![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 19 to 43 of 84. Go back in thread:
Posted by chujoe on May 1, 2010, at 9:14:53
In reply to Re: Best meds for ADD/Depression/Linkage, posted by stargazer2 on April 22, 2010, at 8:28:01
I think ADD can absolutely be an underlying cause of depression -- or comorbidity, as the pdocs so artfully put it. In my case, the ADD has contributed to a sense of worthlessness and hopelessness that's now being treated successfully with Cymbalta, but the ADD issue is still there and I'm thinking about adding an ADD med like provigil, since I can't take stims because of anxiety and tremor.
Good luck and hang in there.
Posted by stargazer2 on May 4, 2010, at 11:33:39
In reply to Re: Best meds for ADD/Depression/Linkage, posted by chujoe on May 1, 2010, at 9:14:53
Hi, you addressed your post to Linkage but he is not one of the contributors to this posting so I wasn't sure if you meant someone else.
Has Cymbalta helped you at all? I took very briefly and was not able to tolerate the side effects...literally could not get out of bed for days. Not good with depression especially when it makes you worse.
Have you tried all of the stims, which ones? Did you try Adderall? It did not make me feel like Ritalin did, which was nervous and antsy.
It had a much smoother effect. What do you know about Provigil that makes you want to try that one?
Posted by floatingbridge on May 4, 2010, at 11:44:22
In reply to Re: Best meds for ADD/Depression/Chujoe, posted by stargazer2 on May 4, 2010, at 11:33:39
Hi Stargazer and chujoe,
(Linkage's post is third from top thread.)
I could see provigil addressing That cognitive part of add for some. Didn't work for me. BTW, I don't understand the relationship of add and depression-- or add can trigger depression, if anyone cares to address that:) My pdoc did say they suspect add hangs out on the same gene as bipolar and by extension, maybe depression. (Have I dazzled you with my use of scientific jargon?)
Stargazer, how is it going?
Posted by chujoe on May 5, 2010, at 14:36:53
In reply to Re: Best meds for ADD/Depression/Chujoe » stargazer2, posted by floatingbridge on May 4, 2010, at 11:44:22
Hi, I'm just getting used to the way these boards work, so it's entirely possible I responded to the wrong person.
Cymbalta has worked pretty well for me. My history: about ten years ago I had a major period of anxiety and was prescribed Zoloft, which worked well enough that I quit taking it after a couple of years. I can't say I was exactly mentally healthy after that, but I went the better part of a decade without taking pdrugs. Then last year I had another major episode of anxiety & depression, but mostly anxiety and was again given Zoloft (100mg), which helped briefly, then got very patchy and gave me the shakes. I saw a neurologist, who diagnosed essential tremor -- it's not that bad, but the Zoloft made it worse, so I was switched to Cymbalta, first 60mg, then 90. It works, though I tend to get sleepy in the middle of the day. I still have a bit of tremor, but it's less of a problem with the Cymbalta.
So my depression is more of the "activated" variety, characterized by anxiety and intrusive thoughts. My diagnosis includes a tendency to OCD. Anyhow, because of the tremor and anxiety, my pdoc thinks I shouldn't take stims.
It's only recently -- even though I'm an old guy of 59 -- that the ADD thing has been clear to me. All my life I thought & everybody else thought I was just disorganized & even though I've had a reasonably successful professional life, in hindsight I see that I've been hampered all along by my inability to stay on task, etc. Talking to my pdoc recently, I mentioned something I'd done & she said, "That's classic ADD."
I've been reluctant to medicate for ADD -- it seems like such a middle-school malady! And I've had it all my life, so why start now? On the other hand, if I had broken my toe when I was six and always walked with a limp and then an orthopedic surgeon said he could fix it, I'd go for it, right? Currently, I'm not taking anything for it, though the Cymbalta has taken care of the H part of ADHD -- I can sit still and watch a movie now without having to get up twelve times. And the Cymbalta has also given me my cognitive powers (such as they are) back to me -- at my age you begin to wonder about dementia & I have to say it has really relieved me of that fear -- I can think again. I just have a very hard time focusing on one train of thought for very long.
Well, that's probably more than you wanted to know, but it's very nice to have found a place where one can talk about these things openly and honestly in a supportive environment.
