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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Janelle on March 21, 2002, at 0:57:13
I've been in and out of depression/anxiety for years now, but this past year has been particularly bad. I've had either a day or a few in a row where I basically don't get out of bed except to eat (sometimes I don't even do that) or use the bathroom, and I've also done the *stay in bed* thing for several WEEKS at a time. I get to the point where I basically cannot function beyond survival mode. Needless to say, when this happens I get even more anxious.
From the posts I read on here, people are struggling yet y'all sound so much more together than I am when I get really depressed.
Is there ANYONE out there who goes through periods where they basically can't get out of bed? Any feedback, words of wisdom or support greatly appreciated.
Posted by JohnX2 on March 21, 2002, at 6:01:24
In reply to Feeling alone, miserable - depression patterns, posted by Janelle on March 21, 2002, at 0:57:13
Hi Janelle,I think you are not alone. I too have suffered severe depression and been stuck in bed. I try to at least get out once during the day as hard as it may be, however. Please remember, a lot of people who are seriously depressed are not accessing their computers and actively posting to newsgroups. So what you read here is not representative of the depressed population. Please hang in there. I know it will get better.
Best Regards
John
> I've been in and out of depression/anxiety for years now, but this past year has been particularly bad. I've had either a day or a few in a row where I basically don't get out of bed except to eat (sometimes I don't even do that) or use the bathroom, and I've also done the *stay in bed* thing for several WEEKS at a time. I get to the point where I basically cannot function beyond survival mode. Needless to say, when this happens I get even more anxious.
>
> From the posts I read on here, people are struggling yet y'all sound so much more together than I am when I get really depressed.
>
> Is there ANYONE out there who goes through periods where they basically can't get out of bed? Any feedback, words of wisdom or support greatly appreciated.
Posted by fachad on March 21, 2002, at 10:44:31
In reply to Feeling alone, miserable - depression patterns, posted by Janelle on March 21, 2002, at 0:57:13
Janelle,
I've got quite a bit to say (no surprise, eh) but I'm going to break it up so it's not one long, rambling post. It will be three long, focused posts instead!
The first is on perspective. First and foremost, Janelle, keep in mind what John said, because it's very significant. There are lots and lots of people who are as depressed or more depressed than you, but they are not using their PCs, they are not sharing their plight on the Internet.
They are TRULY isolated. So even though you find yourself less functional than some people here on PSB, you are more functional than most people who are experiencing a depression as severe as yours. And continuing to function, in whatever capacity you are able, is key to recovery.
I'm going provide you with a rather long quote that has helped me define who I am and what this struggle means to me. When I grasped this concept, it caused a fundamental paradigm shift in me that completely changed the way I looked at depression and emotional suffering forever. It is from "Honoring the Self" by Nathaniel Branden. Here goes:
"The concept of the Will to be Efficacious is an extension of the will to understand. It places emphasis on the aspect of perseverance in the face of difficulties: continuing to seek understanding when understanding does not come easily, pursuing the mastery of a skill or the solution to a problem in the face of defeats, maintaining a commitment to goals while encountering many obstacles along the way."
"The Will to be Efficacious is the refusal to identify our ego or self with momentary feelings of helplessness and defeat. All of us know times of bewilderment, despair, and a painful sense of impotence or inadequacy. The question is Do we allow such moments to define us..."
"The Will to be Efficacious - here was a concept... that helped me understand the difference between those who felt fundamentally defeated by life and those who did not."
"It is impressive to see a person who has been battered by life in many ways, who is torn by a variety of unsolved problems, who may be alienated from many aspects of the self - and yet who is still fighting, still struggling, still striving to find the path to a fulfilling existence, moved by the wisdom of knowing, "I am more than my problems"
"Having the Will to be Efficacious does not mean that we deny or disown feelings of inefficacy when they arise; it means that we do not accept them as permanent. We can feel temporarily helpless without defining our essence as helplessness. We can feel temporarily defeated without defining our essence as failure. We can allow ourselves to feel temporarily hopeless, overwhelmed, while preserving the knowledge that after a rest, we will pick up the pieces as best we can and start moving forward again. Our vision of our life extends beyond the feelings of the moment. Our concept of self can rise above today's adversity."
I hope that passage strikes a chord in you like it did in me, because it is truly profound and provides a perspective for understanding and accepting emotional suffering without giving up.
> I've been in and out of depression/anxiety for years now, but this past year has been particularly bad. I've had either a day or a few in a row where I basically don't get out of bed except to eat (sometimes I don't even do that) or use the bathroom, and I've also done the *stay in bed* thing for several WEEKS at a time. I get to the point where I basically cannot function beyond survival mode. Needless to say, when this happens I get even more anxious.
