![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 121 to 145 of 434. Go back in thread:
Posted by Lorraine on July 31, 2001, at 12:02:17
In reply to Re: Handholding » Lorraine, posted by Elizabeth on July 27, 2001, at 19:51:20
> > > Stahl talks about the "end-stage" of depressive illness as one where the lows are so low but the ability to "feel" generally has been severely blunted.
>
> That's what I experience. I don't think of it as an "end stage," but perhaps it does have something to do with the fact that my depression first manifested when I was quite young. I would like to see more research on childhood-onset depression. I think my depression is probably not similar to most early-onset mood disorders, though.Maybe it's not the time of onset, but the duration of the disease or the length of time unmedicated. You have to wonder how it affects the development of personality and coping skills generally. My son has some anger management issues (has a learning disability also) so he was in therapy from the age of 8 until he was 11. He is so in touch with himself and very perceptive of moods. He also has the "language" of how to communicate about emotional issues generally. He's now 13, and I think whoever marries him ultimately is going to be real lucky. Course this is the effect of early intervention or therapy, not the effect of early mental illness.
> > > > > Interesting about panic and hypothyroidism. All my TSH tests have been pretty normal, and T3/4 augmentation is something I've never tried.
> >
> > It might be worth a try.
>
> What do you think it might help with besides panic? Have you ever tried it?Yes, I have tried T3 augmentation, twice. It is activating. For me, it was like taking an amphetamine. If I took too much, then I became edgy and started skin picking. I got off it the last time because I switched to Moclobemide which is also activating and needed to reduce the amount of activation in my system generally. But my panic attack stuff started somewhere around that time. I wish that I had been keep a mood chart then, like I do now.
> > > Also, the notion of "estrogen dominance" causing panic symptoms is interesting. Apparently, estrogen dominance is not just a problem associated with menopause, but can be a woman's normal state throughout her lifetime. Another avenue to explore.
>
> That is interesting. Tell me, can you make anything out of my experience with the pill? (fairly sudden relapse of depression while taking Parnate)Do you know what your pill had in it? Was it estrogen, progesterone or both and, if both, were they cycled so that the beginning of the month was estrogen with a switch to progesterone at the end? At what point in your cycle did you start the pill? If you started at the beginning of the cycle and your pill was predominantly estrogen at that point, then it might have been estrogen dominance. Progesterone can increase depression (which is why I was initially put on unopposed estrogen). So you might have had an extra dose of progesterone at the time. How are you right before your period? You know doctors who specialize in menopause and pms could figure this out for you. They would first determine your hormone levels and, I think with premenopausal women, they do this over the course of a cycle using saliva testing. I'm sure a mood chart could also help you figure this out--the NIMH has a good chart that tracks monthly cycle along with mood. I'm now sold on mood charting to help me determine what meds, supplements, therapies, hormones, life events, foods are effecting my moods. I'm going to have my hormones tested at the end of this month to determine if I have estrogen dominance.
>
> > > > > Buprenorphine seems to make my periods irregular. I've been wondering about the mechanism there.
> > > If I was successful, then my period would start and I would not be in pain. But if I missed the very very beginning, what happened was my period would be delayed. I explained this to my doctor, who dismissed it out of hand. Point is there was something operating there that might be similar to your situation.
>
> How do you mean? I'm a little confused.My point was just that when I took a pain reliever before I started my period (depending on the timing of when I took the pain reliever), it could delay my period--or make it irregular. It never made sense to me. You are saying that Buprenorphine can make your period irregular. I know Ibuprofen is a different drug, but why should pain relievers affect the timing of periods? And, yet in my case Ibuprofen did and in your case Buprenorphine does.
> > > Decongestants are basically bad speed.So why do some pdocs recommend Benedryl as a sleeping aid?
(Ephedrine or "ma huang" is a step down from bad speed: it's bad Sudafed.)
I took Ephdrine for a while when I was on Effexor. It really is bad Sudafed. < g >
>
> > > But is agitation and activation considered mania?
>
> Not necessarily. They're symptoms of mania, though.
>
> > I once (for a couple of days in the weeks just before the last stock market crash), had incredibly racing thoughts, could hardly contain my excitement and so forth, but was still able to sleep. From my reading of the DSM categories, that would not qualify as mania--although I was euphoric and felt a bit invincible.
>
> Hypomania, perhaps?Well, I looked it up and it might fit (thanx). More reading to do.
> > >I don't think it's a good idea to pretend that we have a decent understanding of the causes of depression, mania, psychosis, anxiety, etc. -- attributing them to a vague "chemical imbalance" ...I think (as I mentioned before) the most reasonable approach to clinical practise is the empirical-descriptive approach (identifying symptom clusters that respond to particular treatments, and using this information to try to predict which treatments will be most likely to work for any particular patient). ....I think that we can simultaneously examine psychiatric illness on both levels (behavioural signs and symptoms, and physiologic ones). Both types of information are useful.
I guess right now the problem is that we don't know enough about the physiology and we don't have meaningfully defined presentation categories. And, we shouldn't pretend that we do on either front. We need research in both areas. The drug company studies of the effect of a drug on "depression" or even treatment resistant depression just lack enough specificity to be helpful in determining whether the drug will work in a particular case.
> > > I do like the way that your doctor does it, basing treatment decisions on statisticsthat's what appealed to me about him
> > >The statistical approach can also be applied to descriptive psychiatry, although it hasn't been used nearly enough IMO.Yes, some correlational analysis studies using say depression presentation criteria and effectiveness of meds would be really useful.
>> > > Complicated stuff. But if it is "insulin sensitivity" or "insensitivity?", then low carb should help.
>
> I dunno, thinking about insulin always gets me confused for some reason.If you ever find yourself in a Nardil weight gain situation again, it might be worth trying to see if low carb helps. Zo over on the thread about Zyprexa said that low carb did not help with it. So it may be that these different drugs cause weight gain for different reasons.
Lorraine
Posted by Lorraine on July 31, 2001, at 12:36:12
In reply to Re: Give me back my hand- (just kidding) » Elizabeth, posted by shelliR on July 27, 2001, at 22:00:10
Shelli:
> > > I'm up with the air about my next step. Yesterday and today I was in a pretty crummy mood, but then I had to remind myself that most people feel down sometimes, not just very depressed people. Like I wasn't as into my work as I am usually, felt it was getting too repetitious. On the other hand, I did not spend the day in bed like I do when I am terribly depressed. Maybe this is what anhedonia feels like; it's something I don't feel too often, sort of a bored, stale feeling inside.
I'm sorry that your meds may be letting you down. I also have a hard time telling on a day to day basis whether it's the med or a normal mood fluctuation that is affecting me. I have found mood charting to be invaluable because I track day to day and can see if a string of days develop or even if there are more down days than there were before. NIMH has a good mood chart if you think it might be useful. I'm sure you are watching it closely. You wouldn't want to wait too long to take action if it is a down swing.
> > > Maybe it's a signal for me to get out and start doing more besides working. I am going to put the decision about parnate on hold to try to see if the estrogen is having any effect. I like to keep my trials relatively clean!
I felt the estrogen immediately in terms of cognitive effects. Some sources say that it can take up to two months to see estrogen's effects. Have you thought about how long a trial you want to give estrogen? I usually find that my mood stability directs whether I add another med or not and muddies the clean trial concept.
> > >I'll let Lorraine try parnate first, although if our reactions to opiates are any indication, we don't react similarly to chemicals.Today is the first day on Parnate. I'll keep you posted.
Lorraine
Posted by Lorraine on July 31, 2001, at 12:59:58
In reply to Re: Handholding Shelli » Lorraine, posted by shelliR on July 27, 2001, at 23:39:14
> > > I think for lots of people giving is definitely a part of getting.
This is definately true for me. Although I also have to watch myself and make sure that I am not over-giving where the gift is not appreciated or to the point where I become resentful.
