![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 332 to 356 of 948. Go back in thread:
Posted by nmk on August 5, 2003, at 15:07:53
In reply to Med free and misdirect » katia, posted by Barbara Cat on August 5, 2003, at 11:51:59
Hi Barbara,
Just checking in and am thrilled to hear that you are feeling better. I hope your 10 day vacation will bring you back smiling and feeling better than ever.
I have since joined the Lamictal club. My pdoc weaned me off Trileptal (pooped out) and I am now up to 75 mg of Lamictal. I hope you can answer a few questions since I am already starting to get discouraged with the side effects. Since I started the Lamictal, I have noticed EXTREME anxiety during the day and difficulty falling asleep at night. My pdoc states that this will dissipate as I reach a therapeutic dose but I am worried. Thank God for my Ativan! I have read numerous posts regarding Lamictal yet nobody complains of increased anxiety. Do I just need to be a tad more patient??
Thanks,
Nicole
Posted by Barbara Cat on August 5, 2003, at 15:14:13
In reply to Re: Best wishes to my friend B-Cat » Barbara Cat, posted by Ron Hill on August 3, 2003, at 20:52:13
Hi Ron,
>>Disruption of my sleep cycle triggers my bipolar symptoms. I take 800 mg of magnesium (half Mg Citrate and half Mg Malate) at bedtime and it is an excellent sleep aid (for me).
>
Magnesium is the king of minerals!! It makes a big difference in my fibro aches and general calmness, but I have to take ALOT. Mg glycinate is supposed to be better absorbed without the pesky diarrea, but I haven't found this to be true. I also take Mg Malate. Also Coral Calcium, but not at the same time as Mg cause they supposedly compete. I'm trying to take as many whole food sources as I can 'cause I don't think fractionated vitamins are too good for me. Plus, I have a suspicion that most of my vitamin pills end up in the toilet. I'm working on probiotics and other things for absorption cause so many meds over the years have caused sluggish digestion.>>Beating yourself up with negative self-talk makes it worse. Like you, it helps me to cognitively understand that my symptoms are directly related to my BPII and that this too shall pass.
>
Yup, if only I had access to those memories and tools when I'm in the depths. I'm usually so dispirited that I berate myself for thinking that God is anything but an insane puppet master. And hah! hope is for delusional fools whom I want nothing to do with. Pretty nihilistic but the time spent there is getting less and less, thankfully.
>
>>Prayer and exercise both improve brainchemistry for me.That's my main reason for taking meds - to get to a place where I can pray and exercise cause I can't do either when my circuits are blown.
>
>>Lamictal causes a severe rash over a significant portion of my body. But for those BP patients that can tolerate it, I think it is a good combination.
>
Lamictal caused a bad itch forcing me to reduce it. But the AD effect seems to be holding once I emerged from the recent bad spell.> > But sometimes I wonder if Nardil or another MAOI in conjunction with Lithobid might be worth a trial.
Have you heard anything about moclobemide? It sounds interesting in that it's a reversible MAOI without the dietary restrictions. I haven't heard anything.
>>ENADA NADH continues to function pretty well to control my atypical depression
I used Enada NADH when a few years ago when I was in the worst of the fatigue of fibromyalgia. It helped alot with energy. I cut back on anything too energizing because of my tendency to panic attacks and mixed states. But I sometimes wonder if my fibro symptoms, muscle aches, fatigue, fog, etc., isn't in part due to the atypical depressive part of the bipolar spectrum. I'm going to order it as soon as I finish this.
>>“do nothing boy”.
Love it. When my husband gets depressed (not too often) he goes into what I refer to as his 'gray zone'. But I tell ya, Ron. I'd rather be 'do-nothing girl' instead of the agonized sobbing and falling apart kind. It's really embarrassing in public cause most folks just haven't gone there. I can't be near a supermarket with lobster tanks. Sometimes I consider Zyprexa cause my states get so horrific that I'm sure they're psychotic (I think that makes me BP-I istead of II). I just hate to take yet another pill that's a pudge maker. But I can't go through many more of those horrors.
> > People like you and I who experienced an inordinately high volume and intensity of childhood trauma damaged our stress response systems due to overuse, and now as adults, the slightest level of stress completely screws up our systems and adversely affects our brainchemistry.
Oh, you bet. We're the canaries in the coal mines. The HPA-axis and corticotrphin neuro-toxic theory makes the most sense to me. Few creatures, especially a delicate child's developing neural system, can go through sustained trauma and not be permanently scarred by it. But hey, maybe this is the shamanic initiation required to open the gates of perception not usually available to 'normals'. It would be great if it was better suppported and honored and there was truly helpful guidance for it instead of being at the mercy of HMO's and the dart-board approach to medicating. I'm convinced that we need med support while we need it, but healing the deeper limbic structures require more realms of delicacy and skill than are usually available from our pdocs.
> > For the past month I’ve been having trouble with wretched dysphoric mood states. I don’t know if it should be classified as a mixed state condition, but it is hell to experience and it is hell for my wife when I’m screaming 24/7. I’ve had some breakthroughs over the past couple of days and I’m doing fairly well today.
Sorry to hear about that, Ron. That rage state is so hard on the body. I become a real harpy when I'm on my way down into a black hole and usually lose a few friends (bah! they weren't true friends anyway, so bleahhhgh!). Sometimes it the prelude to a mixed depression where I no longer notice anyone outside of my private little hell, but sometimes it just hangs around and then passes on. Everything - noises, traffic, bumping into things, really pisses me off, and everyone gets reamed, especially my long-suffering husband. I scream and become vitriolic and say things I'm really sorry for later. But let's face it, everyone has their stuff and sometimes he's a real jerk.
About the nutrients pooping out, yeah, me too. But if I don't take them things get worse. The neuro-nutrients seem promising. I'm working with one called Neurozyme from www.new-chapter.com (actually, I get it from www.iherb.com cause they're cheaper). The ingredients look real good, but again, the bioavailability is the key. The money I spend on all this stuff...
