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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by Joe Rogan on October 16, 2014, at 20:06:23
I cannot stop eating donuts, drinking coffee (all the time, coffee coffee coffee), masturbating, puffing on my vaporizer (it used to be a pack a day of cigarette), and taking Adderall. DO I have a dopamine depletion problem? My sense of reward also seems trashed! I have no motivation to succeed or work. amotivational apathy synrome. It hits me before a possibly successful job interview, BAM. My voice is shaky and lacks confidence. What I say does not sell interviewers at jobs. It barely got me a place to live out of pure luck and I had to lie a little.
TO put it simply: I cannot stop drinking coffee, drinking soda, eating one to two donuts every day, administering nicotine from my vaporizer pen(used to be smoking). AND THESE ARE SPENDING IMPULSES! I buy vials of E-liquid, Soda, Coffee, etc rather than taking care of myself. You know - when you are poor you need to buy NUTRITION. Not sugar and stimulants. $40 what do you buy? A $9 vial of e-juice and the rest on coffees and food.
I use to drink 6 sodas a day. What drug is helpful to suppress this dopamine imbalance and depression of fatigue and burnt out state? Is it Wellbutrin? Itake Adderall + Desipramine. I read that Wellbutrin stops smoking addiction. Desipramine is supposed to help with cocaine dependence. Desipramine felt like it was working for a little while. I only take 50MG.
It feels like Adderall at no tolerance is the only thing that makes me feel undepressed and alive again. 60MG is where it is at. I feel dead without it. Tolerance comes with it as well. My soccial inhibitions are intensified without it too. I'm at harmony with everything and even come close to being able to experience intimacy with a woman again. With no stimulants or sugar there is a great fatigue - a crash state. I face this every morning when I wake up and I fight it with more stimulants, resulting in a greater crash! I'm just trying to be well enough to survive. When I was a kid I use to have tons of adderall.ritalin.. It was just pills in a bottle, these days it is some miracle drug.
Do I have this schizoaffective disease? They told me I had it at a mental hospital one time, it is frightening. I read on Wikipedia that schizoaffective people have a coexisting nicotine dependency. I'm fearing the worst. I thought it was ADHD psychosis, psychosis secondary to depresion, or just OCD filling my mind with intrusive thoughts. I don't hear voices or see anything. I'm self medicating with sugar, coffee, stimulants and my dopamine system is trashed. I'm willing to bet if you brain scanned my head you'd see a problem with the reward system. Switch to Wellbutrin or something other than desipramine? I take Zyprexa and depakote too. Maybe Zyprexa causing this? I mean dude, mountain dew? Also, pork bacon, and porn. What's going to restore the reward system and make me wake up with vitality, a will power to cut the stimulants, and not be crashed and burnt? I read that the adrenals can be burnt out to where it causes these cravings too...Certain cytomegalovirus can also cause fatigue syndrome. It could be OCD too. All of it.. Who knows! My medical care isn't the greatest.
Posted by Joe Rogan on October 16, 2014, at 20:13:37
In reply to PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 16, 2014, at 20:06:23
**coffee, donuts, and food. I'm also incredibly impulsive. I send messages to people frequently without thinking. I find myself isolated at times, stuck on the net. I press "Send" or click "OK" without putting enough thought into it, then say "I should have proofread that better". Same with interviews. I don't prepare my questions or compose myself well enough.. Then again its hard to be organized like I'd want to with no food in your body. All my mind thinks about is survival at my current level. I can barely squeeze in my school homework. Right now my hunger is distracting me.
Posted by Tomatheus on October 18, 2014, at 22:52:13
In reply to PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 16, 2014, at 20:06:23
Joe,
Something tells me that if you were to describe the problems that you've described to us to a few different mental health professionals that you'd likely get at least a few different explanations as to what might be going on with you. Could you have a dopamine depletion problem? I wouldn't rule out such a possibility, but at the same time I'd consider other possibilities. How much Zyprexa and Depakote are you taking? Have you discussed the possibility of reducing your doses of your medications with the medical professional who does your prescribing? I ask these questions because it doesn't seem uncommon for individuals taking Zyprexa and Depakote to experience fatigue. That's not to say that you definitely don't have some sort of biological problem that's separate from your medications that might be causing the symptoms that you described here. I just think that it would be hard to definitively identify the source(s) of the problems that you've described here.
