Hello,

I'm a long term treatment resistant deep depression with anxiety sandwich. And a Coke with Fires too please.

Had D since I was 10, I'm 57 now. It wasn't noticed until I was 35 though and I denied it until 1999. Pretty stupid huh???

Anyway, I've had so many different meds I feel like a guinea pig for the drug companies. Except they don't pay me a cent!

A couple of months ago I just said to my doc "Where the hell am I going? Is this it? The best I can be, the best you can offer?".

We chatted a bit and then he suggested dexamphetamine. It apparently has success with treatment resistant depression. SO WHY WASN'T I TOLD YEARS AGO was the thought I had immediately.

I know it's mainly used for ADD etc and that gives the impression from media coverage that it is mainly prescribed for younger people. As a sideline I would have been diagnosed as ADD if they had known about it when I was little. I drove my mum mad and my father was away as much as he could be I think!

Anyway what I'm needing to ask is how dex has helped you or not? Or similar drugs?

What side effects, how quick it works and so on. Any comment really as I'm ignorant on this issue.

I found one web site covering use of dex for people like me and each of them said it took them out of hell and gave them back a normal life. I think I deserve some of that after 47 years in the hole!

To be up front with you I'm actually scared worse than I can describe at the thought of feeling whatever "normal" is supposed to be. I can handle how I am but it's not a life. How would I react if I was back on the planet and able to function and interact with human beings? I'm not scared, I'm s**t scared as it will be unknown territory really.

What do you all think please? I know docs worry about addiction but I've been taking these other things that don't really work and make ne feel bad often for over twenty years, on and off. Never been tempted to take other than prerscribed dose and really the only non prescribed use I've considered for them is flushing them. Except I know I can't make it without meds. I try at least once a year and last about 6 weeks, which is good, but then...

Best

Friendly

Hi Friendly one :)
You might find some info in this thread, "Ritalin for Depression????"
http://www.depressionforums.org/forums/Rit...ion-t12927.html

(I'm posting this link here, as I have gathered that it is acceptable to post links to posts WITHIN DF.)

Hi Friendly one,

it's not an aside that you think you may actually have ADHD... do you think so? You really should read Driven To Distraction or Delivered From Distraction, both really amazing books. If they strike a deep chord in you then that's about as good as a diagnosis from a doctor. The impact of ADHD, if you have it, on your self image and mental state is huge and it can lead to a lot of healing just to understand it.

I have ADHD and take meds, currently dex, and no, the meds don't make me normal... far, far from it. They just help me cope, somewhat. A lot. Sometimes. They don't fix my ADHD or my erratic, obsessive, impulsive, sometimes creative, tolerant, clueless personality. Is that what you meant by being scared of feeling what normal is like? Or do you mean, you are afraid of not being depressed, because you've been depressed for so many many years? What are you afraid of - that you will realize just how miserable you have been all this time?

Stimulants for depression alone? They act on dopamine, so they can help depression, on the other hand they could increase anxiety, but I have a lot of anxiety and am able to take them along with an SSRI. My psychiatrist says Wellbutrin which also acts on dopamine tends to be much more anxiety inducing than the stimulants.
So I guess you just have to try, and try to find the right dose. In the beginning I went on a way too high dose too fast because I didn't "feel" different or focused... I just hadn't figured out how if affected me exactly - and that gave me tremendous anxiety, so go nice and slow. 5mg, even 2.5mg can have a lot of effect on me the first few days after a longer break.

Hello,

Thank you Moonlightress. Interesting reading and the "related posts" threw up a few too to read. I searched but found little so your lead has given me the sort of feedback I was seeking, from real people rather than docs or drug companies. I always seek such as people on these sites are honest and open about what they experienced. Rare in today's world and I thank you first and all those who commented in the past.

To ZMarie,

I'm not sure why I wrote that. I am ignorant on this issue and the meds so I guess I was relating what I'd been told by my father. I was apparently very "energetic" and difficult to deal with when very young. To a stage where my parents had a makeshift skull cap made for me as I was banging my head against walls and the floor on top of all the other stuff. I never got real info on it, just vague mentions so I don't know the full reality of what I was like.

The diagnosis for children in such states has varied so much during my lifetime I have no real measure or comparison. I'm 57 you see and never been diagnosed with anything but depression, anxiety, then effective disorder state then finally BP2.