Hope you're feeling better, Ron. Please share your breakthroughs if you feel like you want to. We need to hear these lessons from our shamans-in-training community. Good thing we have this board cause feeling rotten is so isolating. - Barbara
Posted by katia on August 5, 2003, at 17:39:38
In reply to Med free and misdirect » katia, posted by Barbara Cat on August 5, 2003, at 11:51:59
Hi Barbara,
If I don't catch you before you go on vacation, we'll talk when you get back. I'm not doing so well. I went from about two really good days to one where the euphoria feeling was edged with raciness and then one day to today - very agitated and irritable! I'm sick of this roller coaster ride. I just got my depakote in the mail today too. I think this swing of my mood is a sign that I need to take it. or at least give it a go. I swing too fast. It's not "normal" is it? I mean at least some people have a good month or two and then crash. I just go on an ultra rapid cycle it seems. God those two days felt so good! anyway, what's real happiness anyway? Was I happy and excited to be alive geniunely? or was I skirting hypomania? Maybe one way to find out is to try the depakote. But then what if it's just that med that's not for me and then I have to go through another year or more of finding the right one - when I am confused if I even have a mood disorder! There are so many influencing factors!re: your conversation with Ron below -
>>I'm convinced that we need med support while we need it, but healing the deeper limbic structures require more realms of delicacy and skill than are usually available from our pdocs.you mentioned shamanism. Have you ever been to one to try and heal the depression? I've been thinking about doing a soul retrieval for over a year. It's all so multi-layered that I'm sure everything plays a part.
anyway, the dog next door won't stop barking and I'm jumping out of my skin!we'll talk soon, I hope.
Katia
Posted by Ron Hill on August 5, 2003, at 21:58:28
In reply to Re: Best wishes to my friend B-Cat » Ron Hill, posted by Barbara Cat on August 5, 2003, at 15:14:13
Posted by Barbara Cat on August 5, 2003, at 22:03:16
In reply to Barbara's Back! » Barbara Cat, posted by nmk on August 5, 2003, at 15:07:53
Hi Nicole,
Thanks for the welcome back. I'm feeling much better. Don't know why, except for the whim of the chemistry gods.Lamictal most definitely causes anxiety, especially when starting or increasing. Some don't get jittery, but I did. It's a common topic on this board. It does go away and then you think it's not working anymore because you kinda get used to the extra zip, but it's still doing it's thing in the background. You have to go baby steps slow on it, like 12.5mg a week. This is excrutiating when you're desperate to feel better, but there's no way around it. I'm sure you've heard of the rash, which is very rare, but still a scare. I went up 25mg from 125 to 150 in one week and got the itches like a dog with fleas. Back down to 125 and get occasional prickles but not like poison ivy. The mood is holding too. I even wonder if 150 was a little too strong and set off a hypomania which usually descends into depression. Looking back, I was feeling a tad too bubbly and having too many spiritual epiphanies. Great while it lasts, but it never does.
So, good luck on lam. It's been a good drug for me. And you know how it is. You've got to give it time but if it's not going to work, you'll probably know in a month. Maybe by then they'll come out with that magic bullet we're all waiting for ;-) - Barbara
Posted by Barbara Cat on August 5, 2003, at 22:52:04
In reply to Re: Med free and misdirect » Barbara Cat, posted by katia on August 5, 2003, at 17:39:38
Hi Katia,
We're leaving in the morning so here I am instead of packing (bleagh!). I'm so sorry to hear about your downturn. It must be disappointing when you were hoping differently. We just have a chemical disorder, plain and simple. Sometimes I accept it and am grateful for the meds and not living in times when we'd be begging for alms or thrown in Bedlam. Other times I try every new thing I can't afford to find that key that's going to unlock it all for me. But no matter what esoteria I try, it doesn't stick if I don't address the chemical imbalance first.Yes, I've done soul retrieval. It helped me understand how and when I became fragmented and split off through fear as a young girl. It was a very good thing, but no, it didn't cure me and the nice effects lasted only a short time. But it was good information and I'm glad I did it. I've been in the company of some very high realized beings on this planet and they too have very dark times. Every one of them has gone through hell and back and still has to deal with intense pain. That seems to be the way it is here - the place we've chosen to come to learn those things that only our life experiences can teach us. The difference with these people is that they don't get stuck in it and just let the fear and anxiety blow through them. They quickly get back to centerpoint. Their presence is one of calm accepting joy instead of blissed out instability. Oh, that's how I long to be (there's that craving again), to just be with it and honor whatever reason it's happening, stop the frantic running from it and just LET GO. And even the desire for all that has to be let go of as well. You live in the Now and do what needs to get done in the Now. But, jeez, it's hard to remember, especially in the midst of a panic attack. Hope it doesn't take another lifetime cause I don't wanna come back here!
You ask 'what is happiness, anyway'. Well, I do know that it's not the ecstacy we crave. Ecstacy and bliss and happy HAPPY! are the polar opposites of despair and depression. The pull/push of desire/rejection for either state sets us off into a spin that keeps the cycle going. It's the craving for happiness that's actually the cause of unhappiness. I think that the key is to develop that calm clear center, the witnessing presence that observes the play and holds the center without getting lost in either polarity. The spiritual teachings help me alot. I shore up on them when I'm feeling good and I may some day be able to just sit with the shit, but until then, I give up. I need meds cause I don't know how to do it on my own.
I really do encourage you to try the soul retrieval. If you work with the right person, it will help you greatly, as long as you don't expect it to be a miracle cure. But then again, who knows? I have considered going to Lourdes... - Barbara
Posted by katia on August 6, 2003, at 2:23:45
In reply to Re: Med free and misdirect » katia, posted by Barbara Cat on August 5, 2003, at 22:52:04
Hi Barbara,
Yes, I have finally realized that within myself - at least I did last summer when I was in "hell" - that I cannot do this without medication. That no matter what "healing" modality I choose or try won't work unless I'm getting chemical help from medication - at least for a good long time.Prior to starting the medication last summer, every second was eternal hell for me. I had completely lost my mind - howling on the floor, making noises I've never heard before, crawling from the bed to bathroom and it taking one hour, marking myself with my fingernails, crying crying crying. And in the midst of these three intense months, I listened to so many tapes, i.e. Ram Dass's lectures/talks, The Power of Now - Tolle, and Pema Chondron's "When Things Fall Apart".
