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Dr. Bob is Robert Hsiung, MD,
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Posted by Dima on April 4, 2009, at 13:55:33
In reply to My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:42:26
I forgot to mention something, and I don't know if it's important. I've tried Adderall three times in the past month at doses no higher than 40 or 60mg in the time release capsule. After about two hours, when the drug is fully working, I feel almost perfect. I have virtually no fear of speaking to people, and love talking. Topics of discussion just roll out of me like crazy. Also, the fatigue I almost always have goes away. Of course, I know that Adderall is not the miracle drug for me, as the effects wear off over time, and tolerance quickly develops. I just thought that maybe the great effects of this could be mimicked in a healthier way.
Posted by Zana on April 4, 2009, at 14:01:43
In reply to My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:42:26
It sounds like a really hard time and that it is hard to sort out what is psychological and what is biological. It is very common to have irrational fears when you are in an anxious, depressed state. But I know it is hard to know what is "you" and what is "depression" or "anxiety."
Wellbutrin wouldn't be my first choice given the symptoms you describe since it can cause agitation and anxiety. But you are going to have to give any med several weeks to know what it is doing for you and meantime, suffer through the initial side effects, some of which will dissipate, others of which will persist.
No simple answers. It's too bad you don't have a therapist to talk this over with.
Zana
Posted by Dima on April 4, 2009, at 15:19:34
In reply to Re: My life so far...what should I do?, posted by Zana on April 4, 2009, at 14:01:43
In terms of psychological causes, I can think of a few possibilities.
My mom died in 2006, but that didn't seem to change me at all, since I had already been at a pretty low mood. I remember having the bad mood even back in third grade.
I've never really had that close of a relationship with my dad, and ever since my mom passed away, it's been getting worse because of how much time I spend with him now. They were separated before, so I had time apart from each, but now I see my dad way too much. He's a completely great, kind, honest guy, but something about him annoys and irritates me like no other. Whenever I'm home, he asks me to help him at least every 20 minutes. He has Parkinson's, so it's pretty understandable and I feel bad for not wanting to help. But for some reason, just the sound of his voice nowadays irritates me a whole lot, and he's the only person that I am this annoyed by.
Posted by Phillipa on April 4, 2009, at 19:48:22
In reply to Re: My life so far...what should I do?, posted by Dima on April 4, 2009, at 15:19:34
Just a thought is it possible that your Dad effects you this way as you fear losing him also? Was the relationship good before you Mom's death? My Mother died when I was 17 and was very scarey. For me wellbutrin increased my anxiety. Were you ever hyperactive as a child? Is it possible you could have ADD or ADHD? Just a start. Love Phillipa ps welcome to babble
Posted by desolationrower on April 4, 2009, at 23:26:51
In reply to My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:42:26
well, give the bupropion some time to work; otherwise, i'd suggest either nortryptaline or desipramine. they might give some of the effect of the adderall, but in a more sustainable way. not quite as good, but ephedrine or yohimbe are otc and might help on occasion if you don't have problems with physical anxiety or agitation; the main thing is to get more experience so that you'll instictivly understand that you'll be able to talk once you're in the situation.
Psychotherapy can help with the anxiety, and especially the homophobia, which isn't really amenable to pharmacotherapy. if you're in school, seeing a psychologist is often covered, and its good to see one along wiht a psychiatrist. have you tried joining a sports league or a frat or something?
-d/r
Posted by Dima on April 5, 2009, at 11:01:41
In reply to My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:42:26
How does this course of treatment sound? I'll try the bupropion for a couple more weeks. If it isn't satisfactory, I'll add Buspirone. If I feel better, I'll take myself off the Bupropion, and see if the Buspar can work by itself.
Posted by garnet71 on April 6, 2009, at 8:14:10
In reply to My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:42:26
Hi Dima,
To respond to your post above asking me to comment about Buspar, I wanted to come back and read your situation. There is something odd about your situation (not you!); either your course of treatment or that you left something out of your story. It doesn't make sense to me-your course of treatment in response to your experience.
