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About sming

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    PDoc Confounder

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    none - I have anhedonia

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  1. Hey @Equilibrium022x, your stack is very similar to mine. I wonder if our TRD brains are like peas in a pod? BTW 30mg Lexapro was also excellent for my TR OCD but the main reason (I think) it was so effective was because it made me so anhedonic, that I just didn't care about trying to control my "dangerous" thoughts (a.k.a. "Spikes"). My spikes require me to be feeling OK-ish in order to fire and 30mg removed that criteria, effectively. FTR, my current witch's brew (in mg) is : 300 Lyrica, 50 Percocet (chronic pain), 2 Lorazepam (breakthrough OCD fear/terror), 200 Provigil (daytime somnolence/exhaustion), 2.5 Abilify, 20 Lexapro, 15 Ritalin OR 15 Adderall, - I need to take one of these two every 2 hours or my mood goes from ~5/10 to 2/10. It's like clockwork. No PDoc has been able to explain this to me. 40 Fetzima, 45 Buspar (anxiety), 300 Trazodone, 50 diphenhydramine (sleep) Cheers, Pete
  2. This is interesting because I read the same i.e. "no withdrawal" and BAM did I get withdrawal from Provigil. I was taking 400mg and doing well for ~ 5 days and then it pooped-out, so I just quit cold turkey. I basically went completely catatonic for 2 days until I found those few reports of severe withdrawal, took 200mg and felt human again in under 2 hours. Beware! Since then I tapered 400 -> 300, 300 -> 200, 200 -> 100, 100 -> 50 and now am off. I spent about 5 days on each dose. HTH.
  3. That's not a bad idea. Yeah it's def "roughly" two weeks since it has several active metabolites IIRC. I might try that as well once my meds go back to their pre-op levels (as right now I'm doing much better due to the large doses of Oxy...). I thought the keto diet had been mostly debunked as effectively just being a low-calorie diet? I'm way, way too depressed to exercise. I barely have enough energy to make a cup of tea most of the time, let alone go for a run or something proactive. Huh. Sounds like the meds really are doing a number on you 😕 I'm fairly athletic under the extra med lbs. You can see it now and again if I hold my breathe in, lol.
  4. Well, if you ever "unlock" these things (like some PDoc's and T's think you can, and then you are just light-years better), then I'll be fucking jealous as fuck! I've had numerous T's and PDoc's ask very awkward questions (e.g. were you touched etc.) about my youth and I honestly can't think of anything untowards at all. I've wracked my brains many times 😞
  5. Isn't it also a feature of BPD? I seem to remember a guy with I think BPD who was hypersensitive like me. There's also this non-condition now : Do I Have Rejection Sensitive Dysphoria? which asks: High sensitivity about the possibility of rejection Overly high standards for yourself Feeling easily triggered toward guilt or shame Isolating yourself in a preemptive strike not to be rejected Aggressive or rageful behavior toward those who have been perceived to have slighted you Frequently feeling an uncomfortable physical reaction due to "not fitting in" or being misunderstood Self-esteem that is entirely dependent on what others think, and rises and falls accordingly Frequent and intense ruminating after an interaction about how you did or said something wrong Sounds like me to a tee. The only person I can play "competitively" is my 9yo son, which is a beautiful thing but also tragic that he's literally my gateway into a passion I've loved my whole life (videogaming). If he doesn't fancy a game, I'm done. If he wants to play with his buddies, I'm done. Etc. etc. One can hope @mikl_pls. I don't mean to pour cold water on shit but I've had a few therapists who were licking their lips when they started work with me only to end up throwing their hands up after a few months/years and teflon-ing me off to some other poor sod.
