![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Roo on July 30, 2002, at 14:52:26
Okay, it's another person possibly jumping on the
BP2 bandwagon...well actually cyclothymia...My p-doc
kind of refuses outright diagnoses...she says she thinks
I have cycling depression that tends to get stuck in the
lows. I've had a hard time accepting all this because I've
always thought of myself as just depressed. But examining
it all now, it makes sense. My moods are definitely
cyclical. The thing is about 3 years ago I had this nightmare
job that put me into a major depression, but it was a different
sort of depression than I ever experienced...it was very, very
agitated and anxious, can't sit still, can't think straight, couldn't
hardly stand to be in my own skin. Never knew how I was going to feel
from day to day. My engagement ended up being broken off--I never knew
how I felt about the guy--one day I'd be totally in love, the other
not sure at all, and kind of repulsed and terrified of committment.
The relationship and the job are long gone, but I haven't been the
same since--I've never really stabilized, and the quality of my moods
have changed a lot. I've never really had suicidal tendencies, but now
when I "cycle" (as the p-doc refers to it) I get really agitated and have
suicidal thoughts and that can't stand to be in my own skin feeling.
I was on a mood stabilizer for a little while and it helped but I quit it
due to weight gain...that was 4 months ago and I haven't been stable since.
Also have not been stabilized on an AD for awhile...the prozac that worked so
well for me for 7 years pooped out...I tried zoloft, but it gave me terrible
diarreah and at 100 mg's made me feel wired and suicidal. Now I'm trying effexor.
My p-doc seems to think I need to be on a mood stabilizer, and I'm begining to
wonder if she may be right...I just don't understand how that one event seemed to
push me over into some other type of depression, this more cycling, anxious kind
with low lows, suicidal stuff. Is it possible that one event can make you into
a bipolar2? It's just so strange to me, but I have to admit, I haven't been stable
for nearly 3 years, since that event. Any thoughts?
Posted by Dinah on July 30, 2002, at 15:13:13
In reply to Questions about DX...please help... :-(, posted by Roo on July 30, 2002, at 14:52:26
Hi Roo, sounds like we have the same sort of problem. My official dx is cyclothymia too. And my depressions are definitely of the agitated jump out of my skin feeling.
My obvious problems with cycling started with postpartum depression and was exacerbated by a nasty trial of wellbutrin. Before that, I probably had some problems and definitely OCD, but things got worse postpartum and never did get back to "normal".
If I were you, I'd go with the mood stabilizers. They're the only thing that keep me going. I'm on a very low dose of depakote and klonopin as needed.
Posted by Roo on July 30, 2002, at 15:32:47
In reply to Re: Questions about DX...please help... :-( » Roo, posted by Dinah on July 30, 2002, at 15:13:13
Dinah--Thanks for responding :-) Isn't it weird
to be so emotionally different after one event? It's like
one event just whacks everything out of balance. I guess
it could be likened to a car accident...some people get their
backs or necks hurt and they're never quite the same.Tell me about some of the side effects you've experienced with
depakote? Any weight gain? I've thought about topomax. I liked
lamictal, but I could NOT sleep on the stuff and the bloat was
really uncomfortable.What do you think about the agitated type cycling? What is hypomania?
Is it only when you up "up" and productive with racing thoughts, or
can it also be when you're cranked up in that really agitated can't stand
it kind of way?Maybe I SHOULD get back on a damn mood stabilizer. Today I got
complaints about my job performance. People are really starting
to notice my non-functional-ness. And I'm at a job where I can
(and have) been able to hide it pretty well, but I guess it's
gotten really obvious.Do you feel when you have that cranked up feeling that you can't
really be productive with it? It would be one thing if I could take
the energy and DO something with it, but it seems to sort of
paralyze me. Do you ever experience that?
Posted by Gabbi on July 30, 2002, at 18:58:28
In reply to Re: Questions about DX...please help...Dinah, posted by Roo on July 30, 2002, at 15:32:47
Roo, its my usual I'm sorry I can't help but I can commiserate type of letter. Actually cyclothymia is what My Doctor actually said, Bipolar 2 was my own interpretation, don't know if its the same or not.
In retrospect it makes a lot of sense to me too, I was diagnosed with A.D.D due to my impulsive behavior, but I noticed it was cyclical impulsive behavior.There have been a few letters of yours, I don't know how much of my blather you've read, but one letter of yours I honestly thought I'd written and forgotten about. Then when I realized it wasn't "me" I'd thought it was ShelliR's and mentioned to her how much it weirded me out(how articulate)She told me it was actually your letter which she'd included in her response to you.
