[cashart10]

Brief history. I saw my psychiatrist about 16 years ago for 4 years. Then I thought I was cured and stopped seeing a pdoc altogether. When my symptoms returned almost 3 years ago, I went back to him. When I got pregnant with my third child I was uncertain about some of his decisions (even though I liked and respected him a lot) so I sought a second opinion. The pdoc I saw then was AMAZING! I don't think I can ever replace her, ever. I adore her for her professionalism, openness, thoroughness, I could go on and on. But, she relocated to a practice over an hour away. So, I went back to my previous pdoc who I have had a longstanding relationship with and who I also trust. Today was my second appt back with him and I came in depressed and suicidal. We agreed last time that we would work on lowering the dosages and amounts of my medications. We started by lowering my lithium from 1800 mg to 1350 mg. And today, he told me that decrease was not creating the depression and that it would stay but given the circumstances, he would not decrease or lower anything else this time. Then he told me he wanted to add an antidepressant. This is something that I have read should not be prescribed to a bipolar patient (especially one who has previously, when I was young, had a manic reaction). Also, the pdoc I was describing earlier, the one I adore, never even mentioned it even though I was so depressed I was admitted into the hospital. I am eager to take it but I am also concerned with what will happen. Do I trust him and take it? Also, when he asked me if I had thoughts about hurting myself and I said yes, he asked me questions as to be expected. I have discussed this with him many times in the past but this time it was so awkward and uncomfortable that I actually laughed while discussing my thoughts of suicide. With the other pdoc, I was a motor mouth and would tell every pertinent (and often impertinent) thought in my mind. Will I just get used to him again (again, I have respected and trusted him for many years) and accept that my old pdoc will never be replaced? They are SO different. What do I do?

PS: Sorry this is so long!

[Wander]

I am sorry you are feeling so bad. Without a mood stabilizer AD's are certainly a no-no for us Bipolars as they trigger mania but with mood stabilizers such as Lithium and Lamictal the AD may not have such an extreme effect. This has been my experience. The Pristiq I am on helped lift me out of a depression but I did go a bit hypomanic so my pdoc recommended I decrease the dose if I got worse. I am now in a mild mixed state so I am considering lowering the dose. Still I am not deeply depressed, just dark and hypomanic. I am holding off as I am afraid of the depression returning in full force. It is a delicate balancing act. The AD's do lift moods but can lift it too high. As I am a rapid cycler I also have trouble keeping up with the mood changes and knowing what to do med wise when they happen. Hope this helps a little. Take care

[Love&Toil]

Thinking of you and hoping the best for you. Give yourself some time to reacquaint yourself with your pdoc. You have a good history together... it takes time to re-establish rapport. There are benefits you can get from both pdocs, different but benefits nonetheless.

[Justugh]

pills are like any other drug buddy system saves lives and police records

if u are not feeling right/good/can deal/cooping well......then try what the doctor offers u

tell a few close friends ppl u have known for years they are your out side ppl if something is off u do not see they will and can tell yah if u ask them too .....i call it slap cross back of the head agreement it goes both ways when friends so just info them and ask to keep a eye out

[Tucson]

My doctor started me with Fluoxetine alone, continued to increase the dose to 60 mg, and did not use a mood stabilizer only until recently which is years later. I asked him why he did it this way. He told me most with BP do not have this problem with ADs. So even though it is something to be concerned about, IMHO I do not think mania with ADs happen anywhere near as much as some people think it does.

FWIW

By the way, the previous post about the buddy system makes allot of sense to me.

[Victoria'smom]

Try the AD. I personally feel a doctor that doesn't treat the depression side is only treating half the problem.

[electricbipolargirl]

Originally Posted by Tucson

My doctor started me with Fluoxetine alone, continued to increase the dose to 60 mg, and did not use a mood stabilizer only until recently which is years later. I asked him why he did it this way. He told me most with BP do not have this problem with ADs. So even though it is something to be concerned about, IMHO I do not think mania with ADs happen anywhere near as much as some people think it does.