  6. Tried Zelnorm and Amitiza - same deal, gah. My gut just does not like being told to empty itself. If you pull the plug on it (from the other end), it doesn't seem to go into crazy cramping ¯\_(ツ)_/¯ I couldn't find anything on "Meclobemide" and Moclobemide is obviously the old MAOI. OK, here's the deal: if I don't do it, you don't do it - capiche? (sure that's gonna work...). Exactly! We wouldn't be on the bloody med merry go round if they bloody worked, would we!!?? That really pisses me off. It also pisses me off that I get berated and preached-at for ordering extra stimulants online. I wouldn't have to do it if I was allowed a sufficient amount, would I!?? Really? I've stuck out a bunch of meds that I've had bad reactions to and none, literally none that I can recall have somehow majestically risen up and become helpful. They typically just get worse and worse. Speaking of naloxone, when negotiating (cause getting logical/obvious post-op painkillers now is like getting blood from a stone...) how much Oxy I can get for my severe post-op pain with my pharmacist, she offered up that they have naloxone and it doesn't need a script. You know, just in case like... like I'm an addict. 😞 THIS THIS. I love Hearthstone. But I can only watch others play it on YouTube because I'm terrified of feeling too hurt from losing, or being humiliated. Or both. I've tried every trick in the CBT, REBT, ACT and ERP books to no avail. I just can't do it -_-... Also because there's not as much money in depression as there is in cancer or obesity... And that religion "if only you could see..." trip. I don't get it that much because I no longer interact with a wide range of people but it's just the worst. The thing is, if "seeing" God worked, I'd bloody well do it! I WANT to see because then I'd feel better!!! Jesus. It's powerful for you too as well then. I tried the oscillating dose and it... didn't help. Perhaps I need to do 5 days @2mg, 5 days @5mg, alternating or something like that. God knows. That is a severe weight gain. Christ. I'm 200lb but normally am 175lb and I hate it. I'm so sorry (for us both) dude 😞
  7. @mikl_pls - am writing in segments as one long reply was really buggy with text disappearing...? Hah, that's exactly what happened to me last week on 1mg Guanfacine, which is like an NRI I think? My energy and focus were improved but I was purely focused upon SI! I was offered Naltrexone (or even tried it..?) because of my chronic opiate use and IIRC it did not go well. They wanted me on buprenorphine (Suboxone) as well but I read a lot of horror reviews online. Docs tended to dump people off of the opiate and onto Suboxone and pretend it was as effective as the opiate and that the problem was solved. Naturally that didn't go well for most folks... Oh man, they let me fly. I just developed post-op thoracic radiculopathy (squished root nerves - oww) and I'm on 15mg Oxycodone doses up from 5mg. It is bliss. My depression is so, so much better. But will I be allowed to stay on it? Of course not. I had to fight to get barely enough pain suppression before returning home 😞 I def know hitherto, but wasn't aware of thitherto - most splendid. you've got me thinking now. Perhaps I can take time off of work just to push through the somnolence/anhedonia barrier and onto 10mg and up... Hmm. If it's potentially like Adderall then that would be nothing short of magic for me. Oh, bugger. That sounds like my anhedonia. I just feel soulless, vacuous, devoid of meaning and purpose. Oh man, we are tragic twins again. This is exactly the sort of thing I'm struggling with. As you age (I'm 44), your MI tends to get worse and more set in. So is my increasing anhedonia down to that, or to just being really depressed, or Abilify, or Abilify + Fetzima, or ... you get the picture 😕 You're absolutely right. I can't stand it when someone tells me exactly how my 4 psychotropics are interacting, or even how just Abilify does. No-one really knows why they affect mood, MI, cognitions. Of course it's not that simple with me. I felt better for a few days and then back down the toilet. I think I mentioned that I might start oscillating between 1.125mg and 5mg - try and keep my down/up-regulating asshole of a brain guessing, you know? Thanks again dude.
  8. Hey @mikl_pls, please accept my customary apology for being so tardy replying. I'll try and address your feedback in one go this time. I tried Linzess and it's just like any other IBS-C med - it causes my pain to skyrocket and doesn't help me to go ¯\_(- -)_/¯ Yeah, I've heard that a fair few times. I'm certain I have inattentive ADD but it's hard to tease that out from anhedonia, dysthymia and good old MDD 😞 I like the sound of this protriptyline. I might ask for that. w.r.t. self-loathing, I think I'm some regional champ. Any "mistake" w.r.t. my OCD rules and I instantly, repetitively loathe myself for "jeopardizing my life". WTF. No amount of logical arguments against it can stop it once it's triggered. Wow you really went through the wringer on the Clomipramine eh? A lot of my med attempts go like that and then the PDoc's down the line look at you like you never stuck things out.
  9. So I went here for OCD treatment and was helped greatly. The founder wrote this weird, sprawling article on OCD and I recommend reading it. You can find it here. I hope it helps a little. Pete
  10. Man, sorry for the late response @mikl_pls . My OCD makes reading large posts very, very difficult I don't even know what the threat behind it is any more Anyway, thanks once more for the info. My PDoc as I mentioned, is great and experienced and isn't swayed by what's de rigueur or not - he just prescribes what the data proves most effective, but is willing to try left field stuff as well for me. Typical that he's out of network ¯\_(- -)_/¯ The crashes have alleviated somewhat of late, or have moved to 2pm. I've no idea why. It seems to rise and fall with intensity, perhaps with my OCD levels. Hah! - constipation. Due to my IBS-C, I haven't done an unassisted #2 for... over a decade? Lovely. Gotcha w.r.t. dirtiness of the TCAs. That might complicate things slightly and I might request Nortriptyline for that matter as it's the least-dirty. I have a ridonculous regimen at present already. Well I hate sedating drugs - they make my OCD (about being so