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Rehabilitation following Burnout

burnout fatigue rehabilitation sleep diet exercise adhd-pi sct cdd stimulants

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#1 Stinkorninjor

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Posted 11 August 2016 - 08:26 PM


Yes indeed.

 

I am drained.

 

Quick breakdown:

I have a combination of psychiatric and neuropsychiatric issues, events covering the last 2.5 years have caused a state of "burnout", the final events fully triggering the disease is an unhealthy relationship with a Borderline Personality Disorder/Emotional Dysregulation Disorder -woman, while attempting to plan and execute a big relocation to a new city, covering approximately a 1000 miles distance.

 

Symptoms:

Fatigue, social withdrawl, cognitive decline in the following regions: reason, verbal memory, long-term memory, short-term memory, somnolence, sleep phase disorder? inability to complete full symptom-list...

 

 

Subject:

Male

30 years old approx

 

ADHD-PI diagnosed, self-diagnosed SCT

Dystymia and anxiety are recurring diagnoses (I have been in remission several times the last 5 years, depending on environment)

 

Stimulants have limited effect on ADHD-PI symptoms, sensitive to side-effects

-----Stimulants trialed:

-----DL-Methylphenidate approx 25% improvement (irregardless of XR or IR)

----------Doses trialed stretching from 5 mg to 60 mg. Maximum benefit achieved at approx 30 mg

 

-----Modafinil approx 20% improvement

----------Doses trialed stretching from 50 mg to 300 mg. Maximum benefit achieved at 200 mg.

 

-----LisDexamphetamine approx 35% improvement (XR, duh!)

----------Doses trialed stretching from 10 mg to 70 mg. Maximum benefit achieved at 40 mg.

 

-----Bupropion approx 15% improvement (XR) 50%(!) improvement (IR - curious. Reasons?)

----------Doses trialed stretching from 50 mg to 600 mg. Maximum benefit achieved at 300 mg. (depression XR, ADHD-PI IR)

 

CYP2D6 Ultra-SLOW metabolizer - multiple mutations make my breakdown of compounds metabolized by this enzyme, practically non-existant.

 

Asthmatic, small symptoms.

 

Heart-rhytm and blood-pressure was perfect within the last two months (EKG) and three weeks respectively.

 

Formerly engaged in the previous recreational sports, but NO MORE:

Bicycling, Jogging, Dancing, Karate

 

Problem-solving personality

Ambitious (I believe I am the perfect candidate for Occupational Burnout - i fit the criteria of persons at risk)

Sociable, outgoing (can't recall correct sci-word...)

Positivist (can't recall correct word...)

 

 

 

Ladies and gentlemen, I would be forever grateful for your help in devising some practical planning for the following aspects of a potential recovery:

 

1. Diet - what foods are high in nutrition and suitable for regaining energy? What perticular diet is suitable to my situation? Give examples, e.g:

"4 meals a day. Resistant starch - potatoes, etc."

 

2. Exercise - what form of exercise-pattern, starting at LOW levels of expenditure are suitable to regain health?

 

"Week 1 - one kilometer walk. 5 push-ups."

"Week 2 - two kilometer walk. 10 push-ups."

 

Et c.

 

3. Medication - what compounds are ideal for dealing with this type of... depression? What dosages?

 

4. Supplements - what supplements and extra additions to nutrition would be beneficial? Give examples, e.g:

"3 grams of Omega-3. 30 mg of Vitamin D3..."

 

5. Quality of life improvements - simple things to do, such as being outdoors if sunny.

 

6. SLEEP - the most important aspect as I understand it. How do I improve deep sleep? What strategy?

 

 

Would be most elated for your input, fellow posters. = )



#2 pamojja

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Posted 11 August 2016 - 08:57 PM

Yes indeed.
 
I am drained ...
 
6. SLEEP - the most important aspect as I understand it. How do I improve deep sleep? What strategy?

 
Indeed, without good sleep nothing will fix it.
 

54 Effective Ways To Fall And Stay Asleep (Even For The Worst Insomniac)

Top 26 Methods For Better Sleep and Circadian Rhythm Entrainment



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#3 Stinkorninjor

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Posted 12 August 2016 - 10:09 AM

Cheers for the link pamojja.

I've gathered I need to improve deep sleep. (phase 4) And I need to make sure I don't have an inflammatory response in my body.

 

Here is my current regimen:

 

Supplements:

930 mg EPA Omega-3
660 mg DHA Omega-3

(3 caps in total @ 70% omega-3 content, taken around 12.00 hours)

 

180 mg Magnesium Lactate

180 mg Magnesium Citrate

(3 tabs total, both compounds in each tab, taken at 23.00-02.00 hours...)

