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PostPosted: Thu May 12, 2016 4:03 pm 
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Hello,
I have been on Suboxone for a year and a half starting on a dose of 12 mg per day and now have tapered to 6mg per day. For about a year I have had sleep issues where I can not sleep more than 2-3 hrs at a time and never seem to get restful sleep until early in the morning. Unless I sleep in til noon I end up nodding off during the day to the point of falling asleep uncontrollably while driving or typing etc. I am also on adderall for ADD at 10mg twice daily. This helped at first but now I can fall asleep while on adderall as well. Another issue that has come up since lowering my Sub dose is severe depression to where I can not enjoy life and am no longer inspired by anything. The combination of it all is ruining my life. I can barely function and have been unemployed for over a year. I just started a new job but can barely keep up as I need to be awake during day hours to fulfill my duties. Has anyone experienced this? My doc has not and only wants to add SSRI's which I do not tolerate. I feel like giving up completely though have a hunch this is med related. Please if anyone has any experience with this I would appreciate your comments.


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PostPosted: Fri May 13, 2016 12:46 am 
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Your situation is a 'chicken/egg' problem to a psychiatrist. Patients who are not busy always get worse and worse. I've become convinced that the mind simply needs to be 'fed'. We need to be kept physically and mentally busy, or else we lose interest in things, we lose confidence in ourselves, we become more and more obsessed with how we feel... the mind doesn't get used enough to need sleep, and the person usually spends too much time at rest and never gets his metabolism high enough to sustain wakefulness. I'm sure most people know how tired they start to get, the more time they spend laying on a couch or sleeping.

Anyway, I have had patients in your situation, describing your symptoms. But I often get the sense that the patient is convinced that he/she cannot go to work until he 'feels better'.... and I'm convinced he won't FEEL better until he is doing something challenging for about 40 hours per week.

It doesn't have to be work; I supposed it could be full-time volunteer work.... but working is what I recommend to anyone who isn't independently wealthy.

Again, what I usually hear back is 'I can't'. Or the person will say 'I already felt this way, back when I was working'. To that I would say, maybe so-- but then stopping working obviously didn't help! I can't live in the person's skin, and maybe the person is right-- and he just cannot force himself to get out there and get challenged. But if that's the case, I don't believe there is much that can be done-- as you've already discovered. I don't think it is a 'med issue', because I've seen the same symptoms in people on buprenorphine, off buprenorphine, or on or off any other meds.

I recommend that you do whatever you can to get your mind and body moving during the day, and resting at night. I honestly can't think of anything that would be more effective than that.


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PostPosted: Fri May 13, 2016 8:04 am 
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Suboxdoc has given you such a great answer and it really hits home with me so I wanted to share with you also . I have several chronic long term mental "illnesses" (I just don't like the word illness but that's what they are called lol ). I am on disability because of them. I understand all those symptoms you talked about. But I have had them long before I started bupe so for me it's not the med for sure. I doubt it's the bupe doing it to you either. Just my opinion. Dr. J is so right about getting up and doing things ie..work, exercise ,volunteer, etc... . When I first got my disability (and before that) I could sleep all day. Had zero energy. Didn't want to leave the house . Didn't like to drive as it made me so tired. So I thought I couldn't work. Finally because of a divorce I had to go back to work cause disability did not cover the bills . Guess what? After about a month I noticed I felt better. I wasn't as sleepy. All those tired issues seemed to balance out. My depression was better too. I just felt better. Idk if this helps. I just hate to see you blame bupe. For me it was active addiction that robbed me of my energy, motivation,happiness,will to push forward,drive,etc. Bupe has given all those things back to me. But if I sit around and do nothing I will be in the same position I was. I know lots of people who do not take bupe who feel just as you do . That's why I think what the Dr said is so correct. He has lots of experience and knowledge. Listen to what he says. Just my opinion. Hope things get better for you.

Willow


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PostPosted: Fri May 13, 2016 12:53 pm 
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Dr J is right on about keeping urself moving and working. If I don't have anything to fill my time I become the most unmotivated, sleepy and just blah person ever. I'd focus on my physical symptoms constantly. But if I'm working or not stuck in the house for days, I notice nothing wrong & feel completely normal. There's times that if I sit down to watch tv, I can't hold my eyes open so I just move around til I can shake it off. I think that's just being a single mother though. I don't think it's suboxone related imo.

