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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by MJC on October 5, 2002, at 21:16:32
I've just been reading over articles concerning being Hyper Manic. This is what my Doctor now claims that I am. It's just a really confusing cycle to try and pinpoint exactly what kind of anxiety disorder I have in order to treat it.
Anyways, for a person that is hyper manic it says that that person is always going through highs and lows. I've been through depression before (after my Mom's death for a number of years) but I can honestly say I haven't been depressed for an extended period of time in over two years. However, my anxiety is through the roof. It's always there, it's just that some days are better than others. On my good days (without medication) I just have this feeling like the world is going to end and that I'm being physically and mentally torn apart. On my bad days I have viscious panic attacks. I don't seem to have any lows though, or any periods without at least some anxiety. Could I possibly by hypermanic? Or is there something else that we're skipping over all together?
At first we thought it was GAD, but my anxiety is way too severe to be that. Then we thought that I had a mild form of aspergus syndrome (high-functioning autism). After going to a conference with my Doctor and hearing her talk to her Colleagues about it, we're both certain that it can't possibly be that either. In the past, when I was sort of well, I had absolutely no problem functioning like a normal person. Through my College years I even tutored students with learning disabilities for about 2 years. Therefore, I can communicate fairly well with other people. When I talk to people, I don't talk "at" them, but I talk to them. The only real sign that it could have been Aspergers Syndrome was because I tend to go through phases. I'll get interested in a little hobby and then follow it obsessively till it tires me out. Once I've learned just about everything there is to learn about it, I move on to something else.
One other point to add, this is something that I've just recently found out since my Mother has been deceased for almost 8 years, she suffered from a bi-polar disorder as well. She was mildly manic depressive. Meaning that she didn't extremely jump to highs and lows but she did have many peaks and valleys. For example, when I was young, fell, and hurt myself, my Mother instinctly panicked, started crying hysterically, and had to get my Dad home from his job (which was about 20 minutes away) in order to drive "us" to the hospital: me to get stitches, her to get sedated. The doctor that is now treating me also treated her in the past, more for depression without medication, but she did take note of her mood swings. Some days she would come in and be absolutely happy, everything was fine in the world. Other days she would be absolutely miserable and close to tears though everything was as fine those days as they were the days in which she seemed overly happy. I know sometimes that these kind of disorders are passed on through the genes.
Any recommendations on this would be greatly appreciative. I'm really interested in find out the root cause of exactly what I'm suffering from so that I know what I'm dealing with. This disorder has become almost too much to bear; at the moment I'm basically out of work being supported by an absolutely wonderful and understanding family and basically being freed from any source of stress untill I'm able to get this disorder underneath my control. My Doctor has also been wonderful and has been explaining in detail exactly what she thinks is going on here, at which point I tend to spend a couple of days doing my own research on it.
So if anybody knows a few things that I'm missing out on here, I know I must be missing a hell of a lot since I was never interested in this type of thing untill it basically consumed my life. Anyways, any feedback would be greatly appreciated.
Thanks in advance,
Mike
Posted by BrittPark on October 6, 2002, at 13:35:36
In reply to Anxiety Disorder -- Advise please, posted by MJC on October 5, 2002, at 21:16:32
It sounds like you might have panic disorder. Front line treatments for panic disorder are benzos and/or an antidepressant. There's some evidence that TCAs are better with panic disorder than the newer SSRIs. Is any of your anxiety anticipatory? That is, do you get anxious about possibly having a panic attack?
Knowing you will find an answer,
Britt
Posted by MJC on October 6, 2002, at 16:37:31
In reply to Re: Anxiety Disorder -- Advise please » MJC, posted by BrittPark on October 6, 2002, at 13:35:36
Honestly, I'm not even sure if any of my anxiety is anticipatory. Right now I'm on a little bit of Clonazepam, Effexor XR, and Trazadone which is kind of balancing things out untill we have a better understanding of this. But I'm just in panic like ALL the time. My mind is basically rushing at 100 miles a minute constantly, providing me with severe insomnia for 4-5 days where I will basically not sleep at all, then on the 5th and 6th days I'll just be so burned out that I can barely do anything. Those nights I'll sleep about 6-7 hours (if I'm lucky) then the cycle will continue all over again. I have a VERY hard time controlling my temper and sometimes I get overly upset about things that I know are minor in nature. I know I'm overreacting but yet I can't stop myself from overreacting.