I wanted to try Buspirone because it acts more specificually on 5HT1A receptor and a bit of positive effects on dopamine, rather than SSRIs which seem to negatively affect my dopamine levels and it somehow acts on other 5H transmitters, whereas buspirone leaves some of them alone, so to speak.
It's odd that you started Wellbutrin if you have some psychotic syptoms of paranioa, because you normally would not want to increase your dopamine levels if that's the case. Really, I don't know much about this stuff, or whether your symtpoms are attributed to anxiety or a mild psychosis, but if your syptoms are anxiety/depression, it seems you should have stayed on the Lexapro longer than 3 days and if symtpoms like tiredness, sexual dysfunction persisted, tried the WB after a few weeks on Lexapro first, but not switched from Lexapro to WB like that.
Buspirone seems to work better for anxiety 'maintenance' and a bit on depression-those who don't have extreme anxiety attacks or a severe depression, though some say it doesn't work at all. It doesn't give me negative side effects at all, but some said (read other related posts on this page) it caused them weight gain. More than 2 doctors have told me Buspirone has the least side effects, and it's in a drug class of its own. I am still having soem anxiety episodes whie on it, so I'm debating moving on to something else.
But its normal to feel very tired while your body is getting used to Lexapro, so 3 days isn't much of a trial; WB normally is tried for the 4-6 weeks too, but i found after taking it several times in the past, I can gauge its effectiveness in just a couple week s(for me) becaues I've taken it several times.
In your case, you don't seem like you can tolerate WB at all, and it seems very strange to me your doctor chose that drug w/your symptoms and only 3 days after a Lexapro trial. Care to tell us more about your situation? Maybe there is somethign important left out. And you said *you* are thinking your depression may be a result of irrational fears, but what did your doctor say?
Let us know how it goes and sorry I couldn't be more helpful!
Posted by garnet71 on April 6, 2009, at 9:06:22
In reply to My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:42:26
Oh, sorry, your treatment wasn't odd, I had misunderstood :)) of course...
Still-try the Paxil for longer than 3 days!! but it still doesn't make sense to go from Paxil to WB after 3 days, espec. cause WB causes anxiety in some people.
Did you previously try other SSRIs, or was your 3 day trial the only one?
Posted by Dima on April 6, 2009, at 15:36:45
In reply to Re: My life so far...what should I do? » Dima, posted by garnet71 on April 6, 2009, at 9:06:22
> Oh, sorry, your treatment wasn't odd, I had misunderstood :)) of course...
>
> Still-try the Paxil for longer than 3 days!! but it still doesn't make sense to go from Paxil to WB after 3 days, espec. cause WB causes anxiety in some people.
> Did you previously try other SSRIs, or was your 3 day trial the only one?
>Well, I haven't told the doctor I have anxiety yet, because I didn't think I did. I thought the worrying was just a symptom of depression. Second, I tried Paxil for three days and stopped because I could not function. I go to high school, and the level of fatigue I experienced was too hard to cope with. I didn't start the Wellbutrin until at least a month after that, when I found a psychiatrist.
Posted by garnet71 on April 6, 2009, at 15:50:52
In reply to Re: My life so far...what should I do?, posted by Dima on April 6, 2009, at 15:36:45
Oh-that explains it. Yeah, Dima, that's happened to me to - inability to function from an SSRI. However, for first time users, that often goes away in a few weeks, though sometimes lethargy lingers - but not as bad as the first couple weeks. If you are still tired after a few weeks, docs normally augment with WB; but I think you have to see if something like the Paxil works first, rather than going straight to WB, esp. since you have anxiety. If your tiredness dissipates, but you don't feel energetic or at par, WB can be a great augment to add.
Could you do your schoolwork at home for maybe 3-5 weeks? When i was in hs, I had to miss something like 4 months because of a virus - conjunctivitis, and did fine that year w/o going to classes. It's def. better to get that over with now then wait till you're in college to have to go through psych drugs.
