View Full Version : Dysthymia? But apprehensive about taking an antidepressant.


geek_girl_913
12-15-14, 08:57 PM
I apologize in advance if this gets lengthy, but I'm feeling quite stuck these days, and need to explain what is going on so that maybe I can process it, too.

Some history: I was diagnosed with ADHD-C nearly five years ago at the age of 23. I began taking Vyvanse, and have been on it ever since. Initially, it was the piece of the puzzle that was missing from my life before being diagnosed. I was able to function on a level much closer to a "normal" person without ADHD. It was fantastic. And it still could be; however...

For the past two years or so, things have declined considerably, with some portions being worse than others. It began with sleeping way more than usual, and feeling unproductive. Fast forward to February of this year, and needless to say things never improved, but got worse. In addition to the excessive sleeping, general fatigue, and difficulty concentrating, I could add crippling brain fog to the list, too. It got to the point where I could fail to develop intelligent sentences, which is a problem when you're a student for a living.

Through all this, I never once considered it to be any form of depression. I really felt as though it was physical in nature, and finally went to the doctor. I did have a very bad hormonal imbalance, but was told that it was not the cause of my symptoms. (Although I did have some minor symptom improvement after I began treatment, but it was short lived.) I should also mention that my doctor simply said that my problems were "allergies" whenever I mentioned the fatigue during my quarterly visits in this time frame. He upped my dose of Vyvanse from 50mg/day to 70, which really did nothing. (To his credit, he asked if I felt depressed, which I scoffed at, but he did not pursue it further.)

A few weeks ago, I was feeling particularly cranky, and felt early in the day that I didn't want to go to a friend's birthday dinner that night, but didn't want to cancel. I figured it would pass, and I would go and have a good time. I instead got so frustrated and upset over the prospect of going out that I started crying. After it subsided, the proverbial light bulb went off--something was very clearly wrong with me.

That event provoked me to start thinking long and hard about what was/is going on with me. I am reasonably sure that I have dysthymia, and I absolutely need and want to get it taken care of. The only problem is that I am apprehensive about taking an antidepressant. I had a depressive episode in 2009 where I tried Lexapro, which lasted one day because it gave me a minor allergic reaction, and was then switched to generic Effexor. I ended up stopping the Effexor on my own after about three weeks because the zombie side effects were so bad I felt like the depression was better. The depression resolved on its own without further treatment a few weeks later.

Because of that bad experience, I'm apprehensive about taking another antidepressant. This is mostly because of the fact that I really cannot afford to go through weeks of being a zombie in order to figure out if it's working or not. I have been barely treading water with my work, and am expected to make up a lot of it during the winter break. Once break is over at the end of January, I am teaching and must begin working on my fellowship proposal, or else I will be without an income come the fall.

I'm torn between trying to address the problem with medicine and simply hoping that it will eventually go away, since I've been mildly better than I was a few months ago. I'm convincing myself that the benefits of the occasional ''good day'' outweigh the guaranteed (in my mind) bad weeks or possibly months with an antidepressant.

Does anyone have any possible ideas as to which path I should take? Positive experiences of your own?

I genuinely feel stuck between a rock and a hard place with this situation, and I donít know anyone whom I could discuss it with and get an objective opinion.

Thanks for reading. :)

Pilgrim
12-15-14, 10:34 PM
Shouldn't Vyvanse address the Disthymia?
I'm not a doctor. Maybe the Vyvanse is not effective anymore. The SSRI will only address anxiety possibly. Talk to your dr. I would be hesitant to.

Corina86
12-16-14, 06:31 AM
I think you should talk to your doctor about this. If SSRI- anti-depressives don't work on you, maybe another type, like Wellbutrin, would.

I don't have depression, but I thought that stimulant medication is supposed to help with that as well. Is there any possibility these are symptoms to you building tolerance to Vyvanse?

geek_girl_913
12-16-14, 05:52 PM
I've wondered whether it is a tolerance to the Vyvanse, and it certainly can be, but I still think it's Dysthymia since I'm just very "blah" on top of everything else. I'd like to try coming off of it for a few weeks, then trying it again to see if it helps.

And Vyvanse is not effective for depression as far as I have read. Shire was investigating it at one point, but it's not on their pipeline site anymore, so I'm guessing it didn't pan out. It may work for some people, though I'd wager that maybe there's underlying ADHD that's getting treated, thus leading to symptom improvement in the depression. The undiagnosed ADHD is what caused my romp with MDD in 2009.