 

Medications:

Agomelatine 25 mg (@ 21.30-22.30 hours)

Bupropion XR 300 mg (at morning)

LisDexAmphetamine 25 mg (at morning)

 

 

Starting this evening I will be adding Melatonin - is it worthwhile when taking Agomelatine? What with it occupying the MT1-MT2 receptors. Primarily in the brain though... surely the antioxidant effect is in OTHER parts of the body as well, yes?

 

Has anyone tried the newer, more powerful antiinflammatories? Thinking Astaxanthine and the like - the supposedly super-strong ones.



#4 Stinkorninjor

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Posted 13 August 2016 - 06:09 PM

I can't f***ing think! Jesus...

 

Anyways, whining aside, I just found this article, and it mentions a study which have found more details on how deep sleep works, and is initiated. It seems important, but I bloody well can't even read it!

 

Study shows how the brain can trigger a deep sleep

http://www3.imperial...-2-2015-10-6-50

 

 

 

 

Also FINALLY found a study regarding deep-sleep and Pregabalin - seems to be the best sleep-promoter in regular use right now.

 

Pregabalin increases slow-wave sleep and may improve attention in patients with partial epilepsy and insomnia.

http://www.ncbi.nlm....pubmed/22424859

 

Right, so I'll be asking for Pregabalin when I finally get a doctors appointment then.

 

EDIT:

Also found this study, which apparently shows that some form of acoustic stimulation enhances deep sleep..? Apparently supposed to be very effective. I'm having a sh*t-load of trouble reading it though, so if anyone wants to read through it and give their thoughts, that would be lovely.

 

Enhancement of sleep slow waves: underlying mechanisms and practical consequences

http://www.ncbi.nlm....les/PMC4211398/


Edited by Stinkorninjor, 13 August 2016 - 06:30 PM.


#5 farware

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Posted 13 August 2016 - 07:49 PM

Well, yea looks like we have a lot in common there. I have been affected by occupational burnout too and a relocation (also 1000km+) was short-lived (1-year) due to too much stress. 
 
Anyway, I think what you you should do is research the effects of stress on your adrenals. It took me quite a while to recover from this "burnout". It's hard to describe what I did, but let me try to sum a few things up: 
 
  • 1) Lower all stress factors - everything that triggers acute stress 
  • 2) Stop taking stims and caffeine. 
  • 3) If you believe you are at the stage of adrenal exhaustion you may need adrenal support - the supp I took for 2 weeks was 
  • BIOTICS Cytozyme-AD - it's a bovine adrenal cortex extract. Because the longterm effects are unknown dont take it for long
  • 4) Once you are done with that, hormone support. Pregnenolone is what I took and am still taking. Its neuroprotective and well tolerated. Its a precusor to all other hormones 
  • 5) Stop activities that exhaust you
  • 6) Consider trying epsom salt baths to calm down every other day 
  • 7) Sleep hygiene: Sleep in completely dark room, shut off electronics etc
 
Do you have a regular sleep pattern? If not, the best way to fix it is to stay up longer every day until you fall asleep at a regular time e.g. 10PM. This usually takes 3-4 nights. I forgot the name its a special sleep therapy. Then go to bed at the same time every day 
 
Also what helped me a lot was to take a break from certain heavy projects and going to extremes to overachieve. Im selfemployed so may not apply to you. 
 
There are a lot of things you have to keep in mind that can cause a stress reaction. You cant fix this with just supplements so as you mentioned daily activity is important but dont overexercise. If you are too active it will stress you again. 
 
 
 
 
 
 
 
 
 
 
 

Edited by farware, 13 August 2016 - 07:55 PM.


#6 Stinkorninjor

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Posted 13 August 2016 - 08:38 PM

 

Well, yea looks like we have a lot in common there. I have been affected by occupational burnout too and a relocation (also 1000km+) was short-lived (1-year) due to too much stress. 
 
Anyway, I think what you you should do is research the effects of stress on your adrenals. It took me quite a while to recover from this "burnout". It's hard to describe what I did, but let me try to sum a few things up: 
 
  • 1) Lower all stress factors - everything that triggers acute stress 
  • 2) Stop taking stims and caffeine. 
  • 3) If you believe you are at the stage of adrenal exhaustion you may need adrenal support - the supp I took for 2 weeks was 
  • BIOTICS Cytozyme-AD - it's a bovine adrenal cortex extract. Because the longterm effects are unknown dont take it for long
  • 4) Once you are done with that, hormone support. Pregnenolone is what I took and am still taking. Its neuroprotective and well tolerated. Its a precusor to all other hormones 
  • 5) Stop activities that exhaust you
  • 6) Consider trying epsom salt baths to calm down every other day 
  • 7) Sleep hygiene: Sleep in completely dark room, shut off electronics etc
 
Do you have a regular sleep pattern? If not, the best way to fix it is to stay up longer every day until you fall asleep at a regular time e.g. 10PM. This usually takes 3-4 nights. I forgot the name its a special sleep therapy. Then go to bed at the same time every day 
 
Also what helped me a lot was to take a break from certain heavy projects and going to extremes to overachieve. Im selfemployed so may not apply to you. 
 
