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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by allisonm on April 9, 2005, at 19:48:31
Here's the situation:
Saw my pdoc Tuesday before last. I was really down. I have felt this way for several weeks. He suggested that I consider upping my dose of Zoloft. I am on 300 Wellbutrin XL and 50mg Zoloft, both of which I take in the morning. I have gained 30 pounds since getting off Serzone and starting Zoloft in the fall of 2002.
I don't know whether this weight gain is from taking Zoloft, or from other things. My boyfriend brought it up yesterday afternoon on the drive home from a perfectly wonderful mini-vacation at Saratoga Springs, where we took mineral baths and massages and walked around the quaint town holding hands, and ate really good Indian food.
He's got Asperger's Syndrome, and is not always able to be diplomatic. I got very upset at his suggestion that I was gaining weight on purpose to perhaps try to end the relationship. He wouldn't accept my thoughts that it might be the Zoloft, or the sedentary life I have been leading of late, or the large amounts of red wine I have been consuming to quell this constant anxiety I still feel. I am hurting. He hugged me goodbye as I left his place today, and all I could do was weep. You know how exhausted you feel after an emotional argument? I was a mess last night, and pretty low on energy today, not to mention crabby. My coworkers don't know why nor do they understand.
I am feeling that upping the Zoloft isn't a fix. My life needs to be fixed. Zoloft isn't going to do it. I understand that drugs put the "floor" under one's feet so that one can start working on problems. This Zoloft increase seems like a cop-out to me, yet I don't have any answers to fixing the current life I have. Well, I do, but they feel drastic and I can't see doing them... at least not right now.
I see my pdoc again on Tuesday. Any ideas?
Posted by Shar on April 10, 2005, at 0:19:20
In reply to OK, oldsters...a call for advice, posted by allisonm on April 9, 2005, at 19:48:31
Hi, Sweet A,
How come increasing one's dose (of, ie, Zoloft) seems to be a cop out?!That sounds like a diabetic saying, well, I know this much insulin helps a little...but I DO NOT want to take MORE!!
If you are dealing with a chemical imbalance, then that needs to be addressed FOR YOUR BENEFIT. So YOU can feel ok.
I do not know much about the condition your sweetie has, except it seems to impair his social skills. However, if he can't love you because you are fatter/skinnier than before, then, that is GOOD info for you! Sheesh! Wait until you're 40-50 years old, things like that change very quickly!
By the same token, you have to answer the question (at least in your own mind) do you want out of this relationship? May be that he is correct. Is he? You can say so in this forum (unless he reads here and knows who you are). Are you tired of him?
The mini-vacation you described sounds thoroughly delightful to me, and I'd be totally delighted to be able to do something like that. And, if, after all that, all he could come up with was essentially a 'you're getting fat' comment...well, it might be a good time to pause, step back, see what you're getting from the relationship, and consider if it is worth your time (oh, I know how COLD that sounds!).
Anyhow, many xoxoxo's to you!
Shar
Posted by allisonm on April 10, 2005, at 10:50:38
In reply to Re: OK, oldsters...a call for advice » allisonm, posted by Shar on April 10, 2005, at 0:19:20
Hi Shar.
Thanks so much for writing.
I guess I'm thinking that I'm feeling bad because life isn't going real well at the moment. So does that mean that the chemical imbalance is worse too, or just that life sucks more than usual? If it's just life that sucks more than usual, should I adjust the drugs to correct the chemical imbalance more? Is the greater-sucking life causing a greater chemical imbalance? Or is the increase in Zoloft going to buffer the sucky life like ativan muffles anxiety and despair? Is that a cop-out to buffer yourself all the time from a life that has taken a downturn? Shouldn't I just pull myself up by the bootstraps and try to change the sucky life by myself without chemical help? That's what I mean by cop-out. What is chemical imbalance and what is life circumstance?
I'm 43, so I think my metabolism might be changing, also wreaking havoc with the weight issue as you mentioned.
I don't think I'm gaining weight on purpose to get out of the relationship. He's hard to get along with sometimes, but there are a lot of things I like about him. I don't think I'm tired of him. He doesn't know about this forum so I can say anything I want.
