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Old 08-18-2005, 09:05 AM   #1
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Unhappy At my wit's end! Major depression with cycling that is not responding to meds. HELP

I have watched a very close friend suffer from bipolar for almost 2 years now. She definitely has occasional manic moods where she is energized, but mostly (especially lately) she has been severely depressed and nothing seems to help. She can barely get out of bed and hasn't worked in months-- this is a vicious cycle as her lack of productiveness makes her feel worse, but without feeling better it is hard for her to get out of bed and do anything with her life. She is on depakote for the mania and remeron for the depression, but as I mentioned the depression is still very serious and does not seem to be helped by the remeron (recently her dose was doubled--still nothing). She's also been on lamictal (briefly), paxil (worked for awhile and then stopped working), wellbutrin and a few other things that I can't recall. Any advice out there? Thank you in advance.

 
Old 08-18-2005, 11:42 AM   #2
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Re: At my wit's end! Major depression with cycling that is not responding to meds. HELP

Hiya Buddha

Firstly, your friend is very lucky to have someone like you who cares so much for her. Secondly, what are her docs doing? Are they aware how bad the situation is, are they taking any action/giving any advice? Thirdyly, you are right that she is caught in a vicious circle with the lack of motivation. Are the two of you close enough that you can set her small goals? Eg, encourage her to get out of bed even if it's just to sit in a chair in front of the TV. Try and get her by an open window so she at least gets some fresh air into her lungs. Is she eating? Try and get her to eat small snacks - even if it's just a banana and a glass of milk. Is she washing etc? Can you encourage her to do that? I know that this kind of thing did help me when I was really bad - it takes a while but you do find you can do a little bit more as time goes on. Can you make an agreement with her to try and achieve one little thing each day? It just might help a little whilst they're sorting her meds out. Let us know how you get on.

Picali xx

 
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Old 08-18-2005, 01:45 PM   #3
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Re: At my wit's end! Major depression with cycling that is not responding to meds. HELP

yes, we're very close and i definitely have tried to get her to set small goals. sometimes it works, sometimes it doesn't. she is eating, but not very well at all. i am very worried about her and frustrated with how little progress there has been the last 2 years. her therapist is pretty involved but d/n seem to be able to offer enough to change things. i truly believe she has a chemical imbalance which she needs to find the right meds for (i've seen the major mood swings, particularly the mania which is definitely not something she can 'work out' in talk therapy). unfortunately, her psych m.d. is someone who she just sees for a few minutes once a month or so. she goes, he fiddles with her meds a little and nothing seems to change. she d/n have insurance so she can't really afford to go more often. at this point, she is so frustrated that she thinks nothing is ever going to work for her--this doesn't help things obviously. i guess what i am wondering if anyone has had an experience with meds not working for awhile, and then finding one (or more than one) that did the trick. i want to give her hope that there is something out there for her that will work.

 
Old 08-18-2005, 02:19 PM   #4
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Re: At my wit's end! Major depression with cycling that is not responding to meds. HELP

Don't know if this will help or not but it took docs six years to find meds that worked - I seem to have a resistance to anti-d's for some reason. My last bout was horrendous - the lithium brought me down from the mania but I then plunged into a suicidal depression that lasted for nine months - I've been on five different anti-d's now, two worked but for some reason they wouldn't give me the one that worked before the second time so it was hellish for best part of a year.

I don't know if that gives you hope or not - I guess yes because there is a combination but not so much because it can take so long to find? You're right about a chemical imbalance - it is definitely a case of finding the stuff that gets the chemical levels back to normal. There is a really good book by a guy called Patrick Holford. It's called Optimum Nutrition for the Mind (or something like that) and it basically explains which foods and supplements create which chemicals in the brain, tells you how much of them you need to eat, what to avoid (caffeine and sugar big no no's). I only mention it because I've found supplements a big help (fish oil in particular). He's quite anti-medication and has the odd rant about it but you can just ignore those bits and pick out the sections that mostly apply to your friend. Just might help as her doctor doesn't sound terribly pro-active, and also might just make up that little bit that the meds aren't quite hitting? Does she smoke/drink or anything - that can make things worse. There's also a lot of evidence to suggest that toxins make us depressed and that some anti-d's can actually make depression worse because of the way the toxins in them react in our bodies. It means it's all a bit of a minefield, but again, it might just be worth trying a detox course at home - you can buy supplements that do this rather than having to live on lemons and hot water for days at a time. If she's up to it at sometime maybe suggest she posts on the board - sometimes just getting replies from people who've been in similar situations can help.

