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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 17 to 41 of 201. Go back in thread:
Posted by zonked on August 26, 2011, at 21:11:25
In reply to 40%, posted by SLS on August 23, 2011, at 6:42:25
> Hi All.
>
> Patience.
>
> Apparently, my brain has taken another major step in its process of recovery and healing. I am perhaps 40% improved. It has been a year since I began taking Nardil. I was afraid that I might be "stuck" at 35%.You've no idea how pleased I am to hear this. Your patience with Nardil in part has made me stick with it through the initial blip. If I hadn't found someone else whose advice and wisdom I trust going through the same thing, I may have thrown them in the trash and demanded buprenorphine or something else rather drastic.
>
So, what explains this protracted process? I haven't encountered anyone else who has had to wait so long to recover from MDD or BD depression. My doctor feels that this is the product of severity and the length of time spent in the depressive state.
>
> Patience.I think your doctor may be right, and it *may* also be true with me (just a hunch, my MD did not say so) but of course, the length of time you've been dealing with this greatly exceeds my own.
Scott, have you had your testosterone checked? I am assuming you have. You've seen my recent threads, I'm sure - but this does not feel like placebo effect. I have had more energy, drive, appreciating the weather, actually logged into Facebook, etc. - than I have in a long time.
As if I could know what placebo effect "felt" like. :-)
But it appears subclinical low testosterone ("normal" enough for two previous psychiatrists to not prescribe me it) may play a role in my recovery as I have felt better the last two days than the last 60. I don't recall the exact number, but my testosterone was in the low 400s a year ago; I forgot to ask the recent result but it was also "low normal". I am 29.
-z
Posted by SLS on August 27, 2011, at 5:06:58
In reply to Re: 40% » SLS, posted by zonked on August 26, 2011, at 21:11:25
Hey Zonked!
I am TOTALLY excited that you are improving.
People who experience the placebo effect usually relapse within a month of reporting an improvement. I am 90%-100% sure that what you are experiencing is NOT a placebo effect. You would not see changes in your vegetative symptoms were your response be attributable to the placebo effect.
What does the placebo effect feel like?
I'm not sure because I have never been apt to experience this. None of the blinded clinical trials that I participated in resulted in a placebo response.
Your initial "blip" improvement was also psychobiological and not placebo, in my opinion.
You know for yourself the truth. I know there is no reason for me to convince you. Perhaps others will profit from the information you can provide. It's great that you are reporting so regularly.
I have had some vitamins and supplements make me feel worse. I am no longer interested in this alternative strategy. I am adamant that I not "rock the boat" and subject my brain to a series of unnecessary insults.
Currently:
Nardil 90mg
nortriptyline 150mg
Lamictal 200mg
Abilify 10mg
lithium 300mg
- Scott
> > Hi All.
> >
> > Patience.
> >
> > Apparently, my brain has taken another major step in its process of recovery and healing. I am perhaps 40% improved. It has been a year since I began taking Nardil. I was afraid that I might be "stuck" at 35%.
>
> You've no idea how pleased I am to hear this. Your patience with Nardil in part has made me stick with it through the initial blip. If I hadn't found someone else whose advice and wisdom I trust going through the same thing, I may have thrown them in the trash and demanded buprenorphine or something else rather drastic.
>
> >
> So, what explains this protracted process? I haven't encountered anyone else who has had to wait so long to recover from MDD or BD depression. My doctor feels that this is the product of severity and the length of time spent in the depressive state.
> >
> > Patience.
>
> I think your doctor may be right, and it *may* also be true with me (just a hunch, my MD did not say so) but of course, the length of time you've been dealing with this greatly exceeds my own.
>
> Scott, have you had your testosterone checked? I am assuming you have. You've seen my recent threads, I'm sure - but this does not feel like placebo effect. I have had more energy, drive, appreciating the weather, actually logged into Facebook, etc. - than I have in a long time.
>
> As if I could know what placebo effect "felt" like. :-)
>
> But it appears subclinical low testosterone ("normal" enough for two previous psychiatrists to not prescribe me it) may play a role in my recovery as I have felt better the last two days than the last 60. I don't recall the exact number, but my testosterone was in the low 400s a year ago; I forgot to ask the recent result but it was also "low normal". I am 29.
>
> -z
Posted by bleauberry on August 27, 2011, at 17:50:52
In reply to 40%, posted by SLS on August 23, 2011, at 6:42:25
Your doctor makes a lot of sense to me. I've experienced the same slow-paced improvement pattern and it is common in many chronic ailments.