Posted by stargazer2 on May 5, 2010, at 22:45:51
In reply to Re: Best meds for ADD/Depression/Chujoe, posted by chujoe on May 5, 2010, at 14:36:53
Welcome Chujoe...I'm somewhat of an oldtimer myself but still want to be trested for ADD as I believe it has contributed to alot of anxiety and feelings of low self esteem my whole life.
I keep thinking I'll get it all figured out and it will be too late to help me. It has affected my ability to form relationships and be able to work without getting bored or losing interest in things.
I do OK but I always thought something was getting in my way, which was my ability to remember, organize and follow through with any task.
Some have said to me, how could you have ADD if you finished college and have been able to work ...I say it wasn't easy but I forced myself to do it, plain and simple.
Glad Cymbalta helped you...I thought it was one of the worst for me...made my depression so much worse.
Posted by chujoe on May 5, 2010, at 23:01:38
In reply to Re: Best meds for ADD/Depression/Chujoe, posted by stargazer2 on May 5, 2010, at 22:45:51
Stargazer, I think a lot of successful people have various sorts of ADD issues that they have found ways to work around. I'm a college professor, which is a career that allows me to structure my own time. That can be good when I'm successful ant structuring it, but I feel like I have wasted many opportunities for advancement and greater success by being unable to get my sh*t together, letting deadlines slip by, having sixteen projects going at once, etc.
I'm having a consult tomorrow with the psych NP to talk about meds. I don't want to feel like it's too late -- I think I can still accomplish some things if I can learn to focus better. So I'd encourage you to look into treatment for ADD -- I'm certain it can contribute to depression.
Posted by floatingbridge on May 6, 2010, at 10:38:21
In reply to Re: Best meds for ADD/Depression/Chujoe » stargazer2, posted by chujoe on May 5, 2010, at 23:01:38
Hi Chujoe,
Welcome, too! My add treatment started at 50--another late-comer. The treatment addition also broke my depression--an unexpected bonus.
Good luck w/ your consult. There's a variety of treatments for add-- or adhd in your case. I'm sure you'll find something helpful that will not aggravate your tendency towards tremor. Best to you.
Posted by chujoe on May 6, 2010, at 17:53:31
In reply to Re: Best meds for ADD/Depression/Chujoe » chujoe, posted by floatingbridge on May 6, 2010, at 10:38:21
Well, this is a surprise, the NP wanted to try me on a low dose of Ritilin in addition to the Cymbalta. If it makes the tremor or anxiety worse, we'll try something else. Anybody else use this combination, or any SNRI + stim?
Posted by floatingbridge on May 6, 2010, at 18:04:08
In reply to Re: Best meds for ADD/Depression/Chujoe » floatingbridge, posted by chujoe on May 6, 2010, at 17:53:31
Chujoe,
Yes, works for me, even with my anxiety issues. I prefer an extended release stimulant. Vyanaase is good too, at least by report--haven't tried it. Best to you.
Posted by chujoe on May 6, 2010, at 19:29:20
In reply to Re: Best meds for ADD/Depression/Chujoe » chujoe, posted by floatingbridge on May 6, 2010, at 18:04:08
Thanks fb. I have anxiety too. The NP says we can go to an extended release once we see how this affects me -- I'm happy to take a slow, step-by-step approach to this.
Posted by hrguru on May 7, 2010, at 8:24:21
In reply to Re: Best meds for ADD/Depression/Chujoe, posted by chujoe on May 5, 2010, at 14:36:53
Well let's see...I am on Adderall (immediate release) for ADHD and Wellbutrin for BP Depression.
You mentioned Cymbalta: Years back, before I was on a stimulant, I used to take Cymbalta, and it worked very well for me- for anxiety and depression *I have a sneaking suspicion that it's because it made me mildly hypomanic, so there would be days I was so sublimely happy that if the sun was shining, I would literally be fighting tears of joy!* That's a good feeling of course, but an AD really shouldn't do that ;)
Then after about a year, it just stopped working. Which sucked. It was as if the pharmacist had switched my script with a placebo or sugar pills. The depression came back in full-force. So I thought, well I guess it's curtains for this drug. Word of advice, if you ever decide to stop taking it, consult your doctor first, because it's an absolutely horrendous withdrawal experience- you have to titrate off of it SUPER carefully and slowly (with your doc's help). This is coming from someone who is an ex-opiate addict (perhaps the worst withdrawals known to mankind). Now don't get me wrong...By comparison, coming off of opiates was, of course, much worse :) But Cymbalta was a nightmare to quit, and it should be handled carefully, that's all.
