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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by MM on July 21, 2001, at 0:18:22
I feel like a failure, especially when it comes to fighting for myself. I know I need to go to a psychiatrist, be open, discuss my meds etc. I have anxiety issues, and I haven't been going to my pdoc like I should. I've met with him 2 times, and he's not mean or anything. He's probably a really smart, nice person, but I feel ashamed. He diagnosed BPII, and prescribed seroquel for sleep (25mgs at bedtime) and lithium. I never got the lithium because it required going to a doctors office for tests. I haven't done it. Since then I decided that I wanted to try Neurontin before lithium, and he said that was fine, but I have to see him for 30mins (10 by myself, 20 w/ me and my parent). He's trying, I know that. Why can't/don't I? I guess it's social phobia or w/e that makes me think that everyone's judging me harshly, or fear that I'm going to make some horribly embarassing, innapropriate mistakes (which I have and do), but it's still real to me, and I feel like he would be reprimanding, or really questioning why I'm not doing what I should. I don't know why, and can't really answer. I'm pretty much agoraphobic. Should I get some other kind of psychiatric help (like tele-psychiatry?). Has anyone heard of special treatment for people like me (prescribing over the phone)? I know this is a med forum, and I'm sorry to be personal, but it seems like there's some people here who have been around the block with psychiatrists etc. and you seem to know your stuff. ANY questions, thoughts, advice welcome. Thanks.
Posted by SalArmy4me on July 21, 2001, at 1:06:32
In reply to Need advice, or something, posted by MM on July 21, 2001, at 0:18:22
Neurontin is good for Social Phobia and related disorders:
Pande, Atul C. MD, FRCPC et al. Treatment of Social Phobia With Gabapentin: A Placebo-Controlled Study. J of Clin Psypharm. 19(4):341-348, Aug 99.
{NOT FROM MEDLINE}
"This study has shown that gabapentin produced a significantly greater decrease in the symptoms of social phobia than did placebo as measured by the LSAS. Treatment response seemed to be influenced by age and gender, an observation for which only speculative explanations can be offered. Because women exhibited greater responses to placebo, the drug-placebo treatment difference was smaller for women than for men. Despite the influence of these variables, gabapentin seems to have anxiolytic activity, which confirms the anxiolytic profile seen in preclinical behavioral experiments."
Posted by sl on July 21, 2001, at 7:25:50
In reply to Need advice, or something, posted by MM on July 21, 2001, at 0:18:22
>Since then I decided that I wanted to try Neurontin before lithium, and he said that was fine, but I have to see him for 30mins (10 by myself, 20 w/ me and my parent). He's trying, I know that. Why can't/don't I? I guess it's social phobia or w/e that makes me think that everyone's judging me harshly, or fear that I'm going to make some horribly embarassing, innapropriate mistakes (which I have and do), but it's still real to me, and I feel like he would be reprimanding, or really questioning why I'm not doing what I should. I don't know why, and can't really answer. I'm pretty much agoraphobic.
Agoraphobic is usually the fear of being outside or going new places. I think you said Agoraphobic because you're uncomfortable with the words "Social Phobia". I have a couple ideas for you. For starters, stop telling yourself you're bad. You're not bad, you're ill! You can sit there and tell yourself it's irrational, but it doesn't go away. That's the thing about PHOBIAS. (it's in the definition of phobia!) You KNOW they're irrational, but they just don't go away. A Phobia is: A persistent, abnormal, and irrational fear of a specific thing or situation that compels one to avoid it, despite the awareness and reassurance that it is not dangerous.