My Dr says that life in general isn't easy and addicts tend to focus too much on their symptoms and thinking it's this or that when it's actually just normal every day life. We tend to forget what life on life's terms is like and always think something's wrong. I agree with that 100%. I remember being in high school and falling asleep at my desk, unable to hold my eyes open. That wasn't because of medication or because something was wrong with me and I thought nothing of it bk then like I would now. I'm just speaking for myself though because I thought I needed to be on an antidepressant a couple yrs ago but after talking with my dr and him explaining all that to me, it made perfect sense, I was expecting to always be 100% and if I wasn't then I thought something was wrong with me. I hope that made sense lol it's hard to explain it typing while my 10 yr old is running around ;)

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PostPosted: Fri May 13, 2016 7:58 pm 
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Thanks for sharing, Willow and Jenn-- the message is very hard for people to hear, and it is often interpreted as 'mean' or uncaring. Going on disability is sometimes the only option. But people in that position have to somehow a way to feel productive. I have great respect for people who have used the support and then transitioned to self-support-- something that must take tremendous courage to do. Again, I realize that the transition is just not possible in all cases... but those who it should feel very proud of themselves.


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PostPosted: Fri May 13, 2016 10:51 pm 
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Thank you Dr J. I have only managed to become partially self supporting. I still get my disability and have tried to go back to work full time. So far I can't seem to handle fully getting off disability. So I work as much as I can handle and still receive my disability. I have often felt like a failure because of this. But have come to realize as long as I keep trying I am not failing. Even if I never fully get off the disability I can still be productive and have purpose. I can still strive to do better and for now work as much as I can handle and maybe eventually I will be able to handle full time. I definitely agree that finding some way to feel productive is so necessary. I desperately needed to be on disability when I was put on it. But I think it also worsened my depression, guilt, anxiety etc in a way. I felt great relief and defeat all at the same time if that makes sense. On one hand it was such (and still is ) a blessing . On the other hand I thought ..wow I must be very sick and worthless if the government agrees I néed this !! So finding a way to be productive is so very important. So I keep trying and do the best I can. I suppose that's all I can do. It's very hard to explain this. It's scary to talk about. Thank you for your understanding. I am not good at opening up and trusting and talking about myself. Thank you for making that easier for me . :D . You and this forum are a blessing for me.

Willow


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PostPosted: Sat May 14, 2016 4:51 pm 
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Try to let those feelings go as best you can, Willow. Every person on Earth is one stumble away from a potentially-disabling injury. I hope things work out for the best--- whatever 'best' happens to be!


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PostPosted: Sat May 14, 2016 5:10 pm 
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Thank you for your comments but I'm afraid you are off on this one. For one I may have gotten my dates wrong but I was working for the first 8 months of this experience sometimes as much as 80 hrs a week and at one point 8 weeks without a day off. The entire time nodding off at work, at lunch and while driving but not being able to sleep more than 1-2 hrs at a time. I was also fairly active during this time. I was fired from my job last may partially because I was lacking energy to fulfill my duties though that was not brought up. The owner just decided to cut my job entirely as I had been very successful in other areas. Over the course of the last 12 months I have been actively looking for professional work sending out as many as 15 resumes a week. While it has been a struggle all along I have tried very hard to stay as active as possible through a MT winter. What I am starting to wonder is if I have sleep apnea. I realized the other night the one thing that changed was I started sleeping on my back exclusively which I have never done before. I also wake up choking from time to time. So it very well may not be the meds. I plan to have a sleep study done ASAP to see if that is the case.


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PostPosted: Sat May 14, 2016 5:20 pm 
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One thing I will say about Doctors, and this is not directed at you Dr. J but your comments did bring it to mind, is that the majority that I have encountered in my life from all fields I have been exposed to, do a horrible job of actually listening to their patients. I am fortunate to have finally found one that I have built a good relationship with who always weighs my thoughts or insights to what is going on into his decision making. This is had a drastic effect on me being able to address my health issues after 4 years of Doc's ignoring me, under treating, mistreating or over treating my health problems. One almost killed me as a result, several put me on meds with out proper consult to side effects or interactions. It's been a long road back but I am grateful to have finally found a good one.


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PostPosted: Fri May 20, 2016 2:32 am 
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Yes, PLEASE get that sleep study done as soon as you can. I knew a man in his 70s who was diagnosed with Alzheimer's even though the symptoms didn't totally match up. This man was driving around and getting lost, forgetting everything, feeling depressed, etc. They started him on a medication that didn't do anything.

I'm not sure how they finally made the connection, but he was finally diagnosed with a severe case of sleep apnea! Once he started using the CPap machine his symptoms, including depression, cleared right up. Your symptoms are definitely consistent with sleep apnea. People who take buprenorphine every day do not nod out.

Please update us once you find out, OK? Awareness needs to be spread about this issue!

Amy

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