![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by shar on January 16, 2001, at 11:47:33
Hi, ya'll. I may have already posted this, but I don't remember it if I did. I just wanted to give you an update.
In our last episode, I had been told that for a person with chronic depression and episodes of severe depression, I was doing pretty good. I was not delusional, hospitalized, hearing voices, etc. And, it was not likely it would get any better.
So, I freaked big time.
My therapist recommended a pdoc, so I saw him, and he is very good. After much discussion, we agreed to stay with my current meds (Wellbutrin and Effexor) but change the way I take them and up the WB. So, now I take 300 mg. WB in the morning, and 150 mg. Eff in the morning. I take the second effexor at night (a total of 300 mg) with my 1 mg klonopin.
I am supposed to report this Friday on whether it seemed to help. I liked his approach to "if you aren't having a hard time, let's not change it" and to try a different schedule based on the properties of the meds themselves.
Plus, since I am in therapy and he knows my therapist, they will communicate. And, he said he would like to see me work on a couple of specific issues in therapy.
All in all, I did not go away weeping, a big improvement over my last visit. I am allowing a tiny ray of hope to shine through. Just a little tho--so if I go crashing down I won't be devastated.
Shar
Posted by SLS on January 16, 2001, at 13:08:06
In reply to Dysthymia--Saw a new pdoc--Better visit, posted by shar on January 16, 2001, at 11:47:33
> All in all, I did not go away weeping, a big improvement over my last visit. I am allowing a tiny ray of hope to shine through.
Woohoo!
> Just a little tho--so if I go crashing down I won't be devastated.Smart.
It is so hard sometimes to prevent yourself from being optimistic. "I feel better today, so, of course, I'm on my way to getting well and having a better life."
Personally, I would rather be an irrepressible optimist and take the occasional falls than be a cynical pessimist, whose very state of mind helps to foster the depressive thinking and affect that might reduce their chances of responding to treatment. Since depressive thought styles can contribute to the onset of an episode of major depression, why would it not also impede the body's attempt to change its chemical state to bring about remission?
If you are not going to allow for too much optimism, which I really do understand from personal experience, then I will be your proxy optimist. :-)
It seems that things are looking up. (I just said a prayer for you).
- Scott
Posted by Noa on January 16, 2001, at 14:58:53
In reply to Re: Dysthymia--Saw a new pdoc--Better visit, posted by SLS on January 16, 2001, at 13:08:06
Glad it went well. It sounds like the rapport was better with this pdoc.
Cautious optimism--if ever there was a good use for this phrase......
Posted by SLS on January 16, 2001, at 19:19:10
In reply to Re: Dysthymia--Saw a new pdoc--Better visit, posted by Noa on January 16, 2001, at 14:58:53
> Glad it went well. It sounds like the rapport was better with this pdoc.
>
> Cautious optimism--if ever there was a good use for this phrase......I have always had trouble with the cautious part. I'm not exactly sure why. One would think that after 20 years of "false starts", I would be at the very least cautious if not totally skeptical. As soon as something begins to work for me, I assume that I am cured and can start the rest of my life. I am so confident of this that I begin to make plans that I couldn't possibly follow through with should I relapse. Even now. I am receiving a mild benefit from having added Risperdal. After six weeks, it is beginning to "kick-in". I am not waiting to see whether it lasts or not. I am under the impression that it will. If it sticks, then I will need to switch two of the antidepressants I take to optimize the quality of remission. I am so hopeful, that I am very close to making decisions that depend on the response continuing. Foolish.
I will say this, though. I truly believe that it is my overly optimistic tendencies that has allowed me to stick around long enough to write this dumb post.
- Scott
Posted by shar on January 16, 2001, at 22:42:40
In reply to Re: Dysthymia--Saw a new pdoc--Better visit, posted by SLS on January 16, 2001, at 13:08:06
Scott,
LOL That is great! Proxy optimist! I wish you could stand in for me during those times optimism is expected! I wish I was more generally optimistic, however, through life I've learned the fall is too great to withstand.Thanks for your prayers and support--
Shar> > All in all, I did not go away weeping, a big improvement over my last visit. I am allowing a tiny ray of hope to shine through.
