[mrsdodge]

I'd like to share my situation and get some feedback on what you all think I should do. This will most likely be long so please, bear with me. Two weeks ago, I went to my family doctor about my mood swings and to talk about the possibilities of me having OCD. He reqested I see a psychologist so I did last Tuesday. She asked tons of questions about my history and so on. I went back last night and we talked some more. She reached a diagnosis. Since she can't write prescriptions, she wrote a letter for me to give to my family doctor. I faxed it to him today. I'll now
share her letter.

The above patient was seen initially on 11/28/06 and again 12/4/06. Her diagnosis was Bipolar Disorder, mixed, severe, w (the w was underlined) psychotic features. Her most significant symptoms are 1 rapid cognitive
processing-obsessive & paranoid ideations, poor concentrations, easily distracted, always thinking, racing thoughts. 2, Physical complaints are headaches,
back aches, bowel problems and feeling tired. Her appetite is an emotional eater. 4; sleep problems, takes up to 30 minutes to go to sleep, wakes up at least 2x a night
or more, dreams of dead people & tired in the am. 5, visual hallunications, flashes of a nightmare type of experience, a sense of a bad feeling; 6, mood swings. 7, paranoid
regarding work situations (my company is outsourcing to India). 8, quick temper always. 9, severe anxiety & irritability with moderate depression and anger. 10, compulsive
behaviors, counts/rituals. 11, strong family history, one cousin commited suicide, one attempted, drug addicts, alcoholics, bipolar disorder. maternal aunt and parents are very anxious, seems to have great enmished relationships
with mom. she was sexually abussed by bf in the past. her symptoms/history are very similar to others who have responded well to: Mood stabilizing drugs such as Lamictal 25 mg HS x14, 50mg x14 days, HS, 100mg hs x 14 days, 100mg BID & increase based on clinical response; and Resperidol .5mg 1 1/2 hr pre HS & repeat x1 if not asleep. Please call if any questions. She has agreed to come for weekly therapy.

She makes me out to be crazier than I feel. I faxed this info to my doctor today and then called later to make sure he got it. His words were, "this woman is crazy, I don't think you're fitting her description and would rather you see a psychirast (sp?)." He initially requested me see a psychologist because he didn't feel he was qualified
enough to treat my symptoms and I needed a mental health specialist. So who do I believe, someone who has only met me twice? Or do I believe a doctor who has treated me for nearly 20 years? She really upset me last night by telling me that I needed to distance myself from my Mom. My family means the world to me. To me, when you're needing support, you automatically turn to family. I'm just so freaking confused right now. I'm also not so comfortable with how blunt this woman is. She's just an older southern lady and doesn't choose her words very well. She speaks exactly how thoughts come to her. To me,
someone in her profession dealing with people with these symptoms, she needs to be a little more kind in her words.
I don't know who to believe. My husband is on the psychologists side simply because he doesn't agree with decisions my family doctor has made in the past. That incident wasnt entirely his fault. My obgyn diagnosed me with Poly Cystic Ovarian Syndrome 10 years ago and
gave me birth control pills to treat it. This past July, I had surgery to remove cancerous cells from my cervix due to the PCOS not being treated properly. So I really don't know what to do. My next appt. with the psychologist is a week from today. I'm on the verge of a bad panic attack. I took half a Xanax, which the family doctor gave me 2 weeks ago just to ease the anxiety. It doesn't seem to help, only makes me sleepy.

Any help that you all can give me will be soo very appreciated. Thank you.

[(JD)]

I would give the psychologist more time. She wrote something for your MD, to convince him of your need for meds and therapy perhaps? I'm not happy that there seems to be more than the MD can handle but he refuses to accept what another professional is saying. How did you get so far beyond the MD without his helping you before now?

Call the psychologist and chat for a minute or two about your anxiety and confusion over her letter to the MD (were you supposed to read it?) I think a good psychologist could put you at ease over this. Take your xanax at bedtime and get good sleep at least?

Good wishes.

I don't like it when they try to diagnose so quickly and sometimes it is hard to hear things like that. Also, that is just a point from where she is beginning, after one interview. If you decide to see her weekly, she will get to know you much better.

You could see a different psychologist for a second opinion and for a better personality match. I actually like that my psychologist is blunt. I can feel the 'thud' of it as it hits me sometimes, but I like the straightforwardness at the same time. I feel secure because I know she will say what she thinks needs to be said.

A psychiatrist will only write prescriptions. If you want to enjoy learning more through therapy you will need a psychologist/therapist.

What is it that you really want to do?

ECHOES

[Brookester]

Mrs. Dodge,

Frankly, I am not at all comfortable with a psychologist giving a medical diagnosis and discussing possible medication avenues. Psychologists in the United States do not have licenses to discuss and/or dispense medication. Just from that standpoint, I would not go back to this woman. She has interferred with your personal boundaries, i.e. stepped right over them and ethically could be in a hell of a lot of trouble with the psychologist's board in Kentucky--that is where you live, right?