If it keeps workin for ya, though - stick with it! I loved it when I was on it!!
Now, as for ADD/ADHD meds: Adderall is the best I have tried and the only one I'll take is the orange oval shaped kind. The little round pink ones are awful. They're both generic brands, but I've found it actually makes a difference. With the orange ones, I feel just "normal," calm, and focused. It's a very smooth medication. If I have to take it in the afternoon or evening- I can even sleep on the stuff (but please understand, I am a freak of nature!) The pink ones have side effects (for me) which I don't like. I'm in grad school, so this is a must for me to be medicated, and the pink ones would always make me so incredibly tired (as though I had taken a sleeping pill) that I was falling asleep in the middle of class. So it was basically like I hadn't taken anything. They would sometimes make me pretty anxious to boot, which is a super fun side-effect- especially when you already had anxiety in the first place.The best medication I have ever taken for anxiety, and perhaps this works for me because I'm dx'd bipolar (I'm not sure), is Topamax. It's an anti-convulsant, and acts as a mood stabilizer. However, I do not have anxiety at all these days. It's wonderful. By the way, I have been dx'd OCD as well, and I have not had any obsessive-compulsive behavior since day 2 of taking this med. I'm really pleased with it. OCD is SO hard to find the right drug to treat, as it is a certain kind of anxiety- you understand what I mean since you and I can relate. You don't have to be bipolar to take Topamax. Some people take it for migraines, and obviously various types of epilepsy as well. In any case, you can always ask your doc for information. He/she is the expert ;)
Hope this helps (at least a little!)
Posted by chujoe on May 7, 2010, at 12:30:29
In reply to Cymbalta/ADHD/Topamax- reply to Chujoe, posted by hrguru on May 7, 2010, at 8:24:21
This is really useful information! For me, the best thing about Cymbalta was that it calmed down the core of my body, not just my mind. I realized, once I'd been on it a couple of weeks, that I had been sitting around with tensed muscles all my life! It also work very well on the slight OCD/intrusive thinking that I've had for a long time. I'll be very careful if I have to go off it, though at this point I'm very happy. I'll report back how the stims are working after I've had a few days experience. Thanks hrguru!
Posted by stargazer2 on May 7, 2010, at 13:41:37
In reply to Re: Cymbalta/ADHD/Topamax- reply to Chujoe » hrguru, posted by chujoe on May 7, 2010, at 12:30:29
Hi,
I saw my pdoc yesterday and although I had had previous success once using Adderall XR many years ago, my doc wanted me to start on Vyvanse, which he said lasts longer than Adderall XR and is similar in action (true?).Took my first dose about 10 AM and although I felt little in the first few hours, I came home and have been fairly productive since then. Too early to tell but I will post my results, if not daily, every few days. I may start a post on Vyvanse alone, to make sure others that can add their feedback see it.
I am feeling extrmely optimistic right now as I am convinced this has been the missing link inthe 20+ years of treatment for depression I have undergone, almost half my life.
I know if I was diagnosed today, I would have had a much better chance of being way beyond this point in my life. Nothing is guaranteed but I feel I have lost out to alot of opportunities due to neglecting this component of my depression.
I would be happy if I could have success with this and get back to working again, as I have at least another 10+ years to go. Of course it could all be just a figment of my imagination, but I hope and pray that this approach to treatment allows me a chance for normalcy and feeling good about myself, that I have been seeking for so long.
Fighting to have a normal life is exhausting and as long as my depression does not return with a vengeance, while I try and get the meds right, I will have a fighting chance.
Stargazer
Posted by chujoe on May 7, 2010, at 14:52:14
In reply to Started Vyvanse today/Fingers crossed, posted by stargazer2 on May 7, 2010, at 13:41:37
Stargazer, good luck with the new medication. I know exactly how you feel about lost time, but I'm trying to let go of regret and get going with my life now that I've found a way forward.
