![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by KCSLL on February 3, 2006, at 18:39:18
First of all I apologize for making this such a long posting…If anyone can help me I would really appreciate it. I am looking for suggestions on which antidepressant I should try.
I have been extremely unmotivated and depressed for quite some time now. I cannot get out of bed in the mornings and feel like sleeping all of the time. My moods are very up and down but for the most part I am incredibly unhappy and completely unmotivated. I am not suicidal although, I can honestly understand now more than ever why people end their own lives.
I work on a computer out of my house which is a huge part of my problem. I cannot change my job mostly because I do not know what else I could do and also because I do have the opportunity to make good money. I used to enjoy my work and now I hate it. Things have gotten so bad that I think I am going to start losing all of my customers. I start things and cannot finish them and therefore cannot charge for work I have done. I am so behind on deadlines and on promises I have made to get work done and I just cannot do the work.
I have a 3 1/2 year old, I am a single mother (with no support from the father) and I am scared because I think I am going to lose everything. I have always had perfect credit but now I have gotten myself so behind in payments with some credit cards that I cannot answer my phone if I do not recognize the number. This is a result of not having any motivation to work or to do anything.
I have absolutely no social life and I rarely leave my house unless I have to. Anyone that has known me cannot believe how I have changed. I have always been very outgoing and very social and have always had a lot of friends. Now I feel so alone and really don't have anyone to talk to. Also, I don't even know what to say any more if I do get an opportunity to talk about my problems because I am so sick of complaining about the same things for so long.
I think a big reason I have become this way is from being a single parent. I have had to work so hard to pay for everything that I could never do anything socially and I let the rest of my life fall apart. I worked every opportunity I had because I did not have another choice. I still had a hard time keeping up financially and slowly I got into more and more debt. Because I worked so much I think I got burnt out and maybe I will start to enjoy my work again one day.
I am currently taking Dexedrine for ADD. I take 2 (5mg) pills three times a day. Dexedrine should help me feel motivated and it does a little but I find I need to take 2 1/2 or 3 (5mg) pills to feel any motivation. Because Dexedrine is so controversial I don’t think my doctor would increase my dosage.
Sorry this is so long. I wanted to explain a bit of my situation so anyone that could offer advice would be able to understand me a bit.
I am going to see my doctor to ask for an antidepressant. My doctor does not know a lot about them so I want to go in knowing exactly what I want. If anyone has any suggestions on what I should try that will help me feel better and feel motivated please let me know.
Thank you very much for your help!
Posted by bogeydune on February 3, 2006, at 19:15:09
In reply to Help Me Please, posted by KCSLL on February 3, 2006, at 18:39:18
Ohh, sweetie,
I'm sorry everthing seems so bad. It's ok to complain...
Have you considered seeing a psychiatric mental health nurse practitioner? They are usually less expensive than doctors, and are trained in the psycotrophic meds. From my experience, seeing a psychologist or therapist weekly helps, because they have a better view to see if the meds are helping over time. She can help you work through your depression, and teach you ways to overcome it. Try throwing the question out to people you know "do you have a good therapist?" You'd be suprised to find out how many people see them.Maybe try a debt consolidation now to help with the fear of those phone calls... sometimes after the problem is addressed, the anxiety goes away.
Hang in there, and be open to the different types of help available...
You're obviously very strong to have come this far.
Posted by forgetful mary on February 3, 2006, at 19:20:02
In reply to Help Me Please, posted by KCSLL on February 3, 2006, at 18:39:18
The first thing you need to do is to see a Doctor...a medical dr to see if there is a medical reason that prompted your lack of concentration. MNY THINGS CAN CAUSE IT...LIKE tHYROID...SO MAKE SURE YOU DO THAT FIRST. next SEE IF A GOOD DR ,pdoC CAN EVALUATE WHAT YOU NEED FOR MEDS OR IF THE MED YOU CURRENTLY TAKE IS NOW CAUSING A PROBLEM...You need a diagnosis first....As far as being asingle parent, I was one too and usually that is a motivator as you are taking care of a child, IF you hate your job after you feel better. no amount of $$ is worth being miserable, then explore other options BUT it may be your depression making you feel that way,,...(sorry for caps,a Boo Boo!) Good Luck
> First of all I apologize for making this such a long posting…If anyone can help me I would really appreciate it. I am looking for suggestions on which antidepressant I should try.
> I have been extremely unmotivated and depressed for quite some time now. I cannot get out of bed in the mornings and feel like sleeping all of the time. My moods are very up and down but for the most part I am incredibly unhappy and completely unmotivated. I am not suicidal although, I can honestly understand now more than ever why people end their own lives.