Your most recent "when everything falls apart", was "me" too. I can't respond to your letters because I'd feel hypocriticalI wait and hope the feeling will pass too, but those are such feeble words.
Well I just thought that I would let you know what my Doctor prescribes when I see him next, and I hope you will let me know how you are doing I'm completely alone next month, and scared about being a guinea pig again, also worried that a "stabilizer" might only dampen my occasional good moods so that I'm depressed consistantly.
This is such a disjointed letter sorry Roo, if you can make sense of any of it, can you keep us "posted"
Posted by Dinah on July 30, 2002, at 19:57:37
In reply to Re: Questions about DX...please help...Dinah, posted by Roo on July 30, 2002, at 15:32:47
Hi Roo,
Well, I tend to forget what happens when I'm hypomanic except for generalities. Hypomanic does NOT have to feel good. That agitated itchy crawly jump out of your skin feeling can be hypomania too. I also consistently get some physical symptoms that are my first alert to watch my mood. The wind hurts my arms, I can smell everything, I get hypersexual, insomnia, things like that. It's happening now and I've got a call into my pdoc to ask him if it's okay to try increasing my depakote for a while.I am sometimes very productive while hypomanic. Sometimes (like now) I am extremely unproductive because I have the attention span of a flea and I am distracted. I'm in big trouble at work.
Depakote hasn't had many if any side effects on me, but you must remember I am on a micro dose of 125 mg. I didn't gain any weight on it but that could be because I had already gained 50 lbs on Luvox and weighed 195 lbs when I started Depakote. I have held steady at that weight.
Hope that helps. :)
Posted by Dinah on July 30, 2002, at 19:59:56
In reply to Re: Questions about DX...please help..., posted by Gabbi on July 30, 2002, at 18:58:28
Hi Gabbi,
Just wanted to assure you that at low doses mood stabilizers don't do away with the good times. I understand from others that at high doses they can flatten your mood, but in general my problems with flat moods came from SSRI's, not mood stabilizers.
Posted by Roo on July 31, 2002, at 9:51:08
In reply to Re: Questions about DX...please help..., posted by Gabbi on July 30, 2002, at 18:58:28
Gabbi--How interesting you thought my posts were yours?
Well thanks for the empathy...it's nice to have it...makes
me feel less like a whiner. I agree with Dinah...mood stabilizers
don't flatten your mood...you just don't down spiral as much...the ssri's
are another story...Yes, I read all your "blather" as you say--your posts always
make me laugh. :-)Dinah--thanks for sharing your experience. I have some
similar stuff--the hypersexuality (although ssri's have
dampened that quite a bit) and feeling really sensitive to
loud noises. And this is a little strange...I don't know if
anyone can relate, but I get kind of emotionally promiscuous...
sharing "too much information" to inappropriate people..it's like
I've got to talk to someone, ANYONE, about my emotional state!
It's gotten me into trouble at work before....embarrassing...D
Posted by Gabbi on July 31, 2002, at 14:36:54
In reply to Re: Questions about DX...thanks dinah and gabbi, posted by Roo on July 31, 2002, at 9:51:08
I'm not going to belabour this anymore but, umm I've actually used that exact term
"emotionally promiscuous" I tried to tell myself it was from having to be so open so quickly with Dr's et al..that I lost that boundary but its more than that its almost a compulsion. Its relatively new with me. Its ruined potential relationships, jobs, and when I have a more "rational" day I'm humiliated, its like being told what you did when you were really drunk at a party.
Anyways, time to go Garrulous Gabbi(roo, no need to respond, you have a life, I just had to comment, cause, its a little weird to me too)
Posted by Roo on July 31, 2002, at 20:09:11
In reply to I'm glad I could at least make you smile:) » Roo, posted by Gabbi on July 31, 2002, at 14:36:54
Gabbi--That's _exactly_ what's it's like...getting drunk
at a party and having people tell you what you say the next day...
perfect analogy...and it's similar to be drunk because you're
in a altered state where you feel like you have so little control...I've scared away potential mates too with this emotional promiscuiousness
and also kind of pathologizing myself..explaining to them, in detail, my
every problem. I usually confess about depression and meds way too early on
in a relationship. I've painted a picture of myself as a nutcase at work...
(well okay, i'm exagerating at bit) but you get the picture. I need to get
a grip. Sometimes I think I really need to just stop trying so hard to fix
myself, and seeing myself as this problem that needs to be fixed, and just
go out and throw a damn frisbee or something. I think we're all pretty funny and
intelligent on this board and that's why I've stayed fascinated for years now by
PB and PSB...but sometimes I wonder if we all have this same tendency to pathologize
ourselves...I know I do anyway.I saw a great poster today, it said "Don't believe everything you think".