Your point about stepping back and seeing what I'm getting from the relationship is right on. My psychiatrist has been asking me that for months and months.
Still, there are a lot of aspects about him that I've not found in others. Some of them might be attributable to his Aspergers. He has a sweetness about him, a gentleness, a gentle sense of humor, a deep love for animals, lots and lots of creativity, a sharp wit, a unique outlook about the universe and how things work in this world. Also a certain kind of charisma.
I don't know. It can be a real joy to be around him. It also can be hellish. I've read this from other writings of spouses and SOs of people with AS. I guess I need to decide if it's something I want to put up with.
Thanks again for writing.
alli
Posted by NikkiT2 on April 10, 2005, at 15:12:52
In reply to OK, oldsters...a call for advice, posted by allisonm on April 9, 2005, at 19:48:31
Oh hun *hugs you*
Living with someone with aspergers can't be easy.. as you know, one of my best friends hs aspergers and he can hurt me SO much.. but he doesn't get why it hurts me. Remember that someone with aspergers has totally different ways of thinking about things.. hve you maybe commented on your weight gain and he's picked up on that, thought about it and simply not understood that its someting he should work out in his head and not voice it?
Its a typical thing for an aspie to do..
The only way I have really found to deal with it, is to rant like h*ll to someone else.. You know you can rant all you like to us here. Just try and focus on the fact that he doesn't mean to hurt you at all..
*hugs you again*
Nikki xx
Posted by CamW on April 11, 2005, at 4:22:18
In reply to OK, oldsters...a call for advice, posted by allisonm on April 9, 2005, at 19:48:31
Allison - I'd blame the weight gain on the Zoloft, but I'd also give the increase in dose a try. There is little risk of increasing weight gain with an increase of dose. We all know that "poop-out" does occur with the SSRIs, and an increase in dose can help.
Besides, 50mg of Zoloft is a low dose, and is usually not a "full dose". You should know if the dose increase is going to do anything within 4 weeks. If by then your mood has not improved you can always drop the dose, or perhaps switch to something like Effexor XR. Again, because of the long time taking Zoloft, the risk of weight gain from a change to another serotonergic antidepressant is low (except a switch to Paxil; the antihistaminic effect of this drug often causes an increase in weight no matter what).
Give the increase a chance. Also tell your significant other, from me, that the weight gain is not your fault, it is the drug. Also, tell him that by taking the Zoloft you are attempting to improve your mood, so that you are better able to enjoy his company; thus the weight gain is a side effect of trying to improve your relationship with him, not trying to drive him away.
Take care and let us know your decision. - Cam
Posted by nikkit2 on April 11, 2005, at 10:07:23
In reply to Re: OK, oldsters...a call for advice » allisonm, posted by CamW on April 11, 2005, at 4:22:18
*does a double take*
Dayam its good to see you here
*gives you a big squidgy nikki hug*
nikki xxx
Posted by allisonm on April 11, 2005, at 18:25:23
In reply to Re: OK, oldsters...a call for advice » allisonm, posted by CamW on April 11, 2005, at 4:22:18
How wonderful it is to see you (your post)! I sure have missed you.
Thank you for the SSRI/weight-gain information. It helps to know it isn't "just me." After finding a combo that seems to work better than any of the myriad pairings so far, I'm bummed at the idea that Zoloft is pooping out. That hadn't occurred to me.
I see my pdoc tomorrow and will bring all of this up. Thanks so much!
Posted by allisonm on April 11, 2005, at 18:37:57
In reply to Re: OK, oldsters...a call for advice » allisonm, posted by NikkiT2 on April 10, 2005, at 15:12:52
Hi Nikki,
At one point he was trying to figure out the chronology of my weight losses and gains over the last 20 or so years, figuring the weight losses happened when I was physically ill (sort of true), and the weight gains came before relationship break-ups (not true). He was just twisting the data around in his aspie mind to form these far-fetched conclusions.
I remember early on in our relationship, when I was truthful and told him that I was taking antidepressants, he was (and still is) against it. At that time, he went so far as to suggest that ADs were unnatural, and if I felt suicidal without them, then maybe that's the way things should be...maybe I should commit suicide, and maybe he should be there to hold my hand while I off myself. Of course, he thought more about it overnight (and after my blasting him) and apologized the next day.
