I went to see the new pdoc this morning.

I don't know.

Yesterday I woke up in a bad depression. Called in sick. Stayed in bed almost the entire day except to take a shower and get food.

He was the 1st pdoc to ever ask so much about social/environmental/family/relationship issues.

I don't like some of the things he said.

He was asking me about T. I told him how I've been with T for two years. He said, "Do you know what the two best therapies for depression are?" He told me "cognitive and interpersonal." He asked me if things go well with my T. I told him, "Yes they do." He said, "Sometimes you can like the person but it doesn't always mean the therapy is helping you to alleviate things. You might want to consider another type of therapy."

I.
don't.
think.
so.



He said that he needs at least two days to think about what medication would best suit me, given that I have tried so many without relief. He said he will call me in two days. We have another appointment for Oct 2nd, but he says he would like me to be on medication before then. He is very interested in putting me on Lithium. I think he is %#@&#! crazy.

I feel very sad right now.

Seven pdocs.
15 medications
Three Ts

I'm only 26 years old. :-(

And now apparently, this pdoc doesn't think my therapy is helping me.

I sort of feel like calling T, but I sort of don't.

[Fuzzybear]

That sucks. ((( pinksoil )))

My guess is the pdoc is wrong. About therapy not helping you. A pdoc i saw said the same. Things are not always as black and white as some pdocs think.

[Mouse_]

Pinksoil, Geez he was very positive. Sounds like he got out of bed and made a decision to fix the world LOL! sorry.

[sunrise]

(((Pinksoil)))

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He was the 1st pdoc to ever ask so much about social/environmental/family/relationship issues.

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I think that is a good thing. That said, however, I think your new pdoc has a shortsighted view of your goals for your mental health. It sounds like he thinks your meds and your therapy are targeting exactly the same issues, and I guess I wouldn't agree with that, based on what you've shared here before. He seems really focused on depression, whereas you seem to be seeing your therapist for much more than that. (Sorry, if I am wrong.) Maybe as you get to know him better, he will realize this is not as one dimensional as he thinks.

I hope you will discuss this with your T. Sometimes I wish the Ts would stay out of meds, and the pdocs stay out of therapy. Therapy is a service you are contracting for, and if it is helping you and you are willing to pay for it, what should pdoc have to say about it? Nada, IMO.

Hope you are feeling better today

Yeah. Sunny-- I was thinking the same thing. I go to therapy for a myriad of issues, not just depression. I understand that there are specific therapies designed to better target depression. I understand that through research it can be determined which therapy is thought to be "best" for treating a certain illness-- but that isn't going to be the case for every single patient. It isn't that clear-cut of an issue. The idea of me leaving my T to try something different is just ridiculous.

I'm definitely going to discuss with my T. As far as Ts staying out of meds-- I do involve my T with aspects of the med situation, but not the meds themselves. I will often talk to T about my decisions regarding whether or not to take medication, what that means to me, how my relationship with my pdoc affects me, etc. T has told me his opinion on meds-- "more talk, less pills", "meds are a tool, not the entire treatment", etc. He has also let me know that supports my decision when I am on meds... but any actual issues with the meds themselves are reflected to the pdoc.

During my schooling I took a class on psychopharmacology because I think it's really important for Ts to be somewhat aware of what the meds are, what they are supposed to do, some side effects, some interactions, etc. I believe this because the T is the one who is spoken to the most often, and most of the time, the T is the person on the treatment team that knows the person best. For this reason, I believe it's really important for Ts to be somewhat knowledgable about meds because while all direct stuff should be referred to the pdoc, there are some red flags that should be known and a lot of individuals will end up being on meds.... I don't think a T should be left in the dark about what their patients' are taking.

Ok, I just hijacked my own thread, hahaha.

I almost called T today, but something stopped me. Again.

[smiley1984]

yes, I agree that not all patients fit into the research models but when treating a patient, these treatments that have been shown to be effective for many people (cognitive etc) are the first place to start and they are no way the only option. But have you tried these types of therapy before? If you haven't tried these therapies which have good outcomes for many, I think he is right to suggest it. But if you have given them a good go I can understand your frustration.

T's have a bias against meds and drs have a bias towards meds. That said the truth is probably somewhere inbetween. Granted they can have side-effects and getting through that first week can be crap and Lithium has to have bloodlevels done etc but it is a well studied/known drug that has been around a while and is known as a good mood stabiliser. Have you given your meds a decent trial of weeks on an adequate dose?