> I work on a computer out of my house which is a huge part of my problem. I cannot change my job mostly because I do not know what else I could do and also because I do have the opportunity to make good money. I used to enjoy my work and now I hate it. Things have gotten so bad that I think I am going to start losing all of my customers. I start things and cannot finish them and therefore cannot charge for work I have done. I am so behind on deadlines and on promises I have made to get work done and I just cannot do the work.
> I have a 3 1/2 year old, I am a single mother (with no support from the father) and I am scared because I think I am going to lose everything. I have always had perfect credit but now I have gotten myself so behind in payments with some credit cards that I cannot answer my phone if I do not recognize the number. This is a result of not having any motivation to work or to do anything.
> I have absolutely no social life and I rarely leave my house unless I have to. Anyone that has known me cannot believe how I have changed. I have always been very outgoing and very social and have always had a lot of friends. Now I feel so alone and really don't have anyone to talk to. Also, I don't even know what to say any more if I do get an opportunity to talk about my problems because I am so sick of complaining about the same things for so long.
> I think a big reason I have become this way is from being a single parent. I have had to work so hard to pay for everything that I could never do anything socially and I let the rest of my life fall apart. I worked every opportunity I had because I did not have another choice. I still had a hard time keeping up financially and slowly I got into more and more debt. Because I worked so much I think I got burnt out and maybe I will start to enjoy my work again one day.
> I am currently taking Dexedrine for ADD. I take 2 (5mg) pills three times a day. Dexedrine should help me feel motivated and it does a little but I find I need to take 2 1/2 or 3 (5mg) pills to feel any motivation. Because Dexedrine is so controversial I don’t think my doctor would increase my dosage.
> Sorry this is so long. I wanted to explain a bit of my situation so anyone that could offer advice would be able to understand me a bit.
> I am going to see my doctor to ask for an antidepressant. My doctor does not know a lot about them so I want to go in knowing exactly what I want. If anyone has any suggestions on what I should try that will help me feel better and feel motivated please let me know.
> Thank you very much for your help!
Posted by Racer on February 3, 2006, at 19:32:39
In reply to Help Me Please, posted by KCSLL on February 3, 2006, at 18:39:18
First the bad news: I don't think you can go in to your doctor with an answer that will work for you. These drugs are way too variable in people's responses to them, so there is no one right answer, not even for people with very similar symptoms. If your doctor does not know enough about antidepressants to prescribe one to you, then I strongly recommend that you see a psychiatrist who specializes in medications to find the right drug for you. If that's absolutely not an option, then I guess asking your GP to do some research himself to help you. Maybe find a couple of drugs that might be options for you, and suggest that one of them might help, and then ask him to find out which would be the most appropriate to start you on?
As for your situation, yes, antidepressants will help with it, but I think some behavioral work will help, too. I say that having been in very similar circumstances (without a child in the equation), and knowing that it's very close to impossible to get up enough steam to start any sort of project like that. I guess the first step would be to try to make a list of baby steps that would add up to an improvement in your situation. Maybe a list that starts with "make a list of all the bills that are behind; make a list of all the bills that are up to date; call the first bill on the first list to make payment arrangements; etc." (Trust me on this -- the accounts receivables people you're going to be talking to are much easier to deal with when you call them to arrange payments.) Baby steps, like do one thing per day. If you do that one thing every day, eventually everything on your list will be done, although you'll have a new list by then ;-) Seriously, though, once you get a chore or two done, it'll get easier.
I think getting in touch with some friends would help, too, just because it sounds as though you've gotten pretty isolated. Doing something with a friend, even just a nice long sit down together, might just give you the jump start you need to do something.
Back to meds: generally, doctors do things in a sort of order, based largely on safety. First they'll try SSRIs, because they have the fewest and most benign side effects. It seems as though doctors are really liking Lexapro right now, and that the people who find it effective like it a lot, too. Next would be the newer drugs, like Effexor and Remeron, which have a different set of side effects, which can be more problematic than the SSRIs. If those options don't help, the next class would probably be the tricyclics, or TCAs. They have more and more significant side effects, though, although they are very effective drugs. If that fails, too, MAOIs are the last major class of antidepressants, and they're usually the last t be tried, because they require a somewhat restricted diet, and the effect of eating a forbidden food can be quite serious. If you're more concerned with getting relief, and are willing to give up certain foods in order to do it, then MAOIs are sometimes considered the big guns of ADs, because they work pretty reliably, by all accounts.