Thanks for your support. It helps to know someone who lives with aspies.
Posted by Shar on April 12, 2005, at 2:16:49
In reply to Re: OK, oldsters...a call for advice » allisonm, posted by CamW on April 11, 2005, at 4:22:18
Allison and Cam,
First, Cam, SO great to hear from you. I have always appreciated your knowledge and how it can dovetail with the more 'emotional' issues we have in relationships.
The best I EVER felt was on Zoloft (it was like Alice going down the rabbit hole...I felt GOOD, energetic, up, talkative...unbelieveable), and then at the max dose (we kept upping the dose) it pooped out, or I did...I don't know if it might work again...I've heard it doesn't [however, Coral is one of those anomalies.]. Plus, I don't have $$ now for a pdoc or Rx for Z.
But, Cam, as for Effexor, wow, withdrawal from that after max dosage, that was a HORROR story for me. So, I know some folks can do great on it, but...it's the last thing (ignorant me) would ever suggest to anybody!
Allison, I don't know anybody with A.S., but it sounds like there are some very cool things going on in this relationship. I'm currently involved with someone who is BP 2 and when he said to me "Hi, my name is Trouble and I'm looking for someplace to happen." it was a done deal (well, that may tell more about me than him...I have a thing for bad boys).
It is up and down and all over the place--sweet, loving, snipy, irritable, sarcastic, dissapointing, uplifting, making plans that may or may not come to fruition, taking care of our 'family' of 3 dogs and 1 cat, lots of UPS and DOWNS. We have common goals, and are devoted to each other. And, if he says something about my weight, I just have to muster the appropriate response...like..."Oh, yeah, look who' talkin' "....
So, yes, it is very WISE of you to consider the BIG picture
My BP and I have big fun and bad times, and it is still the best relationship I've ever had, because we both understand a bit about Mental Health issues. And, we are OLD--me 53 (and why I'm here beyond my over 50 rule) and he (a mere youngster) at 52.
If we had the bucks or insurance it might even be better, but, I love him from my brain--such as it is--right down to my toes. A rare event in the life of a statistician!
Anyhow, I'm so happy that folks have responded here. Many thanks on behalf of us oldies!
xoxoxo
Shar
Posted by NikkiT2 on April 12, 2005, at 12:52:50
In reply to Re: OK, oldsters...a call for advice » NikkiT2, posted by allisonm on April 11, 2005, at 18:37:57
My Dad and my eldest brother (15 years older) are also aspie, so its fairly normal for me!
Having a few problems with J, my aspie friend at the moment. He has fallen in love with a close mutual friend, who is married with 3 kids.. He misread all the signals, and his desire for love and affection (he doesn't get much at home as his mum has no idea how to live with an aspie really) has lead him to believe its romantic love.. Its terribly hard, and the mutual friend is in peices about it and has no idea how to handle it all.. J won't speak to me about it, so I can't help him rationalise it all and help heal the situation..
The suicide line of thought from your SO is so very typical isn't it.. It makes sense in a very black and white, incredibly logical way.. but us "normies" (as my aspie friends like to call us non-aspies!) have learnt lessons through our lives that make us know that its not all black and wite like that..
One the aspie board I use, there is always long discussion on the fact they actually, they're the "normal" people, as they think logically, and its us who let emotions cloud our feelings who are "wierd".
Sorry, kind of gone off on a rant there!
Oh, and SSRI weigt gain is the PITS.. the utter pits. I'm a year clear of meds now, but the weight just won't shift. I eat no more than the skinny girls at work, but I am just a fat whale..
Your weekend sounded awesome by the way.. so so nice!! *g*
Nikki xx
Posted by NikkiT2 on April 12, 2005, at 12:59:45
In reply to Al and Cam, posted by Shar on April 12, 2005, at 2:16:49
hey, I'm not an oldie, I'm a mere spring chicken *G* (Though that biological clock has stared counting fitting 3 babies, and I've started looking at jobs for things like pension and maternity benefits *L*)
*G* Sounds like you and BP have some fun *G* I love the line he used! Please tell me (even if you have to lie *L*) he was wearing a cowboy hat when he said it!!! *G* You had a real sparkle in your voice (type? you know what I mean!) when you spke about your relationship.. and thats really lovely to see!