I thought venlafaxine (Effexor) was supposed to be similar to Wellbutrin in that it's a different type of antidepressant? Or am I mixing it up with something else?

Thanks for your responses. :)

Corina86
12-17-14, 08:29 AM
From what I read on wikipedia (not exactly very reliable source). venlafaxine blocks the reuptake of serotonin and nor-adrenaline, while Wellbutrin is a weak norepinephrine-dopamine reuptake inhibitor. So, it's pretty different.

InvitroCanibal
12-17-14, 02:01 PM
From what I read on wikipedia (not exactly very reliable source). venlafaxine blocks the reuptake of serotonin and nor-adrenaline, while Wellbutrin is a weak norepinephrine-dopamine reuptake inhibitor. So, it's pretty different.

Second that.

add_me
12-26-14, 05:49 PM
I've wondered whether it is a tolerance to the Vyvanse, and it certainly can be, but I still think it's Dysthymia since I'm just very "blah" on top of everything else. I'd like to try coming off of it for a few weeks, then trying it again to see if it helps.

And Vyvanse is not effective for depression as far as I have read. Shire was investigating it at one point, but it's not on their pipeline site anymore, so I'm guessing it didn't pan out. It may work for some people, though I'd wager that maybe there's underlying ADHD that's getting treated, thus leading to symptom improvement in the depression. The undiagnosed ADHD is what caused my romp with MDD in 2009.

I thought venlafaxine (Effexor) was supposed to be similar to Wellbutrin in that it's a different type of antidepressant? Or am I mixing it up with something else?

Thanks for your responses. :)

I was feeling the same way you feel. I had taken Effexor, and a few other antidepressants in the past. I felt like a zombie on Effexor, I stopped taking the drug because I'd rather have depression with highs and lows, than feel like a zombie. I was off antidepressants for about 6 years, but still lived with the depression. I went back to the doctor a few weeks ago and asked for Wellbutrin XL 150mg. So far so good, the depression is lifting, the only side effect was constipation, but nothing a little fiber couldn't fix.

geek_girl_913
12-26-14, 06:44 PM
I was feeling the same way you feel. I had taken Effexor, and a few other antidepressants in the past. I felt like a zombie on Effexor, I stopped taking the drug because I'd rather have depression with highs and lows, than feel like a zombie. I was off antidepressants for about 6 years, but still lived with the depression. I went back to the doctor a few weeks ago and asked for Wellbutrin XL 150mg. So far so good, the depression is lifting, the only side effect was constipation, but nothing a little fiber couldn't fix.

That's definitely encouraging, thanks! I decided that I would also like to try Wellbutrin. My appointment isn't until next week, but I am glad that someone in a similar situation has had a positive experience with it. I just can't take the frustration from this constant state of "meh" anymore; I want to get back to my normal, energetic self.

Happy to hear you're feeling better. :)

sarahsweets
12-27-14, 07:28 AM
I'm not saying vyvanse specifically helps depression but alot of stimulants can be prescribed off label for treatment resistant depression.



I've wondered whether it is a tolerance to the Vyvanse, and it certainly can be, but I still think it's Dysthymia since I'm just very "blah" on top of everything else. I'd like to try coming off of it for a few weeks, then trying it again to see if it helps.

And Vyvanse is not effective for depression as far as I have read. Shire was investigating it at one point, but it's not on their pipeline site anymore, so I'm guessing it didn't pan out. It may work for some people, though I'd wager that maybe there's underlying ADHD that's getting treated, thus leading to symptom improvement in the depression. The undiagnosed ADHD is what caused my romp with MDD in 2009.

I thought venlafaxine (Effexor) was supposed to be similar to Wellbutrin in that it's a different type of antidepressant? Or am I mixing it up with something else?

Thanks for your responses. :)

geek_girl_913
01-31-15, 08:39 PM
**Update**

I have been on buproprion XL 150mg for three weeks now, and I have yet to discern any real improvement... though I haven't gotten worse, either. Still holding out hope for the four week mark though. Plus, I go back to the pdoc on Tuesday, so I'll see what he says. Personally, I did not care for the guy, but I'm of the mindset that if the medication eventually begins having a positive impact, then I could care less. The reason I didn't care for him was because he said that I couldn't possibly have ADHD because "You're too successful. ADHD by definition means failing at life." Since I started this journey, much of the research that I've read is that attitudes such as those are just ignorant, so it shocked me to hear this from a psychiatrist.

