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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Noa on November 19, 1999, at 9:05:26
I have stayed home from work for the past two days, just too hard to face work, where I am overwhelmed. Sometimes I think maybe a non-emergency hospitalization is in order, I don't know. I guess it is time to beef up the cocktail with lithium, lamictal or neurontin. How does one figure out which would be best? I have started having edema (swelling) of the ankles, which is listed as an "infrequent" effect of serzone and effexor Xr, and I still haven't gone to the doctor about it. But I am worried about starting on lithium, which is know to cause water retention, if I already have edema. I don't know why the thought of hospitalization comes to mind, I am not suicidal. I have this idea of washing out on all my meds and starting over fresh. But the truth is, I am not sure that is a good idea. What makes me think anything else would work better? Maybe the best route is to just add to my cocktail. John L., I know you suggested a TCA, but I did try amytriptalne many years ago and reacted badly, so my pdoc feels it would not be a good direction for me to go in. Any of the tcas have anticholinergic effects, which make me simultaneously oversedated and overwired. It happens to a lesser extent with benadryl, etc. Kind of feel like all you can do is sleep only you can't sleep cuz you feel like bouncing off the walls but have no muscle coordination or alertness to do so. I've explained why the MAOIs won't work for me (has to do with my apnea).
As for calling in sick today, I feel guilty and ashamed. The truth is, once I let myself stay home, I felt such relief I didn't feel so depressed anymore. BUt it doesn't last, cuz I start feeling ashamed and thinking about not wanting to go back on Monday, not wanting much of anything. I know I am making things worse for myself by withdrawing, and if I take a leave of absence to go into the hospital, my debt problems will worsen. And that just makes life harder.
Posted by JohnL on November 19, 1999, at 15:36:43
In reply to Still struggling..., posted by Noa on November 19, 1999, at 9:05:26
Hi Noa. So sorry for the hard times. I know that feeling when it takes every ounce I have to get out the door. That's one of the hardest things I've ever done. I can relate and I feel for you.
You are taking Serzone, right? You know, everything you are describing smells of Serzone. I felt that way exactly on Serzone. And I've heard of others with the same experience. The more I think about it the more I'm tempted to point the finger at Serzone. Don't get me wrong. It's a great drug. But when it doesn't work with someone, it rEEAAlly doesn't work. Can make things a LOT worse.
If I remember correctly and you are taking Serzone, well, maybe you might consider withdrawing it. Not sure what else to try instead, but please reply and refresh my memory of what you've already tried. Of all the mood stabilizers, Lithium has the solid track record, especially when used as an adjunt with an AD. I understand your hesitance with it though, and personally I think Lamictal is a great choice. I say that because I am side-effect-sensitive, and Lamictal has always been easy to handle for me. For me it's not a cure-all, but it does have antidepressant and stabilizing qualities to it. Again though, I am real suspect of your Serzone. Take that out of the mix and you might get a whole lot better. There must be a better choice to replace it. Maybe not a TCA, but something. What haven't you tried?
Posted by Noa on November 19, 1999, at 16:27:27
In reply to Re: Still struggling..., posted by JohnL on November 19, 1999, at 15:36:43
thanks, John.
The thing is, I was really feeling better for about a month and a half. But maybe you are right.
What have I tried? Prozac gave me tinitus, headaches,etc. Paxil gave me myoclonus, a lot worse than the effexor does. Wellbutrin, I was only on for a very short time and had diarrhea, but I am not entirely convinced of the cause-effect. I take ritalin and t3 and t4. I was taking trazodone to sleep, too small a dose to be effective as an antidepressant. Its sleep inducing effects started to wear down, and I needed more AD effect, so that is when the serzone came in. I am on as much effexor as I think I can tolerate. Any more would make the fidgitiness unbearable. Sometimes it already is.
Posted by Dee on November 21, 1999, at 22:02:02
In reply to Still struggling..., posted by Noa on November 19, 1999, at 9:05:26
Hey, Noa...
I stayed home two days about a week ago as well. When I met with my therapist, we were talking about what is the difference of feeling depressed and being diagnozed as depressed. I said one of the things the diagnosis ha done for me is that I do not need to feel guilty for calling in sick, because I *am* calling in sick.
We people have no need to add to our misery with self-blame. If you needed to stay home a couple of days then that's OK. I came out of my bottom just nicely this time, I am back to work, and only every now and then feel the old ache in the bottom of my stomach... Thigs will get better.
Lots of love, my special friend
Dee
Posted by Phil on November 22, 1999, at 6:47:21
In reply to Still struggling..., posted by Noa on November 19, 1999, at 9:05:26
Noa, I agree with Dee. Guilt is the biggest waste of time. I'm the kind of person that feels guilty before I've done anything that might cause me to feel that way.
Have you considered Klonopin after ditching the Serzone?Phil
Posted by Noa on November 22, 1999, at 13:04:21
In reply to Re: Still struggling..., posted by Phil on November 22, 1999, at 6:47:21
> Have you considered Klonopin after ditching the Serzone?
>
What is the advantage of Klonopin?
Posted by Adam on November 22, 1999, at 16:40:15
In reply to Still struggling..., posted by Noa on November 19, 1999, at 9:05:26
Noa
> As for calling in sick today, I feel guilty and ashamed.