She's v lucky to have a friend like you - make sure you take care of yourself as well though.

Let us know how things are going

Picali xx

 
Old 08-18-2005, 07:53 PM   #5
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Re: At my wit's end! Major depression with cycling that is not responding to meds. HELP

Here's a thought for you. I was diagnosed with my BP from my neurologist after I had my stroke. He is the one that is taking care of all of my "stuff". He has his own psychologist, whom I go to see once weekly, and she reports to him what is going on, and right now it is a lot, since I am newly diagnosed and very rapidly cycling.

The communication between all of us has been wonderful. And who better to work with a brain dysfunction than a brain specialist? Mine specializes in epilepsy and non-epileptic seizures, but works with BP's b/c there seems to be a link between BP and Epilepsy.

Just a thought.....Kim

 
Old 08-19-2005, 03:09 AM   #6
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Re: At my wit's end! Major depression with cycling that is not responding to meds. HELP

hi buddah, i hope i can offer suggestions, first she needs to get off of all i think she needs to get off of all those medications, at this point she would probably feel better not on any of these, shes on too many i feel, i am not a doctor , whats a doctor anyway, they are usually more messed up than we are.
she needs to clear her system im sure she can handle it, listen, it cant get any worse than it is now right? then take her to the state hospital in her area, Its next to free if not free then she can make payments leisurley just tell them she doent have an income. and go into the emergency room, treat it like an emergencyTell them she had a bad rash from a medication or something, but now the rash is gone, and then ask them to do a complete blood panel and lithium level on her, and see how it reads when you get it back. If i were her i would go with the oldest medication that there is on the market and sstick with one medication, i feel that when mixing meds gets out of hand and the pshyciatriast dosesnt take note properly he can make a mistake by giveing the wrong combination, or forget one that he prescribed to her and gives her one that cant be mixed with another. I just read on yahoo health m.d. that you arent supposed to take remeron with depakote, depakote is an unpredictable drug i feel. and remeron is mostley treament for anxiety. The side affect with the two together is unually increase in depression, abrupt mood cnange and suicide thoughts .I was in the same boat and this is what i did and it worked . good luck buddah, kimber lee

Last edited by kimber lee; 08-19-2005 at 03:13 AM.

 
Old 08-19-2005, 06:23 AM   #7
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Re: At my wit's end! Major depression with cycling that is not responding to meds. HELP

kim--thanks so much for your reply. can yout tell me a little bit more about what happened to you? i am curious b/c it seems my friend may have to do something extreme like that- she has no insurance and is barely able to cover these expenses. her dr recs that she get blood work done but she cant' afford it. how did you clear the drugs out of your system? how long did it take? what were you on? were you able to get the hospital and blood work done for free? my friend is worried she will have to declare bankruptcy over all this. very scary stuff.

congratulations to you for getting your situation under control. you sound like a very strong person.

 
Old 08-19-2005, 09:18 AM   #8
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Re: At my wit's end! Major depression with cycling that is not responding to meds. HELP

