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jeva39

Is there any evidence (in the form of obtainable sources) that suggests repeated psychiatric episodes can cause irreversible problems?

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If one is suffering from a treatment refractory depression involving psychotic episodes, blackouts, dissociation, in short extreme states of consciousness - can repeated instances cause in certain respects irreversible damage even if one is sucessfully treated with ECT and medication? 

During my last hospital stay i was suffering from religious delusions, blackouts (with violent aggression), paranoia..  a very ineffable quality to my experience during this time. even now i feel like i can't or won't speak of it in great detail...

 

anyway  it took time for my brain to heal, but even now years after receiving over 40 bi frontal ect treatments, i feel like i've lost parts of my functioning that I may never get back. for instance, i can't seem to feel things as deeply as before, even though i'm not currently depressed. so i guess what i'm asking is could repeated psychiatric episodes (in my case 4 or 5 severe ones) cause deterioration in functioning over time... perhaps neurophysiological damage of some sort?

Sometimes it feels very much that my condition is a kind of virus in my brain. or the possibility that its a manifestation of some not yet recognized form organic disorder...

would very much appreciate a reply. thank you for your time. :)

Edited by jeva39
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if i may ask, are there any sources mentioning "psychotic depression" or major depression with psychotic features untreated, leading to neurological impairments?

Edited by jeva39

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I tried to narrow the results with quotes using terms like "psychotic" "psychotic depression" "untreated"... maybe what i'm looking for is too specific?

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i don't think I have bipolar, at least i was never diagnosed with it. i was diagnosed with psyhotic depression, 10 years ago and most recently a few years ago following the most horrendous episode of hallucinations, delusions, blackouts, etc. is it possible that bipolarity could explain the blackouts? i'm not sure that blackouts can occur in a depressive episode.. at any rate i intend on seeing a personality and mood disorder "specialist" of some kind downtown soon, to get clarification on my condition and how it should be addressed in the future. if anyone has suggestions for the evaluation, i would like to hear them, thanks :)

Edited by jeva39

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7 minutes ago, jeva39 said:

i don't think I have bipolar, at least i was never diagnosed with it. i was diagnosed with psyhotic depression, 10 years ago and most recently a few years ago following the most horrendous episode of hallucinations, delusions, blackouts, etc. is it possible that bipolarity could explain the blackouts? i'm not sure that blackouts can occur in a depressive episode.. at any rate i intend on seeing a personality and mood disorder "specialist" of some kind downtown soon, to get clarification on my condition and how it should be treated in the future. if anyone has suggestions for the evaluation, i would like to hear them, thanks :)

be honest is really the best way to go about your evaluation. don't focus on the DX, focus on the symptoms.

regarding kindling

https://psycheducation.org/diagnosis/kindling-worsening-over-time/

That site in general talks about folks who are not quite bipolar but it's more than MDD. Ignore the whole bipolar 2 tags..the site delves into the mood spectrum concept. it's quite the helpful site, even if you're DX MDD currently.

recurrence is higher in MDD with psychotic features vs without

https://psycnet.apa.org/record/1996-04574-004

An antipsychotic  or antimanic (lithium or anticonvulsants) may help you.

 

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Following also. I've always heard the more episodes one has, the more damaged your brain can become and as a result, more and more difficult to treat and recover. Apparently some meds (like @argh mentioned) have protective effects, not sure if it is only very specific medications? Good luck with the evaluation, tell us how it goes.

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On 4/29/2019 at 2:18 AM, Blahblah said:

Following also. I've always heard the more episodes one has, the more damaged your brain can become and as a result, more and more difficult to treat and recover. Apparently some meds (like @argh mentioned) have protective effects, not sure if it is only very specific medications? Good luck with the evaluation, tell us how it goes.

 

It is sometimes called kindling where one episode sets you up for another. It is seen in seizures and bipolar. My seizures tend to come in 2's. The first one sets up the next one to happen. Meds generally stop this from progressing onto status epilepticus. 

