[Lola5]

I am at the end of my list of psychiatrists that have been recommended to me by others. I ditched the one who wanted $1,500 as suggested. I tried calling all the others, but they either never returned my call or said they are booked for the next 3-6 months.

I have only one name left. The issue is that this doctor has a one page website on which she mentions in two sentences that she is trained in psycho-pharmacology and TMS (transcranial magnetic stimulation). The rest of the the page is about her use of TMS and its history and benefits for treatment-resistant depression.

I need a psychiatrist who will help me find the proper medication because, like I've said in other posts, I've been on about 40 different kinds. My concern is that upon hearing this this psychiatrist will either push me to do TMS or will take me on in the hopes of persuading me to do TMS. I also have this fear that she won't try to find the right medication for me and instead will prescribe drugs she knows won't work so I will give in and do TMS. I mean she writes about how it requires 60 sessions for the full treatment so I imagine it is a good way for her to make money. I know it sounds paranoid, but I've been treated so badly by other therapists and psychiatrists that I am so wary.

I feel like this is a silly question, but she's the last one on my list and I've run out of people to ask for referrals. I'm so confused.

My pdoc has TMS available in his office and has never pushed it on me. Be sure to take a list of the meds that have been tried. Over the years I suspect close to that number or combinations were tried for me also and eventually my pdoc landed on a particular combination that worked best.

The pdoc may talk to you about tms as an option. Mine did also, but I wasn't interested and he didn't push it at all.

[ruh roh]

I'm really glad you cancelled the $1,500 pdoc. Good for you.

As for the one with the concerning website, you can go into your first appt with a note to yourself not to be talked into this other treatment (just to make sure you don't get sucked into something), just in case that happens (and if not, great).

Another option is to make appts with a few that are 3-6 months out and ask to be on a waiting list in case of cancellations--that way, you have 3 chances of getting an earlier call.

I am still wondering, though why you feel you need medication if 40 different kinds haven't worked. Is it possible to look at other biological or psychological causes?

[Ididitmyway]

Don't rule out general practitioners. As medical doctors they are allowed to prescribe all meds including psychiatric. Whenever you call someone, ask them to refer you to someone else if they can't see you soon. This way your list of options will expand. I feel that putting someone on 40+ meds is a problem in and of itself. I am not a doctor so it's not my professional opinion but it just doesn't make any sense to me not to mention the dangers of all those drugs interactions. I'd seriously question the competence and the ethics of your previous doctors who put you on so many drugs.

[LonesomeTonight]

I've heard about a genetic test that can tell what psychiatric drugs will work best for someone. Is that something you could look into? In the meantime, you could try seeing this p-doc, but emphasize you're not interested in TMS at this time. I understand there could be pressure to do it--a company that does that recently opened an office in our area, and they've been wooing the T's at my T's practice. Like, taking them out to a fancy dinner, giving presentations, etc. So my T was kinda pushing it for a bit there. But then she eventually asked my p-doc about it, who said I have both depression and anxiety, and TMS hasn't really been studied for anxiety, so she didn't recommend it until more studies have been done (since it could theoretically have a negative effect on me).

As for other approaches, since so many meds haven't worked for you--have you ever seen a holistic/integrative doctor? I just started seeing one, and she did a much more thorough history than any other MD has done on me (like pages of questionnaires, a 90-minute initial consulation) and ordered various blood tests--some more standard ones, like CBC, thyroid, metabolic panel, vitamin D, but also for candida, food intolerance, chronic infection etc.--plus a genetic test because she wants to check for possible methylation issues (could be I'm not metabolizing B12 correctly, for example, which could explain my persistent fatigue). But that would be something to consider. Or even if you haven't checked in with a primary care doctor, just to get things like thyroid, anemia, etc. checked. Because all those things can affect your health, including mental health.

So, hope some of that helps!

[Lola5]

It's not a bad idea for me to do some tests, especially a genetic one that can help me figure out which medication will work better. I have an effective general practitioner, but she is not at all knowledgeable about psychiatric drugs. I tried bringing it up with her, but she insisted I need to go see a specialist. She's also new to the office so she just gave me a list of three docs the practice recommends and none of them were good.

