[Nola0250]

So I’m newly diagnosed. Like 3 months ago. Struggling to get stable, dealing with lamictal side effects and weaning that down while ramping up Latuda that is working great. I go see my Tdoc and she says maybe in a year or so I can go off meds. What the...? I’ve had this all my life. I’ve done the reading. I need meds. I hate needing them, but I’ve comw to accept it. If I go off them and have a big episode, there goes my career and ability to support myself. I saw my Pdoc and as I thought, he said that was a very bad idea.

I thought my Tsoc was pretty smart. Now I’m not so sure. Feeling uncomfortable about her.

[bizi]

I am sorry that she got involved with medication. She needs to mind her own business. YOur pdoc deals with your meds. I say find a new T.
bizi

I agree with bizi. Find someone new.

Unless she's undergone rigorous medical training, has a license to do medication management, and has your permission to manage your medications, then what she did was wrong and she violated her license agreement.

My therapist always says she wants me to continue to take my medications (since I'm non compliant), but she never gives medical advice like "in a year or so you can go off your meds." The first is a genuine concern, while the latter is medical advice.

[Nola0250]

Thanks. She wasn’t giving me instruction but sounded like she was giving me something to look forward to. But I was t complaining about them, I was talking about how much better I felt after starting Latuda and decreasing the lamictal a bit. I get she might was something like that to wean me along if I was ambivalent about taking them. Like, “let’s try it for a year and then maybe...”

Anyway, I brought my brother to the apt. He is very supportive and I thought would be helpful to give her some more family background. But now I’m afraid he won’t understand or take my disorder seriously. Or think I’m “weak” when it turns out I can’t come off meds. That’s really what’s bothering me.

[amicus_curiae]

My old therapist was so very out of touch with any sort of psychopharmacology that he’d not dare to make such a bold statement. He left the medications to my new pdoc.

(I saw my new pdoc yesterday — I’ll be seeing her weekly until a therapist is freed up. I like her quite a bit. When I told her that I had serious issues with CBT, she said, “Me, too... I’m more of a Freudian.” She won me over with that. And she’s so young. Everyone is younger than me, these days.)

I’m not sure that you should give up on your tdoc — just let her know that your pdoc isn’t so certain about her excitement just now. Just as I become happy with my meds, someone always wants to be the White Knight who rescues me from chlorpromazine or some other psychotropic med(s).

And you get off of your meds and feel like hell. I thought that I was doing a good thing by going cold turkey, e.g., off opiates. I went through immediate withdrawal and I hurt so much that I’m having trouble using my hands. I had nine pain DXs and the pain came back with a vengeance. But all of my docs are so very proud of me! I wish that they could feel what I feel. I don’t know what you experience but I have a genuine need for antipsychotics and other depressants. I don’t know why some docs (PhD not MD) act so tickled about ending, instead of setting a Maintenence goal, psychotropic meds!

***she’s gone electric***

[AspiringAuthor]

She might be the militant type. I think she is dangerous at this juncture. You have not invested much in the relationship anyway - find somebody else, possibly using pdoc's recommendations. And have the new tdoc talk to the pdoc.

A) She might just trying to be hopeful and positive being your new to recovery.

B) She is delusional as to how good she is as a therapist.

C) She has in her possession a magic wand that fixes people.

D) She knows better than any learned licensed professional.

E) She’s lying.

Fire her....any ounce of credibility was revoked after a statement like that.

I'd rather not be too drugged up. Bipolar is an episodic illness, the meds are mostly for prevention, so the dose usually has to be increased over time. since the body will only build a tolerance. My personal preference of course. I do not like how most meds make me feel, I can manage my bipolar on my own.

[Rose76]

I haven't been to a therapist in a good few years, but I did go to several over long periods of time in the past. It is sounding to me like they have changed in recent years - from what I read on PC.

It used to be that therapists focused on sorting through concrete problems. I guess the insurance companies encouraged therapists to come up with diagnoses, even requiring that in order to pay them. So therapists seem to have gotten into the habit of trying to be amateur psychiatrists. They seem to love to go around "diagnosing" their clients - which they are not truly competent to do. (It takes more than just checking off lists of criteria.) And many seem to love suggesting various drugs. And some seem to love talking about whether you should even be on drugs - as is the case with your therapist. None of this is what constitutes actual therapy. Therapists should "stay in their lane."

