Posted by Lorraine on July 31, 2001, at 12:02:17
In reply to Re: Handholding » Lorraine, posted by Elizabeth on July 27, 2001, at 19:51:20
> > > Stahl talks about the "end-stage" of depressive illness as one where the lows are so low but the ability to "feel" generally has been severely blunted.
>
> That's what I experience. I don't think of it as an "end stage," but perhaps it does have something to do with the fact that my depression first manifested when I was quite young. I would like to see more research on childhood-onset depression. I think my depression is probably not similar to most early-onset mood disorders, though.Maybe it's not the time of onset, but the duration of the disease or the length of time unmedicated. You have to wonder how it affects the development of personality and coping skills generally. My son has some anger management issues (has a learning disability also) so he was in therapy from the age of 8 until he was 11. He is so in touch with himself and very perceptive of moods. He also has the "language" of how to communicate about emotional issues generally. He's now 13, and I think whoever marries him ultimately is going to be real lucky. Course this is the effect of early intervention or therapy, not the effect of early mental illness.
> > > > > Interesting about panic and hypothyroidism. All my TSH tests have been pretty normal, and T3/4 augmentation is something I've never tried.
> >
> > It might be worth a try.
>
> What do you think it might help with besides panic? Have you ever tried it?Yes, I have tried T3 augmentation, twice. It is activating. For me, it was like taking an amphetamine. If I took too much, then I became edgy and started skin picking. I got off it the last time because I switched to Moclobemide which is also activating and needed to reduce the amount of activation in my system generally. But my panic attack stuff started somewhere around that time. I wish that I had been keep a mood chart then, like I do now.
> > > Also, the notion of "estrogen dominance" causing panic symptoms is interesting. Apparently, estrogen dominance is not just a problem associated with menopause, but can be a woman's normal state throughout her lifetime. Another avenue to explore.
>
> That is interesting. Tell me, can you make anything out of my experience with the pill? (fairly sudden relapse of depression while taking Parnate)Do you know what your pill had in it? Was it estrogen, progesterone or both and, if both, were they cycled so that the beginning of the month was estrogen with a switch to progesterone at the end? At what point in your cycle did you start the pill? If you started at the beginning of the cycle and your pill was predominantly estrogen at that point, then it might have been estrogen dominance. Progesterone can increase depression (which is why I was initially put on unopposed estrogen). So you might have had an extra dose of progesterone at the time. How are you right before your period? You know doctors who specialize in menopause and pms could figure this out for you. They would first determine your hormone levels and, I think with premenopausal women, they do this over the course of a cycle using saliva testing. I'm sure a mood chart could also help you figure this out--the NIMH has a good chart that tracks monthly cycle along with mood. I'm now sold on mood charting to help me determine what meds, supplements, therapies, hormones, life events, foods are effecting my moods. I'm going to have my hormones tested at the end of this month to determine if I have estrogen dominance.
>
> > > > > Buprenorphine seems to make my periods irregular. I've been wondering about the mechanism there.
> > > If I was successful, then my period would start and I would not be in pain. But if I missed the very very beginning, what happened was my period would be delayed. I explained this to my doctor, who dismissed it out of hand. Point is there was something operating there that might be similar to your situation.
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> How do you mean? I'm a little confused.My point was just that when I took a pain reliever before I started my period (depending on the timing of when I took the pain reliever), it could delay my period--or make it irregular. It never made sense to me. You are saying that Buprenorphine can make your period irregular. I know Ibuprofen is a different drug, but why should pain relievers affect the timing of periods? And, yet in my case Ibuprofen did and in your case Buprenorphine does.
> > > Decongestants are basically bad speed.So why do some pdocs recommend Benedryl as a sleeping aid?
(Ephedrine or "ma huang" is a step down from bad speed: it's bad Sudafed.)
I took Ephdrine for a while when I was on Effexor. It really is bad Sudafed. < g >
>
> > > But is agitation and activation considered mania?
>
> Not necessarily. They're symptoms of mania, though.
>
> > I once (for a couple of days in the weeks just before the last stock market crash), had incredibly racing thoughts, could hardly contain my excitement and so forth, but was still able to sleep. From my reading of the DSM categories, that would not qualify as mania--although I was euphoric and felt a bit invincible.
>
> Hypomania, perhaps?Well, I looked it up and it might fit (thanx). More reading to do.
> > >I don't think it's a good idea to pretend that we have a decent understanding of the causes of depression, mania, psychosis, anxiety, etc. -- attributing them to a vague "chemical imbalance" ...I think (as I mentioned before) the most reasonable approach to clinical practise is the empirical-descriptive approach (identifying symptom clusters that respond to particular treatments, and using this information to try to predict which treatments will be most likely to work for any particular patient). ....I think that we can simultaneously examine psychiatric illness on both levels (behavioural signs and symptoms, and physiologic ones). Both types of information are useful.
I guess right now the problem is that we don't know enough about the physiology and we don't have meaningfully defined presentation categories. And, we shouldn't pretend that we do on either front. We need research in both areas. The drug company studies of the effect of a drug on "depression" or even treatment resistant depression just lack enough specificity to be helpful in determining whether the drug will work in a particular case.
> > > I do like the way that your doctor does it, basing treatment decisions on statisticsthat's what appealed to me about him
> > >The statistical approach can also be applied to descriptive psychiatry, although it hasn't been used nearly enough IMO.Yes, some correlational analysis studies using say depression presentation criteria and effectiveness of meds would be really useful.
>> > > Complicated stuff. But if it is "insulin sensitivity" or "insensitivity?", then low carb should help.
>
> I dunno, thinking about insulin always gets me confused for some reason.If you ever find yourself in a Nardil weight gain situation again, it might be worth trying to see if low carb helps. Zo over on the thread about Zyprexa said that low carb did not help with it. So it may be that these different drugs cause weight gain for different reasons.
Lorraine
poster:Lorraine
thread:67742
URL: http://www.dr-bob.org/babble/20010731/msgs/72749.html