a little help on med/psych

I truly hate to out myself on this, esp. with all that's going on with the board right now (lots of anxiety and bad situations for folks) but I've always valued my mind and i need to know if this has happened to others as well.

Last week I had a sharp turn downward in my state of mind and some depressive symptoms, i.e., paranoia, self recrimination and etc.  I spoke with my doc and we went from 10 to 20 of Prozac on last Friday.  It's a late presentation, usually depressive symptoms start in first 12 weeks and i'm almost at week 24. I'm also hyperthyroid as of recent testing and I wonder if this adds to it.

This week it's going in the opposite direction, racing thoughts, too many for my taste, not necessarily negative, just kind of weird thinking.  

I'm also a psychotherapist so I quickly recognize the thoughts as not my usual pattern but can't seem to control them with the usual cognitive behavioral stuff I do when I need to.

I've read a lot about the effect of interferons/combo treatment on the psyche but i thought i could do better at handling this.  I don't have a history of psychiatric disorder, substance use, etc.

I don't know whether i should call my doc again regarding this.  Please tell me if anyone else has had these types of symptoms; it is so atypical for me that I don't know what to make of it. but it is somewhat scary.

Deb

[Andiamo1]

I have this problem is spades!  I have become extremely impulsive and get very angry at the drop of a hat.  I have the same paranoid thoughts with a lot of self recrimination.

I found that my recent trip to Maine where I could spend time in a low stress environment (for me) was a great help.  The lack of external stress made a huge difference for me and I calmed down more than I did taking anti depressants .  Is there any external stress that is new in your life that coincides with the start of these symptoms?

It is  a serious problem for me.  I have damaged relationships with people I care about and pick on my wife who is the most wonderful person in my life.  Luckily for me, she knows how much I love her and can forgive me.

[debnevada]

Your answer already helps.....so as much as i hate that you have this, I'm sort of relieved that i am not alone.

I am not sure that I could manage a trip like that; I'm pretty tired. but i will mention it to my husband.

Nothing new on the external stress thing. It seems to me that this is all mitigated by the ifn/riba, and possible recent changes in my hormones, i.e., now HYPERthyroid after many years of being HYPO. I have also had a "cold" for the last ten days or so.

I just know came to the forefront last week.

xo
deb

[geterdone]

Get off the Prozac and find some other AD. It is not mixing well with the present meds. Do you remember one of my posts about getting knocked off the surf board and banging head and floating out to sea? You asked if I was ok, or another post about flying at 32k feet then hitting an air pocket and dropping. I just could not express what was happening at the time so others could understand because I didn’t myself. Then the thyroid test answered many questions I had. Maybe you need to up the thyroid meds? Might not help, but thought I would chime in.

jasper

[jmjm530]

Were you taking Prozac prior to treating, or did you take it in anticipation of treatment?

If the latter, some of what you describe could be from the Prozac itself, especially when you doubled the dose. Yes, interferon is known to cause psychological issues, but so can some of the anti-depressive drugs. I'd tried to go on ADs a couple of times during treatment, but they just made me anxious and I had to stop.

If the former -- you used Prozac prior to treatment -- maybe you need to add a second drug to the mix to bring down the racing thoughts. My doctor mentioned a second drug -- forgot which -- when I got anxious from Wellbutrin, but I decided just to go off the Wellbutrin.

Hope you feel better soon,

-- Jim

[Andiamo1]

I hope you feel better soon.  I agree with what Jim said about Prozac.  I found Lexapro better and effexor even better, but the withdrawal from effexor was so brutal that I would not want any one else to go through it.  I can't stay on any AD for long as they stop working and make things worse.

I find looking at water so soothing that on this trip, where I could not take walks, all I did was sit on a deck and look at it for long periods of time.  Whatever does it for you, be it mountains, water or the desert, give it a try.  Even if you sit on the balcony of a hotel room and just look, it can help.