I agree. My pdoc also said that AD's do not cause mania in people with BP half as much as everyone thinks they do. I was on Paxil for 9 years when they only thought I had depression/anxiety. I never went manic. It was a stimulant (Adderall) that sent me over the moon and made it clear I had BP1. I guess everyone is different.

[cashart10]

Thank you all. That makes me feel better and I think I will try it.

[cashart10]

Also, I think I'm strangely obsessed with my old pdoc. Yesterday, I started to think she didn't really relocate she just didn't like me anymore and made up a story. So, this morning I cAlled to see if she had "left yet". When they said she had, I was worried that she had the office tell any patient that asked that question that she had left. I thought about going to her office. Her picture is still up on the office website. I know how bizarre that is. Plus we had a great relationship. I just miss her so much.

[Victoria'smom]

Can you travel an hour? A good Psychiatrist is worth the gas.

[cashart10]

I would love to travel to see her but there are a couple of reasons why I can't. First, when I am really unwell she likes to see me weekly. Since we have no money, I cannot justify spending so much on gas. Second, my husband and I have discussed it and he thinks it is ridiculous. He doesn't understand.

[Justugh]

called idolization

1 your doctor always played it on the lvl and strait with u why would that change

2 if your doctor was not relocating for her own life she would have kept u as she has invested years into treatment and most ppl want to see the end of it

3she would not have left u like she did unless she felt u had good grib on things this is just a slide back from the lost of a good close friend that helped alot in your life and fear of the new / unknown

4 everyone one has that fear no one likes leaving comfort area and going into the unknown ....so this is natural now u know the doc liked yah and did all she could before she had to fallow her happiness (can not blame her goal in life is to have a happy one ) .....now what u do after all this is what matters now

if u can write a simple email to the old doctor office and ask them for referrals/names to doctors they think would be good for u in your area (they have some network system they can access) .........if at all possible please foward the request to the old doctor for her opinion (this might be possible it might not but unless u ask never know )

other choice is to use your HMO site and surf there doctors in a zip code with a number of miles willing to drive to see rem it only one way miles

pdocs are like the rest of us some u will love others u will hate.

[Justugh]

tell your hubby this
my lady pdoc is like your fav bar/place to eat

comfortable knows what i will get and always been treated right

[~Christina]

I think you need to give the medication a try...You have been so unstable for so very very long now, You need to try things to get you back to some stability.

I hope this med is the one that will feel better

[wildflowerchild25]

I have gone mixed on celexa, but I am on Wellbutrin now and I am fine. So I think some ADs will induce mania but some will not, so it's worth a try, especially since you are on two mood stabilizers.

I wish you the best of luck, I know how awful it is to be stuck in a depression for so long.

[cashart10]

Thank you all. The celexa had a bad side effect of racing heart when mixed with my saphris. So, he changed my prescription to Zoloft. Any experience with Zoloft?

[Tucson]

Originally Posted by Miguel'smom

Can you travel an hour? A good Psychiatrist is worth the gas.

I agree with this. I find that at least 4 out of 5 are either marginally effective or simply ineffective. I find many pdocs do not know there medication as well as they should. And many do not know how to diagnose accurately. This is why the same person can get a different diagnosis from each different doctor. JMO

[Mimielam]

Hi, I think it is totally normal that you where very attached to the other PDOC and miss the therapeutical approach she had. I guess she did help you a lot and perhaps there's something about her that you miss. I often think of a therapist I had for many years. I really liked seeing her and almost hoped she was my friend because she was so supportive and somehow made me feel better. The therapy came to an end..I did tell her about this and she said it was normal that I had these thought and we talked about it and I went on with my life. I'm glad I had the courage to talk about it with her, because after I felt better and understood more about whey I really liked her but that she was doing her job and I was a patient. Anyways. I know the feeling. Perhaps you could talk about this with the PDOC you are with now, it may help. Good luck