Severe depression from childhood memories?

That's why I like this site. There's actually people out there who are or have been in similar situations. My wife on the other hand finds it a total disgust, "talking to strangers about your... drugs" - gee thanks for understanding. Needless to say, there are stressors at home as well. Anyways, I'll be fine, I'll be seeing my psychologist Tuesday, and if she thinks that I need a medical adjustment, then she'll let me know to see my psychiatrist (then I could see him that day or next if needed). I also phoned into the medical nurse for a refill (never never ever the psychiatrist - I accidentally didn't realize that the office is closed early on fridays (I've had appointments late on fridays several times in the past) once, was transferred to the Hospital, who then transferred me to the psychiatrist. TOTAL ACCIDENT!! He blew up, called me a junkie amongst many other things).

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During my next appointment (and I can't believe that he's still my doctor - but like you, worry that if I switch, not only will the doctor change, but the careful balancing act that we have going on will as well), but... he completely justified himself in every way! Anyways back to the topic, I called the medical nurse and positioned it as - I don't really want to adjust my meds if possible as we're on allot, and the balance is also delicate, so I want for his expert advise if I need to see him before our scheduled appointment - of course also explaining the problem first. He knows that I see a psychologist on a regular basis, and really, all he does is adjust medications... nothing else, so there would be no point if there was no med adjustment. The medical nurse - who I love - called me back and relayed the info. It's looking like a move might be likely to Minneapolis (causing a bit of stress, and actually relieving a TON due to finances) and a change in doctors might be somewhat a no choice thing, which worries me, and I also can't help but think that maybe it would be a good thing. Whatever. Thanks for the comment, as I really really do appreciate your comment! I've just never felt like this for sooooooo long, and the last time I felt like this... was not a good time in my life. But ya, getting the bullet out is probably a good thing.

Hi JK! Do you go to the same pharmacy for most scripts? Instead of looking through a PDR, I'd ask The Pharmacist to check and see if they could find some meds that might be causing this. Benzo's can either "enhance" side effects - even if it is a little Methadone - that was the BEST I found for killing pain-but I'm allergic! Anyway, tranqs, sedatives, opioids or their partners may be the culprits in making you so tired. I just cut down on the Opana and I have MUCH MORE ENERGY. After almost 30 days of withdrawal and going insane, I have close to the same pain relief and I definitely have more energy. So who knows? I also drank HERBAL TEAS (no caffeine) with Xanax and Opana, etc. and I would nod off... Also happened with Kava Kava drops and Valarian drops given to me by a Kinesiologist-HE KNEW I WAS TAKING EVERY MED AND HOW MUCH. Actually went through withdrawal when taking these.

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I mean I'd just be sitting there and reading and the next thing my head would be lolling back. I think it's the meds. Klonopin is more sedating than Xanax. Though Xanax is stronger, it's all TRANQUILIZER. I'd check the meds. My PDR's in storage but unless you wanted to go to each manufacturer's site - you could see if there was an overlap. If you're taking GENERIC, it'll be different from BRAND. I ONLY take BRAND. My Psychiatrist and OB/GYN agree. If you get a generic Klonopin, it will most likely have different inactive ingredients; and also, with generics, the is a certain % that must be the main ingredient - less than brand - that's why most people say generics don't work as well as brands. They don't for me. I've taken Xanax for 20 years and I'm still under the starting dosage for Anxiety alone-forget the Panic Attacks. But I've taken generic and they took me OUT; but they didn't last as long either. Just a thought... GOOD LUCK!

This is very interesting. My understanding has always been that generics are the same as the original. I know that that would be what my doc would tell me, or he would play down the differences, so, I think I might do a bit of further research on the topic. Unfortunately, I still get occasional break-threw pain and panic attacks every once in a while... so, the doctor and I both feel that I'm taking the absolute minimum amount possible, which kinda sucks. We've had this discussion before. The Lyrica is partially taken to keep the Tramadol in check cause I'm on an another SNRI that as a result lowers the seizure threshold (the Lyrica is an anti-convulsant, and therefore increases the threshold), along with the Opioid that also adds to the risk. The medication alone has minimal effects for me, however, the Tramadol is the only other med that really seemed to do a bit of good at elevating pain.