It's almost like I'm living my life on fast forward though, at the moment, there is absolutely no outside pressure to be pushing me this way.
On my best days I'm pretty uptight, and on my worse I'm having panic attacks. The only other in between I have is being completely drained of energy and any mental capacity whatsoever.
From what my Doctor and I have found out so far, I don't agree with Paxil. It puts me into almost a zombie like state. If I take a little bit of it (20mg), there is a "tiny" bit of control over my anxiety. If I increase the dosage, everything else in my head slows down (I went for 2 months on 30mg and barely left the couch).
On Effexor XR, well, right now I'm taking 75mg doses at 36 hour intervals. I was taking 75mg every day but it was making me feel like I was on speed. It would also give me episodes where I felt euphoric, which I didn't think was bad but my Doctor said that it shouldn't be doing that and lowered the dosage.
The Clonazepam is basically to help keep things under control, not have any sudden violent panic attacks, while we're trying out the different medications. The trazadone is used to help me sleep. Like I said, my brain travels at about 100 miles a minute, so even when I lie down at night, when I'm absolutely exhausted, my body is hurting, my eyes are burning, my brain is still going and preventing me from sleeping.
When I spoke to my Dr. yesterday she told me that she would like to try out Epival on me and she's already filled out the forms to go have my brain waves read at the local hospital.
At the moment I'm more curious as to what exactly I'm suffering from than as to what medications will help me. I don't have GAD, SD, PSTD, or OCD but kind of all three mixed in together in a nice fancy blend with a dose of panic attacks tossed in. Personally, I can't pinpoint one of the 5 that I'm suffering from more. It's basically all 5 at the same level practically all the time.
For my Dr. to describe to me what she thinks is going on here she drew a line on a piece of paper. She said that that line is the ideal chemical state for my brain, this is where everything is level and I should be normal. Then she said that below that line was where depression would fall into place. Above the line is where anxiety would be. Her guess is that my current brain level is jumping all over the place in the anxiety portion with it basically never reaching the normal level.
So, what could that possibly be? What anxiety disorder would do that to me on a constant basis? In order for me to be treated, I need to understand exactly where I'm at, where I'm supposed to be, and how exactly I'm supposed to get there. I'm a Logistics major so that's practically how my brain works now lol...
> It sounds like you might have panic disorder. Front line treatments for panic disorder are benzos and/or an antidepressant. There's some evidence that TCAs are better with panic disorder than the newer SSRIs. Is any of your anxiety anticipatory? That is, do you get anxious about possibly having a panic attack?
>
> Knowing you will find an answer,
>
> Britt
>
Posted by Alan on October 6, 2002, at 18:52:07
In reply to Re: Anxiety Disorder -- Advise please, posted by MJC on October 6, 2002, at 16:37:31
Anxiety disorders aren't usually defined into nice neat packages that fit the diagnostic criteria of DSM IV. I suffer from GAD/SAD and have several phobias related but it still is an anxiety disorder.
I'm surprised that excluding mania or hypomania, you haven't been prescribed a benzodiazapine in sufficient monotherapy such as xanax, ativan, valium, or klonopin. Why don't you ask your doctor for these medications to at least calm you down in this hyper-aroused state you're in? At least in dosages high enough to be theraputic and not to be complicating the picture with 3 different drugs.
If you respond well to more klonopin for instance then there's some of your answer right there. Or if you can stop the (many times) stimulating effects of any ssri and see if one of the other bzds work for you then at least you'll understand some cause and effect.