>
>
> Woohoo!
>
>
> > Just a little tho--so if I go crashing down I won't be devastated.
>
> Smart.
>
> It is so hard sometimes to prevent yourself from being optimistic. "I feel better today, so, of course, I'm on my way to getting well and having a better life."
>
> Personally, I would rather be an irrepressible optimist and take the occasional falls than be a cynical pessimist, whose very state of mind helps to foster the depressive thinking and affect that might reduce their chances of responding to treatment. Since depressive thought styles can contribute to the onset of an episode of major depression, why would it not also impede the body's attempt to change its chemical state to bring about remission?
>
> If you are not going to allow for too much optimism, which I really do understand from personal experience, then I will be your proxy optimist. :-)
>
> It seems that things are looking up. (I just said a prayer for you).
>
>
> - Scott
Posted by Noa on January 18, 2001, at 8:41:25
In reply to Re: Dysthymia--Saw a new pdoc--Better visit, posted by SLS on January 16, 2001, at 19:19:10
Scott,
For years, I swung like a pendulum between despair and optimism, but the optimism was always very precarious and fragile, so I had to cling to it hard.
Each time I came out of a depression, I was convinced it was gone for good.
When the depression started being more and more recurrent, and worse each time, I started to fear feeling optimistic. When I would start to feel better, I would be hypervigilant for any signs of low mood. And a bad day, or even a bad moment, would signal to me that my hope was in vain, I was doomed to fall again into the pit of hellish deprssion.
In therapy, I have been working on accepting my illness as chronic, on bringing together these two lives I have led--the optimist who hopes/feels/wishes depression is in the past, and the desapairing depressive who feels life will never get any better and isn't worth living.
It is hard, but I am learning to see both of these parts of myself as me, to not have the pendulum swing so drastically, to be able to move from depressed mood to non-depressed mood more fluidly and flexibly, to not have a bad moment signal the downward spiral, to not have to have the shadow of terror ruin my good days--terror of losing the progress, the hope.
It is still a struggle, but I am stronger at this. I still get angry at myself when I have a bad moment or day, but I am better able to tell myself that it doesn't mean the remission is gone for good. And I am better (not fully) able to tolerate the idea, when in a better mode, that even this good mood might be interrupted from time to time by depressed moods. I don't like it, but I can tolerate it.
My wish would be to be rid of this forever, but I am able to be more realistic, and paradoxically, I am feeling much better because I can accept this.
Does this make sense?
Posted by SLS on January 18, 2001, at 10:22:23
In reply to Re: Dysthymia--Saw a new pdoc--Better visit, posted by Noa on January 18, 2001, at 8:41:25
Dear Noa,
Your post could not have come at a better time.
Thank you. :-) :-)
I woke up this morning not feeling as much of an improvement in my condition as I had since Saturday. I am scared. I know intellectually that over the course of time during recovery, there will be ebbs and flows of improvement (I hope). However, as you have said, this momentary (4 hours as of now) slide backward tugs at me to become sad and fearful and saying, "Here I go again." Yes, to me, it seems imminent that my remission is gone for good. I guess feeling this way and acting on the feeling helps prepare me for dealing with the crushing loss. I hope, but I don't always believe.I will try to better incorporate your perspectives regarding acceptance and tolerance of this illness. I have realized and accepted that it is chronic for a very long time. What I will have a difficult time accepting is the thought that my remission will be only partial. I have remained alive for the promise of 100%, not 50%. 50% will get me back to work and enable me to establish a social life - I know this. However, I want so much more. I know that there is a whole lotta’ stuff out there that can fill a life with peak experiences. I know how rich and rewarding life can be. I have seen this during my brief periods of significant responses to medication. 50% will not allow me to experience life in the way that I know is possible. It is there for others. I want it too. I want it all.