Gab away, Gabbi, always love hearing from you. Are you feeling any
better these days?
Posted by Gabbi on July 31, 2002, at 20:37:30
In reply to Re: I'm glad I could at least make Gabbi, posted by Roo on July 31, 2002, at 20:09:11
Precisely what I love about the board too,
and as for the Pathologizing well I won't go on, (ha) but in a response to BarbaraCat regarding her tantrums, I said about the same thing.And about the relationships, its so easy for someone to say "well if they can't accept you for who you are you don't need them"
but in all honesty if I'd only known someone a short period of time and they started telling me all the stuff that I tell people, before I've had a chance to see just what their 'crazy' limits are, I'm not sure I'd stick around though lately I've been so desperate my standards are crashing around my ears....Its so hard to know when you are doing to much "navel gazing" when if you saw your "pathologized" traits characterized in a movie you might find the heroine charmingly quirky..
Its that constant agony of grief and loss that I can't walk away from, or at least haven't found a way to yet. And so far the only time I've seen men fall in love with mentally tortured women is in foreign films....Oh, one more thing about the ridiculousness of depression. this is for you to laugh at by the way. When I read your "when it all falls apart"
As I said, it was "me" and I think we'd all be lying if we said there isn't some comfort in seeing someone you can relate too,, (though of COURSE you'd never wish it on anyone.. well except someone who didn't believe in depression)
But when you said you were going to drive until the gas tank was empty, I thought, "I'm still worse off because I can't even drive" boo hoo.Its nuts.
And yet like you I can seem so casual about it days later...Thanks for saying Gab-away, right now the ONLY positve feedback I get is from the 'board' and little things like that mean a lot
Take care:
keep me posted
Thanks Gabbi-Gabbi
Posted by Gabbi on July 31, 2002, at 23:18:45
In reply to Re: Dare I say ditto again....., posted by Gabbi on July 31, 2002, at 20:37:30
re-read my posts the "when it all falls apart'
I kept referring to that as your post, didn't mean to. A little tuned out in the writing department (as well as others)
Posted by fiona on August 1, 2002, at 10:49:31
In reply to Questions about DX...please help... :-(, posted by Roo on July 30, 2002, at 14:52:26
Hello Roo,
I agree with Dinah, especially about the "ups" not needing to be good. I was originally diagnosed with cyclothymia, but now have been diagnosed as rapid cycling bipolar. My cycles are mostly negative, not always, but a lot of the time I jump from despair to anxiety to agitation. My manic phases start off as mild elation, turning into euphoria, then finishing up as severe agitation and aggression, but these are few and far between and mostly it's the agitation and irritation at myself and the world around me that gets to me.
After 10 months of med changes I am now on a low dose of depakote which seems to be agreeing with me more than any of the rest of the mood stabilisers and antidepressants have. If the mood stabilisers worked for you before then it is prbably a good idea to go back on them. My sister (who is bipolar also) was doing very well on depakote and for a long time she was stable. Hopefully I will also get some stability from the depakote, but as ever, it's a waiting game and we shall see...Wishing you all the luck in getting the right combination for you.
Fiona :)
Posted by Roo on August 1, 2002, at 13:27:04
In reply to Re: Questions about DX...please help... :-(, posted by fiona on August 1, 2002, at 10:49:31
I jump from despair to anxiety to agitation.
My manic phases start off as mild elation,
turning into euphoria, then finishing up as
severe agitation and aggression, but these are
few and far between and mostly it's the agitation
and irritation at myself and the world around me
that gets to me.
Hmmm...That's interesting. I pretty rarely get the euphoria,
and that's what makes me wonder if I "qualify"...the high energy
tends to express itself in anger and frustration. It's more like
I'll feel "normal" for a day or so, then I'll get churned up with
nothing in particular triggering it, and i'll feel teary, an irresistable
impulse to reveal all my feelings to someone, no matter who it is, get
a pack of cigarettes and start chain smoking even though I normally
don't smoke and am an exercise nut...
I don't know, Fiona...I do know that my moods are rarely stable and that
it has effected my ability to function at work and in relationships.I was only on that mood stabilizer for 6 months or so (lamictal),and
I was grieving a 3 year relationship with a guy I was engaged to. But
still, even though I was sad, I was somehow more stable...I talked reasonably
about my sadness and it wasn't the end of the world. Now off the mood stabilizer,
I tend to just get beside myself and not be able to get a handle on it.