I was doing everything I could to stay present during this misery and transform out of it. Cognitively, I have no idea if I moved/transformed anything, or if things could be worse now, but nothing seems to have moved things for me like addressing that I have a mood disorder and need chemical help.
On one hand, depression/bipolar has been absolute hell and it's been a driving force for me to investigate all healing modalities, finally ending with meds. but it seems to have been an impetus for a tough spiritual journey/opening as well.
As with the soul retrieval and everything else I've done - maybe on some level it will help and synergistically move/transform things in me.
know what I mean?
have a good holiday!
Katia> Hi Katia,
> We're leaving in the morning so here I am instead of packing (bleagh!). I'm so sorry to hear about your downturn. It must be disappointing when you were hoping differently. We just have a chemical disorder, plain and simple. Sometimes I accept it and am grateful for the meds and not living in times when we'd be begging for alms or thrown in Bedlam. Other times I try every new thing I can't afford to find that key that's going to unlock it all for me. But no matter what esoteria I try, it doesn't stick if I don't address the chemical imbalance first.
>
> Yes, I've done soul retrieval. It helped me understand how and when I became fragmented and split off through fear as a young girl. It was a very good thing, but no, it didn't cure me and the nice effects lasted only a short time. But it was good information and I'm glad I did it. I've been in the company of some very high realized beings on this planet and they too have very dark times. Every one of them has gone through hell and back and still has to deal with intense pain. That seems to be the way it is here - the place we've chosen to come to learn those things that only our life experiences can teach us. The difference with these people is that they don't get stuck in it and just let the fear and anxiety blow through them. They quickly get back to centerpoint. Their presence is one of calm accepting joy instead of blissed out instability. Oh, that's how I long to be (there's that craving again), to just be with it and honor whatever reason it's happening, stop the frantic running from it and just LET GO. And even the desire for all that has to be let go of as well. You live in the Now and do what needs to get done in the Now. But, jeez, it's hard to remember, especially in the midst of a panic attack. Hope it doesn't take another lifetime cause I don't wanna come back here!
>
> You ask 'what is happiness, anyway'. Well, I do know that it's not the ecstacy we crave. Ecstacy and bliss and happy HAPPY! are the polar opposites of despair and depression. The pull/push of desire/rejection for either state sets us off into a spin that keeps the cycle going. It's the craving for happiness that's actually the cause of unhappiness. I think that the key is to develop that calm clear center, the witnessing presence that observes the play and holds the center without getting lost in either polarity. The spiritual teachings help me alot. I shore up on them when I'm feeling good and I may some day be able to just sit with the shit, but until then, I give up. I need meds cause I don't know how to do it on my own.
>
> I really do encourage you to try the soul retrieval. If you work with the right person, it will help you greatly, as long as you don't expect it to be a miracle cure. But then again, who knows? I have considered going to Lourdes... - Barbara
Posted by fluffy on August 6, 2003, at 11:10:20
In reply to Re: Best wishes to my friend B-Cat » Barbara Cat, posted by Ron Hill on August 3, 2003, at 20:52:13
Hey Ron Hill--
I hate to just bulldoze over everyone else's problems here on this thread. And Ron and Katia--I'm so sorry that you guys are feeling bad now. I guess I'm joining that club unfortunately. I'm starting to get that tired-wired feeling that I got last summer. I'm having severe difficulty getting sleep. I'm only sleeping because of those wonderful spendy pills of Ambien. I can't afford them though, and I'm becoming a junky. Even though I'm taking the Ambien, I'm waking up too early and feeling panic attacks just held at bay. I can't tolerate the least amount of coffee b/c it makes me feel panicky--so that's definitely out of the mix. (sometimes I feel like coffee is my barometer--if I drink it and still feel lethargic, I'm usually depressed. If I drink it and I feel panicky, than I'm on the hypomanic side of things.)
If I can't sleep, then I know an episode is most definitely on its way. I'm still taking 200mg of Lamictal. And so far, it's kept the depression from coming around. But the anxiety/hypomania doesn't budge. I asked my pdoc yesterday what the contingency plan is if I continue to have sleep problems. He suggested Melatonin (doesn't help lately) and if not that, Klonopin. But he said only if I could use it a couple of times a week (so I don't get addicted to it). But frankly, I think I need something every night this month to stave off my yearly mixed state. Has anyone been "addicted" to Klonopin. Can you taper off successfully?
The next step would be to try Li in conjunction with Lamictal. Why do I still feel afraid to try the damned stuff? Would Neurontin help my sleep? Would Trazodone??? I think I'll try the magnesium thing tonight.
I don't really know what my point is to this post. I'm just feeling desperate and I need some advice and support.
Katy
Posted by katia on August 6, 2003, at 15:18:38
In reply to To Ron Hill: Sleep problems--anxiety-HELP!, posted by fluffy on August 6, 2003, at 11:10:20
> Hey Ron Hill--
>
> I hate to just bulldoze over everyone else's problems here on this thread. And Ron and Katia--I'm so sorry that you guys are feeling bad now. I guess I'm joining that club unfortunately. I'm starting to get that tired-wired feeling that I got last summer. I'm having severe difficulty getting sleep. I'm only sleeping because of those wonderful spendy pills of Ambien. I can't afford them though, and I'm becoming a junky. Even though I'm taking the Ambien, I'm waking up too early and feeling panic attacks just held at bay. I can't tolerate the least amount of coffee b/c it makes me feel panicky--so that's definitely out of the mix. (sometimes I feel like coffee is my barometer--if I drink it and still feel lethargic, I'm usually depressed. If I drink it and I feel panicky, than I'm on the hypomanic side of things.)
>
> If I can't sleep, then I know an episode is most definitely on its way. I'm still taking 200mg of Lamictal. And so far, it's kept the depression from coming around. But the anxiety/hypomania doesn't budge. I asked my pdoc yesterday what the contingency plan is if I continue to have sleep problems. He suggested Melatonin (doesn't help lately) and if not that, Klonopin. But he said only if I could use it a couple of times a week (so I don't get addicted to it). But frankly, I think I need something every night this month to stave off my yearly mixed state. Has anyone been "addicted" to Klonopin. Can you taper off successfully?
