first visit

I went to see my new psychiatric nurse practitioner today. I was referred to her by my T because of possible ADHD.

The session was 1 hour and was spent on evaluation. She's very nice and I had no problem talking to her. It was interesting how different this was from a therapy session. It was very clinical, talking all about my symptoms and then later, about drugs to treat them. I actually shared a lot of things with her that I have never told my T. Not that I was hiding them from him or anything, but when he and I get together, it is not so clinical. Also, I am realizing, maybe I didn't want to share certain stuff with him because I am somewhat embarrassed by my sometime dysfunctionality. (Does he really need to know it took me over 6 months to be able to go to the crowded cafeteria for lunch in my new building at work?) The PNP today talked some about the shame of having these symptoms, and I think for me that fits.

She's going to have me do some ADHD assessments, but isn't sure that is my problem. It could be Anxiety or Depression or a mix of all three. She says it takes a while to tease it out. In the meantime, she's going to start me first on Wellbutrin, an anti-depressant she says that often helps with ADHD too. She said it can help with anxiety too for some people but in others make it worse. I just have to try it. She said we could start with the stimulants for ADHD, but let's try this first, as she suspects ADHD may not really be the cause of my ADHD-like symptoms.

And now here is the really strange part. Five days ago I had a dream about our first session and in it, she prescribed me Wellbutrin! I even wrote about that here on PC in another thread so I'm not making that up.

That is just strange.... How could I have known? I was referred to her for ADHD, I would expect to dream about Adderall or Ritalin. I didn't tell her this dream. I can't just share a dream with a stranger. After all, it wasn't until my second or third session that I shared a dream with my T.

And here's some truly great news. My insurance reimburses 90% for her visits! They won't pay a cent for me to see T, but no problem going to get drugs from a PNP.

Sunrise,
Sounds like she is doing a comprehensive assessment and taking time to rule things out before jumping into the ADHD dx. I think this is really good. The systematic evaluation is what's been missing in my treatment plan and it continues to create doubt in me. Did you see yesterday on Good Morning America they has a quick segment on ADHD and some new diagnostic tests? It sounded really interesting but not yet mainstream.

Wow, that sounds like an awesome visit. She seems like she really cares, not throwing meds around like candy.

I hope this proves a long relationship!

Make sure she gives you testing for adults. My T who is a clinical psychologist did my ADD testing and it's all geared towards kids.

This delayed my getting on the meds. I take Vyvanse by the way and it is by far better than adderall.

insurance companies like NP's.. they're cheaper than pdocs.

i'm glad it went well

Sounds good. Wellbutrin is also a med that doesn't cause weight gain I think?

That sounds like a great appointment, I'm glad that you felt comfortable enough to share so much with her.

Sunrise - like Chaotic, I too am glad she is taking such care. "as she suspects ADHD may not really be the cause of my ADHD-like symptoms." I was the same way - I was first dx'ed ADHD and really, 10 years later, that's not what is causing my ADD like symptoms.
Glad you had such a good session, that it is getting covered by INS and - yeah! I remember your dream! Very cool! They say the body knows what it needs....

That's wonderful. Sounds like she's a very competent person. Also, it sounds like you have psychic gifts.

Sounds like a great visit. I enjoyed reading because I am not familiar with PNPs... I am very well-versed in pdocs though! (Went through 7 of them and was just referred for a "2nd" opinion!)

I am wondering if your talk with her inspired you to think more about sharing the more clinical issues with your T. Perhaps don't think of them as clinical, but just as parts of you.... working on allowing him to see all parts of you. He will accept you. I think it is really important for you to tell him some of the things that you told your PNP and also really important to examine (as you have obviously already started to) why it was comfortable to tell her these things verses your T. I bet that would be a good discussion to have with him.

Thanks for sharing your experience.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
pinksoil wrote:
I am wondering if your talk with her inspired you to think more about sharing the more clinical issues with your T.

</div></font></blockquote><font class="post">Yes, you mindreader, you. I saw T yesterday and did bring up a couple of things I told the PNP. We covered so much ground yesterday that it was hard to talk about anything in depth. So I think I will return to this at another session. I think by talking about some of these things with my PNP, it helps me bring them up in therapy. It has also made me think that I want to have a "goals" discussion with T. We've never discussed my goals for therapy before. I think they are shifting right now and I want him to be aware of that, and be able to give input, and get together with me on the same page. Also, I talked with T some about my session with the PNP. He has different insights than she does, and she had different ones from him. It made me realize how valuable it is if one's mental health professionals consult with each other. I think he could give the PNP some really useful information, quite efficiently. T thinks PTSD is a significant part of my "problems" but this never came up with the PNP. I think I would not mind at all if they put their heads together.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
mybestkids2 said:
not throwing meds around like candy.

I hope this proves a long relationship!

</div></font></blockquote><font class="post">
Thanks mybestkids. I think I could have got the stimulants from her if I really pushed. But she didn't recommend them for a first pass attempt at medication, and I agree with her approach to try to explore a bit and tease out what is happeningwith me. I was also OK with her choice of wellbutrin, for perhaps the very stupid reason that was the drug she prescribed in my dream, so I felt like it was meant to be. Or some totally unscientific reason like that.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
lauren_helene wrote:
Make sure she gives you testing for adults.

</div></font></blockquote><font class="post">Yes, the testing is for ADHD in adults. I guess there are a number of assessment instruments for this out there. She said two of her favorites to prescribe are Vyvanse and Focalin.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
_Sky wrote:
Wellbutrin is also a med that doesn't cause weight gain I think?

</div></font></blockquote><font class="post">That's great, because I need to lose weight so I don't need a med that makes that harder.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Kiya wrote:
I remember your dream! Very cool! They say the body knows what it needs....

</div></font></blockquote><font class="post">
</font><blockquote><div id="quote"><font class="small">Quote:</font>
Doh2007 wrote:
Also, it sounds like you have psychic gifts.

</div></font></blockquote><font class="post">
That's very interesting. I told my T about this. I would share this dream "coincidence" with no one else I know (I think he liked it when I told him that), and he said that is a sign of clairvoyance. I'm not sure how to respond to that--it might be a little too "out there" for me. He says I am a very intuitive person and that sometimes such people are also clairvoyant. He said also that those who are clairvoyant often suffer from PTSD, so that would fit with my background. I didn't really understand this connection, but he said something about trauma sufferers having to become almost clairvoyant to avoid real and perceived dangers.

I don't think I believe in coincidences.