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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 41 to 65 of 80. Go back in thread:
Posted by baseball55 on July 11, 2018, at 16:42:41
In reply to Re: Are you okay scott? » alexandra_k, posted by SLS on July 7, 2018, at 14:05:29
> Until last week, I was planning to get well and get a job in automobile sales. Now, I plan to live out my days trying to keep a roof over my head and avoiding depression and pain. I need to continue to process and accept that I will die while never having lived.
>
> That is a very sad statement. I feel very fortunate in that I did not experience depression until my late 40s, by which time I had raised children. had a long marriage, and established a professional career.Your problems with mental illness began (I believe) when you were much younger. But to say that you need to accept that "I will die while having never lived," is not a statement that moves you anywhere positive. Maybe a more spiritual approach would help.
Accept that my life was not what I expected or perhaps had hoped for, but I have had the courage and perseverance to face it.
Accept that I do not feel as well much of the time as I would hope, but I can focus on the little joys that come with living - the warmth of the sun, the antics of a dog in a park - whatever.
I don't want to sound like a Pollyanna and nobody was more resistant to this way of approaching life as me. But I have found that a mindful approach to living is more effective in combatting depression than any drugs I have tried. Trying to stay in the moment, cultivate gratitude and nonjudgmental awareness. As my (Buddhist) DBT therapist told me, "there is peace in the moment."
By nonjudgmental awareness, I mean being aware of things without getting angry, despairing, annoyed, frustrated. Just - I feel a sense of despair right now. Where in my body to I feel this? Just watch and be aware of the sensation - what thoughts does this feeling generate. As if you were an outside observer. The biggest danger to your life and health is to respond instead by thoughts (which I fall into periodically) like, I can't stand this anymore, my life is hopeless, I will never feel better, I'll die without ever having lived.
I'm sorry for the long post and maybe I am completely off the wall. I'm not trying to sell you on some philosophy. But my depression had spiraled so completely out of control that my psychiatrist (who was also my therapist) insisted I do DBT to learn to cope with (if not completely stop) despairing thoughts. I fought the DBT therapy and all it's focus on mindfulness at first. I didn't even really understand it. But now I pretty much get it and it really does help.
Posted by Lamdage22 on July 13, 2018, at 14:21:10
In reply to Re: Are you okay scott?, posted by baseball55 on July 8, 2018, at 18:16:57
My opinion is something along the lines of what baseball said. I would write your options down and try to think about it rationally. You are very depressed right now so your thinking is clouded.
New therapist? Hospital for a few weeks? Meds? (but you already do that) Supplements? Diet? A social worker? A class where you can make new friends? Reconnecting with existing friends? Deepen the relationship?
There are so many things.
Good luck
Posted by Lamdage22 on July 15, 2018, at 6:04:54
In reply to Re: Are you okay scott?, posted by Lamdage22 on July 13, 2018, at 14:21:10
It sucks that you dont feel like doing any of these things when you are severely depressed. But if you dont it will just get worse.
Posted by SLS on July 16, 2018, at 9:32:37
In reply to Re: Are you okay scott?, posted by Lamdage22 on July 15, 2018, at 6:04:54
> It sucks that you dont feel like doing any of these things when you are severely depressed. But if you dont it will just get worse.
I understand the wisdom in this, but depression often leaves me unable to get off the couch. I had a negative reaction to both Trintellix and Effexor. It looks much like too much serotonin. Perhaps I need time to let my brain settle after coming off Parnate. I hope that's all it is.
- Scott
Posted by Lamdage22 on July 16, 2018, at 10:17:57
In reply to Re: Are you okay scott?, posted by SLS on July 16, 2018, at 9:32:37
No matter how big the reward is for getting up? BTW: Was Parnate really that bad for you?
Posted by Lamdage22 on July 16, 2018, at 10:34:05
In reply to Re: Are you okay scott?, posted by SLS on July 16, 2018, at 9:32:37
So if i stood infront of your door to give you ten grand, you couldnt get up and open the door?
Posted by SLS on July 16, 2018, at 12:15:55
In reply to Re: Are you okay scott?, posted by Lamdage22 on July 16, 2018, at 10:34:05
> So if i stood infront of your door to give you ten grand, you couldnt get up and open the door?
I don't know what you want me to say. If I say yes, what would that indicate to you?