>
> The next step would be to try Li in conjunction with Lamictal. Why do I still feel afraid to try the damned stuff? Would Neurontin help my sleep? Would Trazodone??? I think I'll try the magnesium thing tonight.
>
> I don't really know what my point is to this post. I'm just feeling desperate and I need some advice and support.
>
> Katy
Hi Katy,
You didn't bulldoze through! I'm not nec. "bad", but it's touch and go w/ me.
You bring up a good point with me too, as coffee being the barometer. It's true for me too. I have been drinking it steadily for the past year and in the past four months it had been doing nothing for me - no dent whatsoever. But lately, it's been getting me "high". I think the same exists for me - including alcohol for the same reasons.
I'm sorry to hear you're so anxiety ridden. Do you think it may just be a side effect while your body gets used to the lam.?
I've tried Trazadone and it seems to work well enough, depending on the anxiety level. But my new pdoc wanted to get me off of all ADs. You could give it a go. What really worked for me was Seroquel. I only had to take like 1/4 to 1/3 of 25mg and I'd sleep for hours. At present, I"m on nothing (about three weeks now). I even stopped the Seroquel to see how I did on sleep and I sleep so well now. I don't understand it all! However, I don't have to get up for a job - I work nights, so that plays a factor in my anxiety level for sure!
Ask your doc about Seroq. at small doses it could help you temp. get through August.
Katia
Posted by fluffy on August 6, 2003, at 15:30:34
In reply to Re: To Ron Hill: Sleep problems--anxiety-HELP! » fluffy, posted by katia on August 6, 2003, at 15:18:38
Thanks Katia--
I'm glad you're not all that bad off. I'm touch and go as well. Seems like I'm pretty volatile when I don't sleep though. And for the past 5 days...oh jeez!! I'm getting to be a real grouch. I went out to the "food hole" (my friend's name for Whole Foods supermarket) and got some sleep supplement. It has Magnesium, Calcium, Valerian, and GABA. I called my doc just now, and he said to just up my Ambien dose to 10mg. I hope it works at least for the next week or so. I don't get the feeling he's too keen on the supplement I bought.I keep thinking that I don't have enough mood stabilization with Lamictal alone, though. Seems like if I was stabilized, I'd sleep better. I've been on Lamictal for 5 months now, so my system is pretty used to it. It's never helped me with anxiety and/or sleep. I wonder if my doc would give me Seroquel. Seems like it's worked for a lot of insomniacs on this board.
Thanks for the advice Katia!
Be well,
Katy
Posted by fluffy on August 6, 2003, at 15:38:13
In reply to Re: To Ron Hill: Sleep problems--anxiety-HELP!, posted by fluffy on August 6, 2003, at 15:30:34
Oh--and Trazodone helped me too. My doc is hesitating to give me anything seratonin related now, as I had such a bad spell last year on SSRI's and Trazodone. But it's on the roster of things to try.
Posted by Ron Hill on August 7, 2003, at 13:12:50
In reply to To Ron Hill: Sleep problems--anxiety-HELP!, posted by fluffy on August 6, 2003, at 11:10:20
Hi Fluffs,
> And Ron and Katia--I'm so sorry that you guys are feeling bad now.
I'm doing better now. Thanks for your concern.
> I'm having severe difficulty getting sleep. I'm only sleeping because of those wonderful spendy pills of Ambien. I can't afford them though, and I'm becoming a junky. Even though I'm taking the Ambien, I'm waking up too early and feeling panic attacks just held at bay.
> If I can't sleep, then I know an episode is most definitely on its way. I'm still taking 200mg of Lamictal. And so far, it's kept the depression from coming around. But the anxiety/hypomania doesn't budge. I asked my pdoc yesterday what the contingency plan is if I continue to have sleep problems. He suggested Melatonin (doesn't help lately) and if not that, Klonopin. But he said only if I could use it a couple of times a week (so I don't get addicted to it). But frankly, I think I need something every night this month to stave off my yearly mixed state. Has anyone been "addicted" to Klonopin. Can you taper off successfully?
> The next step would be to try Li in conjunction with Lamictal. Why do I still feel afraid to try the damned stuff? Would Neurontin help my sleep? Would Trazodone??? I think I'll try the magnesium thing tonight.> I don't really know what my point is to this post. I'm just feeling desperate and I need some advice and support.
Yeah, I hear ya Katy; good quality sleep in the correct quantity is VERY important for us bipolar patients. My insomnia problems have been resolved (by and large) for a couple of years now. I attribute the improvement primary to magnesium and, to a lesser extent, lithium (my mood stabilizer). I take 800 mg of magnesium at bedtime. I use magnesium malate and magnesium citrate.
It sounds like you have some good ideas regarding things to try for your insomnia. May I comment briefly on a few of them?
Melatonin -- I used to use this. Sublingual was far and away more effective for me than "down-the-hatch" pills. Also minimize the dosage (i.e.; about 0.5 mg/night) and do not take it every night (or else it loses its effectiveness).
Klonopin – I’ve never used a benzo, although I’ve been tempted to try Klonopin to treat my periodic dysphoric mood states. A lot of people around here find Klonopin a very effective sleep aid and a lot of people use it daily for extended periods of time without any problems.
Lithium – If your insomnia is caused by hypomania, then it makes sense that adding another moodstabilizer might help. Lithobid reduces my insomia by treating my hypomania. Of all the moodstabilizers I’ve tried, Depakote had the most dramatic effect in reducing my insomnia. Depakote was notorious for giving me vivid dreams and when I woke up I felt like I had slept very deeply (it also caused me to gain 30 pounds and made me more depressed).
Trazodone – I’ve not tried it but, as you know, it’s known for its sleep aid characteristics.
Seroquel – AP’s are heavy duty stuff with side effects. If it were me I’d try other options first. But that’s just me.
Best Wishes Katy.
-- Ron
Posted by katia on August 7, 2003, at 13:59:55
In reply to Re: To Ron Hill: Sleep problems--anxiety-HELP!, posted by fluffy on August 6, 2003, at 15:30:34
> Thanks Katia--
> I'm glad you're not all that bad off. I'm touch and go as well. Seems like I'm pretty volatile when I don't sleep though. And for the past 5 days...oh jeez!! I'm getting to be a real grouch. I went out to the "food hole" (my friend's name for Whole Foods supermarket) and got some sleep supplement. It has Magnesium, Calcium, Valerian, and GABA. I called my doc just now, and he said to just up my Ambien dose to 10mg. I hope it works at least for the next week or so. I don't get the feeling he's too keen on the supplement I bought.
