Depression

[LordMortis]

My medical system is very good. I don't trust my pharmacist because I don't get all my meds from the same pharmacist. I make sure my medical system also knows I take OTC claritin, aspirin, D3, and a B Complex along with the cocktail they prescribe. It all stays on my profile and follows me from practitioner to practitioner. That wouldn't follow me if I went to someone outside of the Trinity Health system though.

[Default]

Exactly. And there are failsafes. If your doctor misses an interaction, it also has to pass through the doctor's computer, the pharmacist, and the pharmacist's computer (assuming that you accurately report all of your medication and keep the list up to date - that's why they always ask.)

Of more concern is the impact of supplements, which often are not reported. I'm on Vyvanse, for instance, and I have to watch taking vitamin C because of it (I limit high vitamin C foods/supplements to the evening - no morning OJ for me.)

From what I understand, a lot of meds are alkaline/bases, and drinking heavily acidic liquids neutralizes the meds. That's the case with amphetamine and methylfenidate.

[Blackhawk]

For Vyvanse it is the opposite. It's prodrug, which means it's turned into it's active form after it's absorbed. With Vyvanse, that happens in the blood. The more acidic the blood, the faster that process occurs. Most acidic foods don't affect blood PH meaningfully, but vitamin C can. Too much and instead of a dose spread out over eight or ten hours, I get it all in two, then nothing for the rest of the day.

[Carpet_pissr]

Exactly. And there are failsafes. If your doctor misses an interaction, it also has to pass through the doctor's computer, the pharmacist, and the pharmacist's computer (assuming that you accurately report all of your medication and keep the list up to date - that's why they always ask.)

Of more concern is the impact of supplements, which often are not reported. I'm on Vyvanse, for instance, and I have to watch taking vitamin C because of it (I limit high vitamin C foods/supplements to the evening - no morning OJ for me.)

From what I understand, a lot of meds are alkaline/bases, and drinking heavily acidic liquids neutralizes the meds. That's the case with amphetamine and methylfenidate.

Uhhhh, like coffee? LOTS of strong coffee? Asking for a friend.

[dbt1949]

I don't like the idea of heavily acidic or alkaline fluids in my stomach.

[hitbyambulance]

on the FLUoxitene AND Methlyfenidate right now, and i FeEL PREtTY GoOD

[Default]

Exactly. And there are failsafes. If your doctor misses an interaction, it also has to pass through the doctor's computer, the pharmacist, and the pharmacist's computer (assuming that you accurately report all of your medication and keep the list up to date - that's why they always ask.)

Of more concern is the impact of supplements, which often are not reported. I'm on Vyvanse, for instance, and I have to watch taking vitamin C because of it (I limit high vitamin C foods/supplements to the evening - no morning OJ for me.)

From what I understand, a lot of meds are alkaline/bases, and drinking heavily acidic liquids neutralizes the meds. That's the case with amphetamine and methylfenidate.

Uhhhh, like coffee? LOTS of strong coffee? Asking for a friend.

Like, I wouldn't wash it down with oj. I'm running self experiments. Sleep and nutrition (or lack of it) tend to fuck with the program too.

Lots of coffee would fall under "self-medication", absolutely!

[Default]

Exactly. And there are failsafes. If your doctor misses an interaction, it also has to pass through the doctor's computer, the pharmacist, and the pharmacist's computer (assuming that you accurately report all of your medication and keep the list up to date - that's why they always ask.)

Of more concern is the impact of supplements, which often are not reported. I'm on Vyvanse, for instance, and I have to watch taking vitamin C because of it (I limit high vitamin C foods/supplements to the evening - no morning OJ for me.)

From what I understand, a lot of meds are alkaline/bases, and drinking heavily acidic liquids neutralizes the meds. That's the case with amphetamine and methylfenidate.

Uhhhh, like coffee? LOTS of strong coffee? Asking for a friend.