Parnate was a dead-end. I felt better on Parnate than I do today, but I felt it was worth the pain to gamble on finding a better treatment.
- Scott
Posted by Lamdage22 on July 16, 2018, at 12:32:00
In reply to Re: Are you okay scott? » Lamdage22, posted by SLS on July 16, 2018, at 12:15:55
> > So if i stood infront of your door to give you ten grand, you couldnt get up and open the door?
>
> I don't know what you want me to say. If I say yes, what would that indicate to you?I think yes means that you do have a choice. Its a hard one but my definition of "unable" is different.
> Parnate was a dead-end. I felt better on Parnate than I do today, but I felt it was worth the pain to gamble on finding a better treatment.
I see... I dont know what to recommend. What is your plan now as far as medication?
Posted by Lamdage22 on July 16, 2018, at 12:41:23
In reply to Re: Are you okay scott?, posted by Lamdage22 on July 16, 2018, at 12:32:00
I know that you are on a quest for remission but the truth is, we dont know how normal people feel. I would even say that some depression is normal.
I wonder if you have an unrealistic goal. I dont know how you feel with and without Parnate and how that would compare to me, so i dont want to judge you. Everyone is different.
Posted by baseball55 on July 17, 2018, at 19:21:43
In reply to Re: Are you okay scott?, posted by Lamdage22 on July 16, 2018, at 12:32:00
>
> I see... I dont know what to recommend. What is your plan now as far as medication?
>I guess I would also ask if you have any plan outside of medication. I understand (believe me) to be in a depression so severe that getting out of bed to eat or shower seems impossible. But are you able to do small things? To walk outdoors, go to a store and buy milk? If so, could you maybe imagine doing just a bit more. Sitting outdoors? Meeting with a therapist?
I'm just asking, not judging.
Posted by SLS on July 18, 2018, at 8:56:38
In reply to Re: Are you okay scott?, posted by baseball55 on July 17, 2018, at 19:21:43
> >
> > I see... I dont know what to recommend. What is your plan now as far as medication?
> >
>
> I guess I would also ask if you have any plan outside of medication. I understand (believe me) to be in a depression so severe that getting out of bed to eat or shower seems impossible. But are you able to do small things? To walk outdoors, go to a store and buy milk? If so, could you maybe imagine doing just a bit more. Sitting outdoors? Meeting with a therapist?Those are all good ideas. I feel a little better after finessing my medication. After making the adjustment, I was able to get off the couch and go food shopping. I had just about run out of food. I have some psychomotor retardation. I often stand in one place like a statue without moving a muscle. I can remain motionless and stare into space for a minute or two before moving on. This changes as a function of depression severity, of course. Without effective treatment or during a medication withdrawal rebound depression, I am vegetative. I have been in and out of psychotherapy. It has been helpful to deal with leftover issues regarding my psyche, but this doesn't make a dent in the depression itself. One psychotherapist with a PhD recommended that I get the depressive disorder treated before the therapy would be of any help. He told me that it would be of limited value because I couldn't think my way out of a paper bag. I was simply too vegetative.
> I'm just asking, not judging.
Thanks. I appreciate that. It happens sometimes that we try to understand another person's experience by using our own as a frame of reference.
Thanks for your concern and suggestions.
- Scott
Posted by Lamdage22 on July 18, 2018, at 13:27:16
In reply to Re: Are you okay scott? » baseball55, posted by SLS on July 18, 2018, at 8:56:38
Well playing it safe would be to get back on Parnate and either Saphris or Abilify. Or do you have any other good ideas? How did Saphris treat you?
Then you are in a mindset to do all the things we recommended with all of the positive effects and maybe you will come very near to remission.
But you can do stuff in your state right now, too. Youd even have to if you dont find meds thats gets you off the couch. I would go back to the old stuff (Parnate). It is pretty damn effective if i look at you before and now. Maybe thats all that you can expect from meds right now.
Posted by Lamdage22 on July 18, 2018, at 13:28:37
In reply to Re: Are you okay scott?, posted by Lamdage22 on July 18, 2018, at 13:27:16
I would go back to Parnate and Antipsychotic and only try stuff that you can take ALONG with Parnate.
