![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Emily Elizabeth on September 14, 2004, at 21:33:04
Hi all,
I'm sort of new to these boards. I have a question and I'm not sure if it will make sense or not. I guess I'll start at the begining...
A little background on me: I'm being treated for dysthymia and GAD and recovering from a major depressive episode. Right now, I take lexapro (50mg) and neurontin (300mg 4x/day) and ativan (as needed). We have been "tweaking" my meds for 2.5 yrs now and it is starting to wear on me. I have not had more than a month of feeling good during this whole time. To be fair, my life has been pretty awful in the past 2 yrs, so I can't expect the meds to work like magic (e.g., my fiance left me 6 mos before the wedding, my grandmother died, I have worked with very abusive graduate advisors that belittle me constantly...)
I guess I'm not as deeply depressed as I was before, but at the same time, I'm a shell of the person that I used to be. I'm having a hard time deciding if it makes sense to keep messing w/ my meds or just be happy w/ the progress that I have made. My pdoc's plan of action is to keep pushing my doses of lex and neurontin up, if that doesn't work, she wants to consider effexor or augmenting w/ a TCA.
So the bottom line is, how do you know when you are as happy as you are going to get? how do you know when it is time to stop messing w/ the meds? What are your experiences?
Posted by fayeroe on September 14, 2004, at 21:39:52
In reply to How do you know when you are better?, posted by Emily Elizabeth on September 14, 2004, at 21:33:04
So the bottom line is, how do you know when you are as happy as you are going to get? how do you know when it is time to stop messing w/ the meds? What are your experiences?
**from my experience only, i know i'm better when i go days without thinking about "am i getting better?" all at once i'll notice that i'm doing my stuff and not really aware of getting to that point. does that make sense to you? it's what i go on. if i am spending tons of time thinking about my mental state, i know i'm stuck and need to "tweak" things or investigate external pressures to see if that is what the problem could be. good luck, pat
Posted by yznhymer on September 14, 2004, at 22:07:40
In reply to How do you know when you are better?, posted by Emily Elizabeth on September 14, 2004, at 21:33:04
> Hi all,
>
> I'm sort of new to these boards. I have a question and I'm not sure if it will make sense or not. I guess I'll start at the begining...
>
> A little background on me: I'm being treated for dysthymia and GAD and recovering from a major depressive episode. Right now, I take lexapro (50mg) and neurontin (300mg 4x/day) and ativan (as needed). We have been "tweaking" my meds for 2.5 yrs now and it is starting to wear on me. I have not had more than a month of feeling good during this whole time. To be fair, my life has been pretty awful in the past 2 yrs, so I can't expect the meds to work like magic (e.g., my fiance left me 6 mos before the wedding, my grandmother died, I have worked with very abusive graduate advisors that belittle me constantly...)
>
> I guess I'm not as deeply depressed as I was before, but at the same time, I'm a shell of the person that I used to be. I'm having a hard time deciding if it makes sense to keep messing w/ my meds or just be happy w/ the progress that I have made. My pdoc's plan of action is to keep pushing my doses of lex and neurontin up, if that doesn't work, she wants to consider effexor or augmenting w/ a TCA.
>
> So the bottom line is, how do you know when you are as happy as you are going to get? how do you know when it is time to stop messing w/ the meds? What are your experiences?I'm not planning to give up trying for complete remission until I achieve it or die first. Listen, its miserable going through trials of medications with nothing to show for it but a mess of side effects. Not to mention the hassles of therapy, alternative treatments, dietary programs, exercize regimens, light therapy, etc. etc. and so forth. Sure, sometimes I decide to stop fighting and just go with the depression. Take a break, as it were. Adjust the pace of my life and the scope of my responsibilities. But eventually, I learn about some new treatment or some overlooked possibility or gain some insight about a tried and abandoned option used in the past. And I'm back on the case... no matter how hard. I've had remission before... why not again?
Posted by Steve3211 on September 15, 2004, at 16:57:30
In reply to How do you know when you are better?, posted by Emily Elizabeth on September 14, 2004, at 21:33:04
I agree with fay. You know you are in remission when you no longer constantly worry about how you are feeling and analyzing every little emotion or symptom. In other words you forget yourself. I had been symptom free for about six months until family issues once again caused it to arise. The goal I guess is to achieve remission and then be proactive about the issues that brought is up in the first place. I am determined to beat this once and for all.
Best-Steve
Posted by thinkfast on September 15, 2004, at 18:12:22
In reply to Re: How do you know when you are better?, posted by Steve3211 on September 15, 2004, at 16:57:30
wise words from above posters...we all get so wrapped up in this mental health junk that we forget to take notice of the good things that "sometimes" happen...hehe...try and remember all of the things you have learned with all of this and what good it had done for you...it's given me a better understanding of myself and other people as well...I'm in the same boat with the meddications, to the point where it is a true obsession...spending hours and hours doing research for what? Seems like you just have to find something that works on the worst parts of your issues, and keep learning to deal with the rest...good luck..peace
Posted by Philidor on September 15, 2004, at 18:22:01
In reply to How do you know when you are better?, posted by Emily Elizabeth on September 14, 2004, at 21:33:04
WHOA! Lexapro 50 mg??