My concern is that he won't pursue acceptable courses of treatment because he thinks I don't have ADHD, which my last doc very concretely established. I guess I just have to hope that the buproprion works eventually, as I am also going to be coming off of the Vyvanse slowly. Right now, my good days and bad days seemed to have blended together into a mix of both. Not the worst thing in the world, but not the best. Fingers crossed for a marked improvement in the near future!

Pilgrim
01-31-15, 08:43 PM
Goodluck. Go get another dr.

Chicky75
01-31-15, 09:02 PM
Have you thought of trying therapy along with the antidepressants?

Flory
01-31-15, 10:45 PM
Dexamphetmaine the key ingredient in vyvanse is actually pretty helpful in many people with issues with depression, it just might be that it isn't in yours , I do hope you can find some help

Little Missy
01-31-15, 11:28 PM
Goodluck. Go get another dr.

I am compelled to say I have to agree.

finallyfound10
02-07-15, 05:49 PM
How its it going? I'm curious as I also am dealing with Dysthymia!

InvitroCanibal
02-17-15, 05:40 PM
Well, it can get better without ssri's.

Ssris, can interfere with your add meds and also cause anhedonia which can feel worse if you are adhd. I am not saying that you shouldn't or should go on ssri's but I feel like telling you it's sunshine and roses with those meds would be misleading you.

Meds are always quid pro quo. You never gain without losing, so you have to know what is being traded. You have to know your price going into a med trial by reading the side effects over before starting anything and deciding what side effects you can accept and which ones you cant.

If it costs you more than you intended, get out of it/switch meds. (W/doc approval)

Latuda worked very well for me personally. Almost instantly but it is an atypical anti psychotic and not an ssri. There were side effects with it though, like some weight gain, lethargy and restlessness (odd combo). However the benefits were worth it for a little while and it got me out of the state I was in but these days I feel like I understand where my depression is coming from and feel like it is something I need to face and work on without meds.
Otherwise I feel like I am denying my own identity.

But if you are not ready to face it head on or dont have a clear plan of action than i'd say go for it, as they can help you gain insight into where the depression is coming from.

You could also trial out sam-e as it was considered clinically effective for moderate depression. It is a supplement that works in conjunction to vitamin b, thus you need to take it with vitamin b and without food. Costco sells it for 40 dollars for 60 so it can be pricey but that really is the best deal for sam-e.

I leave the choice to you,

Good luck

fracturedstory
02-22-15, 01:40 AM
What was your hormone imbalance treatment like? I'm just curious because I think I have something like that going on with me.

I'm on Paxil for my depression/ anxiety and it doesn't seem to make me zombie, only when I take another dose too soon. I know it may not work as well in others as it has worked in me. You may also have chronic fatigue also. My friend said she got that from stress. I got my CFS following 4 months in bed with pneumonia.

geek_girl_913
03-05-15, 11:55 PM
What was your hormone imbalance treatment like? I'm just curious because I think I have something like that going on with me.

I'm on Paxil for my depression/ anxiety and it doesn't seem to make me zombie, only when I take another dose too soon. I know it may not work as well in others as it has worked in me. You may also have chronic fatigue also. My friend said she got that from stress. I got my CFS following 4 months in bed with pneumonia.
Doc had me take progesterone to start, then started me on a first generation BC pill with 35mg estrogen. I didn't like the pill, so switched to nuvaring and then get blood tests every six months to make sure I'm still in balance.

Also, on the advice of a family member who couldn't get pregnant due to the same hormonal problems (and went to a natural doctor as a last resort), I went gluten free. This is obviously not going to be the case for everyone, but I'm just throwing it out there. It definitely does seem to have helped. I no longer have acne like a teenager, which is fantastic.

geek_girl_913
03-06-15, 12:02 AM
How its it going? I'm curious as I also am dealing with Dysthymia!
It's slow going, but improving; however, that may be changing as I have developed twitching from the Wellbutrin, so dose will have to be reduced or stopped. Yay! (Sarcasm.)
Doctor suggested possibly trying or adding Concerta or Strattera once twitching stops.

I have been going to therapy which is only mildly helpful. But I am trying to remind myself that it took me years to get to this point, so I'm not going to magically wake up and be better, no matter how much I'd like to.

How are you doing in your quest out of dysthymia? Well, I hope.