Of course, my AD's have been all screwed up too lately, so that could
contribute. I guess the bottom line is it wouldn't hurt to try one and
see if it smoothed things out. I was just hoping to be an AD only kind of
gal. It seems like with time, my depression gets more complex and harder to
treat. Is it a progressive disease? In the early years, I used to just
pop a 20 mg prozac and that took care of it all.
> After 10 months of med changes I am now on a
low dose of depakote which seems to be agreeing
with me more than any of the rest of the mood
stabilisers and antidepressants have.Any side effects from the depakote? What other
mood stabilizers have you tried and how did they effect
you?
Hopefully I will also get some stability from
the depakote, but as ever, it's a waiting game
and we shall see...I hope you do too...how long have you been taking it?
Have you noticed anything yet?>
> Wishing you all the luck in getting the right
combination for you.Thanks :-) And thanks for responding :-)
>
Posted by Gabbi on August 1, 2002, at 16:00:31
In reply to Re: Questions about DX...Fiona, posted by Roo on August 1, 2002, at 13:27:04
Regarding whether depression gets more complex...
Unfortunately it does but not always. I'm one of the lucky "progressive" depression types, where it's not me who progresses, but the depression.Its a matter of luck, I swear, of finding the right doctor. I used to think that my depression was sprouting new arms and legs because of my medication, not in spite of it.
My pdoc, very gently tried to tell me he didn't think that was the case, I branded him a pill pusher,found plenty of GP's who agreed with me stopped my medication and the depression came back but so slowly that of course I didn't recognize it, and once again O'D.
I've repeated this several times, and each time my pdoc has taken me back without an I told you so. I've gone from 20mgs prozac to 60 then added t4 thyroid hormone then added dexedrine and occasionally benzodiazepines.My medication still needs to be "Tweaked" frequently and now that I've learned that I need the medication I will accept that. But its not easy.
And for many I'm sure the medication prescribed does cause some of the mood side-effects I've experienced that as well, until I decided to trust only my "superdoc" finally.Damn if there were only easy answers, but even some doctors will admit diagnosing is an art, and though only 1/1000 people may have an atypical response to certain medications, to that person its a matter a good life or a struggle.
Posted by Roo on August 2, 2002, at 9:37:28
In reply to Re: Questions about DX...Fiona » Roo, posted by Gabbi on August 1, 2002, at 16:00:31
> Regarding whether depression gets more complex...
> Unfortunately it does but not always. I'm one
of the lucky "progressive" depression types,
where it's not me who progresses, but the
depression.What's your dx, I forget? What meds do you take? I certainly
feel like I"m not progressing much, but I tend to be too hard
on myself (like a lot of us here)
>
> Its a matter of luck, I swear, of finding
the right doctor. I used to think that my
depression was sprouting new arms and legs
because of my medication, not in spite of it.
Yeah, I think like that a lof of times too...I really do...
I'm not sure if maybe it's all the medication or going on and
off of it that has 'fucked me up' or if it's just a progressive
illness, or if maybe that job trauma way back when just clicked
my brain chemistry into a different place. I guess it doesn't
really matter...it's what I do about it. I'm starting to feel
maybe I do need a mood stabilizer, but I feel all "defeated" about
it.
Sometimes it feels like depression is all I ever talk about or think
about. Back in the day, when I used to just take a 20 mg prozac, it
took care of the depression, and I just got on with life and didn't think
about it all that much.
> My pdoc, very gently tried to tell me he
didn't think that was the case, I branded him
a pill pusher,found plenty of GP's who agreed
with me stopped my medication and the depression
came back but so slowly that of course I didn't
recognize it, and once again O'D.
Sounds like you have had some really awful experiences with
depression (that's an understatement)...I hope you are feeling
a little better these days....less suicidal?> I've repeated this several times, and
each time my pdoc has taken me back without
an I told you so. I've gone from 20mgs prozac
to 60 then added t4 thyroid hormone then added
dexedrine and occasionally benzodiazepines.Oh never mind my last question then, about what meds your
on...
>until I decided
to trust only my "superdoc" finally.How long has your superdoc known you? It is hard to
trust them sometimes, I think. Although I have a very
nice one that doesn't rush me in and out, will let me
gab on about my problems for a long time even though we're
just doing a med check. I've been seeing her over 3 years...I
think she might have a grip on me...I'd always just seen GP's
before then and have never heard of mood stabilizers, AP's or
any of this other stuff. But I quickly became acquainted with
the "med cocktail" way of doing things. It gets confusing then,
though, because it's hard to tell what's doing what.to that person its a matter a good life or a
struggle.It certainly has taken me awhile. I guess it's because
I won't accept certain side effects, such as weight gain
or sexual dysfunction (good luck, hun?!)...well I've HAD
to accept the sexual dysfunction b/c they all have that
(and I've tried the few that don't and they don't work)...