There are a lot of things you have to keep in mind that can cause a stress reaction. You cant fix this with just supplements so as you mentioned daily activity is important but dont overexercise. If you are too active it will stress you again. 

 

 

Cheers for the reply mate. = )

 

All right, let's have a look at the points!
 

1. Attempting to lower stress-factors. I have moved from a big city to a very small one. Nice and quiet. I even live in the outskirts. Moved back home to my mother for a few weeks. (she's not around yet, next week is her return)

 

2. Damn. Yeah, I know, but what constitutes stims, would you say? I have to cut my vyvanse obviously, but do you figure Bupropion + nicotince is an ok combo to use? I'm a bit hesitant to quit stims entirely, since I am completely non-functional without the smaller doses. My mothers assistance will be helpful here.

 

3. BIOTICS Cytozyme-AD? Will look into it. A bit hesitant because of the bovine-extract thing.

 

4. Pregnenolone - will try to get it.

 

5. I have stopped some of the activities that exhaust me (such as the move - I got my biggest burnout after that one), but it's really hard to cut them all. (as a CDD-er, doing dishes and laundry exhausts me, for instance)

 

6. Epsom bath salts - what are these? How do they work, exactly? I actually have a bath-tub now, so I suppose I can try it.

 

7. Sleep hygiene - the most difficult of them all - my Concentration Deficit makes it extremely difficult to keep to scheduled activities. My sleep-hygiene have been bad for more than 20 years now.

I sleep in a dark room though, with mask on my eyes, and with ear-plugs.
Will try to cover the windows more, get it even darker.
f.Lux installed on phone and computer.
 

 

Like you, I am an overachiever, but unlike you, my Sluggish Cognitive Tempo means that my brain has to expend greater amount of energy on tasks which yours can simply go straight through, conserving energy - as such, when I try to overachieve, to measure up to other overachievers, I'm going to burn out quicker.

 

Here's an example of how my state has deteriorated:

 

1. Moved far away. New university.

2. A dream of mine, the subject. I already know more than everyone else in class, I notice. I want to prove what I can do.

3. Finals1, I study and work on my project possibly harder than anyone else - I even drive the neurotypicals in my team to the point of exhaustion! But I vow to never submit - there are nay-sayers in my class, who doubt my ability, because of upbringing this results in extreme overachievement.

 

4. Complete shutdown upon completion of project. I dare say mine was the most ambitious and complex of them all. Pretty good stuff!

I have fever, blisters in my mouth and a similar complete shutdown of cognitive abilities such as now.

 

5. Since I realize none of my medications for CDD quite work (they're adhd-stims...) I begin to lose a bit of hope, through the coming months.

 

6. New class. Same as before.

7. Finals2 - work myself to the limit, but I've learnt my lesson, and I don't work myself quite as hard. Less of a crash, but a crash indeed.

 

8. Become ENBROILED with BORDERLINE WOMAN(!)
9. She steals a great deal of energy - pressure builds.

 

10. Attempts to start my own business, but the pressure is DAMN high, and the woman is in constant need of energy and reassurance.

 

11. Decide I can't take it any more - initiates move back.

12. Does the move with the help of the BPD-er - BAD idea...! The pressure is worse than ever, and she can't really help me with planning, she's even worse than me...!

 

13. Move complete - crash unlike anything before. Complete shutdown.

 

 

All right, the pattern is clear:

I must stop trying to prove to others that I am capable - this burns me out.

I am a naturally supportive and trusting figure - I must cease this, and learn to identify BPD-women so that I do not fall into their, or anyone elses thrall, who would abuse my generosity.

 

 

Now then... how the heck do I do this... BPD-ers are easier to spot now - certain patterns, even in online activity are clear - juvenility is the defining trait for the worst of them - easy to spot.

Stopping myself from pushing... that's going to be hard. I was brought up by a fellow with narcicisstic personality disorder, who punished all signs of weakness and failure. That's difficult to let go of. (that's why I want to try CERC-501 - kappa antagonism should do the trick)

 

It's never going to get better unless I get Strattera though - until then, all I can do is heal this particular cycle, but it will start again eventually, as a side-effect from the CDD.

 

GOD DAMNIT!!



#7 Stinkorninjor

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Posted 26 August 2016 - 12:56 PM

So, I've been studying Slow-Wave-Sleep -enhancers, since that's something I really need - and it appears as if Pregabalin and Gabapentin are the two agents most likely to help with that, easily aquired through subscription that is.

 

But what about tolerance-building? Side-effects profile? EFFICACY in sleep-improvement? Which one of them is the best?

