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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Dave1 on July 18, 2001, at 14:27:32
Hi,
I haven't been to the site for a while, but I am
having some disturbing problems that I wondered if
others with depression have had.I have had chronic depression for about 20 years
No meds help.Lately, I've been having 'reality problems' that
seem to be coming from depression. Some of symptoms
include: People and surroundings looking unfamiliar,
Things seeming distorted, I feel like I have no idea
who or what I am, I feel like I'm not part of my body,
and thing in the environment don't seem to make sense
to me in a way that they used to.I don't know if this is a psychotic depression, schizoprenia or what. I've tried several anti-psychotics but not much success. My Pdoc has suggested
clozaril.Has anyone had these symptoms with their depression, or
had success with clozarill. Any input appreciated.Thanks
Dave
Posted by Amy Blue on July 18, 2001, at 15:20:47
In reply to depression and psychosis, posted by Dave1 on July 18, 2001, at 14:27:32
Dave:
To me this sounds like anxiety, not psychosis. I've had two very harsh, awful periods that were similar to what you're describing. Feeling not alive, totally depersonalized, outside my body, everything distorted, tunnel vision, etc.
Klonopin snapped me out of it. If that hadn't worked, my pdoc wanted to try a low dose of Risperidal which is in fact an anti-psychotic but many people take a low dose to augment anti-depressants.
Just my two cents. Good luck to you -
Amy
Posted by Janelle on July 18, 2001, at 16:22:09
In reply to depression and psychosis, posted by Dave1 on July 18, 2001, at 14:27:32
Hi,
I've had bouts of depression for about 20 years also, although it went un or mis-diagnosed for about half that time.
I don't have your "reality problems" (good phrase you used to label them), BUT know someone who did have symptoms like yours. For example, when he went to take a shower, he felt like the water was not real.He WAS diagnosed as having depression with pyschotic tendencies, was put on Navane and Wellbutrin, which worked. He did not have to stay on Navane very long, was on Wellbutrin about a year or so.
Perhaps this will be of some help. Good luck.
-Janelle
Posted by Janelle on July 18, 2001, at 16:27:03
In reply to Re: depression and psychosis, posted by Amy Blue on July 18, 2001, at 15:20:47
Amy Blue - just thought I'd throw my two cents in also! To me, it sounds like it could be anxiety bordering on psychosis, based on the experience of someone I know who also had these symptoms and was diagnosed as having "depression with psychotic tendencies" (he was getting ideas like water from the shower wasn't real).
Then again, I've been diagnosed (although I didn't need it, I KNOW it!) with extreme anxiety and have had period where I've felt not alive, totally depersonalized, outside my body, obssesive/racing/irrational/worrisome thoughts.
Paxil and Klonopin used to snap me out of it, but when they pooped out, a low dose of Zyprexa seems to have done the trick. Apparently anti-psychotics and anti-convulsants can work for anxiety and as mood stabilizers! Many people indeed do take a low dose to augment anti-depressants.
Again, just my two cents!
-Janelle
Posted by Mark H. on July 18, 2001, at 18:50:58
In reply to depression and psychosis, posted by Dave1 on July 18, 2001, at 14:27:32
Hi Dave,
You might ask your doctor if it would be appropriate for you to try Zyprexa or another atypical anti-psychotic for a short while to see if it helps with your symptoms.
I tried it for about 10 days last year, and it helped me through a period of agitated depression. The first night I slept for 15 hours, and for the next several days I truly didn't care about anything (in a positive but somewhat artificial sense). When I felt I needed to get "back in gear" again, I went off and was fine.
Don't let the label of "anti-psychotic" put you off. It's used even as a single medication for treatment of some depressions, according to my psychiatrist.
Good luck and let us know what works for you.
Best wishes,
Mark H.
Posted by Zo on July 18, 2001, at 22:21:29
In reply to depression and psychosis, posted by Dave1 on July 18, 2001, at 14:27:32
If it's transient, could well be some form of seizure activity, I have TLE and it used to be like suddenly being on acid. . .Very weird things possible.
Zo
Posted by MM on July 19, 2001, at 0:07:38
In reply to Re: depression and psychosis » Dave1, posted by Zo on July 18, 2001, at 22:21:29
> If it's transient, could well be some form of seizure activity, I have TLE and it used to be like suddenly being on acid. . .Very weird things possible.
>
> ZoZo, what's TLE? (I'm guessing it's a kind of epilepsy) I've never heard anyone else but me say that they had this sudden feeling of being on acid. That's what my whatever is like. I'm dxd BPII, no mention of psychosis. I'm so confused trying to figure this all out. I don't think I get hypomanic, I don't think I get psychotic, I know I have anxiety, which is either because of or the cause of depression. I've tried many SSRI's (paxil, zoloft, prozac, serzone, and others I can't remember), and to be honest I don't really know if they helped. Sorry to butt in on dave's post but that acid thing jumped out at me.
Posted by stjames on July 19, 2001, at 1:46:55
In reply to Re: depression and psychosis » Zo, posted by MM on July 19, 2001, at 0:07:38
I don't think I get hypomanic,
You and every other bipolar in the world, no matter if they are full blown manic.
j
Posted by Zo on July 19, 2001, at 2:13:04
In reply to Re: depression and psychosis » Zo, posted by MM on July 19, 2001, at 0:07:38
Temporal Lobe Epilepsy. Seizures of the temporal lobes can cause all sorts of weird perceptual things, and without otherwise feeling weird. Very psychedelic, is all I can compare it to.
