Posted by Levi on August 8, 1998, at 23:28:23
In reply to Re: help Dr Bob, posted by Dreya on August 6, 1998, at 22:15:50
I think I can touch upon the "crux" of the problem. experience. It takes time to develop a relationship with your Doc. He may notice certain "ways" or "things" about you that warrants his actions. It could be positive. When you get down to it, psychiatry is not DSM, it is not in books. These are "references" and "guidelines" for real psychiatry which is clinical and entirely personal. One need not be "psychotic" in order for the Doc to prescribe a neuroleptic (anti-psychotic). His choice could have been highly warranted. But, for yourself, you need to realize some very crucial truths about being a psychiatrist's "patient." First, give him time - the more he knows you the better that he can treat you with proper medication. Moreover, psychotherapy is tailored to the individual. I can't imagine a psychiatrist applying the same tactics or whatever to each patient. Some patients might improve with a book, while others may read the same book and feel even worse. Same with meds - forget what the statistics or even your psychiatrists claims of "superior" meds - although do take into account side-effects and the doc's opinions. Psychiatry is bound up not with the system of trial and error - hit and miss. It could take 5 years to get it going - be patient (no pun) and see what meds you like, which one's benefit and which one's don't. GIVE THEM TIME AND ADEQUATE DOSAGE. Otherwise, they may all be failures, especially with meds such as prozac, zoloft, luvox, paxil, etc. Prozac made Ernie feel like he was "normal" - exacly the purpose. Fred took prozac and became more depressed then ever. You have your own unique responses and take them seriouslly. Just remember that even the best psychopharmacologist in the world still has to play by the rules contained in the "hit and miss game."
Another point is crucial - don't "do businuss" with a stubborn psychiatrist - but give him the time to justify his methods - and judge yourself, after a certain time, if he is going to be the right Doc for you. Don't go "Doc hopping." However, if the cases permit, you may have to jump around to diferent Docs - and if you like what you hear in terms of reputation, etc - that a good start. A good psychiatrist is like a good parent. The parent is (we shoyuld hope) more insightful about life matters than the child. But there's a conversation, not a dictation. It is very important that your Doctor respects you and your opinions and that you work as a team. PLEASE DO NOT even listen to any doctor that tells you to "snap ouut of it". Don't even bother to return to a doctor who says that your condition is a result of bad mothering, or childhood experiences, or is some deficit in your power to change. From what you mentioned, I cannot diagnose you - but I can tell you that it is basically a biological disorder (which is involved in the [social] environment and can be 'trigerred' by many factors) - but stick to a Doc that is trying to regulate your Neurotransmiters (i.e. seritonin, norepinephrine,dopamine,etc) - not a Doc who thinks that the end all of "psychology" is therapy (although it plays its part). Your psychiatrist is on the right track if he acts as a sort of compassionate neurologist. You don't have a disorder. It's a neurological barin disease. You did not get depressed because your fish died last weak. It appears as though your brain needs a little adjusting - Mine sure did and does - and remember that it can take q long time. But have faith in the system. Just make sure your doctor has the capability of being (although confidential and limited) of being your friend and taking your opinions about treatment seriously. You should be a team. He guides, you listen. But he doesn't dictate, and you obey. Keep your chin up - and question the Doc - maybe he will have a very good answer which you can improve upon and understand, which leads me to my last point.
THE BEST METHOD OF GOING THROUGH THIS "PROCESS" IS SELF EDUCATION. I am trying to remain unnoticed, but I'll tell you this - I had panic attacks. And more. Still more. I went to see the doc and he gave me a subscription for Xanax, which would basically reduce the attacks - stop them, calm them. But he repeatedly emphasized that the "root" of the problem is determinant of both the diagnosis and medication. I had panic attacks. But it wasn't until an SSRI worked (took almost three months!) {Luvox} that the panic ceased to exist in any big way. The xanax was for relief - the Luvox (prozac, paxil - could have been any) actually went to the source of the problem - its "root". That doesn't mean an end to a benzodiazapine (xanax, valium, ativan, clonpin, etc.) - it just menas that the, sy, xanax is a secondary "helper" or "augments" the Med which is more related to the "root" - which, although not exlusively, is based upon mantaining a certain seritonin balance in the brain. Seritonin is realted to (who knows how many things!!) Obsessions, depressions, anxieties, etc. (Just to extend a bit - my true root is on the side of too much dopamine in the wrong places plus affective) But norepinephrine and dopamine and who knows what esle is involved in a condition that would "resemble" yours. I once told my Doctor hat the reason that i have insight (a lot don't in these cases) into my NBD is that i have done"immense" reasearch. I have practically become what might be called a psychopharmacological expert layperson who thinks he know what he's talking about. The Doc's might laugh at me. But, I'll tell ya' - I doidn't make anything up - I researched it in the realm of psychopharmacology. I shunned Freud, and so should you. Pat yourself on the back for choosing treatment (if you did 'choose'). There are many lives that are wated because of denial, arogance, stubborness, and lack of insight into illness. BUT - don't pretend you know as much as the Doc - that'll be unproductive. But it will shed light on so many areas that you encounter everyuwhere that this education is, I beleive, highly important. I though it was because it gave me an "objective insight" - my Doc though the "investigations" were good because it enhances the patient-doctor relatonship - which is of the utmost necessity, at least in earlier stages of treatment - too bad it tends to take a long while to develop a good relationship, if any. I've seen my Doc for over 3 yrs - not too long, - but he opens the door and knows me well enough to render a medication adjustment - and he seems to have a pretty good batting average...
I'm not a Doc, but if I can be of any assistence to you, let me know through the 'forum" and perhaps we can exchange e-mails. Just remember - as my Doc says - Remember the source - ignorance - this is the source for anyone's misunderstandings concerning NBD. The CNP (I didn't invent theses words) or Chronically Normal People have bouts of depression. But chronic, severe depression, most no nothing of. Don't bend over backwords getting someone to understand - YOU must understand that this is a brain problem, and its your brain - not "you". Note the distiction, and best wishes.
poster:Levi
thread:242
URL: http://www.dr-bob.org/babble/19980801/msgs/270.html