Soooooo, about my psychiatrist visit....Please read :-)

So, I decided to share my experience at the doctor's (psychiatrist's) office...Which, might I add is my second ever psychiatrist appointment, even though I needed this before now....So, read my experience and I also have a couple of questions for you all...Which I will get to later in the post....And please forgive me if I offend anyone with my language...Online, I speak as I do in real life...Which, at times means I have a potty mouth...I'm not proud, but it is what it is....And I apologize in advance if this is a little on the long side...Moving along....

So, I worked half the work day yesterday, left work early, ran a couple of errands, and left myself plenty of time to find this office building because it is my first time going there...And I know if I get lost, this will most likely result in an "episode"....I get to the doctor's office, sign in, do the usual new patient paperwork....I immediately notice that the secretary is, well, has a bit of an attitude but it's whatever...She proceeds to tell me that I have a co-insurance that i have to pay before I see the doctor....I immediately feel myself starting to slip into a possible episode....I know the on coming feeling all too well....I ask her to repeat herself, then I tell her she has to be wrong because I called my insurance company yesterday to specifically see if I had to pay anything up front and they told me "no"...She stands her ground, no backing down...I proceed to call my insurance company, the lady runs down my coverage, tells me that they shouldn't be charging me anything up front...I have the good plan...You know, the kind where my insurance company covers all basic doctors visits and only charges me 10% of anything beyond basic care....So, I give the phone to the secretary, she leaves the desk, those two converse, then she returns to her desk, again, with an attitude saying I don't have to pay anything....That's right sweetie....I'm employed....I work....I have good insurance, I'm not trying to hear it....With that attitude of hers, she won't last long in an office like that...Cause I can tell you right now, she woulda probably quit shortly after I ripped her a new one....I'm here to get help....There are other people like me who are here to get serious help...Keep the stank attitude cause you ain't helping anyone....I laughed to myself about how ironic it was that I was being triggered within the first 5 minutes of being in a psychiatrist's office of all places...And no I'm not exaggerating....I can read people's body language and tone of voice pretty well....And yes I will admit, that one of my main issues is with my rage...But more on that later.....

I go into a room with a nurse...She has sheets of paper with questions...Very nice lady....We talk... I answer the questions...She nods....Says something here and there....Says, "oh" and shakes her head here and there...I'm looking at the sheet noticing all the notes and arrows pointing this way and that way....

I go back into the waiting room...Wait for the psychiatrist to call me into the office...Very nice guy...He introduces himself....Says he's been doing this for 25 plus years...He's good at what he does...Yadda yadda yadda....With the sheets of paper in hand, and within the first few minutes of me in his office, he tells me what my problems are and where it comes from....Dude is good....Or so I think from the first meeting...Bam bam bam...You got this, that, you got it from here...Pow Pow Pow..I mean, dude is shooting off here and there...I'm nodding...He can tell I'm a little on the suspicious side...So he says, "I know.I've only known you for ten minutes and I couldn't possibly know you this well." I smile and don't answer him....I look away..."But, I can help you."...I believe a lot of the things he has told me....But there are some things that threw me off...That totally surprised me....That I didn't believe at first...But after thinking it over, maybe he's right...And I forgot to get my diagnoses....But from the medication that he prescribed and what it is used for, I have a pretty strong inclination of what the diagnosis is or could be...

Effexor is what was prescribed...Well, it's actually the generic brand...And you know I did my research when I got home....This medication is used to treat major depression, anxiety, social anxiety and even bipolar disorder...So, although he didn't give me a diagnoses i'm pretty sure of what my diagnosis is...

From what I've found, there are terrible withdrawal symptoms if you go off of the medication...Even when your doctor tries to taper the medication, you could still have horrible withdrawal effects...There are also bad side effects....After reading the description of this drug, I'm scared to take it...In fact, I don't think I will take it....Where I'm at today, I don't know if I will be able to take any medication because the side effects for these drugs seem so great...It's scaring me off...Before my meeting, I was all for taking medication if it meant my life would be easier and things would get better....But now? I'm not so sure...So with all of that said, has anyone had any experience with this drug? What has your experience been like? Would you suggest it to someone else?

Aside from that, what he told me in our session really got my brain going...And this is the part where I looked at him like I was saying, "********"...LOL...He said that my depression comes from low self esteem...And low self esteem comes from genetics...And the low self esteem comes from one of my parents, most likely my mother (because of the things we discussed)...He said that low self esteem mainly is associated with genetics...And I asked, "So you're telling me the rape had nothing to do with the low self esteem?"....His reply was that the rape caused the low self esteem to be greater/worser...I can't remember his exact words but that was the gist..And then I said, "Even if I think I am fly and the best thing walking ( which I do...LOL), you're telling me I have low self esteem?"...His reply was you can think you are beautiful and have low self esteem but the key is low self esteem comes more from your feelings of self worth...He said something along those lines...After he said that, it makes sense...I will admit, some of the choices I've made in the past is a direct reflection of self worth...For example, the type of men that I've let in my life...I'm getting better, but not there yet...And I asked him since this is genetic, will by daughter be blessed (I'm being sarcastic) with this condition....As I expected, he says it depends...Depends on her father...Those two are like two peas in a pot or whatever the saying is....They are both very happy people....Exzibit no signs at all of depression...She is just a joyous happy child (she's 6)...My dad has even said, "I don't know what it is about _____ and ____(our dog)being here (at home with us)but they are always so happy"...And of course that comment made me feel good...Thank God I'm not f******* up her life like I feared I would....After re reading that last sentence and I said to myself, "There goes that low self worth again"....Lol...It's not funny...I know...

