
> I am glad that you understand your illness(s) so well.
>
> I experienced ideas of reference during my manic attacks. I needed full doses of Zyprexa or valproate 1000-1500 mg/day to make the psychotic symptoms disappear entirely. However, I am truly bipolar.
>
> > I think Lyrica can still be addicting.
>
> In theory. It does happen, though. I just don't know how often. I would start a new thread and ask who has become addicted to Lyrica; being sure to differentiate between true addiction with cravings versus physiologically dependence with withdrawal syndrome. Lyrica tends to work better for GAD than Neurontin. I guess you should try Neurontin first. Let's hope it works for you. However, unless substance addiction has been an issue with you in the past, you could then switch to Lyrica. Any "high" that you might experience with Lyrica wears of very quickly - within a few days. For me, the high was not at all euphoric. It was more of a feeling of being slightly drunk with less anxiety. I felt in some way lighter and less apt to ruminate. "Horse" would be a good person to talk to about Lyrica.
>
> You are a hard worker. You probably read and learn stuff faster than I do, and I try to check in with you so that I can learn things. I also like to help when I can.
>
>
> - ScottWell, thats a nice compliment. Two of them actually. I dont now if i learn stuff faster, but if so i think its age related. I am not 22 anymore but still fairly young.
I am looking forward to two things right now. Cannabidiol and Glyx-13. They told me Glyx-13 (Rapastinel) would take until 2018 at the very least though. So i try to make the best of the time.
I think my worst enemy is boredom.
Posted by baseball55 on January 5, 2016, at 20:02:26
In reply to Re: chronic suicidality / winning the chronic battle, posted by Lamdage22 on January 5, 2016, at 9:03:23
DBT was developed precisely to help people cope with chronic thoughts of suicide and self-harm. It doesn't matter whether the cause is bio-psycho-social. Intrusive suicidal intentions are dangerous and can occur independent of depressive moods. Coping is the idea of DBT. Take meds, yes. Look for medical cures, yes. But in the meantime, learn to cope with suicidal intentionality so you can stay alive and out of the hospital.
I know recommending therapy on this board is pretty much a waste of words, but that's what DBT was developed to do and it has worked for me. After two suicide attempts and at least seven hospitalizations over five years, I have been hospital free for nearly five years. Not depression-free, but feel some measure of control over the suicidality.
Posted by SLS on January 5, 2016, at 20:30:37
In reply to Re: chronic suicidality / winning the chronic battle, posted by baseball55 on January 5, 2016, at 20:02:26
> I know recommending therapy on this board is pretty much a waste of words
No way! They are words of wisdom.
When I was in psychotherapy, it was my intention to take care of as much old crap as possible and perhaps to continue down a path toward self-actualization. Of course, severe depression makes this very difficult, but I did learn. I told my therapist that she had one job - to keep me alive. Everything else was icing on the cake.
> ...but that's what DBT was developed to do and it has worked for me. After two suicide attempts and at least seven hospitalizations over five years, I have been hospital free for nearly five years. Not depression-free, but feel some measure of control over the suicidality.
That's amazing.
Thank you.
- Scott
Posted by Lamdage22 on January 6, 2016, at 7:38:59
In reply to Re: chronic suicidality / winning the chronic battle » baseball55, posted by SLS on January 5, 2016, at 20:30:37
I only got promethazine for as needed. My Pdoc didnt want to prescribe Neurontin.
Posted by SLS on January 6, 2016, at 11:42:53
In reply to Disappointing. No Neurontin, posted by Lamdage22 on January 6, 2016, at 7:38:59
> I only got promethazine for as needed. My Pdoc didnt want to prescribe Neurontin.
I have seen promethazine (Phenergan) work as a potent anxiolytic when it was chosen to replace Zyprexa in a male who had gained too much weight on Zyprexa. I haven't heard of promethazine as being useful in depression. I hope you find it helpful.
- Scott
Posted by Lamdage22 on January 6, 2016, at 12:11:41
In reply to Re: Disappointing. No Neurontin, posted by SLS on January 6, 2016, at 11:42:53
thanks.
Posted by Christ_empowered on January 6, 2016, at 19:29:42
In reply to Re: Disappointing. No Neurontin, posted by Lamdage22 on January 6, 2016, at 12:11:41
what was your doc's reason for not Rx-ing the neurontin? I just find that strange...I go to a public/community mental health clinic. No controlled substances..EVER. They give me a lil bit of neurontin.
Just curious. I hope the promethazine works.
Posted by Lamdage22 on January 7, 2016, at 3:21:34
In reply to Re: Disappointing. No Neurontin, posted by Christ_empowered on January 6, 2016, at 19:29:42
He didnt like the idea of as needed Neurontin.
Posted by Lamdage22 on January 7, 2016, at 5:32:59
In reply to Re: Disappointing. No Neurontin, posted by Lamdage22 on January 7, 2016, at 3:21:34
he is a very inside the box psychiatrist
Posted by SLS on January 7, 2016, at 6:13:45
In reply to Re: Disappointing. No Neurontin, posted by Lamdage22 on January 7, 2016, at 5:32:59
Magnesium?
Valerian root?
Glycine?
- Scott
Posted by Lamdage22 on January 7, 2016, at 8:42:00
In reply to Re: Disappointing. No Neurontin, posted by SLS on January 7, 2016, at 6:13:45
idk if Glycine is so safe.
Posted by SLS on January 7, 2016, at 14:36:09
In reply to Re: Disappointing. No Neurontin, posted by Lamdage22 on January 7, 2016, at 8:42:00
> idk if Glycine is so safe.
You are right. I didn't research it well enough.
What about sarcosine? I think it might merit a quick search.
I'm trying to think of things that you might find attractive as alternative treatments.
http://www.ncbi.nlm.nih.gov/pubmed/?term=sarcosine+AND+%28psychosis+OR+schizophrenia+OR+psychotic%29
- Scott
Posted by Lamdage22 on January 7, 2016, at 15:17:03
In reply to Re: Disappointing. No Neurontin, posted by SLS on January 7, 2016, at 14:36:09
Thanks, Scott.
Sarcosine gave me akathisia unfortunately.
How is your Resveratrol going?
Posted by Lamdage22 on January 7, 2016, at 15:27:46
In reply to Re: Disappointing. No Neurontin, posted by Lamdage22 on January 7, 2016, at 15:17:03
Maybe it will help psychosis and depression
Posted by SLS on January 7, 2016, at 16:36:28
In reply to Re: Disappointing. No Neurontin, posted by Lamdage22 on January 7, 2016, at 15:17:03
> Thanks, Scott.
>
> Sarcosine gave me akathisia unfortunately.
>
> How is your Resveratrol going?I am waiting for the higher dosage of desipramine to settle-in first. Once I see how far it gets me, I'll add resveratrol. I don't want to confuse things.
I think you are doing the right thing to explore CBD.
- Scott
This is the end of the thread.
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