You're only in the therapist's office for about 50 minutes, maybe once a week. That is precious time and too little to waste talking about whether the doctor has done his job correctly. Actually, the therapist almost doesn't even need to know what your diagnosis is or what meds you're taking. The therapist needs to find out what problems you are having in living your life. Then the therapist should be helping you come up with approaches to solve or at least better manage those problems.

Getting off meds is not a proper goal of therapy. Living a more satisfying life is. Concentrating on the latter should pretty much consume the time you spend sitting with the therapist.

[Nola0250]

Originally Posted by AspiringAuthor

She might be the militant type. I think she is dangerous at this juncture. You have not invested much in the relationship anyway - find somebody else, possibly using pdoc's recommendations. And have the new tdoc talk to the pdoc.

I actually have been seeing her longer, almost a year. She’s the one who pegged me as BP and got me to a psychiatrist late last December. She also recommended all the books I read on the subject. So it seems really weird that she would say this, particularly right now. Maybe she was having a bad day. I’m going to talk to her about it this week and tell her what I think of that idea. Then we’ll see I guess. I would hate to have to start over with someone who doesn’t know me. She at least has seen the many shades of me, and I would hav a hard time explaining in words who I am. Probably would take another year! And who knows, the next one might say something worse

I think therapists that say such things are ignorant, dangerous, and stepping way beyond their place in the mental health treatment realm. What they should be saying is that they will do their best to help you find stability by teaching you the skills and methods to help you do so, and be an important support in the process along the way. If that leads to medication reductions, fine, but all medication decisions are up to your psychiatrist. Frankly, it sounds like your therapist is assuming they can meet certain goals that are not possible or counting chickens before they're hatched. A pdoc that would say such a thing would seem excessively confident, too. Imagine someone saying "I will cure you in one year!" Such a person would seem like a charlatan to me.

I had a therapist who thought he could recommend medications. That wouldn't be that bad, but it was in the aggressive way that he did it. I had to quit him.

[cool09]

That was a bold statement from your T doc. At least you know you're not treatment resistant to medication. Do you have anxiety on latuda?

[Rose76]

Tdoc? I haven't seen that abbreviation before. Here at PsychCentral, the customary abbreviation for "therapist' is simply "T." By throwing "doc" in there, one contributes to the confusion over the difference between psychiatrist and therapist.

[Victoria'smom]

This T would be dangerous for me. I's just tell her we'll see in a year.

[*Laurie*]

I believe it's fine if you and your T discuss how you feel about being on meds. I do not think it's acceptable when a therapist gives a client advice about medical treatment. That responsibility remains with you pdoc.

[bizi]

I refer to my therapist as TDOC because she is a doctor. She has her doctorate in nursing, a nurse practitioner... Then there are psychologists who are therapists. I post over at neurotalk and we use Tdoc all of the time over there. But every forum is different. And I use T here because that is understood here.
bizi

[emgreen]

OK...I'm piling on. I once told my pdoc that my T suggested I change medications & he went through the roof! He asked how many pharmacology classes she had taken (0). I think that kind of approach really ticks off pdocs.

[Nola0250]

Originally Posted by cool09

That was a bold statement from your T doc. At least you know you're not treatment resistant to medication. Do you have anxiety on latuda?

I don’t, but I’m only on 40mg so far, 3.5 wks in. It is definitely improving things so far.

Lamictal gave me word finding difficulty land loss of balance, weaning it down as Latuda goes up

[Sometimes psychotic]

Originally Posted by Nola0250

So I’m newly diagnosed. Like 3 months ago. Struggling to get stable, dealing with lamictal side effects and weaning that down while ramping up Latuda that is working great. I go see my Tdoc and she says maybe in a year or so I can go off meds. What the...? I’ve had this all my life. I’ve done the reading. I need meds. I hate needing them, but I’ve comw to accept it. If I go off them and have a big episode, there goes my career and ability to support myself. I saw my Pdoc and as I thought, he said that was a very bad idea.

I thought my Tsoc was pretty smart. Now I’m not so sure. Feeling uncomfortable about her.

I have bp1 with psychosis my pdoc told me I could go off my meds after 6 months with no symptoms....now what’s different was they had no idea I had bipolar....they thought it just might be a psychotic break alone. Anyway I went off the meds and was fine for nine months then relapsed. Then they figured I was bipolar, now it’s meds for life. I’ve never heard of tapering off meds if you have a bipolar Dx but she might be confused as to medicine because there are occasions where you can go off as above. I’d just ignore any medicinal advice from a T....thy mean well but aren’t qualified.