Or - it's possible you could start Paxil and WB at the same time, depending on the doctor. I'ts important to talk to your doctor about the anxiety symptoms regardless of whether or not you think it comes from depression. Really important to tell him/her this. How would you expect to get the right treatment if the doctor doesn't know all your syptoms--like the worrying and phobias?
You did the right thing finding a psychiatrist rather than continuing treatment with a general practitioner, and to seek advice.
Posted by Garnet71 on April 6, 2009, at 17:08:58
In reply to Re: My life so far...what should I do?, posted by Dima on April 6, 2009, at 15:36:45
Dima,
Just thought I'd ask - do you feel uncomfortable telling the psychiatrist about your phobias?
I'm not saying you are, but if that is the case, you know - they've really heard it all, really. They want to help you be your healthiest, so if they know about such things, they wouldn't judge you; instead, they try to find a remedy/solve the problem.
At first, I thought you were saying you were imagining people being homosexual when they were not, but when I reread, I saw your issue was irrational homophobia. Many irrational phobias go alongside with anxiety, and doctors can help you with that. I have some anxiety-related phobias - like pills and scared of heights, though they aren't full-blown phobias, they do exist.
Also - some psychiatrists are more personable and easy to talk to than others. Some are just plain wierd too.
As for the Buspirone - if your anxiety isn't too dramatic right now, it might be a good idea to try it first rather than the Wellbutrin. It is a good way to avoid the debilitating SSRI side effects - but it doesn't work for everyone. It shouldn't make you all tired and miserable like SSRIs do at first. See what your doc says after you tell him/her about all your symptoms. It would be great if that ended up working for you.
Posted by Dima on April 6, 2009, at 17:09:41
In reply to Re: My life so far...what should I do? » Dima, posted by garnet71 on April 6, 2009, at 15:50:52
> Oh-that explains it. Yeah, Dima, that's happened to me to - inability to function from an SSRI. However, for first time users, that often goes away in a few weeks, though sometimes lethargy lingers - but not as bad as the first couple weeks. If you are still tired after a few weeks, docs normally augment with WB; but I think you have to see if something like the Paxil works first, rather than going straight to WB, esp. since you have anxiety. If your tiredness dissipates, but you don't feel energetic or at par, WB can be a great augment to add.
>
> Could you do your schoolwork at home for maybe 3-5 weeks? When i was in hs, I had to miss something like 4 months because of a virus - conjunctivitis, and did fine that year w/o going to classes. It's def. better to get that over with now then wait till you're in college to have to go through psych drugs.
>
> Or - it's possible you could start Paxil and WB at the same time, depending on the doctor. I'ts important to talk to your doctor about the anxiety symptoms regardless of whether or not you think it comes from depression. Really important to tell him/her this. How would you expect to get the right treatment if the doctor doesn't know all your syptoms--like the worrying and phobias?
>
> You did the right thing finding a psychiatrist rather than continuing treatment with a general practitioner, and to seek advice.It really would be more effort than it's worth to miss school for that long. I am finishing senior year in May, so if I'm trying any extremely drowsy drugs, it'll be after that in the summer. And I am already tired almost all the time, so I would much prefer a drug which carried no drowsiness with it at all.
Also, I've read numerous reports that Paxil takes away the depression, but leaves you emotionally numb. That sounds no better than my current situation. And I am already tired almost all of the time, so I would much prefer a drug which carried no drowsiness with it at all.
Why wouldn't you suggest trying the Buspirone?
Posted by Garnet71 on April 6, 2009, at 17:14:23
In reply to Re: My life so far...what should I do?, posted by Dima on April 6, 2009, at 17:09:41
I was writing you while you were writing me - lol
Yes, give Busprione a try, but make sure you tell your doc all your symptoms first :))
Some docs though are biased for and against specific medications though. But yeah, Buspirone doesn't make you tired. Some people say it works and some say it doesn't, but if you are not TOO bad off now in terms of anxiety, I'd say give it a try.
