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Re: depression, etc. sid

Posted by Elizabeth on February 13, 2002, at 18:21:29

In reply to Re: depression, etc. Elizabeth, posted by sid on February 10, 2002, at 15:34:14

> Different name here of course (Starnoc). It's 10mg, so perhaps it's a higher dosage than Sonata, which would explain it potentially lasting longer.

No, I think Sonata comes in 10's....

> And yes it works. I took it last night and finally went to sleep thanks to it!

Cool. I haven't heard too many success stories about it, so it's nice to know somebody finds it helpful!

> No. The GP does not have an actual doctorate (calling medical providers "doctor" is often wrong). Those who specialize (5-10 more years in school) have an actual doctorate. "Real" obgyn's do that. My GP who only does obgyn-related consultations refers you to a "real" obgyn if you are a more complicated case. You go to her for annual exams, uncomplicated pregnancies, usual stuff.

This is pretty confusing! Here's our system: often, people see a nurse practitioner or physician's assistant (a "mid-level provider") as their primary care provider (HMOs are happy to recognize mid-level providers as PCPs, since they generally cost less to see than physicians do). I believe that mid-level providers can write some prescriptions; I don't know exactly how it works. There are also internists (doctors of internal medicine) and family doctors (family medicine; I don't know exactly how this is different from internal medicine) who aren't specialists and who generally act as PCPs, but who have more training than nurse practitioners or PAs. Some HMOs will also let women see their ob/gyn as a PCP. Usually if you belong to an HMO (and I think that Medicaid -- state-paid insurance for disabled people, the closest thing we have to nationalized health care -- is run like an HMO in most states), you have to get a referral from your PCP in order to see a specialist like a psychiatrist, dermatologist, cardiologist, etc. So for example, an internist or nurse practitioner would probably be comfortable treating an uncomplicated case of depression with one of the newer ADs or perhaps a TCA, but at some level of complicatedness (depending on the individual PCP's experience) -- psychotic features, mania, treatment resistance, suicidality, need for multiple medications, etc. -- the PCP would want to refer the patient to a psychiatrist. The last time I had a PCP was when I was living in Boston; I was seeing a resident in internal medicine at the clinic at one of the Harvard-affiliated teaching hospitals.

> No resistance (except my own resistance to take meds for a long time!). I've responded to therapy, acupuncture and now to Effexor XR.

Ahh, okay. I don't think that PCPs here typically do talk therapy or acupuncture, but I wouldn't expect you to get referred to a psych if you were seeing a PCP here.

> Yoga is helping me with the anxiety these days; I started a class a few weeks ago and I love it. I cross my fingers that I continue to respond well to the meds.

Crossing mine for you too. :-)

> Not my family. There are people in my family who like nothing better than to put me down, I'm not about to tell them the story of my life.

Oh, I didn't mean that! I meant that meeting a patient's family can give the therapist an idea of what kind of atmosphere the patient is living in, or grew up in. Doesn't mean that they sit in on all your therapy sessions! (And I would expect a therapist to know better than to take everything that the family says as gospel.)

> I've learned to grow and live despite my family.

Ack. How come there seem to be so many people who have/had awful relationships with their families? Is this just to be expected, or is it a societal problem, or what?

> Not all women do, not all as bad as me. How old are you?


> It's new to me... I'm 34 and apparently, PMS is the worse in a woman's 30's.


> I used to have cramps a few times a year, but this hormone-driven suicidal thing, that's 2 years old, no more.

Huh. Weird that something like that would start in your 30's. I do get bad cramps, but that's on day 1 (occasionally day 2 as well), not premenstrual, and there aren't any associated mood symptoms.


"pain in the *ss"

> Prunes are good with vanilla yogourt. Alone, they're not great.

I'm not convinced that *anything* would make prunes much better than "slightly tolerable" to me! :-} I'll stick with the Metamucil (every doctor I've talked to about my problem seems to take Metamucil every day, so I figure it probably won't kill me, at least).

> Yes, trying to avoid benzos. My doc is reluctant and me too. I find that I already take enough meds. Roght now I do well with the mouth guard only, we'll reassess if needed later.

Do you ever find that your mouth hurts from clenching? I've never had bruxism myself (at least, not that I know of), but I have had jaw pain a couple of times and it was very distracting/irritating. I think if I had that problem often I'd want to be able to do something about it. A mouth guard does help with most of the problems that are usually associated with bruxism, though, and it's certainly a better choice for nightly use. (Kind of unsexy if you happen to be spending the night with somebody, though!)

> At least now I'm done taking meds for my allergy (I ate some mussel sauce by mistake on Thursday and had to take lots of Immodium and Gravol in order for my body not to react too strongly).

That sounds dreadful. Please spare me the details. :-} Seriously, I hope you're feeling okay now.

> Back to Effexor XR, Allesse, Starnoc if needed, and vitamins. I hate to take meds and can't wait to be free of them.

How are vitamins different, effectively? I don't take any vitamin or mineral supplements unless I have some specific need for them (like anemia or something) -- those pills are huge. I prefer good old-fashioned food when I'm feeling okay, and when I'm depressed -- hopefully, never again -- "not taking vitamin supplements" is pretty low on the list of ways that I fail to take care of myself.





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