[Wonderfalls]

I think changing therapists is a little drastic considering it was one statement and op said he had been with her for some time. I would have just said, "That's not what my psychiatrist thinks.". and see if that ended the discussion. Any more and then "I let my psychiatrist handle all my medications." If that didn't end it for good then that's another story.

[salsharia]

Originally Posted by Nola0250

I actually have been seeing her longer, almost a year. She’s the one who pegged me as BP and got me to a psychiatrist late last December. She also recommended all the books I read on the subject. So it seems really weird that she would say this, particularly right now. Maybe she was having a bad day. I’m going to talk to her about it this week and tell her what I think of that idea. Then we’ll see I guess. I would hate to have to start over with someone who doesn’t know me. She at least has seen the many shades of me, and I would hav a hard time explaining in words who I am. Probably would take another year! And who knows, the next one might say something worse

I agree that speaking with her is best. I think it would be good to ask her the question we are all speculating on here -why did she recommend that you go off meds? Then tell her how that made you feel. At that point you will have more to go off of and if you don’t feel she is supportive in the way you need her to be, it’s totally ok to part ways and even to be honest about it with her and your reasoning why.

Yeah...that’s like telling this train to derail...yeah no.

[AspiringAuthor]

Originally Posted by Rose76

I haven't been to a therapist in a good few years, but I did go to several over long periods of time in the past. It is sounding to me like they have changed in recent years - from what I read on PC.

It used to be that therapists focused on sorting through concrete problems. I guess the insurance companies encouraged therapists to come up with diagnoses, even requiring that in order to pay them. So therapists seem to have gotten into the habit of trying to be amateur psychiatrists. They seem to love to go around "diagnosing" their clients - which they are not truly competent to do. (It takes more than just checking off lists of criteria.) And many seem to love suggesting various drugs. And some seem to love talking about whether you should even be on drugs - as is the case with your therapist. None of this is what constitutes actual therapy. Therapists should "stay in their lane."

You're only in the therapist's office for about 50 minutes, maybe once a week. That is precious time and too little to waste talking about whether the doctor has done his job correctly. Actually, the therapist almost doesn't even need to know what your diagnosis is or what meds you're taking. The therapist needs to find out what problems you are having in living your life. Then the therapist should be helping you come up with approaches to solve or at least better manage those problems.

Getting off meds is not a proper goal of therapy. Living a more satisfying life is. Concentrating on the latter should pretty much consume the time you spend sitting with the therapist.

I almost died because the therapist did not know what meds I was taking and did not spot that I was in suicidal depression due to Risperdal - depression so deep that I lacked the cognitive ability to see that I was depressed as opposed to suffering from bad circumstances.

Considering that you spend 50 mins a week with the T doc and only 30 mins a month with the P doc (it was my case), the T should know what meds you are taking and should help determine if they are a good fit.

I do not take that risk any more and now go to an MD/PsyD who does both therapy and meds, so this problem does not exist for my anymore, and he is so good that I wish I had started with him earlier.

***

Totally agree with what the goal is, though. Not going off meds - living a good life.

[AspiringAuthor]

Originally Posted by Nola0250

I actually have been seeing her longer, almost a year. She’s the one who pegged me as BP and got me to a psychiatrist late last December. She also recommended all the books I read on the subject. So it seems really weird that she would say this, particularly right now. Maybe she was having a bad day. I’m going to talk to her about it this week and tell her what I think of that idea. Then we’ll see I guess. I would hate to have to start over with someone who doesn’t know me. She at least has seen the many shades of me, and I would hav a hard time explaining in words who I am. Probably would take another year! And who knows, the next one might say something worse

True. then I think take the advice above about speaking to her, asking questions, and telling how she made you feel.

Also, one way to conceptualize it is that our brains are different and the meds correct the disordered part to make as function more the way neurotypical people do. So it is not that every brain is the same and you are personally weak for needing the meds - no, the brains are different and you need the meds to, sort of, level off the playing field with others.

Also tell her that you are confused, since OTOH she recommend you see a psychiatrist but OTOH said what she said.

[wiretwister]

my last t ( and former ) stated I was on too high a doses on my meds ...I asked my pdoc about this and he called her ( would loved to have heard that conversation ) ... maybe you will be ready to cut back in a year ... maybe not ... maybe she was giving you a goal to work too .... I don't know ... but for me ( I have always had bad results going off meds .... no matter how slow I taper ) ... hope you stay well ..