Posted by floatingbridge on May 7, 2010, at 17:41:39
In reply to Started Vyvanse today/Fingers crossed, posted by stargazer2 on May 7, 2010, at 13:41:37
Stargazer, sounds very promising. Adding a stimulant changed everything for me. My fingers are crossed! Please let us know how you do.
Posted by hrguru on May 7, 2010, at 19:33:20
In reply to Re: Started Vyvanse today/Fingers crossed, posted by chujoe on May 7, 2010, at 14:52:14
Stargazer,
Chujoe's post summed it up very, very well. Don't worry about the time you've lost. I lost so much time when I was abusing drugs and alcohol. When I became sober, I spent so much time ruminating and punishing myself for time I'd lost. I realized that if I kept spending time worrying about the past, I'd never be able to move forward with my future. I know it's so hard to do that when you have depression to deal before you can move forward with future plans. But you're taking the right steps to search for a way to relieve the depression. Don't give up! :) It might be difficult to do this right now, but try to envision all the possibilities and opportunities that lie ahead for you. These possibilities and opportunities will still be there waiting for you, once you're ready. The right med will help out a lot- it did for me. Most certainly it will help in the workplace.
ADHD is very difficult to deal with in the workplace. If coupled with depression, ADHD can lower your self-esteem even further. I know, because before I was on the right meds, this is often how I felt. I left a job because of the resulting depression (more than once). I once had a supervisor who bullied me about my ADHD, though not in so many words. For example, one time she asked me, "Do I need to speak more slowly so you can comprehend what I'm saying?" And that's just one example of her bullying. The comments were in context to my having ADHD, which I never should have told her I had. She didn't have the right to say these things, but it still hurt tremendously. It's a struggle to get your work done in (just about) any work environment when you have ADHD. But the right meds, time management tools, and organization methods help so very much!
When you also have depression, it sometimes gets to the point where you have to stop working and get yourself on a track towards wellness. And that's okay! :) Like I said, I've been there. Quitting the job (with the boss I referred to before), was one of the best decisions I've made.
The right meds are often crucial, though. And what works for one person may not be effective for another. I had to try a lot of different AD's, before I found an effective one that worked for me. It was frustrating, but in the end, WELL worth the painstaking effort! So far, so good in my case :)
What I have also found with depression, is that it's not just the right meds that get you back onto a healthy track. There are additional things which help in conjunction with the meds. Talk to your doctor and people on here for some ideas. I have a website that I love, and use for tips on how to combat depression, anxiety and bipolar disorder (as I'm dx'd with BP). Here's the website if you ever want to check it out:
www.facingus.org
It's an off-shoot of the DBSA (Depression and Bipolar Support Alliance Organization) Website.
You mentioned Adderall XR vs. Vyvanse. I'm on Adderall IR (the instant release version), which I've heard is completely different from XR. I haven't taken XR, but I have taken Vyvanse. It was moderately effective for my ADHD symptoms, and it seemed to be very effective for my depression, but that's because it caused mild euphoria. Drug-induced euphoria is not a good thing for an ex-opiate addict. It only worked 6 hours for me, and then it had a rough drop off. This really affected my mood, as you can imagine. I also noticed it made me a little bit anxious. Adderall has been much smoother, I've found, so it's a better fit for me. Plus, it doesn't make me feel euphoric at all (another reason it's a good fit for me). Vyvanse is an effective drug, though for many people- it just wasn't right for me.
I've noticed that with stimulants, you tend to be able to notice side effects soon after you first start taking the med. For me, I noticed the side effects mentioned with Vyvanse after day 1 or day 2 of first taking it.
So if it's going well for you, then that is GREAT! Don't worry about it not working well in the future. I've been on Adderall for a year and a half and it still works just as effectively as it did when I first started taking it.
Best of luck with the Vyvanse, and please keep us updated! :)
Posted by stargazer2 on May 7, 2010, at 23:03:40
In reply to Re: Started Vyvanse today/Fingers crossed, posted by chujoe on May 7, 2010, at 14:52:14
Thanks for response...good luck with your trial too. I think the shorter acting meds are alot more difficult to tolerate but the appraoch seems logical.
