[sillyfab]

So here's my situation.

I just started a job in August, and my health coverage will be available on December 1.

My boss caught me bawling outside on break this morning, and we had a discussion about my recent anxiety, stress, and depressed mood. She sent me home at 9:30 this morning. I told her that I was off work tomorrow, that I should tough out today, and then call for an appointment with the doc. She says, "No, your health is far more important. We'll make it being short one day. Try to get an emergency appointment with your doctor today or tomorrow."

So while I'm depressed, it's not as severe as it has been over the past few days. Yes, I cried for no reason at work this morning - so what?

So the discussion I'm having with my partner is this: do I make an appointment ASAP with my PCP and eat the cost? Or do I wait till the insurance kicks in? And if I make an appointment, do I go to my PCP and let him recommend a pdoc, or do I find a pdoc myself?

[Sheba976]

Originally Posted by sillyfab

So here's my situation.

I just started a job in August, and my health coverage will be available on December 1.

My boss caught me bawling outside on break this morning, and we had a discussion about my recent anxiety, stress, and depressed mood. She sent me home at 9:30 this morning. I told her that I was off work tomorrow, that I should tough out today, and then call for an appointment with the doc. She says, "No, your health is far more important. We'll make it being short one day. Try to get an emergency appointment with your doctor today or tomorrow."

So while I'm depressed, it's not as severe as it has been over the past few days. Yes, I cried for no reason at work this morning - so what?

So the discussion I'm having with my partner is this: do I make an appointment ASAP with my PCP and eat the cost? Or do I wait till the insurance kicks in? And if I make an appointment, do I go to my PCP and let him recommend a pdoc, or do I find a pdoc myself?

Primary Care docs are not trained to handle mental illness. I;ve found that they just hand you whatever antidepressant samples they have and send you on your way.

Find a pdoc yourself that will be accepts your new insurance. (Unless your new insurance requires refferals to specialists then you need to see your PCP.

[dragonfly2]

I would definitely check in with your PCP. He/she knows you and can help you stabilize at least in the short term. It could take a while for you to get an appointment to see a pdoc, and it may happen more quickly if you have a referral from your PCP. In some places, you can only get psych services through PCP referrals. And not all PCPs are created equal. Some do just fine with psych meds. Don't discount your PCP, and take the financial hit this time. Even if things don't settle down right away, your boss needs to see that you're addressing this ASAP.

[roads]

Originally Posted by dragonfly2

Even if things don't settle down right away, your boss needs to see that you're addressing this ASAP.

i think dragonfly voices an important consideration in your deciding what to do about your current situation. Your boss needs to know that you will address quickly anything that may affect your work. She's given you time to do that, so you must meet her part-way.

If you trust you PCP to be a good doctor, ask whether s/he feels comfortable prescribing for depression. If the answer's yes, go with that. If 1 Dec comes & you're not better, or if PCP's not comfortable prescribing for depression, ask for a referral to a psychiatrist.

At least, that's what I'd do.

In the meantime...

[sillyfab]

Thanks to all for your advice.

My PCP knows me pretty well, and I'd frankly rather have a referral to a pdoc or T that he trusts to handle such situations if he's not comfy himself.

My PCP is comfy with antidepressants - he's the one who originally put me on Zoloft. I'm going to see him at 1 pm today, and I'll explain to him all the stuff that happened during my time on Zoloft. He may adjust meds or come to the conclusion that I'm BP, or whatever. I've always been pretty confident with him b/c he's not a person who hands out pills like candy at Halloween - when he prescribes something, it's b/c he sees symptoms that indicate something.

Plus, he's my hubby's doc, too, and that means I can authorize info-share if I feel it needs to be done.

I'll update about my appointment when I get home.

[sillyfab]

Appointment went well yesterday. We talked about my symptoms and everything that had been going on with me in great detail. I'm back on Zoloft with a standby script for Seroquel should I feel hypomanic or manic again. I was told that if I ever feel in crisis again, I should go to one of the local emergency spots that handle such crises for eval, as they only admit if you're truly a danger to yourself. My partner's in on all the details of my doctor visit and the treatment plan. In December, I will be doing some labs just to rule out possible underlying problems. Then pdoc referral if the doc, the hubs and I think it's appropriate or if things don't change.

[roads]

Wow, sillyfab, look at all you got accomplished! I am truly impressed.

Just stick with this plan & follow through on the check points. Good going!

[AniManiac]

Ditto on the "wow!" You got things in order pretty quick - way to go!

[Irreplaceable]

Originally Posted by sillyfab

So here's my situation.

I just started a job in August, and my health coverage will be available on December 1.

My boss caught me bawling outside on break this morning, and we had a discussion about my recent anxiety, stress, and depressed mood. She sent me home at 9:30 this morning. I told her that I was off work tomorrow, that I should tough out today, and then call for an appointment with the doc. She says, "No, your health is far more important. We'll make it being short one day. Try to get an emergency appointment with your doctor today or tomorrow."

So while I'm depressed, it's not as severe as it has been over the past few days. Yes, I cried for no reason at work this morning - so what?

