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Old 09-08-2007, 08:07 PM   #1
Stellata
 
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agitated depression

I saw my GP this morning, and was telling her about my recent severe social anxiety and paranoia and rawness.
We talked about medication. I used to take propranolol when I needed it, but had taken myself off it.
But right now I need it occasionally. So I am going to try taking it again. I took a low dose this morning, and feel a whole lot better as a result.

My GP explained how it's good that I take it at the beginning of the agitation cycle, before things escalate.

She also explained how I would feel more sleepy after taking it, and that being in a state of constant anxious agitation is very tiring. [I do have a wonderful GP....]
So, this afternoon I looked up Agitated Depression online. And I found out that
Quote:
an agitated depression, where depression exists alongside anxiety and occasional angry outbursts.
http://www.netdoctor.co.uk/ate/depression/201831.html
and
Quote:
------------a state of clinical depression in which the person exhibits irritability and restlessness....
Agitation occurs in many severe depressive disorders, but in agitated depression it is particularly severe. There is no reason to suppose that agitated depression differs in other important respects from other depressive disorders.
Diagnostic Criteria for Agitated Depression
  • Major Depressive Episode
  • At least two of the following symptoms:
    • Motor agitation
    • Psychic agitation or intense inner tension
    • Racing or crowded thoughts
http://www.depression-guide.com/agitated-depression.htm

which so much described me it's amazing. Well, not great that I feel this way, but great that there's words for it and I'm not alone in suffering in this way.

I just now found this -
Quote:
Some unipolar depressed patients present with agitated depression, a very serious and fairly common clinical picture colloquially known as a "nervous breakdown." These patients are almost always melancholic. In addition to their anhedonia, insomnia, and loss of appetite, they show psychomotor activation in the form of pacing, rubbing their hands together, and/or a feeling that they are "jumping out of their skin."
http://www.medscape.com/viewarticle/471885_4

Wow.
I feel "Why didn't they tell me this before?"
But maybe it's only just now becoming evident to my GP, maybe she knows me better now. Maybe... Whichsoever it is such a relief for me to have words for this distress that I've been suffering every day for the past 3 years, and intermittently before then, because everything was so blurred and mixed up.

I know that my agitation is also Complex PTSD related, but it's so much of a relief. I feel like I'm accepted, medically, at last. That I'm SEEN. And, that is so so important. To someone who just wasn't seen as a child or teenager. Or adult in my 20s. Now, in my late 30s I'm starting to exist in relationship to myself and others.
This is all quite powerful stuff. Deeply moving, in fact.

I just wanted to share my excitement at the discovery, at the naming of what I'm suffering. And to wonder if anyone else has similar symptoms...? I know my dad suffered similar [although he was undiagnosed and untreated] when he was the age I am now... But I don't know anyone else who has this kind of depression. It wasn't a comfortable thing to grow up around.
But I am growing in compassion now.


I would like this to be read and acknowledged, because it's really important to me.

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Old 09-08-2007, 08:34 PM   #2
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Hun, im glad youve got a diagnosis ..

I maybe wrong, but isnt agitated depression also called a mixed state within bipolar disorder?
Sorry im not much use, hope you are okay x





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Old 09-08-2007, 08:36 PM   #3
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Hi Ami. Thanks.
Yes, it seems to be so. But there seem to be the 2 types. Mine being the solely depression variety.

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Old 10-08-2007, 08:10 PM   #4
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It's so good to hear you've got a diagnosis, it can be such a relief to know that you've got something that other people have had.

I've experienced agitated depression as a part of my bipolar cycles. For me, it's incredibly stressful and the feeling of "going crazy" comes to mind. It's really confusing to be in that state, being deeply depressed and having your mind in overdrive. Being dead tired and not being able to sleep. A sense of boredom comes, your mind is saying "go, doing something" while your body is barely able to stand up. Which is probably why the suicide rate dramatically increase with people experiencing agitated depression.

Hmm, this may be only because I am bipolar, but I'll caution anyway. I noticed that the two times I was put on antidepressants they pushed me into a worse state of agitated depression. The symptoms felt as if someone tripled the intensity. Again, this is probably caused because I have bipolar, but make sure to take care.

