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Mental Health (Expert Forum)
Relapsing due to illness
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
Relapsing due to illness
by goldiealg, May 21, 2005 12:00AM
Hi Doctor, I hope you are well. I wrote almost a year or so ago and appreciated your advice. At that time, I was prescribed 200mg Zoloft, 20mg Buspar and 1mg of Klonipin a day. I was very tired and felt like the side effects were worse than anything else in my life. In August 2004, I began a taper and was doing quite well. I managed to only take .25 mg of Klonipin at night to sleep from November to mid February this year. I changed my birth control pill and even my pms was better. Then, I contacted the flu on Valentine's Day. I took Tamiflu, which kept sypmtoms at bay for the most part. I recovered for about five days and then developed an ear infection. This was a very persistent infection and I was prescribed three different antibiotics(intially, the ZPack, then Levaquin for 18 days and then at the end of April, Ketek) and predisone (last week of March). I finally found an ENT that was willing to do some testing and to take the time to talk to me. Even though, my ear infection was cleared by the time I saw this good physician, I had swollen glands and a low grade fever. He noted my throat was irritated as well (which is true, I just didnt have much pain). After a scope and a CAT scan, which were both negative, the ENT diagnose me as having chronic Laringytis due to acid reflux. I have been prescribed Aciphex 20mg. and have been taking it for two weeks. I am still struggling with low grade fever and swollen glands. He tells me to be patient. I am willing to give some more time, but my problem is this....I have become very upset again, lots of stress and low grade depression and much trouble sleeping. I am still taking .25-.50 Klonipin to help me sleep and Zyrtec for my allergies at bedtime. My GP gave me Ambien, 10mg, which does not work at all for me. I am waking up at that familiar 3:00 am again and tossing and turning. It is a very vicious cycle. My job is very stressful as well and I feel like ****...bottom line! I take yoga and am trying to exercise regularily, but I have been weakened physically. I am very reluctant to go back on meds, but think that may be I need an antidepressant again. What do you think I should do at this point? (Please dont suggest a psychiatric consult, because there are none available to me that I care to see at this point...my last one almost killed me with all those drugs).I am willing to talk to GP though. Thank you and have a good day.
Doctor's Answer
by Roger Gould, M.D., May 23, 2005 12:00AM
, May 23, 2005 12:00AM
Well, I won't recommend a psych consult, especially one for medications. If you are to go on any, go back to a low dose of zoloft, 25 to 50, no more.
If you want my best advise, it would be to talk to someone, a counselor, re your stress. No doubt the physical problems have set you back, but nevertheless you have to learn a more direct way of dealing with stress..its always going to be there, right around the corner.
If you don't have anybody, go to www.masteringstress.com. join, ask for a consult, and I will see if I can help you with the specific issues you are dealing with...
If you want my best advise, it would be to talk to someone, a counselor, re your stress. No doubt the physical problems have set you back, but nevertheless you have to learn a more direct way of dealing with stress..its always going to be there, right around the corner.
If you don't have anybody, go to www.masteringstress.com. join, ask for a consult, and I will see if I can help you with the specific issues you are dealing with...
Okay, so here's where maybe I can help: I am sleeping really well these days, whereas a few years ago I had to have Dalmane to sleep, the 30 mg ones. Ambien didn't do a thing for me.
But then I had significant B12 replacement therapy and now I sleep soundly night after night.
Last night I went to bed late, so I'm tired today, but I don't wake up at the drop of a hat anymore, and I even dream. I read that to dream you have to hit a deeper sleep. Previously I never got deep sleep.
So, if I were you, I'd look into the sublingual B12 lozenges -- preferably the methylcobalamin ones. I understand that some Wal*Marts carry them. All health food stores that I know of carry them.
It's not like a sleeping pill though, you have to take it for awhile and build the stores in your body back up. I would say that in a month or 6 weeks you will feel a significant differnce.
In between, the melatonin might work -- it sure helped me. (I had to stop using Dalmane when my balance got really bad -- that's a part of the symptoms of low B12, too.)
www.health-boundaries-bite.com/Fingernails.html
Your fingernails reflect your health --
Learn what warning signs to look for --
Karen Kline
Okay, so here's where maybe I can help: I am sleeping really well these days, whereas a few years ago I had to have Dalmane to sleep, the 30 mg ones. Ambien didn't do a thing for me.
But then I had significant B12 replacement therapy and now I sleep soundly night after night.
Last night I went to bed late, so I'm tired today, but I don't wake up at the drop of a hat anymore, and I even dream. I read that to dream you have to hit a deeper sleep. Previously I never got deep sleep.
So, if I were you, I'd look into the sublingual B12 lozenges -- preferably the methylcobalamin ones. I understand that some Wal*Marts carry them. All health food stores that I know of carry them.
It's not like a sleeping pill though, you have to take it for awhile and build the stores in your body back up. I would say that in a month or 6 weeks you will feel a significant differnce.
In between, the melatonin might work -- it sure helped me. (I had to stop using Dalmane when my balance got really bad -- that's a part of the symptoms of low B12, too.)
www.health-boundaries-bite.com/Fingernails.html
Your fingernails reflect your health --
Learn what warning signs to look for --
Karen Kline
I've found my Primary Care Physician to be ideal compared to psychiatrists and this is after having approximately 23 years of experience with Psychiatrists.
Then on July 16th I felt like I was coming down with a sore throat, and then felt worse and worse and started feeling nauseous and having diarrhea. On July 18th I called my primary care physician who wanted me to come into the office, but I was feeling too sick to go in. The next day it was obvious I needed to see him, so I did. I was dehydrated by then, and he gave me an IV to rehydrate me. He took a throat culture and gave me a strong antibiotic because he suspected strep throat. By that evening, I couldn't keep anything down including the antibiotic, and by morning I was so sick my husband took me to the ER. I was in the hospital for 5 days diagnosed with strep throat and a gastro-intestinal virus.
By the time I got home I was very weak, had no appetite and could only eat a very soft diet. I didn't feel as if I was getting better, and on the 29th I started the vomiting and diarrhea again, and that night I was taken by ambulance back to the ER. This time they diagnosed a yeast infection and a urinary tract infection, and I was in the hospital 3 days. My husband tells me that when I went into the ER both times he was afraid I was at death's door, and the hospitalist who treated me the second time thought he was right. I was one sick cookie.
Today it's August 19th, and I still feel as if I'm a long way from recovery. I'm depressed, and just started on Wellbutrin. I have little appetite, and have lost about 15-20 pounds since all of this started. I drank Ensure after the first hospitalization, but I can't even look at it now. I drink milk and when protein for breakfast, drink Boost Breeze, a protein fruit drink, sometime during the day, and have very little for lunch and dinner.
During all this time since I'm self-employed I've had to work to keep the income coming in. People have been very nice, and have made allowances for my being sick, and I now have a few days to rest. But I'm wondering how long it'll take to get back to normal.
Next week I start physical therapy for my shoulder