>
> From the posts I read on here, people are struggling yet y'all sound so much more together than I am when I get really depressed.
>
> Is there ANYONE out there who goes through periods where they basically can't get out of bed? Any feedback, words of wisdom or support greatly appreciated.
Posted by fachad on March 21, 2002, at 10:56:44
In reply to Feeling alone, miserable - depression patterns, posted by Janelle on March 21, 2002, at 0:57:13
Janelle,
I really do feel empathy for you, and although I have remained somewhat functional throughout all my depressive episodes, "but for the grace of God" I could see myself in the same situation.
The most fundamental component of your treatment and recovery is your resources. Since you are trained as a librarian, I am sure you know how to inventory and catalogue things.
So right now you need to inventory your resources. Resources fall into several categories. The most basic resource is a social support system.
By that I mean people who care about you and can assist you when you need help. Do you have parents, or children, or siblings, or family, or personal friends that you can lean on for help? Do you belong to a church or spiritual group? (I'm not advocating religion, just directing you to look for places where you may have social support systems).
Another fundamental category of resources is financial resources. Everything costs money, and you need a financially stable foundation to keep the world from crashing in on you when you are non-functional. I'm not saying you need to be rich, or have huge savings, just that you need to have some way to live, even if that consists of government assistance or help from family and friends.
Another key resource category is you health care resources. This includes both physical and behavioral health. Do you have insurance? What do they cover? What are the copays? Do you need referrals? It's worthwhile for you to research this so you can "work the system". Knowing how to work the system, whether that system is private insurance, employer provided insurance, or government programs, is critical to getting the most benefit out of this resource.
Finally, your pdoc is a critical resource. I am a huge proponent of staying with the same pdoc for a long time unless he is really bad. That way he knows your history, he knows how you look, he remembers you, and you will receive better treatment as an old favorite patient vs. some person who wanders in once or twice for meds.
Take some time to inventory what resources you have to support you and facilitate your recovery.
> I've been in and out of depression/anxiety for years now, but this past year has been particularly bad. I've had either a day or a few in a row where I basically don't get out of bed except to eat (sometimes I don't even do that) or use the bathroom, and I've also done the *stay in bed* thing for several WEEKS at a time. I get to the point where I basically cannot function beyond survival mode. Needless to say, when this happens I get even more anxious.
>
> From the posts I read on here, people are struggling yet y'all sound so much more together than I am when I get really depressed.
>
> Is there ANYONE out there who goes through periods where they basically can't get out of bed? Any feedback, words of wisdom or support greatly appreciated.
Posted by fachad on March 21, 2002, at 12:23:10
In reply to Feeling alone, miserable - depression patterns, posted by Janelle on March 21, 2002, at 0:57:13
Janelle,
I manipulated the way I posted my responses so they would show up in the order they did. I think that order is reflective of how basic they are and their importance to you.
The most basic thing is your perspective and the overall belief that you will overcome your problems.
The second most important thing is for you to have resources to draw on including social support, financial support, health care resources, and a pdoc that knows you.
Finally there are meds. The right meds at the right doses can really make a difference.
How often do you see your pdoc? When is your next appt? Does your pdoc do phone check-ins with you? All of this applies to meds, because it affects how often you can change doses or start new meds if the old ones aren’t working.
So here are my thoughts on your meds:
EFEXOR: Have you tried to push your dose all the way up to 225mg/day? What other ADs have you tried? Did you push them to the maximum dose before giving up?
LAMICTAL: I can't say I know much about BPII, so I can't really comment on the Lamictal. Maybe you could start a new thread on BPII and how the different meds work. JohnX2 seems to be very knowledgeable here.
ZYPREXA: As to your Zyprexa, I'm probably overcautious, but I wouldn't take an anti-psychotic unless I was psychotic. Maybe you could take Remeron instead of Zyprexa at night to quiet your mind and help you sleep. Also, I've heard that Remeron + Effexor is an especially potent antidepressant combination. Maybe that combo is just what you need.
KLONOPIN: I know that it is important not to abruptly stop taking klonapin. But it may be in your long-term best interest to taper off and discontinue it. The reason I think it might be a good idea is that taking a benzo long term, especially klonapin, can cause depression or make depression worse. It can also cause cognitive impairment and cloudy thinking, which you have complained of having.
So maybe Effexor or the Effexor/Remeron combo could address your anxiety and you wouldn’t need an anti-psychotic for sleep and a benzodiazapine for anxiety.