>
> I keep thinking that I don't have enough mood stabilization with Lamictal alone, though. Seems like if I was stabilized, I'd sleep better. I've been on Lamictal for 5 months now, so my system is pretty used to it. It's never helped me with anxiety and/or sleep. I wonder if my doc would give me Seroquel. Seems like it's worked for a lot of insomniacs on this board.
>
> Thanks for the advice Katia!
> Be well,
> KatyHi Katy,
Seroquel helped me sleep in the short term; I wouldn't take it in the long term. It's powerful and it can help stop the snowball effect of no sleep on top of no sleep etc. You know how it goes; if you get a good night's sleep chances are the next will be good and vice versa.From what I've heard on this board re: calcium and magnesium. They shouldn't be taken together as the mag loses its effectiveness.
just a thought.
sweet dreams.
Katia
Posted by fluffy on August 8, 2003, at 10:28:50
In reply to Re: Sleep problems--anxiety-HELP! » fluffy, posted by Ron Hill on August 7, 2003, at 13:12:50
My pdoc had me up my Lamictal dose (again) last night in an attempt to get a sedative effect. I think it kinda worked. I also took a smaller dose of Ambien (5mg). I'm feeling more human this morning. That's all I know. I had totally vivid and gross dreams and woke up several times though. (like in one of them, my friends were opening cans of worms and pouring them on a plate--EEEWWW!) When I woke up, I had trouble getting out of bed, which for me is normal. (hitting the snooze for 30 min. instead of being wide awake at 4 or 5:00 in the morning with teeth clenched).
I'm still nagged by the fact that the Lamictal doesn't "stick". I am at 250mg now, and I don't want to go any further. I guess I should just be happy that I'm somewhat more stable now and go to the contingency when needed. I just worry, worry, worry, as this is the first year I've been on mood stabilizers vs. antidepressants. I fear another episode like nothing else.
How are you doing Katia? Have you started the Depakote yet? May I ask where you live (b/c you're getting your meds in the mail)? Just curious.
Best to everyone,
Katy
Posted by katia on August 8, 2003, at 15:17:33
In reply to Re: Sleep problems--thanks for input Ron/Katia, posted by fluffy on August 8, 2003, at 10:28:50
> My pdoc had me up my Lamictal dose (again) last night in an attempt to get a sedative effect. I think it kinda worked. I also took a smaller dose of Ambien (5mg). I'm feeling more human this morning. That's all I know. I had totally vivid and gross dreams and woke up several times though. (like in one of them, my friends were opening cans of worms and pouring them on a plate--EEEWWW!) When I woke up, I had trouble getting out of bed, which for me is normal. (hitting the snooze for 30 min. instead of being wide awake at 4 or 5:00 in the morning with teeth clenched).
>
> I'm still nagged by the fact that the Lamictal doesn't "stick". I am at 250mg now, and I don't want to go any further. I guess I should just be happy that I'm somewhat more stable now and go to the contingency when needed. I just worry, worry, worry, as this is the first year I've been on mood stabilizers vs. antidepressants. I fear another episode like nothing else.
>
> How are you doing Katia? Have you started the Depakote yet? May I ask where you live (b/c you're getting your meds in the mail)? Just curious.
>
> Best to everyone,
> Katy
Hi Katy,
I live in a metropolitan area of SF Bay. So it's not that I live in a rural part, it's just that it's cheaper coming from Canada, as my pdoc is Canadian. But just recently I found out that I can be covered under the state system as I'm so poor! So I'm still waiting to start the med b/c I'm waiting for my rx to change to extended release. (b/c Canada has not yet been approved for or gotten the XR formula) anyway complicated story - bottom line I feel very fat right now as I've gained ten lbs. in the past six months and I was really resistent to starting the depakote. I want to LOSE weight now, not gain more - not even one lb. more! But now that I have (almost free) access to the XR formula in the U.S., I'll begin that. Apparently there are less of side effects , like weight gain on the XR.
I'm also feeling a definite rise in my mood - as I felt a week ago. it alternates between feeling "normal" to great to irritable and racy. But I have felt a cloud lift and although it's still partly cloudy it's better than a foggy and thunderous stormy day! So, I've kinda just wanted to give it a go w/o meds for a bit to see what happens. I know everyone does this and eventually ends back on meds, but after a year of trial and error to no success on ADs, I'm a bit disheartened, esp. with this lift in my mood happens when I'm off of everything! I feel back to my old self prior to the major depression that was the impetus for me to get help over a year ago. Not that my "old" self is totally healthy and functioning - not at all, it's just I know how to handle myself with no meds in my mixed bizarre-o state as I've been for most of my life (unless I'm in the throes of a suicidal depression). When meds that don't work enter the picture, things get even crazier.
I'm still sleeping forever tho'. And I don't see how depakote's going to give me energy. I have trouble settling down and falling asleep b/c my energy comes on late afternooon/night. then I finally fall asleep around 2/3 and sleep til noon! It's bizarre. My "symptoms" make no sense.
We'll see. maybe I'll just start the depakote this w-end!
Glad to hear you slept well finally! Just had a cup of coffee and feeling inspired and "high". is that the barometer reading? :-) Where do you live?
katia
Posted by fluffy on August 8, 2003, at 16:33:23
In reply to To med or not to med? » fluffy, posted by katia on August 8, 2003, at 15:17:33
Hey Katia--
I live in Houston, Texas.
As to the question--"To med or not to med?"--well I suppose that you're the only one who can make that choice. You've armed yourself with information about different meds and their side effects. It doesn't seem that you are questioning your diagnosis anymore. You know what's going on. With that said, I would suggest that you monitor yourself well--keep a mood chart (even when you aren't taking anything). It's a way of seeing as objectively as you can if you are still cycling or not. Write down your symptoms, thoughts and questions. Take it to your appointment and be assertive with your doctor about what you want out of a med/treatment. Trust your instincts. Do you trust your pdoc? That's really important.