I really do understand your frustration about seeing yet another dr with yet another opinion. But have you tried the stuff he's suggested before? You aren't happy now so maybe think about it.

In 1 1/4 years:

2 gp docs
2 shrinks
3 psychologists
2 social workers
13 different medications that each caused serious side effects
3 medications that work but all addictive so they won't prescribe them
2 hospitalizations, 1 due to the trauma of first hospitalization
0 suicide attempts

Symptoms increasing worsening with continued care, improvement only when off med's and away from doctors. Go figure.

[lauren_helene]

Oh goodie he's going to do CBT for ya Pink?

What about the Mayo Clinic? Have you considered going there?

[Lemon]

Pink, it does sound like he doesn't understand your perspective on what you want from therapy yet, but that could come with time. What I liked about your appointment was that he actually is going to take a couple days to think about what to recommend to you. I've never had a doctor do that, usually they just quickly take a history and throw out what they think. Its impressive that he's willing to put some more thought into what would work best.

[ECHOES]

pink, I was on AD's for over 10 years, a variety of them. Lithium at one point.

I completly support whatever anyone wants to do with regards to meds. But, I also like to let others know that I stopped my meds 2 years ago. I wanted to see what I was like after all that time. lol. Also, I felt they just didn't work well or consisitently, even after adjustments to dosages and trying different meds and different combinations of meds. Even depressed, I couldn't cry. At all. For any reason. It felt like if I could just have one good cry, I would feel better. I felt just emotionally numb. One day I thought, hmmm take a pill and feel depressed..... or not take a pill and feel depressed. So I cut out the pill.

It took a while to get to therapy, but now I'm there and it is so helpful. No pill could do what this does, for me.

I think I've found what works for me and just wanted to share it.

Each person has to do what works best for them.

I also like that he said he would take a couple of days to think about it. He said he would call me back in two days and if I didn't hear from him, to give him a call.

But I'm really scared.

And confused.

I have been without meds now (except Klonopin as needed) for a couple months. And I've been pushing along. But I don't feel good. So do I look at the fact that I've been surviving (with bouts of depression and suicidal ideation) and say... well at least I'm doing what I have to do, so I don't need meds... or do I come to terms with the fact that just because I do the things I need to do, I am not doing so well underneath it all.... and I might need them.
I don't know, I don't know. Then again, I guess I really wouldn't know b/c I've never experienced a med that works well for me.

Lithium scares me. All drugs scare me.

I want my T.

[pachyderm]

My one and only poem:

The doctor
Gives the patient
A pill
To relieve
His
Anxiety

Just my peculiar take on things. And it's a generic "His."

[Kendyll]

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pinksoil said:So do I ...say... well at least I'm doing what I have to do, so I don't need meds... or do I come to terms with the fact that just because I do the things I need to do, I am not doing so well underneath it all.... and I might need them

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This is SO where I am right now, except i'm already ON meds!!!
I've felt well before, and I know it's about more than just surviving. just doing the stuff I need to get done really isn't a life. Sounds like depression to me...

Today is my second visit with my new pdoc. I know how rough it can be to switch! Seems like every time I JUST get comfy with one, they retire or move out of state. if I didn't know better, I'd think it was ME

[MissCharlotte]

((Pinksoil))

My vote: fire him and call T.

Maybe 8 is your lucky number this week.

I am so sorry you are having such a crummy experience. Take gentle care.

[ECHOES]

((( pink )))

Yeah I know the whole medication issue hard and it's very personal too. Very frustrating trying to find the one/ones that will help. You just want to feel better.

I wanted to share too what someone shared with me once when I was battling suicidal ideation frequently. I had given it a try once, obviously unsuccessfully!, a year before she told me this---that suicidal thoughts are quantifying--they are a way of saying *how much* pain you are in and *how much* you are hurting. This, along with the idea that 'thoughts are just thoughts' that don't have to be acted on, has helped me so much when I start thinking that way again.

Sometimes I can just let those thoughts be ways my mind, soul, inner child, or whatever/whomever are trying to get my attention about something, to acknowledge something lurking and causing me pain so much that I want to take myself away from it, run from it. Suicide is the ultimate taking myelf away, running away. So, when I can, if I can slow down, then I'll try to see it as metaphorical.

I don't know if that makes sense for you or not.

Just sharing what works for me sometimes.