Dear Noa, you always make sense. (Don't contradict me)! For me, your words have been very valuable. You are an extraordinary combination of wisdom, compassion, and sharing. Your gift to others of your honest self-disclosure is warming and allows others to feel safe. It also allows others to see past their illnesses and recognize that they are indeed as human as the rest of us. I just want to extend to you my appreciation for your existence and my gratitude for your effort to help others.
Sorry for all the mushy stuff. I know that I will be rereading your post for quite some time to come.
Thank you.
Sincerely,
Scott
-----------------------------------------------------------------> Scott,
>
> For years, I swung like a pendulum between despair and optimism, but the optimism was always very precarious and fragile, so I had to cling to it hard.
>
> Each time I came out of a depression, I was convinced it was gone for good.
>
> When the depression started being more and more recurrent, and worse each time, I started to fear feeling optimistic. When I would start to feel better, I would be hypervigilant for any signs of low mood. And a bad day, or even a bad moment, would signal to me that my hope was in vain, I was doomed to fall again into the pit of hellish deprssion.
>
> In therapy, I have been working on accepting my illness as chronic, on bringing together these two lives I have led--the optimist who hopes/feels/wishes depression is in the past, and the desapairing depressive who feels life will never get any better and isn't worth living.
>
> It is hard, but I am learning to see both of these parts of myself as me, to not have the pendulum swing so drastically, to be able to move from depressed mood to non-depressed mood more fluidly and flexibly, to not have a bad moment signal the downward spiral, to not have to have the shadow of terror ruin my good days--terror of losing the progress, the hope.
>
> It is still a struggle, but I am stronger at this. I still get angry at myself when I have a bad moment or day, but I am better able to tell myself that it doesn't mean the remission is gone for good. And I am better (not fully) able to tolerate the idea, when in a better mode, that even this good mood might be interrupted from time to time by depressed moods. I don't like it, but I can tolerate it.
>
> My wish would be to be rid of this forever, but I am able to be more realistic, and paradoxically, I am feeling much better because I can accept this.
>
> Does this make sense?
Posted by michael on January 18, 2001, at 14:58:36
In reply to Re: Dysthymia--Saw a new pdoc--Better visit » Noa, posted by SLS on January 18, 2001, at 10:22:23
Scott -
I know what you mean about 50% vs. 100%. It is frustrating to have had that glimpse of 100%, and then to seem to get stuck at 50%...
I'm thankful that I'm not as miserable as previously, but it is incredibly frustrating not being able to find how to get to that next level, that last step, especially when you know it's there, and you know how much easier, and interesting and fun everything is when you are there.
The only thing that I can do is be thankful for the relief the 50% provides, and take advantage of that to try to persevere in looking for some way to the get the second 50%... At least we know it's there, we just gotta find the path...
I know I'm not a fountain of wisdom regarding this... My initial motivation for writing this post was to pass along a saying that the father of a friend of mine used to say:
"Keep your pecker up!"
His father is Iranian/Persian, and that is suposedly brittish (I think?) for 'keep your chin up' (pecker apparently being slang for chin)
Not a lot to offer in the way of inspiration, but when I think of it, it always makes me smile, if not actully chuckle/giggle a little... (hope you're not brittish, or from whaterver region this little item is from, since that'd probably kill - or at least diminish - the humor)
So, for what it's worth Scott (and everyone else), Keep Your Pecker Up! I'll try to do the same... michael
> Dear Noa,
>
> Your post could not have come at a better time.
>
> Thank you. :-) :-)
>
>
> I woke up this morning not feeling as much of an improvement in my condition as I had since Saturday. I am scared. I know intellectually that over the course of time during recovery, there will be ebbs and flows of improvement (I hope). However, as you have said, this momentary (4 hours as of now) slide backward tugs at me to become sad and fearful and saying, "Here I go again." Yes, to me, it seems imminent that my remission is gone for good. I guess feeling this way and acting on the feeling helps prepare me for dealing with the crushing loss. I hope, but I don't always believe.