My other mother-bird bit of advice would be to not let yourself go too far. If you start feeling like a hefty episode is around the corner, you'll save yourself a lot of grief by starting SOME kind of med (in the mood stabilizer family). Even if it doesn't work the way you want, at least you will feel pro-active in getting help and understanding what may or may not work for you. Also--it's a bit alarmist--but apparently BP can get worse and more treatment resistant the longer it goes untreated.
I remember going off of AD's and feeling a lot better. It WAS like a cloud lifted. Anything was better than how I felt on those damned things--cycling or not. But eventually, my mood went way down again, and I needed help. Also--I didn't want to put my new boyfriend through that shit. He was incredibly supportive, and comments on my progress since that time.
Please take lots of care. Sorry if I lectured you too much. Just trying to speak from my experiences.
Best,
Katy
Posted by katia on August 8, 2003, at 17:11:52
In reply to Re: To med or not to med?, posted by fluffy on August 8, 2003, at 16:33:23
> Hey Katia--
>
> I live in Houston, Texas.
>
> As to the question--"To med or not to med?"--well I suppose that you're the only one who can make that choice. You've armed yourself with information about different meds and their side effects. It doesn't seem that you are questioning your diagnosis anymore. You know what's going on. With that said, I would suggest that you monitor yourself well--keep a mood chart (even when you aren't taking anything). It's a way of seeing as objectively as you can if you are still cycling or not. Write down your symptoms, thoughts and questions. Take it to your appointment and be assertive with your doctor about what you want out of a med/treatment. Trust your instincts. Do you trust your pdoc? That's really important.
>
> My other mother-bird bit of advice would be to not let yourself go too far. If you start feeling like a hefty episode is around the corner, you'll save yourself a lot of grief by starting SOME kind of med (in the mood stabilizer family). Even if it doesn't work the way you want, at least you will feel pro-active in getting help and understanding what may or may not work for you. Also--it's a bit alarmist--but apparently BP can get worse and more treatment resistant the longer it goes untreated.
>
> I remember going off of AD's and feeling a lot better. It WAS like a cloud lifted. Anything was better than how I felt on those damned things--cycling or not. But eventually, my mood went way down again, and I needed help. Also--I didn't want to put my new boyfriend through that shit. He was incredibly supportive, and comments on my progress since that time.
>
> Please take lots of care. Sorry if I lectured you too much. Just trying to speak from my experiences.
>
> Best,
> Katy
Hi Katy,
yea, that's what I'm worried about. BP getting more treatment resistant as time goes on. Since understanding more about BP and realize I'm falling into the spectrum, in retrospect I've been cycling since I was a teenager - I'm 33 now. I wonder if it's already too late? Also, in retrospect, I realize I had my first manic episode when I was 17 turning 18 - right before and after graduation from high school - spring and summer. During that late fall and winter, I fell into an awful depression. it's only in retrospect that I can see it. At the time, I thought it was something I did wrong, to have fallen out of such a good mood. I kept trying to get that back, not understanding what was wrong with me. it's one thing to be in hell and not know or understand why you're there and another altogether to have some sort of dx and understand what's going on with you. You know what I mean? And since that one eposide, I've not had such a good one since - just chronic depression and mixed and some hypomania. I lived in the dark for so long, just by opening up to the knowledge that there is a mood disorder going on, opens up so much in me - and it's healing in itself.
Everything you say sounds true. I guess my one concern is - if ADs help depression and they didn't help me - mood stabilizers help with the highs? So maybe I'm holding the unconscious assumption that if I take mood stablizers, I'll just be taking away the high? Even tho' my pdoc told me it will even out my moods, I'm somehow not convinced. and I"m exhausted with med trials and feel half way decent at the moment that I'm reluctant to give any a go. I also just found out that I WON'T be getting the XR version of depakote.
I will start a mood chart - my therapist also recommended it.
Have you found mood stabilizers take away the depression too? My main prob. is depression and not enough energy.
warmly,
Katia
Posted by fluffy on August 8, 2003, at 17:36:13
In reply to Re: To med or not to med? » fluffy, posted by katia on August 8, 2003, at 17:11:52
Hey Katia--
You are probably not treatment resistant at this point. Maybe if you were like 50 years old or something. Besides--how will you know if a mood stabilizer will work or not if you don't try it? SSRI's and other AD's DON'T work on BP folks w/o the presence of a mood stabilizer.
For me, Lamictal has chased the blues away--it has a reputation for being an anti-depressant mood stabilizer. However, the risks of taking Lamictal ONLY involve still having a hypo-manic episode. Depending on the severity of your manic or mixed episodes, it may be recommendable to add another stabilizer on top (if you do the Lamictal thang). A lot of people who have only a problem with depression who haven't responded to AD's have responded to Lamictal. Also Lithium. I forget--are you the one who has a reaction to it? According to research, Li and Lamictal make great partners for lots of BP peeps.
You could try Lamictal first, and if it doesn't control the more agitated states, then you could add Li, Trileptal, Neurontin, Topomax, or Depakote (other anti-epileptics that control mania), or give a minor anti-psychotic a trial (like Zyprexa or Abilify). One of my friends who is BP responds well to Zyprexa and Wellbutrin. The important thing is to treat your SYMPTOMS. .
Another approach could be to try the depakote first, and if it only treats your "highs" or mixed states (as you fear) and not your lows, you could add an AD like Wellbutrin or Effexor (a non-seratonin related AD). There are lots of approaches, so it can seem daunting. But just try one thing at a time--add or subtract as you go.
Anyway--I know that I don't really know you, but I care anyway. Keep in touch, and let me know any thoughts.