So, what would I do if I were you? I would probably discuss the possibility of reducing either your Zyprexa or your Depakote with the medical professional who prescribes your medications, if you haven't already done so. I would also consider other treatments that might have effects similar to those of Adderall and/or desipramine. Discussing Wellbutrin, or possibly even an SNRI like Effexor or Cymbalta (as alternatives to desipramine), with the professional who prescribes your medications might be a good idea. An alternative idea that you might want to think about is getting your vitamin D level checked, given the evidence that exists supporting some kind of a relationship between vitamin D levels and mood. I've personally been supplementing with vitamin D3 after a blood test found my level of the vitamin to be insufficient, although at this point, it's hard to say for sure the extent to which I might be benefiting from D3 supplementation.
That pretty much sums up my ideas as to what I'd probably do if I were in your position. I'm sorry that I didn't chime in to respond to your post sooner, and I wish you luck with your treatment.
Tomatheus
Posted by SLS on October 19, 2014, at 6:26:55
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 16, 2014, at 20:13:37
Hi Joe.
I agree with Tomatheus.
It is important for you to work closely with a psychiatrist. I think that you need to be screened for mania / hypomania. If these diagnoses can be ruled-out, you could then start working on revising or confirming your diagnosis. This should help to determine which treatments to try next.
As far as your attempting to produce a biological theory to explain your symptoms - forget it. Neuroscientists cannot yet do this with precision. It is therefore important to choose treatments based upon clinical presentation - symptomatology and reactions to previous drug exposures. Psychiatrists can do this right now.
Dopamine? Perhaps. However, I should think that you have "too much" rather than "too little" based upon your writings.
Things are not so simple as to conceptualize the brain as a sack of neurotransmitters. Circuitry is perhaps more important.
Good luck.
- Scott
Posted by Joe Rogan on October 19, 2014, at 17:12:10
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue? » Joe Rogan, posted by SLS on October 19, 2014, at 6:26:55
Yeah he is going to test my Vitamin D levels, Tomatheus.
But I think it has something to do wih reward system of my brain. I seek instant gratification instead of the reward of accomplishment and hard work. This is evident by uncontrollably eating donuts and drinking soda, drinking caffeinated beverages (coffee), and jerking it. Depressed people think about sex a lot. Also, too much pork and meat but that has improved since taking desipramine. Yeah the doc has me on 750+750 MG of depakote and 15MG of Zypexa at night.
Posted by SLS on October 19, 2014, at 18:07:54
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 19, 2014, at 17:12:10
> Yeah he is going to test my Vitamin D levels, Tomatheus.
>
> But I think it has something to do wih reward system of my brain. I seek instant gratification instead of the reward of accomplishment and hard work. This is evident by uncontrollably eating donuts and drinking soda, drinking caffeinated beverages (coffee), and jerking it. Depressed people think about sex a lot. Also, too much pork and meat but that has improved since taking desipramine. Yeah the doc has me on 750+750 MG of depakote and 15MG of Zypexa at night.That all sounds good to me.
Regarding your drive to seek instant gratification, do you receive it, or do you not experience any reward despite your impulsive behaviors?
If you do not experience reward, despite your drive to seek it, you might be depressed without mania.
If you do experience reward from the drive to impulsively seek appetitive gratification, I would look at the possibility that your mania is not yet under control - with or without depression. People who are manic are too distractable to focus on the accomplishment of tasks that require an investment of time and sustained concentration.
- Scott
Posted by Tomatheus on October 19, 2014, at 18:46:14
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 19, 2014, at 17:12:10
I follow your logic, Joe, and I think it's possible that the problems that you've described in your posts here might stem, at least in part, from problems with dopaminergic neurotransmission. Unfortunately, there is to my knowledge no valid, commercially available test that measures dopamine levels. Researchers sometimes measure the level of dopamine's metabolite, homovanillic acid (HVA), in the cerebrospinal fluid of humans in attempts to understand differences in the functioning of the dopamine system that might exist between patients with mental disorders and mentally healthy controls. Unfortunately, levels of HVA in spinal fluid may not reflect actual levels of dopamine in the brain. Although it's possible that an abnormally low HVA level might reflect reduced dopamine synthesis (which could be seen as "dopamine depletion"), it might also mean that dopamine is being broken down too slowly, which would cause dopamine levels to actually be too high. So basically, even some of the methods that are used in mental health research to try to measure dopamine levels in humans have their flaws, which means that it's highly unlikely (at least in my estimation) that a valid test that measures dopamine levels will become commercially available anytime soon.