Anyway, hopefully you'll start feeling better, now that you know what's going on you can understand more as to what will help/not help.



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Old 10-08-2007, 08:19 PM   #5
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Thanks, Sarika.

I've had the depression diagnosis for a while, with the anxiety and such always being a problem. But yesterday was the first time really that my GP acknowledged the level of distress that it gives me.

Although the word 'agitation' has always been a word I knew.. mainly from my mum criticising my dad's moods .. it feels like I've learnt a new word, and that's such a relief.

You describe it so clearly.

I can more clearly understand why efexor was so so bad for me, as it's a stimulating anti-depressant. I've been on remeron nearly 2 years, and it's mainly calmed it down to a mostly tolerable level. But I still need the propranolol in addition when things are very bad.
And it's a comfort to know that my GP will give me some valium if things get too bad, and the propranolol don't do enough.

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Old 12-08-2007, 07:08 PM   #6
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Things are really really hard today.

I feel so trapped, imprisoned, on-edge, alone.. but I also want to hide to feel safe. It's hard.

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Old 12-08-2007, 10:12 PM   #7
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Aw, I hope you're okay. It can be so hard feeling "split" or "torn" as I call it. I was reading one of my books earlier that discribed what it feels like...hmm...here it is (from the book Why Am I Still Depressed?)

"This combination is one of the most severe and dangerous mood states known. You feel overenergized to the point of agitation, and yet you are terribly depressed. You may feel extremely irritable and extremely hopeless at the same time, giving you an angry, 'What's the point, any-way?' attitude. Your mind is usually racing with thoughts, nearly all of them very negative. Perhaps worst of all is a reversed self-confidence, where the grandiosity [that defines mania] is instead experienced as a profound lack of self-esteem, to the point where you feel worse than worthless: you are slime, you are a burden to others, and you cannot do anything correctly or of any value."

I thought that it was a pretty good description, expecially good for people who haven't experienced agitated depression.

If you're still experiencing the same symptoms after 2 years, even if they are "tolerable", you should definately move to a different medication, or add an addition. And possibly have that medication become one that you take on a regular basis, not just (as you mentioned) as needed. It was the goal 10-or-so years ago to treat symptoms so they are managable. However, the current goal is to treat to remission. Yes, you're still going to have the normal ups and downs of life, but they won't impact areas of your life so much. So, I would suggest bringing the idea up with your doctor. You shouldn't feel like this right now, no one ever deserves to be.

Take it easy right now, try and get some rest if you can.



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Old 13-08-2007, 08:46 PM   #8
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Thanks Sarika.

I'm no stranger to feeling split and torn, from my dissociativeness.

I would say it's emotional arousal [in a hyper-vigilant sense] rather than energised. Because I feel so totally exhausted all the time, even though my brain is wired in this fight or flight state.

My anger is more of a self-protective-don't-hurt-me stuck in the past still feeling present type anger.

I really apppreciate your comments on the medication.The psychiatrist wanted me on minimum meds possible, in line with my psychotherapy. The thing is, when on therapy breaks - like now - I need something in addition, really, to take more edge off the rawness.

I'm seeing more and more how my agitated depression, coloured as it is by severe social anxiety/avoidance as a result of childhood trauma and abuse... is PTSD related.

I'm doing a bit better today, because it's been quiet, and I've been around people I feel safe with, at work. And so I feel I exist.

It's tiring stuff, though. And I can't take the propranolol before bed, as I discovered last week, because it gives me insomnia. I need to tell my GP about that, see if she can give me something that's ok to take in evenings if need be, we shall see.

