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Crazy moodiness - angry/worthless/so tired


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Hi,

I've been a member here for quite a while, but I get really nervous about posting, so I haven't done so much. I just kind of don't really know what to do right now. I was diagnosed years ago with MDD. I used to SI, but haven't for a few years; used to be anorexic; have some anxiety-NOS stuff that hasn't been as bad lately as it used to be, and so on. I've been diagnosed with BPII in the past, but I don't know how accurate that is. I also get sick constantly - physically sick. I've been tested for everything known to humankind, I think, but there doesn't seem to be anything specific wrong - I just catch every bug around.

I take Zoloft (200mg), Edronax (4mg), Xanax (0.5mg for 'sleep'), and have cut down Lamictal from 400mg to 200 in the past few months. I want to stop taking it entirely due to weight gain from carb cravings. The problems I've been having predate the beginning of Lamictal withdrawal.

I feel entirely worthless. I spent six months in an interstate eating disorder program a couple of years, and then a bunch of stuff went really wrong - still not sure exactly what - and I was just wrecked cognitively for about a year, during which time I couldn't function at all. Anyway, that has improved quite a bit, however, the upshot is that I ended up having to move back in with the mother, couldn't work for quite a while, couldn't study, and so on. I'm working and studying again now (each part time), but I cannot afford to get out yet. I am desperate to do so, and am trying to get on my feet financially, but it's taking quite a while. I'll be 29 this weekend and am living. at. my. mother's. house. I feel like people think I'm an utter loser, probably because I *am* an utter loser. I lived by myself from 18-26, and I miss it SO MUCH. I just feel like such horrible worthless scum.

I am also really ragingly angry. Not in a violent sense or anything; it's really more that I am constantly enraged - like, absolutely INFURIATED - by political issues (mainly over social and fiscal conservatism; the horrible direction in which Australia is going in terms of healthcare, social security, foreign policy and so on). Reading the paper is a horrible nightmare, as is watching any news, as I know that I will get stressed and worried and enraged and so on.

Uni is stressing me - I have not yet completed a degree as I've been dropping out for the past 10 years due to academic anxiety, anorexia, depression and so forth. Academic anxiety is still a major problem. I need a job that allows me to work more hours, but I have huge gaps in my resume + have no qualifications, which makes me barely employable.

The major problem right now, aside from the anger thing, is fatigue - it's constant and severe. I am barely able to get up/function in the morning (mornings are particularly awful). I am exercising moderately and eating well, and it just goes on and on. My GP and psychiatrist are stumped.

Okay this is ridiculously and insanely long; I'm sorry. I'm just wondering if anyone has any insight, if indeed anyone reads this through to the end.

Thanks very much.

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Blueberry,

Usually I'd be cheerier in response, but I just got rejected for a job that I could do standing on my head blindfolded, that the recruiters said I was perfect for, because of my illness. I also live at home. So right now all I can do is empathize. You're not a loser.

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Hi Blueberry, sorry things aren't working so well right now.

Lamictal can cause aches, heaviness and stiffness. This is fairly common, particularly when first starting or increasing dosage, though it usually wears off with time.

I would be very surprised if discontinuing Lamictal has any affect on carb cravings since it just isnt' associated with that effect. Normally the SSRI AD's are the culprit. Let us know how that turns out.

Since Lamictal is a mood stabilizer, decreasing dosage would tend to unmask rage symptoms. And yes, these are fairly typical bipolar symptoms. I've just decreased my Cymbalta, an AD by half and I'm having problems watching the news!

You are maxed out on Zoloft. 200mg is the maximum recommended dosage. In trials Zoloft caused fatigue and somnolence at nearly double the placebo rate.

Edronax is an NRI similar to Strattera for those of us who don't have access to Edronax. The normal dosage on Edronax is 4 -10mg, so you are the low end. However, there is a possiblity that you may be experiencing the fatigue and fuzziness as a side effect of the Edronax, whereby your brain may not have enough norepinephrine, or too much MAO. This is sometmes reported by people who are doing pretty well on the drug and increase it looking for more improvement, then suddenly feel wiped out. This is getting above my level, so I will ask one of the other mods to take a look and comment.

Your pdoc should be very clear as to whether he is treating you for bipolar disorder or not. Time and again we see members who have failed years of depression treatment and do well once treated for bipolar. If Lamictal hasn't worked for you, ask your psychiatrist whether he is considering lithium or divalproax (depakote), both excellent mood stabilizers. I guarantee that taking enough of either of those meds WILL control your moods. From there its a matter of trade offs.

best. a.m.

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IIRC zoloft is one of the more weight neutral of the SSRIs.

You might want to look at having a sleep study done to make sure you actualy get rest while you're asleep. If you have sleep apnea or have abnormal REM patters you could sleep 18 hours a day still never be rested.

Have you had your thyroid and adrenal hormone levels checked? None of the meds you're on or have been are known for carb cravings. some kind of hormone imbalance could account for both that and fatigue.

If you're not infuriated by political events, there's something wrong with you. I personally like rioting but people tell me that that is no longer the acceptable way to bring about social change.

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Edronax is an NRI similar to Strattera for those of us who don't have access to Edronax. The normal dosage on Edronax is 4 -10mg, so you are the low end. However, there is a possiblity that you may be experiencing the fatigue and fuzziness as a side effect of the Edronax, whereby your brain may not have enough norepinephrine, or too much MAO. This is sometmes reported by people who are doing pretty well on the drug and increase it looking for more improvement, then suddenly feel wiped out. This is getting above my level, so I will ask one of the other mods to take a look and comment.