Without a valid test to determine the level of dopamine in your brain, it's really just anybody's guess as to whether dopamine depletion might be a problem for you. Vitamin D seems to increase the activity of the tyrosine hydroxylase enzyme (at least in the adrenal medullary cells of mice -- Puchacz et al., 1996), which converts the amino acid tyrosine to dopamine, so measuring your vitamin D level might tell you whether one chemical that influences dopamine is outside of the normal range. However, the number of factors that might influence brain dopamine levels, be they biological or otherwise, seems to me that it would be very high, so even the result of a vitamin D level test would from my perspective tell you very little about how elevated or depleted dopamine might be in your brain.
And then there's Zyprexa. Among the pharmacological actions of the atypical antipsychotic that you're taking is the blockade of D2 (and D1, D3, D4, and D5) dopamine receptors. This action could account for at least some of the problems that you've described experiencing here. Furthermore, a relatively recent randomized double-blind study (Kluge et al., 2007) found that Zyprexa can induce food craving and binge eating. I know that you've stated that you're taking Zyprexa for schizoaffective disorder and that you might need some sort of dopamine-modulating antipsychotic to keep some of your symptoms under control. However, if your food cravings are becoming really problematic, I might advise talking to the professional who prescribes your medications about either trying a lower Zyprexa dose or switching to a different antipsychotic.
Well, this sums up my thoughts on what you've written for now, so I'm going to bring this message to a close. I wish you much luck on getting the problems that you've described in your posts under control, whether that involves taking a medication that boosts dopamine or something else. Take care.
Tomatheus
==
REFERENCES
Kluge, M., Schuld, A., Himmerich, H., Dalal, M., Schacht, A., Wehmeier, P.M., et al. (2007). Clozapine and olanzapine are associated with food craving and binge eating: Results from a randomized double-blind study. Journal of Clinical Psychopharmacology, 27, 662-666. Abstract: http://www.ncbi.nlm.nih.gov/pubmed/18004133
Puchacz, E., Stumpf, W.E., Stachowiak, E.K., & Stachowiak, M.K. (1996). Vitamin D increases expression of the tyrosine hydroxylase gene in adrenal medullary cells. Brain Research: Molecular Brain Research, 36, 193-196. Abstract: http://www.ncbi.nlm.nih.gov/pubmed/9011759
Posted by Joe Rogan on October 19, 2014, at 18:57:29
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue? » Joe Rogan, posted by SLS on October 19, 2014, at 18:07:54
Only smoking a cigarette gives me the go-pep. Never do I feel alive if I smoke say, one cigarette in a 2 week period. I usually puff the vapor pen.. I hate cigarettes they're disgusting but the instant effect of clarity, concentration, and motivation that it gives me can't be reproduce. Adderall pre-tolerance gives me social abilities and allows me to be intimate with women again. However, both nicotine and Adderall build a tolerance quickly so these pre-tolerance effects are short lived. Do I get pleasure? No. I stopped jerking it 3 days ago. It no longer pleases my brain. Now I have a donut/coffee/soda eating and drinking problem. I keep eating glazed twists at the local donut shop.
I have intense problems focusing on schoolwork or doing my computer programming work without the speed. My cognitive process also does not work properly, I constantly misspell words and am generally neglectful before I press the enter key. Sometimes I forget things, my mind while my mind is constantly ruminating. It is totally reckless and impulsive at times. is this typical of schizoaffective? I don't hear voices but music is always playing in my head - plus my jaw moves to thoughts. I get intense states of rumination in my mind.
Posted by Joe Rogan on October 19, 2014, at 18:59:46
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 19, 2014, at 18:57:29
That ,and my motivation levels are drastically effected. I don't feel like doing anything. I alwyas think about easy money or being rich. and I make excuses. I do manage to bathe, but sort've don't brush my teeth every night. I sleep in every day until 12PM which is really unhealthy and I feel really dead when I wake up. I'll try focusing on eating primarily tunafish, salmon and other Vitamin D containing foods, maybe I'm not getting enough sunlight too.