My strategy with meds is to focus in on specific target symptoms, the things that are bothering you the worst, and try to treat those. That is a different strategy from starting from a (somewhat arbitrary, IMHO) DSM diagnosis and then treating the diagnosis with the meds that are used for that diagnosis.
Also a key strategy with meds is to cause no harm. This seems basic but people forget it all the time. It is better, IMHO, to take a med that does not work very well, but does not cause terrible side effects, than it is to take a med that works great, but causes overall harm to you. Safety first, then tolerability, and then efficacy.
Keeping med regimens as simple as possible is also very beneficial. If you are lucky, one med can do it for you. Most likely there will be some combination. Whenever you go down the polypharmacy trail, there are always consequences you did not expect. Like klonapin treating anxiety but worsening depression, or maybe one drug interferes with the action of another, or the metabolism of another. However you look at it, when you are using a combination it is more difficult to manage.
So it is best to ask of each med, what benefit are you getting from it? What side effects is causing? How would you be worse off, in terms of your target symptoms, if you were not taking that med? Even if you had problems from not taking a particular med, is it still possible that you would be better off overall? Could a more benign med be used instead?
These are all things to go over with your pdoc at your next visit. Just tell your pdoc that you want to focus on target symptoms, because that is what YOU are experiencing. Also that you want to make sure that all of your meds make sense, and if some that are causing you problems could be eliminated or replaced with a less problematic med.
Well, Janelle, I hope all this helped and that it was not too much for you to take on one day. I hope you’re doing better soon.
> I've been in and out of depression/anxiety for years now, but this past year has been particularly bad. I've had either a day or a few in a row where I basically don't get out of bed except to eat (sometimes I don't even do that) or use the bathroom, and I've also done the *stay in bed* thing for several WEEKS at a time. I get to the point where I basically cannot function beyond survival mode. Needless to say, when this happens I get even more anxious.
>
> From the posts I read on here, people are struggling yet y'all sound so much more together than I am when I get really depressed.
>
> Is there ANYONE out there who goes through periods where they basically can't get out of bed? Any feedback, words of wisdom or support greatly appreciated.
Posted by Denise528 on March 21, 2002, at 14:24:46
In reply to Feeling alone, miserable - depression patterns, posted by Janelle on March 21, 2002, at 0:57:13
Hi Janelle,
Over the past few days I've seen your notes on here and have actually thought how together and well balanced you sound. I think you are a well balanced person who just happens to be suffering from this awful affliction. I really sympathise with you, I am managing to get out of bed but some days are torturous and I just want to crawl back in there. I can't really offer any advice as I am going through a bad spell myself right now so I'm not a good source of positive inspiration. All I can say is that you are not alone and that hopefully sometime in the near future it will all seem worthwhile.
Denise
Posted by Janelle on March 21, 2002, at 14:59:02
In reply to Perspective » Janelle, posted by fachad on March 21, 2002, at 10:44:31
Fachad,
I don't know what to say ... wow ... I can't believe the time and effort you put in here to give me some support. I read through all your posts once and plan to re-read them several more times at least (my ability to read is severely hampered; I have difficulty focusing on long passages and get overwhelmed easily and this whole thing is foreign to me as I've always been a top-notch reader). Actually, I've just decided, duh, I should PRINT them out!Fachad, I am so touched by your continuing kindness, thoughtfulness and concern. Knowing you are out there, understanding what I'm going through and feeling means a lot to me. I feel like this PB board is like a cyber support group, which is especially important to me since I can't get out much, and have yet to be able to make it to a *real life* support group (that is one of my goals eventually).
I'm just curious about one thing and ironically it has nothing to do with the content of your messages (the messages were so well done that I don't have any questions about them!) -- you mentioned that you "manipulated" your posts to come out in the order they did - does this mean you did not compose them in that order, but somehow managed to get them on the board that way? Just as an example of what I mean, did you compose the "Resources" post first (before the perspectives one), yet somehow get the
"Perspectives" one to appear first? If so, how on earth did you do that?!Thanks again for EVERYTHING.
-Janelle
Posted by Janelle on March 21, 2002, at 15:06:25
In reply to Re: Feeling alone, miserable - depression patterns, posted by Denise528 on March 21, 2002, at 14:24:46
Posted by fachad on March 21, 2002, at 18:42:18
In reply to FACHAD: wow, you are AWESOME! More: » fachad, posted by Janelle on March 21, 2002, at 14:59:02
I'm really glad you appreciated the stuff I wrote. I have seen your posts for the past few days and I just perceived that you really needed some support right now.