Good luck - I will be thinking of you - Eric

[geterdone]

Even if you sit on the balcony of a hotel room and just look, it can help.

That would be the last thing to tell someone on prozac.

[debnevada]

Jim:
Started taking an AD just prior to beginning treatment for prophylaxis, started with Lex and shifted to Prozac for the effect on appetite it has. I've not taken ADs at all until now - 47 years.  I guess I didn't think that doubling the dose would have that effect on me when i was on such a baby dose to begin with but I am pretty sure the doctor felt it was important or else he wouldn't have doubled it.  That really helps, though, Jim, I didn't even think of that doubling being a problem. As always, you seem to know how to address how my mind works, James. Thanks and I'll keep ya posted. Deb

Jasper:
I remember those conversations with you. I remember thinking you were zooming at that time but wasn't sure if it was upsetting you or not. I guess we know what happened, huh? The only problem with what you said about thyroid is that I'm not HYPO (low) like I used to be, I'm now HYPER and haven't stopped taking synthroid because the doc says stay on it because it might reverse again. So I prolly don't need MORE right now, I prolly need less. But thank you for your "chiming"...I always welcome it from you, Jasper.

I wish we'd talk more about how nuts this **** makes us, if it does. Who I am and how I feel is the most important thing to me, not hair, not fat, not any of that and this is the scariest part for me.

Deb

[debnevada]

you are such a dear, despite what Jasper says, I 'm not by ANY stretch suicidal.....just...it seems.....a little crazy....middle aged crazy? IFN crazy?

Deb

[jmjm530]

LOL.
------------------
Hope all of you on tx just keep hanging in there, because one day it will be over and your mind will return to normal, whatever normal is.

Seemed every time I got in my car I ended up screaming at someone out the window, not to mention how many times I hung up the phone on relatives, friends, etc.

But all that stopped when the meds left my house, so no more screaming in the car, and no more hanging up on the few friends I have left :)  Depression after treatment is another story though, so better close that balcony door :)

-- Jim

[tumbleweed1999]

Hey! Girl - You're soo "cool".  -:))  I would never guess from your different posts that you were having these kind of problems.  I understand, sort of, where you're coming from. - Having had some minor (compared to now) problems over the years.  I do agree with Andiamo - if you can get away for a while, it would be very soothing for the soul.  Make a loving pact with your husband that it would be "your time" and he gets all the responsiblities of "taking care of you"'.  ie: doing the meals & cleanup, making you 'comfy', going for long 'quiet' walks with you, or just listening quietly even when you don't make a lot of sense (to him), etc..  You've been tx for 6mos. now and you are in deep need of a "time out".  Our minds and bodies can only take so much ( eventho' our Father said the He would not give us more than we can handle) and removing ourselves from stressful situations, even for a little while, can do absolute wonders.

As for the meds sx - I agree - Prozac is terribly bad news.

Take care, girl, keep us "updated", and I will keep you in my prayers.

Geri

[jmjm530]

Since you didn't need Prozac prior to treatment, the possibility exists that all the psych symptons you mentioned (on both doses of Prozac) may be caused by the Prozac.

Don't know a lot about ADs, but what research I did suggests that you have to be very flexible making adjustments, like upping the dose, lowering the dose, or changing meds. In your case, since you didn't need it to start with, one adjustment might be just stopping the meds.

At this point, I really wouldn't wait but would call your doctor today to discuss exactly how you're feeling and the idea that it might be Prozac related.

All the best,

-- Jim

[debnevada]

I called. Going tomorrow. He's going to call a buddy of his to see how to taper off. Sorry I started on them to begin with I think.