> > > Gratitude is a really good thing in general. I think it is a very spiritual thing, to be grateful. I see it as a humble experience because the things that I feel graditude about are gifts; I have not directly caused them, nor can I take credit for them.I like this sentiment. It is true that as I have lived with this disease I have become more grateful so the unexpected gifts and I suppose that my level of expectation has generally decreased so that more things appear to be gifts.
> > >Like I think if you are very good at something, it is okay to acknowlege it, because a talent is a gift, not a product of the ego, although using the gift may be.
I do this too. Drives my kids nuts. They think I should respond to compliments by saying "it's kind of you to say so".
> > >sorry, didn't mean to get philosophical on you :-) )
It's your best feature.
> > >What is a QEEG?Quantitative Electro-encephalogram. They hook you up to a bunch of electrodes on your scalp and measure your brain waves, then they convert this data into numbers (quantitative).
> > > A lot of people who were abused in early childhood have temporal lobe epilepsy.I wasn't physically abused, if that's what you mean. I was emotionally abused--neglected more actually. I was severely traumatized as a child. But if it's physical injury, my hunch would be I sustained it in one of my car accidents--although those were fairly minor. The people at EEG Spectrum (the brainwave feedback place) asked me a lot of question about brain injury and thought perhaps the car accidents were the culprit.
> > >I know someone who had one doctor give her the diagnosis and the second take it away, so I imagine there is some interpretation involved.
I'm sure there is--as my pdoc says it's a matter of where you fall on the continuum. I'm not taking the diagnosis very seriously because of this.
> > > Was it strange to meet another babbler in the real world? I don't know what that would feel like. Dr. Bob was in my area for a conference and meeting with people from the board (I think two people came). I was ambivelent and it turned out I was in the hospital anyway.I felt ambivalent as well. I thought it would be like the scene in Wizard of Oz where the curtain flies up and you see that the wizard is really just an old man. But I was pleasantly surprised. He seemed to be a bright, caring and connected person. As I have said to him, psychobabble is a self selected group that has a number of great characteristics: generally bright people who believe in taking charge of their treatment options and doing research on their situation. Those characteristics alone are not that common in the general population.
> > > p.s., congradulations on picking parnate--I hope it goes well.
me too :-)
Posted by Elizabeth on July 31, 2001, at 17:34:53
In reply to Re: hand holding, posted by Lorraine on July 31, 2001, at 11:03:39
Hi Lorraine.
> > > >I'd try rxlist.com
>
> Yes, I use this and drkoop.com drug checker for drug interactions.I'm not sure about drkoop.com. I think that both sites would probably tend to come up with nonexistent drug interactions.
> I've been on the Neurontin long enough (6 mos) to know that it is not the answer to this problem, although it does help smooth things out generally. My pdoc prescribed Ativan for me to try out.
Good luck with that. How much Neurontin were you taking, incidentally? I've heard wildly variable claims about what the effective dose range is.
> Now what they say about Effexor withdrawal is to augment it with a long half-life med like Prozac to ease the transition. I wonder if a similar argument would work with MAOs?
Umm. I'd avoid Prozac if you've taken a MAOI recently! (Benzos do help with MAOI withdrawal, though.)
> Are there some that have a longer half-life?
Nardil and Parnate are both very short-lived. I don't know about others.
> But then there is a wash-out switching from one MAO to another, right?
Yes, although some people feel that this is only a problem when switching between hydrazine and non-hydrazine MAOIs.
> I'm assuming that if you felt anxious on withdrawal, that Parnate was medicating the anxiety when you were on it. I'm not sure that this logic holds though.
Rebound anxiety does suggest that the drug is an anxiolytic, yes. (Parnate controlled my panic symptoms well, BTW.)
> Let us know what the serum level check reveals. It could be an important piece of information about your metabolism.
Funny you should mention that. The serum DMI level was 456 ng/mL (therapeutic dose range is supposed to be 150-250). So my pdoc (well, the guy who's covering for him) wanted to repeat the test, so I went in today and got more blood drawn. AFAIK I did it right (blood draw 10-12 hours after last dose).
-elizabeth
Posted by Elizabeth on July 31, 2001, at 17:59:13
In reply to Re: Handholding » Elizabeth, posted by Lorraine on July 31, 2001, at 12:02:17
> Yes, I have tried T3 augmentation, twice. It is activating.
That's what I've heard, so it surprises me that it would be useful for panic.
> I got off it the last time because I switched to Moclobemide which is also activating and needed to reduce the amount of activation in my system generally.
A lot of people seem to get overstimulated when they first start taking moclobemide.
> > That is interesting. Tell me, can you make anything out of my experience with the pill? (fairly sudden relapse of depression while taking Parnate)
>
> Do you know what your pill had in it?It was a combination pill (Ortho Tri-cyclen) -- estradiol and norgestimate. The ratios changed every seven days (the amount of norgestimate increased while the amount of estradiol remained fixed), and of course there were the inactive pills for the last week of each month.
I don't recall when I first started taking it or when the depression emerged.
> Progesterone can increase depression (which is why I was initially put on unopposed estrogen).
I took Depo-Provera for a little under a year. I would say I got depressed, but I did get irritable and moody.
> How are you right before your period?
No premenstrual mood changes. (I just get bad cramps on day 1, which the pill was supposed to alleviate.)
> I'm sure a mood chart could also help you figure this out--the NIMH has a good chart that tracks monthly cycle along with mood.
I did that (mood charting) for a while. I couldn't find any patterns.
> My point was just that when I took a pain reliever before I started my period (depending on the timing of when I took the pain reliever), it could delay my period--or make it irregular.
I gather that opioids can do that in general (although I'd previously thought that irregular periods were just due to the junkie lifestyle). NSAIDs are better for cramps, anyway. It's odd that ibuprofen caused the same thing for you, though -- I'd never heard of or experienced that (I always take NSAIDs -- usually Relafen -- at the start of my period).
> > > > Decongestants are basically bad speed.
>
> So why do some pdocs recommend Benedryl as a sleeping aid?Benadryl is an antihistamine, not a decongestant. As a rule, antihistamines are sedating (if they cross the blood-brain barrier easily, that is).
> I guess right now the problem is that we don't know enough about the physiology and we don't have meaningfully defined presentation categories. And, we shouldn't pretend that we do on either front.
Exactly.
> The drug company studies of the effect of a drug on "depression" or even treatment resistant depression just lack enough specificity to be helpful in determining whether the drug will work in a particular case.
That's right. "Depression" (or even "major depressive disorder") is a pretty big umbrella.
> Yes, some correlational analysis studies using say depression presentation criteria and effectiveness of meds would be really useful.
They used to do this; it's how atypical depression and panic disorder were identified. For some reason, interest in this type of research has plummeted.
> If you ever find yourself in a Nardil weight gain situation again, it might be worth trying to see if low carb helps.
I'm never taking Nardil again -- in the long run, it did more harm than good. And anyway, a carbohydrate-restricted diet would be very difficult for me to maintain (the four food groups, for me, are: starch, starch, carbohydrates, and starch).
> Zo over on the thread about Zyprexa said that low carb did not help with it. So it may be that these different drugs cause weight gain for different reasons.
Zyprexa is a strong antihistamine. Nardil isn't; I've never been clear on the mechanism of Nardil-associated weight gain.
-elizabeth
Posted by Elizabeth on July 31, 2001, at 18:22:34
In reply to Re: DID, MDs, DSM, EMDR, etc. » Elizabeth, posted by shelliR on July 30, 2001, at 22:23:16
> It’s a variant, but a significant variant, much less of a disruption of my life as a adult. And yes, abuse has to occur and the child must have a tendency to dissociate.
My understanding is that people have different defensive styles, and dissociation is one of many possible defense mechanisms.
> I don't know if this is a fact or not, but it seems from my observations that the abuse had to have been kept a secret; even in the case of siblings both being sexually abused by the same adult, it has generally never been discussed until they were adults with the people that I have come to know.
Well, do you know anyone who was abused but did speak to someone about it?
