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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by UgottaHaveHOPE on May 9, 2006, at 12:56:14
The pdocs keep saying its like flip sides of a coin. But how do you know which one is your primary? And do you take meds for your primary or both?
Posted by yxibow on May 9, 2006, at 14:41:17
In reply to Which comes first, anxiety or depression?, posted by UgottaHaveHOPE on May 9, 2006, at 12:56:14
> The pdocs keep saying its like flip sides of a coin. But how do you know which one is your primary? And do you take meds for your primary or both?
Aye, there's the rub, said Shakespeare.
When I didn't have this complicated ** of a disorder, I had dysthymia (least depressive of conditions) and some social phobia, homesickness, and various other things that contributed to anxiety feelings.
This is the big cointoss of SSRIs -- only the most sedating would probably treat both -- Luvox, and possibly Paxil. Otherwise, and one may discover neither of those two also do the same, the only combination is really an SSRI + a small dose of long acting benzodiazepine such as Klonopin (some find depressing) or Valium or possibly Ativan.
Otherwise, its a chase trying to treat both at the same time. I agree its a big problem, especially if you are not an SSRI responder. Then you probably need more stimulating things like Cymbalta or Effexor or whatever and the dose of benzodiazepine has to be even more.
A low dose of a low potency atypical like Seroquel might also be added in adjunct or instead of a benzodiazepine. If you're one of the few who responds to Buspar, that might work, though I wouldn't count on it. And then there's the gamut of AEDs -- one might respond to Neurontin or Lyrica as an adjunct to the antidepressant, but that also is a lower percentage.
just a thought-- Jay
Posted by curtm on May 9, 2006, at 14:55:45
In reply to Which comes first, anxiety or depression?, posted by UgottaHaveHOPE on May 9, 2006, at 12:56:14
Let's say "normality" comes first.
>> But how do you know which one is your primary? And do you take meds for your primary or both?
** This may seem quite hypothetical, but it makes sense.
My perspective of it from a graphing point of view is that everyone with any mood disorder, manic and/or depression, has a baseline that is pretty much set for the individual (think of it as the x-axis.
This baseline is offset from a "normal" person's baseline to your "primary" side, as you put it. A manic's baseline would be very high, and a severly depressed person's would be very low.
A wave represents your mood swings traveling above and below YOUR baseline, so first I think you would need to stabilize the intensity of your mood swings with, well, mood stabilizers to hold your baseline. Then the "stabilized" baseline could be raised or lowered in the positive or negative, whichever is the case.
That is why mathemeticians aren't psychologists...
Posted by Phillipa on May 9, 2006, at 22:16:20
In reply to Re: Which comes first, anxiety or depression? » UgottaHaveHOPE, posted by curtm on May 9, 2006, at 14:55:45
Chicken and egg. In my case I know the anxiety came first in the form of panic attacks. When they were controlled not problem let it get to panic and depressant sets in. I think the body does this to preserve sanity if nothing else. Give you time to sleep hopefully. Love Phillipa
Posted by FredPotter on May 10, 2006, at 0:18:54
In reply to Re: Which comes first, anxiety or depression?, posted by Phillipa on May 9, 2006, at 22:16:20
I often try to observe my feelings very closely, as I'm sure many people do. One of my routes to anxiety and depression is the tiny thought that I'm abandoned, alone, everything is pointless, and bang I'm both scared and depressed. As security and a sense of purpose are so crucial to our sense of well-being (happiness), any loss of them results in anxiety and depression as a duality. Perhaps it's like light being both wave-like and particle-like. Perhaps the very first thing inside us is a sense that something is wrong.
My first panic attack was 42 years ago and I still remember it. I was 17 and in bed. I didn't observe what presaged the Big Bang but it was the worst experience of my life. And if allowed to continue I think, like Phillipa, it ends in depression
Fred
Posted by curtm on May 10, 2006, at 8:49:29
In reply to Re: Which comes first, anxiety or depression?, posted by FredPotter on May 10, 2006, at 0:18:54
Hey Fred, Curt here.
Ha'ya doin' Ha'ya doin,I am interested in your studies in particle-like relationships of the manic depressive. Perhaps you have discovered a breakthrough in the research of mental disorders. Could you elaborate more about the elements and processes involved in the system?
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