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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 Twinleaf on January 7, 2015, at 16:20:14
My seriou depression developed about 20 years ago after a rapid series of deaths in my family. As I was trying to get more educated about what had happened to me, I kept reading about over-activity of the HPA axis, with resulting elevated levels of cortisol and damaging effects on the hippocampus ( abnormalities in CA3 cells and an absence of daily growth of new neurons)
I had my cortisol tested, and it was elevated and did not decrease during the day as it was supposed to. Since then, I have focused my efforts on treatments which lower cortisol - TMS, tianeptine, interpersonal psychotherapy, doing my best to replace lost relationships, meditation and exercise. I should say that I tried all the usual medications -about 12 different ones - without help. These cortisol-reducing efforts really seem to have helped a lot! My depression is mild to often non-existent, having been severe originally. I have followed my cortisol levels, and they have been gradually trending back to normal; the totals are normal, but the levels don't decrease quite as much during the day as they optimally should. But much better than 20 years ago.
I thought I would mention this, as it really seems to have helped me a lot, and I don't think I have seen many other posters focussing on the role of HPA over-activity and elevated cortisol in trauma-related anxiety and depression.
I would love to know what others think of this. I realize there are genetic influences in many depressions where this might be less important.
Posted by Christ_empowered on January 7, 2015, at 17:10:14
In reply to Focussing on stress levels, posted by Twinleaf on January 7, 2015, at 16:20:14
This is awesome, what you've done.
My crazy insane psychotic break 7 years followed a period of stress, deprivation, and being extremely low on the totem pole. My parents have since moved up in the world, and they're willing and able to take care of me and protect me. That takes care of some very basic things needed for recovery.
On top of that, I do Orthomolecular. I had to put it together myself, based on a rudimentary understanding of Dr.Abram Hoffer's work. High dose niacinamide, c, e, selenium, zinc, etc. etc.
Interestingly enough...high doses of C (grams) can reduce cortisol levels and improve ability to adapt to stress. For all the OM docs talk of the OM protocol being specifically anti-schizophrenia, for me...its an incredible de-stress, de-toxifying cocktail that also seems to reduce the side effects of my neuroleptic.
I'm glad you shared your story for another reason...behind every diagnosis, there's a story, usually one that goes untold. Sometimes, I think psychiatry mystifies life by denying us that abillity to construct our own narrative and tell our own stories and own our lives.
Posted by Twinleaf on January 7, 2015, at 21:03:24
In reply to Focussing on stress levels, posted by Twinleaf on January 7, 2015, at 16:20:14
I'm very curious - has anyone posting now checked their cortisol levels? I originally got the idea of doing it from posts and links on Babble! (10-12 years ago).
Posted by alexandra_k on January 8, 2015, at 14:40:46
In reply to Re: Focussing on stress levels, posted by Twinleaf on January 7, 2015, at 21:03:24
I'm not sure if this helps you, or not, but I've found some stuff on cortisol levels and intense exercise / over training. Sometimes people train so hard they fall into depression. It could be a similar physiological response, so it might be worth taking a look at some of that literature.
One thing that I've found sort of interesting is about how some athletes track their body temperature as a proxy for cortisol levels. The idea being that if they take their temperature at the same time every day then over time they can check if there is something abnormal for them - and ease off their training / take it easy accordingly. To prevent things deteriorating.
Might be worth following up on.
I suspect something like this has gone on for me. With years of stress response when I was growing.
Posted by Twinleaf on January 8, 2015, at 15:18:40
In reply to Re: Focussing on stress levels, posted by alexandra_k on January 8, 2015, at 14:40:46
Those must be quite some workouts! I think I'll be safe with my daily dog walk..
Posted by alexandra_k on January 8, 2015, at 19:52:54
In reply to Re: Focussing on stress levels » alexandra_k, posted by Twinleaf on January 8, 2015, at 15:18:40
> Those must be quite some workouts! I think I'll be safe with my daily dog walk..
oh, yes! some exercise is relaxing and rejuvenating. yoga. or walking.
some other exercise is... well, the aim is to catabolise in order to anabolise back stronger. Like a hard-core spin class, or crossfit, or people who are more seriously competitive for sports.
there can be a fine line between catabolising optimally for subsequent growth and... injuring yourself / over-training.
and what is catabolic for one person (e.g., walking if you are a very heavy person and not adapted to walking) can be relaxing and rejuvenating for another (e.g., a marathon running taking a walk on their day off in order to assist recovery).
anyway...
i thought you might be interested in the temperature-tracking idea. because taking your own temperature would be a lot cheaper than getting your cortisol levels tested (i would bet). and also would be a faster track of where your stress levels are at than waiting on lab results. if it works, i mean...
that is partly why i'm feeling exhausted now, i've realised. it wasn't just that class started... it was that i went to a f*ck*ng spin class as well and started doing 20 minutes on the elliptical which (since i'm really really really not adapted to that anymore) is positively catabolic for me...
Posted by Twinleaf on January 8, 2015, at 20:52:59
In reply to Re: Focussing on stress levels, posted by alexandra_k on January 8, 2015, at 19:52:54
You are right -they are expensive. I haven't actually taken one for several years as they are pretty normal now, and I only did it every few years before that also. There is definitely a rough correlation between lower levels and depression-free intervals for me.
I don't think I'm obsessive enough to monitor tiny differences in my temperature!
I adopted this way of doing things when all the AD's I took were ineffective, and because I realized I was basically suffering from PTSD. I got the idea from some very fascinating and knowledgeable posts here on Babble, and wondered if anyone else had the same idea..
Posted by Hugh on January 10, 2015, at 6:58:53
In reply to Focussing on stress levels, posted by Twinleaf on January 7, 2015, at 16:20:14
How do drugs that increase norepinephrine levels affect you? I react very poorly to them. And I suspect that HPA overactivity has a lot to do with my depression and anxiety. I hope to try Stellate Ganglion Block (SGB) in the next few months. It appears that this reduces noreprinephrine levels and can calm down the HPA axis considerably.
SGB is used at dozens of pain clinics around the country. I'm going to try to find one that is willing to let me try it off-label. If I can't find one that will do this, there's a doctor in Chicago who specializes in SGB.
http://eugenelipovmd.org/areas-of-focus/ptsd
Posted by Twinleaf on January 10, 2015, at 9:52:26
In reply to Re: Focussing on stress levels, posted by Hugh on January 10, 2015, at 6:58:53
I also do poorly on activating meds.
If I had a flare-up, I would look at the Stellate Ganglion Block and deep TMS. Thank you for the info on Dr. lipov - great to have!
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