Posted by SLS on July 18, 2018, at 14:03:00
In reply to Re: Are you okay scott?, posted by Lamdage22 on July 18, 2018, at 13:28:37
> I would go back to Parnate and Antipsychotic and only try stuff that you can take ALONG with Parnate.
That is an option that would probably get me back to the point I was three months ago. That would be better than nothing, but I am looking for something closer to the remissions I experienced in the past. Right now, I think my brain is a mess from all of the dramatic changes in drug exposures. That's my fault. I was impatient. I should have taken more time to taper and discontinue Parnate. With a little luck, I won't have to go through that again.
- Scott
Posted by Lamdage22 on July 19, 2018, at 5:28:05
In reply to Re: Are you okay scott? » Lamdage22, posted by SLS on July 18, 2018, at 14:03:00
Its your life. What is left that you didnt try yet?
Posted by SLS on July 19, 2018, at 11:47:45
In reply to Re: Are you okay scott?, posted by Lamdage22 on July 19, 2018, at 5:28:05
> Its your life. What is left that you didnt try yet?
I am less depresssed on Effexor 75 mg/day, but I feel zombified. My doctor wants me to reduce the dosage.
- Scott
Posted by baseball55 on July 19, 2018, at 17:46:50
In reply to Re: Are you okay scott? » baseball55, posted by SLS on July 18, 2018, at 8:56:38
Yes . I have been in that vegetative state. Parnate was the only thing that helped. Also abilify (but the weight gain was insane). I think others always have the urge to suggest ways to "snap out of it," even when none of that worked for us.
One difference, I think, between you and I is that I would "snap out of it" enough to get agitated and consumed with suicidal plans. I tried twice to kill myself and spent months in psych wards. But in those periods, I was able to talk and reach out.
I've been okay with only short-lived episodes of severe depression over the last four years. And I forget, sometimes, just how horrible it was and how hopeless I felt.
I just get concerned when you say things like you did in an earlier post (can't recall your exact words, but something about how you had to accept that this misery would be all you could expect(?))
These are the kind of thoughts that lead to suicide and I hope you don't kill yourself.
Are you ever suicidal?
Posted by Lamdage22 on July 19, 2018, at 21:24:23
In reply to Re: Are you okay scott?, posted by SLS on July 19, 2018, at 11:47:45
At least you are under the care of a doctor. You could also get on Skype with people despite your "vegetative" state. Possibly even a psychologist. I think you could use relieving conversations even though you may not be able to do alot of therapy. But thats just one professional opinion of that PhD anyway.
Posted by Lamdage22 on July 20, 2018, at 0:05:09
In reply to Re: Are you okay scott?, posted by Lamdage22 on July 19, 2018, at 21:24:23
You probably need to do more than just finding the right med to reach remission. Thats the nature of human beings.
Posted by Lamdage22 on July 20, 2018, at 0:07:31
In reply to Re: Are you okay scott?, posted by Lamdage22 on July 20, 2018, at 0:05:09
> You probably need to do more than just finding the right med to reach remission. Thats the nature of human beings.
Temporarily you may reach it but finding the right med wont solve all of your problems. Be realistic
Posted by SLS on July 20, 2018, at 7:26:35
In reply to Re: Are you okay scott?, posted by Lamdage22 on July 20, 2018, at 0:07:31
> > You probably need to do more than just finding the right med to reach remission. Thats the nature of human beings.
>
> Temporarily you may reach it but finding the right med wont solve all of your problems. Be realisticAs I've mentioned before, I believe in, and have used, psychotherapy as one tool. I've used exercise as another. Diet, too. As with healthy people, life comes with challenges and issues to be dealt with. Always. These are not the things that get in my way. I am sure that my conception of remission and how life can be experienced without bipolar depression is not unrealistic. I have had brief remissions before, and the world becomes a very different place to live in. Normal issues become easy to deal with. Challenges are not so insurmountable. It feels good to work for things. Even cleaning my apartment becomes rewarding.
If you had a severe case of the flu and were unable to get out of bed or think straight and function, would it be unrealistic to expect that you would feel better once the infection passed? Would you expect to function as well after the infection as you did before the infection? If symptoms persisted, how would you know? Would you be able to remember what it felt like to be without these symptoms and live life as you did before the infection? Would it frustrate you to not be able to climb a flight of stairs because of a lack of energy and strength? Would you accept this or would you continue to seek medical treatment?
