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About cryinginmoscow

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    rants of a depressed 19-year old
  • Birthday 04/27/97

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  1. I'm on Ritalin extended release. The reason I switched was that I wake up late and have insomnia. I don't see myself abusing amphetamines because I have never enjoyed uppers.
  2. I am on Concerta 72mg and Bupropion 300mg and both of these medications are known to increase the blood levels and effects of Vortioxetine. I'm on 10mg of Vortioxetine, should I reduce this to 5mg? I stopped taking Concerta for a few days and felt less depressed? However, another influencing factor is a medication called Naltrexone that I also take. I didn't take Naltrexone or Concerta for a few days and only took Vortioxetine and Bupropion together and felt a little better. I'd like to know your opinion on this matter.
  3. Citalopram generally causes weight gain (just saying) I mean there are mixed opinions but the Citalopram could be causing an appetite increase, but you'll have to say if you noticed a difference - for me I noticed a huge difference when I was off and on Escitalopram (Escitalopram is Citalopram's big sister)
  4. Does anyone else have a more scientific explanation or are we just gonna say it's the money thing?
  5. Can someone tell me why Vyvanse is approved for Binge Eating Disorder, meanwhile other amphetamines aren't? Is it because Vyvanse targets different pathways that Concerta doesn't because I recently switched and I'm afraid I made a mistake.
  6. Yes, I need body sculpting procedure and tummy tuck, but my GP only told them about the tummy tuck, and now I'm scared they won't do the full process, and I need the whole procedure to move on finally. I need an arm, thigh, butt lift as well as tummy tuck and possibly some work on the chest as well.
  7. I am going to be brutally honest with the description of my regime. When I eat healthily, it consists of a few hundred calories over 1000. (I'm not sure if we're allowed to use numbers here, so I'll refrain from giving away the exact number of calories) Eating healthy consists of meeting my macros. My macros is a new form of my eating disorder that came to existence after losing so much muscle mass from extreme starvation and overexercising and starting body building to regain the lost muscle mass. You see, I used to be a "cardio bunny" at the gym, which means whenever I would go to workout at the gym, I'd only engage in cardiovascular exercises. During this period (16-17 years old) I was eating below XXXX (thousand unit) calories and consuming XXX (hundred unit) calories while I would do cardio for 2 hours and then gradually I found myself exercising for 8 hours a day while still consuming XXX calories. My hair was beginning to become thinner and fall out in the shower more often, my hands and feet were always cold, I developed eczema on my hands and knuckles, and I was dizzy and lightheaded. After doing this much work, I looked in the mirror, waiting to see the body I was dreaming of; firm and tight, yet I saw excess skin. Seeing those results made me binge eat. I got into the cycle of extreme starvation and exercising and binge eating because the results wouldn't change. Then, I sought out an expert, and he said that I was not losing just fat but also muscle, this is true as I couldn't lift 2lbs over my head without my arms shaking. So, I knew I had to eat more because to create muscle your body has to have the additional energy (calories) to use to build the muscle. So I started eating lots - it was like a hall pass to binge - I built muscle, and then I had to start "cutting." The term cutting means to lose the fat you gained while you were gaining muscle too because it's inevitable that you'll gain some fat too and this requires you to keep your protein intake high. So I began eating high protein, moderate healthy fats and the rest of my calories spent on carbohydrates (as you can see the way I speak about calories as if it's currency already shows that I have a problematic eating disorder). I prioritized protein to preserve muscle mass and shed mostly fat because I was desperate to get the body I want - firm and tight and without loose skin. It didn't work, and I relapsed into a binge eating episode and then cut again. At least this time I was only exercising for roughly an hour sometimes 1 hour 15 minutes and I was doing weights as well as cardio (THE ONLY IMPROVEMENT). I can continue doing this for a long time with strict discipline. My food is very bland because all I care about is reaching my macros, especially reaching the protein goal. I ate this for several months: Two eggs with 1tbsp of olive oil and mushrooms Two small slices of brown bread with two cans of tuna and 15mg of mayo and one medium avocado Six scoops of protein powder spread throughout the day with almond milk I rely on a multivitamin too as you can see there is no fruit and hardly any vegetables. I did not enjoy it. I felt imprisoned, but if I even slightly made a change, it had to be very controlled and thought out because then I'd feel like I was cheating on my diet. I got to a weight I was happy with and then was waiting for the funding request response. Then somehow I ruined all of my progress and managed to stupidly binge, for an entire month (April) and when I binge it's always junk food and I can over 5000 calories a day. Despite promising myself I wouldn't relapse, I did. My theory is that I get fed up of eating healthy and exercising because when I look in the mirror I still have the excess skin and my body looks unattractive. I want to look good naked, and I believe that my hard work shouldn't go unrewarded. I have poured tears, sweat, blood (from self-harming), time and energy into this for years now and I still can't appreciate my body's aesthetic because of the excess skin. Luckily, I have now had my funding application approved by the NHS to have the surgeries for free. I am just afraid they might back out which will cause a relapse in suicidal symptoms. I now have to work to lose the weight I gained... Again... It's so tiring and exhausting reframing your mind to get back into that mindset. I feel exhausted just thinking about it. I have to be on a plan? I can't be like other people who can eat anything they want and change it up. It has to be a plan otherwise I binge. Also, everything is very much black or white, therefore I can't incorporate a treat or a cheat day, if I do, I'll binge.