Coffee is ph 5, which is as acidic as...
Bananas. Put milk in it and that reduces the acidity. The issue you are going to have with it is caffeine. Combine that with having a stimulant in your bloodstream and you are going to either be awake for a while, or you might get jittery. If you are drinking tons of stimulants, you are doing the self-medication shuffle. If you don't have any adverse effects from the two combined, you'll be fine. It's no where near as acid as orange juice

[Jeff V]

Some of you out there are depressed or have been depressed in the past. How do/did you handle it?

That might describe my current situation -- 1.5 years with no job, not old enough to meaningfully retire, and a wife that can't make up her mind whether she really wants me to work or just be a full-time Mr. Mom. She'd prefer the latter if I was better than I am at house keeping and spending more time with the kids. Generally I treat it with alcohol, but that's about to become scarce. Motivation is difficult, if not for obligation, I'd probably not get out of bed in the morning. Gaming helps keep me sane I guess, but it seems like it's been a very, very long time since I've looked forward to anything. This year we seem to be going all-in on a Disney vacation in June, of which my ambivalence couldn't be stronger. But my wife really wants to do it, and she has the kids on board. We're going with another family, likely renting a van and the other father and I will tag-team driving to the Crappiest Place on Earth. She is claiming this is trip is going to be VD, anniversary, Mother/Father's day, birthdays, and Xmas all rolled into one. The sad thing about not being the breadwinner is I have no hand when it comes to alternate plans that I might rather enjoy. And then there's the impending 2024 relocation to the Philippines. She realizes though that my Social Security taken early will not be enough to sustain us there. We'll have a house in the province that is being paid for by proceeds from a chicken farm she owns. She plans on stashing me in the Manila condo, which will be more expensive to occupy -- it won't even be complete until 2024, and if we are not occupying it, the building will manage it as an AirBnB, ostensibly making enough to pay for itself at that point.

Should I become gainfully employed in the next couple of years (by gainfully, I don't mean a crap job that pays the bar bill but the $$$ I've been accustomed to making) I would do everything possible to not retire until 70 (max SS) or even later (kids won't be out of college until I'm at least 77). If I can manage to realize my wife's other dream by doing so (world travel), she'd be happy with it. But right now, she's working so much OT (she worked 13 days in a row until Tuesday) that the stress is really getting to her and she pines for return to the simple life. So we are probably both depressed for different reasons, and still have to try to manage to keep the kids happy (which they largely are, although my daughter often chides me for being "grumpy.")

[Default]

Remeron is kicking my ass atm.

[Default]

Update on the two doses of Adderall XR.
The first dose of 10 mg is carrying me through the morning fairly well. I can usually time the second dose well enough to get me to 830 pm. Adding the Remeron reduces the effectiveness, it feels like.
Yes, I'm not as depressed as I was before, but subtracting some of the workload, and some sunny days might have done the same thing too. I do feel like Remeron has dulled my edges a little bit. I may skip Saturday's dose just to see.

How's everybody else doing?

[dbt1949]

I'm more depressed. Some of that may go in a month or two.

[Sudy]

Up to 100mg on the Lurasidone/Latuda. I'm not noticing major side effects which is good, except for pesky sexual ones that remind me of SSRIs. I'm dealing with some pretty severe anxiety most nights and I don't know whether it's related. Probably not as that seemed to be ramping up even before I started the Latuda. I get to see my doctor in a few days which will hopefully be productive. (It isn't always; I really have to steer things sometimes.) Still no word on when I get to see the new on-staff psychiatrist.

I need it to be spring as soon as possible. Between that and everything else, it's been over six months since I felt "normal for me", and I was only hanging on even before then.

[hitbyambulance]

40mg of FLUoxitene now (doubled) with the usual side effects. the 'waking up at 5am' needs to stop.i will say the work anxiety is GREATLY reduced - to the point where putting up with the side effects is worth it. going to pause on the methylphenidate for two days to see what happens.

[Default]

40mg of FLUoxitene now (doubled) with the usual side effects. the 'waking up at 5am' needs to stop.i will say the work anxiety is GREATLY reduced - to the point where putting up with the side effects is worth it. going to pause on the methylphenidate for two days to see what happens.

