Seeing P-doc later - worried

I am seeing my p-doc today and I am really worried about the appointment. At my last appointment I was talking about my concerns about my Lithium and my doc was acting threatening and telling me she will refer me out for ECT and that she would not be able to treat me.

I decided to give it a little longer. So I am now having the issue that I am putting on too much weight (7 pounds in less than two months). My ankles are beginning to swell and I am still rather unstable (seen in my most recent posts here and on the SI forum).

I really don't want to take a drug that is making me gain weight and is working just a little bit. There is some improvement. I am not getting as depressed for as long as I was before, but other symptoms are not being addressed. I still have bouts of paranoia, agorophobia, and urges to SI.

I am afraid that she will basically kick me out of her practice and I will be out on my arse with no more meds.

Speaking of unstable, I feel like I am on a mild upswing. I am getting irritated easily and having trouble sleeping, even with Seroquel.

So I guess my question is, do I tell her what is going on with the risk she will threaten me again, insist that she treat me even if I want to go off of Lithium, or just let is go and keep gaining weight?

The minimal relief I am getting from the dose of Lithium I am taking is not worth the weight gain I am getting from it. Seven pounds doesn't sound like much, but it would take me several months to lose that amount, even without meds. Nothing fits anymore and I don't have the money to keep buying bigger clothes.

BNLsMOM! (I get confused with the timestamps on posts -- you are going in the upcoming day, right and haven't been yet? If you *have* been, how did it go?) I'd probably tell her what's going on. It'd probably be best to approach it in a casual, "well, this is what's going on" kind of way without saying you want to go off it (ie. not giving the solution, but allowing her to give it without feeling you've already made up your mind, you know?) Sometimes, docs seem to feel threatened if they perceive the patient is directing the treatment. Even when we *do* know quite a bit, sometimes it's best not to let on and let them feel they are in control. We can always disagree if it really goes too astray from what we want, you know? Just give the symptoms and see what she says.
And maybe she was just having a bad day the other time...
Good luck and let us know how it goes!

Is there something else that she can give you? AND no therapist should ever threaten their patients - that is awful. I would ask if there is anything else she could give you - I'm taking Effexor XR and Abilify - I have to watch what I eat with the Abilify as I did gain some weight was able to lose it by watching what I eat. The Effexor cuts my appetite, the abilify is suppose to increase weight gain - so I'm somewhere in the middle.... My weight is slowly coming off....slowly.... Maybe you should look for a different therapist as this one should know better that to threaten a patient! That upsets me - I had the same thing happen to me. He threatened me to the point that I didn't want to see him any longer. My family doctor is one that I can confide in and he told my therapist to back off - the therapist then refered me to someone else - unfortunately she was as rude as he was. I'm now seeing a wonderful Psychiatrist and will be asking him today if he could please recommend a therapist for me to see. My psych I only see every threee months but I feel now that I'm ready to see a therapist and he said to let him know when I feel ready.

I hope your session went well. Please keep up posted. (Sorry - I lost direction... )

BNLsMOM, I am so sorry this is going on. I know you are having trouble with your feelings and things at home and you don't need to be worrying (afraid) of your pdoc too! Did you ever talk to your T about how she (pdoc) treated you last time? What did T say?

I think she is being very narrow to act like lithium or ECT are the only options for treating bipolar. There are tons of different meds to try. I know I am working my way through the list! Haha, not really funny, but I have to try to have humor about this...anyway, if you aren't feeling better enough with the lithium then you deserve to try something else. Remember, the worst thing she can do is not change your meds. No matter what mean things and no matter what she threatens, you are in control. She cannot make you think and do things the way she wants. There is nothing wrong with going to a new pdoc. I know its not ideal to change again, but if she doesn't work with you kindly and in a caring manner, you should think about moving on. You shouldn't be scared of your doctor.

So after all that, I guess I'm saying you should be honest with her.

(BTW, personally, aside from topamax, I've never taken anything for bipolar that didn't cause weight gain.)

Do you take the XR version of Seroquel? I have to take the non-XR type b/c the XR made me stay up all night.

It was around midnight eastcoast when I wrote this so I haven't been to see her yet.

Last time, that is the approach I took. I never said I wanted to go off the med. I just said that I had some new symptoms, thought there might have been an allergy and wanted to get her opinion. She just made the assumption herself.

I have tried a lot of meds. She has strong opinions on what the best meds are and she has tried her favorites with me. I don't think that she feels she is out of options. I think she is trying to "keep me in line."

You have to be honest with your pdoc. That's a given.

Honesty got me in the position I am in with her, but I plan to tell her what is going on. I will assure her that I am med compliant, but I am trying to figure out what is the best for me. Continuing to gain weight is not a good option for me because it is uncomfortable, and because of myriad weight related health issues in my family history.

I am going on vacation and when I get back I think I will have to shop for a new p-doc again. (If this appointment goes badly)

I had a pdoc that was very judgmental and dismissive of my own opinions. Needless to say, I "kicked her to the curb." My new pdoc is better, but I think he neglects to inform me about certain things.

But if you are that frustrated, I say go find a new pdoc!

My old pdoc's office smelled like cat pee.

She is so weird and inconsistent and unprofessional. At the end of the appointment, she talked to me through a toy shark!

You don't do that to a psych patient that you have labeled bipolar with psychotic features. You don't do that to a paitient period.

She says if I have to go off Lithium that she will take me off mood stabilizers altogether and start trying anti-psychotics. This is completely different from what she has said in the past.

I asked about other mood stabilizers and she said that they are all crap. I asked why people use them and her answer was, "that the drug addicts like to get high off them."

I think my mouth was opening and closing but no words were coming out.

Then she talked to me through a toy shark and used a cartoonish voice, aparrently that's how sharks would talk if they could. I almost said that she needed meds more than I did.

The woman is unstable and unprofessional and makes my old p-doc who I was unsatisfied with look like the saint of all p-docs.

Wow, that is truly bizarre behavior from a professional! And to say that "drug addicts" like to get high off of mood stabilizers! I haven't found one that makes me feel "high" in the least bit and I hate to say it, but she seems extremely unprofessional and quite jaded.

Ditto.

All the mood stabilizers I have taken make me sleepy.

I think you might need to find a different psych.

Remember, you PAY them to help you. If you were a boss and had an employee who was incompetent, wouldn't you replace them with someone who was better?

I have printed out info from two more p-docs in the area. I will call them tomorrow.

Definitely time for new pdoc. How bizarre! I take tegretol as a mood stabilizer and I can't say it's made me high. There ARE other options for you.

Good Luck!

This pdoc is so very unprofessional! My mouth dropped reading the 'drug addicts' thing. Damn.

Good luck with your search!

Search update: Of the two I called, one is not taking patients and the other is on a limited basis. The receptionist took a bunch of info and said that they will call me back.

Good luck on getting a new pdoc. The one you are seeing now need to retire and go into early childhood education. There it is appropriate to talk through stuffed animals and there aren't drug addicts!

So glad you are searching for a new Pdoc. I agree she seems really out-there in her approach to you. I wish you much success in finding the right pdoc for you. We all do.
J

I think your psychiatrist has long since gone off the deep end! Maybe you could recommend HER some appropriate meds?

And as to taking the other mood stabilizers to get high--yeah, RIGHT--I really get SO stoned off Lamictal...

!!!!! Disregard my previous response. Clearly she's.... wow, just wow. Beyond the pale and in another realm altogether from appropriate interaction! Glad you are looking for a new P-doc and best of luck in finding a good one! Sorry you had to deal with such a ... there are hardly words for it... unprofessional, ignorant, just altogether yikes...
BNLsMOM