Good luck :-)
Posted by Dima on April 6, 2009, at 18:10:17
In reply to Re: My life so far...what should I do? » Dima, posted by Garnet71 on April 6, 2009, at 17:14:23
Well thanks for the replies! During my visits to the doctor so far, I have in fact been afraid to talk about that stuff. And I thought they would just go away with the meds. Now that I'm realizing that she probably should know about that too, I think I'll feel more comfortable telling her next visit.
Posted by metric on April 7, 2009, at 12:01:59
In reply to Re: My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:55:33
> I forgot to mention something, and I don't know if it's important. I've tried Adderall three times in the past month at doses no higher than 40 or 60mg in the time release capsule. After about two hours, when the drug is fully working, I feel almost perfect. I have virtually no fear of speaking to people, and love talking. Topics of discussion just roll out of me like crazy. Also, the fatigue I almost always have goes away. Of course, I know that Adderall is not the miracle drug for me, as the effects wear off over time, and tolerance quickly develops. I just thought that maybe the great effects of this could be mimicked in a healthier way.
Try to obtain d-amphetamine (Dexedrine, DextroStat). It's a better antidepressant than Adderall. None of the traditional "antidepressants" are remotely similar to amphetamine if that's what you're hoping. You could try modafinil (Provigil).
Did you become tolerant to it? Or is that just something you're concerned will eventually happen?
Posted by fuzz54 on April 7, 2009, at 20:40:57
In reply to Re: My life so far...what should I do?, posted by garnet71 on April 6, 2009, at 8:14:10
Your fear of being gay is irrational since you aren't attracted to men. That could be a sign of anxiety, depression, or both. I'd stay away from Wellbutrin unless you just can't get out of bed as it can be a double edge by giving you motivation and also more anxiety. Drugs are usually only part of a larger picture when trying to get better. Sometimes it takes awhile to get used to therapy, but it has to be something you want to do. There is hope. You may not see any, but that's just depression clouding your view on reality.
Posted by rjlockhart04-08 on April 8, 2009, at 1:33:20
In reply to My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:42:26
Looking back, they are fears that start at 18, phobia's, and fears that where not thought about in the past. They start poppin up, it's a wierd feeling because you have never experienced this feeling "unknownness, semi-confusion". Back them, i did not talk, alot, i was mellow, and kept back because i didnt have common relating with people. I just made aquantanices....didnt keep relationship, buddies, because i was unstable, i would just say somethings, and people thought i was wierd. I hated going to social's.
Get to the point on this: fears about unknown, phobia's, can become severe, studdering, mmmm unstable image. Not using my personal background, but it can come to the point of "stiff, to nervous on a thought".
What happen's, people catororize people from what there outer actions, their looks, their personality, if its good thats great, but inner thoughts come.. In the past, i fought alot of my fears, and denied them inside. They came back, to a point where "reprogram" thinking. Starting having diffrent images, and when you think of something, or maybe a "daydream" of the future how you want to see yourself, it does happen, but not fact.Personality change, i would get really random, and people thought i was random. Well, after years, it turned into "passive-agressive" basically walk around, things get on your nerves, people, say things, I would make indirect dis remarks, that where deep, i'll had to them apologize later. It's the sub-coun, operating. People give me a hard time, I usally will make up a fast comment, "Well, patty, or sue, whatever the hell your name is, havin a bad day? join the club!" Gotta a Light? i smoke light's.
Sometimes people walk off, say: bye, don't come back, got on my nerves in the first place, thanks.Its dynamic rotates to any circumstance, or new image, drop the old one. It's from an unstable self-image, in the past. So, establish "unique" changes. Not wanting to associate with other's.
