First appt with pdoc.....

I had my first appt with a pdoc, as recommended by my headache specialst and again most recently by my T - who actually picked up the phone and called the pdoc while I was in T's office because he was so concerned about how low I was feeling with this depression.

It was a difficult appt. The pdoc was very kind and open. I felt comfortable, but still had a mask on. It's hard opening up in an emotional way during a first visit.

He asked me a ton of questions...and some of them were extremely personal, which I guess was expected. He asked if I had been physically or sexually abused...and then wanted details. Wow. I was so uncomfortable...and was only able to explain it in a non-emotional way, just matter-of-factly. It was the only way I could get through it.

He said a few things that were interesting.

One was that it seems that my history of abuse has just changed forms over the years and that my subconscious seems to seek this out - like I am reliving childhood trauma in different ways. And that I am trying to find a release for my inner child to heal. He pointed out the pattern of physical abuse from my parents....to multiple CSA....to being in an abusive marriage....to having an abusive boss....even making group T a somewhat abusive place for me. Interesting.

He also said that what he feels I need to do is get naked. I was soooo uncomfortable with that part of the discussion. He said that it starts with the person....getting comfortable with my own body. Getting to know my body and accepting it for what it is. I told him that I never even got naked in front of my own husband for nearly 15 years. He said he could tell because of how uncomfortable I was in talking about sex and that I disclosed that I do not like to be touched.

He also said that getting naked in therapy and group T, not physically, but just letting it all go - accepting me and freeing myself - is important, regardless of the reactions from others.

Wow. Tough stuff. I can't imagine either of those things happening...and I have no idea how I can get to a place where those things would happen for me. It just feels impossible.

He then decided to increase my dosage of Lexapro....from 10 mg. to 20 mg....and then depending on how I feel in a couple weeks, increasing it to 30 mg....then 40 mg....and then possibly adding a small dose of Lithium.

Anybody have any experience with Lithium? I was really surprised that he recommended that.

He said that he's not suggesting that I'm bipolar at the moment, but that it's possible. I don't see how that is, because I don't have manic episodes.

All in all, it went well, I guess. I need to call him in 2 weeks to let him know how I'm feeling after being on the 20 mg. Lexapro...and we'll go from there.

Sounds like a very caring pdoc. Most won't get into that much depth unless they do therapy.

I have taken lithium in the past. It is sometimes prescribed for depression and is the only medication that has been shown to have a positive effect on suicidal ideation. It is a good med. You'll have blood tests to check lithium levels. Blood levels need to be in a therapeudic range; that's how they decide what dose you need. You'll be thirsty -- a lot. Just drink water and go to the bathroom a million times a day. The only really bothersome side effect I had was hand tremors that were pretty noticeable, but the lithium worked so I lived with the tremors.

Thanks, Chris.....

My T speaks very highly of this pdoc. His approach is not just clinical and is very much therapeutic.

He is only going to be practicing here until August, so I don't want to get too attached on a therapy level...I do want to learn about his views. He seems very hands-on, to get to the meat of the issues. My T pretty much lets me lead the way which doesn't help me get to the tough stuff because I tend to avoid it. *sigh* Perhaps I will address this with T, if I can build up the courage and energy.