  8. The reason why I can't walk out with the prescription in hand is that it costs an extra £90 and then the order is not written on NHS prescribing paper, so therefore I'd have to pay for all of the medications which would be extremely expensive. As for your techniques, I am a very black and white individual, in the sense that I cannot operate at the gray level yet. Everything is one way or the other, and there is no middle ground. When I am eating healthy, I'll be honest with you, but there is no enjoyment in the food, so don't want to be mindful of it. It's not just me presenting the typical symptoms of a binge eating disorder. Through the years of dieting, I have developed maladaptive ways of coping with excessive eating. Despite my weight now, I continually carry those anorexic and bulimic tendencies. I am presenting precise characteristics of binge eating disorder. However tomorrow I'll start disciplining myself in such a way that I will eat the same thing every day for months because changing it up makes me feel like I am not on an official diet. The behavior is very typical of anorexics because it's about control and knowing what they're eating. If I enjoy the way my food tastes during a diet, I feel as if I'm cheating. This example of dieting is also a typical behavior of anorexia. It's almost as if when one eating disorder is triggered, the other goes into a short hibernation until it ferociously wakes up and forces the other eating disorder into hibernation. These psychological issues can subside through therapy; but the impulse and compulsiveness, physical sensation and feelings, they're instilled into my behavior so profoundly. Some form of biological or neurological implications has to be present at this point. I have read about this in Stahl's essential pharmacology and found out that habits themselves can change the brain function and appetite. Also, when I have a food plan or diary, it feels like I am force feeding myself because I am genuinely not experiencing hunger but at the same time I am. It's as if my appetite control is mixed up and I don't know why. They offered me to have a brain scan when I was a child because I was overweight but skipped this because of fear of something being wrong with me, and I didn't enjoy being under the spotlight for my weight and everyone always just seeing me as a number on the scale or my figure. I was invisible, regarding my emotions and my humanity. These conversations around me made me feel as if I wasn't human or normal like everyone else was. I began to call myself fat in depreciating way at such a young age; it's no surprise that I have no self-esteem and have such a severe eating disorder. When you hear the worry for you, whether with good intent or not repeatedly in and out through every environment, such as home, school and in public. You begin to lose yourself in all of that.
  9. Medication that is capable of doing that is what I am looking for because I can discipline myself and eat healthily and exercise, but then begin presenting symptoms of food addiction through overeating and giving into those cravings when not even hungry or when full; it's a longstanding issue which I have dealt since childhood. I was always overweight for my age, so I have always been fat, and I was bullied a lot for it. I couldn't turn it off or make it stop, and became morbidly obese in my early teens. My weight was dangerously high, to the point where I was not sure if they were going to have my size in clothes anymore. I don't know how it happened, but I managed to pull through school and pass my exams. However, several months into my healthy diet I developed the extreme opposite of food addiction, and I started presenting signs of anorexic behaviors and bulimic tendencies. Although never purging, overexercising was my way of compensating and dealing with a binge episode. I never considered my eating issues to be, binge eating disorder until I started dieting and losing weight. During this time, I was eating clean for a year, and several months. I had disciplined myself, but I cracked one day because of the depression I felt when I looked into the mirror and saw the excess skin. The excess skin was like someone was holding the foot down on a break and not letting me enjoy the hard work I was putting in. As a result of this depression, I gave myself into the cravings, and that's when I realized that what I thought was "normal" throughout most of my life was indeed a disorder. A food addiction or binge eating disorder. I was in unhealthy, abusive environments that didn't want me to prosper. Therefore, I blamed myself for overeating. I thought it was down to laziness and greed, but the truth is, it is related to brain circuits, and there is scientific evidence to prove this. I am not saying that it all comes down to neurons. Obviously, your external environment also has an impact, and I acknowledge that as a child, the lack of structure with meals created an imbalance as I ate whenever I wanted as did my family. There was no breakfast, lunch, snack and dinner. It was disorganized, and this didn't help, neither did the fact that I had ADHD and it was undiagnosed and swept under the rug and untreated up until now.