Posted by Phillipa on August 27, 2011, at 21:45:08
In reply to Re: 40%, posted by bleauberry on August 27, 2011, at 17:50:52
Testosterone and hormones are not alternative. Your body is hormone regulated starting with pituitary gland, cortisone is a hormone also, thyroid as well the list goes on and on. Phillipa
Posted by Phillipa on August 27, 2011, at 21:57:36
In reply to Re: 40%, posted by Phillipa on August 27, 2011, at 21:45:08
Our bodies are a working network of hormones necessary to life itself. Correct balances of all are needed for optimal health. Phillipa
Posted by hyperfocus on August 29, 2011, at 16:35:28
In reply to 40%, posted by SLS on August 23, 2011, at 6:42:25
That's really good to hear Scott, I'm glad for you and I hope it continues. Is it minute improvements every day or did it sort of kick-in unexpectedly?
Posted by SLS on August 31, 2011, at 8:01:48
In reply to Re: 40% » SLS, posted by hyperfocus on August 29, 2011, at 16:35:28
Hi Hyperfocus.
> That's really good to hear Scott, I'm glad for you and I hope it continues. Is it minute improvements every day or did it sort of kick-in unexpectedly?
Yes/Yes
During the first three weeks after adding Nardil, I experienced a blip improvement that disappeared quickly. Since I felt that I reached a dead-end, I decided to keep taking my drug treatment regime steadily and settling for a minor improvement. Four months later came a pleasant surprise. I started to improve again. Unfortunately, the improvement did not follow a smooth, accelerating course. At first, I could only discern a positive trend in my condition when I looked at things on a weekly or monthly basis and not on a daily basis. This past week has produced an acceleration in my rate of improvement. However, it has been a year since the addition of Nardil. It is almost unacceptably slow. However, for me, it's the only game in town, and I'm blessed to have it.
- Scott
Posted by Phillipa on August 31, 2011, at 20:08:09
In reply to Re: 40% » hyperfocus, posted by SLS on August 31, 2011, at 8:01:48
Why do you feel it's so slow seriously? Phillipa
Posted by SLS on September 1, 2011, at 7:31:33
In reply to Re: 40% » SLS, posted by Phillipa on August 31, 2011, at 20:08:09
> Why do you feel it's so slow seriously? Phillipa
You don't consider it slow to have to wait over a year to glean a 40% improvement? It is possible that it will take another year to achieve remission. That's two years from start to finish. I would hate to think that this is the rule rather than the exception. My doctor has been less patient than I am. He thought to try other drugs to speed things up. I tried Latuda, but found that it made things worse. Even some common alternative treatments were either ineffective or exacerbating. I believe that my current regimen is sufficient to attain remission. One thing that is interesting is that the better I feel, the more I appreciate the severity of my baseline state. I have had to re-evaluate my relative progress and find that I am not as far along as I thought I was. Still, this is good stuff, and I truly believe that I am heading toward wellness.
- Scott
Posted by Dinah on September 1, 2011, at 8:12:45
In reply to Re: 40% » Phillipa, posted by SLS on September 1, 2011, at 7:31:33
I think I've grown to appreciate the incremental approach to wellness. Taking little bites out of a problem from various angles. 40% is something to be pleased with. And it gives you a base from which to try other things that might be helpful that might not have been helpful without that 40%.
Specifically, what would you like to be better? Can you break down which elements have gotten maybe more than 40% better, and which perhaps less?
Posted by SLS on September 1, 2011, at 12:18:26
In reply to Re: 40% » SLS, posted by Dinah on September 1, 2011, at 8:12:45
> I think I've grown to appreciate the incremental approach to wellness. Taking little bites out of a problem from various angles. 40% is something to be pleased with.
The degree of relative wellness I have attained is nice to experience. I do not take it for granted. However, it would be nice to have covered a 40% gain in 12 weeks rather than 12 months. I accept it, though, as any stable improvement is in itself a miracle. I simply would rather that my rate of recovery be somewhere other than at the pole of a bell curve.
> And it gives you a base from which to try other things that might be helpful that might not have been helpful without that 40%.
I hadn't thought of it that way.
My doctor tends to think that things should be happening faster, and has thought to continue to try new treatments. I elected to leave well enough alone. It is serendipitous that I should have discovered the length of time necessary for me to respond to treatment. I had resigned myself to taking the same four drugs and settling for a lifetime of severe depression. After four months of an unchanged depression, I suddenly began to improve. This was towards the end of November, 2010. I then added lithium two months later based upon its theoretical mechanisms of action. It almost immediately reduced the oscillations in mood that I was experiencing.
> Specifically, what would you like to be better?Motivation, energy, cognition, and memory.
> Can you break down which elements have gotten maybe more than 40% better, and which perhaps less?Not really. I feel that everything improves at the same time at the same magnitude.
Thanks, Dinah. I appreciate your insightful questions and perspectives.