Edited by notloki
correct tense and add " Meds generally stop this from progressing onto status epilepticus."

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You aren't very specific about the blackouts. But, mine are a form of epilepsy. Previously called petit mal seizures, now called complex partial seizures.

 

One of my old pdocs explained how these seizures can effect psychotic symptoms of other disorders. Can make them more prominent or just change them. I've experienced A-typical visual hallucinations for eg.

 

And epilepsy has a kindling effect of doing brain damage with every seizure. Even if it is barely noticeable. 

 

I'm not a doctor though. And don't even play one on t.v. 

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3 hours ago, notloki said:

 

It is sometimes called kindling where one episode set you up for another. It is seen is seizures and bipolar. My seizures tend to come in 2's. The first one sets up the next one to happen.

Does this mean that if you've had seizures your whole life that they may never be controlled? I've had epilepsy since childhood but was only started medication in my late 20's and I'm still having seizures most nights. 

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13 hours ago, argh said:

be honest is really the best way to go about your evaluation. don't focus on the DX, focus on the symptoms.

regarding kindling

https://psycheducation.org/diagnosis/kindling-worsening-over-time/

That site in general talks about folks who are not quite bipolar but it's more than MDD. Ignore the whole bipolar 2 tags..the site delves into the mood spectrum concept. it's quite the helpful site, even if you're DX MDD currently.

recurrence is higher in MDD with psychotic features vs without

https://psycnet.apa.org/record/1996-04574-004

An antipsychotic  or antimanic (lithium or anticonvulsants) may help you.

 

Sorry for the late reply. Thank you, argh, this is really helpful.

Edited by jeva39
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On 4/29/2019 at 7:18 AM, Raspberry said:

Does this mean that if you've had seizures your whole life that they may never be controlled? I've had epilepsy since childhood but was only started medication in my late 20's and I'm still having seizures most nights. 

Sorry, that is a question for a neurologist who knows your case. In my case I am near 100 % controlled.

Edited by notloki
add "is"

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still haven't found anything specific to psychotic depression, however there seems to be a school of thought that psychotic depression is on a schizophrenia spectrum. on that line of thinking...

https://www.mdedge.com/psychiatry/article/99930/schizophrenia-other-psychotic-disorders/beyond-dopamine-brain-repair 

There's an entire section on neurogenesis

specific medications or medication families are called out in that article.

Perhaps too broad of a brush, but I'm guessing, with the exception of AAPs and maybe the glutamate stuff, that info in that article might be applicable to MI in general...it seems as it's at least agreed upon by the experts that episodes of MI, regardless of the flavor will damage your brain.

Edited by argh
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On 4/30/2019 at 7:43 PM, argh said:

still haven't found anything specific to psychotic depression, however there seems to be a school of thought that psychotic depression is on a schizophrenia spectrum

from what i can tell some sources see psychotic depression is a condition on its own, or instead it's seen as a variant of major depressive disorder, (MDD w/ psychotic features). iv never heard of it being on a schizophrenia spectrum though...

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As someone else already said, the kindling theory of mental illness — I originally heard it associated with bipolar disorder, but wouldn't be surprised in the slightest if it's the same or similar across (at least) Axis I diagnoses. Look at the news in the last decade at least of labs trying to find biomarkers for depression that can be found in blood serum, especially the idea of depression possibly being an inflammatory process with the release of molecules like cortisol.

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Just stumbled on this thread & have to put my $0.02 in.

I struggle with C-PTSD & treatment resistant depression.  Shocks, TMS, decades of meds & therapy maintained my existence but brought little in the way of relief.  And it left me diminished cognitively & physically, where you are now.

But things changed.  I started to heal.  It took years, but my brain began healing also, and a lot of its function has returned.   Not all, and not always in ways I expect or recognize,  but it's happening.

What I'm telling you is don't lose hope.  No matter how damaged you are, it is possible to heal.  

Hang in there.

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It seems common sense that severe mental illness causes life long damage. The illnesses do not have cures so they last a lifetime.

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