As depressed as you are, feelings of guilt and shame may be difficult to resist. But try
to resist them. Taking care of yourself means showing yourself an abundance of compassion and
forgiveness. You're allowed sick time. I know loads of people who take "mental health days"
because they need to catch up on their yardwork or other trivial concerns. I took a month
of mental health days in a row earlier this year. Two months later I got promoted. It's
not the end of the world, for you or your employer.>...where I am overwhelmed. Sometimes I think maybe a non-emergency hospitalization is in order, I don't know.
It may be. Speak to your doctor. I found it helpful in some ways. If a med change/adjustment is in
order, and you are feeling overwhelmed, it might be a good place to rest and regroup under close
observation while you wait for the meds to kick in.>If I take a leave of absence to go into the hospital, my debt problems will worsen.
If you are experiencing hardship, creditors can be kept at bay. You may want to contact a local
consumer advocacy group or health and human services dept. (city, state) who can direct you to some
local credit counseling resources that may be available free of charge. A local chapter of the
National Depressives and Manic Depressives Association (www.ndmda.org)might be able to steer you
in the right direction, too. Your doctor might even know of some good strategies, or be able to
direct you to people who can help you. Your bankruptcy is of benefit to no one, so rest assured
creditors will not drive you in that direction if temporary postponement of payment will allow you
to stay healthy and productive.>I've explained why the MAOIs won't work for me (has to do with my apnea).
Are nasal decongestants the only solution for sleep apnea available to you? From what I understand,
there are some relatively minor laser surgical procedures that sometimes can be of great benefit for
those who suffer from sleep apnea. Perhaps speaking to an ear, nose, and throat specialist could
give you information on some alternatives. MAOIs might be a good thing to try, if that can be made
possible.As for Serzone, someone above mentioned that when Serzon is bad, it can be really bad. All I can say
is I experienced a worsening of both depression and anxiety while on Serzone that was more severe
than I had ever experienced at any other point in my life by a very wide margin. I can't say if this
was a result of taking the drug, or not. All I can say is that my coincidental decline was precipitous
and absolutely terrifying. If you feel your symptoms have worsened, talk to your doctor, please.
Be careful. And be well.
Posted by Phil on November 22, 1999, at 18:45:01
In reply to Re: Still struggling..., posted by Noa on November 22, 1999, at 13:04:21
Noa, Not being a doc, I have no idea if Klonopin is right for you. But, if you are feeling overwhelmed, as I feel sometimes, Klonopin will help tremendously with anxiety.
It has helped me alot.Phil
Posted by Noa on November 22, 1999, at 20:03:53
In reply to Re: Still struggling..., posted by Phil on November 22, 1999, at 18:45:01
I just saw my pdoc tonight. He gave a list of possible changes, including an MAOI, increasing the serzone, increasing the effexor, increasing or changing the stimulant, starting on lithium or lamictal. I think to start I am going to increse the serzone a bit. I don't think this will be sufficient but it might help a little, and it might help more with the sleep problems. The MAOI is still out, because I am dependent on my nasal cpap to breathe and sleep, and if I have a cold, I have to use decongestants. Adam, lasar surgery has been explored, and I am not a good candidate. It might help a bit, but it would not likely eliminate my apnea. I am already supposed to have an increase in my ritalin, from 30 to 40 mg per day because I will be starting on the susained release. I also think I will go with the lithium or lamictal. I will be seeing my internist tomorrow. I am concerned about the swelling in my ankles, and whether this is a problem for starting lithium. My pdoc recommends the lithium over the lamictal as a first start with mood stabilizers. He thinks I am cycling, and have a cyclical depression in the bipolar family of depressions. He also wants me to check my thyroid and estrogen levels first before making any changes. I'll do that tomorrow.
Posted by Noa on November 22, 1999, at 20:09:03
In reply to Re: Still struggling..., posted by Noa on November 22, 1999, at 20:03:53
BTW, I went to work today, altho I got in about 3 hours late and went home 30 minutes early, and was pretty useless in between. My friend got me up and out.
I also told two coworkers and then, later, my boss. Her first question was , "What can we do to help?" She suggested it would be ok for me to cut back my hours a bit, and come in late every morning. I brought up the idea of a leave of absence and she said if I needed that it would be ok, too, although she was concerned about how I would spend the time, whether it would make things worse if I were inactive. She was genuinely very caring and kind about it. I might take her up on cutting back on my hours, even though it would mean less money. But maybe it would help to not have to wrench myself out of bed so early. I might investigate a light box, too, which my pdoc said "couldn't hurt".
Posted by Adam on November 23, 1999, at 16:48:28
In reply to Re: Still struggling..., posted by Noa on November 22, 1999, at 20:09:03
I'm really glad to hear your employer is being so supportive, Noa. It helps so much.
> BTW, I went to work today, altho I got in about 3 hours late and went home 30 minutes early, and was pretty useless in between. My friend got me up and out.
> I also told two coworkers and then, later, my boss. Her first question was , "What can we do to help?" She suggested it would be ok for me to cut back my hours a bit, and come in late every morning. I brought up the idea of a leave of absence and she said if I needed that it would be ok, too, although she was concerned about how I would spend the time, whether it would make things worse if I were inactive. She was genuinely very caring and kind about it. I might take her up on cutting back on my hours, even though it would mean less money. But maybe it would help to not have to wrench myself out of bed so early. I might investigate a light box, too, which my pdoc said "couldn't hurt".
This is the end of the thread.
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