- Scott
Posted by Phillipa on September 1, 2011, at 19:55:54
In reply to Re: 40% » Phillipa, posted by SLS on September 1, 2011, at 7:31:33
Sorry Scott poor wording as I consider it very slow. Was more or less asking what you attributed the slowness to other than the length of your illness. If you ever wish to research a med research requip as an old poster here is on low levels of it with a few other low doses of things. He was suicidal at one point got ECT on all the Maois. Today married a child and law practice. We talk daily. I once had to have him committed via long distance telephone to his pdoc as was about to shoot self. True story. But hope this gives you even more hope of a full recovery. Phillipa
Posted by Lamdage on September 5, 2011, at 21:30:50
In reply to Re: 40% » SLS, posted by Phillipa on September 1, 2011, at 19:55:54
Hey Scott, its good to hear you are improving!
May i ask for how much of your lifetime you have been depressed and from what age on?
I find it sad that most people get help so late in their illness.. If there was less stigmatization people wouldn't have to hit the lowest of rock bottom before they get treatment. It seems quite common from what I've seen and i am in the same boat since i have been depressed from VERY early on in childhood.
A question on the Lamictal: Did it affect any of your memory/cognition symptoms negatively?
Thanks
Posted by SLS on September 6, 2011, at 10:23:59
In reply to Re: Scott, posted by Lamdage on September 5, 2011, at 21:30:50
> Hey Scott, its good to hear you are improving!
Thanks. :-)
> May i ask for how much of your lifetime you have been depressed and from what age on?
10 years - mild
15 years - moderate
17 years - severeNow 51 years.
> A question on the Lamictal: Did it affect any of your memory/cognition symptoms negatively?I'm okay at 200mg. Anything above this dosage produces brain-fog and cognitive / memory impairments without any discernible additional improvement.
> ThanksYou're welcome.
- Scott
Posted by Lamdage on September 7, 2011, at 4:51:21
In reply to Re: Scott » Lamdage, posted by SLS on September 6, 2011, at 10:23:59
So i assume you didn't get treatment for way too long.. Its a very interesting topic, how depression and anxiety are so hardwired in the brain and what changes lead to improvement.
New conditioning, chemical changes, maybe even new nerve endings etc? Will definitely do some googling :)
Posted by Lamdage on September 7, 2011, at 5:11:17
In reply to Re: Scott, posted by Lamdage on September 7, 2011, at 4:51:21
And of course sh*tty psychological patterns :/
Posted by SLS on September 7, 2011, at 13:46:01
In reply to Re: Scott » Lamdage, posted by SLS on September 6, 2011, at 10:23:59
40% was nice for a few days. Unfortunately, it didn't last. I remain at a 25% improvement as of two days ago. After being on Nardil for a whole year, this is wholly inadequate. I don't feel very much different than I did a year ago. I made an appointment to see my doctor tomorrow. I would like to discontinue Nardil and replace it with either Pristiq or Effexor.
I would like to thank everyone for their help and support over the years.
I haven't given up.
- Scott
Posted by SLS on September 7, 2011, at 13:49:19
In reply to Re: Scott, posted by Lamdage on September 7, 2011, at 4:51:21
> So i assume you didn't get treatment for way too long..
I was first diagnosed and treated for MDD in 1982 at age 22.
- Scott
Posted by floatingbridge on September 7, 2011, at 16:14:21
In reply to 40% down to 25%, posted by SLS on September 7, 2011, at 13:46:01
> 40% was nice for a few days. Unfortunately, it didn't last. I remain at a 25% improvement as of two days ago. After being on Nardil for a whole year, this is wholly inadequate. I don't feel very much different than I did a year ago. I made an appointment to see my doctor tomorrow. I would like to discontinue Nardil and replace it with either Pristiq or Effexor.
>
> I would like to thank everyone for their help and support over the years.
>
> I haven't given up.
>
>
> - ScottWell, shista, Scott.
Have you tried either?
Please let anyone here know ways we can support you through the wash and start up and any other way.
fb
Posted by SLS on September 7, 2011, at 16:54:21
In reply to Re: 40% down to 25% » SLS, posted by floatingbridge on September 7, 2011, at 16:14:21
> > 40% was nice for a few days. Unfortunately, it didn't last. I remain at a 25% improvement as of two days ago. After being on Nardil for a whole year, this is wholly inadequate. I don't feel very much different than I did a year ago. I made an appointment to see my doctor tomorrow. I would like to discontinue Nardil and replace it with either Pristiq or Effexor.
> >
> > I would like to thank everyone for their help and support over the years.
> >
> > I haven't given up.
> >
> >
> > - Scott
>
> Well, shista, Scott.
>
> Have you tried either?
>
> Please let anyone here know ways we can support you through the wash and start up and any other way.Thanks.