> Zo, what's TLE? (I'm guessing it's a kind of epilepsy) I've never heard anyone else but me say that they had this sudden feeling of being on acid. That's what my whatever is like. I'm dxd BPII, no mention of psychosis. I'm so confused trying to figure this all out. I don't think I get hypomanic, I don't think I get psychotic, I know I have anxiety, which is either because of or the cause of depression. I've tried many SSRI's (paxil, zoloft, prozac, serzone, and others I can't remember), and to be honest I don't really know if they helped. Sorry to butt in on dave's post but that acid thing jumped out at me.
Posted by Zo on July 19, 2001, at 2:14:03
In reply to Re: depression and psychosis, posted by stjames on July 19, 2001, at 1:46:55
> I don't think I get hypomanic,
>
> You and every other bipolar in the world, no matter if they are full blown manic.
>
> jSorry?
Posted by MM on July 19, 2001, at 3:52:29
In reply to Re: depression and psychosis » stjames, posted by Zo on July 19, 2001, at 2:14:03
Well maybe I do, but it doesn't feel good. It would be more of the mixed state kind I guess. Super anxious, agitated.
Posted by Elizabeth on July 19, 2001, at 7:41:26
In reply to depression and psychosis, posted by Dave1 on July 18, 2001, at 14:27:32
> Lately, I've been having 'reality problems' that
> seem to be coming from depression. Some of symptoms
> include: People and surroundings looking unfamiliar,
> Things seeming distorted, I feel like I have no idea
> who or what I am, I feel like I'm not part of my body,
> and thing in the environment don't seem to make sense
> to me in a way that they used to.That sounds like derealisation and depersonalisation -- dissociative symptoms (though to be related to anxiety or panic attacks, and IMO they can happen with depression too). They're not considered to be symptomatic of psychosis, but some people are helped by antipsychotic drugs.
Which antipsychotic drugs have you tried so far? Clozaril is problematic because you *must* have frequent blood tests for a rare but dangerous dyscrasia that it can cause.
There's a small chance that you might be experiencing partial seizures, which would be exacerbated by many antipsychotic drugs.
-elizabeth
Posted by Dave1 on July 19, 2001, at 16:49:25
In reply to Re: depression and psychosis » Dave1, posted by Elizabeth on July 19, 2001, at 7:41:26
> > Lately, I've been having 'reality problems' that
> > seem to be coming from depression. Some of symptoms
> > include: People and surroundings looking unfamiliar,
> > Things seeming distorted, I feel like I have no idea
> > who or what I am, I feel like I'm not part of my body,
> > and thing in the environment don't seem to make sense
> > to me in a way that they used to.
>
> That sounds like derealisation and depersonalisation -- dissociative symptoms (though to be related to anxiety or panic attacks, and IMO they can happen with depression too). They're not considered to be symptomatic of psychosis, but some people are helped by antipsychotic drugs.
>
> Which antipsychotic drugs have you tried so far? Clozaril is problematic because you *must* have frequent blood tests for a rare but dangerous dyscrasia that it can cause.
>
> There's a small chance that you might be experiencing partial seizures, which would be exacerbated by many antipsychotic drugs.
>
> -elizabethHi Elizabeth and everyone else who wrote back,
I've tried most of the new anti-psychs, and a
few old ones. Risperdal helped at first, but
only for a couple of days. I know the problems
with clozaril, but I heard it helps in 30% of the
cases where no others help.As for the TLE, my pdoc did mention something like
as a possibility,Dave
Posted by Zo on July 19, 2001, at 17:39:48
In reply to Re: depression and psychosis, posted by Dave1 on July 19, 2001, at 16:49:25
Just to add, a rather small dose of Neurontin (400mg) takes care of most of my TLE, incl. photosensitivity. It may be particular to TLE, and is certainly easier to tolerate than most AS meds.
Zo
Posted by judy1 on July 19, 2001, at 18:52:46
In reply to depression and psychosis, posted by Dave1 on July 18, 2001, at 14:27:32
I think like several other posters commented you are having feelings of derealization and depersonalization (both dissociative states) and fairly common in panic and anxiety disorders which can be comorbid with depression. Having experienced both frequently (my pdoc does not consider it a psychotic state- he saves delusions and hallucinations for APs) For this he uses benzos to lessen my anxiety which in turn lessens some of my symptoms. Unfortunately I have a pretty severe dissociative disorder which requires intensive psychotherapy. Hope some of this helps- judy
Posted by Elizabeth on July 20, 2001, at 0:27:46
In reply to Re: depression and psychosis, posted by Dave1 on July 19, 2001, at 16:49:25
> I've tried most of the new anti-psychs, and a
> few old ones. Risperdal helped at first, but
> only for a couple of days. I know the problems
> with clozaril, but I heard it helps in 30% of the
> cases where no others help.That's 30% of people with *psychotic disorders* who don't respond to other APs. I really don't think psychosis is your problem. I'd try a different class of drugs altogether -- perhaps the benzodiazepines, as some people have suggested -- since antipsychotics have been so disappointing.
-elizabeth
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