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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by SDA on April 16, 2004, at 16:47:34
First a little back story: I guess I'd say I've been depressed for around 6 months. There had been spells of feeling "alright" or intensely worried/nervous. Mostly though, I felt extreme self loathing and near-suicidal depression and regret. The only thing that was almost constant was a very noticeable drop in my ability to think. I went very quickly from feeling like a genius to having difficulty with simple algebra and arithmetic. These problems started at least a few weeks before I felt depressed.
I've taken a couple different meds since about a month after the onset. Prozac was the worst, and almost agitated my thoughts to the point of suicide. I've been on Zoloft for 4 or more weeks now. I worked my way up to 100mg, but had to drop back down to 75mg because it just felt like too much to me.
How I'm feeling now: I still have feelings of unreality (or "brain fog") and occasional depressive/crying spells. Mostly I just feel mentally and physically ill with the absence of major sadness. I can try to do my class work (physics mostly), but most of the time my brain just won't budge; it almost hurts to think in the same way it hurts to bike up a very steep hill. There are other times, however, when the ability to think abstractly (calculus ect.) and juggle concepts around in my mind returns. These tend to be brief windows of opportunity, so I try to do as much as I can before I take another nose-dive. Trying to get my brain working in this state is much like trying to start up a rusty old lawn mower.In addition to these cognitive ups and downs, I also often get a fuzzy sensation in my head (almost as if pressure is being applied form within the skull). These feelings tend to get worse with lack of sleep, but sometimes happen regardless. I could be wrong, but it seems like they have become much more frequent over the past few weeks. Sometimes I feel intolerant of bright lights (i.e. its painful to stare at my computer monitor) and have difficulty focusing my vision.
I guess its feeling more and more like I'm bipolar (periods of "creative madness" and mental slumps). My question for you is if this is typical when one is recovering from depression, and if it ever smoothes out.
Posted by Sad Panda on April 17, 2004, at 6:39:07
In reply to does it sound like my Zoloft is working?, posted by SDA on April 16, 2004, at 16:47:34
> First a little back story: I guess I'd say I've been depressed for around 6 months. There had been spells of feeling "alright" or intensely worried/nervous. Mostly though, I felt extreme self loathing and near-suicidal depression and regret. The only thing that was almost constant was a very noticeable drop in my ability to think. I went very quickly from feeling like a genius to having difficulty with simple algebra and arithmetic. These problems started at least a few weeks before I felt depressed.
>
> I've taken a couple different meds since about a month after the onset. Prozac was the worst, and almost agitated my thoughts to the point of suicide. I've been on Zoloft for 4 or more weeks now. I worked my way up to 100mg, but had to drop back down to 75mg because it just felt like too much to me.
>
>
> How I'm feeling now: I still have feelings of unreality (or "brain fog") and occasional depressive/crying spells. Mostly I just feel mentally and physically ill with the absence of major sadness. I can try to do my class work (physics mostly), but most of the time my brain just won't budge; it almost hurts to think in the same way it hurts to bike up a very steep hill. There are other times, however, when the ability to think abstractly (calculus ect.) and juggle concepts around in my mind returns. These tend to be brief windows of opportunity, so I try to do as much as I can before I take another nose-dive. Trying to get my brain working in this state is much like trying to start up a rusty old lawn mower.
>
> In addition to these cognitive ups and downs, I also often get a fuzzy sensation in my head (almost as if pressure is being applied form within the skull). These feelings tend to get worse with lack of sleep, but sometimes happen regardless. I could be wrong, but it seems like they have become much more frequent over the past few weeks. Sometimes I feel intolerant of bright lights (i.e. its painful to stare at my computer monitor) and have difficulty focusing my vision.
>
> I guess its feeling more and more like I'm bipolar (periods of "creative madness" and mental slumps). My question for you is if this is typical when one is recovering from depression, and if it ever smoothes out.
>
>Hi SDA,
It sounds like Zoloft is trying, but it's just not the right med for you. I'd maybe try one more SSRI like Lexapro & if that fails give Effexor a try. Another thing you could try would be to add a sedating AD like Remeron to give you a solid nights sleep if you aren't already.
