Psycho-Babble Medication | about biological treatments | Framed
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Toby, please help again... (sorry, long)

Posted by Racer on June 16, 1999, at 0:39:51

Hi, Toby. I copied this from my response to you above, because I couldn't bear to type it again. There's new news since I wrote it, so I'll tell you that as well, then let you read the rest.

First of all, I called the doctor last week, told her that I was feeling suicidal again, and was told that it was because I had too many problems to work out in therapy, that no drugs would fix them, etc. While this didn't do much for my state of mind at the time, it did make me think of some other things. For one thing, I realized that I wasn't as screwed up as all that, since I didn't internalize it as I once would have: I took it as another sign of her shortcomings rather than my own. (For me that's healthy. I've got the guilt virus pretty bad...) Secondly, I realized that it was stupid to continue trying to deal with my depression with a doctor who was so much of a problem. I'm trying to get transfered to the county seat's clinic, which is a pain in the posterior, since it's so far away, but it's still a better solution than trying to deal with her. I'm going to take along a list of my concerns to the new doctor, including my concern that I be an active participant in my own treatment. After all, if I suffered from any other chronic illness the doctor would INSIST that I become informed and take an active interest in what was being done for me and what I could do to participate in my treatment. Besides, I'm suffering from depression, not stupidity. My GPA in college science and biology was 4.0, I've worked in the horse and dog worlds for a couple of decades now (including doctoring them), and it's in my best interest to understand my own chemistry, since no doctor is going to care about it as much as I do.

So, I'll be seeing a new doctor, but I'd still like to hear your opinion about the basic question: what's the next step? Another drug all together? An additional drug to egg this one on? Nothing?

Oh, one other thing I didn't mention in the original post: I'm having a lot of trouble sleeping. It's not just getting to sleep, but staying asleep. I wake frequently, though I can get back to sleep within about half an hour or so. This isn't helping anything at all, and it makes it hard for me to tell if I'm so lethargic because of lack of sleep or because of the depression or because of the drug.

Thanks again, and sorry to go on at such length.
I'm glad you remember me. Maybe it's silly, but I am. Thank you.

OK, the MHC does not offer any therapy of any kind. The only thing they offer is meds. And they only offer those
for a limited time, then they have to kick us out of the program as soon as we are "stabilized" according to their
standards. The doctor is now saying that this drug is working effectively for me. She doesn't listen when I try to tell
her that I'm feeling suicidal. To me, the fact that I am feeling like killing myself is proof enough that the drugs are
not effective. Does that make sense? Does to me, but then I'm the crazy patient, not the sane and competant

So, the one drug that helped in the past was Paxil. The side effects with that one were constant fatigue and weight
gain. The fatigue was barely tolerable, I felt stupid all the time because I never quite felt awake. The weight gain
was significant: about 60 pounds in the first few months, though it leveled off after that. And I was anorgasmic
(though the doctor who prescribed it said that the anorgasmia was only a side effect for men! What a crock!). I
couldn't survive that sort of weight gain now, for a number of reasons. Mostly because when I gained all that
weight before, I could afford to get new clothes. Also because I was then in an anorexic state, so needed to gain a
bunch of weight. I don't need to gain that way now.

The other drugs that I've been on have also been problematic, so they're out of the question.

Wellbutrin is right out, because of the eating disorder. Because I'm so screwed up about food anyway, I'm not
willing to try an MAOI. Maybe that makes me crazy, but I think I really would rather die than make food even
more of an issue for me. Does that seem totally crazy?

This is so frustrating, because it's taking all my energy to keep trying to find a way to get help for myself. So far,
I've been able to make telephone calls to try to get some help, as a substitute for suicide attempts. Isn't that
considered a good thing? Shouldn't there be some response to that? Isn't that a sign that I'm serious about trying to
get help? I'm so frightened, because I can feel my energy draining, and I'm afraid that next time or the time after I'll
just take the poison to get it over with. All the things that have stopped me in the past are getting weaker and
weaker. I used to be so afraid of the pain and agony of death by poison, but now I'm starting to think to myself,
"I've been going through hell and pain and agony and despair for a year now, the agony of the poison would only
last a short time compared to that." That's really frightening to me. Somewhere out there there must be help. I just
can't seem to find it and I do think that the doctor I'm seeing now should be forced to suffer what I'm going
through to see how "hwlpful" her comments are. I do wish that she could suffer from her behavior, but then I know
that she already does. She must know that she's not competant, and it must be painful for her. I just want revenge.
That doesn't feel good, either.

Anyway, with the eating disorder (which is troubling me again), the low blood pressure, the suicidal impulses and
all the rest, can you tell me whether you, were I your patient, would keep me on the Effexor XR (which is helping
the anxiety if not the depression), add another drug to it, or change it altogether? Also, if you added something,
what would you try first? If you changed it, what would you try first?

Thanks for all your time. I realize that you can't prescribe for me, but since I have no trust or faith in this doctor at
all now, and because I'm so scared, I hope that you can tell me something that I can try to talk to her about. If I
have already looked up the drugs and know something myself, at least then I don't get so scared by her.




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Psycho-Babble Medication | Framed

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