Practical Suggestions:
Sit down (alone) with a notebook and write "I have Social Phobia" 10 or 20 times (or more), til you can write it without wincing or worrying. Practice saying it in your head, hear your voice in your mind. If you have somewhere private, practice saying it to the mirror. It feels stupid, but at least you can associate yourself with saying it to a face. If you're comfortable with your parent, take the notebook and show it to them, and TELL them, "I'm practicing to tell the doctor". They'll probably look at you funny, but they'll READ it and know, and you won't have to tell them. If you can, rip out a line of the notebook and give it to your doctor. Stare at the floor, looking him in the face will make you afraid (cuz it's a PHOBIA). He'd have to be dumb as a rock to miss it. If he asks you Why you think you have social phobia....*sigh* If you know how, let your fear of answering show on your face and just look at him. Again, he'd have to be a fool to miss it.The stuff I suggested above, starting with the notebook, is a sort of "systematic desensitization". It's a treatment used with phobias of all kinds, to get you used to the idea gradually, before confronting your fear. Those steps might take you a week or two, or a day or two, depending on how bad your phobia is. But eventually I hope you'll be able to tell your doctor, or at least your parent so THEY can tell your doctor. (if your parent criticizes or picks on you, don't even try to tell them, go straight to the doc and try your HARDEST to tell him! It's much more important that HE know.)
My history: I've had depression since I was 11. At age 11, I probably would have been diagnosed as social phobic too, but I didn't see a doctor til I was 19. It got better for me over the years (I'm 27), but certain situations still make me nervous. My depression medication helped a lot, but now I'm dealing with a new doctor, trying to get the anxiety involving social situations fixed up so I can live like a normal adult.
>Should I get some other kind of psychiatric help (like tele-psychiatry?). Has anyone heard of special treatment for people like me (prescribing over the phone)?
Eep. I asked for something like that, and they jumped all over me in here. Prescribing over the phone is hard, tho, anyway. What you really need to do is try to show your fear on your face. You don't have to say anything, you don't have to look at him, fix your eyes on the front of his desk, on the floor in front of him, on a spot behind his head, or whatever. If you look at him, you'll freak.
>I know this is a med forum, and I'm sorry to be personal, but it seems like there's some people here who have been around the block with psychiatrists etc. and you seem to know your stuff. ANY questions, thoughts, advice welcome. Thanks.
There you have it. I hope you appreciate how open I was with you. Remember, you're not a bad person!
Luck...
slPS if you can't ever tell him, if you can't get up the nerve, try to suggest Paxil to him, it's a medication approved for Social Phobia. It's best if he KNOWS, so if it doesn't work you can try something else, but if all else fails.... :)
Posted by MM on July 21, 2001, at 16:32:52
In reply to Re: Need advice, or something, posted by sl on July 21, 2001, at 7:25:50
Thanks sl. I think I'm dxd or it was discussed that I have social phobia, which I agree with. I said agoraphobic because I was diagnosed with that in the very beginning of all this because I don't leave the house much, (which probably has evolved from social phobia) so the agoraphobia fits. I am now diagnosed with Bipolar II disorder.
My Pdoc knows I'm scared. I was pretty freaked out when I went to see him before. I think I feel so guilty because of my mom, not the doc. I'm 18, I should be moving out right about now, not hiding in the house. Every time I have a fear or w/e it's like I failed everyone. There's a lot of tension and unspoken pressure to get better, NOW. Anyway, just wanted to thank you for your suggestions. Sorry I kinda rambled.
Posted by sl on July 21, 2001, at 18:46:02
In reply to Re: Need advice, or something, posted by MM on July 21, 2001, at 16:32:52
> My Pdoc knows I'm scared. I was pretty freaked out when I went to see him before. I think I feel so guilty because of my mom, not the doc. I'm 18, I should be moving out right about now, not hiding in the house. Every time I have a fear or w/e it's like I failed everyone. There's a lot of tension and unspoken pressure to get better, NOW. Anyway, just wanted to thank you for your suggestions. Sorry I kinda rambled.That's okay! We here on Psycho-Babble totally understand. Sometimes you just need to "talk". I hope you have a counselor/therapist you can see regularly (once or twice/wk) to talk about this stuff. Sometimes they can't make the mental illness better but they can make it easier to live with.
It may encourage you to know that LOTS of people are staying at home much longer. Years ago, yeah, they were supposed to be out at 18. But it's getting REALLY common to live at home til you're financially stable. My sister and brother still live in my mothers rental unit, they're 23 and 25, mom lived there with them til 2 years ago.
My now-ex-boyfriend lived at home when we met, he was 26. When I had a problem, financial and mental, I moved home for 8 months til I could get control.Maybe your mother needs to stop being selfish.
sl
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