Knowing what I do about psychologists, I would be very tempted to turn her into the State Board for flagrant misuse of her title as she does not have permission to be giving you a psychiatric diagnosis.

Cancel your appointment with her. She is a total source of anxiety.

Get another referral from your doctor. Remember, a lot of the people in the psychological arena are morons, but there are several who are very competent. Sometimes you must search high and low until you find one who meets your needs.

I once interviewed seven (7) different psychiatrists in Southern California before I chose which one to work with because there are so few that are truly good and care about their patients. It is a full time job finding a decent psychiatric care provider. Remember, this is your life, so find the best and then stick with them.

Many Blessings,

Brookester

[mrsdodge]

I still have mixed feelings about this. The MD sent me to her for therapy. She jumps the gun, making a diagnosis and suggesting he write scripts for these medications. That is what my md is concerned about. He doesn't have the training and knowledge to treat what he thought was just ocd. She did tell me that I could read the letter. I don't like how she comes off as being pushy. If I try telling her I'm not comfortable talking about distancing myself from my family, she says, well in time after you start taking these medicines, you'll feel more at ease with it. Give me a break. I'm not that crazy. I'm sane enough to know that I do not and will not distance myself from my family. It's like she's a control freak. She wants me to see things her way. She even admitted that in her younger years, she was treated for Bipolar. I'm thinking she still has it. lol.

Echos, to answer your question, I just want my life back. I want to be able to concentrate on one thing for longer than 30 seconds. I want to live without constantly being afraid something bad is going to happen. I want to be able to kiss my husband good-bye before work and not be afraid that'll be the last kiss. It's like my whole foundation has been rocked and I really am just sick and tired of it. I've always had trust issues. It's really hard for me to trust this lady whom I've only met 2 times. I do, however, feel like I can trust my MD who has known me for 20 years. I guess I do want some kind of medication to help me cope and get through this but I don't want my personality to change. I don't want to feel like a zombie.

Brookester, yes I do live in KY. I'm not very aware of the laws but will look into them today. I'm not even going to bother calling either one of them today because it just stresses me out soo much. She does make sense about some things but she just made me feel like I've totally lost my mind. After my post last night, I got soo frustrated and so confused, that I actually started having chest pains. I felt like I was going to pass out. In no way am I suicidal so don't take this that way.. but I just can't take this anymore. Something has to give. Brookester is right, she is a total source of anxiety. Sometimes it takes just hearing (well, reading) someone else say it. I'm more stressed after this last appointment than I have been in a very long time. She's not helping. I guess it's time to work on my husband and try to get him to understand how I feel about this. Thanks for all your input so far. Please feel free to add anything you think could help.

[Perna]

Why are you still seeing the psychologist if she was for diagnosis purposes to help your family doctor treat you? I'd take the opportunity, since you're not thrilled with the psychologist and her recommendations to go to a psychiatrist and see what s/he has to say?

Everyone is going to see you "differently" when first meeting you, even doctors/psychologists. You aren't going to "die" of psychological problems like with the physical PCOS so I wouldn't put too much store yet in who's right/wrong and would trust my family doctor more to "know" you enough to be able to tell if on the whole you're as "sick" as another doctor says or not. Go to someone he more or less agrees with (or someone you like who speaks in a way you are comfortable with) and maybe explore therapy with that person. I'd give this present psychologist a pass and move on to finding someone more compatible.

i'd see a psychiatrist for an assessment.

i ihonor your doctor for speaking up about being uncomfortable with the psychologist's actions.

i would not want to continue to deal with a person who has made me as anxious as she made you.and she sure did hang a lot of DXs on you for such a short visit. makes me suspicious of her....

find another one or go to a psych doc.......good luck, pat

[radio_flyer]

Excellent advice.....

[mrsdodge]

Thank you all for your help and support. I've decided to speak to my md and ask for another referral. Now if I could just convince my husband. My creative mind is on leave so I'm not doing such a good job at figuring out how to break this to him.

[mrsdodge]

Well it's decided. I just talked to my hubby and explained that I wasn't happy with how quick this lady was to diagnose me with so many things and make it look far more serious than it really is. I've got a call into my family doctor to let him know of my decision to seek a second opinion with a psychiatrist. He (my husband) took it well. He said he just wanted to make sure I didn't let this slip from my mind and that I did get it taken care of. And of course, he'll be beside me the whole way. So I'm feeling good about this now. Thanks again for the help you all.

[gardenergirl]

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Brookester said:

Knowing what I do about psychologists, I would be very tempted to turn her into the State Board for flagrant misuse of her title as she does not have permission to be giving you a psychiatric diagnosis.


</div></font></blockquote><font class="post">

Just to clarify, the above statement is not correct. Psychologists are qualified and legally allowed to diagnose. Psychiatrists often refer clients to psychologists for diagnostic assessment using psychological tests, history, and interviewing.

That said, I don't agree with Mrs.Dodge's psychologist providing detailed recommendations regarding medication to the physician, unless she is a prescribing psychologist. Maybe she and the physician have an excellent working relationship in which they consult frequently regarding all aspects of treatment, but I think that should happen in some format other than the patient's chart. I certainly would not put in writing any medication recommendation, particularly one so specific. Instead, I might suggest a classification of meds or better, call the physician to talk about it.

