Shown: posts 9 to 33 of 36. Go back in thread:
Posted by brynb on January 24, 2013, at 22:03:17
In reply to Re: disheartening psychiatrist appt. » Phil, posted by g_g_g_unit on January 24, 2013, at 21:38:09
hi gggunit-
I'm in agreement w/ Phil here. I was recently dumped by my pdoc (and therapist) because I'm wasn't responsive to their treatment and they basically didn't know what to do with me.
sorry to hear about what you're going through. I think it's worth looking for a new pdoc. sure, we need to put effort into our care and progress, but that only goes so far.
good luck.
-b
Posted by sigismund on January 24, 2013, at 22:17:57
In reply to Re: disheartening psychiatrist appt. » g_g_g_unit, posted by brynb on January 24, 2013, at 22:03:17
ADHD with OCD is sufficiently out of the box to make it difficult to treat in Australia. I was surprised you could get an ADHD diagnosis and Dexedrine with the OCD. Anything further than that is a step too far, I guess. Maybe they don't know.
If there is a way of choosing your thoughts and feelings by radical acceptance or whatever the hoohar is, well then....but really, does anyone feel they do that? Acceptance, yeah, it comes with resignation and tiredness, but I think he means something different. Unless he just thinks you should stop complaining. That's what ECT is good for I guess.
Posted by Phil on January 24, 2013, at 22:19:54
In reply to Re: disheartening psychiatrist appt. » Phil, posted by g_g_g_unit on January 24, 2013, at 21:38:09
I can relate to the last part there. It sounds like you have no choice but to look for another doctor.
Do you like any of the mental health forums there at home that you like? Maybe get some input on doctors?
University types that have a private practice? pdoc writers for publications or blogs?
I'm grasping at straws here, :)
Posted by g_g_g_unit on January 24, 2013, at 22:38:04
In reply to Re: disheartening psychiatrist appt., posted by sigismund on January 24, 2013, at 22:17:57
> If there is a way of choosing your thoughts and feelings by radical acceptance or whatever the hoohar is, well then....but really, does anyone feel they do that? Acceptance, yeah, it comes with resignation and tiredness, but I think he means something different. Unless he just thinks you should stop complaining. That's what ECT is good for I guess.
Well, he brought up mistaken constructs I carry around regarding e.g him (i.e. I transfer a lot of feelings towards my father onto him, and so remain too scared to challenge his authority) and used that as an example of my lack of willingness to challenge my thought processes. He also said I'm entertaining some fantasy of a life with no pain, anxiety, struggle, but I think that's a fairly natural reaction to 7 years of torturous, OCD hell. Prior to that, I was a pretty diligent, ambitious adolescent.
Posted by g_g_g_unit on January 24, 2013, at 22:46:38
In reply to Re: disheartening psychiatrist appt. » g_g_g_unit, posted by Phil on January 24, 2013, at 22:19:54
> I can relate to the last part there. It sounds like you have no choice but to look for another doctor.
> Do you like any of the mental health forums there at home that you like? Maybe get some input on doctors?
> University types that have a private practice? pdoc writers for publications or blogs?
> I'm grasping at straws here, :)
>
The mental health forums here are pretty sparse. I talked to my GP and psychologist but they don't really know any psychiatrists who deal with tough-to-treat cases.I've e-mailed a couple of university professors but they typically don't bother responding.
My psychiatrist did offer to refer me on, so maybe I should just go with that, though he did seem unenthusiastic about the whole process.
Posted by Phillipa on January 24, 2013, at 23:01:42
In reply to Re: disheartening psychiatrist appt. » Phil, posted by g_g_g_unit on January 24, 2013, at 22:46:38
Maybe also babblemail Jono as also from your part of the world. I guess check out the doc your other one recommended and see what you feel. Can you google that doc? See if reviews on him/her? Phillipa
Posted by g_g_g_unit on January 25, 2013, at 5:31:55
In reply to Re: disheartening psychiatrist appt. » g_g_g_unit, posted by Phillipa on January 24, 2013, at 23:01:42
I told my psychiatrist I felt suicidal, and had been researching methods (which is true), figuring it would help.
