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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Meltingpot on January 14, 2010, at 14:54:24
Hi,
I doubt I will get any answers to this but I'm going to ask the question anyway. I've been diagnosed as having dysthymia with moderate to severe symptoms. I also have anxiety. I have tried most medications and most of them have helped a little, Seroxat helped the most for two years (I enjoyed life for a while) and then stopped working. Off medication my anxiety gets very bad to the extent that all I want to do is keep moving all of the time.
I don't know what to do next. I don't want to live like this for another 10 years. I keep thinking if I'm still like this in five years and still asking the same old questions and repeating the same old story then I'll probably seriously think about ending it all. Well I say that now anyway.
All psychiatrists have told me that ECT does not tend to work for my type of anxious depression and I believe them. But I cannot find any evidence that proves that ECT does not work for my type of depression. There don't seem to be any studies, I've trawled the internet looking (as I'm so obsessed) and I can't find any personal experiences of people with dysthymia and anxiety who have had ECT so I'm not sure what the psychiatrists base there opinion on. I know Max Fink says it but then he doesn't cite any studies either.
Has anyone on this board who has been diagnosed wth dysthymia and anxiety ever had ECT?
Denise
Posted by inanimate peanut on January 14, 2010, at 15:21:49
In reply to Dysthymia/Anxiety - ECT, posted by Meltingpot on January 14, 2010, at 14:54:24
In general, it's hard to find studies that say something doesn't work for something else. It's generally that they notice that it does work and thus commission a study in an attempt to prove that. The lack of studies on it may be an indication in and of itself that it doesn't work.
I was looking into ECT not long ago. You'll probably gets lots of responses here, as people were very responsive to my questions. My question is to whether you've talked to an ECT doctor about this. That's where I learned that it only works for about 50% of people, and with the memory and other possible side effects, it just wasn't worth it for me. An ECT doctor might also be able to answer your questions about dysthymia/anxiety. It doesn't do any harm just to have a consult. Then you can also find out if they will even considering doing the procedure on someone who's not severely depressed (because they may not).
Posted by Phillipa on January 14, 2010, at 16:25:57
In reply to Re: Dysthymia/Anxiety - ECT, posted by inanimate peanut on January 14, 2010, at 15:21:49
Denise I was told by a pdoc that it doesn't work for anxiety and is saved for suicidal patients? As at the time was in a support group and a girl attending had had it and couldn't go back to school as couldn't remember things. When questioning the doc I asked why the ECT and he said only way to prevent suicide. Then asked about the memory and school he said was hoping in six months she might be able to return. Phillipa
Posted by alchemy on January 14, 2010, at 17:31:49
In reply to Re: Dysthymia/Anxiety - ECT, posted by inanimate peanut on January 14, 2010, at 15:21:49
Although I had a positive experience with ECT, it seems to only work when I am "major messed/depressed". But that's just me.
I did have a serious out-of-the-blue extreme anxiety episode for a few months & went to the hospital. My dr. said ect could still work for anxiety. But I only did a couple - I had too much anxiety about ECT (before I wasn't as nervous).I feel the same way you are. I don't have it to the point where I would just grab a bottle of pills, but I can't continue. I read my journal going back so many years and I have never wanted to live.
I'm sorry for your pain as well.
Posted by bleauberry on January 15, 2010, at 16:30:40
In reply to Dysthymia/Anxiety - ECT, posted by Meltingpot on January 14, 2010, at 14:54:24
I had rather serious anxiety and depression before ECT.
Following the 12th shock, I actually had 2 days of zero anxiety. I even stepped up to a microphone in front of 300 people and spoke with perfect confidence and boldness. Two days later I was in an ambulance attempting suicide. ECT did not work for either depression or anxiety. The problem with ECT is that, even when it does work...which isn't nearly as often as claimed...it is usually very short lived.
When you say you've tried lots of medications, we don't know what they were. ???
Have you ever been on Parnate? Nardil? You definitely qualified for one of those a long time ago, and should not even consider ECT or any other meds until you've been on those. A tiny bit of Klonopin with them is common and good synergy.
Posted by Meltingpot on January 16, 2010, at 14:09:44
In reply to Re: Dysthymia/Anxiety - ECT, posted by inanimate peanut on January 14, 2010, at 15:21:49
Hi,
Thanks for the advice but there is no way I could get to see an ECT Doctor in the UK. You don't get to see ECT Doctor's here in the UK, although I would like to get the chance to talk to one.
