Posted by Andy123 on July 15, 2001, at 23:17:18
In reply to Re: Accutane depression, and Brain Swelling » Andy123, posted by adamie on July 15, 2001, at 20:48:49
> I am honestly not being delusional. My depression has not had any phychotic features. My head hasn't changed size but it just looks different. It's not something which is very noticable but after a shower when I comb my hair back, I just look different than normal. At first I was quite shocked when I realized this. Right now I seem to look more like my old self but I dont know. I know it is hard to believe but accutane is known to have caused brain swelling in many cases. I certainly would hope it is just something with my vision causing me to percieve my own apperance differently but I strongly feel that is not the case.
> I dont know how to mention this to my therapist. If I mention it she may think I am crazy and not take things I say too seriously. I guess I will see. I will mention my concerns regarding brain swelling. Thank you for replying.Adamie, (I have read both of your responses.)
You aren't capable of discerning whether these beliefs are delusional or not, as this is the nature of a delusion. You are convinced that they are true, but in fact they are not. Brain swelling could not by any stretch of the imagination change the shape of your head. The thick bone structure surrounding your brain would require unreal amounts of prolonged pressure to alter its shape. "brain swelling" isn't diagnosed by the size of the head, as I am sure you are aware. I'm not sure how intracranial pressure is diagnosed except by symptoms. But trust me, your head has not or could not change shape because of brain swelling. Right now your perceptions ARE distorted by depression.You really, really have to write down what you were thinking and percieving as you looked in the mirror and saw changes in your head, and you need to take these written perceptions to your psychiatrist. It is going to be best for you. Try to get in to see your doctor before Thursday.
Concerning what "more aggressive treatment" might mean in this context: when there are psychotic features in depression, a more sedating antidepressant might be able to alleviate the delusional somatization. Others on this board might have input into how true this is... The other option would be to add a small dose of Haldol, Navane or some other antipsychotic on a temporary basis.
But its not my place by any means to be advising you so specifically, as I'm just another patient myself! Its important that your psychiatrist hear the whole story of what is going on in your thought processes. Don't hold back because of your fear of having your opinion disregarded. Telling them about these perceptions won't deligitimize the importance of following up on the Accutane side effects.
By my own totally unqualified opinion, you have to do two things: (1.) disclose fully your thoughts about how your head seems different in your perception (2.) make sure they follow up on the possibility of intra-cranial pressure, as its a known side-effect caused by Accutane.
Its very common to have resistence to being treated with sedating antidepressants or antipsychotics, as you might already be sluggish from the depression. The other reason the latter choice is often resisted is the possibility of EPS, which can make someone very sick. If the dose of antipsychotic is low, the chances of this happening are much lower. Also the new antipsychotics (e.g. olanzapine)don't seem to cause these problems nearly as often. But the alternative could be to continue spiralling into panicked states and paranoid belief systems. Your illness won't resolve if you have irrational belief systems that feed into the depression.
poster:Andy123
thread:70157
URL: http://www.dr-bob.org/babble/20010714/msgs/70275.html