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Dr. Bob is Robert Hsiung, MD,
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Posted by Gesund on January 17, 2003, at 1:13:54
Lately I have been having disorientation, difficulty speaking (slurring words), difficulty holding a train of thought, memory loss. All this on top of my usual depression/anxiety.
I have suffered from depression/anxiety for 30 years. The latest physical symptoms described above seem to have crept up on me over the last few years. I am in my mid 40's.
I went to see a Neurologist who seemed to give me a cursory examination and concluded that my symptoms were related to depression. He suggested that I see a psychiatrist. So after pondering my situation, I finally broke down and decided to seek psychiatric help. (yes after 30 years of suffering!) This experience has not been too good. So far I have found highly priced psychiatrists who only do legal/expert witness work or other psychiatrists who are not taking new patients and others who simply do not return calls.
Today I found a person with an MD after their name practicing psychiatry. I spent an hour with her discussing my symptoms. She wanted to know about me, my childhood etc. Towards the end of the session I mentioned to her that I felt I needed some more definitive medical tests before launching into psychotherapy. She said I would have to go back to the neurologist for that. I left her office with a free starter pack of Lexafor and some general advice about exercise and diet.
While I am sure all this will be helpful, I am still convinced that physical causes of my symptoms have not been eliminated.
So my question to the group is:
A new psychiatrist, a new neurologist or something else?Thanks in advance
Posted by Noa on January 17, 2003, at 6:16:25
In reply to Psychiatrist or Neurologist?, posted by Gesund on January 17, 2003, at 1:13:54
Just to add to the puzzle here (sorry)--I wonder if you should see a good neuropsychologist for testing, which I think could help sort out emotional stuff from cognitive/language stuff.
Posted by judy1 on January 17, 2003, at 10:41:11
In reply to Psychiatrist or Neurologist?, posted by Gesund on January 17, 2003, at 1:13:54
I would definitely seek a second opinion from a neurologist before embarking on the psych merry-go-round. It does sound like you have a lot of neuro symptoms and since you were dissatisfied with the first neurologist you saw, it only makes sense to see someone different. My shrink insisted I have a thorough neuro exam and sent me to get one. In my case I do have both neurological and psychological problems. Best of luck- judy
Posted by judy1 on January 17, 2003, at 10:43:28
In reply to Re: Psychiatrist or Neurologist? » Gesund, posted by judy1 on January 17, 2003, at 10:41:11
BTW, my neurologist did (as Noa suggested) send me for neuropsych testing to get a complete picture. take care.
Posted by BekkaH on January 19, 2003, at 0:38:32
In reply to Psychiatrist or Neurologist?, posted by Gesund on January 17, 2003, at 1:13:54
Gesund, you are absolutely right about the importance of ruling out physical causes, and I find the treatment you got from both the psychiatrist and neurologist disturbing. A good psychiatrist will want you to have a full medical work-up, including blood tests (routine tests, as well as tests for endocrine function, immune function, etc) and neurological tests. There are MANY medical conditions, such as thyroid, adrenal and autoimmune diseases, that can mimic the symptoms of depression, and they should ALWAYS be ruled out before a psychiatric diagnosis is made and before psychoactive drugs are taken. Some psychotropic drugs can alter the values of some of the blood tests, so if you can get by without taking the drugs, you'll probably get more accurate readings. I urge you to see a NEUROLOGIST, but not the neurologist you saw recently. Can you find another one? Do you know someone who can recommend a good one? The slurred speech alone warrants a FULL neurological examination and diagnostic imaging (such as CT scans and/or MRI). I don't know where you live, but if you live in the United States, there is an excellent series of guides available that lists the top doctors all around the country. The series is called "THE CASTLE CONNOLLY GUIDE" to the "TOP DOCTORS IN AMERICA." There are also regional guides, such as "TOP DOCTORS IN THE NEW YORK METRO AREA." Some of the doctors will have long waiting lists, but BE PERSISTENT and trust your instincts.
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