I enjoy writing and clarifying and sharing my thoughts and experiences. So I'm really pleased that it had a positive effect on you. (And if you print out my posts, does that mean I'm a PUBLISHED writer? woohoo!)
You asked,
"Just as an example of what I mean, did you compose the "Resources" post first (before the "Perspectives" one), yet somehow get the "Perspectives" one to appear first? If so, how on earth did you do that?!"
Well, this is probably boring and off topic, but since YOU asked, I'll tell you: yes, that’s EXACTLY what I did.
The "Resources" post was written first and just flowed out as I was typing, and I was going to end it with the quote from Branden. (I really like that concept of the “Will to be Efficacious”).
Then I thought to myself, "Jesus, dude, you are really putting the "babble" in psycho-babble. If this person is having trouble just getting out of bed, how in the HELL is she going to read through one of your "War and Peace" length posts?! Maybe, if nothing else, her insomnia will be cured."
Anyway I cut and pasted the "Perspective" section into a new reply in a new browser window (I’m a computer geek, remember) and that's when I made the statement about doing three long posts rather than one that rambled forever. I knew I wanted to say a few things about "Meds" too, so I wrote that up in another reply in another window. That's when I saw the rank ordering of importance.
Resources are more fundamental than Meds, because without resources, you will not even be able to get meds! And perspective is more fundamental than resources, because if you REALLY lose your perspective, and give up, all the meds and all the resources in the world will not be able to help you. You could be surrounded by people who love you, and up to your ears in the world's best pills, and still not "get it". So these three items formed a natural hierarchy, each being necessary to derive benefit from the next, and I wanted them to be seen in that order.
So at that point it was very easy. The PSB board displays posts in the order they are submitted, so I just finished off all three posts, each in a separate window, and then clicked the submit and confirm button for "Perspective", checked to see that it had posted, then submitted "Resources" checked the board to see it there below "Perspective" and then finally submitted "Meds".
Maybe a little OCD going on there, but I liked how it turned out and I’m glad it helped. There really is a lot there; I hope you really do re-read it and that it helps you not only to feel better, but also that it suggests to you an action plan.
> Fachad,
> I don't know what to say ... wow ... I can't believe the time and effort you put in here to give me some support. I read through all your posts once and plan to re-read them several more times at least (my ability to read is severely hampered; I have difficulty focusing on long passages and get overwhelmed easily and this whole thing is foreign to me as I've always been a top-notch reader). Actually, I've just decided, duh, I should PRINT them out!
>
> Fachad, I am so touched by your continuing kindness, thoughtfulness and concern. Knowing you are out there, understanding what I'm going through and feeling means a lot to me. I feel like this PB board is like a cyber support group, which is especially important to me since I can't get out much, and have yet to be able to make it to a *real life* support group (that is one of my goals eventually).
>
> I'm just curious about one thing and ironically it has nothing to do with the content of your messages (the messages were so well done that I don't have any questions about them!) -- you mentioned that you "manipulated" your posts to come out in the order they did - does this mean you did not compose them in that order, but somehow managed to get them on the board that way? Just as an example of what I mean, did you compose the "Resources" post first (before the perspectives one), yet somehow get the
> "Perspectives" one to appear first? If so, how on earth did you do that?!
>
> Thanks again for EVERYTHING.
> -Janelle
Posted by Janelle on March 21, 2002, at 18:53:20
In reply to Selective Posting Order and my Writing Techniques » Janelle, posted by fachad on March 21, 2002, at 18:42:18
Fachad,
Thank you for having the sensitivity to realize that I really need some support right now. I'm in a bad way, anxious about my depression and inability to do much of anything (except come on here it seems! LOL!)
I was SO impressed and touched by those three posts you did that I AM going to print them out so you can consider yourself a published author! :-)
Not only that but I am bringing the printout of your MEDS piece to my next pdoc appointment and plan to read it to her to see what she says. I see where you're coming from about the Zyprexa and Klonopin vs. Remeron, etc.
Believe it or not, I'm enough of a computer geek myself (plus I am fascinated by computers in general and strive to learn as much as possible about them) so I understood EXACTLY what you meant when you said you cut and pasted the "Perspective" section into a new reply in a new browser window, and so forth with the other two sections.
Believe it or not, I also followed what you said about how the PSB board displays posts in the order they are submitted, so you just finished off all three posts, each in a separate window, and then clicked on each one to submit in the order you wanted them in!
Nah, I would NOT say that is a little OCD going on there (I have OCD tendencies and believe me, what you did is NOT OCD, it's being very intelligent, organized and articulate!)
Thanks for your response!
-Janelle
This is the end of the thread.
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