![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Abby on January 17, 2001, at 22:40:48
I just saw a new psychiatrist. He took all of my symptoms very seriously and was very thorough; the consultation lasted three hours.
He diagnosed me as bipolar and discussed the limitations of the DSM. He gave me reading which was more sophisticated than the typical pamphlet, though the lithium materials were aimed at a lay audience, they were not fluffy. He gave me a copy of an article by Akiskal. Usually you have to worm this stuff out of doctors. I don't know whether he was just flattering me or what, but he said I probably knew more about mood disorders than a lot of psychiatrists.
We're going to modify my drugs gradually. The risperidone goes which is good. We may try to remove Zoloft and replace it with an anticonvulsant.
He doesn't take insurance anymore, but my insurance will reimburse me for a portion of the cost 70% of the reasonable fee, though I'm sure he charges above the reasonable fee, but something is better than nothing. Anyway, it feels great to have confidence in someone.
A quick note on my drug responses. I got depressed initially in the fall when I was 19. Zoloft provided significant relief within a few weeks. Maybe, it was almost euphoric; I was certainly bubbly. Maintenance treatment has helped, but I've gotten more anxious over time and my sustained focus has been reduced. So, if you are young when you first experience depression, and an SSRI seems like a miracle in less than 3 weeks, talk to your doctor about considering a bipolar spectrum diagnosis. (I should mention that I have a family history of bipolar.)
Abby
Posted by Shell on January 17, 2001, at 23:34:37
In reply to Yay, found a good psychiatrist, new diagnosis, posted by Abby on January 17, 2001, at 22:40:48
> I just saw a new psychiatrist. He took all of my symptoms very seriously and was very thorough; the consultation lasted three hours.
>
> He diagnosed me as bipolar and discussed the limitations of the DSM. He gave me reading which was more sophisticated than the typical pamphlet, though the lithium materials were aimed at a lay audience, they were not fluffy. He gave me a copy of an article by Akiskal. Usually you have to worm this stuff out of doctors. I don't know whether he was just flattering me or what, but he said I probably knew more about mood disorders than a lot of psychiatrists.
>
> We're going to modify my drugs gradually. The risperidone goes which is good. We may try to remove Zoloft and replace it with an anticonvulsant.
>
> He doesn't take insurance anymore, but my insurance will reimburse me for a portion of the cost 70% of the reasonable fee, though I'm sure he charges above the reasonable fee, but something is better than nothing. Anyway, it feels great to have confidence in someone.
>
> A quick note on my drug responses. I got depressed initially in the fall when I was 19. Zoloft provided significant relief within a few weeks. Maybe, it was almost euphoric; I was certainly bubbly. Maintenance treatment has helped, but I've gotten more anxious over time and my sustained focus has been reduced. So, if you are young when you first experience depression, and an SSRI seems like a miracle in less than 3 weeks, talk to your doctor about considering a bipolar spectrum diagnosis. (I should mention that I have a family history of bipolar.)
>
> AbbyThat's great! I think having a doctor with whom you are comfortable and whose judgment you trust is indispensable.
I may be moving soon, and the prospect of finding a new doctor does not thrill me. He wouldn't happen to practice in Ohio, would he? :)
Shell
Posted by Greg on January 18, 2001, at 8:17:52
In reply to Re: Yay, found a good psychiatrist, new diagnosis, posted by Shell on January 17, 2001, at 23:34:37
Abby,
What fantastic news! Finding a really good doctor can help bring some peace of mind in and of itself. I've been lucky as well to have found a really good psych a few months ago. I was having trouble finding the right med combo for my BP II, but this guy was able to target my symptoms and get me on the right meds.
I hope this works out really well and you continue to get healthier and happier every day!
Greg
> > I just saw a new psychiatrist. He took all of my symptoms very seriously and was very thorough; the consultation lasted three hours.
> >
> > He diagnosed me as bipolar and discussed the limitations of the DSM. He gave me reading which was more sophisticated than the typical pamphlet, though the lithium materials were aimed at a lay audience, they were not fluffy. He gave me a copy of an article by Akiskal. Usually you have to worm this stuff out of doctors. I don't know whether he was just flattering me or what, but he said I probably knew more about mood disorders than a lot of psychiatrists.
> >
> > We're going to modify my drugs gradually. The risperidone goes which is good. We may try to remove Zoloft and replace it with an anticonvulsant.
> >
> > He doesn't take insurance anymore, but my insurance will reimburse me for a portion of the cost 70% of the reasonable fee, though I'm sure he charges above the reasonable fee, but something is better than nothing. Anyway, it feels great to have confidence in someone.
> >
> > A quick note on my drug responses. I got depressed initially in the fall when I was 19. Zoloft provided significant relief within a few weeks. Maybe, it was almost euphoric; I was certainly bubbly. Maintenance treatment has helped, but I've gotten more anxious over time and my sustained focus has been reduced. So, if you are young when you first experience depression, and an SSRI seems like a miracle in less than 3 weeks, talk to your doctor about considering a bipolar spectrum diagnosis. (I should mention that I have a family history of bipolar.)
> >
> > Abby
>
> That's great! I think having a doctor with whom you are comfortable and whose judgment you trust is indispensable.
>
> I may be moving soon, and the prospect of finding a new doctor does not thrill me. He wouldn't happen to practice in Ohio, would he? :)
>
> Shell
Posted by Noa on January 18, 2001, at 8:26:04
In reply to Re: Yay, found a good psychiatrist, new diagnosis, posted by Greg on January 18, 2001, at 8:17:52
Hey, Abby, that is good news. Keep us posted on how the med changes go.