Posted by stargazer2 on May 7, 2010, at 23:19:11
In reply to Re: Started Vyvanse today/Fingers crossed » stargazer2, posted by floatingbridge on May 7, 2010, at 17:41:39
How long are you on Adderall now and was that the first stim they tried? When I took Adderall, it was a capsule and was the brand version and I remember it was very smooth too, nice to not have a drugged feeling.
Thanks for encourgaement, nice to know you have gotten alot of relief. Did your doc figure out you may have ADD or yourself?
Makes me wonder why no one approaches this disease with logic, like an assessment for ADD, Bipolar, anxiety with the depression eval.
Docs should be able to figure the symptoms of ADD out, especially after someone changes their jobs every year or two...or when they say they can't concentrate or read books, etc. Seems so obvious to me (now) and my inability to communicate this to him and say what I think is really happening. Not that I saw the forest through the trees.
I've been directing my care for the last few years as his approach seemed very circuitous. I told him I had no more time to waste to figure this out. Now I know we have to take control of things sooner rather than later...I just was too depressed to do much but agree and be miserable...
It just makes me angry that the so-called experts, are not experts...just random pill dispensors. Sad...
BTW: Vyvanse was $155 for 30 days.
Posted by hrguru on May 8, 2010, at 3:40:19
In reply to Re: Started Vyvanse today/FB, posted by stargazer2 on May 7, 2010, at 23:19:11
Hi Stargazer!
How long are you on Adderall now and was that the first stim they tried? When I took Adderall, it was a capsule and was the brand version and I remember it was very smooth too, nice to not have a drugged feeling.
---- I've been on it for about a year and a half, and Adderall was the first one I tried, so I kinda lucked out. The only reason I tried to switch over to Vyvanse was because I have a tough time remembering to take pills every 6 hours (imagine that!)
>
> Thanks for encourgaement, nice to know you have gotten alot of relief. Did your doc figure out you may have ADD or yourself?---- I think I've probably always known, but I wouldn't admit it for a long time. I didn't really have behavioral problems growing up, and my grades weren't that bad until I got to college. They were so bad I almost got kicked out of school. When I started grad school I finally gave in and went to the doctor. My parents were in denial as well, but my friends knew, everyone else knew. I went to the doctor for an eval. and since I was a recovering drug addict (as much as it makes me still cringe to even type that), I had to take 2 written standardized ADHD tests and some other test that would show whether or not I was likely to abuse stimulants (or something to that effect). I felt kind of like I was on trial, but at least I know it's a proper diagnosis!
> Makes me wonder why no one approaches this disease with logic, like an assessment for ADD, Bipolar, anxiety with the depression eval.
----- Yeah, it makes me wonder too! Well, when I did my outpatient treatment, they always did weekly depression and anxiety evals. But ADHD/ADD was a one-time thing for the sake of diagnostic purposes. This is stupid. Why wouldn't a doctor want to regulate these symptoms to see how the medication is helping to alleviate them? There are Bipolar evaluations as well. However, sometimes patients tend to downplay their symptoms, maybe because it's overwhelming to think "I might have bipolar disorder." I've been there. It's a surreal experience to sit there in an office and answer the doc's questions (face to face), and I found myself downplaying my own symptoms and being in denial of my disorder.
>
> Docs should be able to figure the symptoms of ADD out, especially after someone changes their jobs every year or two...or when they say they can't concentrate or read books, etc. Seems so obvious to me (now) and my inability to communicate this to him and say what I think is really happening. Not that I saw the forest through the trees.
>----- They should, but they don't always tell you their motives when diagnosing for this disorder, and here's why I think this is the case. ADHD/ADD is a strange disorder. They have wonderful meds to treat it. But, there's that one big caveat with psychostimulants- they only provide a "calming" effect if you truly have ADHD/ADD. Since, the disorder is diagnosed based on subjective information from the patient, doctors have to make sure they diagnose it properly, and medicate accordingly. Also, as we know, the symptoms of ADHD can mimic other disorders. Especially bipolar disorder. It can be very difficult to distinguish one from the other. Some people with bipolar disorder cannot take psychostimulants (as it makes them manic), so some docs like to spend time with these patients to properly diagnose. But I think a very skilled doctor can tell the subtle differences, based on symptoms, history, and behavior.