I sleep a little better with the Remeron, but I also drag more in the morning. You may need a lower dose of methylphenidate, if it has been going on for longer than two weeks. I actually found my anxiety to drop when I started Adderall, because I could reason my feelings out instead of just reacting.

[hitbyambulance]

so far it's actually consistent with my previous experience of SSRIs - i always have sudden wakeups in the early morning in the 4-6 week adjustment period on them.

[Kraken]

Today it was warmer, and not actively raining, so I thought I'd be able to walk for the first time in two weeks. Got suited up and promptly slipped on some ice. I didn't injure myself badly, but I had to cut the walk short after half a mile. I'm going to be housebound until some more ice melts.

Resuming my morning walks would be the best thing for my mental health right now.

[LordMortis]

Update on the two doses of Adderall XR.

Part of my many treatments put my on a heavy dosage of Adderol and quickly moved it up to the max dosage and it did absolutely nothing. My shrink was dumbfounded. No jitters. No mood change. No sleep changes. No focus improvement. No bite in my "stress" which became a sort of stand in for every mental thing that can ail you. However, after we moved to Modafinil (which is Adderol like drug) and I found that if nothing else, I was more "present" on crazy high doses of Modafinil and it great things for my ability to focus but they would only fill one month at at a time with very limited drug coverage and I find that jaw would unconsciously tense up so much that I'd start get jaw and headache so I eventually stopped taking it. It did some good things for me but not the good things it needed to do.

[Default]

30% of people have no reaction to amphetamine. 30% of all people have no reaction to methylphenidate. It's not the same people for both. So try methylphenidate.

[KKBlue]

I take a handful of drugs for other maladies as it is and I wonder at the side effects and interaction with these other drugs. Has there ever been any studies on this? Especially on people who are 198 years old.

Doctors and pharmacists are supposed to know these things of have software that does.

Growing up, my mother always had a great relationship with the local pharmacy, they were another source of information and knowledge beyond the doctor. She was legit in grieving mode when the drug store closed about 25 years ago.
The current pharmacist's office got a big ol' gift basket from me last year because of all the help we received juggling medications & reactions & interactions & insurance. My mom struggled w getting the right blood pressure medication (actually still has medically induced Lupus)
Anyways, a thought is to talk to your pharmacist for further understanding about the meds you are on. Like was mentioned, please do include all pills you take for a true analysis. Go ahead and ask for the printouts of the drugs currently taking which should have listed side effects and or interactions with other medications.

[LordMortis]

(actually still has medically induced Lupus)

Ooph. That has to be hard on everyone involved. Does medically induced mean it can somehow get better?

[KKBlue]

Lord! Thank you for the acknowledgment... not a fan of taking care of my mom because there never seems to be enough I can do. Such a challenge to navigate when to step in then ball-change to allow others to help.
The one takeaway golden rule if to always have another set of ears when ever someone from the medical profession is involved. Dr visits, hospital stays, and phone calls in regards to health care ALWAYS need another person in the room for the best possible outcome.

Her recovery is slow with her system getting back to a better place of well being. The hospital Dr picked up on the problem a prescription was causing. The lab results was the deciding piece. Just a super drag because I feel her primary let her down as she was seeking a drug that would not interact negatively with her body. I was vocal to be a good daughter without taking the independence from my mom.

Sigh... life... why can't you be a WDW everyday?!?

[dbt1949]

My dad had medically induced lupus. Because of a new (at the time) blood thinner medicine.
I don't think it had anything to do with his death a year or two later. He had a heart attack from getting really pissed. A malady I too have to watch out for. Altho getting olde has mellowed me out a lot.

[Sudy]

I've started to feel oppressive agitation at close to the level Abilify caused me. Sent my doctor a web message and he suggested I go back down on the Latuda dosage until I see him next week. I'm going to have to talk to him about prioritizing treatment of the anxiety, because it's just as bad as the depression right now, if not worse. I snuck a couple of Mrs. Nym's for-emergencies-only clonazepam, but mostly they just make me sleepy.

