Psycho-Babble Medication | about biological treatments | Framed
This thread | Show all | Post follow-up | Start new thread | List of forums | Search | FAQ

Re: Finding the right Doc - Help

Posted by Toby on September 2, 1998, at 12:46:54

In reply to Finding the right Doc - Help, posted by Lynn on September 2, 1998, at 10:36:55

I read your previous post from 8/25. You said your diagnosis is bipolar with frequent mood shifts but also that the primary mood is depressed. Have you really ever been manic (euphoric and all that) or are the mood shifts mainly depression and irritability? (Either way, the diagnosis may be right, it's just that different symptoms require different tracks of treatment.)
In any case, to your current question, I know good docs in NC but would need to know generally where you live in order to refer you to them.
Also, just finished an article in Clinical Psychiatry News, August edition on "Adding Stimulants Improves Depression Symptoms." Beware of increased irritability, but overall, benefits occur in about 1-2 weeks with peak improvement in 6-8 weeks. Symptoms that improved were mood, attention and concentration, energy, sleep, suicial thinking, and irritability/agitation (interesting that stimulants make some people irritable and relieved irritability in others). You may want to refer to the title of this article and the name of the paper it was in, in case the doc balks at even trying a stimulant.
Another new alternative for mood stabilization is Topiramate which is expensive ($1-3 per pill) but quite effective for depression, mania, irritability and energy without weight gain.
In slight defense of your doctor, making changes in medication too quickly can defeat any gains that might be made, but seeing you only every 3 months is perhaps too long if you are not stable yet. Managed care has indeed changed the way psychiatrists are allowed to practice in many areas and many are no longer reimbursed for seeing patients for more than 15-20 minutes at a time for medication checks, leaving the psychotherapy to less expensive therapists (of course, less expensive in the short term; if you don't get a chance to adequately get your problems addressed, you will require longer-term treatment and more frequent visits, ultimately making treatment more expensive -- we complain, nobody listens). If you can afford private treatment for 50 minute sessions, then you may want to call around to find which docs in your area will accept "fee for service" on an hourly basis. If you are insured though, call the insurance company to find out what their policies are for psychiatric treatment; you may be able to get them to pay for a 50 minute session with a physician; if not, then you are probably stuck with the 15-20 minute med checks. In that case, you just need to go armed with info to each session, keep a journal of your symptoms and response to medications, and engage in whatever psychotherapy is available to you. Ask if you can be seen every 4-6 weeks for awhile when new meds are tried.




Post a new follow-up

Your message only Include above post

Notify the administrators

They will then review this post with the posting guidelines in mind.

To contact them about something other than this post, please use this form instead.


Start a new thread

Google www
Search options and examples
[amazon] for

This thread | Show all | Post follow-up | Start new thread | FAQ
Psycho-Babble Medication | Framed

poster:Toby thread:503