Psychiatry & Psychology--General/Rucurrent expression and pain
Greetings. I suffer from bipolar like rapidly recurrent depressive episodes with no well period. Never had mania or hypamania. Predominant symptom, alongside mood, is pain. It is throbbing, all over the body, but mostly centered below the neck and in upper legs. I've had this combination for 5 years, and absolutely nothing has worked.
While from what has been now reviewed extensively, pain and depression co occur quite frequently, and it is not clear which comes first. Maybe in most cases, it is the same disorder. In my case, I have lately realized that I need to address pain more specifically as a symptom, and that it is quite likely my problem is primarily pain related, which then triggers mood.
I came to this conclusion with some brief trial with Ketamine under a doctor's direction. What I found is that while a single infusion of Ketamine lifted mood rapidly and for several days, pain remained unabated, and eventually pulled my mood down again. As you know Ketamine doesn't work as well on pain, which is why I was able to tease mood and pain apart.
I recall Tofranil worked well for me, but I was taken off it for fear of a accelerated cycling. Since then, have tried Effexor and Cymbalta, individually, to no effect. Again tapered off for fear of cycle acceleration. Have thought of Gabapentin, but there isn't much encouraging news on it.
Am presently taking Lamictal 400 mg, and presently escalating Nimodipine. Would like to run this past you, 1) does it make sense to pay closer attention to pain management, perhaps through consulting a neurologist as well, and 2) some judicious use of Tofranil can be justified. Best regards.
1) does it make sense to pay closer attention to pain management, perhaps through consulting a neurologist as well...
and 2) some judicious use of Tofranil can be justified.
These are two good avenues to head down at this time.