I did something I knew would be a bad idea. I tried to find some public mental health support Discord servers. But most of them either skew very young and are more social hangouts, have people describing some very severe emotional states that aren't being addressed appropriately, and/or are over-policed by people who have no professional training but try to act like it. Yes, I saw all that coming and yet I dove in anyway. I really wish there were a good way to find communities with more senior members. I believe age is a thin veil and I have something to learn from everybody, but at a certain point of imbalance you just don't fit in.

[Isgrimnur]

I snuck a couple of Mrs. Nym's for-emergencies-only clonazepam, but mostly they just make me sleepy.

[Sudy]

Lol... I think pretty much everything puts me to sleep at this point. So that's what I do--sleep.

We used to use Gravol as our off-label sleep aid. After working night shift on-and-off for over a decade, I think I just gave up on having a healthy or comprehendible sleep schedule.

[hitbyambulance]

the methylfenidrate is making me feel like i can actually self-learn things again.

[dbt1949]

I take hydroxyzine . A medicine that's good for just about anything, including anxiety. Just treats symptoms.

[Carpet_pissr]

Hi. My name's Carpet Pisser. Today was a bad day. I spent almost all of it desperately trying to find multiple doctors that:
1. Were accepting new patients
2. Were accepting new patients THIS millenium
3. Could possibly kill two of my medical birds with one stone as it were

I haven't had a "regular" GP in many years after mine retired about 8 years ago. When that happened, I started using his Nurse Practitioner as a kind of stand in, who I thought was fantastic, but he left and went to a different state a few years ago.

So I have not been to a non-ortho doc (broke my elbow last year), in years. That means no physical, no ADHD meds, no anti-depressants, no Xanax. Ironically, because (probably) of my ADHD tendencies, I was just going down multiple rabbit holes of medical apps, websites to rate docs, etc. I probably had 30 tabs open just going back and forth like a mad man.

Anyway, just ranting. Ideally, one doc could do it all but I know that's not possible. MAYBE one can do most though? But again, trying to find a doc blind is crazy.

There are several doctor ratings' sites but they all seem very suspect at best (in terms of any kind of accuracy), and that may also be a geographic problem (probably in a larger city, there would be a lot more reviews). Funny how none of the sites have terrible reviews for ANY docs. I find that shady as hell. Really? NO one star docs around here? Not even 2 or 3 star docs? They're ALL AMAZING?!? I know for a fact that's not true! Been to a few "one stars" meself!

Anyhoo, I need, probably in order of importance:
1. Doc that can Rx an anti-depressant so I can get that going again. I have needed this for a looong time, and have no idea why I have put it off, or resisted it internally.
2. Doc that can Rx a rehab scrip to at least get a couple of sessions for my recently re-dislocated kneecap.
3. Doc that can do a full physical, with blood work, etc.
4. Need updates on several vaccines (and not even sure which ones, at least tetanus)
5. Some kind of therapist probably ^&@#^&*^@#&
6. MAYBE consider trying ADHD meds again. I went to a psychiatrist for this a couple years ago and he was definitely one of the one stars. Half a star, if that, actually.

That's a lot of medical crap I've let pile up, and trying to "service" it all is frustrating as hell. The GP's recommended by my current specialists (like my amazing ENT) is not accepting new patients (and it FEELS like the only ones that ARE, are terrible. It's like driving down a city block and every restaurant is packed to the gills...except THAT one over there, and there's a guy outside waving a flag trying to get you to come in. WHY IS NO ONE EATING THERE?!? IS IT HORRIBLE?

[hitbyambulance]

i'd personally see a psychiatrist separate from a GP. you could expand your search from your general area - it really doesn't matter where they practice, since it's all video appointments anyways.

[Carpet_pissr]

i'd personally see a psychiatrist separate from a GP. you could expand your search from your general area - it really doesn't matter where they practice, since it's all video appointments anyways.