Posted by Joe Rogan on October 19, 2014, at 19:02:15
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 19, 2014, at 18:59:46
It couldbe vitamin D related. One time I woke up at 6AM after doubling my adderall dose to 60MG. I felt full of energy and refreshed. It has something to do with dopamine release in the brain. Taking a fresh dose of Adderall high enough to induce euphoria and not be tolerant seems to make my brain well! Same with smoking a cigarette in a 2-4 week period. That's what I mean by 'pre-tolerance' before your body builds a tolerance.. Like when it hits you really good.
Posted by Joe Rogan on October 19, 2014, at 19:49:22
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 19, 2014, at 19:02:15
Yeah it was self medication. You shouldnt take double your dose of amphetamine salts but I've been under pressure to study for my exam and to write computer code for a living which my brain functionally cannot do on it's own. I have a high tolerance to just 30MG of adderall. It doesn't work on it's own. Also, that may have messed up the doctor's diagnosis. He tested me for mania but I Was on 45MG of Adderall instead of 30. I asked him about 'self medicating' and if it was an issue unique to bipolars or something that effects depressed people as well. I don't know if it is self medicating or my internal drive for success hving me on the 'edge' with coffee and uppers. One cannot deny the positive effects that a cigarette w/ nicotine delivers (as previously mentioned). I'm still a functional mess without it. But my tolerance break should do the trick of making his prescribed maximum of 40MG work eventually.
Posted by SLS on October 19, 2014, at 19:56:52
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 19, 2014, at 19:02:15
I think you should explore substituting Abilify for Zyprexa. It can act as a dopamine blocker or a dopamine stimulator, depending on the levels of dopamine in the synapse. Abilify has antipsychotic, antimanic, and antidepressant properties.
The nicotine thing is interesting. Perhaps your nicotinic tone is too labile. Interesingly, the metabolite of ketamine, hydroxynorketamine (HNK) blocks nicotine type 7 receptors, and has rapid and robust antidepressant properties as demonstrated in rodents. It is possible that NMDA receptor antagonism is not at all contributary to the therapeutic antidepressant effects of ketamine. In addition, HNK is 1,000 times more potent than ketamine as a stimulant of neuro-regenerative pathways. I would be first in line to try HNK in a clinical trial.
It will be important to observe you over time to see whether or not your diagnosis of schizoaffective disorder should be re-evaluated by your doctor. It might not matter too much in choosing treatments, though. A bipolar mixed-state would be treated very much the same as schizoaffective disorder. If your are schizoaffective, you might need a drug like Risperdal rather than Zyprexa. Saphris might also be effective, but without the metabolic side effects of Zyprexa and Risperdal.
- Scott-
Posted by phidippus on October 20, 2014, at 21:27:26
In reply to PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 16, 2014, at 20:06:23
Have you ever tried a mood stabilizer?