And.. I have to agree with you completely re; effexor.. It was the worst hell I have ever been to, and I would not, and could not, wish that on my worst enemy..
You sound good today, THATS why you're here over your 50 rule :)
Nikki xxx
Posted by allisonm on April 12, 2005, at 21:46:51
In reply to Re: OK, oldsters...a call for advice » allisonm, posted by NikkiT2 on April 12, 2005, at 12:52:50
I met with my pdoc today and further discussed the continuing downturn in mood and his suggestion of upping the Zoloft.
He thinks it's a combination of increased sucky life with Zoloft poop-out. He agreed with Cam that weight gain probably wouldn't happen with an increase in dose. He also suggested upping the Wellbutrin XL as an alternative because he said he's found WB is better at addressing feelings of no energy and inertia. So we decided to up the WB XL from 300mg to 450 and leave the Zoloft at 50mg.
I told him about the mini vacation at Saratoga Springs, and he was similarly surprised that my SO would suggest it. I also mentioned how my SO (during our argument about weight gain) said that he cared about me, and also repeated same last night on the phone. He's never said that before...typical of Aspergers. My pdoc thought that was a major change in my SO and seemed optimistic. I felt better when I saw this reaction. That maybe bringing up the weight issue is just his way (awkward, tactless way) of trying to show that he cares.
Posted by allisonm on April 12, 2005, at 22:03:14
In reply to Re: OK, oldsters...a call for advice » allisonm, posted by NikkiT2 on April 12, 2005, at 12:52:50
Saratoga Springs was really nice. We went to the Roosevelt bathhouse, which was built in the 1930s and is located in the state park. They renovated the place, but kept the original tile on the walls and the original bathtubs, which are quite long and very deep so that you have to step down into them. They are designed so that you can immerse your entire self in the mineral water including your knees and shoulders. The mineral spring water is brown, naturally carbonated, and heated to however you want it.
Then I had a hot stone massage. Heaven!!
My sweetie had a Reiki adjustment, which he seemed to like.
We stayed at a bed and breakfast just a few blocks away from the quaint downtown. Our room was large with lots of windows and a private second-floor porch, where we sat outside on the first evening (it was unusually warm) and drank wine and watched the world go by. We were still in the off-season, so prices were high, but not astronomical. Downstairs, there were two gas fireplaces and several sitting rooms with lots of antiques and comfy corners. They also had a wonderful wrap-around porch with lots of white wicker chairs with thick cushions. And there is a resident cat who craves attention. And they served warm cookies out of the oven daily at 4 p.m. Oh, Nikki, I could go on and on... There are several natural springs downtown that run into old stone catch basins under Victorian gazebos. One spring has water that tastes just like Alka-Seltzer. My sweetie bottled some to take home. It smells like sulphur, but is terrific for settling the stomach. The other springs are simply good-tasting, un-messed-with mineral water.
The racetrack there wasn't open yet, but was quite picturesque and historic-looking. And there are lots of shops and boutiques downtown, and restaurants, and bars... We stayed two nights. It was a very nice, quick get-away.
Posted by shar on April 13, 2005, at 1:29:34
In reply to Update on meds, posted by allisonm on April 12, 2005, at 21:46:51
A,
Well, I would like to see you get on WB which is activating, AND up the Z some. But, that's just me. I don't have the chemical knowledge to support it, just personal experience.I take WB now, and do not fear it as I do Effexor. I also had great luck with Risperdal until the tremors set in. Then we tried Nortrip, and I was so nauseated all the time I couldn't do it.
So, I think a little WB (which may actually help with the weight gain...as in losing some), plus a little more Z could make a difference.
HOWEVER, most important of ALL...this needs to happen so that YOU, YOURSELF can feel better. Not to please someone else!! If your Mister can't take some weight gain and weigh (no pun intended) it against your whole being (body, mind, spirit)...well, that is very good information for YOU.
It's like having a dis-ease. "Well, I might be able to get better, but this or that med might cause weight gain; and then..." Pooh! If you had diabetes or heart trouble or something else, would it still be the same? If so...more good information for you.
