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Stress and "Erosion"


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People always say bipolar is treatable and you can improve but I'm just not seeing it. I'm in my 40's, have been depressed nearly my entire life and was diagnosed as bipolar a few months ago. Antidepressants helped while in my 30s, but starting 3 years ago I started to get worse, and even more worse (worser?) for the last nine months.

Problem is, stress is a killer. Every time there is a stressful event, and this can be drug related like withdrawal or trying to go off a drug (as prescribed by doctor), I never fully recover from it. So every stressful event produces erosion. And I don't get it back. Discouraging is too mild of a word. I feel like I'm wasting away bit by bit. And I can't describe to my wife how harmful stress is.

I'm Bipolar II/NOS. Controlling hypomania, dysphoria isn't much of a problem. Anxiety and depression are what keep getting worse. And I still cycle between baseline depression and terrible anxiety/depression. Ativan is the only thing that helps but I don't want to build a tolerance.

Will it ever stop getting worse?

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Wow. I feel very similarly, having been through some super stressful stuff the past couple of years.

Will it ever stop getting worse?
I have to hope so! I do believe that these aren't permanent set-backs. But the time for repair when we're bipolar is a *lot* longer and harder than for "normals". This is particularly so when we're not getting full support from meds because we're always fighting something new (or even old). I think (hope) the situation will be different on the right meds. Still a some time to process and deal with triggers, but shorter.

I also think it's really important to make every effort to minimize the stressors in our lives. I read this summary of some research that was done on a bunch of stable bipolars and that was the top-most common thread between the cases: keeping regular hours/habits/etc, limiting exposure to stress. (I'm struggling right now with how to walk the talk in my own life while maintaining a career, but that's another story.)

Is there anything you can do to avoid some of your triggers?

Good luck,

cache-monkey

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I agree with Cache-Monkey about the triggers. Triggers that set me off are kind of random- like one day, the dog is great and a joy, and the next, i hate the dog and want to sell it on eBay (just kidding! lol).

If the Ativan is helping, you may want to look into SSRI drugs that help with stress.

Also, there are lifestyle ways we can control stress in our lives. I just take a walk after dark to clear my head, or I write my RANTS here (especially about people who suck). I also stay far away from my mother!

I hope at least some of this helps-

loon

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There have been some significan't but not super major life stresses that couldn't be avoided. Also some drug changes. The other stress is work. I work a few scant hours a week at home. Sometimes it wipes me out. But we can't afford for me to do no work.

I'm in the process of appealing to a judge for disability. It will be at least a year and a half til we see a judgle. Just THINKING about that is stressful.

And there will probably be another drug change coming up. I hope this one actually improves things.

Lexapro is the SSRI that helps just a little. Any less than 10mg and it becomes less effective. Any more and things get worse. Although maybe I've gotten worse enough that's it time to try more again. If I can afford it.

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It is my opinion that meds bring us up to a level where we can be more rational and consider our lives and ourselves from a more logical view rather than the total emotional overload we experience with our disorders.

Keeping that in mind, it is important for you to get your meds right.

I took Lex up until a couple of weeks ago. It did work for my background anxiety. I am having a little problem with it now that Lex is gone, so I can totally see where you are coming from.

But why is it so bad to up the lex? I was taking 20mg. 10mg i think is considered to be the lowest effective dose. Also, give your body some time to adjust to med changes. A part of my problem in the past was that med changes were too fast. Now I'm on the meds that seem to be holding me in...you've just got to play around and find what works for you.

The depression end sucks, and the weird middle states suck worse. I'd say think about asking your pdoc if you could up the lex.

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But why is it so bad to up the lex? ...

The depression end sucks, and the weird middle states suck worse. I'd say think about asking your pdoc if you could up the lex.

SSRIs have always been a problem. I've never been able to take more than 10mg Prozac, whatever the equivalent is for Zoloft and Paxil. They made me super tired, and depression symptoms, including physical start coming back again when I go higher. I will ask my doc about it but I'm thinking there may be other things we're going to be working on first.