He asked who I (metaphorically) wanted to kill.
I said the me who is defective and born with an illness that has derailed my life. That was the trigger which led to him accusing me of having a fatalistic mindset and not being invested in wanting to change. I said I can't change because my day is so preoccupied by intrusive thoughts that I don't even know who I am anymore, which led him to suggest that I'm somehow 'using' the obsessions as a kind of secondary gains to avoid dealing with life.
He is right in that I can't accept a 'defective' me, who is ill and will never self-actualize, but he grossly underestimates how much suffering I am experiencing, and how little I can do to control it. It almost felt callous. I've been hurt and reeling the entire day. I saw this guy for 2 years and was never entirely comfortable around him, but I thought we had developed some kind of trust.
Is this "tough love"?
Posted by Twinleaf on January 25, 2013, at 6:23:01
In reply to Re: disheartening psychiatrist appt., posted by g_g_g_unit on January 25, 2013, at 5:31:55
I don't see anything wrong with your thinking; you have expressed very clearly how all of us feel when we are in the grip of depression. What one hopes for in a pdoc or therapist is someone who both understands the severity of our illness, but also believes in us and will work with us in every possible way to help us get better. I think you have sized up this pdoc's shortcomings accurately; he is kind of blaming you for your illness - and also seems to have an outmoded Freudian viewpoint that one doesn't see much anymore. Trust your instincts, and look for someone who is hopeful and empathic, and who believes in you and has the skills to really help.
Posted by g_g_g_unit on January 25, 2013, at 6:57:57
In reply to Re: disheartening psychiatrist appt. » g_g_g_unit, posted by Twinleaf on January 25, 2013, at 6:23:01
> I don't see anything wrong with your thinking; you have expressed very clearly how all of us feel when we are in the grip of depression. What one hopes for in a pdoc or therapist is someone who both understands the severity of our illness, but also believes in us and will work with us in every possible way to help us get better. I think you have sized up this pdoc's shortcomings accurately; he is kind of blaming you for your illness - and also seems to have an outmoded Freudian viewpoint that one doesn't see much anymore. Trust your instincts, and look for someone who is hopeful and empathic, and who believes in you and has the skills to really help.
Thanks Twinleaf. I found your message reassuring. It's so easy to doubt myself, particularly in the face of an authority figure (and one I highly respect at that). Regardless of his shortcomings, he is an intelligent, perceptive therapist: As I've maybe iterated already, what hurt the most was that what he said was right -- I do live in denial of my OCD, and have never really come to terms with it, or mourned the loss of the 'ideal', healthy person I see.
That said, I don't see that as grounds to deny me pharmacological treatment, particularly when I am trying to get across precisely how disabling those symptoms have become. I have made him do things that he hadn't done before (prescribed Memantine off-label; used a higher dose of Parnate than recommended) but it's easy to try and frame desperation to get the best treatment as 'pathological'. This has happened to me before; doctors will try a couple of approaches (often monotherapy) and then when I don't remit, or only some of my symptoms are resolved or whatever, they'll accuse me of having some kind of obsession with medication and then act like they're doing me a favor by denying further treatment.
Yeah, the blaming the patient thing has come up once before -- I remember complaining that I was feeling horrendously apathetic on Lexapro and simply wanted to sleep all day, didn't have the motivation to attend to basic tasks like answering e-mails etc. SSRI-induced apathy is a well-known syndrome, but instead he asked what was 'subconsciously' preventing me from attending to these tasks. When Dexedrine didn't improve my ADD or quality of reading, he suggested I had some 'fantasy' regarding what Dexedrine was capable of doing for me.
I don't want to sell the guy short, because he's helped in a lot of ways and often been supportive of my ideas, but I guess it is time we part ways; I've never felt 'loved' by him, and there is probably too much father-transference going on. I just have no idea how the hell I'm going to find another psychiatrist. The last esteemed 'professor' he referred me to was a nightmare. My other option is to simply get a hospital referral from my GP and go inpatient somewhere private (and somewhat reputable) at the end of February, though that might be a gamble, since I have no idea who I'd be seeing for treatment.