Denise
Posted by Meltingpot on January 16, 2010, at 14:11:53
In reply to Re: Dysthymia/Anxiety - ECT, posted by Phillipa on January 14, 2010, at 16:25:57
Hi Phillipa,
Thanks for this information. Although, I chatted with this woman who had anxiety along with depression and she said that after she had ECT the anxiety went away because the depression went away.
However, my psychiatrist did say that ECT does not tend to work for anxious types of depression.
Denise
Posted by inanimate peanut on January 16, 2010, at 19:43:34
In reply to Inanimate Peanut, posted by Meltingpot on January 16, 2010, at 14:09:44
Sorry, I didn't stop to think about that. I wish that were an option, but I guess you're doing the next best thing in gathering all the research and personal feedback that you can get. Good luck with it!
Posted by Phillipa on January 16, 2010, at 20:18:29
In reply to Re: Dysthymia/Anxiety - ECT, posted by Meltingpot on January 16, 2010, at 14:11:53
That would be me as panic age 24 never depressed. Once anxiety controlled no depression. So I guess there are two types of depression. And you'd think the treatments would vary more? Love Phillipa
Posted by Meltingpot on January 17, 2010, at 15:57:17
In reply to Re: Dysthymia/Anxiety - ECT, posted by alchemy on January 14, 2010, at 17:31:49
Hi,
I was very fortunate as in my early 20s, after about 7 years of milder depression and anxiety which started to get worst the Doctor prescribed an antidepressant (which I didn't think would work as I didn't think I was depressed) The drug worked really quick and I was depression free after that for over 10 years. I did realise how lucky I was to have found something so effective but I didn't realise at the time how lucky I was compared to other people with depression, as I assumed that antidepresants worked for everyone with depression. I couldn't see how they couldn't help someone given the powerful effect they had on me.
This time I haven't been half as lucky (I'm now in my 40s) but I do remember those good times and for me it does give me some consolation that I had 10 very good years and that my childhood years were also good. I realise now that some people don't even get that.
So are you saying that the ECT helps when you get really bad but the rest of the time you feel mildly depressed and not completely well. Have you tried a lot of different types of medication?
I would consider something like Deep Brain Stimulation (not sure what there is to lose) but they only seem to be doing trials on people with major depressive disorder.
Denise
Posted by Meltingpot on January 17, 2010, at 16:17:39
In reply to Re: Dysthymia/Anxiety - ECT, posted by bleauberry on January 15, 2010, at 16:30:40
Hi,
Yes I've tried Nardil about 3 times, each time for about a month. The first time it made me feel really stoned and more relaxed I guess but didn't seem to do much for my mood. Neither did it do much the 2nd and 3rd time. However, it was only after the first time of trying Nardil that the Seroxat seemed to work. I repeated the experiment coming off Seroxat to go back on Nardil to go back on Seroxat in the hope that I could replicate the experience but to no avail. I've even come off all meds for three months (apart from Zyprexa now and again) in the hope that having a drug holiday would help but it doesn't seem to have. I'm back on Seroxat and although I feel better than I did I still feel depressed in a lot of ways. I still have suicidal thoughts.
In my 20s I know that I would have responded to pretty much any antidepressant that was given to me. This time round though it has been so much more difficult. 2 years of trying to no avail to finally to get a response with Seroxat and then that to stop helping as much 2 years later. My fear is that something else has gone wrong further down the line. Trouble is they don't know what that is because they don't really know what causes depression in the first place, or why antidepressants work when they do work.
I was thinking that if I did have ECT then perhaps it might make me more receptive to antidepressants. I really don't know what else to try.
I've tried most medications in most classes, I've tried rTMS, I've tried magnesium injections, high dose vitamin B, St Johns Wort, Folic acid and many others but they don't seem to help at all.
I know lots of people are in the same boat, I'm just getting tired of feeling stuck in the same boat year after year after year. Not really looking forward to anything or feeling enthused by anything. I am able to work and I can still enjoy certain activities but the things I don't enjoy the things I used to enjoy and I don't have half of the energy I used to have. I used to be able to stay up until 3am in the morning. Now I have to get to bed by 10:00pm regardless of what time I get up.
Thanks for always trying to think of something, I do appreciate it.
Denise
Posted by bleauberry on January 18, 2010, at 18:36:46
In reply to Re: Dysthymia/Anxiety - ECT - Bleauberry, posted by Meltingpot on January 17, 2010, at 16:17:39
I certainly feel your frustration. ECT does look like at least an option to maybe reset things for a new start? I don't think it would much, but anything is possible. For me it actually made meds much more intolerable. I could take 20mg prozac prior to ECT and it was like candy. After ECT I can't even handle 2mg. Weird things can happen in ECT. It is like everything else...try it and see what happens...because we can't predict.
