Desperate for a solution to my depression and sleep problems

[ballards]

I am a male in my mid-forties. In 1999, I underwent back surgery and was left with chronic back pain, for which I was prescribed OxyContin. OxyContin caused acute pancreatitis, and I was switched to Hydrocodone, which I took regularly for four years. In 2000, I started to feel severe depression and insomnia. In 2002, I was diagnosed with bipolar disorder, and was given Zyprexa. Zyprexa helped somewhat, but triggered diabetes and seemed to lose effectiveness after the first month or so. Over the past year, on the advice of doctors, I have tried several other antipsychotics, SSRIs and MAOIs,including Effexor, Paxil, Risperdal, and Wellbutrin - nothing seems to have helped as much as the Zyprexa did. Zyprexa has only marginally reduced my symptoms, but really worsens my diabetes, so several weeks ago I discontinued the Zyprexa and switched to 5L-Hydroxytryptophan (5-HTP), which has provided me with similar results to Zyprexa but has allowed me to control my diabetes with medication and diet only. However, I still suffer daily bouts of feeling intense sadness, a lack of motivation, anxiety, hopelessness, pessimism, a loss of interest in my hobbies and activities; I have difficulty concentrating, remembering things, and making decisions. I am unable to work in my job as a computer programmer because whenever I sit down and try to work, I get a sense of panic which prevents me from doing anything useful.

I have severe insomnia; I have tried several sleep-inducing drugs, Ambien as an example, but they do not work for me - the only way I can get to sleep is to take a dose of Hydrocodone just prior to going to bed - otherwise I will sleep for only a few minutes at a time and will be tired and irritable all day. However, I would like to discontinue or reduce my dependence on Hydrocodone, as I have suspect it is related to my depression symptoms.

My doctors, both medical and psychiatric, seem at a loss to explain what is wrong with me or to be able to find therapies that will fix it. While I suspect that neurotransmitter inbalances may be at the root of my problem, based on my experience with Zyprexa and 5-HTP, I wonder if a serotonin deficiency is really the full story, but I do not know where to turn for solutions. I am desperate for solutions that will allow me to return to the full, happy life I once had, and allow me to start working again.

[Roger Gould, M.D.]

I have seen this endless quest for a cure by medication many times before, and along with the same side stories of side effects and unintended consequences.  At this point I would strongly recommend that you ask your psychiatrist for a referral to someone who does intensive psychotherapy.  That is what you need..it can be short term,but it must be intensive and dynamic, so you can probe below the surface and deal with the source of your depression.