> Body therapy is the combination of therapy with on-hands massage type work.
That sounds really cool! And I can see how it would be helpful to someone in your situation.
> Co-conscious means that I always know when my personalities are talking -I can hear them when they are talking and I don’t let them take over my body.
Talking...so they talk to each other, or is it just several different internal monologues?
> I suppose it’s odd, but it doesn’t seem odd to me.
It's odd, trust me. :-)
> Actually my youngest one, who has recently turned three and a half (a momentous event for a child who had declared she did not want to get any older) has the name Elizabeth.
Say hi to her for me, then.
> BTW, they get older on their own, they tell me when they have gained a half year or a year and they sound older.
Does the aging occur at the same rate as real aging? Or do they age in a discontinuous fashion?
> Ever had a sleep or ambulatory EEG?
>
> No, because sleep hasn’t been a problem (except on nardil) and I have no indication that I sleep-walk.Sleep studies can illuminate more than just sleepwalking. Anyway, I'd be curious if there were predictable changes in your brain wave patterns when you switch identities.
> Have you noticed any effect of the medications you're taking on this phenomenon?
>
> No, I never even deal with it with medications—just the depression and the anxiety.So I gather. (I was wondering whether any of the antidepressant and anxiolytic medications you've tried had an incidental effect on the dissociation.)
> Well, I don’t take it anymore! When I used to take it then I spelled it selegiline! < g >.
So, it improved your spelling? Or your typing?
> More on the topic of medication, the last three days have been pretty awful for me and I am wondering if the estrogen I’m taking is making my depression worse.
Could be. I had major problems with the hormonal contraceptives that I tried (see one of the posts directed to Lorraine).
> It’s either that, or the oxycontin is starting to be less effective. Bummer.
FWIW, I've heard of a number of cases in which people took full opioid agonists (morphine, oxycodone, and -- get this -- oxymorphone) as antidepressants for periods of months or years and never became tolerant.
> Hope you are continuing to do well.
Yes, very. Thank you.
-elizabeth
Posted by Elizabeth on July 31, 2001, at 18:23:18
In reply to Re: DID, MDs, DSM, EMDR, etc., PS » shelliR, posted by shelliR on July 31, 2001, at 9:23:57
> Also, when you went to college at 16, were you placed in any special program, e.g., for gifted highschool children, or were you just in the pack at 16?
In high school, you mean? I was taking a lot of advanced-placement classes and a math class at the university where my parents teach. I had skipped two grades (3rd and 8th).
In regard to your question about my depression: in the past, I've tried to rationalise it as being the natural consequence of this, that, or the other, but the truth is that there was no known cause: there wasn't anything that happened that could have explained why I became depressed.
-elizabeth
Posted by Lorraine on July 31, 2001, at 22:31:59
In reply to Re: Handholding (Shelli, Lorraine), posted by Elizabeth on July 29, 2001, at 14:01:07
> > > And to Lorraine: I don't know when you first became depressed or seriously anxious, but I've had problems since childhood (first dx of major depression when I was 14, but my doctor and I felt that I'd probably suffered at least one previous episode, when I was 10-11 and possibly dysthymia long before).
Elizabeth: I was severly traumatized when I was 8, and it is clear that I had a break-down at the age of 11 or 12, although nothing was diagnosed then and I tried to hide everything. I started seeing a therapist when I was 15. No diagnosis until I was 43.
> > >I think that early-onset depression has much more profound effects on a person than adult-onset depression has. In a sense, I had an incomplete childhood. Although the effect is qualitatively different from the effects of serious abuse in childhood, the degree of impairment that results is comparable, I think.
I honestly wouldn't know which of these categories I would fall into because if someone had intervened at 11 or 12, I'm sure I would have been diagnosed with childhood depression and certainly I spent a lot of my childhood crying. But we didn't know about depression then.
> > > It's a lot fuzzier than I think most people realise. You're right that EEGs are subject to interpretation. It does sort of make sense that people who'd suffered abuse would have hyperactive limbic systems (perhaps including the potential for limbic seizures), though.I don't think I had physical abuse (with few exceptions). The question is whether emotional abuse or depression can cause lesions. Anyway, I guess the suspicion would be car accident side effects.
Lorraine
Posted by Lorraine on July 31, 2001, at 22:35:04
In reply to Re: Give me back my hand- (just kidding) » shelliR, posted by Elizabeth on July 29, 2001, at 14:04:32
> > I'll let Lorraine try parnate first, although if our reactions to opiates are any indication, we don't react similarly to chemicals.
>
> So, Lorraine is your guinea pig? :-)
>
Hey, wait a second guys, I thought I was riding on your experiential coat tails!
Posted by Lorraine on July 31, 2001, at 22:43:38
In reply to Re: Give me back my hand- (just kidding) » Elizabeth, posted by shelliR on July 29, 2001, at 23:51:29
> > > It's complicated and it's sounds much more bizarre than it feels, I am so used to it by now. I have different personalities inside; girls clustered around three and eight, related to sexual abuse at those ages. If you heard them you would not think they are me--the three year old especially, not only has the voice of a three year old, but has the verbal patterns of a three year old: repetition, disinterest in answering questions, etc. and chatters on and on. I worked a lot with them in therapy with EMDR and in body therapy, and at this point while still present, they do not dominate my life
Shelli: I just want to say that navigating your path through this life with alters sounds like a real challenge. In therapy, I had to embrace the 8 year old child in myself that I had discarded as quickly as I could, but that is a far cry from dealing with and negotiating with alters. I have been on a couple of support groups with people who had alters and I found that these people were remarkably careful and considerate in how and whom they let communicate with the group. Then to have people discredit the notion of alters as well--that just makes things more difficult.
Lorraine
Posted by Lorraine on July 31, 2001, at 23:04:47
In reply to Re: DID, MDs, DSM, EMDR, etc. » Elizabeth, posted by shelliR on July 30, 2001, at 22:23:16
> > >You might also want to read the book I mentioned before "the Magic Daughter: A Memoir of Living with Multiple Personality Disorder " by Jane Phillips. She is a university professor, writes anonymously, and I think gives a good idea of how it feels to try to work and be multiple.
I think I'll order this book--it sounds interesting.
>
>
> > >EMDR sounds pretty flakey to me, and the evidence supporting it is very sketchy, but I've encountered a number of people who felt it was helpful for them, enough to make me wonder whether there might be something to it after all.
>
> I sort of have the same feelings about its scientific reality, but it does seem to help people process through memories much quicker and less painfully than without EMDR.Solomon, the author of The Noonday Demon, also speaks highly of EMDR. Enough so that I have thought of pursuing it--although, honestly, I think I have uncovered all my childhood stuff and talked it to death so I'm not sure it would add anything new.
> > > What is body therapy? That's one I'm not familiar with.
Shelli--how do you go about finding a body therapist?
> > > BTW, they get older on their own, they tell me when they have gained a half year or a year and they sound older.When they reach a certain age, do they become integrated into your personality?
> > > Well, I don’t take it anymore! When I used to take it then I spelled it selegiline! < g >.I thought it was a requirement that you stop taking it when you've learned how to spell it. At least that's what my pdoc told me last week when he switched me from selegiline to Parnate.
> > >I wish I had access to the whole study re menopausal depression and estrogen. Actually, my pdoc has a copy of it I think. I’m going to ask him to leave it for me with his receptionist when I see him (maybe Thursday) so I can see if anyone’s depression increased. It’s either that, or the oxycontin is starting to be less effective. Bummer.That is a bummer. I think (but don't know) that you should have your estrogen levels taken before they put you on estrogen to make sure that you don't get estrogen dominance. I mean didn't the study deal with women who were deficient in estrogen?
That reminds me to contact my pdoc for an article that he says just came out about the development of more MAOs.
I hope your dip is momentary, Shelli, and you bounce back, switching drugs is a PITA. Day one on Parnate was not good--muscle tension in my back, hyperventilating starting up again--then holding off on the Neurontin to get a sense of the drug on its own, then taking a considerable amount of Neurontin (am and pm doses in rapid succession). Oi! I think I will be sea sick. Let's hope tomorrow I can gain a better footing with this new combo.