Geri:
Well, I WAS a shrink and am good at compartmentalizing so my "nice" posts don't show it. Besides, doing for others sure helps me feel better about life in general, no sh!t.  Being on the board is a give and take as far as I'm concerned so I try not to post about me unless it's "something".  Thanks for the compliment and your prayers. Everyone here is always in mine as well.

deb

[GrandmaA]

When the thyroid is off it is really a BIG deal. Just before I started tx, my thyroid went from hypothyroid to hyperthyroid. I had switched to another medication that apparently was an overdose. It is most important to get that thyroid back to normal ASAP. It can cause many of the symptoms you are complaining about. I was bouncing off the walls and drove like a maniac all the way to San Francisco when I was hyperthyroid.  I got there 1 1/2 hours early.  I couldn't understand why everyone was so slow (it was because I was on FAST FORWARD).

[Forseegood]

all I know is I have been suffering from anxiety attacks (not so much anymore) for years. I can usually calm myself down cause I've developed enough tools in my arsenal, but if I ever really have a bad one, I'll take an ativan. The anxiety itself seems to make my thoughs go beyond the rational, to the irrational, even though I'm telling myself that I am okay, my subconscious mess takes over, and I end up thinking all kinds of crazy things. When I first would got  these years ago, I used to go around and put all the sharp edged things in drawers, like I might lose control or something. It sounds funny now, but it sure isn't when youre going through it. What I find helpful too, is to do some real practical things, to take my thinking into the more logical part of my brain. A grocery list, a cross word puzzle, watching the news on TV.

I've been suffering depression and anxiety for years, and hypnosis tapes really help too. There are good ones really cheap, like 7 dollars a piece, on hypnosisdownloads. dot com. Listening to  help with anxiety and obsessional thinking from there have really helped. Perhaps this doesn't apply to your case, but I thought I'd throw a few things out there, that have really helped me out, cause believe me, I can relate. Hope you feel better soon.

[FullOfHope77]

Reminds me of when i first tx'ed in 96 and heard the heater downstairs 'click' to come on and started running thinking it was going to blow up???? Why I thought that I have no idea but this was Inf only tx in those days. I laughed at myself and had a couple other really odd experiences too but please know that 'this too shall pass' you will normalize again and be just fine. I feel the weirdness starting again for me now that I'm 3 mos in and know it will  increase with time. I do 5 mg of Lex and stay there religiously and take it the same time ea day and it really does help me balance. I refuse to take even a normal dose due to what I understand SSRI's actually do but know that benefit can be gained if done 'in stride'. Thanks for sharing so much as it makes all of us feel like we're going to be okay again someday. :) Keep telling your patients that too... (likely you're the only one that really knows that one...) thanks again!

[debnevada]

Hi Ladies and Gentleman:
Grandma, thanks for the advice; I've called the doc and talked with my liver nurse. We'll also take care of the thyroid again in that appt. I appreciate it.
Forsee:  Anything that helps I will try.

FullOHope: Same thing!  I had a pain in my back this morning and thought i was going to grow a hump when I looked!  I'm not practicing now, I was a forensic therapist years ago. Burnt out on it (capital crimes).

I'll keep everyone posted and thanks for your concern. If it was not so troublesome i wouldn't even mention it.

deb

[geterdone]

Aw…. Yes! In its rawest sense, it's the old INFRIBAPTSSD is the way I look at it at the present moment. Now, if you can figure that one out, your doing OK!
LOL, sorry...
jasper

[FullOfHope77]

Interferon/Ribaviran Post Traumatic Syndrome Stress Disorder (did I get it?)
:)
Too funny, but worth remembering as whatever it is we will survive and likely be the better for it...

[geterdone]

My man, you are on your way to SVR… I mean that.
Took me an hour to think that one up, and 30 seconds to get it busted, dang.
jasper

Deb, we got your back, be good!

[Andiamo1]

You seem so far from suicidal, that it never entered my mind to worry about it.  Thank you for reassuring me though.  When I first read the comment, I did think I might have made a mistake.

I feel better now that I am off effexor. Not normal by any means, but better.  I hope the same happens to you.

