I want your thoughts

[numbone]

At the present time I take 450 mg wellbutrin xl, 300 mg effexor xr, and a 200mg provigal when I wake up.

Between 10 and 11 AM i take my metadate 30 mg, and then klonopin as needed.

My pdoc has not been able to come up with a definitive dx on me and is instead focussing on the symptoms.

Sometimes i think he is just trying meds to rule out dx, like the wellbutrin and effexor, to show that i am not manic, ect.

Now recently i am having ptsd from dealing with Hurricane Andrew, and Wilma, not to mention charlie, and all the others.  Some days i feel almost like myself, while other days i feel like driving the car into the highway posts at 100 and just ending it.  The problem is i won't do that because of the effect it would have on my family. 

Top it off that it is the holiday season.  My father had me work for him throughout high school.  We always were open thanksgiving eve, christmas eve, and my birthday.  Even though i havn't worked there for years i just tend to get edgy and dissasociated at this time of year. 

I am already doing EMDR and meditaion, but that only goes so far.

Please if anyone has thoughts ideas or comments please post

[Fiona]

At the present time I take 450 mg wellbutrin xl, 300 mg effexor xr, and a 200mg provigal when I wake up.

Are you really wide awake all day? On that combination...

My pdoc has not been able to come up with a definitive dx on me and is instead focussing on the symptoms.

Sometimes i think he is just trying meds to rule out dx, like the wellbutrin and effexor, to show that i am not manic, ect.

Dianosis is not really important, except as a kind of 'shorthand' for describing you and suggesting particular courses of treatment. So don't worry if there's no clear diagnosis involved in this. The goal is, at any rate, to alleviate your symptoms whatever you want to call them.

Now recently i am having ptsd {clipped}

I am already doing EMDR and meditaion, but that only goes so far.

It does have a nasty habit of coming back around and getting you, over and over and over. You might find some good things in the PTSD board.

Fiona

[Loon-A-TiK]

From what I gather, and just what you posted, it seems like there are attention issues, possible depression issues, and trauma/dissociation issues going on. What are the Effexor and Wellbutrin trying to treat? Depression?

These are of course only my thoughts and I am no pdoc, but I blame PTSD for a lot. PTSD is an anxiety disorder AND a dissociative disorder. I have it, and have read a lot about it. It seems you think you could also have it. Ask your pdoc if any of the depressive symptoms could be from the PTSD. It would be interesting to see if the depression symptoms started when the traumatic events happened or shortly afterwards. Not being able to deal with the events, your mind protects itself by taking you away from them. It doesn't mean they aren't there, but they are there very deep. And it is difficult, although usually non-medicinal, to work out the roots of dissociation with a trusted therapist.

You could read forever about what mania feels like and if you've never felt it, chances are you wouldn't realize it if you had it. It is like smooth sailing- everything is right! The questions on the dx quiz are kinda stereotypical and in my very humble opinion do not show the complexity of the manifestation of mania (or any BP symptom).

[Pastafarian]

you are not being treated for bipolar depression.  Thus, by process of elimination, your dx is unipolar depression.

[revlow]

numbone:

Hi. I just came across your topic. I'm so sorry to hear how you're feeling.

I'm kind of unclear. Were you having any symptoms before any of the hurricanes? Either way, before or after the hurricanes, what are your symptoms? Believe me, I do understand what it's like to "...feel like driving the car into the highway posts at 100 and just ending it." Are there any other ways, besides being depressed and sometimes thinking of suicide, that you can use to describe how you're feeling? Anxious? Irritable? Or...? Has it only been since the hurricanes you've been getting treatment, or were you before as well?

PTSD is certainly enough to cause the problems you're having. However, the reason I'm asking you all the above Qs is that, along with Loon-A-TiK, I agree there's more subtlety and complexity to bipolar disorder than many people know. For example, I was considered to have extremely treatment-resistant depression for years, since I was 18. I'm only now getting the treatment I need because, at age 50, I've finally been diagnosed with Bipolar II Disorder (BPII). I never had the typical "manic" episodes people think of with bipolar disorder. The right meds have made an incredible difference.

If you want to learn more about this, go to: Mood swings without "manic" episodes: Bipolar II - more than plain depression, but never delusional or psychotic -- really good resource of info on BPII and other types of bipolar disorder that are difficult to diagnose. Read over what it says. If the majority of it hits home, you may want to bring this possibility up with your doctor.

