i have lived with depression for thirty years with first suicide attempt at fifteen, have had some years of remission in between. have tried several meds over the years, prozac, seroxat, anafranil, mannerix, amytryptiline, xanax, klonopin, effexor xl, lustral, lexapro, lithium, zyprexa, thyroxine, rivotril, stilnoct. none worked for me but xanax, rivotril have been the most helpful with agitation and lack of sleep. was dxd with bipolar with dysphoric mania only last year and that's not a solid diagnosis. i think effexor last year triggered cutting and during the last four weeks i have found it impossible to stop. every day i say 'today i wont' but end up doing it anyway. pdoc and i decided that i should stop all meds before christmas except thyroxine, xanax and rivotril so that a new regime could begin. i started lamictal three days ago and he's talking about introducing abilify. any help anyone has to offer would be enormously appreciated.
i have been in deep dysphoric mania now for over a year without a break. (had one good day last year!) finding social interaction more and more difficult and losing my ability to put on the 'happy act' for any length of time. my fifteen year old daughter and my two sons 20 and 22 are the only things that are keeping me going right now. my function level is just enough to take care of my daughter and keep her thinking that i'm doing ok. she has also dealt with depression as have my two sons. i have a wonderful pdoc but no other support where i live.
Did your pdoc tell you that the effexor started your cutting? That sounds a bit strange. Cutting or any type of self harm generally is a learned coping behaviour that we use because we were not taught a correct way to cope with stress/anger/pain/fear, etc. I've honestly never heard of self harm being caused by a medication.
I have BiPolar disorder with Severe Suicidal Depression and also Self Injure/Self Harm myself by cutting. I have been cutting myself since I was 12 stemming from physical/sexual abuse and I am not 39. Once this behaviour starts it is not easy to stop.
Are you sure that you just didn't start cutting because you couldn't figure out another way to deal with your pain, anger, and frustration at not being able to find a medication that works or a way to control your depression?
hi kat. yes effexor or any AD can trigger mania in a bipolar person. have yet to meet a doc that will admit that something he prescribed caused something! i think it triggered the extreme agitation and tension and cutting and burning relieved that. after the first time i cut i was devastated that i had done it and then only did it a few more times after that. also got great comfort from the six or seven scars that i had until they started to fade. was extrememly agitated again about three/four weeks ago and the relief from cutting is amazing but not worth the increase in depression afterwards. yet i don't seem to be able to stop. i am hoping that the new combo of meds when we get them sorted will balance me out enough that i wont need to do it if i cant stop by miyself. the effects of effexor are well documented! most Ad's carry the warning, if you are bipolar do not take this med! yet docs continue to prescrible. they can work well in combination with a mood stabiliser, unfortunately lithium didn't work for me and i guess pdoc thought, understandably that they would work together. thanks for your reply.
No, I know that AD's are not to be taken alone if you have BP. They do work well generally with an anti-psychotic or a mood stabiliser. I just don't think the meds caused you to start cutting.
As you said the cutting relieved the stress and agitation. So the self harm was not a result of the meds, it's a decision you made to find a way to help you deal with your feelings. The problem here is that just because you change meds, you may not find it as a "fix" to make it able to quit. Once a person starts self harm it can be very very hard to stop. It's very easy to become "addicted" to the rush you get when you cut, the endorphins that are released make you feel good for a while. Yes and then afterward you tend to feel bad again...it's that never ending circle. When I started cutting as a child at first it was to replace the pain I was going through with another pain and then it became more of a symbolic thing, by bleeding it felt like I was "bleeding" out all of the bad things inside of myself, because I always felt like I was bad and that's why my father abused me, I felt like it was my fault, that I did something wrong. And to this day it's still more about the "getting the bad stuff out" as opposed to the pain. Most of the time when I cut myself I don't even feel it. Earlier in the year I had a hypnotic dream state in my sleep where I thought I was attacking my father with a knife, when in fact I was cutting my arm to ribbons. It took 20 stitches to put the 7 cuts back together and I never even felt it, never woke up from the cutting.
So it's about different things for different people. My advice for you would be to start doing alternative coping skills as soon as possible, since you haven't been cutting very long, you have a better chance at stopping this now.
no to be repetitive! the agitation and extreme tension were caused by effexor and lexapro which then triggered the self harm. had i not been on these drugs i would not have been in this state! yes, now it is becoming more like an addiction and i am trying to find other coping mechanisms. also hoping new meds will actually work. having a really bad, bad day. know you are only trying to help. and it is appreciated.
Sorry I didn't intend to come on too strong, I just hate for docs to misinform people about how they develop certain disorders. I really am sorry that you are having a bad day. I hope your new med cocktail solves the problem for you, hopefully you get to start them soon. I have a list of alternative coping skills that I've posted here on the board before, my tdoc gave them to me and some of them work pretty well, if you'd like I can share them with you. Once again please know I was not trying to offend you.