Probably be removing the Risperdal since it isn't doing much and it's expensive. And the Trileptal isn't working. May be trying the big Z which could theoretically eliminate everything but Lexapro but I'm not sure. I'm also going to suggest gabapentin since anxiety is my worst symptom right now.

Feeling very hopeless. I see my pdoc on Friday. He doesn't have the best bedside manner so I have to muster up my self confidence.

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I know cache-monkey mentioned a regular schedule and I think that is very important- your body physically needs to be able to predict within reason what might happen next. Getting the right amount of sleep, a good diet, etc. I'm sure you've heard it.

I saw you have some IBS-symptoms going on, also. I don't know exactly what that means, or what you have done or are doing to address the problem, but try to make sure you aren't neglecting that physical aspect of your health also. Do whatever you have to to get that at least manageable if not 'figured out'. Even if the symptoms are a product of the anxiety, they should be treated. They may be due to other factors though and the anxiety could be a contributor, not the cause. The anxiety and stress and physical issues can all feed off of eachother.

I don't want to be discouraging and I hope I'm not but it can take a while for your brain to get in order. Your body needs to get in line also. It's hard to reprogram your brain to react in a different way to stressors. If you have been depressed for this long, it will be a little while before that happens. And your are still changing meds around. It does get better. It feels like erosion because we actually take a lot longer to repair and stabilize than we think. And if you aren't sleeping well, that is doing a lot more to you than you probably realize. So maybe you need to start practicing the dreaded Sleep Hygiene.

Also, have you talked to your doctor about trying something other than propanolol? It may be influencing your moods or effecting your sleep. I'm really not all that up on beta blockers but maybe you could look here. Your ADs might be influencing hypertension or the Inderal could be influencing moods. Or both. Well, or neither. Do pay attention to what your body is telling you, though. It all ties in together.

Hope your appointment goes well on Friday. If you never bring in notes or cards to appointments, maybe you should start. It could help you get everything across to him that you want to say.

~navy~

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Lemonflavor,

Yes things will get better. Med change overs can be particularly trying.

A couple things to discuss with your Pdoc.

- Beta blockers (proponolol) can cause depression. I just went through 3 weeks of flip-on, flip-off depression which correlates with using a beta blocker for anxiety and lithium tremors.

- Benzos (klonopin) can cause depression. Even though they help anxiety, they may make depression worse.

Remeron and Lexapro both have 'black box' warnings about causing depression/suicidality in children and adolescents. But antidepressants can cause worsened conditions in adults as well. My family doc originally put me on Paxil an SSRI, which greatly worsened my depression to a dangerous level. It took my Pdoc getting me on mood stabilizers and off the SSRI to stabilize things.

I'm confident that you will be able to level off and then improve. Discuss your situation and some of these ideas with your pdoc. Also, be sure that you aren't sugar coating things or holding back with the pdoc. Be sure he understands how poorly you feel.

Best, a.m.

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I know cache-monkey mentioned a regular schedule and I think that is very important- your body physically needs to be able to predict within reason what might happen next. Getting the right amount of sleep, a good diet, etc. I'm sure you've heard it.

I saw you have some IBS-symptoms going on, also. I don't know exactly what that means, or what you have done or are doing to address the problem, but try to make sure you aren't neglecting that physical aspect of your health also. Do whatever you have to to get that at least manageable if not 'figured out'. Even if the symptoms are a product of the anxiety, they should be treated. They may be due to other factors though and the anxiety could be a contributor, not the cause. The anxiety and stress and physical issues can all feed off of eachother.

I don't want to be discouraging and I hope I'm not but it can take a while for your brain to get in order. Your body needs to get in line also. It's hard to reprogram your brain to react in a different way to stressors. If you have been depressed for this long, it will be a little while before that happens. And your are still changing meds around. It does get better. It feels like erosion because we actually take a lot longer to repair and stabilize than we think. And if you aren't sleeping well, that is doing a lot more to you than you probably realize. So maybe you need to start practicing the dreaded Sleep Hygiene.