Medications:
Paxil, first thing, in the past it been "blackboxed" for people under 18, because of bad reactions. Paxil increases Serotonin in the nerve synpase, the tranmisstion is full. Serotonin is mainly for happiness in seeing life as it is, sleep, feeling stable, definetly elimiates depression.. Main it causes "mental fog", great for anxiety, i've read various articles, "unmotivated, tired, lethargic" yet "not in the dump's" which, feel empty, incomplete inside. It deals alot with how you look at life. Paxil is a strong SSRI. Dopamine/norephinephrine are low, or cancelled out because the serotonin satruration is full.
Wellbutrin, increases motivation, indirectly, people who have "low energy". But, also, it made me, battery-like, the worst mood, irrtiblible, i would make saracastic comment's to every second if something happened. It works, good with some ADHD cases, by increasing dopamine, motivation, norephienphrine, attention, vigilent, staying alert.
Some thought, imput:Prozac is good, because it provides "lift" and it's mild stimulating, but i've read it helps with anxiety. Reason, it's stimulating, it also effect's NE and increases "lift". It's good, but i've also read the bad reports too.
Adderall/Dexedrine is psychoactive, produces increased motivation, dilegence, on something, or getting things done Feeling like you cant think. Also is abusable, which can lead to tirenesss, and horrible depression. So, follow the intructions on the bottle.
There's something called Strattera, it's for ADHD, and said to be AD, it's not. It increases NE levels, more alert. Takes about 3 weeks to start working.Have you heard of Nuerontin, Lycria are the new generation anti-anxiety GABA associated, medications. Older, where Ativan, Valium, Xanax which are still used in needed cases.
Mood stablizer's: Lamictal, Lithium, are ok, but not the best. They normalize nuerotrasmitter's back to normal nevel's. That may help. Tell your doctor, Wellbutrin, it's making "moody", like you said, somedays are ok, other's are bad. That's not a stable balance, effect's how you operate in general, negative feelings, moods.
Lamicatal may help. Reconsider on the Paxil, it causes drowsiness in general. Prozac, is diffrent, but more "lifting".
Best luck, take care
rj
Posted by desolationrower on April 8, 2009, at 7:06:17
In reply to Re: My life so far...what should I do?, posted by fuzz54 on April 7, 2009, at 20:40:57
> Your fear of being gay is irrational since you aren't attracted to men. That could be a sign of anxiety, depression, or both. I'd stay away from Wellbutrin unless you just can't get out of bed as it can be a double edge by giving you motivation and also more anxiety. Drugs are usually only part of a larger picture when trying to get better. Sometimes it takes awhile to get used to therapy, but it has to be something you want to do. There is hope. You may not see any, but that's just depression clouding your view on reality.
wellbutrin doesn't cause more anxiety than an ssri
its not as good as a benzo for anxiety, but at least make the comparison to something equivalent
-d/r
Posted by garnet71 on April 8, 2009, at 8:45:35
In reply to Re: My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:55:33
"I forgot to mention something, and I don't know if it's important. I've tried Adderall three times in the past month at doses no higher than 40 or 60mg in the time release capsule."
Hey Dima - I somehow missed your post about Adderall. That's a really high dose to take when you first try it (they started me at 10 mg). I just wanted to let you know that Adderall can cause extreme ~paranoia~ in some people, anxiety. So, if you had those thoughts after you took Adderall, that is not uncommon, esp. in high doses.
Posted by garnet71 on April 8, 2009, at 10:13:35
In reply to Re: My life so far...what should I do?, posted by desolationrower on April 8, 2009, at 7:06:17
> wellbutrin doesn't cause more anxiety than an ssri
>
> its not as good as a benzo for anxiety
>
> -d/rOh-sorry, Dima, I said something like that too...
"WB causes anxiety in some people"Feeling kind of stupid now :(
well, I guess you'll have that on forums from time to time.
Posted by rvanson on April 9, 2009, at 21:58:57
In reply to My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:42:26
> Sorry if this post is kind of long, I feel like all details should be accounted for. So I am an 18 year old male. Pretty much as long as I can remember, I haven't been genuinely happy. Maybe for brief periods due to great circumstances, but in general, my outlook on life has been bleak.