Hi Buddha,
I can't say I know a lot about this stuff to be honest but I will let you know what my PDoc said to me. When I first went in I had said I thought I would like to try Lamictal (seemed that the side effects were relatively low as long as you started taking it very gradually) - anyway - he said that when he had first started practicing - he was prescribing the "new generation" of bipolar drugs a lot - they were new when he came out of school - but that now, he rarely has a patient that is only on Lamictal or other anticonvulsants - that he finds that he is always having to create a "cocktail" with these drugs. He said he has gone back to always starting with Lithium and finds that occassionaly he has to add an AD for limited periods but that it is a very effective mood stablizer. I was nervous about taking it - you know the whole lithium poisoning thing - but I cannot tell you how much better I am feeling right now and it has been less than 2 weeks. I know it isn't a lot of info - it was just my DOCs opinion but you can never have too much info I don't think. I respectfully disagree with Kimberlee that your friend should go off all drugs - although I really do understand what she is saying and I do agree that she is probably on way too many - I would suggest that she starts with one and stay on it for a while before adding or subtracting - I do think she does need to clear her system of all the mix. If she is struggling too much to risk a bit of a dip in her feeling (which it sounds like she may be) I would suggest that she consider being hospitalized until her medications are sorted out. I do get confused about that though because I don't understand the American system - here if you are hospitalized it is covered - is there some sort of way she can get treatment w/out paying if it is life threatening? Anyway - just my 2 cents....Good luck to you both......
Jen
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Old 08-25-2005, 06:15 AM   #9
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Re: At my wit's end! Major depression with cycling that is not responding to meds. HELP

Hi buddah, sorry it took so long to get back to you, this is what you do, take your friend to the state/county hospital and treat it like an emergency, go to the emergency room, you may have towait awhile, a long time as a matter of fact, but get her a wheelchair from inside and get her from your car. go in and say your friend has just had a siezure and your not sure why. think of soemthing simple you both can go along with, tell them that they should do a complete blood panel becasue the good freind that you are really thinks that is best for her, and a lithium level test, the forms that she will have to fill out will be short, the financial questions are short, just say that she has no income and that she lives in her car or soemthing, unless of coarse she owns a home. dont offer too much info, and be blunt, kinda play dumb but be ever so gracious to all whom is helping you. you really wouldnt be lying just fabricating a little,play it up. this is what i did and i owe a small amount for a 2 day stay at the hospital with tests up the ying yang a 12,000.00 bill quickly got reduced to 1,500.00 in small agreed payments of my ability, i pay 25.00 a month. ill get back to you, gotta go, keeep in touch kimber lee

 
Old 08-26-2005, 05:23 PM   #10
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Re: At my wit's end! Major depression with cycling that is not responding to meds. HELP

[F ONT=Times New Roman]I know how you feel[/FONT] My son who is now 14 is bipolar/adhd and believe me it has been a rough 14 years but god has seen me through this far. He has taken every MED there is since the age of 5 and is finally taking Meds that seem to be working. The cycling is never going to stop says his Doc but it will be easier. He has been through that manic depression to manic fits stage and drove me nuts in the process but I have learned to understand that this is something he can't help. The best thing you can do for your friend is be there . The meds my son is taking now are Abilify, Lithium, Adderall-XR and Adderall. may this combination can help your friend it has done wonders for me and my son. If at any time you would like to get in touch with me please feel free. Good Luck

 
Old 08-26-2005, 06:59 PM   #11
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Re: At my wit's end! Major depression with cycling that is not responding to meds. HE

Before I was diagnosed with Type I Bipolar Disorder I became so severely depressed that I was catatonic.
Total lack of response to any stimuli. Refusing food, and then hydration.
The one thing that DID work to pull me out of it is highly controversial for many reasons.
ECT.
It saved my life - and all other avenues should be exhausted.
But if it is severe enough there is this one last option to try.
(It's 30 years later, and I have been stabilized on lithium for 20 yrs, am a productive person in society and most people have no idea that I have a major mental illness. It definitely worked for me in my case)

Last edited by Ruth6:11; 08-26-2005 at 07:00 PM.

 
Old 08-26-2005, 07:17 PM   #12
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Re: At my wit's end! Major depression with cycling that is not responding to meds. HELP

thanks everyone for your responses. ruth, can i ask you more about ECT b/c one doctor suggested this for my friend, but switched doctors (to a new one who hasn't recommended it). what was it like? would you recommed it to other people who are also not responding to meds? what meds did you try before going to ect? thank you in advance for your response. i appreciate your insight!

 
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