Posted by jono_in_adelaide on January 25, 2013, at 16:27:08
In reply to Re: disheartening psychiatrist appt. » Phil, posted by g_g_g_unit on January 24, 2013, at 20:56:03
Just accept that he isnt right for you, and that you arnt right for him, and accept the referal to the more experienced psychopharmacologist.
You seemed to do well on diazepam a while back for your anxiety, why not go back to that, and push the dose (you can take upto 8 of the 5mg tablets in a day)
Posted by jono_in_adelaide on January 25, 2013, at 16:36:46
In reply to Re: disheartening psychiatrist appt., posted by jono_in_adelaide on January 25, 2013, at 16:27:08
Also, as we discussed previously, seriouskly think about the following combo:
Which ever SSRI has given you the best results (I think it was Zoloft in your case, but pick which ever one has given you the most benifit) and combine it with bupropion (Wellbutrin XL) 300mg per day
This combo will help you avoid the "flattening" that SSRI's sometimes bring, allowing you to push the dose high enough to get as much response as you can for your OCD and anxiety, say 200mg/day of Zoloft, the bupropion will also help motivation, drive and your ADD
Bupropin is very expensive in Australia, but it can be obtained for about $40 per month from a reputable source in the US - PM me for the details.
Also, accept that some of what the doctor said might just be right, that there is stuff that you need psychotherapy for, that th truly get well you need a combo of the right meds and the right therapy.
so
- Diazepam for the anxiety
-A high dose of SSRI for the OCD, anxiety and depression
- Bupropion for motivation and drive.
Please think about it seriously mate
Posted by baseball55 on January 25, 2013, at 18:30:27
In reply to Re: disheartening psychiatrist appt., posted by g_g_g_unit on January 25, 2013, at 5:31:55
He sounds incredibly insensitive. But, for me anyway, I believe suicidal plans did provide a "secondary gain" in that they gave me some peace and the thought of a way out. But, as my therapist told me, they are not your friends. They are your enemies. It took me some time to see that.
Posted by g_g_g_unit on January 26, 2013, at 1:32:59
In reply to Re: disheartening psychiatrist appt. » g_g_g_unit, posted by baseball55 on January 25, 2013, at 18:30:27
> He sounds incredibly insensitive. But, for me anyway, I believe suicidal plans did provide a "secondary gain" in that they gave me some peace and the thought of a way out. But, as my therapist told me, they are not your friends. They are your enemies. It took me some time to see that.
I can't tell if he's insensitive, distant, or if it's just the most suitable demeanor re: analytically-based psychodynamic approaches. I've never felt 'loved' by him though. For some reason, he did bring up how I construct these notions that people have no good intent towards me; it almost felt like some kind of ad hominem attack that he was launching into. But there's never been an effusive warmth in his manner that's countered that impression, whereas I have felt love/care by other professionals (usually psychologists).
I just don't understand this whole "it's for your own best interests that I don't prescribe medication" thing. It's happened to me about 4 times now. It's demeaning and makes me feel like some kind of addict (even though I'm not requesting scheduled drugs), and makes me wonder if I do have some kind of pathology/obsession, or if psychiatrists here are simply too conservative, or if I'm just doing a bad job of relaying information. I must admit that sometimes I will hide my distress out of fear that the psychiatrist will "take control" and overmedicate me. But I am also trying to look out for my own best interests. So it's a difficult balancing act.
No one asks to be unwell, and who naturally doesn't want the 'best'/'perfect' treatment (even if it doesn't exist)?
Posted by jono_in_adelaide on January 26, 2013, at 6:33:37
In reply to Re: disheartening psychiatrist appt. » baseball55, posted by g_g_g_unit on January 26, 2013, at 1:32:59
If 4 seperate psuchiatrists have taken the decision thatt hey can no longer prescribe for you, I think its somthing you need to give some very serious though to - it it was one, I'd just say he was an arsehole and forget it, if it was two I'd say unfortunate coincidence, but if its 4, then they might be onto somthing - somthing thats going to be hard to accept, but may well be essential to your recovery?
