Posted by g_g_g_unit on November 5, 2011, at 7:37:55
In reply to Re: a little progress (sort of) » g_g_g_unit, posted by Phidippus on November 4, 2011, at 19:57:50
> >decided to take up his suggestions, i.e. >increasing the Lexapro to 20mg and switching out >Depakote for Zyprexa.
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> What are you treating?inattentive ADD, OCD and Major Depression.
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> > I suppose I'm still hesitant about being on an >AP,
>
> What is your hesitation? APs can be powerful adjunct treatment for a variety of mental illness.Two reasons: a) the fact that most meds I've tried so far have worsened my attention and I didn't think APs would be any different in that respect.
b) My depression is primarily characterized by anhedonia, amotivation, social withdrawal etc. and (correct me if I'm wrong) I figured APs would only worsen those symptoms .. the way Lexapro already has. Unfortunately, while stimulants are reasonably effective, they ratchet up my anxiety to unmanageable levels.
I'm aware then that the logical thing to do would be to combine an SSRI, AP and a stimulant but I was under the impression the former two might render the stimulant reasonably ineffective?
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> >don't want to be termed non-compliant because I >have no concrete reasons for rejecting a trial.
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> What's the big deal about being termed 'non-compliant'. Its not going to go on your record.
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> >I've grown increasingly more terrified of giving >my own input regarding medication.
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> Do you know why this is? I'm going to assume you have OCD and challenge you with the question, could it be the OCD that's causing this terror?Maybe. I didn't have the most stellar upbringing - I was never physically abused, but dissent really wasn't encouraged in my house. My dad was particularly liable to snap at me and it's left me terrified of dealing with male authority figures. When I ask myself "what's the worse that could happen?", I immediately leap to the thought that they might physically strike me (which is what would occasionally happen with my dad); I figure that's the OCD at work. But I'm also just very anxious around older males in general ..
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> >(who I'll often have OCD-inspired mental >dialogues with when anxious)
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> What are these dialogues like?Since I'm currently in psychotherapy with him, they usually just involve me spontaneously engaging with him in issues that have arisen that week, or elaborating on points from our last meeting.
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> >In the case of reporting side-effects, I'm >overcome by this terrifying feeling that I'm >being judged, that he thinks I'm crazy or >neurotic or just making stuff up.
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> Is there a possibility you may be confusing anxiety for perceived side effects?
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> >In the case of Lexapro, I said that it is >inspiring a "slight" (to ease the impact) >feeling of unreality.
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> Well, now, case in point-the feeling of 'unreality' could easily be attributed to anxiety about the medication.Maybe, but I haven't been feeling terribly preoccupied with Lexapro. In fact, 15mg has done quite a good job of quelling my anxiety (pending I stay away from stimulants), but I'm often struck by a vague, dreamlike sensation while on it. It is causing a lot of anhedonia and sleep disturbances and it's my understanding that both can contribute to DP/DR. I often notice that the sense of unreality dissipates when my anhedonia does (typically as a rebound effect of Ambien).
> Reading your post, I am surprised at the level of anxiety you have over medication and medication related issues. You really need to be more open with your psychiatrist about what your feeling on these drugs. If you open a dialogue with your doctor he may be better able to assuage the medicines impact on you. You need to let him know about your fears so he can educate you on the medication, tell you what to expect and confront you on your paranoia. There is nothing to fear in having a completely open relationship with your doctor. The biggest roadblock I see is your own anxiety, which may be fueling misperceptions.
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> Eric
>Thanks. I'm surprised it's reached this point too, though it is my first ongoing relationship with an older male psychiatrist (I usually don't stick around long), which may be why these issues have all finally boiled up. The alienation brought on by immigration has also left me with a more concrete sense that "I don't count".
I have done my best to be open with my psychiatrist so far - in fact, our last session was quite an accomplishment. But I am overcome by the sense that I'm being judged, looked down upon, etc. which is fueled by his bouts of silence. By contrast, my GP will usually offer immediate sympathy in relation to a complaint. Maybe it is just a panacea, or mollycoddling, but I am extremely sensitive and I find those displays of warmth helpful.
poster:g_g_g_unit
thread:1001616
URL: http://www.dr-bob.org/babble/20111027/msgs/1001692.html