  10. I've studied how long the effects of Vyvanse last and it is quite long. Because I wake up during the late morning hours or sometimes in the mid-afternoon, due to having no responsibilities in life, depression, insomnia and other factors. I asked my pdoc if it's possible to consider Concerta as an option for treating my ADHD because the effects last for a lengthy time like Vyvanse but not as long. The issue though is that I'm unsure if it will be helpful for binge eating disorder because it doesn't have the license for that. However, I think after you take Vyvanse you may even have to wait two hours before you notice any effects because it's a prodrug and it has to go under metabolization before it begins working, I believe this was to avoid any abuse. I don't plan on abusing any of the medications, and I don't have a history of intentional abuse - the only time I have ever taken an excessive amount of a prescription drug was in my suicide attempts, and they have all been an overdose with benzodiazepines, except for one. Other than that I have followed the prescribed guidelines set by my prescribing doctor. As the NHS has now approved my surgery, I don't consider myself as wanting to commit suicide anymore and I know it sounds a bit ridiculous that whether I live or die depends on this surgery, but it is a critical operation. The surgery will help with a longstanding battle I've had with the eating disorder. You see, I feel stuck in the past - when I was majorly overweight, in fact morbidly obese - because of the excess skin. Despite having a smaller frame, when I look into the mirror the excess skin is a constant negative reminder and excess luggage I am carrying that won't let me fully move on with my life. It causes a lot of psychological distress and issues with my self-esteem. I hope you understand where I am coming from and don't see this as a case of BDD because multiple doctors have assessed my body and they can physically examine the excess skin and say it's there - as in, it is indeed visible when I undress. This has stopped me from wearing clothes I like and want to wear, socializing and engaging in any relationship - in fact; it's been a primary cause of a lot of ended friendships and relationships. Furthermore, I can't fully be intimate with my partners, I'm always having to wear a t-shirt or keep some articles of clothing on and I can't connect on a personal level because of this. Yes, sex isn't the most important thing in life, but it is psychologically unhealthy to be unable to engage in intimacy at a healthy and appropriate level. Due to this, I had many fast, impulsive, flings with men I didn't even find attractive because I wanted to explore my sexuality but was too afraid to open up to the people I did find good looking. Most of the time I didn't even want to finish what I "started" but felt compelled to do so as it was my responsibility and obligation to complete the sex; this made me feel like a lot of these sexual encounters were forced. Looking back, I have a lot of anxiety and related trauma to these memories. I even had a huge H.I.V scare. I know you're thinking, how the excess skin and an eating disorder has any of relation to this, but the eating disorder completely encompasses every area of my life. My eating disorder causes low self-esteem and body-related issues and feeling so negative about myself allowed people to take advantage of me, hurt and abuse me. Getting back to the relevant topic, the effects of Vyvanse can last up to 12-14 hours whereas Concerta is 8-10. Considering that I wake up later, it might be better for my insomnia if I were to try Concerta a for a week or two and see if it makes it easier to get to sleep at night at an appropriate time so that I'm not awake and thinking about food and trying to resist the temptation and strong urges. At one point, I didn't believe that Vyvanse was having any benefit, so I stopped taking it for a while, but I have recently started taking it again as it's on repeat prescription and I have noticed that my concentration is better, I am more motivated to finish tasks that I start, and I feel more productive. Vyvanse also does help control my appetite to an extent, however there are issues that remain that question the validity of continuing to treat this disorder through a monotheraputic standpoint. I do need to add naltrexone as I have read a lot about it, especially in Stahl's essential pharmacology which shows how naltrexone potentiates bupropion. The clinical data shows that the two agents have better results than taking either one alone, so it is a clinical fact that monotherapy in regards to pharmacology treatment for food addiction isn't the best option available for reducing the episodes; although it is still a viable option, the addition of naltrexone to bupropion is better than taking either one of the drugs alone. I think I do need to be on medication for my ADHD because of diffucilties getting things done without it and I have noticed that Vyvanse