Posted by shelliR on July 31, 2001, at 23:55:33
In reply to Re: DID, MDs, DSM, EMDR, etc. » shelliR, posted by Elizabeth on July 31, 2001, at 18:22:34
>
>
> > I don't know if this is a fact or not, but it seems from my observations that the abuse had to have been kept a secret; even in the case of siblings both being sexually abused by the same adult, it has generally never been discussed until they were adults with the people that I have come to know.
>
> Well, do you know anyone who was abused but did speak to someone about it?
No one who has DID. Other people though, but they don't have DID, so maybe that's why I got that idea.
>
> > Body therapy is the combination of therapy with on-hands massage type work.
>
> That sounds really cool! And I can see how it would be helpful to someone in your situation.It is great. I just wish insurance would pay for it. I pay so much for insurance which covers my therapy and it's frustrating that they will only cover MDs, psychologists and social workers. The woman that I want to work with is a MA counselor and she is not covered, even though it would be cheaper for them.
>> Talking...so they talk to each other, or is it just several different internal monologues?
No, they talk to me, comment about things in general. Like, "you forgot to give us lunch" or "why is that lady so fat", stuff like that, unless I ask them deeper questions. And then I rarely get any answers. They don't want to talk about what happened anymore and I think that's okay, at least for the younger ones who have worked their abuse though. They can be very funny, and the youngest even makes the others laugh.
>
> > I suppose it’s odd, but it doesn’t seem odd to me.>
> It's odd, trust me. :-)
:-). It's amazing how unstrange it is to me. It's funny to think about it. It's so unstrange to me that I never thought about mentioning it before (although I have mentioned it in posts a long time ago re dissociation) and so unstrange that I didn't think, "should I tell this bizarre thing." Maybe because when I go into the hospital for depression, I always go on the unit for trauma and dissociative disorders. I am generally the least dissociated person there. It's really only a part of who I am, of course.My close friends all know and my family but we rarely talk about it--it's sort of like once someone gets it, and I answer their questions for a while about it, there's not much more to say. And other friends have no clue, but it really doesn't feel like I'm holding back. It just never comes up :-)
But again , I want to emphasize that they don't talk unless they're allowed. Like when I'm out they're allowed to talk in the bathroom. So I'll be out to dinner with someone, totally unaware of them, but when I go to the restroom, they come out immediately to assess that particular restroom. And they are also allowed to talk on elevators if no one else is in there, and at home. Sometimes I let them whisper other places like when I go to flower shops and they like to give me their opinions.
> > BTW, they get older on their own, they tell me when they have gained a half year or a year and they sound older.
>
> Does the aging occur at the same rate as real aging? Or do they age in a discontinuous fashion?
Totally discontinuous.
>
>
> Sleep studies can illuminate more than just sleepwalking. Anyway, I'd be curious if there were predictable changes in your brain wave patterns when you switch identities.A past friend of mine (DID) had totally different eegs depending on which personality was out. The neurologists were clueless what was going on because this was before she was diagnosed. Last time I talked to her she was starting to get strange seizures and she couldn't drive for a while until she was put on an anticonvulsent. I don't know what they was all about, but I do know that horrible abuse changes your brain.
>
> > Have you noticed any effect of the medications you're taking on this phenomenon?
> >
> > No, I never even deal with it with medications—just the depression and the anxiety.
>
> So I gather. (I was wondering whether any of the antidepressant and anxiolytic medications you've tried had an incidental effect on the dissociation.)
no, just valium makes me more grounded when I'm very dissociated. But some doctors don't like to give valium so they give me klonopin instead which isn't that helpful, but does help some.
>
>
> > More on the topic of medication, the last three days have been pretty awful for me and I am wondering if the estrogen I’m taking is making my depression worse.
>
> Could be. I had major problems with the hormonal contraceptives that I tried (see one of the posts directed to Lorraine).
>
> > It’s either that, or the oxycontin is starting to be less effective. Bummer.
>
> FWIW, I've heard of a number of cases in which people took full opioid agonists (morphine, oxycodone, and -- get this -- oxymorphone) as antidepressants for periods of months or years and never became tolerant.I hoped that would be the case. But I am definitely depressed, although still functioning.
I hope to talk to my pdoc about bup and/or parnate. In my eight minutes I may only get to one. I have the option of seeing him as often as I want, it's just a pain to go there if I'm not down there already for therapy. And he hates phone calls.
But the mantra remains, he gives me oxycontin. And many other pdocs think he's a genius.
>
Actually, tomorrow I'm going to call my gyn because I want to get her opinion about the estrogen possibly making me more depressed. She has a lot more experience with estrogen than my pdoc.Take care,
Shelli
Posted by shelliR on July 31, 2001, at 23:59:09
In reply to Re: PS » shelliR, posted by Elizabeth on July 31, 2001, at 18:23:18
> > Also, when you went to college at 16, were you placed in any special program, e.g., for gifted highschool children, or were you just in the pack at 16?
>
> In high school, you mean? I was taking a lot of advanced-placement classes and a math class at the university where my parents teach. I had skipped two grades (3rd and 8th).No, I meant at college. But now I understand you were already used to being with kids two years older than you for years. But sixteen is young to go away to college, emotionally, I would think. Did you adjust easily or was it difficult for you?
>
> In regard to your question about my depression: in the past, I've tried to rationalise it as being the natural consequence of this, that, or the other, but the truth is that there was no known cause: there wasn't anything that happened that could have explained why I became depressed.Is anyone else in your family depressed?
>
Shelli
Posted by shelliR on August 1, 2001, at 0:16:27
In reply to Re: Handholding Shelli » shelliR, posted by Lorraine on July 31, 2001, at 12:59:58
>
> > > >Like I think if you are very good at something, it is okay to acknowlege it, because a talent is a gift, not a product of the ego, although using the gift may be.
>
> I do this too. Drives my kids nuts. They think I should respond to compliments by saying "it's kind of you to say so".You have raised your kids to be very polite. That's good. They can understand the rest when they are older.
>>
>
> > > > A lot of people who were abused in early childhood have temporal lobe epilepsy.
>
> I wasn't physically abused, if that's what you mean. I was emotionally abused--neglected more actually. I was severely traumatized as a child. But if it's physical injury, my hunch would be I sustained it in one of my car accidents--although those were fairly minor. The people at EEG Spectrum (the brainwave feedback place) asked me a lot of question about brain injury and thought perhaps the car accidents were the culprit.No I didn't mean just physical abuse; I just meant abuse in general and neglect is certainly a form of abuse.
>> I'm sure there is--as my pdoc says it's a matter of where you fall on the continuum. I'm not taking the diagnosis very seriously because of this.
Well, if you did, would there be a different treatment plan?
>
>
> I felt ambivalent as well. I thought it would be like the scene in Wizard of Oz where the curtain flies up and you see that the wizard is really just an old man. But I was pleasantly surprised. He seemed to be a bright, caring and connected person. As I have said to him, psychobabble is a self selected group that has a number of great characteristics: generally bright people who believe in taking charge of their treatment options and doing research on their situation. Those characteristics alone are not that common in the general population.That's great. I don't regret not having met Dr. Bob and the two other people. I hadn't really had much of a sense of the two people who went; I hadn't been on the board that long. I thought, and still think for now I'd rather keep it on the board.
>
I'm sorry that your first day on parnate was so awful. I've been working all evening, then answered two posts from Elizabeth and I am really tired. It's 1am est. But I'll check in with you tomorrow to see how you're doing and respond to the other posts.I hope you are able to sleep well tonight and that tomorrow is a better day.