Eric
Posted by Joe Rogan on October 21, 2014, at 16:55:23
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue? » Joe Rogan, posted by phidippus on October 20, 2014, at 21:27:26
I previously stated I'm on Depakote ER 1000MG every night. Again, aside from my constant mental ruminitions that make my jaw move and are embarassing thoughts at times, and impulsive spattering of text/speech without careful tact and thought, along with my constant bingeing on sugary donuts and coffee - my reward system is toast. All I'm motivated to do is earn enough money to eat donuts and subsist on handouts. I have a glazed twist addiction. Same with coffee and my vapor pen. Yeah Nicotine from a real cig hits me really hard and makes my mind normal. It only works once, if I smoke again I get tolerance to that effect. Same with pre-tolerance adderall doses. Donuts coffee are my "crack", and I don't really care if donuts kill me-I'm a 31 year old loser, no car, can't pick up chicks (something wrong with my intimacy and deferred gratification), always striking out at job interviews, and can never afford anything. Psychologically distressing . All I want to do is wake up, scrape up $4-6, and buy a donut + a coffee. eat and rest or sit on my computer trying to build myself better into my full-time field of work.Also I want to try to figure out what is wrong with me and why I am not doing some form of under the table manual labor to temporarily support my gainful employment search. It seems I have this seething animosity for the fact that I would have to touch a shovel or paintbrush ever again after the efforts I've put into real steady gainful employment. A REAL JOB. I'd rather just give it all the finger and panhandle. I may end up back in jail and homeless. I can't seem to get a full time job in my field (no motivation usually means you won't be employed). Sometimes echoes of sentences or patterns ring through my mind. Sometimes embarassing or undesirable thoughts and patterns. This all became worse after stopping Venlafaxine in 2010. I thought maybe I don't need these drugs and stopped. The only reason I went on them is because I couldn't find gainful employment and I thought maybe there is something wrong with me. I wonder if it is like a Effexor discountinuation syndrome. I took it for 10 days then stopped. I wonder if it is better than desipramine? Should I get a desipramine increase? Seems like my life improved on 50MG. I'm also considering Wellbutrin. I also think Abilify and Paxil had something to do with all this too. I developed psychosomatic anxiety to try out benzos (never had them before) but the anxiety became real! Yeah something about the Abilify two-way dopamine blockade. Ever since taking benzos in 2009 I have had anxiety. I took abilify for about 4 days and couldn't handle the jittery legs feeling it gave me. Maybe I'll try it again and see if it returns my motivation to stack money without limits rather than stacking to comfort and retiring to my room for rest. The hunger is bad too.
That's why i wonder if this is one big reward-system deficiency or problem it renders me pretty helpless. Especially with no cash and the welfare medical system. I see a psych once a month.
Posted by Joe Rogan on October 21, 2014, at 17:06:12
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 21, 2014, at 16:55:23
and don't forget fap it! Sometimes I wonder if I'm punishing myself...
Posted by SLS on October 21, 2014, at 18:50:00
In reply to PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 16, 2014, at 20:06:23
Mixed-state hypomania?
Yes or No?
- Scott
Posted by Joe Rogan on October 21, 2014, at 20:42:33
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by SLS on October 21, 2014, at 18:50:00
I don't know. I don't really seem to be experiencing any mood extremes. What definies a mixed state? High energy? Pressured speech or overpowering conversations with others by interrupting or not allowing them to speak? Speaking too much during a sale or business transaction, causing a loss of the transaction or a reduction in success?
Posted by Tomatheus on October 21, 2014, at 20:59:46
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 21, 2014, at 20:42:33
Joe,
I know that this is the medication board, but one question that comes to mind when reading your posts is this: Do you have any experience with psychotherapy? If yes, what were your experiences with therapy like? If no, do you think you might find therapy to be beneficial?
Tomatheus
Posted by SLS on October 21, 2014, at 21:17:59
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 21, 2014, at 20:42:33
> I don't know. I don't really seem to be experiencing any mood extremes. What definies a mixed state? High energy? Pressured speech or overpowering conversations with others by interrupting or not allowing them to speak? Speaking too much during a sale or business transaction, causing a loss of the transaction or a reduction in success?
Yes.
Also, having a high sex-drive, despite the presence of depressive symptoms.
It is not necessary that you experience "extreme" mood swings to be diagnosed as having bipolar disorder. Hypomanic mixed-states can be very stable.
What do your doctors have to say? What do they think? What diagnoses have they given you?
What do you think of Tomatheus's ideas regarding psychotherapy? One can profit from psychotherapy, even if they have a biological mood disorder that requires medication or other somatic therapies. Just imagine how much psychological damage a protracted episode of depression or mania can produce. Psychotherapy can help someone to clean up that mess.
- Scott
Posted by Joe Rogan on October 21, 2014, at 22:27:28
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue? » Joe Rogan, posted by SLS on October 21, 2014, at 21:17:59
> > I don't know. I don't really seem to be experiencing any mood extremes. What definies a mixed state? High energy? Pressured speech or overpowering conversations with others by interrupting or not allowing them to speak? Speaking too much during a sale or business transaction, causing a loss of the transaction or a reduction in success?
>
> Yes.
>
> Also, having a high sex-drive, despite the presence of depressive symptoms.
>
> It is not necessary that you experience "extreme" mood swings to be diagnosed as having bipolar disorder. Hypomanic mixed-states can be very stable.