I have had anxiety and depression for over two decades and it began with PTSD. I've had my blood tested, MRIs, CTs, but ultimately it's been attributed to the initial traumatic episode.

I might not need meds, but my problem is that I have been on a medication for several years. It seemed to work at first, maybe even the first year, but it's slowly stopped. I worry that it might be a cause of my problems getting worse. I'm afraid to go off of it myself and want somebody knowledgeable who can tell me the reason I've been getting worse, help me get off this medication and figure out if I need a new medication or some other treatment.

Interestingly, i started off as you did. I had an onset of PTSD, so no one evaluated me for ADD, health problems, other issues.After a couple of years, finally found a good internist who took care of some of the undiagnosed health issues that cause depression, but all the specialists were no help. I had CT scans, MRIs, etc, as well.

It wasn't until i addressed the sleep issue, which none of these specialists considered, that I started to improve and it's going well now. Finally.

Antidepressants also worked for me with my onset of PTSD, for about a year. The thing is, trauma screws up your nervous system, preventing the restorative sleep. It is also linked with auto-immune disorders.

I was thinking of doing the genetic tests just recently, but they are very limited and for me, would result in being prescribed more rounds of antidepressants and other related medications instead of someone thinking out of the box to solve the problems. I wish i knew about it years ago, though.

Good luck to you.

Originally Posted by Lola5

It's not a bad idea for me to do some tests, especially a genetic one that can help me figure out which medication will work better. I have an effective general practitioner, but she is not at all knowledgeable about psychiatric drugs. I tried bringing it up with her, but she insisted I need to go see a specialist. She's also new to the office so she just gave me a list of three docs the practice recommends and none of them were good.

I have had anxiety and depression for over two decades and it began with PTSD. I've had my blood tested, MRIs, CTs, but ultimately it's been attributed to the initial traumatic episode.

I might not need meds, but my problem is that I have been on a medication for several years. It seemed to work at first, maybe even the first year, but it's slowly stopped. I worry that it might be a cause of my problems getting worse. I'm afraid to go off of it myself and want somebody knowledgeable who can tell me the reason I've been getting worse, help me get off this medication and figure out if I need a new medication or some other treatment.

One of the reasons the meds only work for a short time is probably because trauma recovery really can't be treated with meds. The nature of PTSD is that symptoms will increase as we experience symptoms when we are triggered in some way. It looks a lot like recurrent depression, and in a sense it is, but what is really going on is in increase in PTSD symptoms that is setting off depression/anxiety, etc. You may find that you don't need to be on meds all the time but only at those times when symptoms of depression or anxiety increase to such a level that you can't manage.

Do you have a really good therapist with experience in working with clients with PTSD? The real improvement and healing from trauma is not going to happen with only meds; you really have to work through the trauma and find healing somehow. For me that was through therapy.

[Ididitmyway]

If you want to slowly and safely taper off the meds, be sure to tell this to all those you interview. As far as why the meds stopped working, I don't think there is one specific cause for that. Trauma is a complex phenomena that consists of many dynamics, and I wouldn't have high hopes that someone will give you a simple answer as to what causes the meds to stop working or to give you any satisfactory answer at all. From my experience, the best that the current medical system can offer you is to find the optimal meds that could more or less manage your symptoms without doing too much damage to your brain and other organs. It doesn't treat the root causes. The sooner you'll accept the limits of what you can get the better you'll be equipped to deal with the system. Self-education is key in your healing process. The more you educate yourself about trauma, the better you'll navigate your recovery. You have to take control of your healing into your own hands and to be able to critically evaluate what a health provider is doing instead of blindly trusting and relying on their expertise.

[Lola5]

Originally Posted by lolagrace

Do you have a really good therapist with experience in working with clients with PTSD? The real improvement and healing from trauma is not going to happen with only meds; you really have to work through the trauma and find healing somehow. For me that was through therapy.

That's the other difficult search I am on. The reason my PTSD got so bad was because of two years with a very manipulative therapist. I've been scared to go back to therapy every since. I'm trying though.

[Lola5]

Finally called this psychiatrist. $600 for an initial one hour session. $300 for subsequent 30 minute follow up appointments. I feel so disappointed.

Expensive. I hope you can find another psychiatrist.