Analysing brain waves seems an odd thing to do to diagnose unless she suspects something physiological instead of psychological.
Alan
Posted by maririp on October 7, 2002, at 11:54:36
In reply to Re: Anxiety Disorder -- Advise please » MJC, posted by Alan on October 6, 2002, at 18:52:07
I think allot of people are misdiagnosed about panic disorder..i suffered from my first full blown panic attack in 1986. I was lucky to be diagnosed properly..I found that xanax helped me the most..i also have taken many anitdepressants over the years..recently i started lexapro. I went through therapy and learned to control my panic attacks. I still have xanax on hand but dont need to reach for it as much. The wrong kinds of meds can trigger anxiety. also coffee and chocolate things high in caffeine will only make matters worse.
Posted by Gracie2 on October 9, 2002, at 0:43:09
In reply to Re: Anxiety Disorder -- Advise please, posted by maririp on October 7, 2002, at 11:54:36
My panic attacks have been stabalized with Seroquel. This was first prescribed for me in a roundabout way because I didn't immediately admit to my psychiatrist that I had a history of drug abuse. Once I was truthful about it, that was the end of the Xanax and Klonapin, which were only marginally helpful anyway.
In the past there have been some rather strong reactions on PB about my recommendation of Seroquel. I can understand that, because I have the same reaction to any mention of Depakote, which was a horrible drug for me. However, I would not presume to tell anyone that they should avoid Depakote if their doctor prescribes it.
Seroquel is a strong anti-psychotic and I'm sure that some have had an adverse reaction to it, but some people also have an adverse reaction to penicillin. For me, Seroquel has been a godsend.
My bipolar symptoms have stabalized, my anxiety attacks have stopped, and my insomnia is gone.
-Gracie
Posted by Alara on October 11, 2002, at 10:14:29
In reply to Anxiety Disorder -- Advise please, posted by MJC on October 5, 2002, at 21:16:32
MJC, I hear you, believe me. In fact, a lot of people in this forum would be sure to relate. There are few things in this world that are more anxiety-provoking than to be going through the psychiatric-diagnosis process.
I remember the first time that I saw a psychiatrist. Did I have GAD? OCD? Was I manic-depressive? Did I have Borderline Personality Disorder or Schizophrenia? The more that I thought about my possible psychiatric label, the more my anxiety grew. I believed that I was destined for the back wards of the world’s most notorious psychiatric institutions. That’s what you call panic.
Of course, both my psychiatrist and psychotherapist at the time knew better than to put a label on me. They understood that I was a complex case, a sensitive person who needed more than anything else to be validated, to be understood. They knew that labelling a person who was fixated upon `what was wrong with her’ could be disastrous. Thank God they was so wise.
MJC, I can really understand your need for a label. After all, if you know what is wrong, you can fix it. Right?
Well, that’s not the entire truth. Sometimes we can focus too much upon the things that are wrong. If you begin to accept some of your flaws and at the same time develop enough confidence in your own ability to survive, the potential labels will become less threatening and I suspect that your anxiety levels will also plummet! Of course, this takes a lot of hard work
There’s another issue: You want to treat your `problem’ with appropriate medications and you can’t do that without a diagnosis. Right?
Well, that’s not entirely true either. Mental health professionals will usually have a gut instinct regarding the most appropriate drugs for you based upon their previous experience with patients. It’s not really so much about labels. (Dr Bob, please forgive me if I’m wrong.) In fact, it is often a trial and error process, but you sound as though you have some very supportive people behind you. I suspect that you’ll be fine.
Remember that your eventual goal will be to maintain a healthy, normal life without the need for pdocs or medication (just as a child aims to individuate from his/her parents and support him/her self in the end). My belief is that a firm label won’t help you to do this in the long run.
In the interim, I’d suggest that you take the suggested medications and work on understanding yourself. Chances are that, if you persist, you’ll be fine. Most of us have the ability to surface in the end. J
This is the end of the thread.
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