 

 

Article comparing slow-wave inducing agents:

Enhancement of Slow Wave Sleep: Implications for Insomnia

http://www.ncbi.nlm....les/PMC2824211/

 

 


Edited by Stinkorninjor, 26 August 2016 - 01:50 PM.


#8 Stinkorninjor

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Posted 16 September 2016 - 01:28 PM

Right, so I've been using 30 mg Mirtazapine and 5 mg Oxazepam for sleep, and I'm not so sure this is working... Mainly because, whether I take the oxazepam or not, I always wake up once during the night! I only seem to sleep 4-5 hours uninterrupted, and then I wake up, and have to redose to fall asleep again.

 

What on Earth... I haven't had this problem in the past, I usually only had problems FALLING asleep, but would then sleep soundly.

 

This, however, is my full daily regimen:

 

 

Duloxetine 30 mg (morning - 9.00-11.00 hours)

 

Omega-3 930 mg EPA (morning)
Omega-3 660 mg DHA (morning)

 

Melatonin 2 mg (21.30 hours)

 

30 + 10 mg Mirtazapine (23.00 hours, re-dose at 04.00-06.00 hours)

 

Oxazepam 5 mg (23.00 hours)

 

 

Is it the 'Limerick Rocket Fuel' which is interfering with my sleep, by chance? I know Duloxetine at least, increases REM-sleep, so that might be the problem - perhaps in combo with Mirtazapine, which I believe increases both REM and Slow Wave Sleep - the combo may be making the REM overpower the SWS.

 

Might have to cut it then... Still, I need to start tapering off both anyways, since I plan to go on NSI-189 + Tianeptine soon.

 

EDIT:

 

Just found references which show that Duloxetine actually enhances SWS! I also realized that I get restless legs from Mirtazapine - that's why I even keep using the Oxazepam in the first place... The feeling I get from Mirtazapine is more... 'restless body' than legs though - as if a low-level version of the same feeling is spread to several parts of my body.

 

Could anybody have a look at this nifty little link? It goes through a lot of this stuff, but my burnout mind can't process sh*t right now - too unrested once more.

 

http://www.sleepsoma...sleep/2014/7/18


Edited by Stinkorninjor, 16 September 2016 - 01:49 PM.


#9 jack black

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Posted 16 September 2016 - 02:50 PM

I can't help you much with sleep issues as I don't know much about it, but sedatives should help some. I'm thinking about valeriane roots, benadryl, promethazine, or even alcohol (last resort).

But, IMHO you have too much on your plate and need to remove stress from your life. Adaptogens like ashwaghanda can help some, but don't expect miracles.

You really need vacations in some exotic or wild place, maybe physical work, and time away from the usual stressors including internet.

BTW, shouldn't you post it in a different subforum?

I'm rooting for you (in the American sense, not the Australian one). Keep us posted.

Edited by jack black, 16 September 2016 - 03:01 PM.


#10 devinthayer

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Posted 16 September 2016 - 05:25 PM

TLDR. At work, but got your message, so I am making this efficient.

What I do suppose is the problem if it is burnout is elevated cortisol levels that come with use of stimulants. It could also be that you have so many stimulants that it is causing blood sugar problems. For correcting cortisol, both Ashwagandha and Rhodiola Rosea seem to provide substantial long term stabilizing effects. For the blood sugar, you need to actually avoid high glycemic foods and stick to eating higher fiber carbs. I know this is not a typical recommendation, but you may also find relief in glucuronolactone (alone or in a caffeine free drink) which can help reduce fatigue from blood sugar spikes by cleaning up some lipid soluble metabolites.

As always, avoid caffeine without the use of a PDE4 inhibitor. Switch to green tea for the L-theanine aspect if you have to, and lie on your side with a fan on. Drink a cold glass of water before bed, and every time you get up to pee, rehydrate with a glass of water. Sounds dumb, but it helps to dilute diuretics from the prior day.

Edited by devinthayer, 16 September 2016 - 05:29 PM.


#11 theCLK

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Posted 18 September 2016 - 08:50 PM

Hey Stink,

 

It's been very busy right now and haven't had the time, but i thought of you last night and thought i would weigh in.

 

Admittably, I don't know much about Mirtazapine and Oxazepam, but I'm wondering if certain things in trace amounts are collecting in your colon and keeping you agitated at night. I know this isn't going to be loved by this western audience, but I would suggest administering an enema to clean yourself and reset. It's possible that there's something (could even be a intolerant food particles agitating you). If this does help you, it gives you a different approach to the problem.

 

Speak to you soon.



#12 Stinkorninjor

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Posted 19 September 2016 - 01:17 PM

Hey everyone! = ) I give big thanks to all of the replies - I'm taking them all into consideration.

 

I've been cutting stress out of my life for a few weeks, and that has definitely helped - the combo of Mirtazaine and Duloxetine helped too (Limerick Rocket Fuel). Been cutting stimulants to the best of my ability as well, mostly Modafinil and Vyvanse.