Lizzie80
06-11-15, 10:27 PM
**Update**

I have been on buproprion XL 150mg for three weeks now, and I have yet to discern any real improvement... though I haven't gotten worse, either. Still holding out hope for the four week mark though. Plus, I go back to the pdoc on Tuesday, so I'll see what he says. Personally, I did not care for the guy, but I'm of the mindset that if the medication eventually begins having a positive impact, then I could care less. The reason I didn't care for him was because he said that I couldn't possibly have ADHD because "You're too successful. ADHD by definition means failing at life." Since I started this journey, much of the research that I've read is that attitudes such as those are just ignorant, so it shocked me to hear this from a psychiatrist.

My concern is that he won't pursue acceptable courses of treatment because he thinks I don't have ADHD, which my last doc very concretely established. I guess I just have to hope that the buproprion works eventually, as I am also going to be coming off of the Vyvanse slowly. Right now, my good days and bad days seemed to have blended together into a mix of both. Not the worst thing in the world, but not the best. Fingers crossed for a marked improvement in the near future!

Sorry, a rant here against this guy you saw...apologies in advance towards you. It's him I want to shake and yell at!

The guy who said that ADHD means failing at life is a yahoo who should be kicked out of business. It is a well-known, well-documented freaking fact that MANY people with ADHD compensate for it through excessive interest in perfecting school performance, job performance, sleep habits, diet, supplements, exercise routines, organizing strategies, cleaning routines, and much more. They often do this to the point of physical and/or mental collapse, particularly in today's high expectations world. When someone with ADHD also has anxiety disorder(s) and/or OCD, this chronic overcompensation is their way of life. They live in perpetual fear, perpetual shame, perpetual exhaustion.

If someone with ADHD have a high IQ and/or is very charming and talented in some noticeable area, they may be able to charm their way through life - at least for a time - despite some disastrous habits or a lack of skills like time management. Regardless, high achievers or the highly anxious with ADHD that are unmedicated (heck, even some WITH medication!) do something like three times the work of non-ADHD people to achieve the same level of success. It's exhausting, and they can rarely keep it up. And if they keep up the success in one area (say, work), then some other area of their life must suffer the cost- such as their romantic life. I personally know few ADHD people with success in every single area of life who do not have both a great medication strategy in place, AND a great support system of other people, because that is usually what it takes to be so well-rounded. However, that is just my opinion...

And hello, there are plenty of failures out there who don't have ADHD, they're either just lazy or accept mediocrity with great ease and don't care a whit. I think that's probably a VERY small subclass of humanity, but it does happen. By this guy's definition, it sounds like one automatically has ADHD if they are a failure, no? Yeah, he makes loads of sense. :scratch:

Psychiatrists are the biggest nuts I've ever spoken to in my life. I used to work in collections on the phone, so that's saying something! (Any p-docs out there, if you're not an a-hole, just don't read the rest of this post. It's not applicable to you. If you are an a-hole, you won't care what I'm about to write, anyway.) I used to work as a senior provider rep for an extremely large insurance company in the States. Every single rep in the call center, if we got a p-doc on the phone, we wanted to hang ourselves from the rafters. These dudes and dudettes were the most argumentative, disorganized, mean-spirited, unprofessional dolts in the entire medical industry. They could not bill correctly to save their souls (which trust me, is not that hard). Yet when their claim filed three years after the date of service got denied, when they have a whole year to file the darn things, they'd cuss the insurance rep out. Yes, I'm being totally anecdotal, but I'm just saying...there might be a reason why psychiatrists are (unconsciously) drawn to the field they are! Because many of them could use some serious time in a padded room...sorry. Just never, ever, EVER take the advice of most of these people without a gigantic grain of salt.

wrd9000
10-13-15, 09:25 AM
I've suffered for years with dysmythia and the only thing that worked for me was psychostimulants. Adderall made me jittery but Dexedrine was much smoother. I'd like to try some of the other drugs like Focalin or Desoxyn to see if they are better. My spouse was feeling depressed over our daughter's mental hospitalization and he took some of my Dexedrine which he commented that it magically lifted his depression.

Little Missy
10-13-15, 09:37 AM
I've suffered for years with dysmythia and the only thing that worked for me was psychostimulants. Adderall made me jittery but Dexedrine was much smoother. I'd like to try some of the other drugs like Focalin or Desoxyn to see if they are better. My spouse was feeling depressed over our daughter's mental hospitalization and he took some of my Dexedrine which he commented that it magically lifted his depression.

Letting your spouse take some of your Dexedrine is a felony.