Good luck with everything.
Last edited by katlin09; 01-24-2009 at 04:06 PM.
Reason: to change post
Thanks for your concern, part of the problem is we're in the middle of trying to find the right combo, I've tweaked, changed, added, taken away, etc. so many meds over the past 2 months it's hard to keep up. We thank we've gotten the right combo now, but sometimes I have bouts of mania whilst trying to completely adjust. I see my pdoc on Tuesday so we'll discuss it then.
okay, here are some alternative coping skills...put your tight rubber band on your wrist, not so tight that it cuts the circulation off, and everytime you have the slightest urge, snap the crap out of that rubberband, and your wrist. You should snap it hard enough that it hurts, thus emulating the pain of cutting or burning. Do it as many times as you have to, until the urge to harm yourself passes.
Next, if you cut for the pain of it, fill a bowl with ice, wet your hand then tape a ziploc baggy over it, thrust your hand in the bowl of ice for 5 - 10 minutes or until you cannot stand it....it will hurt like a son of a b****. If it doesn't get rid of the urge...keep doing it over and over again.
If you need the symbolic part of it, seeing the blood, like me, put a very tight non latex glove on, I use the Mr. Clean brand 'cuz they are see through and it looks like my skin....I use a red marker to act like I'm cutting myself then take red food coloring and drip it down my hand over the glove....my brain gets the symbolic message that it needs and if it doesn't I repeat it until it does.
Get one of those, autograph bears, or dolls, that are plain white....cut them with red markers, wherever you want to cut yourself, write your name on the dolls forehead and let it be you and cut(mark) it as much as you want....without actually harming yourself.
Take Vitamin E capsules and try to "squish" them between your fingers (believe me this is harder than it sounds) then let the contents run down over your hands or arm or whereever you would cut yourself. The squishing distracts from cutting, and the fluid lets you feel the "blood" running over your skin. The bigger the capsule the better.
Put a picture up of whoever causes you the pain that creates the urge to harm yourself (yourself, pdoc, bf, whoever) and throw silly putty at it as hard as you can over and over again, you can yell while doing it, let the tears flow freely if you need to, whatever emotion you need to get out that causes the urge to harm yourself.
You had mentioned that the scars gave you comfort, take a red marker, not necesarily a permanent one, but one that will take a while to fade or wash off and "draw" scars on yourself, or just fill in the old ones so that you can see them, and get the comfort you need without causing new ones.
I know some of these sound "cheesy" but you'd be surprised how well they can work, you get the pain, or sensations that you need without harming yourself or creating permanent scars.
Try these okay, or at least one of them....anything except hurting yourself. Remember you're strong and you can go without hurting yourself. And we're here for you, 'kay? I'm here all the time, late at night, early in the morning and during the day, yell if you need to talk.
How is the Lamictal going? Have you noticed a change from it yet? I know it takes a while, took me a few weeks before I notied an improvement, but once I did it became somewhat of a saving grace for me. I'm on a pretty high dose, actually over the FDA limit, but my pdoc regulates it very carefully. One thing to mention that I don't know if your pdoc told you, in the activation stage of Lamicatal it can cause increased irritability and anger issues, but you just have to stick with it and it goes away after a couple of weeks. Also it can cause insomnia so it's better to take it in the morning and early afternoon. Well I guess that's my wealth of information. *l*
I sincerely hope this helps and the meds give you the peace and calmness that you so deserve.
thank you so much for all that info. first of all hope the tweaking of your meds work. i did try the rubber band and the ice but not some of the others so will try them, am also going to buy some really cheap dishes in town today and throw them at a wall! i reached one hundred yesterday and know if i go over that it will just continue in a vicious cycle. realised that i have actually been sh'ing for years with destroying my scalp (from about age 12, didn't realise until now that it actually was sh!) anorexia, suicide attempts. Nearly succeeded in that one in dec '07 and i think that is part of it i feel so detached really since then. feel i shouldn't be here. my pdoc keeps asking me to please not join the enemy and harm myself as i have been harmed. am seeing him this evening. thanks also for info on lamictal. i did find myself with a much shorter fuse at the weekend with my daughter and wondered because normally am a very laid back person! no response yet to lamictal but only on dose six so it takes a while to see if they work and then a while more to find out they dont. (shouldn't give up hope it is just that we've been through so many combos of drugs that dont work for me!) anyway hopefully this time we will get the right ones. i think he's adding in abilify soon too. hope, hope. because i really cant do this for much longer. it is no life. what a terrible disease!
thirty six hours free. cant believe i made it this far. really difficult. pdoc was great yesterday and i gave him my implements. even as symbolic gesture it helped. he also filled up my mp3 player, which i bought yesterday on his advice with mozart which worked well last night as distraction and diversion. my cold has turned into flu so feeling quite miserable but still glad to have got even this far. thank you so much for your encouragment.