 

Sadly I ran out of Modafinil, so I only have the dreaded Vyvanse, which I try to use as sparringly as possible.

 

Currently I am in the process of discontinuing both Mirtazapine and Duloxetine - I'm thinking I'm almost at the end-point of that, my body is getting used to the lower dosages.

 

I've ordered Magnesium-L-Threonate and will be starting that soon - I figure I'll go for 667 mg x2 for a start. (double the daily dosage)

 

I have also started NSI-189(!) which I am fairly careful with. I've been experiencing curious effects... almost like agitation, but also like a complete feeling of fatigue - as if I was sick or something, in the flu. It could be related to discontinuing the other compounds though, or I could simply have the flu. (been feeling congested recently)

 

Anyways, I'm using a milligram-scoop to dose the NSI, so it's hard to tell what dosage I'm doing - should be around 20-40 mg. I'm keeping it to around 3 scoops, which should be around 30 mg.

 

The fatigue is usually during the day, the first few hours of NSI, later, during the evening I can often experience a curious sort of mild energization - a restlessness, similar to what I get from Mirtazapine, just without the sedation.

Again, it could be from the discontinuation.

 

Today was also the first day of trying Vyvanse, 20 mg (5 mg lower than usual) with NSI - and so far so good! I actually seem... LESS anxious than usual while on the Vyvanse. I do feel rather SHAKY however...! Litterally - my hands are shaking, yes I don't feel quite as much effect on my heart and so on, so it's a rather curious effect... I suppose this is what they say when they describe NSI potentiating stimulants, isn't it?

 

I've started making plans again, I've also started exercising a bit more - I've been on a walk, done some sit-ups, and intend to do more later today. Started talking a bit more to my old friends again as well. All of this might be placebo, but it IS a rather stark difference from three days ago, when I started NSI.

 

Just hope I don't get too much of a crash when the Vyvanse wears off...

 

So, new regimen:

 

Duloxetine 15 mg (morning)

 

1240 mg EPA Omega-3 (lunch)
880 mg DHA Omega-3 (lunch)

 

1 km walk

5 minutes of meditation

10 sit-ups

10 push-ups

 

Mirtazapine 15 + 10 mg (hard to quit! I actually woke up TWICE this night, because of the lower dose, I'm guessing)

 

 

Should be quite some neurogenics going on with all this...



#13 Catwoman

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Posted 19 September 2016 - 02:33 PM

Well, if you can manage it...try to build up the walking!

I've been a runner for years, but I never stuck with it. I always started late spring and ended up with 5 km runs in late fall. Then winter and no more running because of the bad weather.
This year I picked up with more determination and now run for about 50 minutes. It's all about keeping it up and prolonging distance. In your case, just do this carefully and gradually!

For the meditation part, have you ever listened to yoga nidra sessions? I find them quite relaxing. Jennifer Piercy offers a few amazing sleep sessions. You can find them on the Insight Timer App (together with tons of other guided meditations from different disciplines), I also love the binaural beat tracks from Gunther Goerg (nature sounds combined with bb's which are really easy to listen to). You can listen to examples on thetamusic.org or get shorter versions with Insight Timer.

Drink more water...said to be good for about every thing ;-)

Medication wise I can't help you, sorry....

 



#14 Stinkorninjor

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Posted 19 September 2016 - 05:02 PM

I think I can actually manage to increase it now - I actually think I may be responding to NSI-189 after only a few days of administration...! : O

 

On the other hand, I was already building up to neurogenesis with the Limerick rocket fuel, so it makes some sense - and hey, NSI is supposed to work faster than other AD's, right? Anyways, I will keep the regimen up, and we will see what's what.

 

And it's cool when it comes to the medication part - I think I've got it covered with some of the others, and I have a few ideas myself.

 

What do you figure a good exercise schedule should be? = ) Perhaps 1 kilometer walk this week, then perhaps 1 kilometer jogging the next, yeah? Until I can work myself up to some proper running again.



#15 Catwoman

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Posted 20 September 2016 - 11:10 AM

For running you can follow a basic program. Three days a week, with one day to rest in between.

I remember using this protocol: http://www.runinfo.n...mabeginners.pdf
It's in Dutch but I'm sure you can find one in your own language. Basically 'lopen' is just running and 'wandelen' means 'walking'.

It gets tricky at week 10, because most beginners aim for the 'magical 30 minute run' and in week twelve it will ramp up to 15 minutes of running, 5 minutes of walking on a steady pace and then continue with 30 minutes of running.
You could do 4 or 5 kilometers in 30 minutes when you feel reach a comfortable and steady stage. 