- Scott
Posted by Zonked on September 7, 2011, at 20:58:51
In reply to 40% down to 25%, posted by SLS on September 7, 2011, at 13:46:01
Scott, I don't understand why given all your conventional treatment failures you haven't been given opiods. To me, it's inexcusable. What is your MD's justification? How much more do you need to suffer? You're entitled to a decent quality of life. Sure, there are drawbacks, but what does it matter now? Cycling you through mildly effective or ineffective treatments seems ludicrous to me at this point. Especially when there are things sitting on American pharmacy shelves RIGHT NOW which way help you. I am not blaming you, but the system. Why won't your doc give you bupe, stimulants or oxycontin? If he's concerned about potential abuse, couldn't he start you out with a small quantity and see you a bit more frequently at first? I hope it's not that he's afraid of the DEA. That's not reason for you to suffer. Sorry if I sound a bit frustrated... it's with a medical system that likely can return you to a normal level of functioning but hasn't because of drug addicts. It doesn't seem right.
Posted by Phillipa on September 7, 2011, at 20:59:00
In reply to 40% down to 25%, posted by SLS on September 7, 2011, at 13:46:01
Think has anything to do with the daylight hours? Less light? Maybe a light box would help? Phillipa
Posted by Lamdage on September 8, 2011, at 3:06:42
In reply to Re: 40% down to 25% » SLS, posted by Phillipa on September 7, 2011, at 20:59:00
Scott sorry to hear that. Let us know what you and your doc are considering now!
Posted by Solstice on September 8, 2011, at 7:47:58
In reply to 40% down to 25%, posted by SLS on September 7, 2011, at 13:46:01
> 40% was nice for a few days. Unfortunately, it didn't last. I remain at a 25% improvement as of two days ago. After being on Nardil for a whole year, this is wholly inadequate. I don't feel very much different than I did a year ago. I made an appointment to see my doctor tomorrow. I would like to discontinue Nardil and replace it with either Pristiq or Effexor.
>
> I would like to thank everyone for their help and support over the years.
>
> I haven't given up.
Scott -Your courageous and steadfast 'fighting the fight' is an inspiration. During my times in the valley of it, I've often been a big baby and toyed with the idea of giving up.
As I've been reading your threat, I've become increasingly interested in how you go about rating where you are at a given point (0% vs 15%, 25%, 40%). I read where one of these included being able to drive, but unable to work. It makes sense to me that various specific characteristics of functioning would be a great way to assess whether one is at 25%.. vs 50%.. vs 75%.
Have you constructed a list of characteristics of functioning that helps you determine your level of functioning? For example, I guess at the social level, there would be complete withdrawal, vs. being able to tolerate receiving phone calls from certain people, vs. willing & able to place phone calls to certain people, vs. being able to tolerate receiving phone calls from people who are not in the inner circle, vs. being willing to go out and participate in various types of social interaction (i.e. it's one thing to go to Sonic with a trusted friend and eat in the car at the drive-thru, vs. going out with a group for a big meal at Logan's Steakhouse). Anyway, do you have behavioral functioning characteristics categorized in such a way that they end up putting you at a certain percentage of functioning? What it brings to mind for me is the Glascow Coma Scale for assessing level of coma.
Solstice
Posted by Solstice on September 8, 2011, at 8:36:03
In reply to Re: 40% down to 25%, posted by Solstice on September 8, 2011, at 7:47:58
> > 40% was nice for a few days. Unfortunately, it didn't last. I remain at a 25% improvement as of two days ago. After being on Nardil for a whole year, this is wholly inadequate. I don't feel very much different than I did a year ago. I made an appointment to see my doctor tomorrow. I would like to discontinue Nardil and replace it with either Pristiq or Effexor.
> >
> > I would like to thank everyone for their help and support over the years.
> >
> > I haven't given up.
>
>Scott -
Your courageous and steadfast 'fighting the fight' is an inspiration. During my times in the valley of it, I've often been a big baby and toyed with the idea of giving up.
As I've been reading your (s/b *thread*), I've become increasingly interested in how you go about rating where you are at a given point (0% vs 15%, 25%, 40%). I read where one of these included being able to drive, but unable to work. It makes sense to me that various specific characteristics of functioning would be a great way to assess whether one is at 25%.. vs 50%.. vs 75%.
Have you constructed a list of characteristics of functioning that helps you determine your level of functioning? For example, I guess at the social level, there would be complete withdrawal, vs. being able to tolerate receiving phone calls from certain people, vs. willing & able to place phone calls to certain people, vs. being able to tolerate receiving phone calls from people who are not in the inner circle, vs. being willing to go out and participate in various types of social interaction (i.e. it's one thing to go to Sonic with a trusted friend and eat in the car at the drive-thru, vs. going out with a group for a big meal at Logan's Steakhouse). Anyway, do you have behavioral functioning characteristics categorized in such a way that they end up putting you at a certain percentage of functioning? What it brings to mind for me is the Glascow Coma Scale for assessing level of coma.
Solstice
>
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