>
> I will try to better incorporate your perspectives regarding acceptance and tolerance of this illness. I have realized and accepted that it is chronic for a very long time. What I will have a difficult time accepting is the thought that my remission will be only partial. I have remained alive for the promise of 100%, not 50%. 50% will get me back to work and enable me to establish a social life - I know this. However, I want so much more. I know that there is a whole lotta’ stuff out there that can fill a life with peak experiences. I know how rich and rewarding life can be. I have seen this during my brief periods of significant responses to medication. 50% will not allow me to experience life in the way that I know is possible. It is there for others. I want it too. I want it all.
>
> Dear Noa, you always make sense. (Don't contradict me)! For me, your words have been very valuable. You are an extraordinary combination of wisdom, compassion, and sharing. Your gift to others of your honest self-disclosure is warming and allows others to feel safe. It also allows others to see past their illnesses and recognize that they are indeed as human as the rest of us. I just want to extend to you my appreciation for your existence and my gratitude for your effort to help others.
>
> Sorry for all the mushy stuff. I know that I will be rereading your post for quite some time to come.
>
> Thank you.
>
>
> Sincerely,
> Scott
>
>
> -----------------------------------------------------------------
>
> > Scott,
> >
> > For years, I swung like a pendulum between despair and optimism, but the optimism was always very precarious and fragile, so I had to cling to it hard.
> >
> > Each time I came out of a depression, I was convinced it was gone for good.
> >
> > When the depression started being more and more recurrent, and worse each time, I started to fear feeling optimistic. When I would start to feel better, I would be hypervigilant for any signs of low mood. And a bad day, or even a bad moment, would signal to me that my hope was in vain, I was doomed to fall again into the pit of hellish deprssion.
> >
> > In therapy, I have been working on accepting my illness as chronic, on bringing together these two lives I have led--the optimist who hopes/feels/wishes depression is in the past, and the desapairing depressive who feels life will never get any better and isn't worth living.
> >
> > It is hard, but I am learning to see both of these parts of myself as me, to not have the pendulum swing so drastically, to be able to move from depressed mood to non-depressed mood more fluidly and flexibly, to not have a bad moment signal the downward spiral, to not have to have the shadow of terror ruin my good days--terror of losing the progress, the hope.
> >
> > It is still a struggle, but I am stronger at this. I still get angry at myself when I have a bad moment or day, but I am better able to tell myself that it doesn't mean the remission is gone for good. And I am better (not fully) able to tolerate the idea, when in a better mode, that even this good mood might be interrupted from time to time by depressed moods. I don't like it, but I can tolerate it.
> >
> > My wish would be to be rid of this forever, but I am able to be more realistic, and paradoxically, I am feeling much better because I can accept this.
> >
> > Does this make sense?
Posted by Noa on January 18, 2001, at 15:46:45
In reply to Re: Dysthymia--Saw a new pdoc--Better visit » Noa, posted by SLS on January 18, 2001, at 10:22:23
Wow, Scott--yeah it was mushy, but I am moved.
Are you in therapy? I do not feel I could make any of this "integration" progress without therapy. Yes, the remission wasn't possible without the meds, but all this other stuff needs the therapy. Really, the combo has been essential for me.
Posted by Abby on January 21, 2001, at 22:38:32
In reply to Dysthymia--Saw a new pdoc--Better visit, posted by shar on January 16, 2001, at 11:47:33
Shar,
I'm so glad. Finding a good doctor and feeling that a therapist and psychopharmacologist are on the same wave length is so helpful. You need (sometimes!) to be suspicious of the all you can expect is 50% way of thinking. Sure you can't always be at 100%, but it can be too easy to let doctors off the hook when you're at a stage where you can function only part of the time. Anyway, I'm very happy for you.
Abby
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.