Posted by ChicagoKat on January 26, 2013, at 11:08:19
In reply to disheartening psychiatrist appt., posted by g_g_g_unit on January 24, 2013, at 20:21:08
my lord g_g_g, I am so sorry about what is going on with you. you definitely need a new pdoc, I hope you can find the strength to do so.
And try nott to take what that loon said too seriously. Anxiety and depression are true illnesses, and you need medication to help you get better, to give you a foundation from which you can work to get better.
I really feel for you. I hope you are able to find a new pdoc. Maybe you should check yourself into a psych hospital. There you will get a pdoc to take care of you, and maybe you will really like him or her. That's how I found my pdoc, who is absolutely wonderful. Hang in there....I really hope things get better for you.
Kat
Posted by g_g_g_unit on January 26, 2013, at 21:14:47
In reply to Re: disheartening psychiatrist appt., posted by jono_in_adelaide on January 26, 2013, at 6:33:37
> If 4 seperate psuchiatrists have taken the decision thatt hey can no longer prescribe for you, I think its somthing you need to give some very serious though to - it it was one, I'd just say he was an arsehole and forget it, if it was two I'd say unfortunate coincidence, but if its 4, then they might be onto somthing - somthing thats going to be hard to accept, but may well be essential to your recovery?
It wasn't four psychiatrists. Initially, it was my GP .. prior to my ADHD dx., doctors would just put me on an SSRI or something for anxiety and then I would complain I couldn't concentrate (I nearly lost my job, back when I was working), so I'd stop taking it. But at the same time, I was in so much agony from the anxiety that I needed to be on something, so it became a cruel catch-22. Instead of treating the whole picture, docs will just treat some symptoms, or maybe fail to augment a med that's partially working or whatever. And then they'll look at my history and be like "well, you've tried a lot, so there's nothing I can do" and I'll get turned away at a first consultation.
I admit that there is definitely a part of me that is searching for a 'perfect' med regime, or that my standards might be too high. But at the same time, I rarely get anyone who's willing to think outside the box or look at the whole picture. They'll just try each med in monotherapy and then when it doesn't work, move onto the next one and so on. So this is the first time I was turned away from a psychiatrist after actually working with them for a decent period of time. The rest were just a couple of GPs who were bothered that I was doing my own research to try help myself and a one-off appointment with a psychiatrist.
Posted by Emme_V2 on January 27, 2013, at 11:44:36
In reply to disheartening psychiatrist appt., posted by g_g_g_unit on January 24, 2013, at 20:21:08
> Now, I'm trying to be as rational as possible and take everything in stride, but I found his response to be extremely disheartening. If it makes any difference, he comes from a more analytic/psychodynamic background, but he suggested that the obsessions were acting as a way for me to prevent coming to terms with more salient problems like a general lack of responsibility on my part; a chronic, idealized dependence on medication to 'fix' me etc.
He said that to you?? Lack of responsibility?? Idealized dependence on medication to fix you?? I'll keep my tongue (or keyboard) in check and not use any expletives. It really sounds as if this guy is arrogant and condescending and is blaming you for the fact that he hasn't been able to help you more to date. That's not anyone's fault really - it's just the way it is at this moment. I hope the psychopharmacologist he's referring you to will be able to help.
I really don't think it's unrealistic to want to find medication that helps relieve your suffering. We all do. We all know that the pills aren't going to jump out of the bottle and magically do our windows, pay our bills, and drive us to our therapists. But if you got a little relief, you'd stand a chance of doing all of those other helpful things that will get your life back to functioning. It sounds like you are suffering badly and clearly need better care than this man is able or willing to offer. Good luck with the new guy. Are you looking for a new therapist as well?
emme
Posted by bleauberry on January 27, 2013, at 12:48:30
In reply to disheartening psychiatrist appt., posted by g_g_g_unit on January 24, 2013, at 20:21:08
That's too bad he changed direction like that. He should have had some transition period for existing patients on meds. I agreed with him on only one part, and that was that if one does not take responsibility for their illness they won't get better. We cannot rely on doctors for many reasons....they are too busy, hands tied by politics and regulations, and quite bluntly, they generally do not have the magical knowledge or expertise that we fantasize they do. We place almost all of our trust in someone else who is basically guessing at what to do with us. Whatever psychological issues the doc thought needed to be worked out, well, yeah, someday it will be good to talk about those things, but in my experience, doing so will not improve your symptoms at all.