Cheers,
Panda.
Posted by SDA on April 17, 2004, at 20:38:53
In reply to Re: does it sound like my Zoloft is working? » SDA, posted by Sad Panda on April 17, 2004, at 6:39:07
I should note that I was on Zoloft for a few years at 200mg for OCD. This was when I was in my early teens. I was also taking Wellbutrin for "depression". I think this was more due to my parents making inaccurate observations of my behavior and my pill-happy doctor pushing pills down my throat. What I experienced back then was NOTHING compared to the depression I've been going through for the past several months.
I stopped taking all of my meds before starting college. It seemed to me that without them I was a new person, and I liked it.
As you can see, I'd be VERY hesitant to start loading up on medications again. I am curious about MAOIs though, since I hear that they don't interfere with your personality or intellect.
Posted by Sad Panda on April 18, 2004, at 2:35:30
In reply to Re: does it sound like my Zoloft is working?, posted by SDA on April 17, 2004, at 20:38:53
> I should note that I was on Zoloft for a few years at 200mg for OCD. This was when I was in my early teens. I was also taking Wellbutrin for "depression". I think this was more due to my parents making inaccurate observations of my behavior and my pill-happy doctor pushing pills down my throat. What I experienced back then was NOTHING compared to the depression I've been going through for the past several months.
>
> I stopped taking all of my meds before starting college. It seemed to me that without them I was a new person, and I liked it.
>
> As you can see, I'd be VERY hesitant to start loading up on medications again. I am curious about MAOIs though, since I hear that they don't interfere with your personality or intellect.
>
>I would not tolerate a drug that altered my personality or intellect at all. Zoloft is the best of the SSRI's, but it isn't for everyone, I would recommend you try a different SSRI such as Lexapro before moving on to a different class of drugs. MAOI's are the best AD's, but have diet & drug restrictions which might cause an anxious person to be more anxious. Some of the TCA's are still good AD's too. The only real reason for the existance of SSRI's is the overdose factor. It's unlikely you can OD on a months supply of SSRI's, but you can OD on a months supply of TCA's, so doctors are happier to give out SSRI's. Most suicidal patients don't use their pills anyhow.
Cheers,
Panda.
Posted by psychosage on April 18, 2004, at 23:41:20
In reply to Re: does it sound like my Zoloft is working?, posted by SDA on April 17, 2004, at 20:38:53
> I should note that I was on Zoloft for a few years at 200mg for OCD. This was when I was in my early teens. I was also taking Wellbutrin for "depression". I think this was more due to my parents making inaccurate observations of my behavior and my pill-happy doctor pushing pills down my throat. What I experienced back then was NOTHING compared to the depression I've been going through for the past several months.
>
> I stopped taking all of my meds before starting college. It seemed to me that without them I was a new person, and I liked it.
>
> As you can see, I'd be VERY hesitant to start loading up on medications again. I am curious about MAOIs though, since I hear that they don't interfere with your personality or intellect.
Did wellbutrin work for you? I was thinking low dose Zoloft with some wellbutrin. I was on both, and once I had them in a combo of Z 37.5 {yes!}/WB 300mg.All serotonergic drugs as far as i am concerned basically make you stoned, in relation to a high-functioning alert brain handling a lot of intellectual work.
You really have to balance out your needs between your intellect and your relationship to your emotions. They work well together if there is balance. If not, they both become pathologized, so your intellect sputters and your emotional side is inarticulate.
Provigil is a wonderful adjunct that I enjoy,
Zoloft definitely made me sleep an hour extra every day.
Posted by SDA on April 19, 2004, at 1:05:46
In reply to Re: does it sound like my Zoloft is working? » SDA, posted by psychosage on April 18, 2004, at 23:41:20
I have absolutely no idea if the Wellbutrin worked or not. Like I said, I don't think I was truely depressed back then. I was also too young to know any better.