Today is my 42nd wedding anniversary, so I just got back from taking my wife to dinner.  She managed to put up with me for 35 regular years and 7 on interferon!!  Now that I am on it again, I spent the evening thinking about all we have been through together and how much stronger we are from the suffering.  The good years are fun, but they don't teach you much.  the bad years teach you how to enjoy the good years.  I am sure you have many good years ahead of you.

[Andiamo1]

I can relate very well to your story.  I crashed and burned when I was in my senior year of high school.  I dropped out and did 5 years of drugs.  I was very lucky; I met my wife and found a great analyst.  I was able to get it together and build a good life out of the ashes.

Unfortunately, it left me with HCV which I am still dealing with.  But I can't complain.  I had an interesting career and I am much stronger from the therapy.  I found developing software to be much like meditating.  It helped me relax and concentrate on things outside of my own experience.

Now that I am about to beat the dragon, I dream about what I will do with my renewed energy and mental clarity.  One thing I can guarantee, I will never waste another minute of my life on any drug that diminishes my awareness of life.

[tumbleweed1999]

HAPPY ANNIVERSARY!!!!  A bit late in the day, I know, but 42 years deserves recognition. -:))).  You have obviously been blessed with a good soul mate.  Hope you have many more wonderful years together.

Geri

[debnevada]

i'm with geri....Happy Anniversary to you, dear and your lovely wife.

[meki]

Deb - you'll be ok - Prozac and things like that were awful things for me... They made me feel "ick"... Yawns... paranoid... LOL! I couldn't take them --- they were awful...

However - ABOUT PANIC ATTACKS:  after TX - I feel much more ADHD than ever before - scattered... A couple panic attacks - every once in awhile.

I use Lorazepam for massive ones --- maybe once a month - usually right before my period --- I get GROSSLY uncomfortable in my skin... Like I can't sit right... like I can't get comfy... will I blow up... If I push too hard to pass gas - will my intestines fall out... My chest walls feel constricting like I've got a corsette on ---  I get itchy all over -- I can't find a comfortable position to lay in --- will my heart get squished if I lay on that side too long... Did I leave the iron on...  If I plug something in will the current run up my arm and kill me, do I have boogers hanging out my nose ---- I mean REALLY WEIRD stuff. LOL!

I think they are hormonally related - most of them. The racing thoughts --- the can't get it together. They seem to be aggravated by my menstrual cycle - when it's normal or not - I can usually tell 2 days in advance when I'm going to start --- just by the way I'm feeling in my own skin...  Sounds weird... but YOU outed yourself first.... LOL!

And they only last for a little while --- but I bring myself down with Ativan - and then I'm fine for the rest of the month. They didn't happen prior to TX --- but hey --- well - Yanno --- that's just the way life tosses you into the salad mixture. LOL!

It sounds like you're going through something similar - but with the "saddies" the "blues" tossed in.

I've never been a blue kind of person - so maybe that's it.

But heck deb --- in your shoes --- I might just have had quite a few blues attacks. Seriously - I mean you've had some hard core stuff to deal with....

And TXing - certainly doesn't help doodley squat.

Meki

[meki]

42 years?  What --- is she nuts?

ROFLMAO --- just kidding... Happy Anniversary kiddos!

Make sure you celebrate in some special private way.

Meki

[hippygem]

I did the treatment in 2004 and was put on prozac (lovan) at that time, just before tx and during, then 6 months after tx finished, I went off them again.
The treatment was a nightmare, and I thought that prozac was adding to this.
Now, in the last 2 months, I am on Prozac again, and my experience with it is totally different from when I took it on treatment.
I blamed the excess brain fog partly on the prozac, the scalp issues,  the excessive depressive issues, and cognitive.  I know that interferon does all this but I though the prozac added to it.
I was wrong, I am alright in every sense taking prozac at this time, the only side effect is my sex drive which has diminished.
Anyway this is just my take on this issue and my experience with prozac during treatment and many years later.
We all react different to anti depressants, you may just not have found the right one for you yet, also remember that you dont have to take a full dose of them, people with liver disease should only take half a dose, I am actually down to a quarter of a dose, just to take the edge off the depression and anxiety.  You can experiment yourself how much you need, sometimes we follow doctors instructions but from my experience not all of those instructions apply to everyone as we are all different.