>
> What do your doctors have to say? What do they think? What diagnoses have they given you?
>
> What do you think of Tomatheus's ideas regarding psychotherapy? One can profit from psychotherapy, even if they have a biological mood disorder that requires medication or other somatic therapies. Just imagine how much psychological damage a protracted episode of depression or mania can produce. Psychotherapy can help someone to clean up that mess.
>
>
>
> - ScottYeah I am being supplied with a therapist. I emailed her a bunch of times about my problem(s). I think a lot of this is psychological behavior-based in nature. If I could just be well it would work out. I take mood stabilizers, they should be working right? What about low-dose lithium for aggressive impulsivity? It seems I have this aggressive impulsivity. Not so much being aggressive, but the fact that I am extremely impulsive. That would be, for example, posting on this board 4-5 times without properly summarizing everything into say, 1 or 2 posts. Firing off the "Send" button too much too fast, instead of kicking back and planning my responses carefully. The therapy option is in progress but I only get to see the psychologist twice a month.
Posted by Tomatheus on October 21, 2014, at 22:56:25
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 21, 2014, at 22:27:28
Joe,
Thank you for responding. I agree with what Scott wrote in his post regarding psychotherapy, as I think that it can be helpful to have a professional with some degree of expertise to meet with regularly to talk about some of the issues that you've been discussing in your posts. It's seems like you've been doing an effective job of identifying problems that you want to see changed, and I think it's good that you have a therapist who can help you create the kind of changes that you're hoping to create. Sometimes all of us need some help with taking the steps necessary to grow and change, and engaging in psychotherapy is certainly one strategy that I think can help with taking those steps.
Thanks again for your response, and I wish you luck with the multi-modal approach to treatment that you're taking.
Tomatheus
Posted by Joe Rogan on October 21, 2014, at 23:15:00
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue? » Joe Rogan, posted by Tomatheus on October 21, 2014, at 22:56:25
Thanks Scott. At first I was not convinced of the hypersexuality part, I do recall desipramine bringing forth side effects of 'increased interest in sex', which was previously dulled. My brain is always seeking it's candy (dopamine release) whether from soda, caffeine, nicotine, sugar, or what have you.But, there is a self harm aspect involved. Binging on sugar is known to be harmful. Self harm, like punishing myself, is one of the things I sort've identify with. One time I cut my arms a little, this was about 9 years ago. I don't know why I did it, I guess it felt the thing to do. Then comes the police because I did it on camera... I just said I didn't do it and he let me walk, fortunately.
Posted by Joe Rogan on October 21, 2014, at 23:18:09
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue? » Joe Rogan, posted by Tomatheus on October 21, 2014, at 22:56:25
Also, without Adderall I can't do any work at all. No schoolwork can get accomplished. It is only on 30-60 MG of Adderall that I can do it. I can't really be taking the 60 because it isn't prescribed that high. With this dose I have been able to progress in education like never before.
Posted by SLS on October 22, 2014, at 8:59:31
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 21, 2014, at 22:27:28
>
> Yeah I am being supplied with a therapist.You might want to make list of those issues and goals you wish to work on. This list, of course, will change as you progress and learn more about yourself.
> If I could just be well it would work out.
Yes!
Your ability to make progress in psychotherapy is dependant upon the severity of your affective symptoms. The lack of mental energy and slowing of thoughts can limit one's processing and internalization of new material. Cognitive deficits, memory impairments, and perceptual warping greatly influence the results of psychotherapy. When fully depressed, I can't think my way out of a paper bag.
When I am at my worst, I dictate to the psychotherapist that he has only one job to perform - to keep me alive.
You'll be okay.
- Scott
Posted by SLS on October 22, 2014, at 9:06:02
In reply to Re: PLEASE HELP: Is there some kind of dopamine issue?, posted by Joe Rogan on October 21, 2014, at 23:18:09
There is no reason why you could not take a stimulant along with antipsychotics - or even MAOIs. It occurs very often that ADHD occurs comorbidly with bipolar disorder. Just remember that mania without ADHD can produce distractibiliby, disorganization, and the tendency to start a lot of projects and complete none of them.
- Scott
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Dr. Bob is Robert Hsiung, MD,
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