As for the intellect/emotions thing: I'm currently at a top university majoring in physics. Obviously I value intellect VERY hightly. At the moment I don't feel terribly sad at all, just mentally crippled and physically ill.
Posted by SDA on April 19, 2004, at 1:24:34
In reply to Re: does it sound like my Zoloft is working? » psychosage, posted by SDA on April 19, 2004, at 1:05:46
> I have absolutely no idea if the Wellbutrin worked or not. Like I said, I don't think I was truely depressed back then. I was also too young to know any better.
>
> As for the intellect/emotions thing: I'm currently at a top university majoring in physics. Obviously I value intellect VERY hightly. At the moment I don't feel terribly sad at all, just mentally crippled and physically ill.Scratch that. A wave of saddness just hit me, and I started spontaneously crying and comtemplating suicide. After about 5 minutes I was more or less alright.
Maybe I really am bipolar. Here's a little more backsotry that points in this direction:
As I said before, last year (my freshman year in college) I went off meds for the first time since age 11. I felt like a new person, and I liked it. On the other hand, a lot of weird things started coming up, although I didn't pay enough attention to them at the time. I somehow got into the habbit to getting only a couple hours of sleep on week nights, but still pulled off straight A's. My self esteem was also WAY too high, and I had the classic "racing thought" of a manic person. Perhapse my number finally came up, and the boom has finally gone bust on me.
Posted by psychosage on April 19, 2004, at 11:11:40
In reply to Re: does it sound like my Zoloft is working?, posted by SDA on April 19, 2004, at 1:24:34
> > I have absolutely no idea if the Wellbutrin worked or not. Like I said, I don't think I was truely depressed back then. I was also too young to know any better.
> >
> > As for the intellect/emotions thing: I'm currently at a top university majoring in physics. Obviously I value intellect VERY hightly. At the moment I don't feel terribly sad at all, just mentally crippled and physically ill.
>
> Scratch that. A wave of saddness just hit me, and I started spontaneously crying and comtemplating suicide. After about 5 minutes I was more or less alright.
>
> Maybe I really am bipolar. Here's a little more backsotry that points in this direction:
>
> As I said before, last year (my freshman year in college) I went off meds for the first time since age 11. I felt like a new person, and I liked it. On the other hand, a lot of weird things started coming up, although I didn't pay enough attention to them at the time. I somehow got into the habbit to getting only a couple hours of sleep on week nights, but still pulled off straight A's. My self esteem was also WAY too high, and I had the classic "racing thought" of a manic person. Perhapse my number finally came up, and the boom has finally gone bust on me.
Wow, that was some mood swing. Well, I have been in and out of an elite university in the Northeast for a very very long time. Meds knocked me out the last time, so I do suggest you be very very vigilant about your side effects.I suggest you stay close to your counseling and psychological services in the event of a crisis. You may also need some people to vouch for you in case you need accomodations to finsih your work as the semester ends.
You can bring up the issue of the bipolar possibility with a psychiatrist and or therapist. You are at the age where it begins to really manifest itself, so it would be good to catch it early.
Here are some good links, and think about asking your pdoc for wellbutrin or any other options.
Generally, SSRIs {anything serotonergic}, mood stabilizers {maybe not keppra, an anticonvulsant occasionally used as a MS} and neuroleptics {maybe not abilify} compromise the very functions you are worried about. however, perhaps you are at the point where you have to step back and like I said before, take care of your emotions. It is really hard to think in that way when you are used to being hyperbusy and high-achieving, but you won't be functioning optimally down the road if you don't slow down.