You'll know you're getting better, dear, when you get yourself another SHRINK. That is an UNHEARD OF dose of Lexapro. 10-20 mg a day is the most recommended. And she plans to up the dose even more??
And the neurontin on top of that? No wonder you feel like a shell.
Look, there is no evidence---no studies, nothing--that more than 20mg Lexapro will do anything but give you more side effects. The research does indicate that 20 will give you twice the side effects of 10mg. And you're taking 50?
So step one is tell her you want to get off the Lexapro as quickly as is safe. If she wonders why just say that you don't think it's helping and that you're a little leery of taking MORE THAN TWICE THE DOSE INDICATED in the package insert(under DOSAGE AND ADMINISTRATION):
http://www.lexapro.com/pdf/lexapro_pi.pdf
Then while you're finding another p-doc
(to respond to your other question) I suggest you take the Beck Depression Inventory:http://www.ibogaine.org/graphics/3639b1c_23.pdf
(Scroll down to p.2)
Then score yourself as follows:
1 – 10: These ups and downs are considered normal.
11 – 16: Mild mood disturbance
17 – 20: Borderline clinical depression
21 – 30: Moderate depression
31 – 40: Severe depression
over 40: Extreme depressionThis is a very respected test. (Not like the tests you find in Cosmo or USA today.) It is recommended by experts like Dr. David Burns ("Feeling Good") You can use it repeatedly to gauge your progress week by week. (And it stays accurate!)
I've used it myself many times. Don't consider yourself "recovered" until you make it to the single digits. Hope this helps.
Good luck,
Phil
1 – 10: These ups and downs are considered normal.
11 – 16: Mild mood disturbance
17 – 20: Borderline clinical depression
21 – 30: Moderate depression
31 – 40: Severe depression
over 40: Extreme depression
Posted by Dr. Bob on September 15, 2004, at 19:07:14
In reply to Re: How do you know when you are better?, posted by Philidor on September 15, 2004, at 18:22:01
> experts like Dr. David Burns ("Feeling Good")
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by Pfinstegg on September 17, 2004, at 18:30:34
In reply to Re: How do you know when you are better?, posted by Philidor on September 15, 2004, at 18:22:01
You're the first person I've seen here, besides me, who uses the Beck Depression Inventory! I've gone from "Extreme" in 2002 to "Normal" for the past six months by doing, well, everything you can think of, short of ECT- (a lot of different meds, TMS, supplements, psychotherapy). I agree that just being able to forget about how you're feeling, and just live, is the best indication of recovery, but for those of us who aren't quite there yet, I agree that the Beck Inventory is very helpful. It's particularly good as an on-going record to share with your pdoc.
Posted by sunshine211 on September 18, 2004, at 6:38:52
In reply to Re: How do you know when you are better? » Philidor, posted by Pfinstegg on September 17, 2004, at 18:30:34
You will have ups and downs no matter what. But to know if things are going smooth, take inventory. Use the test mentioned before, journal and read back logs, OR look at your life right now and compare to a month or six months ago. Do you feel better? No one can forget their worst days. There are in-between days too. If you can appreciate and find more POSITIVES in your day you are 'getting better' The key I found is to recognize the good and bad. The meds allow you to do that, depression does not! Hope this helps.
Posted by Philidor on September 18, 2004, at 14:41:00
In reply to Re: How do you know when you are better? » Philidor, posted by Pfinstegg on September 17, 2004, at 18:30:34
I agree that the Beck Inventory is very helpful. It's particularly good as an on-going record to share with your pdoc.
Yes, I couldn't agree more! It's like a psychological "fever thermometer" that can give both you and your doctor some sort of objective evidence that you really ARE sick!
Far too many people (like maybe our Emily Elizabeth??) are inclined to think that there's really nothing wrong; it's just that this is Life, and Life sucks, always has, so you might as well accept it.
That's one of the funny things about depression (and believe me, I've been there---I mean WAY DEEP down there); it doesn't just cast a gloom on the present, but on your whole past. So that you can't even RECALL feeling any better than now.
And the truth is, my problems today are really no less serious then they were back when I felt so low. BUT THE WAY I FEEL ABOUT THEM---that's what's different!
Same with the good things, the things you used to enjoy so much, but don't anymore.
I like to say that depression is a loss of appetite for life. The menu hasn't changed. Your favorite restaurant is just as popular, the Linguine Alla San Remo that you were once so wild about, it's still the same.
So I suppose when you find yourself thinking about it and the wine and seeing Lenny (Greatest Waiter in town) and about going back there sometime, that's when you know you're getting better---know what I mean?
Phil
Posted by Dr. Bob on September 18, 2004, at 15:54:38
In reply to Re: How do you know when you are better? » Philidor, posted by Pfinstegg on September 17, 2004, at 18:30:34
> I agree that the Beck Inventory is very helpful. It's particularly good as an on-going record to share with your pdoc.
FYI, I've recently made the CES-D, an alternative to the Beck, available here:
http://www.dr-bob.org/cgi-bin/pb/ces-d.pl
Bob
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.