With walking I'm not sure. You could extend your walks by adding 5 to 10 minutes every time you go for a longer walk or add 15 minutes and each time just walk with a slower pace. Important as well to take rest when you feel it's too much and take water with you!
See if you can go for a longer walk at least two times a week, but more important: don't go overboard and ask too much of yourself.


 



#16 Finn

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Posted 20 September 2016 - 04:43 PM

 

 

Is it the 'Limerick Rocket Fuel' which is interfering with my sleep, by chance? I know Duloxetine at least, increases REM-sleep, so that might be the problem - perhaps in combo with Mirtazapine, which I believe increases both REM and Slow Wave Sleep - the combo may be making the REM overpower the SWS.

 

 

 

https://en.wikipedia...Binding_profile

 

After H1, the next strongest affinity mirtazapine has is for alpha-2A and alpha-2C receptors.

https://en.wikipedia...ki/Autoreceptor

 

As an example, norepinephrine released from sympathetic neurons may interact with the alpha-2A and alpha-2C adrenoreceptors to inhibit further release of norepinephrine.

 

 

So mirtazapine's alpha-2A and alpha-2C receptor antagonism inhibits the inhibition of  norepinephrine release, autoreceptors work as negative feedback loop, so it's limiting the efficiency of "braking", maybe too much norephinedrine could mess up sleep?

 


Edited by Finn, 20 September 2016 - 04:47 PM.


#17 Stinkorninjor

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Posted 11 October 2016 - 02:55 PM

@Finn: cheers for the info. I think this could be the case - because whenever I DON'T use Mirtazapine I don't seem to wake up during the night.

 

Seems like I can't use it, for one reason or another.

 

 

Right, I'm currently going through another bout of severe fatigue again... hard to say what's causing it, since NSI-189 has such unpredictable results. However, I have seen the recent reports that show how CFS has to do with a hypometabolic state - as a way of protecting the body against dangerous viral infections.

 

How then, does one go about increasing metabolism?

 

Like, a combo of these?

 

Acetyl-L-Carnitine

Creatine

 

What else?
 



#18 jack black

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Posted 11 October 2016 - 09:52 PM


As always, avoid caffeine without the use of a PDE4 inhibitor. Switch to green tea for the L-theanine aspect if you have to, and lie on your side with a fan on.


I meant to ask: what is the significance of PDE4 and fan on?

#19 jack black

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Posted 11 October 2016 - 09:55 PM


Right, I'm currently going through another bout of severe fatigue again... hard to say what's causing it, since NSI-189 has such unpredictable results.


Sorry to hear that. Any recent stressors? If not, maybe time for holiday from NSI?

#20 Stinkorninjor

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Posted 12 October 2016 - 07:17 PM

 

Right, I'm currently going through another bout of severe fatigue again... hard to say what's causing it, since NSI-189 has such unpredictable results.


Sorry to hear that. Any recent stressors? If not, maybe time for holiday from NSI?

 

 

Sure, there's a new stressor: I recently started a new course wherein I'm trying to learn how to be a business-man, so that's something. The tempo is slow though, not at all super-high, but it still made me really, really tired.

 

I've been gone from the course for 2 days though - I'm going to give it another go tomorrow.

 

I think my biggest problem right now is probably still fatigue and bad sleep. I NEED Gabapentin if I'm to ever, ever improve sleep...!

 

 

With deeper sleep, the fatigue should get somewhat better - then, when I've got the sleep, I can start increasing metabolic rate! = ) Depression is nearly gone I would say - only a few weeks more of NSI-189 + Tianeptine - quite the bit of neurogenic activity here with the added Omega-3...!



#21 jack black

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Posted 14 October 2016 - 10:42 PM

my wife takes Ambien for sleep (sometimes, not all the times) and she likes it. it's supposedly harmless, but she had some episodes of sleepwalking and doing crazy things when the dose was too high (women should take much lower doses).

i usually don't take anything for sleep, as i don't need it, except for rare situation and then benadril, tylenol PM, or vodka shots seem to work.

you should be able to figure out something that helps with sleep, or remove excessive stimulation.



#22 Stinkorninjor

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Posted 15 October 2016 - 08:40 AM

Yeah, I've actually got some hope of solving this - but it's one of those things that are tricky. Gabapentin should do the trick, but it's hard to find from a reliable source online, for a reasonable price.

 

(in comparison, Pregabalin is very easy to find - apparently the choice of drug for all of the users and abusers out there - BAH!)

 

 

I recently noticed that me waking up in the middle of the night is apparently not caused by Mirtazapine after all - using only Melatonin 5 mg, Magnesium-L-Threonate 2 grams and 5 mg Oxazepam (LONG-acting benzo - good for keeping you asleep for a long time, apparently) I still woke up...!

 

It's either something completely unconnected to my meds, or it may be the Melatonin. I've actually heard that supplementing with that can cause such side-effects with prolonged use... going to skip it tonight and just use the other compounds.