Good luck! Also, don't be hesitant to walk into an ER if you are suicidal or self-injurious.http://www.thecrimson.com/mentalhealthseries.aspx
http://www.mcmanweb.com/index.htmlhttp://bipolar.about.com/library/howto/ht-explain.htm
Check out Dr. Kay Jamison from Johns Hopkin.
http://www.medscape.com/viewarticle/418724?WebLogicSession=P98TwdNSwgRUL7qZqRH69mlKakc0BI3QiPi4tFFB2lo8YpJ9qO6Q|5556142915857907078/184161392/6/7001/7001/7002/7002/7001/-1
Posted by bobbiedobbs on May 3, 2004, at 13:54:35
In reply to Re: does it sound like my Zoloft is working? » SDA, posted by psychosage on April 19, 2004, at 11:11:40
Thought your remarks on the tightwalk of treating emotional difficulties while maintaining intellectual/cognitive functions was very well expressed. Hits at the heart of many individuals' difficulties in seeking relief while being able to continue to meet their external (and internal) intellectual needs. This is often underappreciated by therapists who rightly advise patients to stay the course when acclamating to a medication but who don't fully appreciate the difficulties. Perhaps the PDOCs have limited choices, or perhaps they need to ramp up their "bedside" counsel. In any case, I just wanted to say I appreciated your counsel in this string. That said, if Nardil worked for me and didn't make me tired, but stopped being effective after several years, and I've had cognitive difficulties/the "out of it" effect on Lexapro, Prozac and Luvox, would you suggest Zoloft, Effexor or Marplan. I am team leader of a group that writes job aids. The work, and managing ornery personalities, requires a bit more energy and cognition than I seem to have at the moment. Thanks, PHil
> > I have absolutely no idea if the Wellbutrin worked or not. Like I said, I don't think I was truely depressed back then. I was also too young to know any better.
> > >
> > > As for the intellect/emotions thing: I'm currently at a top university majoring in physics. Obviously I value intellect VERY hightly. At the moment I don't feel terribly sad at all, just mentally crippled and physically ill.
> >
> > Scratch that. A wave of saddness just hit me, and I started spontaneously crying and comtemplating suicide. After about 5 minutes I was more or less alright.
> >
> > Maybe I really am bipolar. Here's a little more backsotry that points in this direction:
> >
> > As I said before, last year (my freshman year in college) I went off meds for the first time since age 11. I felt like a new person, and I liked it. On the other hand, a lot of weird things started coming up, although I didn't pay enough attention to them at the time. I somehow got into the habbit to getting only a couple hours of sleep on week nights, but still pulled off straight A's. My self esteem was also WAY too high, and I had the classic "racing thought" of a manic person. Perhapse my number finally came up, and the boom has finally gone bust on me.
>
>
> Wow, that was some mood swing. Well, I have been in and out of an elite university in the Northeast for a very very long time. Meds knocked me out the last time, so I do suggest you be very very vigilant about your side effects.
>
> I suggest you stay close to your counseling and psychological services in the event of a crisis. You may also need some people to vouch for you in case you need accomodations to finsih your work as the semester ends.
>
> You can bring up the issue of the bipolar possibility with a psychiatrist and or therapist. You are at the age where it begins to really manifest itself, so it would be good to catch it early.
>
> Here are some good links, and think about asking your pdoc for wellbutrin or any other options.
>
> Generally, SSRIs {anything serotonergic}, mood stabilizers {maybe not keppra, an anticonvulsant occasionally used as a MS} and neuroleptics {maybe not abilify} compromise the very functions you are worried about. however, perhaps you are at the point where you have to step back and like I said before, take care of your emotions. It is really hard to think in that way when you are used to being hyperbusy and high-achieving, but you won't be functioning optimally down the road if you don't slow down.
>
>
> Good luck! Also, don't be hesitant to walk into an ER if you are suicidal or self-injurious.
>
> http://www.thecrimson.com/mentalhealthseries.aspx
>
>
> http://www.mcmanweb.com/index.html
>
> http://bipolar.about.com/library/howto/ht-explain.htm
>
> Check out Dr. Kay Jamison from Johns Hopkin.
>
> http://www.medscape.com/viewarticle/418724?WebLogicSession=P98TwdNSwgRUL7qZqRH69mlKakc0BI3QiPi4tFFB2lo8YpJ9qO6Q|5556142915857907078/184161392/6/7001/7001/7002/7002/7001/-1
>
> http://www.bipolarworld.net/job_school/job_school.htm
>
> http://www.crazymeds.org
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