My own theory is that when antidepessants universally fail after longterm use, it has something to do with adaptive changes at receptors. Some of the things that could reverse those include Pindolol, Buspar, Abilify, Milnacipran. Mainly I think we are focusing on the 5ht1a receptor as the guilty one.
Outside of that theory, another commonly overlooked deficiency is endorphins. We concentrate so much on serotonin, NE, and DA, we totally forget about the powerful mood boosters...endorphins. A ton of people at med rating forums have discovered that when prescribed a certain med for pain, with a history of failed antidepressants, Tramadol was like magic on the depression. LDN also has potential.
5ht1a
endorphinsMilnacipran+Pindolol
Milnacipran
Milnacipran+Risperdal
Tramadol
Any SSRI+Pindolol+Buspar
Milnacipran+Abilify
LDN with any of the above no matter whatHopefully there might be some helpful ideas here.
> Hi,
>
> Yes I've tried Nardil about 3 times, each time for about a month. The first time it made me feel really stoned and more relaxed I guess but didn't seem to do much for my mood. Neither did it do much the 2nd and 3rd time. However, it was only after the first time of trying Nardil that the Seroxat seemed to work. I repeated the experiment coming off Seroxat to go back on Nardil to go back on Seroxat in the hope that I could replicate the experience but to no avail. I've even come off all meds for three months (apart from Zyprexa now and again) in the hope that having a drug holiday would help but it doesn't seem to have. I'm back on Seroxat and although I feel better than I did I still feel depressed in a lot of ways. I still have suicidal thoughts.
>
> In my 20s I know that I would have responded to pretty much any antidepressant that was given to me. This time round though it has been so much more difficult. 2 years of trying to no avail to finally to get a response with Seroxat and then that to stop helping as much 2 years later. My fear is that something else has gone wrong further down the line. Trouble is they don't know what that is because they don't really know what causes depression in the first place, or why antidepressants work when they do work.
>
> I was thinking that if I did have ECT then perhaps it might make me more receptive to antidepressants. I really don't know what else to try.
>
> I've tried most medications in most classes, I've tried rTMS, I've tried magnesium injections, high dose vitamin B, St Johns Wort, Folic acid and many others but they don't seem to help at all.
>
> I know lots of people are in the same boat, I'm just getting tired of feeling stuck in the same boat year after year after year. Not really looking forward to anything or feeling enthused by anything. I am able to work and I can still enjoy certain activities but the things I don't enjoy the things I used to enjoy and I don't have half of the energy I used to have. I used to be able to stay up until 3am in the morning. Now I have to get to bed by 10:00pm regardless of what time I get up.
>
> Thanks for always trying to think of something, I do appreciate it.
>
>
> Denise
Posted by Phillipa on January 18, 2010, at 21:04:41
In reply to Re: Dysthymia/Anxiety - ECT - Bleauberry » Meltingpot, posted by bleauberry on January 18, 2010, at 18:36:46
Blu all I know is when took but one pill of percocet after the surgery two years ago I felt great. I definitely believe in the opiod theory. Phillipa
Posted by alchemy on January 28, 2010, at 19:39:58
In reply to Re: Dysthymia/Anxiety - ECT - Alchemy, posted by Meltingpot on January 17, 2010, at 15:57:17
Hi Meltingpot. I have tried a lot of antidepressants. I started on Prozac in my early teens. Drugs have only helped a little & I would say I have always been depressed.
Only after my 1st hospital "visit" about 4 years ago did I work with one psych dr. consistently. My dr. has said in a round-about-way that I am a hard one to treat because of some paradoxical reactions and lack of response. I think I would fall into the category of treatment resistent. My current thoughts of suicide are usually because it has gone on so long (I am 37 now). I would also do the Deep Brain Stimulation- drill a hole in my head, I don't care.
Yes, for me, ECT was miracle when I have been in a black hole. When I tried it as maintenance and then later as a no-med option, it didn't seem to be as effective.
Bleuberry has a good point, people do respond differently. I only needed 5-6 treatments. I think it usually takes 10-12. Psychiatry numbers say it is effective 80% of the time, but I'm not sure what the numbers are for maintenance. The effects usually fades, but for some, maintenance works. They just go in for a "tune up".
It is a hard decision. What does your dr. say? If you have 2 treatments a week rather than 3 I've heard that you are less likely to have side effects.
This is the end of the thread.
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