is beneificial and that I really do have ADHD because I've taken a break from it for a month to put that hypothesis to the test. The medications I proposed and discussed with my new psychiatrist are: Vortioxetine - as the framework for treating major depressive disorder with recurrent episodes of dysthymia or the other way round. A benzodiazepine for generalized anxiety disorder - I have taken Clonazepam, but I find that waiting for the effects is rather slow for me although when I do begin to experience them, they are pleasant and help relieve the anxiety, having also tried Lorazepam, I can't say many good things about that drug. For some reason, Lorazepam and Xanax don't help me the way they should or do for others. I believe I do have some form of panic disorder, but this is only if the generalised anxiety disorder goes untreated. The anxiety continues to manifest on top of more anxiety, thus creating a monster panic attack and then the sensation and symptoms of the panic attacks continue to scare me, therefore causing more panic attacks. This cycle continues if I am not on any benzodiazepines which is rather detrimental to my mental health. A medication for my ADHD - to help me focus and complete tasks that I start, hopefully, allowing me to be more productive so I can manage my independent studies and finish creating my portfolio so that I can apply for an internship or a job in the field of work I'm interested in and not to be homeless shall I say or dependant on benefits (I've just turned 20 by the way) not that I am insulting people who do receive benefits or are homeless because I know it's not your fault and it's nothing to be ashamed of. Bupropion along with naltrexone - the combination of these two medications show a lot of positive results in regards to treating the binge eating disorder/food addiction. However, the stimulants (Vyvanse or Concerta) can also help so I suppose it may not be necessary to take bupropion along with a stimulant and naltrexone. However, the studies have not mentioned the combination of vyvanse + naltrexone, whereas they have with bupropion + naltrexone. Although vyvanse and bupropion are similar in their mechanism of action, concerning the way they both increase dopamine and norepinephrine - that is what makes them good candidates for the treatment of binge eating disorder - I would assume that the stimulant does this better than bupropion, therefore maybe you are right, to suggest that I can just be on vyvanse or concerta + naltrexone without the addition of bupropion. As for insomnia, I'm given 150 mg Trazodone but it gives me headaches, and it loses efficacy over time. I am already receiving two presciptions for benzos (Clonazepam + Lorazepam), so I was wondering if my presribing doctor could rearrange this simply to Diazepam for the anxiety and Temazepam for the insomnia. I have mentioned all of this information to my new psychiatrist but I am afraid that being articulate about my suggestions could scare him away, especially because I do a lot of research and I am not afraid to pull out printed copies of clinical trials, data, and significant psychiatric literature to prove that what I'm asking for has meaningful evidence and it's within reason. I want to get better and I want to put my health first and I need to be on track with the latest treatments available for my mental illnesses and some psychiatrists refuse to be flexible; they prescribe the very minimum of what is expected of them because they feel safer and from personal experience, the psychiatrists I've met have all seen me as threatening their authority or questioning their skills because I bring knowledge to the session. They don't see it as me wanting to cooperate or being enthusiastic about getting better, instead they think of it as an insult. Also they view me as liability because I have showcased severe symptoms of suicide and depression; I suppose what's more important to them is their reputation, despite my intention never being to threaten their reputation. The suicide and depression is simply a manifestation of the mental disorders I have. I sincerely just want to receive the best help possible that I can with the money I am paying out of my own pocket (especially since I am poor, it's more important that I get my money's worth) I have gone to such great length for treatment as the NHS (free healthcare provider) has been horrible with managing my case as the mental health facilities are severely underfunded, especially in my area. Doctors often use the word "postcode lottery" to describe where you'll find better treatment on the NHS for mental illness. A lot of the time I have to deal with the accusation of Dr shopping from the new psychiatrists or psychologists, despite the fact that I've seen my previous psychiatrist for several months before HE CHOSE TO DISCHARGE ME because of my symptoms putting my health at risk and he didn't want to manage my case because if I had made a suicide attempt, they'd investigate