Katy
Posted by fluffy on August 8, 2003, at 17:58:11
In reply to Re: It's not to late to medicate!, posted by fluffy on August 8, 2003, at 17:36:13
I re-read your post, and I thought I might just comment on the other issue you brought up. About that 20/20 hindsight--I think I can relate to that feeling of seeing the cycling even at a young age. I can look back now after having a formal diagnosis of BPII and see that my first episode of major depression was when I was 19. I wore the same sweatshirt for 3 months, didn't eat, cried around everyone--I didn't even understand that I was depressed. As for hypomanic--well, I'm not sure. I've always been outgoing and energetic. So it was hard for me to tell what was my hypomanic "up" mode and my "normal" mode. But after having treatment, I can definitely see how last summer I was HYPOMANIC! I had many, many plates spinning at one time, and it was impossible to keep up with my own pace. Eventually, I crashed and burned into the most agitated and anxious depression (i guess a mixed state) that I'd ever had. That's when I begged for treatment. It's also when I was precribed AD's and relapsed into an AWFUL mixed state. I also wondered how I could feel so bad after having felt so energetic and happy. It's the hallmark so to speak of bipolar disorder. It's what makes it so hard for us to understand. You can bet that I was pondering not getting treatment after having been burned by the meds I'd tried before. It's the hardest thing I've ever dealt with--EVER. I felt really betrayed by the whole psychiatry/medication thing, and I honestly thought I was beyond hope.
Don't feel alone in this, Katia. This board is great for giving and getting support.
Take lots of care,
Katy
Posted by katia on August 8, 2003, at 18:08:22
In reply to Re: one more thing, posted by fluffy on August 8, 2003, at 17:58:11
Thanks for all of your posts!
I probably will try the depakote, I'm just working up to it.
Effexor was one that I did try and it made me hypomanic/mixed - I actually lost weight on it. I was also extremely sensitive (what a surprise!) to the w/drawal effects. I had it everyday, even tho' I was taking my meds same time everyday. I won't go thru' another effexor withdrawal - no thanks! I also went thru' a hellish w/drawal on Zoloft.
From what I am hearing - depakote will not be enough to rid me of the depressive side. B/c of the Lamictal rash, my pdoc wants to start me on depakote. why not? It's worth a try and if it doesn't work, then I'll try something else.
and BTW, we're getting to know each other!
thanks again,
Katia
Posted by SUMMER2002 on August 8, 2003, at 22:25:42
In reply to Re: one more thing » fluffy, posted by katia on August 8, 2003, at 18:08:22
> Thanks for all of your posts!
> I probably will try the depakote, I'm just working up to it.
> Effexor was one that I did try and it made me hypomanic/mixed - I actually lost weight on it. I was also extremely sensitive (what a surprise!) to the w/drawal effects. I had it everyday, even tho' I was taking my meds same time everyday. I won't go thru' another effexor withdrawal - no thanks! I also went thru' a hellish w/drawal on Zoloft.
> From what I am hearing - depakote will not be enough to rid me of the depressive side. B/c of the Lamictal rash, my pdoc wants to start me on depakote. why not? It's worth a try and if it doesn't work, then I'll try something else.
> and BTW, we're getting to know each other!
> thanks again,
> Katia
Don't write off Lamictal - it has helped a great deal with no other side effects
Posted by flammula on August 13, 2003, at 20:37:29
In reply to Re: Gosford Park, Li and creativity, posted by fluffy on July 17, 2003, at 12:00:57
> Hey Barbara Cat--
>
> It's cool to hear what you do creatively. I passionately wanted to be a dancer, but opted to be a visual artist due to extremely short limbs and a bubbly butt.
>
> My work is dependent on a kind of choreography, though. I work more like an architect or a scientist than a mad, paint splattering expressionist type. I plan, concentrate and contemplate quitely rather than produce in a mad and tearful rage. Personally, the meds seem to have helped me complete my work (as with you). I really, really hate that image of visual artists...one that Kay Jamison catagorizes as the artist's temperment. (The Rothko, Pollock, Van Gogh types) I wonder if they would have opted to stay on meds rather than having a bad temper and losing friends. I kind of hated that book "Touched with Fire". Not all bipolar artists rely on their hypomanias to produce worthwhile work. She qualifies her generalizations a lot, but I couldn't help but feel that her points were exaggerated and romantic.
>
> I was curious about Lithium specifically because of its reputation for putting the fire out so to speak. Kay Jamison seems to dwell on it quite a bit. Her book actually makes me feel a little frightened about TAKING Lithium! Something I'm sure she didn't intend to purport.
>
> Rock on with your creative endeavors!
>
> Katy
I like what katy says about Touched With Fire--I thought it was exciting to read and had some useful insights but was generally WAY too glamourizing of both manic-depression and the artistic process.
--flammula, bipolar poet
Posted by Barbara Cat on August 15, 2003, at 13:53:31
In reply to Re: Sleep problems--anxiety-HELP! » fluffy, posted by Ron Hill on August 7, 2003, at 13:12:50
Hi Everyone,
I'm back from my vacation. Went to Katia's neck of the woods, SF Bay Area where we used to live. While it was great fun to see old friends and hubby's family it SURE is wonderful to be back home. Everytime I go away, even for a short time, I suffer incredible anxieties that I'm going to return to a smoking heap of cinders for a house and all my cats flattened in the road (we have a fine cat/house sitter, the road in question is a quiet country one, so gimme a break). All kitties were purring and happy, house was fine. But Oh God, IT COULD HAPPEN!! When am I going to calm down, when am I going to learn to trust? My husband just 'puts light around them' and goes his merry way, trusting that all is well. This is unimaginable to me. Sometimes I think it's my anxiety and hypervigilance that keeps the universe from blowing up, but of course I'm wrong (aren't I?).About sleeplessness, what is making more sense than anything else I've come across is that we of the mood impaired seem to be suffering from a reversed day/night adrenal hormonal response. Our adrenal cortisol which should be high in the morning (it eventually goes on to make norepineprine, dopamine) is high at night. Our adrenal DHEA which brings down cortisol is low at night. DHEA repairs which should be happening at night, and cortisol breaks down which should happen during the day. Having these cycles out of sync causes major problems. A theory is that adrenal stress is the major contributor. Our poor hyperalert selves perceive threat everywhere and the adrenals pump out adrenaline to run from those imaginary tigers. Eventually the adrenals can't handle the load and other systems have to take over, like our thyroid and reproductive hormonal systems. Continual cortisol produced by the adrenals eventually converts to a form that in high enough amounts, become toxic to the limbic brain area where our stress and hormonal regulating structures are found. Eventually these brain structures suffer damage and can't efficiently communicate with each other, are not able to regulate the very delicate hormonal balance entrusted to them (neurotransmitters and peptides are part of this hormonal biosphere). When this system gets disregulated, insomnia is only one of the signs. Even more unfortunate is that it becomes a self perpetuating loop, creating that very distinctive tired/wired feeling you can probably relate to. A major indicator is getting that second wind after 10pm, but feeling like a mack truck collision in the am.