Good luck.
Posted by KCSLL on February 3, 2006, at 20:54:01
In reply to Re: Help Me Please, posted by Racer on February 3, 2006, at 19:32:39
Thank you to each of you for your kind support. I really appreciate the time you have all taken to reply to my posting.
I know that seeing a psychologist would be the best thing I could do but I do not have extended medical coverage and cannot afford one right now. I did find a great counsellor (who is funded through the government). Unfortunately I have not been able to see her lately because I have moved and she is far from my new place. I will get myself there again because she was very good to talk to and I learned a lot going to see her. From the sessions I had with her I have learned that I am addicted to chaos and actually cause a lot of the chaos in my life. I do believe this is true and I think what has happened is it has just gotten so out of control that I am breaking down. She strongly suggests I go on a silent retreat for 10 days. She said I would get more out of that than all of the counselling she could ever give me. Of course because of the chaos I cannot take the time off of work to go to the silent retreat to help with the chaos in my life.Thank you also for the information about the medications. Knowing the order as you explained them is very helpful. I tried to look up some information earlier about the different classes of antidepressants and got a little overwhelmed at all of the information and didn’t really know where to start. You made it clear for me. I tried Citalopram about a year ago. I didn’t really feel anything on it but I may not have been on it long enough to know. I am going to see my doctor tomorrow and want to be educated a bit about what I would like to try. I will use the information you provided to look into some different options. I will also take the advice to see if there may be a medical reason why I am feeling like this. I have been tested for a hyper thyroid a few times in the past because I have some of the symptoms. I did not know that your thyroid could have something to do with depression, I am going to ask my doctor to test it again. Depression seems to run in my family. I have felt down at times in my life and believe that I have definitely been depressed before but this time is just so different because I have felt this way for so long and feel so hopeless this time. I have always been a very strong person and able to overcome just about anything and now I feel completely defeated. I am the person that usually motivates other people. I always believed anyone can succeed in anything they want to and now I find it hard now to picture my life getting any better or succeeding in any aspect of it. I feel like I have had to fight so hard for everything and I have no fight left in me.
I apologize for being all over the place and I hope I am not coming across complacent and whiny. I know there is no simple solution and that I need to do like you suggested, baby steps. It is just so hard to motivate myself to do anything and so easy to do nothing.
I guess we end up like this from a bunch of different events over a long period of time and have to accept that it is going to take time to change. It is just so hard when it is you.
I really do appreciate your support, it is so nice to know that there are such kind people out there.
Thank you again all of you.
Posted by Phillipa on February 3, 2006, at 21:28:52
In reply to Re: Help Me Please, posted by KCSLL on February 3, 2006, at 20:54:01
Don't forget to have your thyroid checked. It is very important in depression/anxiety. And there are mental health clinics that can help you get medicaid if you need it. Hope that helps a bit more. Fondly, Phillipa
Posted by 4WD on February 3, 2006, at 22:34:30
In reply to Re: Help Me Please » KCSLL, posted by Phillipa on February 3, 2006, at 21:28:52
Hi.
I don't know where you live but in most places there is a county mental health system that bases its fees on your income. It's usually very inexpensive and the doctors there can be very good.
They would give you an intake interview and your would see a psychiatrist who would start you probably on an antidepressant, probably, an SSRI. Then you'd see a nurse practitioner, probably for monthly followup visits and see the doctor every 2-3 months. They could also provide counseling. A lot of the time, they will give you samples of medications until you know if one is going to work for you.
I have been where you are. It's how my depression started out, back in the 80's. What Racer said about baby steps is very true but I understand how overwhelmed you are feeling. I do think it would help if you could force yourself to call one credit card company each day to make payment arrangements. That would relieve a lot of stress and give you a beginning sense of accomplishment. Little steps give you a small bit of encouragement which kind of feeds on itself.
You may not need meds forever. But it sounds as if you do right now, to get out of the slump you are in, fast. Meds and therapy would be ideal but the meds work a lot faster than therapy.
I'll pray for you.
Marsha
Posted by blueberry on February 4, 2006, at 4:51:15
In reply to Help Me Please, posted by KCSLL on February 3, 2006, at 18:39:18
It might be a good idea to ask your doctor for a referral to someone who is very experienced with depression medications. It is important to have someone with experience and knowledge. They need to know what the best first choices might be, what to do if that doesn't work out, and they also need to be able to educate you about the medication and the process and coach you through it. Kind of hard to do all that if the doctor isn't very familiar with these meds.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.