I must add this...For the last, almost year, I've been on a mission...I've researched researched researched...I've goggled, read articles, watched seminars, heard testimonies....I've really done my research and learned as much as I could about depression, anxiety, bipolar and BPD...Trying to learn how my brain is working...What is going on with me....Aside from that, I've been lurking/just reading some of the comments on here for at least a month or so before I even joined the site...And I must say, you all have really opened my eyes...And I can relate to you all on so many levels...There are words that you all have wrote, that seemed like they were taken from a page in my diary...I never EVER thought there were so many people out there...Like me! I can't believe it...When I feel like the alien in the room with three heads, and then come here and feel so....I can't even describe it....Another post on that for another day....

So what do you guys think? About the meds and everything discussed in our session?

Hey Irreplacable,

I am unsure about your meds etc I am on Depakote and Serequol for Bipolar....

I just wanted to say hi and welcome to the forum

Hey Irreplaceable,

I can't really answer to the other stuff, but I can tell about my own experiences with medication.

When I first realized that I was "sick" and had a mental health issue about 7 years ago, I was very resistant to the idea of going on meds. Like you, I was scared to death about side effects. Especially sexual side effects, which just about every single medication out there seems to cause. I had just gotten separated, and yeah, I wasn't going to have any of that. lol

Anyways, over time you will realize that not every medication reacts the same way to every patient. Some people get side effects, some people don't. Some side effects are far more common than others. And finally, some side effects are dose dependent.

Most medications have a "sweet spot", where you will get maximum benefit with minimum side effects. Those sweet spots can take a long time to find, but in the end it's worth it. For example, my sweet spot with Lithium is 450mg. That's a pretty low dose, but anything higher and my hands and legs start shaking pretty bad. I'm also on Topamax as a 3rd line bi-polar med, and to control my migraines. At 75mg it's just perfect, but if I go up to even 100mg, I get wicked bad headaches that last for days and days on end. Took a long time to get there.

Not knowing your own diagnosis is a bad thing. Next visit, you should definitely take a notebook and a pen and write down what the doctor says. It's really in your best interest as a mental health patient to be educated and informed about your condition as well as possible treatment options.

I don't know if this site allows outside linking, but I use crazy meds for most/all of my med research. Here's what they have on Effexor (hopefully I don't get banned/warned for this). I share your concerns:

http://www.crazymeds.us/pmwiki/pmwik...ffexor.Effexor

Not taking your meds isn't likely to score you any points with your psychiatrist, but since you are just beginning treatment and you haven't started taking it yet I think you are within your rights to ask him why he selected this medication and to ask him if there are any alternatives.

When is you next followup scheduled for?

Thanks for responding ....And a couple of things I forgot to add:

My first psychiatrist appointment, which was earlier this year with another dr, I was diagnosed with PTSD....Which I basically already knew, judging from my past history...At that point I was prescribed Fluoxetine...Which, basically had no effect on me whatsoever....I identify more with Bipolar....Although I realize I also have PTSD as well as anxiety (social and general)...Alot of what people are saying on here, in this forum, and just in general from what I've found, I have alot of the Bipolar symptoms that they have....Just wanted to add that since I posted in this section of the board...

My next appointment is scheduled for next Tuesday...And I think at that point, if I haven't started the meds he prescribed, I will ask him more questions about the medication....

Odoyle, you're right...Everyone has different side effects...Which is why I'm not completely turned off at the idea of meds...I think it's the fact that meds for mental health scares me a little more than meds for any other condition..Don't ask me why, I really don't know...

Again, thank you all for reading and for responding....
Thanks again!

Welcome to PC!

I had no problems going on or off Effexor when I took it. Out of all the psych meds I've taken, only one (Prozac) caused any serious side effects. All the other side effects have been trivial compared to the benefit that I got from taking meds. So it might be worth a try - but you certainly have the right to ask the doc for more details if you didn't get enough explanation during your first visit.

You should ask the doc about your diagnosis on your next visit - and you can ask what symptoms make him think those are the issues you're facing. It might help you better understand the whole process and what comes next in your treatment. And that's another thing you could ask about - what are the next steps for you?