- Scott
Posted by Lamdage22 on July 20, 2018, at 9:00:35
In reply to Re: Are you okay scott? » Lamdage22, posted by SLS on July 20, 2018, at 7:26:35
I dont want to argue with you. I think i would only make you mad at me and it wouldnt help neither you nor me.
I just ask myself: What is the difference between being outright lazy and being lazy because of depression? Is there a difference?
Posted by Lamdage22 on July 20, 2018, at 9:04:22
In reply to Re: Are you okay scott?, posted by Lamdage22 on July 20, 2018, at 9:00:35
Do successful people always have good brain chemistry and lazy people always have a bad one?
I dont think so
Posted by Lamdage22 on July 20, 2018, at 9:21:42
In reply to Re: Are you okay scott?, posted by Lamdage22 on July 20, 2018, at 9:04:22
To me waiting to see a therapist because of illness is like having a cold and not wiping your nose because you are going to get antibiotics. I dont like the state you are in and i hope something good comes out of it.
Did you ever do trazodone? Oddly, it is pretty helpful to me. Do you think Rapastinel may be a game changer for you?
Posted by alexandra_k on July 20, 2018, at 9:59:09
In reply to Re: Are you okay scott? » Lamdage22, posted by SLS on July 20, 2018, at 7:26:35
> I am sure that my conception of remission and how life can be experienced without bipolar depression is not unrealistic. I have had brief remissions before, and the world becomes a very different place to live in. Normal issues become easy to deal with. Challenges are not so insurmountable. It feels good to work for things. Even cleaning my apartment becomes rewarding.
You are reminding me of something that I have experienced when it comes to features of my environment.
I was in a place where I really did not feel okay, at all. I didn't have the personal space that I needed. I lived in a situation where I had a shared communal kitchen and I really just needed to not have people contact. Or I lived in a tiny little studio apartment and there was a constant succession of partying or screaming or yipping or squawking from people upstairs or downstairs or through paper thin walls or through single paned windows.
I remember saying to people (anyone who would listen) that I just needed a quiet place away from the noises of unsupervised teenagers / very young adults.
And 'rubbish rubbish rubbish pooh pooh pooh you are asking too much, you are being unreasonable, whatever kind of upset you think this is causing you this is not causing you there is something wrong with you'.
And it turned out...
They were wrong.
Because when my environment shifted all that anxiety and stress and agitated pacing and feeling like I wanted to gnaw my arm off or scratch my face off or bang my head... All of that behavior (which is typical for animals that are kept in a over-crowded state where they are prevented from engaging in 'natural behavior') all of that... Simply melted away. For really.
And, of course, that's why living in the inner city slums was only supposed to be temporary. And why people pay so much money for million dollar houses in adjacent suburbs that are quieter for being priced so as to keep the masses of teenagers out.
My point (in case it is getting lost, here) is that I think I get what you mean about feeling like things aren't okay... And feeling like things, sometimes, feel better. And yeah, sometimes they just do.
I personally found that medication messed with me rather a lot. Changes to medication took me quite some time to adapt or adjust to, I mean.
When I quit smoking I felt like a whole different person and I didn't think I was ever going to come right. I didn't think I was ever going to be able to read, again, or to engage in focused work. To write philosophy. I thought all of that was lost forever because it really genuinely was impossible for me for more than a few years.
And now I can do it... But I don't want to do it. But I'm doing it. Because I can make myself do things that are hard. Because I'm (mostly) not lazy... Mostly... But there really was a time... For a few years... When I really couldn't do it.
Could I have done it for a million bucks?
Possibly.
I'm not sure what that shows, either. That's a massive alteration to the incentive structure. The things that can be brought with that.
Hells, that would buy enough methamphetamine (or whatever) to make anything temporarily enjoyable... To get one through...
But that isn't the point...
That isn't the thing to be doing... To help...
I don't know. I'm just trying to not tell you to do x and y and z to make things better because sometimes... I don't know... SOmetimes acceptance is change? When it's not the 'party line' any rate.
So...
About them cars. Are you into cars? I ask because I am sort of into motorcycles. Mostly transport necessity, though. But they are kind of fun. LIke a mechanical horse that doesn't crap anywhere. Or that cr*ps all over the environment and is everybody elses problem rather than mine. Heh.
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