depressed that I spontaneously off myself) go bananas as I interpret my slovenliness as increased depression. I guess I should opt for Desipramine. Cool. I tend to get hit by sedation/somnolence even by activating meds e.g. Bupropion, Provigil (which admittedly are completely different molecules and modes of action). Hmm. I like the quick response time. I also couldn’t care less about cadiotoxicity. At this rate I won’t be around long enough to die from heart problems, that’s for sure. I wonder if I could replace Trazodone (and Fetzima) with this one too? It sounds similar in its effects. Clomipramine has been suggested to me a number of times because IIRC it’s good for OCD. That might make this one a strong contender to try first, actually as OCD underpins a lot of my depression (e.g. repetitive, unstoppable self-blame). Roger that. Hah. I have those too, like Abilify and Lexapro. They always function like before. But very few of the other meds (including MAOI’s) I’ve taken twice or thrice do that. Interesting. A bit like Abilify+Lexapro for me. Except (I think) that I feel horrific on just those two - just less horrific than on everything else… Do you feel “OK” on these two? Or just “not as bad” as when on other regimens? Huh. That’s interesting because opioids are brilliant anti-depressants for me, if not the best. I actually feel well and content on them and no other med has ever given me those feelings. Weird. Gotcha. MAN. That's exactly what I just experienced - the dysphoria, somnolence, and for me - brutal anhedonia. I'm anhedonic without Abilify but I've literally discovered this last week whilst tapering down Abilify that Abilify has been making it much worse I normally feel so, so terrible yet unpredictably so (I can't ever get a baseline "mood"), it's very hard for me to ascertain whether I'm doing better or worse on a med. Generally what happens with any given med is that (if it does anything at all) it merely changes my OCD, depression and anxiety's texture in some way and/or changes the nature of the collective side effects. "Theretofore" - good word, didn't know that one. Holy holy shit. I've been at 2.5 forever and recently tried going up to 5 gradually and just became more and severely depressed, somnolent and anhedonic. I can't even comprehend what 30mg would do to me... w.r.t. what I just said, the 2nd time I tried Abilify I somehow managed to hit 7.5mg (I was on a totally different regimen) and was compulsively cleaning and playing video games at 3am. It was amazing but it didn't last. Oh don't say that 😬 Holy crap, that is a terrible turnaround for the worse. With your complicated and rapidly-changing regimen, are you double-sure it was the Abilify and not, say, a natural degeneration/progression of your MI? Or some other factor? I was a depressed empty shell but being happy and empty is not much better. It's like what makes you you is sucked out of you - your soul is just gone. You just become this mannequin version of yourself. None of them are! I liked one PDoc who was saying how much he hates the term "atypical antipsychotic", because when you look at them as a group, they have no common chemical properties whatsoever. He argued strongly that the whole "atypical AP" buzzword was marketing bumf to distance these expensive new AP's from the cheap (but equally effective), older ones. Agreed. It's used willy-nilly by even GP's as an augmentation agent but it's a serious, serious med. It's an antipsychotic. Should John Jones really be prescribed an AP because he's been feeling low for 3 months? I think it's insane. Many thanks, ditto to you. I am feeling more human since going down to 1.125mg at least - some of "me" is peeking out for a few hours a day. FML eh?
  11. That's me right there. My brain is irretrievably busted. By which means, I do not know but ultimately it doesn't matter - the fact is is that it's fooked.
  12. My OCD prevents me from reading loads of comments so I don't know if this has been suggested before but you know that the whole "action before feeling like action" is covered big-time in the "Feeling Good" (David Burns) book? I fucking hate that book. I naively followed all the exercises, expecting change and... nothing. To my knowledge, the prick who wrote it has never encountered someone with either TRD or anhedonia. He's such a condescending wanker. To be fair, I'm sure a huge chunk of non-TR folks he sees are "miraculously" transformed by these CBT techniques and he has to instill optimism but please, it's like us anhedonic folk literally don't exist.
  13. Yep. It's the worst. Same here. It's horrific depression OR soul-consuming emptiness, it would seem. Have you considered obtaining Provigil? I've had success with it - temporarily at least - numerous times. The last time, over New Year's, I felt "OK" for 5 whole days when I took 400mg (double the recommended). You need to convince your PDoc that you have daytime somnolence from your meds and/or sleep apnea or... I forget. Or you get it illegally, like I do ¯\_(ツ)_/¯ FWIW it's non habit-forming and 99.999%* of the time causes no withdrawal upon cessation. * Yep, I got severe withdrawals.
  14. No good suggestions unfortunately, compatriot*. Actually, one severe and/or crap suggestion is to get yourself on a med/meds that cause early waking. Due to my regimen, I involuntarily wake up - like wide awake - between 4 and 6 a.m. no matter how tired I was nor how late I stayed up (although I'm always in bed by 7pm because there's no point in being awake once my Adderall doses are done). But this is merely shifting the problem forward a few hours actually i.e. I go to sleep stupid early because of my depression and you get up stupid late because of your depression ¯\_(ツ)_/¯ On weekends, when I don't "have to" be at work (and I appreciate I'm lucky to be able to hold down a job), I struggle with the "futility & uselessness of life" all the more. In between kid-juggling (I have kids. I do not have a weirdo hobby of literally juggling kids or anything), I lay in bed, because sitting up is too much effort. I stare at the wall or sky most the day because I can't think of a single thing that I want to do. With any luck, I fall asleep. Life. Fucking. Sucks. * That's a crap joke that only other Welsh people will get.
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