So the discussion I'm having with my partner is this: do I make an appointment ASAP with my PCP and eat the cost? Or do I wait till the insurance kicks in? And if I make an appointment, do I go to my PCP and let him recommend a pdoc, or do I find a pdoc myself?

First, your health is important....I have found that, when I downplay/ignore how I'm feeling and keep pushing myself to keep going and get things done and putting off important doctors appointments for whatever reason (normally aren't for good reasons because my health should come first ALWAYS), in the end, this always leads me to "crash" or have meltdowns...The moment I ignore warning signs, is when things go bad...Every. Single. Time. So my answer to you would be, think about your health first....Then evaluate your expenses...Will you going to the doctor and having to pay out of pocket costs, would that leave you without money for day to day necessities?...Fore example, rent/mortgage $, gas $, food $, $ for utilities...If you think that you may be ok until your health coverage kicks in, then maybe you can wait....It all depends on your finances and how you feel...But then again, with this illness, you may be ok today but tomorrow feel horrible and you may not have a choice but to go to the doctor and eat the cost....My first response would be, even after I evaluate my expenses, if I feel like I'm headed to a bad place or could, maybe I should see someone now....But like I said, you're ok today, but who is to say how you will feel tomorrow? Or the next day....Or the next week....Research to see if there are any clinics or resources available to you in your area that would get you the health care that you need while you wait for your insurance to kick in....

As far as what you should do about a doctor, I always like getting referrals...It's better to get a referral from someone...From reading the comments on here, it seems like there are alot (and maybe i'm exaggerating) of people who go through more than one doctor trying to find the right one for them...It doesn't hurt to ask your doctor for a referral...You have to start somewhere....

[sillyfab]

Originally Posted by roadrunnerbeepbeep

Wow, sillyfab, look at all you got accomplished! I am truly impressed.

Just stick with this plan & follow through on the check points. Good going!

Originally Posted by AniManiac

Ditto on the "wow!" You got things in order pretty quick - way to go!

Well, I don't *think* I would ever try to harm myself, but because I grew up knowing about some family members' mental illnesses, I've seen how it changes the way a person reacts to his/her thoughts. Plus, when you really get down to it, the best time to get help is at the first sign of the illness getting worse. I am so not ashamed to ask for help! LOL I guess growing up around mental illness and knowing about it sort of clues you in on recognizing things. But, I'm in nursing school, too, and that helps - we're trained to recognize symptoms as early as possible.

I'm not gonna lie: I used to hear "suicidal thoughts" as a side effect of some drugs on t.v. and think, "What? People control their thoughts, not the other way round!" But I have to admit - until you've experienced INvoluntary thought, you just don't understand it.

Plus, it helps a lot when you have a PCP who really pays attention to what YOU think about your health. I said to him, "I know, I was bad - I stopped the Zoloft myself." And he said, "I would never be mad at a patient for making changes s/he felt were necessary," or something like that.

I do feel a little better today, but I'm not sure it's what I'd call "baseline." I still feel down somewhat, but it's only day 2 of meds. It needs time to hit my system really good and take therapeutic effect.

Thanks for the encouragement everyone!

Originally Posted by sillyfab

...But I have to admit - until you've experienced INvoluntary thought, you just don't understand it.

Plus, it helps a lot when you have a PCP who really pays attention to what YOU think about your health. I said to him, "I know, I was bad - I stopped the Zoloft myself." And he said, "I would never be mad at a patient for making changes s/he felt were necessary," or something like that...

I'm glad you recognize the change in thought patterns that come along with this -- good for you! The only thing I'd say is that it is easier to recognize in someone else, so something to be aware of (which I suspect you are). Like so many, I can sooo see it in others, but when it is happening to me, it is perfectly logical, no matter how whacked it is. Guess that's another caution. My psych is pretty ok with my making adjustments too, but with the understanding that I'm not the only one watching myself, because, when it is "logical" to me, I sometimes have very bad reasons for adjusting them. Guess those are connected, lol!

Good point about people not being able to understand INvoluntary thought until one has personally experienced it. That's probably why so many well-meaning people are perplexed and can't believe that it's not within our control. Sure, we can try methods to detour them, but it doesn't keep them from coming.

Irreplaceable is right in saying to be sure to put your health at number one. And I don't say this from a perspective of anything approaching financial comfort. When I moved, one of the first things I did was work on getting a psych, because I knew that w/o that, everything else would be for naught. No job, no insurance, small savings. Didn't matter, because I knew that without psych and meds, I'd never make it, let alone be able to face the challenges of the other stuff.

As far as the recommendation question. You say you are confident in your PCP, so yeah, ask for a rec. I always get hinky about PCPs handling psych meds, because I had a very bad experience. Mine was comfortable with ADs too. Except it turned out she was in way over her head, couldn't (wouldn't?) recognize it, and I didn't know any better for a long time. It was hell.

"Plus, when you really get down to it, the best time to get help is at the first sign of the illness getting worse."
(Sorry to have missed putting this as part of the quote capture.) You couldn't be more right. Let us know how it goes, ok?