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Old 27-06-2010, 01:43 PM   #9
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Hi Stellata, I was diagnosed with agitated depression but I believe I have the same issue as you, ie unipolar depression with the added bonus of a 'nervous breakdown'. I really started to feel depressed after my foster brother committed suicide and I felt that this challenged my perception of my self efficacy as I worked as a social worker. I started to believe that I could have done more etc. I lost weight, couldnt concentrate, permanantly seemed to have the taste of stress in my mouth. I was totally unsupported in work, they simply ignored me when I approached senior managers for help and piled more responsibility on me and when I didnt follow a financial procedure over 25 that I didnt know about, they didnt miss the opportunity to discipline me during which time they suspended me from work for 7 months. I tried to keep busy and get a volunteer job but work accused me of breaking the terms of my suspension even though my GP supported me and wrote to say so. I have subsequently resigned and I am concentrating on getting better and trying to recover my life. I believe that I experienced a nervous breakdown although I still jump when the mail comes or when my mobile rings as I seem to have carried that anxiety over, I still experience depressive feelings and low self esteem and keep expecting things to go wrong. I am glad I found this forum, I dont feel quite as exposed and alone.

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Old 27-06-2010, 01:55 PM   #10
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For me, it's incredibly stressful and the feeling of "going crazy" comes to mind. It's really confusing to be in that state, being deeply depressed and having your mind in overdrive. Being dead tired and not being able to sleep. A sense of boredom comes, your mind is saying "go, doing something" while your body is barely able to stand up. Which is probably why the suicide rate dramatically increase with people experiencing agitated depression.


"This combination is one of the most severe and dangerous mood states known. You feel overenergized to the point of agitation, and yet you are terribly depressed. You may feel extremely irritable and extremely hopeless at the same time, giving you an angry, 'What's the point, any-way?' attitude. Your mind is usually racing with thoughts, nearly all of them very negative. Perhaps worst of all is a reversed self-confidence, where the grandiosity [that defines mania] is instead experienced as a profound lack of self-esteem, to the point where you feel worse than worthless: you are slime, you are a burden to others, and you cannot do anything correctly or of any value."

Sorry to mini hijack, but, thank you for making sense/putting words to what i feel

Katie, glad you have found a 'dx', something, and yes, you DO have a great GP.
But, she also has a great 'patient'
xxx

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Old 27-06-2010, 02:16 PM   #11
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I have agitated depression, which is why I'm on a sedating antidepressant and have taken antipsychotics when things have got really bad. I also try and do things that keep me occupied but don't need lots of concentration, like colouring in or digging.
I'm glad you feel like you have found an explanation that resonates with what you're experiencing.





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Old 27-06-2010, 02:18 PM   #12
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I have the same. Or according to that symptom list I do.
Amuses me, diagnostic criteria. Agitated depression or dysphoric mania? Same difference really isn't it.




Stop thinking about what I want, what he wants, what your parents want. What do you want?

(Used to be ~sonic~)


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Old 27-06-2010, 02:21 PM   #13
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Hey. :)

Prometheus, I had a similar kind of situation where I chose to resign from my first teaching job [in the mid 90s], or face disciplinary procedure. I was having an - unrecognised at the time - breakdown. But.

This thread was a while ago, nearly 3 years ago now. I've come a long way since then. But yes, I still get the agitation. I manage it more effectively though, as we understand the roots and causes much more in therapy.

I'm glad you find these desciptions helpful, romp.

And thanks. *blushes*

I think, for me, it's slightly different to 'mania'. More a state of 'hyper-arousal'. I don't mean to split hairs, and maybe I'm in denial. But, that's how I feel... subtle difference. For me, anyway. Jumpy, scanning the environment, always on the run, worried, endlessly worried. But I can slow my mind down, with help - which may be an indicator of the different roots. Uh. Anyway.

Heidi, I too am on a sedating anti-depressant, but now a much lower dose from which I started. It seems a much more effective dose for me. I think, for myself, there's a point where the needing-to-heal mind rebels from what it experiences as excessive sedation. I hope that makes sense! But then when I was most ill I needed that increased sedation. Delicate balance...


Last edited by Stellata : 27-06-2010 at 03:30 PM.
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Old 27-06-2010, 02:27 PM   #14
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Rather than 'patient', i think it should it should be 'teacher'
As in, she is willing to learn from you to also grow as her own person.
A rare gift.
xx

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Old 27-06-2010, 02:31 PM   #15
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Quote:
Originally Posted by Stellata View Post
Hey. :)

Prometheus, I had a similar kind of situation where I chose to resign from my first teaching job, or face disciplinary procedure. I was having an - unrecognised at the time - breakdown. But.