him. However, every time I have had a suicide attempt, this never happenened, in fact after coming to a session after a suicide attempt they were completely oblivious until i told them. I still have an open file with the NHS and they always TALK to the NHS first and the psychologist I was seeing I saw for six months before switching because I didn't find her approach helpful (DBT - I've never liked it or found it helpful) and because she wasn't willing to support my request for funding for the surgery. The other psychologist whom I saw for seven total months (he discharged me) I wanted to leave so badly sooner, but I couldn't because I felt that if I did it would look bad on paper and further fuel the idea that I can't commit; and I was scared that no other doctor would want to see me again. I wanted to stop seeing him because he promised to practice schema-focused therapy with me, but instead he ate my pocket with the first six sessions as they were nothing but talking about score sheets which HE HAD ME FILL, BUT NEVER REFERRED BACK TO. The purpose of the test sheets were to find out whether or not the therapy was having any benefit, so it was pointless to do those scoring sheets in the first place and I had to spend more than £1000. Secondly, he didn't really know anything about schema-focused therapy and he relied on his colleagues to guide him, he was more knowledgeable with DBT and in some sessions, it was a full blown DBT session, other sessions it felt like I was talking to a wall or I was writing my diary out loud. I just found it very confusing and unhelpful, an example would be if I came to the session with and spoke about issues regarding my body and food, his response would be to work on my people's skills (using DBT techniques). He also rushed me, such as making me reveal my weight after binge eating despite feeling very uncomfortable, but he said if I wasn't cooperating and I didn't want help if I wouldn't tell him.
  12. Although come to think of it Prozac is a 5-HT2C antagonist but I still wouldn't regard this as the best option moving forward.
  13. I keep relapsing. I'm going from restricting but in a reasonable manner to lose weight and then the restriction gets unhealthy and then I relapse into binge eating disorder for one or two months and then I finally have enough strength to pull through it. By the way, the unhealthy restriction doesn't trigger the binge eating relapse, it was stressful events such as a major altercation with the police in March and the ongoing battle to get funding approval for surgery (which I FINALLY GOT AND This is why it's so important I stop binge eating now to lose weight for this surgery) I want to STOP the binge eating and get back on track with healthy eating and exercise, but I'm struggling to do this alone. I am not taking any medications at the moment. It's been a week since I saw my new psychiatrist and I still haven't received a report containing the prescription. I genuinely need this prescription as the medications we discussed are primarily to stop the unusual cravings, impulsiveness, and compulsiveness. I used my research to bring forward the suggestion of Naltrexone and Bupropion (a robust combination) along with a stimulant that not only will help my adult ADHD but binge eating disorder as well. I also mentioned an antidepressant called Trintellix and I spoke about changing my medications for insomnia and anxiety. I just really need to vent because I have no one to turn to. I keep promising myself I won't binge the next day, but I give in every day, I relapse and I feel like I betray myself and then I feel disgusted, bloated, full and like I've gained a mammoth of weight. To be honest, I'm staying away from the scale because I know it's bad. This case is becoming so desperate, I feel rebound depression, anxiety, and suicidal thoughts. I've already begun isolating myself again.
  14. Your options are Take your Naltrexone with the drug Wellbutrin they work very well together. Studies show that monotherapy doesn't hold up well with binge eating disorder/food addiction. I would try this option first. I'd probably also inquire about increasing Naltrexone to 100mg if you can manage the side effects. Wellbutrin you should be looking at the maximum dose of 300mg I think it's higher if it's the Wellbutrin XL but we don't have that in the UK, we only have Wellbutrin SR. Zonisamide should also be taken with Naltrexone for maximum benefits. Topiramate should be taken with a stimulant such as Vyvanse (Lisdexamfetamine) or if you can't get that, use Wellbutrin. Generally, if you are taking Topiramate with a stimulant, you can theoretically not take the maximum dose of the stimulant. Lorcaserin (Belviq) is a SSRI also studied for binge eating disorder/food addiction. Please inform your PDOC that it shows in all trials that there are better results with the combination drugs instead of monotherapy, they especially record continuous weight loss/stability after 24 weeks whereas monotherapy has some issues.