So by taking responsibility for our own illness, what I am referring to is basically this....pretend there are no doctors....we must learn more about our disease so we can use what we can to feel better. A good example right here would be Lemon Balm tincture, about a dropper full, in a glass of water, to shut down that anxiety in about half an hour without causing sedation. And hundreds of other examples. And maybe surf around to study other diseases that can cause your symptoms. For example my depression is caused by the bacteria in lyme disease. I can improve my depression by taking herbs that help to reverse what the bacteria are doing. Psych drugs definitely have their place, but I much prefer they not be used for longterm. Reducing the body's load of bacteria, fungi, virus, chemical toxins, metal toxins,and inflammation, can all help to feel better emotionally because all of those things impact our brain and our mood molecules.
So anyway, good bye to the ole doc and hopefully a much better one is right around the corner for you?
Posted by jono_in_adelaide on January 27, 2013, at 17:34:35
In reply to Re: disheartening psychiatrist appt. » jono_in_adelaide, posted by g_g_g_unit on January 26, 2013, at 21:14:47
Well GGG, I'd take the referal to the psychopharmacologist for drug treatment,but maybe keep seeing your old shrink for psychotherapy type treatment, and try and give some thought to what he said. it isnt easy being told an unplesant home truth, but sometimes we do need to be told..... a couple of years from now you might thank the guy for saying what he did. But I'd def start seeing the new doctor for ongoing management of your drug treatment
> > If 4 seperate psuchiatrists have taken the decision thatt hey can no longer prescribe for you, I think its somthing you need to give some very serious though to - it it was one, I'd just say he was an arsehole and forget it, if it was two I'd say unfortunate coincidence, but if its 4, then they might be onto somthing - somthing thats going to be hard to accept, but may well be essential to your recovery?
>
> It wasn't four psychiatrists. Initially, it was my GP .. prior to my ADHD dx., doctors would just put me on an SSRI or something for anxiety and then I would complain I couldn't concentrate (I nearly lost my job, back when I was working), so I'd stop taking it. But at the same time, I was in so much agony from the anxiety that I needed to be on something, so it became a cruel catch-22. Instead of treating the whole picture, docs will just treat some symptoms, or maybe fail to augment a med that's partially working or whatever. And then they'll look at my history and be like "well, you've tried a lot, so there's nothing I can do" and I'll get turned away at a first consultation.
>
> I admit that there is definitely a part of me that is searching for a 'perfect' med regime, or that my standards might be too high. But at the same time, I rarely get anyone who's willing to think outside the box or look at the whole picture. They'll just try each med in monotherapy and then when it doesn't work, move onto the next one and so on. So this is the first time I was turned away from a psychiatrist after actually working with them for a decent period of time. The rest were just a couple of GPs who were bothered that I was doing my own research to try help myself and a one-off appointment with a psychiatrist.
>
>
Posted by jono_in_adelaide on January 27, 2013, at 17:43:26
In reply to Re: disheartening psychiatrist appt. » jono_in_adelaide, posted by g_g_g_unit on January 26, 2013, at 21:14:47
and ggg, PLEASE give some serious thought to trying my suggestion of Zoloft in an adequate dose to control your OCD (say 200mg/day) plus Bupropion XL 300mg/day
I can give you a legitimate source for Bupropion from the US that works out at $40 a month, about a quater of what it costs in Australia.
The Bupropion has a strong antidepressant effect in its own right, and helps to mitigate some of the SSRI side effects that you fear.
Given your state of anxiety, you'll probably need a benzo - I'd suggest diazepam seeing as alprazolam doesnt sit too well with you.