>
> Also, I have some irrational fears, which I am just recently beginning to think may be anxiety. First, I get nervous and anxious when I have to talk to someone. Anyone. I fear not knowing what to say to keep the conversation going, and most of the conversation is spent with my mind racing trying to think of topics. I am fine in front of large crowds. If a speech is prepared beforehand, I could probably say it in front of a thousand people, with little problem. Second, and a lot more weird and embarrasing, I have a fear of being gay. I have not been attracted to males, and have certainly been attracted to females, yet every time the thought crosses my mind, my stomach does a somersault. I have nothing against gays, and do not feel there is anything wrong with living that way, but I have a huge fear of one day waking up and realizing that I am in fact gay. For a perfect future, I see myself living happily with a great girlfriend.
>
> At the beginning of 2009, I decided to finally see a doctor. I went to my family doctor, who quickly prescribed Paxil 20mg and sent me on my way. I took it for three days, but the insane drowsiness and sexual side effects were too much too bear.
>
> I scheduled an appointment with a real psychiatrist. First I went to two therapy sessions, which seemed extremely pointless and it seemed that we were both just saying things to fill the hour time slot.
>
> After that, I was scheduled to see another doctor there, who prescribed Wellbutrin SR 150mg. Well, Budeprion, which I've read can be quite different. I took it for a week, but I had to stop because of a never ending feeling of a lump in my throat and my mouth constantly filling with saliva. I saw the doctor again, and she decided to try the XL version. She gave me a prescription for the 150mg pills, and said after about two weeks, go ahead and take two per day.
>
> I've been on the Budeprion XL for about three weeks, and just started taking two pills per day three days ago. The three weeks have been like a rollercoaster of moods, and I don't know if it's the drug or I'm just attributing how I normally feel to it. Some days I feel good. Not great, but good. At those times all I think is that this drug is perfect, and to keep at it. Other days, like today, I feel horrible. Nothing worse than it was before the drug, but still not what I was looking forward to. If I realize the drug is not working, I plan on trying brand-name before any other drug, because of the many reports of differences I've read.
>
> Recently, I found information about Buspirone, which seems like a possibility if Wellbutrin doesn't work. I assume that maybe the depression is only there because of the irrational fears.Wellbutrin is called "Bupropion" as a generic.
Buspirone is a good idea for an add-on med, but it's more for anxiety then depression. However its worth a try. Thhe side effects were not too bad for me but it didnt do anything for me.
Posted by Amelia_in_StPaul on April 11, 2009, at 22:35:53
In reply to My life so far...what should I do?, posted by Dima on April 4, 2009, at 13:42:26
Dima, are you still here? It sounds like you may have OCD. A common obsession with OCD is fear of being gay.
Posted by Dima on April 11, 2009, at 23:09:18
In reply to Re: My life so far...what should I do?, posted by Amelia_in_StPaul on April 11, 2009, at 22:35:53
I have never had the notion that I have OCD. I don't really see what other obsessions I would have.
I just looked up what you said, though, and it seems pretty similar to what I experience. I've never been able to find people who seem to share the same fear.
Posted by Neal on April 12, 2009, at 2:30:50
In reply to Re: My life so far...what should I do?, posted by Dima on April 11, 2009, at 23:09:18
the irritation with your dad could be from the Wellbutrin (buproprion) partly; it's a prime side-effect of the drug, especially at first few weeks.
Posted by Dima on April 12, 2009, at 9:47:03
In reply to Re: My life so far...what should I do?, posted by Amelia_in_StPaul on April 11, 2009, at 22:35:53
> Dima, are you still here? It sounds like you may have OCD. A common obsession with OCD is fear of being gay.
Wow, Amelia, thank you so much. I've read a few articles already on HOCD. It matches my thoughts perfectly. It's amazing to finally have an explanation and to have hope for an end to it. I see my psychiatrist on Tuesday, and I will tell her about it.
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