Posted by Chris A. on January 19, 2001, at 15:34:15
In reply to Yay, found a good psychiatrist, new diagnosis, posted by Abby on January 17, 2001, at 22:40:48
> So, if you are young when you first experience depression, and an SSRI seems like a miracle in less than 3 weeks, talk to your doctor about considering a bipolar spectrum diagnosis.
Abby,
You said it so well. Amen to that statement! My health and life have been extemely negatively affected because doc after doc missed my bipolar spectrum dx and inappropriately prescribed ADs time after time. The first time I took Prozac was my first noticeable hyomanic period (I noticed it, called my pDoc and he just told me to cut the dose from 20 to 10 mgs). Then it dumped me to the very bottom and I have not been at all well since. The cycling started and has only accelerated despite ongoing aggressive treatment. Beware, anyone out there. If in doubt choose an anticonvulsant or low dose lithim over ADs. Interrogate your doc as to his or her knowledge regarding the subject (in a friendly manner, that is), and be completely honest about any personal or family history, medications ever taken (rx, OTC, "natural", herbal or illicit). Think about and research these issues completely. Your life and well being may depend on it. If in doubt get a second opinion, preferrably from a psychiatrist specializing in mood disorders at the best University Medical school available to you.
When anyone starts speaking of their antidepessant "poop out" I get scared for them. More or different ADs are rarely the answer. If I were practicing that would be a warning sign to prescribe a mood stabilizing med immediately. Sorry if I've offended anyone, but the message needs to get out loud and clear before more people die or develop increasingly severe brain disorders. I have no known history of bipolar disorder or mental illness of any kind in my family. That's just to say that you're not "off the hook" just because of lack of family history. Early depression is a red flag as well as are ADD and ADHD.Thanks, Abby! I wish you the very best of health and happiness.
Blessings,
Chris A.
(standing on my soapbox)
Posted by SLS on January 19, 2001, at 17:33:40
In reply to Re: Yay, found a good psychiatrist, new diagnosis, posted by Chris A. on January 19, 2001, at 15:34:15
Bullseye.
Thanks guys.
> > So, if you are young when you first experience depression, and an SSRI seems like a miracle in less than 3 weeks, talk to your doctor about considering a bipolar spectrum diagnosis.
>
> Abby,
> You said it so well. Amen to that statement! My health and life have been extemely negatively affected because doc after doc missed my bipolar spectrum dx and inappropriately prescribed ADs time after time. The first time I took Prozac was my first noticeable hyomanic period (I noticed it, called my pDoc and he just told me to cut the dose from 20 to 10 mgs). Then it dumped me to the very bottom and I have not been at all well since. The cycling started and has only accelerated despite ongoing aggressive treatment. Beware, anyone out there. If in doubt choose an anticonvulsant or low dose lithim over ADs. Interrogate your doc as to his or her knowledge regarding the subject (in a friendly manner, that is), and be completely honest about any personal or family history, medications ever taken (rx, OTC, "natural", herbal or illicit). Think about and research these issues completely. Your life and well being may depend on it. If in doubt get a second opinion, preferrably from a psychiatrist specializing in mood disorders at the best University Medical school available to you.
> When anyone starts speaking of their antidepessant "poop out" I get scared for them. More or different ADs are rarely the answer. If I were practicing that would be a warning sign to prescribe a mood stabilizing med immediately. Sorry if I've offended anyone, but the message needs to get out loud and clear before more people die or develop increasingly severe brain disorders. I have no known history of bipolar disorder or mental illness of any kind in my family. That's just to say that you're not "off the hook" just because of lack of family history. Early depression is a red flag as well as are ADD and ADHD.
>
> Thanks, Abby! I wish you the very best of health and happiness.
>
> Blessings,
>
> Chris A.
> (standing on my soapbox)
Posted by JahL on January 20, 2001, at 7:59:20
In reply to Re: Yay, found a good psychiatrist, new diagnosis, posted by Chris A. on January 19, 2001, at 15:34:15
> > So, if you are young when you first experience depression, and an SSRI seems like a miracle in less than 3 weeks, talk to your doctor about considering a bipolar spectrum diagnosis.
>
> Abby,
> You said it so well. Amen to that statement! My health and life have been extemely negatively affected because doc after doc missed my bipolar spectrum dx and inappropriately prescribed ADs time after time. The first time I took Prozac was my first noticeable hyomanic period (I noticed it, called my pDoc and he just told me to cut the dose from 20 to 10 mgs). Then it dumped me to the very bottom and I have not been at all well since. The cycling started and has only accelerated despite ongoing aggressive treatment. Beware, anyone out there. If in doubt choose an anticonvulsant or low dose lithim over ADs.> When anyone starts speaking of their antidepessant "poop out" I get scared for them. More or different ADs are rarely the answer. If I were practicing that would be a warning sign to prescribe a mood stabilizing med immediately. Sorry if I've offended anyone, but the message needs to get out loud and clear before more people die or develop increasingly severe brain disorders. I have no known history of bipolar disorder or mental illness of any kind in my family. That's just to say that you're not "off the hook" just because of lack of family history. Early depression is a red flag as well as are ADD and ADHD.
> Chris A.
> (standing on my soapbox)Mmmm... sounds like you're talking about me.
The Valproic Acid I started a few weeks ago is my 1st AED & after multiple AD failures, is the 1st drug to offer sustained mood improvement.
HOWEVER it does nothing 4 amotivation/concentration difficulties etc. My question is; might the 'Prozac miracle' you allude to, be re-attainable now my mood is 'stabilized' (I had brief, overnight remissions on 3 SSRIs), by restarting an AD???
Thanks,
Jah.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.