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Everything is so delicate, that it's hard to adjust anything without possibly throwing something else out of balance, or at least that's how it feels. I'm constantly fighting back the anxiety with help from the therapist. You know, I'm sure that a very very large portion of the "sleepy" problem is the Klonopin, however, it seems to be a necessary evil. When I tried to switch to Xanax ER and regular Xanax for flair ups to try to minimize the benzo usage, it was a disaster. The Xanax ER only lasted 12 hrs. and went into withdrawals by the fourth day or so, once the Klonopin had exited the system. The regular Xanax medication wasn't strong enough to really do very much. It really seemed like a good idea, and the goal was to help reduce the sleepy factor, but in the end, I couldn't just make the switch, and had to go back to the Klonopin, although was able to reduce the K from 4mg to 3mg (I'm sure that it could have worked, but I'd have to take 2 ER Xanax per day at least, and probably would have to go through a very heavy amount of regular Xanax (what the doc gave me was a joke, and I half way wonder if he wanted for this to fail)... so there really wouldn't be much of a point, except having to take more pills during the day. I really think that due to the fact that I'm taking a total of 5 different medications that cause tiredness, and all sort of potentiate each other might have a little something to do with the need for Nuvigil. I kinda wish that I could just bump the Methadone up to 30 - 35mg vs. the current 20mg and just drop the Lyrica and Tramadol, but, the doctor feels that it's just too risky to increase the Methadone. It may be due to giving me a little room if a gain a tolerance that he can up the dosage at a later point due to the new regulations for pain usage - can't go over 30 or 40mg, forgot... But really, at the end of the day, I don't care about the Nuvigil. I don't feel any "crashes" or "ups" from it. In fact, I don't feel anything at all, as far as I'm concerned, it's a gummy bear that keeps me awake, and that's it. I really am however going to look into the non-generic thing though, if there's a better quality of Klonopin and Methadone I'm all for it. I just called Walgreens, and the pharmacist said that they both have identical active ingredient (Clonazepam), but different binding chemicals, and that's it. But... I do wonder if there are more subtleties involved than the pharmacist really wants to explain, or even knows about... Regardless, if it weren't for the q&a, Narcolepsy wouldn't be something considered. And if I do have it, it would have to be a very very mild case that's just being potentiated by all of the meds. At this point I'm not sure if I even care. I'm not really sure if there would be anything drastically changed. Maybe would help with some of the other symptoms if my sleep was better regulated, but, I'm kinda at a point where I feel like shutting down. I've had enough. Narcolepsy? sure, why not. More panic attacks, ok. Pain? ok, sure, I'll take some more. I've clicked over into a very negative mood right now, so I should probably sign off. I really do appreciate the input though. Ever since the flashback, my moods click from down, to severely depressed. I feel manic depressive, except, the manic portion starts at down and blue before the drop.

Hey JK- Man, it's tough... and SO ARE YOU! Good Lord! EVERY DOC I HAVE GIVES ME BRANDS - NO LIE. THEY KNOW THERE'S A HUGE DIFFERENCE SO THE PHARMACIST - (sorry for the caps-fingernails are long... ) is full of it. He doesn't make the drugs - he can only read. There's a PDR for BRAND DRUGS and a PDR for Generics - Do I really have to say more? PLUS - My Psychiatrist-Director at Big University says "XANAX "ER" DOES NOT WORK". He said he patients don't like it and a lot of BT OR he would have put me on it. I mean who wants to wake up at 2am every night to take Xanax. Have to for Panic Attacks - which, he believes, are caused by a "chemical imbalance" - well, I was 5 years having these things before being DXed and I thought it was everything from the FOOD I ate to the FULL MOON! LOL! He and I sit and discuss psych issues, basically everyone's but my own - and I've been on 1.5mg Q4H Xanax for years with opiods - now Opana.

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PLUS more PRN for Panic Attacks. Why in the world would people pay $60 bucks/co-pay for brand if the generic was the same - and believe me, i've tried. My drug bill is humongous/month even with insurance! I'll look for the info about generic vs. brand. It's either on the NIH or FDA site about the VARIABLE AMOUNT OF ACTIVE INGREDIENTS ALLOWED BETWEEN GENERIC AND BRAND. Also, the "inert' ingredients have A LOT to do with how the drug titrates up in your system AND how long it lasts. Xanax is stronger than Klonopin. My best friend takes Klonopin and a Whopping Amount of Oxycontin and Dilaudid for BT and everytime she takes the klonopin, she nods off - usually with a cigarette in her hand. I caught her in my Guest Room early one a.m. CUTTING MY BEDSPREAD because she nodded off! It would have been a little hole, but she was so nervous she made it so big, I had to toss it - hundreds of $ down the drain - no problem. Last time her dog peed in the bed! Anyhoo - I would just be talking and her to me - and I'd look over and she'd be OUT OF IT.. Anyway, I KNOW my Xanax and Opana make me tired. I've gone down on the Opana and I have more energy. WHAT IS THE DEAL ABOUT QUANTITIES OF NARCS CHANGING? Maybe it's State - do you know more? I hope your appt. went well. Was thinking about you. I hope you got some sort of insight or resolution. When you have so many personal worries, and worries about your meds-which any good Psychiatrist should know the side effects - make him bring out his PDR! Anything the depresses the CNS - Benzo's, Opioid s, other pain meds, etc. is sedating and can either INCREASE or DECREASE the efficacy of your med(s). I used to do it all myself. I just gave up. There's soooo much out there - the Director of Endocrinology at the Mayo in Rochester, MN even said "complicated case" - so where does one go from there? I've just about given up too. If it weren't for my husband and my animals I'd be gone. I hate this life - I look forward to a GOOD CHANGE. So I'm forgetting about the past and looking towards the future. And trying to stop worrying. I feel for you, and I wish I could help. I do like it that we both do "write" a lot. It's like a conversation. Of course, I'd let you interrupt me..It wouldn't be this one sided. But if there's any one or two things you need or wonder about - give me a yell. I'm REALLY ROOTIN' for ya and I want you to FEEL GREAT - and me too! Hope your day is filled with calmness, no anxiety, and RELIEF from it all. You're super intelligent - know your stuff AND MORE - and I KNOW you'll get it straight. Deep Breath and KNOW there's people out there who are always thinking about how you're doing and want YOU to feel GREAT!