Shelli
Posted by shelliR on August 1, 2001, at 10:26:45
In reply to Re: Give me back my hand- (just kidding) » shelliR, posted by Lorraine on July 31, 2001, at 22:43:38
> Shelli: I just want to say that navigating your path through this life with alters sounds like a real challenge. In therapy, I had to embrace the 8 year old child in myself that I had discarded as quickly as I could, but that is a far cry from dealing with and negotiating with alters. I have been on a couple of support groups with people who had alters and I found that these people were remarkably careful and considerate in how and whom they let communicate with the group. Then to have people discredit the notion of alters as well--that just makes things more difficult.
>
> Lorraine
Hi Lorraine.I'm glad that you've met people with alters before; it probably doesn't strike you as completely bizarre then. Again, I do not have the diagnosis of DID; I have been spared a lot of the internal struggling that others go through, and the competition for power, although I have done some difficult work around the fears of the younger ones. I don't know why they still hang out in me, but it's fine with me, and I will be sad if they decide to integrate. But the decision to integrate is really not up to me, anyway. If it happens, it will be spontaneous.
Shelli
Posted by shelliR on August 1, 2001, at 11:13:06
In reply to Re: DID, MDs, DSM, EMDR, etc. » shelliR, posted by Lorraine on July 31, 2001, at 23:04:47
> > > >You might also want to read the book I mentioned before "the Magic Daughter: A Memoir of Living with Multiple Personality Disorder " by Jane Phillips. She is a university professor, writes anonymously, and I think gives a good idea of how it feels to try to work and be multiple.
>
> I think I'll order this book--it sounds interesting.I hope you like it; tell me what you think after you've read it.
> Solomon, the author of The Noonday Demon, also speaks highly of EMDR. Enough so that I have thought of pursuing it--although, honestly, I think I have uncovered all my childhood stuff and talked it to death so I'm not sure it would add anything new.I wouldn't go looking for new trauma unless you feel that there is something unresolved that is contributing to your depression.
> Shelli--how do you go about finding a body therapist?I started thinking about it and I don't remember how I even heard of body therapy. I got the name of my body therapist from a training center for body work near me. I asked them if they had any names of people who had specifically worked with trauma, and they gave me the name of one of their instructors. And she was so good. Then when I wanted to start again, I got names from her, because she is almost an hour away, and also charges $125.00. She has a phd in counseling which does me no good insurance wise. I did try a social worker trained in body work, but I didn't like her approach--she tried to make me talk too much, like what color is the depression, what shape, etc., etc. and it didn't feel helpful. With the two body therapists I liked, I did end up talking alot (me & kids), but it was much more organic; we talked because we wanted to say something, tell her what things were happening in my body when she touched us, rather than answer questions that I couldn't relate to.
Is your depression centered in a specific area of your body?
>
> When they reach a certain age, do they become integrated into your personality?I really have no idea how it will happen and if it will happen. My therapist said that if that was the only issue left for me (kids inside), and everything else was worked through, she wouldn't keep me in therapy for that reason.
>
> That is a bummer. I think (but don't know) that you should have your estrogen levels taken before they put you on estrogen to make sure that you don't get estrogen dominance. I mean didn't the study deal with women who were deficient in estrogen?
>Yes, and I guess I assumed that my estrogen had dipped because of my age, but maybe it hasn't. Again no other signs until last month I just spotted, didn't have a real period, but then this week got it again regular. I have an appointment with my gyn next week and I'll discuss it with her. I have stopped the estrogen, at least until I talk with her.
>
> I hope your dip is momentary, Shelli, and you bounce back, switching drugs is a PITA. Day one on Parnate was not good--muscle tension in my back, hyperventilating starting up again--then holding off on the Neurontin to get a sense of the drug on its own, then taking a considerable amount of Neurontin (am and pm doses in rapid succession). Oi! I think I will be sea sick. Let's hope tomorrow I can gain a better footing with this new combo.How are you doing on day two of Parnate? With nardil, I had zero side effects from the beginning. Maybe others on the board can be helpful with knowing whether it took a while to adapt to parnate. You might ask, or first search the archives. I've never adjusted to any medication which gave me side effects at the beginning, but lots of people on the board have had the experience of it taking time to adjust to a med which turned out to be a success. I hope you're in that category. If not, there's always nardil.
I do believe that I will either go back on nardil with concerta, or start parnate next week when the prozac is cleared out. I just took concerta (had already taken oxy a few hours ago) to see how I do on the two of them together. Today's the only day this week I can afford to lose so that's why I decided to do try it.
take care, shelli
Posted by Elizabeth on August 1, 2001, at 13:58:22
In reply to Re: DID, MDs, DSM, EMDR, etc. » Elizabeth, posted by shelliR on July 31, 2001, at 23:55:33
> It is great. I just wish insurance would pay for it. I pay so much for insurance which covers my therapy and it's frustrating that they will only cover MDs, psychologists and social workers. The woman that I want to work with is a MA counselor and she is not covered, even though it would be cheaper for them.
I have the reverse problem: my insurance doesn't want me to see a psychiatrist for psychotherapy because they don't want to spend the extra $. (So they only pay for about half the cost of each session.)
> No, they talk to me, comment about things in general. Like, "you forgot to give us lunch" or "why is that lady so fat", stuff like that, unless I ask them deeper questions.
What does giving them lunch entail???
> > Does the aging occur at the same rate as real aging? Or do they age in a discontinuous fashion?
>
> Totally discontinuous.That's weird. (Not that the rest of this stuff isn't weird.) Do you have any idea what triggers the aging?
> A past friend of mine (DID) had totally different eegs depending on which personality was out.
Yes, I've read about that sort of thing. Interesting stuff.
> The neurologists were clueless what was going on because this was before she was diagnosed.
You say that you find all this dissociating and so forth completely natural. Under those circumstances, I can see how it would be hard for a clinician to figure out what was going on.
> no, just valium makes me more grounded when I'm very dissociated. But some doctors don't like to give valium so they give me klonopin instead which isn't that helpful, but does help some.
They don't like to give Valium? Why not -- not trendy enough? < g >
> I hope to talk to my pdoc about bup and/or parnate. In my eight minutes I may only get to one. I have the option of seeing him as often as I want, it's just a pain to go there if I'm not down there already for therapy. And he hates phone calls.
He should get over it (the phone call thing). Doctors need to be on call, IMO.
> But sixteen is young to go away to college, emotionally, I would think. Did you adjust easily or was it difficult for you?
It is natural for me to be around older people, just like having several people in your head is natural for you. :-) (I'll let you be the judge of which one of us is weirder.)
> Is anyone else in your family depressed?
Yes, on both sides of my family. (no bipolar, AFAIK)
-elizabeth
Posted by Elizabeth on August 1, 2001, at 13:59:02
In reply to Re: DID, MDs, DSM, EMDR, etc. » shelliR, posted by Lorraine on July 31, 2001, at 23:04:47
> I thought it was a requirement that you stop taking it when you've learned how to spell it. At least that's what my pdoc told me last week when he switched me from selegiline to Parnate.
"Tranylcypromine." There's a toughie; I guess that means it should keep working for a while. < g >
> That reminds me to contact my pdoc for an article that he says just came out about the development of more MAOs.
Probably reversible ones, though. I don't know if this is generally the case, but moclobemide (Manerix, Aurorix) has a reputation for being, well, lame. Do you recall the name of the article, any of the authors, or anything else that could help me look it up?
-elizabeth
Posted by shelliR on August 1, 2001, at 20:54:25
In reply to Re: DID, MDs, DSM, EMDR, etc. » shelliR, posted by Elizabeth on August 1, 2001, at 13:58:22
> > No, they talk to me, comment about things in general. Like, "you forgot to give us lunch" or "why is that lady so fat", stuff like that, unless I ask them deeper questions.
> What does giving them lunch entail???
it actually means that they are hungry and I've been too preoccupied to eat. It's not like they eat different things than me. And it's not like I'm June Cleaver.>
> > > Does the aging occur at the same rate as real aging? Or do they age in a discontinuous fashion?
> > Totally discontinuous.