In the 70's the ADD diagnosis was called "hyperactive" and that description fits what I was like according to my brother who was older than I.

The web tells me that is essentially what ADD/ADHD is but it never even entered my head to consider it for myself as I've been so long in various depressed states. It's really only since my pdoc suggested dex that I've looked into it and my ignorance shows.

I have trouble reading and have had for years due to D. I can read and write endlessly on the web but books? I just seem to forget what I've just read before I turn a page so I tend to do all my searching on the web. Don't ask me why I can do it here and not from a book normally. I've puzzled over it long and hard and got nowhere.

I am currently reading novels, slowly, but it's a joy. I tried reading a couple of semi text books and the blankness sturck so maybe it's the type of book. WHo knows? I'll try and get a copy of one those two you mention and try reading them anyway. If it does strike a chord I'm thinking I won't be able to put it down. Hope.

The reason my doc finally offered this option to me is I have been saying to him for years now that I'm sort of OK in that I don't often feel the panic and extreme anxiety I used to so the meds are helping with that. But the tiredness, lack of concentration, lack of motivation and all round lethargy has stopped me from doing just about anything useful

So he suggested dex and on listening to him I was extremely excited just to think I could gain some or all of the energy etc I've lacked for so long. I have felt that iron overcoat feeling since my very early teens and that's been a long time now.

As soon as the excitement died away though I started thinking about what I may become. Would I respond to dex and would it do what it promises? Or another wild goose chase or even a worse med nightmare than many I've already had?

I am scared of not feeling "safe" as I do now. I'm so used to this it is normal as I have experienced it. Giving up safe territory for the unknown is terrifying. Even though the promise is of better things. So yes I'm afraid of not being depressed. Sound ridiculous I know but that's how I feel right now.

No, I'm not afraid of realising how miserable I've been for so long. I already know that. It's only in the last few years I've been under constant treatment and been able to generally control the depths so before that it was a horror show I avoided as long as I could, mainly alcohol. A bit slow, yes?

Another thing I'm thinking about is that I have been diagnosed as BP2 based on 2 certain periods of hypomania and a couple of possible, light periods. In those periods I felt unbelievably good, strong, healthy and full of energy.

What puzzles me about that is this med sounds like it will give me what hypomania did yet the pdoc was very quick to kill off the hypomania when he saw it. That may sound silly or dumb but it just feels like he's willing to give me the dex to feel what I could feel naturally by stopping lithium. It's just so unexpected after so long to be promised feeling good and it does scare me big time as I do not know what that is except for hypomania.

Is that give you any idea of how I feel? I'd be happy to get concentration and motivation out of it and energy would be great.

I am getting an idea of how you are feeling, I think. I do understand being terrified of new territory, I'm just usually not as conscious of it as you are. I remember being strangely terrified when I was diagnosed with ADHD and told the stimulants could potentially fix all the things I saw as inherent character flaws in me... It's been a little scary ever since, it was scary to be functional, I went off my meds... I am still working on it.

If you do get one of the books, get Delivered From Distraction. It's his new one and it was written specifically for ADHD people who have a very hard time reading a whole book, especially from start to finish. It has really short chapters, and a chapter in the beginning titled "Read This If You Can't Read A Whole Book". It also gets into the connections, differences and similarities between bipolar disorder and ADHD. They can be very similar, and often co-exist.

But I guess whether or not you had ADHD from the beginning doesn't matter as much as if the medication will help you with the symptoms you have now?From what I know with BPD you can usually safely take antidepressants or stimulants without becoming manic once you are stabilized on a mood stabilizer. If you are on a too high dose, you'll probably feel a little hypomanic, but that is easily adjusted as they work immediately and wear off the same day.
The trick is to get the dose just right, and NOT forget to eat or sleep! Get a pill cutter if you don't have one.

Depending on your financial situation, there is also Provigil which is expensive and not officially approved for ADHD, but that helps wakefulness and focus somewhat without being particularly stimulating. It's not known to do wonders, but it's been found helpful, I wish I could try it. Oh well, one day the patent will expire...

Please feel free to PM me about ADHD if you feel like! Keep us updated on how the meds work for you. When will you start them?

Hi again ZMarie,

Thanks again for replying and the offer re PM's. I tend not to use PM's as I think anything discussed is usually best on the forum for all of us but I certainly will contact you on this issue as I know nothing really.