> I've been directing my care for the last few years as his approach seemed very circuitous. I told him I had no more time to waste to figure this out. Now I know we have to take control of things sooner rather than later...I just was too depressed to do much but agree and be miserable...
---- I am glad you told your doctor what was weighing on your mind. He needs to know if you aren't seeing results from his methods. Your health and well-being is what's most important :)
> It just makes me angry that the so-called experts, are not experts...just random pill dispensors. Sad...
---- I know :( You can thank drug reps for that. When I see them come into my Pdoc's office, I want to ask them how they sleep at night.
>
> BTW: Vyvanse was $155 for 30 days.---- Ugh! When I took it, there was a number you could call and do a survey, and they would send out a coupon you could use toward the next month's script. Do they still do that? Might help at least a little.
Posted by chujoe on May 8, 2010, at 8:32:29
In reply to Re: Started Vyvanse today/FB » stargazer2, posted by hrguru on May 8, 2010, at 3:40:19
This is more "philosophical" than practical, but I think pdocs are generally working with a system of categories for something called Mental Illness that does not fit very well with the actual experiences that people have. It's as if all their diagnostic tools are designed to help them decide whether patient X fits into box 1 or box 3; sometimes, it turns out, they have to slice their patients into pieces and put part in one box and part in another. Which is not very good for the patient!
But patients are also persons and we know from recent research that persons daily modify their brains by having experiences; the brain is "plastic," as they say, and responds to what happens to the person. This is not all that surprising when you think about it: If you have the experience of smoking, you are more likely to get lung cancer; if you have the experience of drinking too much alcohol, you are more like to have cirrhosis of the liver, etc. We even know, now, that the experience of being poor, or a minority, or socially marginalized is bad for your "physical" and "mental" health. (I put those words in quotes because I don't think those labels are very useful or true to the actual experience of persons.) Those of us suffering from the sorts of issues discussed on this board would do well, in my opinion, to resist becoming patients and insist on remaining persons, even when consulting with our physician, psychiatrist, therapist, etc.Our experience counts. Of course, such an attitude also requires us, as persons, to take responsibility and to make decisions that give us the sorts of experiences that will get us where we want to go -- and that may not be some other person's idea of perfect, normal, "mental health." (I actually don't think there is such a thing.)
So maybe the box model needs to be replaced with a kind of cluster diagram in which some primary problem is put in the center and then other problems are clustered around it. And that center will almost certainly change over time as our experiences change. No diagnosis is completely stable over time. If lung cancer patients stop smoking, I read in the Times yesterday, their survival rate doubles. Just because you're DXed with BP when you're 20 doesn't mean that you will always be BP, though the box model tends to force you to keep your diagnosis, to stay in your box.
The cluster diagram way of looking at "mental illness" is supported by recent studies that suggest that various diagnoses once considered separate diseases are better understood as related symptoms that shade into each other and that are modified by the person's psychology and experiences, as well as by his or her brain chemistry.
[Note: My thinking about these issues has been strongly influenced by Richard P. Bentall's book, Madness Explained: Psychosis and Human Nature, which cites dozens of studies and draws on the history of psychiatry in making its arguments. The book is sometimes technical, but never incomprehensible to the non-expert reader.]
Posted by floatingbridge on May 8, 2010, at 11:31:50
In reply to Re: Started Vyvanse today/FB, posted by stargazer2 on May 7, 2010, at 23:19:11
Hi Stargazer,
Hope today is going well.
I haven't tried adderall. Dex spansule is the only true stim I've tried. I would try vyanase, though. I like longer acting meds.
I self-diagnosised. However, my current doc is pretty hip. With my first, tentative mention we tried
a scrip. Night and day! And we had worked diligently on trd for almost a year. (Not that I'm cured;) ) We tried provigil because I couldn't get my head around stim use--but it Did not work for me :(Yes, after over ten years of treatment. No one checked my thyroid or did any other diagnostics besides a depression inventory. Perfunctory questions about past abuse left to dangle as well.
Health care has a way to go. Starts with us here as informed health care recipients as well as providers and systems.
best! fb
Posted by hrguru on May 8, 2010, at 19:34:45
In reply to Re: Started Vyvanse today/FB, posted by floatingbridge on May 8, 2010, at 11:31:50
Stargazer-
I'm really sorry. I feel really idiotic right about now. That message you posted was meant for floatingbridge, not me. Then I go and post some really long message in response to yours. It was obviously meant for FB.