> That's weird. (Not that the rest of this stuff isn't weird.) Do you have any idea what triggers the aging?
I'm guessing that the more secure they get, the more they are ready to pass into a new developmental stage. The youngest one is the easiest one for me to analyze because she is the most different from me now and probably the most different from how I was at age three. She identifies with being very little ( I was quite tall at three) and she used to collect stuffed animals of mice and repeatedly say she was a very little mouse. I just asked her if she still feels like a very little mouse and she said, "no, I am three and a half now." She is very confident in her childlikeness and unlike me at three, she feels it is quite natural to be loved and treasured. She has talked about things that I don't quite understand, like her mommy went away and never came back. And my mother was in the hospital for about a week when I was close to age three. But I don't know why the mommy never came back in her mind. And she talks about sexual abuse that I have no memory of. The details are so vivid, her emotions reinactments so strong, and the descriptions so unadult, that I am sure it happened. Anyway, with sexual abuse I think you always would believe an uncoached three year old. And my first knowledge of my sexual abuse came to me totally independent of therapyAlso, when I was three I tried to burn down my neighbor's house so the fire engines would come (tried with matches to burn brick), and she takes the credit for that, but I do remember lighting match after match. And of course the house did not burn down, and no one found out about it. You might ask what a three year was doing all by her self outside trying to burn houses down--sort of indicates the pattern of neglect in my family.
I had a client who had adopted a son from South America and they had to wait almost two years to finally bring him home. When I met him (he was three), he opened his hand and showed me that he had a little church mouse (not visible to the naked eye :-) ). His name was Brian and the mouse's name was also Brian. I think he sort of choose to keep a part of him separate (as a mouse) to remind him of his old country, his caretakers there and his friends in the orphanage. And mice have often played roles in fairytales, and children's stories, so I think the mouse thing is sort of a part of the collective unconscious.
>
> You say that you find all this dissociating and so forth completely natural. Under those circumstances, I can see how it would be hard for a clinician to figure out what was going on.Well, if I was losing time and buying things I didn't want, and people knew me who I didn't know, and if I found myself in places with no clue how I got there, then it *would* feel strange and very horrible I think. My friend was diagnosed as scheizophrenic in NIMH, because she heard voices inside, but she didn't fit a scheizophrenic profile. It took her therapist years to realize what was going on, in fact her friends who had seen Sybil on tv wondered about it first.
BTW, he is still her therapist. I think he feels so bad about misdisagnosing her (it took eight years!) that he doesn't charge her anything over what her insurance pays. Actually she is his only patient (talk about a transference dream) because he (MD) and a psychologist run a very well known treatment center for people with dissociation and substance abuse, which keeps adding new locations. The only clinical work he does now is run some of the groups out of the centers, if he's still doing that. Mostly he is administrative. It's called the Kolmac Clinic.
> > no, just valium makes me more grounded when I'm very dissociated. But some doctors don't like to give valium so they give me klonopin instead which isn't that helpful, but does help some.
>
> They don't like to give Valium? Why not -- not trendy enough? < g >
Not only not trendy, but even worse: "post-trendy" meaning it is almost blacklisted! Remember miltown (meprabamate?)
>
>
> He should get over it (the phone call thing). Doctors need to be on call, IMO.
--not holding my breath.> > Is anyone else in your family depressed?
> Yes, on both sides of my family. (no bipolar, AFAIK)Anyone in your immediate family (sibs, parents)?
>
shelli
Posted by shelliR on August 1, 2001, at 21:29:38
In reply to Re: DID, MDs, DSM, EMDR, etc. » shelliR, posted by Lorraine on July 31, 2001, at 23:04:47
Actually, after yesterday's "seasickness" I am somewhat concerned that you haven't posted, and hope things are going better. Somehow though, I don't have a good intuition about your absence from the board today. I hope I'm wrong, and am looking forward to hearing.
Shelli
Posted by Elizabeth on August 2, 2001, at 8:39:49
In reply to Re: DID, MDs, DSM, EMDR, etc. » Elizabeth, posted by shelliR on August 1, 2001, at 20:54:25
> Anyway, with sexual abuse I think you always would believe an uncoached three year old. And my first knowledge of my sexual abuse came to me totally independent of therapy
Well, it's good to feel confident in your memories. Being diagnosed as "mentally ill" can often make people feel much less self-confident, I think.
> Also, when I was three I tried to burn down my neighbor's house so the fire engines would come (tried with matches to burn brick), and she takes the credit for that, but I do remember lighting match after match.
< VBG > Glad it wasn't a wood house!
> You might ask what a three year was doing all by her self outside trying to burn houses down--sort of indicates the pattern of neglect in my family.
It does indeed. I think there are a lot of children who experiment with fire (hence the warnings not to play with matches). I wonder if the behaviour is linked to particular traits.
> > You say that you find all this dissociating and so forth completely natural. Under those circumstances, I can see how it would be hard for a clinician to figure out what was going on.
>
> Well, if I was losing time and buying things I didn't want, and people knew me who I didn't know, and if I found myself in places with no clue how I got there, then it *would* feel strange and very horrible I think.Sure. But since you don't see anything unnatural about it, it might not come up in a clinical interview.
> My friend was diagnosed as schizophrenic in NIMH, because she heard voices inside, but she didn't fit a scheizophrenic profile.
When did that happen? In the past, schizophrenia has been a sort of umbrella diagnosis, and many people were misdiagnosed with schizophrenia when they were really suffering from, e.g., bipolar disorder.
> BTW, he is still her therapist. I think he feels so bad about misdisagnosing her (it took eight years!) that he doesn't charge her anything over what her insurance pays.
Hmm, I wonder if I can come up with a scam to make my pdoc feel guilty enough to charge less. < g >
> Actually she is his only patient (talk about a transference dream) because he (MD) and a psychologist run a very well known treatment center for people with dissociation and substance abuse, which keeps adding new locations. The only clinical work he does now is run some of the groups out of the centers, if he's still doing that. Mostly he is administrative. It's called the Kolmac Clinic.
I think it would be cool to set up a private clinic with a couple other clinicians like that. (I'd probably be more interested in treating "dual diagnosis" patients with mood or anxiety disorders and addictions.)
> > They don't like to give Valium? Why not -- not trendy enough? < g >
>
> Not only not trendy, but even worse: "post-trendy" meaning it is almost blacklisted! Remember miltown (meprabamate?)"Remember" doesn't seem like quite the right word. I do know of it. It seems that it's a metabolite of Soma (a muscle relaxant that I use for back pain), although I don't have any idea to what extent since I've never taken meprobamate.
> > > Is anyone else in your family depressed?
> > Yes, on both sides of my family. (no bipolar, AFAIK)
>
> Anyone in your immediate family (sibs, parents)?My mother and my (younger) sister have been, but I never witnessed it. (I just thought my sister was holing up in her room in the way that teenagers generally do. In retrospect I feel bad for having failed to notice what was going on. I made her promise that if it ever happens again she will tell somebody in the family.)
-elizabeth
Posted by Lorraine on August 2, 2001, at 11:10:25
In reply to Re: Give me back my hand- (just kidding) » Lorraine, posted by shelliR on August 1, 2001, at 10:26:45
[re: temporal lobe epilepsy]
> >as my pdoc says it's a matter of where you fall on the continuum. I'm not taking the diagnosis very seriously because of this.
>
> Well, if you did, would there be a different treatment plan?I suppose the only difference would be that I would actually believe that I need to take anti-convulsants. He has me on them anyway, but I've always thought that that was just his med preference as opposed to understanding the need for taking them.
> > >I thought, and still think for now I'd rather keep it on the board.
Well, I'm glad that I met Neal and if the opportunity came up I would encourage you to meet the psychobabbler. There is no commitment to meeting someone one time and there is always the possibility that you will meet someone with this illness that can be a real life friend. I have good friends and some of them are depressed, but none of them have the type of treatment resistant depression or the degree of life impairment that I have so it is nice to meet someone who "gets" it without a lot of explanation.