I particularly like your notes on remembering to eat etc. Those are the things the med people don't really tell you and I thank you, again.

When will I start it? I'm still worrying about it and I have another issue to consider which is my partner. She has D too, of course having lived with me for a long time now. She has seen so many different versions of me on the various meds and treatments that I need to prepare her as well as myself. The last thing I want is to feel good and have her suffering and wondering what on earth is going on etc. In the end I'm not in a rush for once as I'm stable, OK and able to think this through before I jump. Or just procrastinate? Same, same really!

I explained this to my pdoc, he knows her quite well as she often comes with me, at his request usually, and he was a bit taken aback. He said "Don't you deserve some happiness?". At that time I was still feeling somewhat angry dex hadn't been mentioned in 8 years so I bit my tongue.

That book sounds perfect! Written almost exactly to suit how I described me and others in the same boat isn't it? That made me laugh, thank you. Laugh that someone had written a book to cater for people who find it hard to read books. That's actually brilliant although it sounds like a joke.

I'll try a jest here. It also reminds me of a TV show back in the 70's where John Cleese was starting out. And Marty Feldmann. This skit they had was about an inventor who had invented a device for deaf people so they'd be able to know when the phone was ringing. It was just a headband with a light on it.

When the light flashed the deaf person knew the phone was ringing so they went to it, picked it up and said "Hello".

Then hung up in disgust shouting"There's no one there! There's never anyone there!".

Best

Friendly

Brilliant isn't it? The strike of genius can be explained by the author, Edward Hallowell, having ADHD himself. He is about your age I think, and he was never able to take any of the medications, but he is a very successful psychiatrist.

The John Cleese skit made me laugh, thank you... that is so cruel, so him!

FriendlyOne
This isn't what you asked, but have you been on Wellbutrin? With or without a mood stabiliser (you mentioned lithium)?

Moonlightress,

No I haven't. Just looked it up on RXList which actually gives a descripton if Zyban, stating it has the same active ingredient as WB. Is that identical or just similar as there can be a world of difference.

Not sure what RXList is telling us really but if this is the med known here in Australia as Zyban my pdoc and I have considered it several times. This is the med originally pushed as a stop smoking drug and is now recognised as helping d people, yes?

I have a mental block on that med due to the initial media explosion when it got a name for doing nasty things to people (was it heart attacks? I can't remember now.). I believe it was somewhat of a beatup but it was certainly given a bad rep by that media coverage. This would be, what, 5 years or more back now?

I won't try it due to that as I'm not convinced it was all wrong. You know how we get such stances in our minds. I had actually asked for it back then as I had smoked since I was 20. Gave up 15 months ago, finally. So I don't need that any more. Cigarettes that is.

I'm waffling.

What do you say about it Moonlightress? Good things?

Thanks and best

Friendly.

Hi Friendly :)
Zyban and Wellbutrin are exactly the same thing: bupropion hydrochloride. It's an anti-depressant that also helps people stop smoking. What got me thinking about it, was what you had written in one of your earlier posts in this thread:

The tiredness, lethargy, lack of motivation.... these were all things that bupropion helped me tremendously with. It was not a full solution for me, and it didn't help with my mood, but now that I have Lamictal and Efexor added to it, I feel like I am at last, crawling out of the hole.

Bupropion is an energising AD - it works on noradrenalin and dopamine(NDRI). I must've completely missed all the media hype!! It's working great for me and I think it's a wonderful drug - it doesn't have that emotion-numbing effect of the SSRIs and I feel more energetic and ALIVE on it. It can increase your chance of having seizures (perhaps that's what you heard?) but as long as you don't exceed the prescribed dosage, the chances are very small, as the seizures are dose-related. I think the max is 450mg. I'm on 300mg. I would think that Dex had much more serious side-effects than bupropion, although you can never tell how each of us will react, can you? Bupropion can be a bit rough in the first 2 months or so, with up/down emotions seeming to be heightened, but then it smoothes out and I'm likin' it!

BUT, I really don't want to interfere with what you and your pdoc are doing, and what he is recommending to you, as he obviously knows you far better! And I also know very little about treatments for ADHD and bipolar, so I wouldn't presume to be able to comment. Just wanted to tell you my opinion about / experience with bupropion, in reply to what you said about tiredness that's all.
---

(As a complete aside: for some reason we have Australian commentary on our TV feed from the Olympics (perhaps your guys offered South Africa a good deal?), so now I can add audio, to my visual of you as a galloping, Aussie-speaking, two-legged horse! Great image!!!)