Totally appreciate the comment. Ya, it is obvious from the onset of sleepiness that it was caused by the combo of just about everything that I take, as they all indicate an increased effect of sleepiness, as well as respiratory depression. The docs concern over me nodding off during the day was due to the fact that the Nuvigil was working great for a while, like a month. Then slowly decreased in effectiveness after a month, then, I find my self eventually nodding off at work again - great!! So... he upped the dosage of Nuvigil, and one of his primary concerns is that it is severely unlikely that I would build a tolerance over time to Nuvigil, something that according to him doesn't happen. So... it indicates that regardless of alllll the depressants, and things that would knock most people out, indicates a possibility of an underlying sleep disorder, such as Narcolepsy.

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It may very well be something that I've had for years, and was undetected due to it being very very minor, however, the meds might be amplifying a minor condition, that with the current situation, becomes a very major problem. My gut feeling is that I have a sleep disorder of some sort - as I do fall immediately into a very deep sleep immediately, minutes after closing my eyes, and have always been like this. I've also been blessed with a dark family history plagued with numerous mental problems, however, until my generation, has been totally undiagnosed. My sister diagnosed with severe depression and ADD, my brother is blunt out psychotic (obsessed with normality, can't take social cues, talks to himself in the bathroom, thinks everyone is out to get him, and at times violent, and I really could go on and on about this and other abnormalities. He won't accept treatment, and the tiniest notion that there might be something wrong with him will put him into a violent rage. Almost did it on purpose one time so that I could have him punch me (I don't think that he could hit very hard honestly - and I've taken Karate for years prior, and know how to minimize impact), then I could call the cops, report battery, and possibly force treatment onto him. After some thought, it seemed like it might not be the best thing for him or me, unless he really does snap. Ultimately, not sure what the right thing for him would be. Regardless if the family motto was that we don't have problems, it's not very difficult to see past that. Anyways, it'll be interesting to see how the sleep thing pans out. If it is a sleep disorder - diagnosed with an official sleep session with a neurologist, it could be causing at least a portion of the depression that I get along with other issues. The psychologist last Tuesday helped yank out other garbage buried deep within... Now, I feel less suicidal, the same feelings of wanting to do self harm, but a little bit less intense - such as my past of cutting (didn't even know when I was a kid that it had a name associated to it) - anyways it always strangely felt good... I've lately also been more prone to anger followed by a severe drop in mood, and feels almost like the depression is shifting towards a bipolar direction, along with remerging panic attacks, yesterday had two, although didn't last very long (5 minutes). I think that we have progressed to fast, and my systems reacting way too strongly. My therapist told me that I needed to see my psychiatrist immediately, however, my psychiatrist's nurse (can't really speak directly to the official man himself) told me that my therapist was out of line, and that my conditions have not stabilized. At the time, I was feeling for that portion of the day better, and we decided that we would just keep the original appointment, as my psychiatrist is an ass-hole, and doesn't like dealing with me, or at least that's the feeling that I get. I'm a problem for him, and he knows sooooooo much more than everyone else. I was told that he might give me a call - that I of course never received.

Anyways, regarding the limitations of Methadone for pain management is if I'm not mistaken only the recommendation, and not an enforced amount. The usual dosage for a non-cancer adult patient for chronic pain is around 30mgs. Turns out that 30mgs is where the possibility of heart failure starts, therefore, the risk vs. benefit scenario really starts at that level. My doctor chronically tells me what he wants me to think, and I usually as a result (actually would regardlessly) do my own research and am surprised that I didn't catch this one. If you hadn't asked about the cap on narcotics, I'd still would say that the fda doesn't allow dosages over 30 or 40mg for Methadone used for chronic pain, however, I can't manage to find this anywhere at all, even the fda site states that ultimately the dosage is up to the doctor. Maybe it is and or was a possibility, however, due to my lack of trust of my psychiatrists info, I couldn't truely say for sure. I'm sure that he's just says and does this to avoid any sort of contact or questioning from them. Methadone is weird though, it builds in your system and everyone reacts differently according to metabolism and etc. If I'm not mistaken, it also becomes more potent the longer that it is taken, but those are just my words taken from an article on the web, and might be interesting to do further research to find out if this is true or not. My doctor at one time told me that Tramadol is a potent narcotic, and a scheduled substance. I told that he was misinformed regarding the scheduled status (I think he knew), he disagreed, so I told him to check it out on any creditable site, and he did, and therefore might be another reason for his disliking for me. Oh well. Narcotic is a stretch and may or may not be true, depending on who you talk to, but regardless is a dramatic way to put it. Mild Opioid with the same effective qualities as does Codeine yes. Potent Opiate, no. Narcotic = ??? It does hit on the Opioid sensors, but is also an SNRI, so it's grey.
Will be talking to you later,