This was a while ago, nearly 3 years ago now. I've come a long way since then. But yes, I still get the agitation. I manage it more effectively though, as we understand the roots and causes much more in therapy.

I'm glad you find these desciptions helpful, romp.

And thanks. *blushes*

I think, for me, it's slightly different to 'mania'. More a state of 'hyper-arousal'. I don't mean to split hairs, and maybe I'm in denial. But, that's how I feel... subtle difference. For me, anyway. Jumpy, scanning the environment, always on the run, worried, endlessly worried. But I can slow my mind down, with help - which may be an indicator of the different roots. Uh. Anyway.

Heidi, I too am on a sedating anti-depressant, but now a much lower dose from which I started. It seems a much more effective dose for me. I think, for myself, there's a point where the needing-to-heal mind rebels from what it experiences as excessive sedation. I hope that makes sense! But then when I was most ill I needed that increased sedation. Delicate balance...
Yeah, different people will experience it differently I guess. Another term for agitated depression is a mixed bipolar episode (hypomania and depressive symptoms) but it's all just terminology. I wish I was able to calm myself on command in the same way




Stop thinking about what I want, what he wants, what your parents want. What do you want?

(Used to be ~sonic~)


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Old 27-06-2010, 02:34 PM   #16
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I think the 'calming in ammand' has come thru her har d work..?
NOT meant as a dig/whatever....but just, it takes work...
I wish i had it too. :\

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Old 27-06-2010, 02:39 PM   #17
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Quote:
Originally Posted by romperfry View Post
I think the 'calming in ammand' has come thru her har d work..?
NOT meant as a dig/whatever....but just, it takes work...
I wish i had it too. :
I wasn't digging either. I'm genuinely impressed!
I've been working on my illnesses for a good twelve years now but racing thoughts are relentless.

But such is life. This isn't my thread.




Stop thinking about what I want, what he wants, what your parents want. What do you want?

(Used to be ~sonic~)


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Old 27-06-2010, 02:42 PM   #18
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Quote:
Originally Posted by Stellata View Post
Hey. :)

Prometheus, I had a similar kind of situation where I chose to resign from my first teaching job, or face disciplinary procedure. I was having an - unrecognised at the time - breakdown. But.

This was a while ago, nearly 3 years ago now. I've come a long way since then. But yes, I still get the agitation. I manage it more effectively though, as we understand the roots and causes much more in therapy.

I'm glad you find these desciptions helpful, romp.

And thanks. *blushes*

I think, for me, it's slightly different to 'mania'. More a state of 'hyper-arousal'. I don't mean to split hairs, and maybe I'm in denial. But, that's how I feel... subtle difference. For me, anyway. Jumpy, scanning the environment, always on the run, worried, endlessly worried. But I can slow my mind down, with help - which may be an indicator of the different roots. Uh. Anyway.

Heidi, I too am on a sedating anti-depressant, but now a much lower dose from which I started. It seems a much more effective dose for me. I think, for myself, there's a point where the needing-to-heal mind rebels from what it experiences as excessive sedation. I hope that makes sense! But then when I was most ill I needed that increased sedation. Delicate balance...
It makes a lot of sense, I've struggled an awful lot with being excessively sedated and that leading me to start panicking and feeling like I won't be able to breathe and I'll be unable to get help and then fighting against the sedation, which is even more tiring!





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Old 27-06-2010, 02:45 PM   #19
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Originally Posted by I.Heart.Hobbit View Post
I wasn't digging either. I'm genuinely impressed!
I've been working on my illnesses for a good twelve years now but racing thoughts are relentless.

But such is life. This isn't my thread.
^^sorry, knew it would come off wrong.

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Old 27-06-2010, 02:48 PM   #20
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Quote:
Originally Posted by romperfry View Post
^^sorry, knew it would come off wrong.
It's okay, don't worry about it.




Stop thinking about what I want, what he wants, what your parents want. What do you want?

(Used to be ~sonic~)


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