Posted by Racer on August 25, 2004, at 0:04:22
In reply to Psych eval woes -- any insight?, posted by Aphrodite on August 24, 2004, at 21:12:03
Whaddaya know? I'm hardly out of my own crisis, but here's something I can actually answer -- because I just did the initial thing with a new, private psychiatrist today.
First off, I'm with Dinah all the way: the meds can help provide enough relief that therapy can be much more effective. Now, I'm not typical -- I probably score 25 out of a possible 10 on the "depression predict-o-matic", but the first time I took an antidepressant it was almost like a miracle. We'd been bogged down in therapy for a long time, after a lot of good work, but we were at a point where it was just plain too painful, too impossibly painful to get any further. My therapist was actually against medications -- which eventually led to me ending therapy with her, but that was much later -- but my GP "strongly recommended" that I see a pdoc and go on an AD. I did, and it helped. No, people didn't suddenly start breaking into song in the streets, but it did allow us to get past the roadblock to some of the most painful portions of my past -- and to work through those issues effectively enough that none of those old maladaptive coping strategies has come up until this recent nightmare. Let's see, that's about six months on Nortryptiline about 20 years ago? Yep -- even worth the weight it put on me.
The best news about ADs, by the way, is that there a many more now, and many are much easier to take than the old ones. Yeah, I'd rather not have to take anything, but if it provides you with a tool to help you make the therapy work for you, and it helps keep you from the sort of agony that intense therapy can bring on -- for a first episode of Major Depression, most authorities say stay on the med for anywhere from nine months to two years, and you can probably stop it and never need it again. Scary, yes -- maybe worth it. (And I'm one of those goofy 'won't take aspirin for headache' types who really hates taking any medication for anything. Last thing I am is a med happy drug pusher. But, sometimes it can help, and it doesn't have to be forever.)
As for the eval.
Would it surprise you to learn that sometimes I talk too much? We went about two and a half hours instead of his official one and a half hour initial eval. During that time, he asked for family and medical history, asked about some specific symptoms, and mostly heard me out. Yeah, he asked a few questions that scared me -- things that sounded like "QuickFixDiagnosis" warnings, but when they came up I told him that I thought they were byproducts, not diagnoses, and we talked about it a little and he *said* he agreed.
Now, you might not be surprised to hear that I was scared to death -- almost literally -- about this appointment. Honestly -- I very nearly called to cancel the appointment WHILE I was driving there. First thing I told him was that I'd been in a nightmare for almost a year, and that I was almost too scared to be there. (Of course, now, hours later, I'm kicking myself for saying so, since 'gee, I must look nuts...' etc) Having that on the table up front helped me.
Several people I know, respect, admire, and trust have told me that they much prefer their DOs to any MD they've ever seen.
And, remember a couple of Helpful Hints: you can always say no. Just because s/he wants to prescribe it, don't mean you gots to take it. And ask up front about drug trial philosophy: how long does this doc have you take something before deciding to switch/change dose/stand on your head? What criteria does this doctor have for response? What lab tests will this doctor have done? (Do get your thyroid checked -- everyone says it, it's worth asking for just in case.)
And my own, personal advice to you, on accounta I like you: Always remember, it's harder to get into Veterinary School than Medical School...
(Racer's Reaction to Certain Stressors: I get way over-chatty. Like no one noticed. At least this was one where maybe my chatty can be helpful -- I hope so, at least.)
poster:Racer
thread:381925
URL: http://www.dr-bob.org/babble/psycho/20040821/msgs/381986.html