As a heads-up, Effexor alone would be a standard treatment for depression. Most of the time, pdocs will start bipolars on a mood stabilizer, and then add an antidepressant (unless you're already on one that doesn't make you manic...) because a lot of bipolars get manic on antidepressants alone. So don't be too surprised if the doc tells you that the diagnosis is depression and not bipolar disorder - and if you really feel that there are hypo/manic elements to your problems, you should definitely let him know about it. Don't get too carried away with diagnosing yourself - of course, we all do it, but the intricacies of psych diagnosis are nontrivial and best left to professionals!

I have taken Effexor in the past and it worked very well for me and I don't recall having side effects. I went off it cold turkey and felt bad for a couple of days and that was it.

On another note, I notice that many people on bipolar communities talk about going to a psychiatrist, getting a prescription and then not filling it. Why bother going to a psychiatrist if you aren't going to take the medicine? Most psychiatrists don't do therapy, they prescribe medications.

Hi, Irreplacable! Welcome! Yep, you'll find some other "aliens with three heads" in here, too!

I agree with you. That receptionist/secretary didn't know her stuff and certainly wasn't a helpful person. I've had experiences with these types in psychiatrists' office, too. Sad to say, I sometimes think that some of them just think of us as "crazies" who never know what we're talking about. I'm glad she got her come-uppance (sp?) anyway.

I haven't personally taken Effexor, but I've taken its first cousin, Pristiq. My sister has been taking Effexor for years and has had to be taken off of it cold turkey several times in order to get various serious medical procedures done. She did have withdrawal effects, but she's still here and doing well. If you are indeed feeling depressed, then I'd definitely try it. All drugs have potential side effects, some very minimum. I'd definitely start taking it before you see the pdoc again. It sometimes takes a while to see if a drug is the right one for a given person.

I know nothing other than what you said about your history, so I can't say much about what the pdoc told you. I've not heard that low self-esteem is "inherited." I do know there's a genetic component to basic personality, though.

I'm wondering if you are also seeing a therapist......These folks are the ones trained in really helping people figure themselves out. If you have PTSD, for instance, they can help with that.

Definitely get your official "diagnosis" when you go in next time, and then go from there!

Note: I'm the person who does the "shrink joke" thread in "social chat," so you might notice that I think lots of shrinks are a bit "off" themselves!

I wondered at this too. Have to wonder if he meant it not so much as "genetically" per se as that the way people are raised often goes generation to generation. A repeated pattern kind of thing. (???)
Anyway! Welcome to the forums, Irreplaceable!

Thank you everyone....***SIGHS*** I feel better now about the medication...And, I am beginning to get a bit excited about the positive affects it will have for me....If not this medication, then perhaps another...My psychiatrist states that he will discuss the diagnosis with me on the next appointment....There were questions I didn't think to ask during the session...At the time, I was just focusing on what he was saying...I'm a thinker...I take things in, then I take time to digest it and get my thoughts together....He was saying so much that I felt like I was in a whirlwind...Things are becomer a littler clearer now, and I'll write down the questions that I have so nothing will be forgotten...

I will keep you updated..This information may be useful to someone out there in cyber world...

Thanks for all the "welcomes"....I'm glad I found this site....Again, thanks for the responses....I don't have a PC at home so I couldn't wait to get to work to see what you all I had to say...Lol...

Irreplaceable ..

Welcome to PC .. I hope you can find all the support here to help you cope ... I know its been a huge help to me..

Wishing you Peace and Love ~

I'm a pretty laid back guy but if a secretary copped an attitude with me like that I'd have to tell her how it was :P At least I'd want to...

I'm really glad you are feeling better by posting on these forums... I know it is helping me somewhat too just knowing there are others out there with similiar issues as me and some of them worse. My heart really does go out to you and others that have to deal with such depression. I'm holding fast on my own depression and trying to deal as best I can.

I'm probably going to talk with my doctor next week (my xanax is running low lol) and seeing about setting up an appointment with a counselor/psychologist/psychiatrist.

I wish you the best of luck and take care

I want to touch on what Payne & Innerzone did re: this genetic basis for low self-esteem. This is not a mainline belief in psychiatry. You know, of course, that all psychiatrists aren't created equal--& some are better matches for a patient than another.

If you ever feel that this doc's 10-minute analysis might not be adequate, think about requesting a change. With good insurance, that ought not to be a problem. You didn't label any of your experience a Red Flag, but you seemed uneasy about more than the receptionist.

I was on Effexor for about 6 months it actually did absolutely nothing, but i did not have a hard time going on or coming off it. Like you, i have extreme anxiety about taking medications, especially because i sit there and read the med fact sheet that lists all the side effects etc. I brought it up with my PDOC and he said basically, if people read the same drug fact sheet for asprin or tylenol they would not take it either, because they have to list EVERY side effect that even just 1% of people May experience so when you read it you start to think the drug will just kill you. Anyways i finally after this little talk started a new medication about 3 months ago and it's like a miracle, no side effects, I'm actually happy and functioning, no depression (even though it's winter) and I never would have found the right medication...if i wasn't willing to try right?

Welcome to PC