> >
> > > I'm sorry that your first day on parnate was so awful.It was a first day. My second day was better, but not great (I'm still on a low dose--5 mg 2x day and Neurontin 300 mg 3x day). I need to take it up slowly because I don't want hyperventilation to be a major problem. It sort of went away during the wash-out period, when I dropped the selegiline--even though I was still taking Adderal (and Neurontin). I'm kind of draggy. My pdoc says I can add Adderal to the mix, but I have a hunch I won't need to once I get to a therapeutic dose. I was able to REALLY sleep soundly last night and the night before, a luxury that the Adderal had impaired significantly. I also learned that I can make it through a wash out period fairly functional by taking Adderal and Neurontin during it. This is actually good news.
> > >I've been working all evening, then answered two posts from Elizabeth and I am really tired. It's 1am est. But I'll check in with you tomorrow to see how you're doing and respond to the other posts.
The problem is that I was out of town for a few days and then responded to each posting (I should have combined them like I am doing now). You shouldn't feel compelled to respond to my compulsion < vbg >. But the thought is kind.
>
> > > I'm glad that you've met people with alters before; it probably doesn't strike you as completely bizarre then. Again, I do not have the diagnosis of DID; I have been spared a lot of the internal struggling that others go through, and the competition for power, although I have done some difficult work around the fears of the younger ones.Although what is striking to me about DID as well as your situation is how it all becomes in large part a "management" issue--e.g. only letting the little ones talk in the restroom and so forth. There actually is a lesson there for people who do not have alters--namely compartmentalizing when it is appropriate to have certain reactions. For instance, I used to have shame spirals (fortunately therapy irradicated this one). It would have been great to have said ok I can have shame spirals but only at certain times. Maybe not doable, but the effort would have been grand and I'm sure I would have learned a lot in the process. The cognitive therapy piece of the equation for me was to recognize the trigger and the beginning of the thought thread and pull it back in before the spiral got full steam.
> > > I don't know why they still hang out in me, but it's fine with me, and I will be sad if they decide to integrate.
This is such a sweet way of looking at it. Did you ever resist or resent their presence?
Lorraine
Posted by Lorraine on August 2, 2001, at 11:42:31
In reply to Hope you're okay on your 2nd day of parnate » Lorraine, posted by shelliR on August 1, 2001, at 21:29:38
[re: "the Magic Daughter]
> >I hope you like it; tell me what you think after you've read it.I ordered it from half.com. I'm not sure it is still in print, but at half.com you can get out of print or hard to locate books (like Tess Gallegher's "Moon Crossing Bridge"--which is a poetry book that she wrote shortly after the death her husband (or lover?)Ray Carver. When someone's husband dies, I like to give them this book because it is so lovely--but it is hard to find). I also ordered the PDR and got it for less than half price (which is still expensive, but look how much money I Saved). Anyway, I'll let you know what I think of The Magic Daughter after I have read it.
> > > I wouldn't go looking for new trauma unless you feel that there is something unresolved that is contributing to your depression.I suppose you are right. The thing about when I worked out my traumas before was that I didn't "remember" certain things and so had to "try on" various scenarios and walk around with them for a week or so to see if they "fit". For instance, when I set my pajamas on fire when I was eight, I don't know if there was a precipitating incident or a suicidal intent or if I was just a kid playing with matches that panicked. I "decided" the latter scenario was the truth. There also was some sexual abuse by my father when I was older. So I wonder here too although it's not something that I have a strong intuition about.
> > > Is your depression centered in a specific area of your body?I'm not sure. I feel a lot of heaviness in my chest. And I once worked with a massage therapist when I was during a wash out period and I think I cried the entire massage. She was wonderful and worked with me on breath (I was hyperventilating pretty badly at the time). I've had this happen before with other massage therapist who were emotionally oriented.
> > >I have stopped the estrogen, at least until I talk with her.
This sounds right and you are very lucky to have an ob/gyn you think highly of.
> > > How are you doing on day two of Parnate? With nardil, I had zero side effects from the beginning. Maybe others on the board can be helpful with knowing whether it took a while to adapt to parnate. You might ask, or first search the archives. I've never adjusted to any medication which gave me side effects at the beginning, but lots of people on the board have had the experience of it taking time to adjust to a med which turned out to be a success. I hope you're in that category. If not, there's always nardil.Yes, I should check other's reactions. I very frequently get the back ache thing from meds. I have read the archives--but didn't really see what I was looking for there. Maybe I'll do a general posting and see what people say.
> > > I do believe that I will either go back on nardil with concerta, or start parnate next week when the prozac is cleared out. I just took concerta (had already taken oxy a few hours ago) to see how I do on the two of them together. Today's the only day this week I can afford to lose so that's why I decided to do try it.Shelli, I'm glad to see that you are moving quickly on adjusting or changing your meds. Let me know how the concerta and oxy trial goes. The Parnate is having some positive effects--less aggitation than the selegiline and I suspect that the mood support is going to be more robust than stimulants or selegiline. We'll see.
> > > Actually, after yesterday's "seasickness" I am somewhat concerned that you haven't posted, and hope things are going better. Somehow though, I don't have a good intuition about your absence from the board today. I hope I'm wrong, and am looking forward to hearing.Thank-you for your concern. Things are better--although yesterday was rough because my 13 year old son lost his temper and started hitting me yesterday (he's 5'8" and strong) and telling me that he was going to kill me. It was very upsetting. First, it was hard to get "safe" because he wouldn't let me out of the room, then there was the issue of what to do to help him get control of his anger--trying to find a therapist and so forth. A real family crises. But I made it through and the family was able to talk it through last night and do some healing.
Shelli, so you know, I am one of those people who have "emergency" plans in place in case things get too tough. I have the book on suicide to read, the people to call, and at least one hospital that I could check myself in. I have never had to use my plan, but I have it in place because I believe that when things get rough sometimes it's easy to lose focus and I should just do step 1, then step 2 and so forth. I have also been blessed in that I don't have suicidal thoughts generally and have never attempted to harm myself.
Posted by Elizabeth on August 2, 2001, at 14:21:22
In reply to Re: Give me back my hand- (just kidding), posted by Lorraine on August 2, 2001, at 11:10:25
> I suppose the only difference would be that I would actually believe that I need to take anti-convulsants. He has me on them anyway, but I've always thought that that was just his med preference as opposed to understanding the need for taking them.
Do you feel like they've helped you? A doctor's preference isn't sufficient reason to stay on a drug that isn't doing much good.
> Well, I'm glad that I met Neal and if the opportunity came up I would encourage you to meet the psychobabbler.
I had an opportunity which I missed a while back. I kind of regret that I wasn't able to meet with the group.
> There is no commitment to meeting someone one time and there is always the possibility that you will meet someone with this illness that can be a real life friend.
Yes. This is one way in which I found support groups helpful. I think if I'd had my act more together in college, I might have started a support group (for people with psych disorders -- there were a lot of us at my school).
> I have good friends and some of them are depressed, but none of them have the type of treatment resistant depression or the degree of life impairment that I have so it is nice to meet someone who "gets" it without a lot of explanation.
I know what you mean. At present, none of the people I interact with day-to-day "gets it." I think that one of my friends who I see fairly often probably has depression and/or panic attacks, but she doesn't want to get treatment (she's seeing a therapist, but only very irregularly).
> It was a first day. My second day was better, but not great (I'm still on a low dose--5 mg 2x day and Neurontin 300 mg 3x day).
The split dose of Parnate is a good idea for minimising the initial side effects. (I would even consider going down to 5 mg once a day.) How do you get those tablets to break evenly, incidentally?
> I need to take it up slowly because I don't want hyperventilation to be a major problem.
Yeah, Parnate did that to me too at first (and again when I tried adding stimulants to it). Other than beta blockers and relaxation exercises, the only thing I can suggest is patience. I can't remember: did you ever try a cardioselective beta blocker (e.g., atenolol)?