Please let us know how your doing. Take care.

[revlow]

PS...

Just wanted to make sure you know that I am not minimizing the effects of PTSD. Been there, done that. Unfortunately, many times. Among others incidents: had my house burned down to the ground by 4 teenagers who broke in; and been raped twice (same stranger who'd been stalking me, 10 days apart). So I know PTSD first hand. But, at the same time, I also had an underlying already-existing problem with depression.

Hence, all my Qs in my post above. Might help us to give you better feedback.

[numbone]

Sorry I'm trying to be somewhat brief.  I entered therapy and pdoc 1 yr ago.

Went in for depression, suicidal thoughts, self hurting thoughts, anorexia, and chronic insomnia. 

They started me w/ wellbutrin and remeron, stopped the insomnia but i was still losing wait and the depression hadn't changed.  Basically what  I id as depression is these moments out of blue where I feel how much I hate myself and just want to either give up through dissassociation or hurting myself.  Don't worry, i've had these feelings my whole life, and i have things to hold onto not to end it.

Added to the combo different ad's and different doses, zoloft, effexor with the wellbutrin in AM and Remeron in PM.  Finally added the effexor and kept remeron and wellbutrin.  Since depression wasn't helped he added a few antipsychotics first risperdal and then zyprexa with no change.

Dropped the zpyrexa and risperdal, had a few fucked up situations in my life so i did take occassional xanax and klonopin.

Next to be added was the provigal.  It seemed to help a little w/ time management and focussing on one thing at a time, the negative was it was inconsistant and weak, kinda like tylenol to remove a limb.

So now we take well 450 xl, effexor xr 300 mg. and provigal when I wak up.  Take the ritalin (metadate 30) when i hit the road for work.  The klonos i take in half mg amounts between 4 and 9 pm so i can relax enough to fall asleep before 3 am I know he still wants to play w/ dosages before trying any more meds, but we still are not quite there.

I'm getting better organized and using time management to give myself extra time at the customer sight as well as for travel.  I'm not multitasking as much, unless its for one problem.  Depression still hits from nowhere.  Can't take remeron or any heavy sleep meds cause my wife gives birth end of february so I'll be sleeping in shifts to make it easier on her.

Add that to the hurricane, financial worries of another kid on the way, and in all this appearing to be calm to keep my wife from freaking.  Not to be an asshole, but her hormone levels are very high right now.

[revlow]

I wish I had more I could say, but -- other than Effexor (which I was on 15 years) -- I have little to no experience with the meds you mentioned. Anyone else?

I'm sorry you're going through so much. I'm relatively new here (reading CB for awhile; only posted the last couple of weeks), so forgive me if this is stuff you already know. I know I've seen your name in other topics, but I don't remember where. Have you posted this question in one of the other areas, say [url="http://www.crazyboards.org/index.php?showforum=11"]Non-SSRI Antidepressants

[numbone]

Here is some fucked up shit.  Friday I got fired from my job.  Told my wife rigt away.  We both took the weekend off to get a little perspecitvie.

TOmorrow in AM going for p-doc appointment, i'll update the cocktail as it changes. 

Oh and i actually think this coud be a good thing

[numbone]

So now the doc has changed things he wants me to add lamictal to the wellbutrin, effexor, metadate, provigal, clonopin,  What do you think?

[Velvet Elvis]

Of the ACs, Lam. is the one best known for its AD properties so it makes sense to me.  My pdoc has recently tossed an AC (tegretol) into my cocktail as well.  Sometimes "recurrent" depression can be closer to bpII, as described in the excellent link posted above by revlow.  A mood stabilizer can make a big difference.

[numbone]

Well the doc bumped up the lamictal to 300mg and feels ready to give me my diagnosis.

One of the problems have been that i test positive to anumber of conditons at the lower levels of the scale.

So for now the diagnosis is bi polar, not sure which flavor and ADHD.  Oh and the ptsd was just an addition since all those hurricanes.  Hope all is welll with ya'all.  Tueseday feb 14 (Valentines Day) my wife is having the c-section, and i think i've come to grips w/ the concept of more than one child.  Don't worry we are taking steps so there won't be any more.  I just have a bit of fear that some of my biochemical problems might be passed on, or even worse they pick up some of my symptoms as bad habits.