The best to you.
Linda

[meki]

Sex drive diminished?

Sheesh - maybe I need to take some prozac.

ROFLMAO!

Meki

[l-horn]

I started getting a little bummed around week 30 or so and was given Lexapro and it worked like a champ for me but it did take a week or two to kick in. After that, smooth sailing. In fact, I'm still on it a month post tx. I'll probably start weening off here ...

Jeez did I say 30 day's post tx ? It seems like it's been YEARS.

[meki]

Dang I-Horn - rock the heck on!

[Andiamo1]

Thank you all for your anniversary wishes.  I will pass that on to Mafalda.

Meki, yeah she is nuts.  Most people wouldn't put up with me for a week.

[Andiamo1]

I can easily see how difficult commercial shipping must be.  Sailing for pleasure is very different.  You can chose when to go to sea and while you are out there you are doing what you want to do.

Thank you for your description of it.

[meki]

Oh yes they would... You need to start looking in the mirror and seeing your own value, you goof.

Seriously - you have a lot to offer the world. It is time you believe in your own self worth.

We all have bad days, weeks, months... It is the cumulative that makes us all that we are.

It is the way our inner core truly is...

And your wife knows that you have a beautiful inner core -- and that is the radiance that she thrives on... For 42 years ... That means you gots a lot of inner radiance...

Ahem.... or elephantitis.... (Just kidding - LOL!)

Meki

[Andiamo1]

You are a sweetie!!!

[nygirl7]

I've read a lot about the effect of interferons/combo treatment on the psyche but i thought i could do better at handling this.


oh Deb PLEASE!!!!!!!!!!!!!!  You have NOTHING to do with this - there is nothing you could handle better this is a physiological problem that is coming from the interferon...we were ALL warned it could happen to us easily enough (which is why I went on Paxill a month BEFORE I started treatment at my doctors recomendation).

There is nothing for you to handle!!!  This is not just some weakness that you can't control please oh please get that out of your head.

Take the meds, be honest with your doctor and do everything he says.  Call him and talk to him.  Don't mess around with your life - you are too special and important to take any chances.

This IS a common problem and it has nothing to do with YOU yourself.  It's the damn meds, please try and remember that.  You can't control it anymore than I could control my rash or anemia. It's the exact SAME THING AS THAT.

Deb

PS If you need someone to talk to i can get you my contact info - I won't post it unless I know you are looking for it (just cause I'm a chicken enough) but plenty of people in here have my email address anyway and I can send you my phone number that way.

[debnevada]

yes i would like it. I'm going to give you mine here so look fast because it either won't come through or they will delete the message.

it is debfromca

and the place that it goes to is hotmail dot com

[debnevada]

just email you from the merlino post.

[Andiamo1]

Just checking in to see if you are feeling any better today.  

I find that my mood cycles over the week.  I take my shot on Monday and feel my worst by Tuesday. By Thursday, I am starting to feel better and by Monday morning I am ok.

I hope you get some good days every week.  I know we all will be talking about this when our treatments are over and our good health has returned.

[debnevada]

It seems definitely better today. All last week was weird. So this is an improvement. I have appt. with doc to discuss ADs again.

[Forseegood]

"One thing I can guarantee, I will never waste another minute of my life on any drug that diminishes my awareness of life."

To use a hackneyed old phrase that many of us used in the old days, "right on to that!" Hey, when I'm anxiety and depression free, and enjoying life as it comes, the last thing I want to do is cloud up my mind with a lot of stuff to alter my mood. Having a great day is all the altering I need!

Happy Anniversary to you, that's really great, soul mates for sure, so nice that youre getting together with NYgirl!

