Posted by delna on October 18, 2009, at 2:46:58
In reply to Re: What is the best med for lack of motivation? » Maxime, posted by Deneb on October 17, 2009, at 21:17:09
**Long post**
Deneb,
You sound frighteningly like me when I was at college! Firstly I too am a scientist and secondly I too had to prolong both my degrees.
>Starting my last year of high school I was put on Zoloft, whereby I started having very intense mood swingsOk, this is exactly what happened to me. I had depression and anxiety and was put on Paxil by a GP and went 'high' for a few weeks. Then I slumped into apathy. The doc kept increasing my dose and I started swinging mood wise. (more about that later)
>It is not just lack of motivation for studying that I have. I just seem to have a lack of motivation for most things in life. My favourite thing to do is sleep. I can sleep more than 14 hours a day.
>Just the other day I slept from about 3 AM to 3:30 PM, got up for a bit, grew tired again and went back to bed until 7:30 PM.
Sometimes I wake up early for class only to go home to sleep some more.Again this is just like I was. I'd come home from a lecture and pass out for many hours. I too had no motivation for anything.
>My room and my bathroom is completely disorganized and messy.
Me too
> I have mood regulation problems. I tend to get really excited and happy one minute and depressed and suicidal the next. It is probably my borderline personality.
Ok this is the scary part. Exactly like me. I too was diagnosed with borderline personality disorder. I'm not trying to diagnose you but I can tell you that eventually it turned out that I had bipolar disorder. Your depressions fit the atypical variety (seen in bipolar) and the fact that you swing makes me suspicious.
It took some years and a clever pdoc to look at my past and find that I did infact have a history of spontaneous hypomanias and mixed episodes plus all the other indicators of bipolar. Many bipolars are originally misdiagnosed as either depressed or as having BPD. Just to clarify I am not saying that you are actually bipolar- its just that I was, and my clinical picture looked more like yours but eventually the bipolar came out in a big way.
IMHO I think you need an expert diagnosis. It took years for my diagnosis to change from borderline to depression and anxiety to bipolar II rapid cycling and finally to the dreaded bipolar I rapid cycling.
I had a therapist too and she told me I was not bipolar (there was no such thing) and I was happy to believe her because it meant no harsh drugs. But actually she ruined things for me because it just delayed my treatment and now I am a pretty resistant case.
But from what I see you are already on some 'hardcore' drugs like antipsychotics which personally I only agreed to take when I was confirmed to be bipolar I because I was so terrified of them. A full diagnosis will really help because then you can be treated properly...
Sorry if I am confusing your already complex situation but I had to share this because our stories are too similar. It's only at 33 that I got a really thorough diagnosis and it turned out to be bipolar I, even though I spend nearly all my time in the depressive phase (which is common in BP)
Again I am not trying to diagnose you... I just
think an expert pdoc needs to review your history.
>I often wonder if it is necessary to take two SSRI's at the same time. It seems like SSRI overkill to me.I have never in my life heard of such a treatment rationale. Infact 2 at once is not safe. SSRI's definitely promote apathy- they are infamous for it! You usually augment the first SSRI with Wellbutrin or Provigil or another agent. I know alot of people are taking nortryptiline with success but personally (with no disrespect to others) I would not take it. Firstly if you are indeed bipolar it might make you swing madly as TCAs are infamous for that. But ofcourse if you are not, it can work wonders!
Now I am on a mood stabilizer (lamictal), provigil and have just started a MAOI (since the SSRI just didn't work and I crashed into depression despite it.)
I was torn between Parnate (MAOI which is supposed to be the last word in atypical depression) and Effexor (SNRI, which helped in the past with mood, motivation, anxiety, OCD etc)but chose parnate in the end. The reason being that effexor has a very difficult and long withdrawal period and if it didn't work well I could not switch to Parnate for ages . But SNRI's DO tend to work (at high enough doses) much better than SSRI's- especially for those with motivation problems.
parnate is not scaring me at all in terms of food interactions and drug interactions (you just have to be extra careful) but then I have only been on it for 15 days....For me the only side effect that sucks is sedation but I believe that gets better in time and at the right dose. Haven't seen much benefit yet..
Incidentally, what REALLY helped my mood, motivation whilst keeping me stable was low dose Geodon. It was miraculous! Like waking up from a coma. But sadly, I had to give it up (after 2 years) because i had a bizarre reaction to it.
My pdoc (a psychopharmacologist in NYC) said Abilify was the next best thing (especially if you are sensitive to sedation)But I didn't try it because of fears of TD (which I think I had on Geodon- not sure)Well I hope I haven't rambled on too much and caused confusion......Please forgive me if I have. Your story just hit home for me.
I hope you find some decent help and find a good drug (or combo) that works for you.
Good luck
Take care
Love
DPS: Sorry if I went off on a tangent. If I did please ignore this post.
poster:delna
thread:921259
URL: http://www.dr-bob.org/babble/20091012/msgs/921347.html