Posted by Phillipa on January 27, 2013, at 20:30:55
In reply to Re: disheartening psychiatrist appt., posted by jono_in_adelaide on January 27, 2013, at 17:43:26
Jono if anxiety is present wellbutrin will most likely increase it. As even with benzos I ended up in the hospital after one week on 150mg a day. I was tripping over my pups leash when walking him and even fell down. It was horrible for me. And I don't get the system in Australia much better than England as benzos are okay and other meds as well. How are things with you? Phillipa
Posted by hyperfocus on January 27, 2013, at 21:34:27
In reply to disheartening psychiatrist appt., posted by g_g_g_unit on January 24, 2013, at 20:21:08
The co-morbid ADHD inattention with anhedonia and amotivation can be devastating. It makes it so much harder to do the things that can help the depression, like working at something you like or exercising or reading or just napping.
If you feel like you're in danger of harming yourself then you need to protect yourself, certainly. But apart from this case if you did go inpatient what do you expect will happen? The doctors there won't be any more caring -- they'll be worse. The probable outcome is that you'd be medicated to the ears with anti-psychotics and spend half-the-day sleeping and the other half zombiefied and walk out of there no better than when you went in.
I honestly don't know why the Xanax wouldn't at least manage the anxiety to let you function a bit-- it's the first time I've read of a reaction like yours. I suppose you could try other benzos but I think this guy feels more meds are a dead-end. You could just try the therapy and see what happens. Different types of therapy can get you the same place meds can without the over-reaching constant dread of poopout.
I think we all idealize treatment and recovery. The meds that can help the ADHD are probably going to worsen the depression and anxiety and OCD. There may not be any lucky combination cocktail for you, at least not right now. Med-wise you should just pick the thing that you want to improve that you value the most and can improve your general day-to-day life. For me personally I can live with constant depression and social anxiety but the thing I HAD to have was the ability to concentrate and get some fulfillment from reading and working and exercise. I hope that eventually I'll be able to make the other stuff less noticeable.
I think therapy works within a long-term framework. Part of that framework means changing the expectations you have for yourself healing from your illness. It may take years and it's quite likely you're not going to be the person you were 7 years ago. A lot of stuff is going to be different -- it might be impossible to recover a lot of things from your previous life. But that doesn't have to be a bad thing. If after a year you find yourself able to work 3-4 hours a day from home and sleep a lot and be a recluse, then that might be a good medium-term target. It doesn't mean you're gonna stay there but it's better than fruitlessly trying to find meds to make you 'normal'. Normal doesn't mean anything.
Posted by g_g_g_unit on January 28, 2013, at 2:31:57
In reply to Re: disheartening psychiatrist appt. » g_g_g_unit, posted by Emme_V2 on January 27, 2013, at 11:44:36
> He said that to you?? Lack of responsibility?? Idealized dependence on medication to fix you?? I'll keep my tongue (or keyboard) in check and not use any expletives. It really sounds as if this guy is arrogant and condescending and is blaming you for the fact that he hasn't been able to help you more to date. That's not anyone's fault really - it's just the way it is at this moment. I hope the psychopharmacologist he's referring you to will be able to help.
>
> I really don't think it's unrealistic to want to find medication that helps relieve your suffering. We all do. We all know that the pills aren't going to jump out of the bottle and magically do our windows, pay our bills, and drive us to our therapists. But if you got a little relief, you'd stand a chance of doing all of those other helpful things that will get your life back to functioning. It sounds like you are suffering badly and clearly need better care than this man is able or willing to offer. Good luck with the new guy. Are you looking for a new therapist as well?
>
> emme
>Hmm, well, it was strange. He made a point of bringing up how I was always afraid of him and never genuinely believed he cared for me -- i.e. the fact that I couldn't challenge that belief was proof of my lack of willingness to change. It's left me quite confused because I blame myself for not being able to feel or experience his 'care', but at the same time, I've never felt an overwhelming sense of warmth from him as a father figure that would undo the damage my own father has done.
Anyway, I don't know if he will refer me. He also made a point of mentioning a psychopharmacologist he sent me to for a one-off appraisal (who was a stuff old jerk), but then said there are "other psychopharmacologists out there".
I was seeing a separate CBT therapist for OCD, but my depression was too severe to implement any changes. I'd like to continue seeing him, but I would first need to get my anxiety/depression more under control.