It is? From my hours of searching today, I didn’t get that impression. In fact in one case I saw where an “e-appointment” was available to existing patients only.

Maybe I should just do virtual though (which is available through my insurance, but treated (and charged) as an ‘urgent care’ visit. Probably worth the extra cost to save time and angst (for the stuff where I just need a rx).

[dbt1949]

I've had therapy sessions before. Found them rather useless. Got better results from my regular doctor and pills.

[Sudy]

I decided to leave one of my mental health support Discords after a member posted a picture of a man's penis and testicles hanging out of his jeans (he claimed it wasn't his own) and the other members took it in stride.

In his defense it was a NSFW channel, but I didn't think porn was its intent. Please also note that I'm not against penises in the abstract; I just don't see how they're going to help me conquer bipolar depression.

[hitbyambulance]

i'd personally see a psychiatrist separate from a GP. you could expand your search from your general area - it really doesn't matter where they practice, since it's all video appointments anyways.

It is? From my hours of searching today, I didn’t get that impression. In fact in one case I saw where an “e-appointment” was available to existing patients only.

Maybe I should just do virtual though (which is available through my insurance, but treated (and charged) as an ‘urgent care’ visit. Probably worth the extra cost to save time and angst (for the stuff where I just need a rx).

i just remembered it's illegal for a psychiatrist to practice 'out of state', so you have to keep the psych search confined to your state's borders.

[Sudy]

Today was the best mental/emotional day I've had in a while. I think this was mostly due to getting up earlier/being active while the sun was out and keeping busy. I'm pretty sure the severe agitation I've been feeling is due to the Latuda dosage. Per my doctor, I've been lowering it back down the past few days. I'm hopeful I can eliminate the agitation without going too low on the dosage. On the plus side, the agitation has made it hard to stay in bed. But it makes it hard to do anything at all, which is a horrible, stressful feeling.

I've also been wondering whether wanting to sleep less and having modestly more energy represents a hypomanic state for me. If irritability is a synonym for agitation (medically it's not... precisely) then it could be a symptom. But in total, I just don't see the other symptoms in myself. If I'm capable of hypomanic states they must be extremely muted. Hypo-hypomanic.

[Kraken]

I lost my shit today when Wife asked me to edit a story for her. I'd already edited the damned thing once, but there were enough changes that it needed another pass. I should be glad that she's feeding me work and paying my rush fee. It's easy money. But I already had to catch up with two other jobs and start on a third one today. I'd thought I could do all that AND finally start on our taxes when Wife said "oh hey, can you take another rush job?" I already worked all day Saturday and was looking forward to an afternoon off on Sunday so that I could have the pleasure of compiling our tax return. Alas, that will have to wait another week.

All the normals were having sportsball parties today. I just wanted to start taxes, and I failed.

[Sudy]

I hate it when leisure time and/or alone time becomes something else with little notice. It literally hurts part of me.


Saw the G.P. today. Taking me off the Latuda because of the agitation. I wish we could have found a way to address the agitation instead. Going to try me on valproic acid. At this point I think he's just checking off boxes for the most archaic medications possible. Valproic acid doesn't even treat mixed mania or bi-polar lows. At this He might actually be trying everything he can think of. But that's the good news... I also asked about stimulants again, and he told me to wait for the psychiatrist who I finally have a date to talk to in a few weeks. I really wish it could be in-office, but I'll take what I can get.

[hitbyambulance]

looks like the methylphenidate is causing my blood pressure to rise after taking it. that's not good.

[Isgrimnur]

I'm on 200mg of generic Zoloft with an as-needed anxiety med whose name I can't currently recall.

I started having suicidal ideations at 14. I was untreated until 32, when I got some therapy, and unmedicated until 41.

[Carpet_pissr]

I'm on 200mg of generic Zoloft with an as-needed anxiety med whose name I can't currently recall.

I started having suicidal ideations at 14. I was untreated until 32, when I got some therapy, and unmedicated until 41.

Did you get to the root cause via therapy?