Posted by Londonboy on May 14, 2008, at 4:32:34
Hello everyone, I'm new to this board and have a few questions that I hope people may be able to give me some insight into...
I am now 29 and have suffered episodes of depression since my early twenties which have been treated by various SSRIs and Effexor. From these drugs I have experienced poopout, sexual dysfunction, hypomania (mainly from paroxetine), lack of effectiveness and emotional flattening, and as a result have tended to come off them frequently, only for another depressive episode to kick in later, again requiring treatment.
As a child (aged 8/9 onwards) I suffered panic attacks, tended towards disruptive behaviour and social withdrawal, and my overriding memories of childhood are ones of exclusion and a feeling of inadequacy. My teens were characterised by academic under achievement, school expulsions due to absence and disruptive behaviour, drug use (but not dependency) and nicotine dependency which, despite several earnest attempts, I still have not shaken off.
In my adult life I have been through a series of jobs, almost all of which I have done well in up to a point at which things fall apart emotionally and I quit.
In February I had another major episode after coming off paroxetine at the end of last year. During January I was rather manic, working long days and accomplishing quite a lot in my life that needed doing (more of that later), but by February I hit rock bottom again.
I saw my (new) Pdoc in March and he started me on Cymbalta (duloxetine) 60mg which, within a week, had me up and doing again. We were both rather surprised by its rapid onset.
My Pdoc has diagnosed me with a "biological tendency towards depression" as opposed to suffering from reactive episodes, and I think he is probably correct in this - in light of this, he has also prescribed me Depakote 500mg which I have been taking for the last few days. I am told not to expect much in the way of noticeable effects, but that he will maintain me on this indefinitely and in a couple of months taper me off the Cymbalta.
All well and good, except I think I suffer a further problem which we may have missed up to now....
From reading , I have learned that although AD(H)D is now diagnosed frequently in children (possibly over diagnosed), many adults suffering from the condition may be misdiagnosed with other conditions such as bipolar disorder (biological depression?). Indeed, after taking this quiz - http://psychcentral.com/addquiz.htm - I get "moderate adult ADD" as the result. In almost all my reading on the subject, the symptoms of adult ADD seem to fit better than other symptom lists.
One further event may prove enlightening: Last year I was prescribed bupropion (Wellbutrin) for smoking cessation. I was already taking sertraline for depression, and my doc was happy to prescribe the bupropion on top after reading that it is sometimes used as an SSRI adjunct in the USA.
During that time, I noticed that my drive was superb - I was consistently able to focus on tasks better than I'd ever been able to before, my productivity was superb with no distractedness and full completion. I felt like a "whole person" for the first time in my life. Sadly, in the UK, bupropion is only licensed for smoking cessation, and not for depression, so after 3 months, I had to come off it.
Now, here's the thing. I mentioned that I had a productive (possibly hypomanic) January. Well, in that time I somehow managed to get myself a place at a very prestigious university to read psychology as a mature student.
Obviously this is a HUGE opportunity for me, and I am very excited, but my excitement is tempered by my self-knowledge. I must, over a three year period, apply myself to the course, much of which I know will be dull and routine. If I could get myself back in that place I was at last year, I know I would have no problems, but as things stand, I am very worried about returning to the miserable days of my teens with uncompleted assignments and mounting stress levels.
So, I would be very grateful if anyone has any observations, in particular about my current medication and if there is anything I might try beyond what I have already had. I am seeing my Pdoc next week and would love to have some ideas to discus with him.
Thanks in advance!
poster:Londonboy
thread:829018
URL: http://www.dr-bob.org/babble/20080510/msgs/829018.html