Anyhow, I hope you do extra-special-great in dealing with all of this! This post is only me ranting, and nothing more.
xoxo
Shar
Posted by shar on April 13, 2005, at 1:50:05
In reply to Re: Al and Cam » Shar, posted by NikkiT2 on April 12, 2005, at 12:59:45
Nik,
No offense meant by oldies. I meant it 'categorically' not personally. But, I do wonder, about youngsters (well, younger than 53) having kids and maybe passing on depressive genes. I had my son at 18, so that knowledge was not even in the equation then.My Sweetie has no children, and I don't have any plans to! But, he is the end of his line; the last male of his original family. And, I know women can have kids late in life, but I don't really pursue the issue because (a) I almost died when I was pregnant before and (b) what would he and I create with our diagnoses? God forbid I would pass on a life of desperation or otoh BP2 to an innocent being.
In answer to your question about fun, etc......Well, of course! We were in bed and he had his cowboy hat, chaps, spurs, and boots on when he said it!
Total Lie! He actually had very little on, because he's not from Texas! He is a blue blood from blue grass country.
We do have some fun! He totally understands my bent sense of humor, and tells the most hilarious stories, that sometimes I request them. Like a kid "Tell me about the time...". Even just thinking about the stories makes me laugh (not just smile).
A good thing for me to remember when his/my dark days are present....
"THATS why you're here over your 50 rule" well, maybe you're right. I think it is only kindliness on his part because he knew I was so close to the end. But, he seems to like it here ok.
xoxo
Shar
> hey, I'm not an oldie, I'm a mere spring chicken *G* (Though that biological clock has stared counting fitting 3 babies, and I've started looking at jobs for things like pension and maternity benefits *L*)
>
> *G* Sounds like you and BP have some fun *G* I love the line he used! Please tell me (even if you have to lie *L*) he was wearing a cowboy hat when he said it!!! *G* You had a real sparkle in your voice (type? you know what I mean!) when you spke about your relationship.. and thats really lovely to see!
>
> And.. I have to agree with you completely re; effexor.. It was the worst hell I have ever been to, and I would not, and could not, wish that on my worst enemy..
>
> You sound good today, THATS why you're here over your 50 rule :)
>
> Nikki xxx
Posted by coral on April 14, 2005, at 16:51:12
In reply to OK, oldsters...a call for advice, posted by allisonm on April 9, 2005, at 19:48:31
While I have no way of accounting for it, but Zoloft has never pooped out on me. During the bleakest time of my depression, it took 200 mgs for six months to work. I've gone for years w/o Zoloft. However, during the episodes when I found it necessary, it actually seems more potent. Max I've ever used since the "dark days" was 50mgs. Finding Zoloft was like finding a miracle, after an agonizingly long time of other drugs completely failing to work.
So, for me . . .
Side effects? Yes, mental zinging going on/off, sexual delays, and dry mouth.
Benefits? Absolutely. As someone said, it's like putting a floor underneath oneself, allowing one to get balanced.
Coral
Posted by shar on April 16, 2005, at 0:52:34
In reply to Re: Coral -- the exception, posted by coral on April 14, 2005, at 16:51:12
Hi, Coral!
Oh, sure, you ALWAYS have to be special! lololol! I'm just giving out some BS here, nothing bad meant!
I suggested to my pdoc (when we had our last visit like 3 years ago) that I wanted to try Zoloft again, in conjunction with Wellbutrin, and he said if it pooped out before, it probably will again. So...much to my regret we didn't try. I actually believe it might help; AND that it also might poop out again with me.
But, it makes me wonder, if it helps me for 6 months, and I can use the energy from it to find a decent job, well...I can white-knuckle it through the next 3 years. But, I was the minority opinion there.
My belief (well, my WP has done most of the research in this area) is that the current anti-d research/activity is exceedingly shortsighted, not taking into consideration that it's 3!! neurotransmitters that need to be in balance; not just one or two, and people in the US are so freaked about things that up dopamine levels.
Oh, well, that's just my take. If I had a chance to do Zoloft again I definitely would (if I could afford it) but I can't even afford a visit to a pdoc who might be up for prescribing it. But, it's like the brass ring in my mind.
Great to hear from everyone!!
xoxo
Shar
This is the end of the thread.
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