Meds can knock us out, can interrupt the stress loop, but won't solve the problem. Certain natural substances help. About 6-10 grams Vitamin C divided daily is crucial. But even natural meds won't do the trick - it's more like taking away than adding more stuff. More important is to avoid any kind of concentrated sugar after 6pm, especially alcohol (waaaaah!!), sweets, anything stimulating like evening news, sitting in front of the computer monitor after 10pm, coffee after 4pm, reading murder mysteries before bed. Basically lights out by 11pm (light stimulates cortisol and reduces melatonin). Whatever exercise you can tolerate in the am, just get your butt moving. Terribly boring stuff, but so is insomnia. We know that stress is a killer, pure and simple, and our highly attuned nervous systems are warning us that we have to do whatever is in our power to reduce it. Interestingly, meditation raises DHEA naturally and lowers cortisol and so does exercise (in the morning). You don't have to be in your 50's to finally realize, jeeze, wish I'd made these lifestyle changes earlier! But take my wizened word as Gospel truth - you'll wish you had.
I am doing so much better, thank you so much one and all for helping me through my recent dark times. Isn't it true that every time we think that this is the BIG ONE we'll NEVER recover from, and we always do. Maybe somewhat scarred, but at least we weren't sucked into that black hole like we're sure we'll be every danged time. I even weaned off of Ambien (my refill didn't arrive in time before vacation so I didn't have much choice). After a few rough nights, but with the help of valium, I'm now sleeping naturally again. I even wonder if my improved mood has something to do with getting off Ambien. It was hard to follow the above suggestions of low stress/lights out by 11 while on a whirlwind vacation, but I mostly adhered to it and I do think it made a huge difference. Dear friends, hang in there (Katia, please, please, please try Depakote. If lithium makes you nervous, then there are others you can try. You can't imagine the relief you'll get when you're on a med that helps you find the eye of the storm. You can always go off it!). If it weren't for my Babble-Buds, and what I've learned on this board, I would be dead by now, and of that I have no doubts. So if I can gain a temporary respite, believe me, SO CAN YOU!! And from this vantage point, a temporary respite is a great gift and is enough to keep me going and growing. - Barbara
Posted by Barbara Cat on August 15, 2003, at 14:12:44
In reply to Re: Med free and misdirect » Barbara Cat, posted by katia on August 6, 2003, at 2:23:45
Katia,
Personal question, but did you have an abusive or stressful childhood? I certainly did and think that things were miswired back then. I remember a poll going around on this board a while back about that question, and it surprised me how many did not have difficult early years. Your hell sounds awful and sorry you had to go through that. Did anything trigger it that you're aware of? Could it trigger it again?As far as the spiritual study and practice, it doesn't cure us and isn't too available when we're in the worst of it, but I can't imagine where I'd be without it. When I'm a little better and realize others have gone through it and came through it stronger, it comforts me and helps me be better when I'm better (but not when I'm not). I keep hoping one day I'll believe it when I really need it.
>
> Prior to starting the medication last summer, every second was eternal hell for me. I had completely lost my mind - howling on the floor, making noises I've never heard before, crawling from the bed to bathroom and it taking one hour, marking myself with my fingernails, crying crying crying. And in the midst of these three intense months, I listened to so many tapes, i.e. Ram Dass's lectures/talks, The Power of Now - Tolle, and Pema Chondron's "When Things Fall Apart".
Posted by katia on August 15, 2003, at 16:17:22
In reply to Katia » katia, posted by Barbara Cat on August 15, 2003, at 14:12:44
Welcome back Barbara! I missed you! How was your holiday?
> Katia,
> Personal question, but did you have an abusive or stressful childhood?I think my childhood was stressful because I was so sensitive. The 70s were good, but when I hit 11 in 1981 that's when trouble started for me. What maybe was extremely traumatic for me was nothing for the next guy. and then it cycles and compounds each other - trauma more sensitivity, more depression, more trauma etc.
(what feels like trauma).
>>Did anything trigger it that you're aware of? Could it trigger it again?
Last summer, yes and no. I was already in a deep depression as i had moved to Scotland to be with my then boyfriend. I was falling deeper and deeper the longer I stayed there. In the end, I found out i was pregnant and he sent me back in the midst of a deep terrible depression with a one way ticket and wouldn't talk to me anymore. I had to stay at a friend's house - who is no longer a friend. I nearly lost all my marbles then. So yes the pregnancy and wonderful boyfriend I had triggered me to go as low as I did, but I was already in a clinical depression - unrecognized as such and untreated.
> As far as the spiritual study and practice, it doesn't cure us and isn't too available when we're in the worst of it, but I can't imagine where I'd be without it. When I'm a little better and realize others have gone through it and came through it stronger, it comforts me and helps me be better when I'm better (but not when I'm not). I keep hoping one day I'll believe it when I really need it.ditto.
I'm having a hard time at the moment. I have begun taking depakote and it's made me a bit wired. I feel out of control. I went out last night and stayed up past the sun rise and did things I shouldn't have done and now I'm (as you said) crawling into my hole cringing at my life and embarrassed at my behavior - wondering when all this craziness will end.
yes, I know I should contact my pdoc, but what am i to say? I'm too embarrassed. and he'd probably just say, wait a few more days and see how you feel. my body feels toxic. I feel awful.
I'm sick of this!
i'll just crawl back into my hole now.
Katia
> > Prior to starting the medication last summer, every second was eternal hell for me. I had completely lost my mind - howling on the floor, making noises I've never heard before, crawling from the bed to bathroom and it taking one hour, marking myself with my fingernails, crying crying crying. And in the midst of these three intense months, I listened to so many tapes, i.e. Ram Dass's lectures/talks, The Power of Now - Tolle, and Pema Chondron's "When Things Fall Apart".
>
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