Even if it takes a while for the guy to swing back around to the site!

A.M. is correct to note that for some folks an NRI will leave them wiped out instead of energized. Here's a CrazyMeds NRI link that discusses a bit of that (down around item 9.) Basically, if you do not have enough noradrenaline to start with or require a bit of a push to get it in circulation, an NRI will make things worse. First off, you can't inhibit reuptake if there's nothing to reuptake. Then, when the NA does come back out of the nerve synapses, all the monoamine oxidase (MAO) made in the interim to account for all the "extra" activity is just sitting there... waiting and hungry. So what you did have just gets nuked.

If it's a matter of needing more stimulus to get NA in circulation, a stimulant at a low dose is often the best way to go about it if you are already exercising regularly. ADD and some types of depression can require such a combination even when it looks risky on paper.

What bothers me is that you are reporting a high-stress school and home life situation, a tendency to go off in a "slow burn" (where a person keeps coming back over and over to a small irritation until they're irritated and frustrated enough to explode) and you're wiped out regardless of how much you think you are sleeping. At the least, you are stimming yourself by staying angry and irritated all the time ... possibly just to stay awake?

I'll second the advice given to:

- check out thyroid function

- check out adrenal function (you should not be catching every cold and flu bug that goes around)

- get evaluated for any potential sleep disorder (Central sleep apnea usually doesn't even cause snoring)

- get a thorough evaluation from your current doctor and maybe get a second opinion. If there's ADD, or Bipolar Disorder, or Temporal Lobe Epilepsy in the picture, your current med combination may not be helping (and it's not even guaranteed for depression)

I had many of the same symptoms you report, and I functioned best with bupropion and Adderall. The bupropion made sure I had no problem getting to sleep at any time of the day, AND it stopped my brain going around in circles over piddly stuff. It may be right (or available) for you, but you need to know that there are things that work even when they shouldn't/

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I agree that the rage may indicate bipolar.

I can feel you on the job front. I have huge gaps in employment, and the longest I've been at one job is a year, so my resume looks like shit. It gets particularly bad AFTER college. Ugh. And I'm around the same age as you--27. All you can do is accept that your life has not taken a traditional course thus far and not blame yourself for what has happened in the past. Mental illness is a disability like any other, and it often causes serious issues with functioning just like any other disability. Where it gets tricky is trying to explain that to a potential employer...you're like nuclear waste and the unemployable scum of the earth if you have mental problems. I find that funny, because I bet some of those interviewers, the potential bosses, are fucking batshit crazy and get away with tyrannizing other people for their entire working lives. That's how the boss of my last serious job was--a fucking cunty tyrannical nutjob.

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Replying properly, in case someone reads:

(Firstly, once again, thank you so much)

Karuna: I'm sorry about the job. That is really crappy.

AirMarshall: So you really think dropping Lamictal wouldn't change appetite stuff? That sucks. I've been on it for a couple of years at 400mg, and am currently down to 200. The anger thing has been going on since before I started to reduce the Lamictal - I was kind of vaguely hoping that decreasing it would be helpful with that, but alas no. I'm also not sure if it's a coincidence, but I've started having huge problems with restless leg syndrome at night and am having huge problems sleeping. This happened a few years ago (without the RLS, though) - I stopped sleeping entirely for about a week and a half. It's not that I feel a reduced need for sleep - I just can't.

I think my psychiatrist considers the problem to be MDD, and that I for some reason just happened to respond to Lamictal. I've never had a lot of success with any meds, and there have been many. When I do 'respond', it is often in the form of a paradoxical reaction of some kind. One guy diagnosed me with bipolar I a few years ago, but that was after one incredibly short appointment and pretty much entirely on the basis of insomnia, so I'm not really sure what to think. I've never really experienced any traditional type of mania, as far as I know.

Velvet Elvis: Yeah, I think I will request a sleep study. I've done so before, but my psychiatrist seems to be resistant to the idea. I have no idea why. He can be kind of a dick, but I've tried getting second opinions and third opinions and so on, and basically it seems that every psychiatrist who has any kind of reputation for competence no longer takes new patients. This applies to the ones who haven't left the state long ago.

Every thyroid panel I've had has been normal. I don't know about adrenal hormones, but I'll request another bunch of bloodwork.

True re: politics...I would just welcome the chance to be able to switch it off occasionally, you know?

null0trooper: Thanks for the information regarding Edronax and noradrenaline (thanks to AM as well). I had been thinking maybe it was a dopamine issue. I don't know if this is significant, but when I've tried increasing the dosage, I've felt really anxious - more so than usual, that is. I will take up your suggestions re: blood testing and a sleep study, if I can get a referral from someone, and speak to my GP and pdoc about a psych evaluation. I feel like they've pretty much written me off as a medical & psychiatric freak and just laugh stuff off a lot of the time. Like, they literally do - it's not mean spirited, but it's invalidating nonetheless.

I've asked about bupropion, but it's only available as Zyban here, and is authorised for only three months of treatment. A private script would cost an absolute ton.

Thanks so much.

hollywoodfreaks: Thanks you heaps for understanding! Employers can be such cretinous, nightmarish beings, and it sucks when such people have power over you. We're supposed to be experiencing a 'resource boom' and 'record low unemployment' here at the moment, and it's so frustrating to hear the government exalting over the statistics when I'm still in a crap position. They're also reducing the amount of money paid to people on disability pensions in an attempt to force people into the workforce, which just bothers me to no end since people on disability kind of by definition are unable to work. I will stop before I get angry, lol.

Thanks again, and apologies for length.

Blueberry

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