Sorry about that :(
Posted by floatingbridge on May 8, 2010, at 22:37:01
In reply to Re: Started Vyvanse today/FB- oops, posted by hrguru on May 8, 2010, at 19:34:45
Hey, your input is interesting--. No apologies needed--though, I know your post was to Stargazer ;)
Best regards,
fb
Posted by hrguru on May 9, 2010, at 1:39:32
In reply to Re: Started Vyvanse today/FB- oops » hrguru, posted by floatingbridge on May 8, 2010, at 22:37:01
Thanks floatingbridge,
Your input was interesting as well- and helpful.
Sometimes these threads are a bit confusing to a novice (like myself) ;)
HRGuru
Posted by hrguru on May 9, 2010, at 3:18:46
In reply to Re: Started Vyvanse today/FB » hrguru, posted by chujoe on May 8, 2010, at 8:32:29
Hi Chujoe :)
I agree with your philosophies! People want to be treated as human beings, not as "patients." All we want is to feel better, not to be diagnosed with multiple mental illnesses simply because of shared/overlapping symptoms. The new DSM will be out in 2013, and I think they're working on making criteria for certain disorders more comprehensive & based on more subjective information from patients. You can check out their website. Their research is open to the public:
http://www.dsm5.org/Pages/Default.aspx
I think it's about time we started telling our docs what we do/don't feel comfortable with regarding our treatment, and what's effective. It surprises me that Pdocs wouldn't ask for more feedback on how meds are working. Since when did the best pharmacotherapy approach become just arbitrarily throwing dozens of meds at us as if we were medical guinea pigs? This frustrates me greatly.
I told my doc I did not feel comfortable taking a med he suggested. I asked if he would prescribe Topamax. He wasn't happy about this (they all hate this of course). He told me it would never work for BP disorder, and he laughed when I told him how well it was working to control rapid cycling. It was not quite doing the trick for my DP. Something was "missing." He recommended a pretty powerful anti-psychotic (usually used for schizophrenia). This med wasn't for me. I asked for Wellbutrin. Again, he wasn't happy, but still agreed. Amazingly, this combo worked! I told him how much better I was feeling and thanked him sincerely. He couldn't even act like he was glad I was feeling better! It was disheartening, but the fact is I am feeling so much better- so it doesn't matter how he reacted. I still find it strange, however, that there are many docs out there that seemingly want to keep us from feeling better. It's very counterproductive to treatment, to say the least.
When someone is dx'd with a mental illness, it's so often referred to as a "disease"- which to me says two things. One, it's a serious illness (often it is), and two it's possibly going to be life-long. The second bothers me. My doc tells me all the time that BP disorder is "life-long," it's "pervasive," & can "never be cured"- even though I have shown so much improvement. I haven't had a mood swing now in about a month (which is a far cry from the rapid cycling I was experiencing before). I'm now on the right meds, and I'm feeling hopeful for the future- but it shatters a person's hope when a doctor says something like that.
I also agree with your cluster approach- fully. I think that these disorders should be dx'd and treated together- when realistically possible. This may help doctors realize that some of these "diseases" may not be life-long. Case in point: My doc also refers to my past substance addiction as a "disease" as well, and he tells me I'll struggle with it my entire life, although I am now in what he calls "remission." I know people share the belief that it's a disease. I don't believe this. I think it stems from either my ADHD or BP disorder (not sure which), but I think the substance addiction was born from the fact that for so long neither of these disorders were treated. Now that I am properly medicated for both ADHD and BP, I never think about opiates or alcohol. Ever. And I find this interesting. Plus, substance abuse is supposed to be genetic, but no one in my family has ever had substance abuse problems. No one in my family has been dx'd bipolar (but that doesn't mean BP is not in my family). ADHD, however...runs rampant in my family :) This is why I agree that it's based on a person's psychology and experiences- as well as brain chemistry. But...these disorders may not be life-long. There is light at the end of the tunnel, I believe :)
I need to check out that book, because I like these points of view. Thanks for mentioning it!
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