Posted by ksvt on January 25, 2001, at 20:56:01
In reply to Re: how to express how bad things are to the shrink, posted by medlib on January 23, 2001, at 2:30:48
> > medlib - what a great outline. I have an appointment with a new pdoc in about 3 weeks and I think I'm going to try to work my way through your list. Like Dave, I frequently put on a happy face - it's sort of like a knee jerk "how are you?" "I'm fine." This certainly isn't very constructive but it's a pattern one can slip into rather easily particularly when you're not seeing these people very frequently and for such short sessions. ksvt
> > Hi -
> >
> > I only get to see a psychiatrist (I do have a therapist that I see weekly.) for a half hour every 3 months. Things have been so bad lately, and I feel like I am spiraling deeper and deeper into depression. Neither of my meds (Effexor XR and Zyprexa) seem to be working. I am so scared that I'm not going to be able to convey how bad things are to the psychiatrist. I tend to put a "happy face" on things. Any tips on how I can best serve my needs tomorrow?
> >
> > Thanks!
> >
>
> Dave--
>
> I recommend that you:
>
> 1) Establish an accurate tone from the very beginning. Print out your post and any relevant replies and hand them to your pdoc when you first walk in.
>
> 2) Write it down beforehand! Specify what outcome(s) you would like to see from this appointment. State to what degree (if any) your increasing depression feels situational. Include questions or concerns you need addressed. For example, if med change, what time table for improvement, how to monitor and adjust, etc. More frequent contact? How, how often?
>
> 3) Quantify your present state of being. "On a scale of 1-10, I'm a ___ and dropping rapidly."
>
> 4) Don't end the session without arranging for more frequent followup of some kind (at your expense, if necessary)--by telephone or e-mail, if not in person. (If you are spiraling down, does anything else *really* have a higher priority?) Make sure you have his/her promise to respond promptly to whatever non-inperson contact is arranged. Discuss "emergency" options. Med changes should be followed up in some fashion at 2 weeks, then monthly--if all goes well; sooner, and more often, if not. (I see my pdoc l5 min/month and can call in between visits when necessary--a fairly standard arrangement, I gather.)
>
> 5) Arrange for contact between your pdoc and therapist if it is not already in place. You may need to sign forms for 1 or both granting permission to release records. Ask your therapist to contact your pdoc promptly if s/he observes any sudden or significant change in you.
>
> 6) And lastly, take on, at least temporarily, an Advocate role. Envision your upcoming meeting in whatever non-medical metaphor or model suits you best. You are your Most Important Client consulting a specialist you've hired re a matter of Significant Concern; self-effacement in this context is not only not appropriate, it's destructive--and you're too responsible a person to let your client down.
>
> Do let us know how things go--we care.
> Well wishes---medlib
poster:ksvt
thread:4138
URL: http://www.dr-bob.org/babble/social/20010105/msgs/4211.html