> My pdoc says I can add Adderal to the mix, but I have a hunch I won't need to once I get to a therapeutic dose. I was able to REALLY sleep soundly last night and the night before, a luxury that the Adderal had impaired significantly.
Don't expect to sleep much once you're on a therapeutic dose of Parnate! What happens, IME, is that your sleep requirements go down, so that you feel rested after just 4-5 hours. On the other hand, a lot of people get drowsy in the afternoon on MAOIs: it might be that they just fragment your sleep or disrupt your circadian rhythm.
> I also learned that I can make it through a wash out period fairly functional by taking Adderal and Neurontin during it. This is actually good news.
It sure is. I'll make note of that. Do you think there were withdrawal symptoms precipitated by discontinuing the selegiline, or just a relapse?
> The problem is that I was out of town for a few days and then responded to each posting (I should have combined them like I am doing now).
Yeah, I've been trying to do that too. The thread had gotten pretty unwieldy!
> There actually is a lesson there for people who do not have alters--namely compartmentalizing when it is appropriate to have certain reactions.
That's something that never came naturally to me. (I think that's an ADD thing, perhaps.)
> For instance, I used to have shame spirals (fortunately therapy irradicated this one).
Okay, I have to ask: what do you mean by shame spirals?
> This is such a sweet way of looking at it. Did you ever resist or resent their presence?
I think that a lot of people with DID (or subclinical DID, like Shelli has) feel an attachment to their alters, and as a result they don't necessarily *want* to integrate. I think that if somebody is co-conscious and is otherwise functioning well and feeling okay, it's probably fine to choose not to integrate (if you have the choice). Although I do wonder what sort of effect this kind of compartmentalisation has on inter- and intrapersonal relations.
On to your other post:
> I ordered it from half.com. I'm not sure it is still in print, but at half.com you can get out of print or hard to locate books
Amazon does that too. I got my hands on some vintage psychiatry textbooks (odd thing to collect, I know) and a book my dad wrote back in the '70s from Amazon. (I'm really hoping he will be able to finish the book he's writing now -- it's going to be quite a piece of work.)
> I also ordered the PDR and got it for less than half price (which is still expensive, but look how much money I Saved).
That's cool. You might be able to find stuff like that (outdated PDRs) on eBay, too. I got my copies of Schatzberg & Nemeroff (both editions) from Amazon at about 2/3 the cover price (when they were new).
> I suppose you are right. The thing about when I worked out my traumas before was that I didn't "remember" certain things and so had to "try on" various scenarios and walk around with them for a week or so to see if they "fit".
Wow. How did you construct the scenarios in the first place?
> For instance, when I set my pajamas on fire when I was eight, I don't know if there was a precipitating incident or a suicidal intent or if I was just a kid playing with matches that panicked.
You and Shelli were quite the little pyromaniacs, weren't you? :-)
> There also was some sexual abuse by my father when I was older.
God, that's awful. How old were you? It's almost unbelievable that things like that happen (not that I don't believe you, it's just so horrible that I don't *want* to believe it).
> > > > Is your depression centered in a specific area of your body?
>
> I'm not sure.I'm still wondering what she meant by this. Shelli?
> I feel a lot of heaviness in my chest.
That must be pretty common, because a lot of people seem to experience it (hence the idiom "getting something off your chest").
> And I once worked with a massage therapist when I was during a wash out period and I think I cried the entire massage. She was wonderful and worked with me on breath (I was hyperventilating pretty badly at the time). I've had this happen before with other massage therapist who were emotionally oriented.
That's really interesting to me. I went to a massage therapist a few times when my back pain started (my GP recommended her). This was just massage, not massage + psychotherapy or anything. :-) The massage did help, but only for a short time, and after doing it for a couple months I decided that it wasn't worth the expense. (It sure was nice, though.)
> Yes, I should check other's reactions.
Here's one data point for you: I found that the sympathomimetic stimulation from Parnate became much less with time.
> I very frequently get the back ache thing from meds.
This is the kind of thing that gets me thinking, "I wonder what causes that?"
> Shelli, I'm glad to see that you are moving quickly on adjusting or changing your meds. Let me know how the concerta and oxy trial goes.
I'm still impressed that someone was willing to prescribe oxycodone for depression -- and I'm generally pretty optimistic about the chances of convincing a doctor to do something unorthodox. I don't think that there are too many references in the literature to this (although opium and its derivatives have been used as antidepressants for millennia).
> The Parnate is having some positive effects--less aggitation than the selegiline and I suspect that the mood support is going to be more robust than stimulants or selegiline. We'll see.
That was my experience with Parnate vs. selegiline. There are a lot of stimulants, and they vary in their central and peripheral effects. (Methamphetamine has the most favourable ratio of central to peripheral effects, which is also why people abuse it so much.)
> Thank-you for your concern. Things are better--although yesterday was rough because my 13 year old son lost his temper and started hitting me yesterday (he's 5'8" and strong) and telling me that he was going to kill me. It was very upsetting.
I can imagine! Does he have any psychological problems that you know of?
> ... But I made it through and the family was able to talk it through last night and do some healing.
That's good; it means that the whole incident wasn't completely negative -- you did get something of value out of it.
> I have also been blessed in that I don't have suicidal thoughts generally and have never attempted to harm myself.
I think it's reasonable to have a plan in case you ever do, since people generally aren't very clearheaded when they're feeling suicidal.
-elizabeth
Posted by shelliR on August 2, 2001, at 18:25:21
In reply to Re: Hope you're okay on your 2nd day of parnate » shelliR, posted by Lorraine on August 2, 2001, at 11:42:31
Hi Lorraine,
Hope you are having a third good day on parnate.
> > > >I have stopped the estrogen, at least until I talk with her.
> This sounds right and you are very lucky to have an ob/gyn you think highly of.yes, I wish she could be my internist and pdoc also.
BTW, what is the most accurate test for estrogen levels?
> > > > Actually, after yesterday's "seasickness" I am somewhat concerned that you haven't posted, and hope things are going better. Somehow though, I don't have a good intuition about your absence from the board today. I hope I'm wrong, and am looking forward to hearing.
>
> Thank-you for your concern. Things are better--although yesterday was rough because my 13 year old son lost his temper and started hitting me yesterday (he's 5'8" and strong) and telling me that he was going to kill me. It was very upsetting. First, it was hard to get "safe" because he wouldn't let me out of the room, then there was the issue of what to do to help him get control of his anger--trying to find a therapist and so forth. A real family crises. But I made it through and the family was able to talk it through last night and do some healing.Once in my house, a client was over with her son and daugher and she said something that embarrassed him horribly and he threatened to kill her. I was not in the room--the daughter and I were downstairs, so I didn't even know that this happened until later. He was only eleven but his mom was really scared and did get him to a shrink I think. She should not have said what she did, (it was meant to tease, not to humiliate), but to have your son say I'll kill you is very scarey. I glad you all were able to talk it through.
>
> Shelli, so you know, I am one of those people who have "emergency" plans in place in case things get too tough. I have the book on suicide to read, the people to call, and at least one hospital that I could check myself in. I have never had to use my plan, but I have it in place because I believe that when things get rough sometimes it's easy to lose focus and I should just do step 1, then step 2 and so forth. I have also been blessed in that I don't have suicidal thoughts generally and have never attempted to harm myself.
I'm glad to know that both that you rarely have suicidal thoughts AND that you have a plan if you do.
I actually wasn't thinking that you were going to harm yourself, I was just afraid you were having a really sick day from the parnate. It seems like you are feeling very optimistic about the parnate and I am for you also. In fact, I'm pretty sure I'll start parnate next week rather than nardil with concerta. Yesterday oxycontin with concera was fine until the early evening, when I felt a little sick in my stomach and totally exhausted When I tried to take a nap, I couldn't fall asleep. So last night I was a complete zombie, didn't do the treadmill or work. And then I had trouble falling asleep at 1am. So I'm still not real positive about stimulents for me.more to come in another post..
Shelli
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