#23 Stinkorninjor

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Posted 21 October 2016 - 06:50 PM

So, I've been going through the litterature, and there IS one other compound which could work, other than Gabapentin or Pregabalin, which is actually AVAILABLE - Tiagabine.

 

Does anyone know of ANY source for this compound? It's not exactly the easiest to find.



#24 Stinkorninjor

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Posted 03 January 2017 - 10:46 AM

So, things have changed:

 

I experienced increased deep sleep while on a combo-regimen of Modafinil 150 mg and Gabapentin 300 mg.

 

I'm currently on Atomoxetine 40 mg and NSI-189 40 mg.

 

I'm... not quite sure about this combo though.

 

It's curious, but brand-name ATX Strattera did not feel like this at all! I feel kind of... DIZZY! And tired, yet energized at the same time. Motivated, yet a bit too tired to really do anything.

 

Curious! I might have to try and find some Modafinil to stack with this.

 

Still, I have improved my cirkadian rhytm thanks to stacking some stuff on top of Melatonin and Gabapentin, so that's something. I

 

have also started exercising again! I do some sit-ups and some pull-ups, push-ups, every morning. It varies a bit, but at least about 30 repetitions of all exercises all in all.

 

 

I gotta' say though... I'm having second thoughts on ATX now... because this dizziness is not good! I added some Vyvanse to try and get rid of it, but it doesn't seem to be helping all that much... perhaps this is related to me taking a second 300 mg Gaba-P when I woke up during the night... problem is, I woke up at about 6 o'clock, clocking in at about 6 hours of sleep - I then went to sleep again, getting another 2,5 hours, and got up at 8.00 hours - this is probably not enough time for Gaba-P to stop working!

 

Yeah... I just realized... it's probably a combo of MORONtin and ATX making me dizzy and disrupting mental processes.

 

All right, 40 mg ATX trial, continues.



#25 Stinkorninjor

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Posted 27 January 2017 - 02:34 PM

So, I finally got to do some blood-work, and here are some basic results:
 

Haemoglobin Blood-value: 146 (not bad!)

 

TSH: 2.74

 

 

The test for Lyme Disease antibodies also came out negative, which means that I most likely DON'T have Lyme Disease either.

 

On another note, I think I've figured out why I have problems with Slow-Wave Sleep:

- after talking to my previous partners I've come to the conclusion that I most likely have PLMD - Periodic Limb Movement Disorder. I have, upon closer introspection, always noted that I twitch during sleep, but I never figured it had anything to do with my sleeping-issues. My partners described my movements as almost... EPILEPTIC! As if someone had connected electrical wires to random muscle-groups of mine, which then intermittently made my arms or legs twitch and vibrate even.

 

PLMD is often connected to Neurodevelopmental Disorders, primarily Parkinson's Disease and NARCOLEPSY.

 

SCT is a disorder which shares characteristics with both ADHD and Narcolepsy - and I have noted a distinct improvement of Sleep-structure when on low-dose Modafinil - Modafinil has also been proven to have slight Anti-epileptic properties, and has shown efficacy against various forms of Myoclonic twitching.

 

The fact that Gabapentin and Modafinil helps is also CLEAR signs towards this.

 

PLMD can also be exacerbated by trauma and extreme stress - and my life with a Histrionic was certainly traumatic and stressful, so was the event which resulted in my burnout. All in line with my conclusion that I have PLMD.

 

So... what now?



#26 jack black

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Posted 28 January 2017 - 02:47 PM

There are 2 persons in my immediate family who have that night time twitching. They are fairly normal, except for increased anxiety. Really not sure what it means.
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#27 Stinkorninjor

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Posted 28 January 2017 - 08:10 PM

There are 2 persons in my immediate family who have that night time twitching. They are fairly normal, except for increased anxiety. Really not sure what it means.

 

Well, unless they have impaired attention, day-time somnolence and fatigue, then it may not mean too much.

 

It should be noted that we have posted evidence of some of the data revealing decreased efficacy of the GABA-networks in the brains of people with Autism-spectrum-symptoms - that is most likely the source of some of the increased anxiety some autists have, as well as the increased vulnerability to SEIZURES! Apparently Autists can much more easily get seizures from medications than others, as well as a noted increased statistical commorbidity of Epileptic disorders among people on the spectrum.

 

This may well be in line with a hypothesis implicating multiple Glutamate-receptors in the disease - most notably NMDA... since GABA and NMDA revolve around each other in an axis - perhaps they should try MEMANTINE for that anxiety...? Might help with sleep and seizures too, allowing their gabaergic systems to subdue more activity.

 

 

Reason why I mention it like that, is because it has generally been noted and accepted that PLMD is not an entirely homogenous disorder - not everyone with the disorder have problems with Slow-Wave Sleep - some do not actually have any issues from their symptoms. Which is another feature the disorder shares with RLS - there are people with RLS whom have problem with SWS and non-restful sleep as well, but it's by no means a universal truth - the majority of sufferers with RLS are actually o-k - if they actually fall asleep, they stay asleep and CAN have restful sleep.