I'm pretty bitter about that b/c sex is important to me,
even if I'm single and not in a relationship, it still is.I wrote a poem last night about my broken heart, and I thought
about you and our "emotional promiscuiousness" and thought of
sharing it with you, but it's too corny!!Hope you are well--Ruth
>
>
Posted by Gabbi on August 2, 2002, at 22:56:29
In reply to Re: Questions about DX...Gab-on, posted by Roo on August 2, 2002, at 9:37:28
Too Corny huh?
I'm not demanding that you show me the poem, but I have a whole stash of journals that I would be mortified if anyone read... not because they reveal sordid details of my life, but because they have really bad yearbook type "poetry" about my broken hearts. "Dreamer" and I also had a back and forth chat under BLUUEzzz where I mentioned that I'm theoretically a feminist, but still cry like a kid over my last boyfriend cause I felt so safe when he held me. I cringe at admitting that but its true.
I think its impossible to talk about being devastated without sounding like a bloody cliche.
Well not IMPOSSIBLE. I wish I could give this man credit but I don't know who he is, and he's not 'famous' but he said "ever since you left me I've had a taste in my mouth like a mayonnaise flavored soft drink" I loved that, not just because it wasn't a dripping cliche but because I swear I KNOW the taste he was talking about.
Thanks for asking about me, yeah this depression battle just sucks... especially because the longer it lasts the more quickly I cycle in and out, but unfortunately it makes the people who support me less and less patient.
What really chokes me is that I do believe there are other ways to treat it, like accupuncture or other more exotic less noxious therapies (besides the St.Johns wort kava kava....etc) but who can afford it?I'm terrified of slipping into a subsidized housing, slovenly flabby chain smoking (I do that too, when I'm "up") shadow of who I was. I was also a health freak, kick boxer,gym regular.
Oh geez didn't mean to scare you, I'm a rarity most people don't have treatment resistant depressionI've been really bad at actually "answering" any questions in posts lately, I apologize if I went on my own self-obsessed way. I'll read it again to see if I miraculously referred to *anything* you actually asked!
Thank-you so much
for your empathy and humor, it keeps me feeling more like the "Frasier" type neurotic depressive rather than the flabby chain smoking hopeless one.Love Gabbi-Gabbi
Posted by Gabbi on August 2, 2002, at 23:49:01
In reply to Re: Questions about DX...Gab-on » Roo, posted by Gabbi on August 2, 2002, at 22:56:29
Oh well first, I posted a note to someone today saying "oh I'm so sick of hearing myself talk about depression"
After re-reading your post I realized you just said the same thing.My official dx or "title" is cyclical unipolar progressive refractory(treatment resistant)depression with borderline personality traits
I know about feeling defeated about the medication, there aren't words for it, its soul sucking, as far as your morale goes, nevermind just the damn nuisance of always making sure you have it, picking up the prescription, the constant self-analysis.
"Is it my medication, or have I had too much coffee, not enough sleep, am I talking myself into being depressed just because I've been diagnosed with it, that hyper awareness of how you feel all the time"
Although I firmly believe when you are in a major depressive episode there is no question that you could talk yourself out of it or into it.I had inorgasmia with paxil, but not with Prozac, though apparantly the dexedrine helps alleviate that. And dexedrine is only worth it I think if you have the refractory depression, because in itself over time it can actually cause a permanent baseline depression....
ARRRRGH, To just be able to chuck it all in a bag and walk away.
Cycling on and off medication will increase depression this is based in relatively unbiased research but I also learned the hard way. There are just so damn many other possible factors.
Sometimes I have a 'good day' and end up feeling terrible because I have no friends to call, and don't even remember what I liked doing, I can't redecorate my apartment because I don't have one anymore, and in the small town where I'm stuck for now, there just isn't the activity going on that I was used to, so even if I'm not 'clinically depressed' I will trigger another episode. It has also been proven that because of an increase in cortisol that becomes permanent due to the stress of being depressed that the more "episodes" of depression you have the more easily they are triggered thereafter.
There is an interesting study on that but I'll spare you the details.
Its my roundabout way of saying as hard as it is in my opinion don't cycle on and off medication.I didn't mean that to sound whiny either, Its just the frustration, and that worn out feeling you were talking about..
Oh time to Gag Gabbi
once again sorry for the rambly way I have of trying to get across a point...
This is the end of the thread.
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