[tumbleweed1999]

Would you mind if I emailed you occassionaly??

Geri

[debnevada]

of COURSE!

FORSEEGOOD:
are you just not too jealous of andiamo and NYG? i am!
(seriously I'm happy that one of us can hang with her right now)

[geterdone]

Deeebbb, No!... not kicked from the row boat, ya mean I can’t sit next to ya anymore cuz ya got another fella. I even walked down the hall with slumped shoulders.

Blame it all on my roots
as I showed up in boots
And ruined your black tie affair
The last one to know
The last one to show
I was the last one

You thought you’d see there
And I saw the surprise
And the fear in her eyes
When I took the riba with a glass of champagne
And I toasted you as I usually do and
Said, memory, we may be through
But you’ll never hear me complaaain

‘Cause I’ve got friends in low lit places
Where the interferon drowns
And the Riba Light chases my blues away
And I’ll be okay, sniff, sniff :-((
I’m not big on social graces
Think I’ll slip on down to the ole oasis
Oh I’ve got friends… in low lit places

Well, I guess I was wrong
I just don’t belong
But then, I’ve been there before
Everything’s all right
I’ll just say goodnight
And show myself to the door
Hey, I didn’t mean
To cause a big scene
Just give me another riba and then
cuz” I got friends in low lit places
Down at the ole oasis and I’ll be ok

I know, I know, I'm trying to keep a lid on it

jasper

ROTFLMAO

[debnevada]

would it be wrong, under the hep c circumstances, to say that I have not always been a one man woman?

i guess you've never read the sweet potato queens book of love.

a girl needs at least five men in her life.

longingly,
deb

[geterdone]

HA! huh? she dose? sweet potato queens... humm... be right back.

jasper

[theflyjd]

Hi debnevada. I don't know if you remember me or not but I post every other month or so to let everyone know how I'm doing. I guess I'm the Marathon Man (I have done 5 this year while on this ****). Anyway, when I was on  my first treatment of interferon in 2005, I became SUDDENLY very depressed and angry. It was kind of scary because it overcame all the methods I used in life to regulate bad thoughts (yoga-karate-the gym). At one point I nearly threw my computor out of my upstairs office window because it wouldn't cooperate with something I was doing. Luckily, I was prepared when I started tx and had a therapist and a psychiatrist available to help me work through it. The second time I was on the Interferon ('06-'07), I didn't have any of those types of problems. I have been on Infergen now for the last 8 weeks and so far so good. I think I might be too tired now for bad thoughts. You have potentially the best world by being able to evaluate yourself because of your training. However, the old adage from Law school was "...the lawyer that represents himself has a fool for a client..." Get a lot of opinions and I wish you the very best.

[debnevada]

i sure do remember you, because i still am amazed on your doing marathons during tx and also with your medical history.  I asked you about the Pacific Shoreline which i ran last year, remember? (BEFORE all this **** started).

The mood swings seemed to have evened out a little but i am still followng up on it.  Like you I have tricks I use to negate bad thoughts but they were not working either. and what's weird is that i didn't have those feelings in the toughest first 12.

but i have to agree. if i were not so aware of blips in my radar because of my background, i'd just attribute this differently.  The old adage is true!!  :-)

I really appreciate you ringing in and I'll keep you posted...when is your next marathon?

Deb

[theflyjd]

If the Procrit kicks in I might do the Long Beach because it is completely flat. But other than that I think I will retire while on this stuff. I do remember you told me about the Shoreline. I might do that next year because it is pretty flat (I've heard) as well. Right now my Marathon is walking upstairs once a day. But other than being tired I'm doing okay and it sounds like you are doing much better. Thats great! I will keep you posted on my adventure and you do the same. I'll let you know how the 12 week test goes. Thanks again.

[Andiamo1]

I am glad to hear that you are feeling better.

We are having dinner with nygirl next Wednesday.  Very excited about that.