Also, have you talked to your doctor about trying something other than propanolol? It may be influencing your moods or effecting your sleep. I'm really not all that up on beta blockers but maybe you could look here. Your ADs might be influencing hypertension or the Inderal could be influencing moods. Or both. Well, or neither. Do pay attention to what your body is telling you, though. It all ties in together.

Hope your appointment goes well on Friday. If you never bring in notes or cards to appointments, maybe you should start. It could help you get everything across to him that you want to say.

~navy~

Navy, I do everything you say. Nobody lives a more regimented life than me except those in the military. Plus I am anal-retentive-boy on top of it. I eat well and exercise (what little I can do) four times a week. (I eat every day) I write things down before appointments so that I don't miss anything. Also sometimes I'm so depressed I can't talk, then I just hand them to him. I thinks he now likes reading them better than hearing me talk.

My doc is dropping my meds one by one to see if any is a problem. We tried Lexapro and it was a disaster. Haven't gotten to propranolol yet. I take it when my heart is skipping beats and "thumping". Otherwise I don't take it. I don't notice it affecting depression. If I go off it and my heart is skipping and thumping it's terribly uncomfortable. ACE inhibitors don't seem to work as well.

I've been reducing the benzos at night to almost nothing. During the day I take a few days, then don't take it a few days. Feel much worse when I don't have it. If I totally went off for a couple weeks I'd probably end up in hospital where they would give me more. ;)

I know you guys are right about the med-go-round. I've never been on the same meds for more than a couple months in a over a year. It's so hard to find anything that comes close to working.

Also, be sure that you aren't sugar coating things or holding back with the pdoc. Be sure he understands how poorly you feel.

I used to hold back but I don't anymore. I'm not sure if he believes me, especially because I'm SO sensitive to side effects and withdrawal. Or maybe it's my own paranoia.

IBS symptoms are mainly diarrhea from anxiety.

Thanks for all the comments.

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I have spent the last 3 years searching for triggers--for patterns, for things I could attempt to control so that I could live on a more even keel. I have had no luck at all.

I stick to my meds religiously, which of course helps, but then there are those out-of=the blue shit days when nothing helps, I just want to gobble Lortabs and muscle relaxers and sleep.

I did feel better , physically, when my suposedly IBS was correctly dx'd as a mild case of Crohn's disease, ansd I was put on Asacol, which is for me a wonder drug. Its hard to remain stress-free, no matter what your mind set is, when you are constantly afraid of shitting in your pants with no warning or provacation. You may want to check out that med--its expensive as hell, but I would hock my soul for it

Today, for example, I have gotten a few things done, but basically just wept the entire day--no real reason, I just cried--a lot. And when I got a late b'day gift from my daughter--something only she would think of and go on eBay to find for me--I was beyond even being coherent.

But I am not cycling, so the days go by--and the great job hunt is looming around the corner.

Speaking of stress--

china, poor, weeping, but fairly stable--tho I don't know why or how--

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Oh, yes, dear Libby, faithfully for one more week--next wed. is "Burn the Brace Day". However, if I want to go back to my old employers and spend 8 hours a day entering data in a computer and filing =-big whoop--I have to wait for the doc to clear me--5 more weeks.

To make a long story short, we cannot pay our rent this month, I have no gas in my car, and I have no idea what will happen to us before the 5 weeks transpires. I have found a job I can apply for, but cannot afford to fax them a resume--nor can I afford to go get my car tag renewed, tho it expired June 30.

I am totally at the bottom--I am seriously heading back to bed, stuff some muscle relaxers and an Ambien, and hope the day will go away. I do not know what to do--I am out of tricks, or resources, or "creative budgeting techniques". We are stone cold broke--and there is no change in sight.

Sorry for hi-jacking the post--I just feel so totally lost and hopeless. I never wanted any of this--and there's no help, nothing.

Sorry for the typiing--hard to see when you are crying so hard--

china

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