 

It seems like us PLMD-ers have more Non-restful sleep, but it's by no means a universal truth with PLMD either.
 



#28 Stinkorninjor

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Posted 18 August 2017 - 08:25 AM

Right, a few weeks back, I did some more bloodwork, so here is some recent data, which can hopefully be used to determine if I have any physical abnormalities causing fatigue and such:

 

 

EVF: good*

Lymphocytes: good*

Electrolytes:

-Sodium

-Potassium

-Magnesium

-Calcium

-Iron

 

Were apparently all in perfect order.*

 

Kidney-function:

good*

It was not revealed if they merely measured creatine-levels, did eGFR or made measurements of Cystatin C.

 

 

*(range was not revealed, it seems to be implied that my values were all in the middle-range)

 

 

What then remains to be checked for abnormalities are the following:

ALT/AST:

HDL/LDL:

SHBG:

DHEA:

 

 

 

Multiple blood-pressure measurements have been good as well - I am curious what it's like at the moment though, since I'm undergoing some kind of intracranial pressure increase, and possible blood-pressure increase, as a result of discontinuing Guanfacine too quick - It was quite painful... but after reintroducing 1.5 mg Guanfacine, most of the problems have gone away. Still, I am experiencing some, dizzyness and slight, slight headache at the moment.

 

So far, I seem to be fairly healthy!

 

Hmm... would be interesting to get those final results, but otherwise, my issues are more likely to be purely neurologic in nature, or possibly there is an auto-immune component - some such diseases should already have been catched with some of these tests though, shouldn't they?

 

 

Also, does anyone know if there are any tests which can be used to check for CFS? There have been some recent breakthroughs in this regard, I believe - using metabolomics.

 

I don't believe I have exercise-malaise though... I don't seem to pay any greater price for exercise per say - I seem to be more sensitive towards a general increase in activity - socializing, working, organizing, that sort of thing - which is more indicative of burnout.

 

Man, I really should try and get an fMRI done, shouldn't I? Those things are generally immensely expensive though.


Edited by Stinkorninjor, 18 August 2017 - 08:31 AM.


#29 Finn

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Posted 25 August 2017 - 10:02 AM

 

Multiple blood-pressure measurements have been good as well - I am curious what it's like at the moment though, since I'm undergoing some kind of intracranial pressure increase, and possible blood-pressure increase, as a result of discontinuing Guanfacine too quick - It was quite painful... but after reintroducing 1.5 mg Guanfacine, most of the problems have gone away. Still, I am experiencing some, dizzyness and slight, slight headache at the moment.

 

 

 

So how was your guanfacine experience overall? Did it help on anything for you?



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#30 Stinkorninjor

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Posted 25 August 2017 - 05:01 PM

 

 

Multiple blood-pressure measurements have been good as well - I am curious what it's like at the moment though, since I'm undergoing some kind of intracranial pressure increase, and possible blood-pressure increase, as a result of discontinuing Guanfacine too quick - It was quite painful... but after reintroducing 1.5 mg Guanfacine, most of the problems have gone away. Still, I am experiencing some, dizzyness and slight, slight headache at the moment.

 

 

 

So how was your guanfacine experience overall? Did it help on anything for you?

 

 

It did, actually.

 

It's anxiolytic, which is nice, and it seemed to stabilize mood generally, which is logical if it truly does decrease activity out of the amygdala - it also enhanced attention to some degree, not necessarily as dramatic as stimulants, but it did have some effect. It also made it easier to fall asleep, improving circadian rhythm.

 

However, the pro's were not enough to surpass the con's when used as mono-therapy.

BUT...! When combined with a stimulant...! DAMN! This stuff is good. DAMN good! I've never gotten as much out of Methylphenidate as when I used it in combination with Guanfacine! The two really DO balance each other out, and eliminate most of the worst side-effects from both. It's dose-dependent though, you really have to balance it just right... it's not too hard though, after a few days I'd say most people will figure it out.

 

Can't wait to try it out with RACEMIC Amphetamine, if I actually get it prescribed via license! = ) I have a feeling that's gonna' be the winning combo... Mainly because fellow SCT-er and amateur neuroscientist extraordinaire, GetOutofBox have come to the conclusion that Dexamphetamine and Intuniv is the most effective treatment he has used.

 

(still not perfect however, but good enough to give, say, 65% symptom-reduction - that's a helluva' better figure than the regular 25-35 % reduction we get from other mono-therapy compounds! I'm thinking, if Racemic AMP turns out to give me 40% reduction, then adding Intuniv might finally get me up to 75% reduction! :D That's about what the regular ADHD-ers get, so that would be optimal)


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