Posted by Amelia_in_StPaul on April 11, 2009, at 18:35:18
Hi all,
I am new to this board. I live in Minnesota (St Paul); my psychiatric care has been spotty at best. Let me back up a little...Since the age of 17, I have had a diagnosis of major depression; PTSD was added to that a few years later. Then features of borderline personality disorder was added to that around the same time. Flash forward to my late 30s...I was in a master's program for psychology and everything changed. I started to become obsessed that I was becoming schizophrenic, like my sibling. Then I was diagnosed with OCD. A year and half after that diagnosis, my OCD rages on, as does PTSD, BPD, and depression.
I had always had atypical depression and fluoxetine worked for that. I didn't have a lot of anxiety. When I was diagnosed with OCD, I had been off my fluoxetine for a year (prior, since age 20, I'd been on and off it, mostly on). I was barely functioning because of depression and, most of all, anxiety.
I was in the uni's hospital and was treated very, very poorly. It reactivated my PTSD. Then I went into another hospital's partial program, which was great. However, because I still thought I was becoming schizophrenic, I established a relationship with a specialist in psychosis at the U. I didn't want to continue seeing him because he only admits to the uni hospital, where I had such a terrible experience I was shaking when I left.
However, he has been reassuring and I like that aspect. He is in general a very, very nice man and very smart. But I feel that, treatment-wise, this isn't working.
I have been back on fluoxetine since August 2008. I am on 20 mg; it took me since April 2008 to tolerate that much. And the only way I could tolerate it at all was because I was put on ativan at the same time (.5 morning; 1.5 evening). Otherwise, I had felt, not euphoric but a little high, a little spacey and light. I had not felt that way before. It was so bad, that before April I had tried with a nurse practitioner to go back on fluoxetine twice, only to quit because of how it made me feel.
In fact, everything I tried during my year off Prozac didn't work--I became extremely anxious and irritated on Wellbutrin, while Zoloft made me sleepy and wired at the same time.
These are the problems: 1) the treatment for OCD is a higher dose of SSRI (I've never been higher than 20mg of fluoxetine); fluoxetine was all I could ever tolerate, yet I am an intermediate metabolizer of cytochrome P540 2D6. I have tried many SSRIs and SNRIs over the years. 2) I want to get off ativan (it's been a year now!) but as a test I missed my morning .5 dose and felt the same old kinda high feeling I've felt before. 3) I used to take 25 mg of Trazodone to sleep. I'm back on that, too, and it was working, but lately I have a lot of wakings through the night. My psychiatrist thought the best thing to do was to increase the dose, but what happened is what usually does: I sleep more soundly, but am dead tired for 3 hours after waking. Since this regiment means I am in bed for 12 hours (mostly sleeping), I am really in bed or sleepy for 15 hours.
Compounded to the problem is that my psychiatrist doesn't think I have OCD. He thinks my obsessions are a part of PTSD (but the DSM does not list obsessions as a feature of PTSD, at all). My therapist, meanwhile, treats the OCD (she's a specialist), but won't touch the trauma, for whatever reason. They both seem to have blinders on; they seem to be equipped to see in me what they specialize in (my psychiatrist has special experience w/PTSD as well as psychosis) and nothing else. Maybe that's being harsh.
I do admit that I am also afraid to try new things. In that awful hospital, I was "persuaded" to take a small dose of Seroquel, and it sent me into a panic attack because all the sudden I was--not hallucinating, but things appeared larger than they were, and I felt like I was on acid. Also, early and fatal heart disease is rampant in my family.
Does anyone have any idea what I should do??? I think I need a new psychiatrist, but do not know where to turn anymore. Everything is raging--OCD and depression and PTSD and BPD. I reduced my Trazodone back to 25 mg, and I wake up utterly exhausted and feel utterly exhausted throughout the day. I've nearly fallen asleep driving!
Any thoughts? I am at my wit's end. I contemplate suicide nearly daily. I don't know where to turn.
Thanks,
Amelia
poster:Amelia_in_StPaul
thread:890010
URL: http://www.dr-bob.org/babble/20090408/msgs/890010.html