Hi Moonlightress,

Thanks for taking the time.

I looked up Zyban on Wikipedia and it was indeed siezures and the med was withdrawn, back in 1985/86. So much for my memory! Although it stuck in my head. It is written up as being a dose dependent issue as you state.

I suspect you are like me in regard to meds at least in that I take them very seriously these days and check as much as I can in the knowledge docs of all types may be flogging what the free ticket giving sales rep has given them. I don't feel that any more with my pdoc and this isn't a new med so that concern isn't valid here.

But the point is I'm guessing you, like me, are very careful about what you take, why you take it and when and how much the doc prescribed.

I can't see any point doing anything else really as then the doc can't help much.

As such I don't worry about doing other than agreed so the seizures wouldn't be much of a risk really, fingers crossed as always!

I really do appreciate you taking the time to analyse my words and come up with a response. That tells me you care, regardless of who you are dealing with. You just care and that's outstanding.

I'm not thrilled about potentially taking dex as you would have seen. It's a new world really and Zyban is more within my realm of acceptable risks now I've actually read about the thing blocking my head on it.

I have tried Lamictal but nothing for me other than end of hypomania instantly. To be blunt I was much more afraid of taking Lamictal than Zyban and again that was from a comment my pdoc made when he first raised it with me. It's silly but you'd be aware there is a potential side effect with a rash which can be very nasty, small chance and only if not monitored etc as I understand. Anyway the first time my doc raised it I asked what side effects and he, jokingly, said "Well it can make your skin fall off". So I had a mental image and the med was out until I went further down the list. He said it in humour and explained immediately but those words stuck. Ain't brains wonderful things?

I take lithium and Effexor now so I'll ask the pdoc if Zyban might be the mix I'm seeking. I'm doing OK mentally just totally lacking the things listed.

Your advice is excellent and I always respect advice from people who have actually used the med as there is no better advice. Docs really just don't understand unless they take them too do they? They know the theory and reports and trials etc but feeling is the real deal. As such I'll always consider advice such as yours. As it happens my pdoc has suggested it too, a while ago but I just blanked him as I did above/below. Thanks for persisting. It has moved ahead of dex as I write. I see pdoc in about 3 weeks so who knows?

Very best

Friendly

You're really very welcome. Actually I've had another couple of thoughts from your post above, but they'll have to wait until tomorrow. Till then.

Dexedrine was like a sugar pill to me, it did nothing at all, even at 3 x 15mgs.

Yes, then it was discovered that the seizures were dose-related, and once the thresholds were sorted out, it was re-introduced.

For sure. My current pdoc doesn't tell me a THING, which is quite off-putting. When he put me on Wellbutrin in the hospital, I felt so weird taking something I hadn't read about, that I went along to the pharmacist and asked her for a package insert (and assured her I wouldn't freak out over the list of adverse effects!)

But now I am about to play Devil's advocate! I trust you will just discard anything I say that isn't true for you, or that you don't agree with, ok?

I'm assuming that Dex works pretty quickly and there isn't the usual waiting period that there is with anti-depressants. (I could be wrong on this!) So if you went for the Dex option, you would likely know whether it was going to be a good thing or a bad thing, pretty quickly. You also mentioned ADD or ADHD earlier in this thread. I don't have any personal experience of this other than the people I know who have it. Ideally you should be evaluated for ADD/ADHD. But if you DO have it and the Dex DOES help with it... then ... it could just change a lot of things. In a good way. Will leave you to chew on that...

Sorry! That's quite funny! He does need to be a little more careful about his jokes, perhaps! But my skin has not fallen off. As long as you "start low and go slow", the rash is actually rare, and IF it happens you'll have time to notice it, report to the doc, AND stop taking the drug, before you're in any danger. It also has a very low side-effect profile. But not that I'm trying to persuade you. Instant end of hypomania sounds horrible :(

Both lithium and Efexor CAN make you tired. I've been more tired since restarting the Efexor.

So, this was just to give you some food for thought and perhaps a few more questions for the doc. I'm sure you and he will be able to work it out.

Best!