Good luck Mrs.Dodge. It certainly sounds like a difficult time. Based on what I read in your post, I think I'd say go with your gut about the psychologist. Talk to her again, but if your gut still says "ick", then perhaps try the psychiatrist your doc mentioned?

Take care,

gg

[gardenergirl]

Oops, posted my post before I saw you made your decision. Sounds like a good one, and I'm glad your husband is supportive.

Good luck!

gg

[mrsdodge]

See that's the thing, she isn't allowed to write anything. She can make suggestions, but not that much in detail. She told me that the first visit.

I agree with seeing a psychiatrist, but I have to defend the pyschologist's point of view. My therapist recommended a p-doc for me to see & an outpatient program cuz she diagnosed me with bipolar & she recommended certain medications to the p-doc (after I gave my consent for them to converse) & she was right on the money! I value & trust her perceptions of what is going on with me. In the past I was misdiagnosed with unipolar depression & was not helped by AD's. She communicates with my p-doc regularly & between the two of them I've finally gotten some relief & quality of life.--Suzy P.S. My diagnosis is very similar to what your therapist said & the treatment is similar to what she recommended.

[mrsdodge]

So how exactly have the meds helped you? What were your symptoms to being with?

I have been diagnosed w/ bipolar 1. I have had mixed episodes where I've been really depressed & agitated. When depressed I had suicidal thoughts (attempted a few times when I was younger); paranoid delusions about my husband hating me & wanting me to hurt myself; very low self-esteem; really really negative thinking;very self-conscious--thinking people were looking at me with disgust & that they could tell I was "crazy." I abused alcohol (in fact my first child was a preemie due to my smoking & drinking while pregnant). I now drink occassionally & moderately & have quit smoking due to being on the medication. I didn't need to self-medicate anymore.

When I was manic I was elavated; spent a bunch of money on things like an 800 dollar vacuum cleaner, gold-plated tweezers for myself & my daughter, clothes, books, etc. I would join every organization there was & volunteer to do many jobs that needed to be done. I even ended up on tv for one of my crusades & I'm basically a very shy person. There is no way I would normally be comfortable being interviewed on tv.

When I started on the anti-psychotic Abilify & Lamictal I couldn't believe what a difference it made. I was no longer having all the negative thoughts. I wasn't ruminating on my childhood (pretty bad with a bipolar/alcoholic mother who committed suicide & an alcoholic father who abandoned us). I was able to put all that in the past with a, yeah, it was a bad childhood, but I've got my own life to live now.

I also have ADD & anxiety so I take meds for those too.

I'm just feeling so much more rational, not so easily aroused into anger, hurt or sadness, but I'm not "cured." I had an episode in Aug. where I overdosed & I had been stable for about 5 years. My doc says with bipolar there is always a chance of relapse even when on the right meds & that I had let myself be hypo manic for about 5 mos. without reporting it to her (felt too good plus I didn't know I was going to crash into a painful depression). So my Lamictal has been increased & Trazadone added to help me sleep.

My husband couldn't believe the difference in my attitude. Before he was walking on eggshells cuz I could erupt into a rage from him just looking at me & I would perceive it as he was plotting against me. I used to get all irrational & run out in the middle of the night & go to bars just to make him worry. I guess to sum it up, I was thinking irrationally which made me act in a rash & irrational manner.--Suzy P.S. Because my mother had bipolar that was a strong indication that I might have it, too. It is very genetically based. Any history of that in your family?

[mrsdodge]

I have an aunt who is manic depressive and some cousins who have shown signs of it as well but none have been diagnosed. I'll be calling my doctor back today to see what our next course of action will be.

I'm actually having a really good day today. The company I work for has training siminars each year where a speaker comes in and teaches us how to be more professional in our field. Yesterday was more directed towards the career aspect of life but today was towards self improvement. I took a lot away from this class. The speaker, Ray Spies, is amazing and gets better with each year he comes here. One thing he said that really sticks out in my mind is about anger. The example he gave was: You could cut me off in traffic or stop at a changing traffic light when you had plenty of time for 2 cars to get through. Chances are, that makes you angry. But the other driver isn't who actually angers you.. you make the decision to get angry. It's a mindset. Our minds make the decision to let something get to us, or just shrug it off like nothing happened. It gives me something to think about.

I won't bore you anymore but I'm telling you, this man was far better than the psychologist I've seen twice. He gave some charts to use to control anxiety and so on. I'd be more than happy to type some of my notes up this weekend and post if anyone is interested in reading them.

I'd love to see some notes on this fellow's presentation. I'm all for learning as much as we can to get the best quality of life. Glad you're feeling better. I just got back from a support group I go to for people with bp & depression. We learn different techniques from each other as to how to handle stress, improve self-esteem & manage symptoms, etc. Sometimes we just vent! We can have a lot of impact on our wellness--not just take the meds.--Suzy