Posted by g_g_g_unit on January 28, 2013, at 3:07:08
In reply to Re: disheartening psychiatrist appt. » g_g_g_unit, posted by hyperfocus on January 27, 2013, at 21:34:27
> The co-morbid ADHD inattention with anhedonia and amotivation can be devastating. It makes it so much harder to do the things that can help the depression, like working at something you like or exercising or reading or just napping.
I know. Dealing with that on top of severe OCD is a nightmare.
>
> If you feel like you're in danger of harming yourself then you need to protect yourself, certainly. But apart from this case if you did go inpatient what do you expect will happen? The doctors there won't be any more caring -- they'll be worse. The probable outcome is that you'd be medicated to the ears with anti-psychotics and spend half-the-day sleeping and the other half zombiefied and walk out of there no better than when you went in.
>How do you know? Was that your inpatient experience? The facility I'd like to go to has a specialized inpatient OCD program, as well as a day program for ADHD.
I've essentially lost the ability to take care of myself; my OCD has grown so severe that I am constantly fearful of losing my mind, dissociated, agoraphobic etc. I am beset by phobic avoidance on all fronts, 24/7. On top of that, I'm stuck living with a family who don't really understand or think I'm just not trying hard enough.
I wanted to go to hospital to a) spend time away from my family, b) drive the point home to my family about how severe my condition is, c) get acute relief for anxiety, because I can barely even leave the house to get to my psychiatrist appointments anymore.
> I honestly don't know why the Xanax wouldn't at least manage the anxiety to let you function a bit-- it's the first time I've read of a reaction like yours.
Paradoxical reactions to benzos aren't unheard of.
>I suppose you could try other benzos but I think >this guy feels more meds are a dead-end. You >could just try the therapy and see what happens. >Different types of therapy can get you the same >place meds can without the over-reaching constant >dread of poopout.
I just don't think talking to him for an hour a week is going to do much for my severe anxiety and avoidance issues, let alone my OCD. I need something more structured, like exposure therapy.
>
> I think we all idealize treatment and recovery. The meds that can help the ADHD are probably going to worsen the depression and anxiety and OCD. There may not be any lucky combination cocktail for you, at least not right now. Med-wise you should just pick the thing that you want to improve that you value the most and can improve your general day-to-day life. For me personally I can live with constant depression and social anxiety but the thing I HAD to have was the ability to concentrate and get some fulfillment from reading and working and exercise. I hope that eventually I'll be able to make the other stuff less noticeable.This is good advice. Does amitriptyline do anything for your inattentive symptoms? I suppose if I *had* to choose, I would need to get rid of the constant, plaguing anxiety, though at the same time I'd also like to improve my attention/interest in things. It's hard to find a balance.
>
> I think therapy works within a long-term framework. Part of that framework means changing the expectations you have for yourself healing from your illness. It may take years and it's quite likely you're not going to be the person you were 7 years ago. A lot of stuff is going to be different -- it might be impossible to recover a lot of things from your previous life. But that doesn't have to be a bad thing. If after a year you find yourself able to work 3-4 hours a day from home and sleep a lot and be a recluse, then that might be a good medium-term target. It doesn't mean you're gonna stay there but it's better than fruitlessly trying to find meds to make you 'normal'. Normal doesn't mean anything.
Posted by g_g_g_unit on January 28, 2013, at 3:10:35
In reply to Re: disheartening psychiatrist appt., posted by jono_in_adelaide on January 27, 2013, at 17:43:26
> and ggg, PLEASE give some serious thought to trying my suggestion of Zoloft in an adequate dose to control your OCD (say 200mg/day) plus Bupropion XL 300mg/day
>
> I can give you a legitimate source for Bupropion from the US that works out at $40 a month, about a quater of what it costs in Australia.
>
> The Bupropion has a strong antidepressant effect in its own right, and helps to mitigate some of the SSRI side effects that you fear.
>
> Given your state of anxiety, you'll probably need a benzo - I'd suggest diazepam seeing as alprazolam doesnt sit too well with you.Thanks Jono. Zoloft was definitely the least offensive SSRI I tried re: energy, cognition etc., but it caused a lot of restlessness and insomnia, so I couldn't get past 25mg. I'll see what my next shrink (whoever that ends up being) says.
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