![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 12 to 36 of 78. Go back in thread:
Posted by gazo on March 19, 2007, at 20:41:24
In reply to Re: Your Opinion: Am I Right Or Just Crazy/Irratio » gazo, posted by Jeff Smith on March 19, 2007, at 19:19:40
is there anyone who can help you with a more effective letter maybe? maybe that is one thing the guidance center people would be good for.
Posted by Jeff Smith on March 20, 2007, at 1:08:48
In reply to Re: Another perspective » Jeff Smith, posted by Racer on March 19, 2007, at 19:37:15
> First of all, anti-psychotics are used for a lot more than psychosis these days. Low dose APs are used for OCD, anxiety, sleep disturbance, as an augmenting agent for antidepressants, and I'm sure other uses I'm not thinking of. The fact that your NP prescribed Abilify isn't so surprising, actually, as it's often used to kick up the effects of anti-depressants.
>
> Second, from your description, I wonder if you might be bipolar? The sort of anger you're describing sounds a little like a mixed state. If so, finding a mood stabilizer might help.
>
> And there are ways to mitigate the weight gain from antidepressants -- one of which is to add Wellbutrin. If you're taking Wellbutrin and it's not doing the full job, maybe adding a low dose of an SSRI would kick it into gear. There are also other drugs, of entirely different classes, that might work better for you. SSRIs are not the only game in town. The meds board here is a great resource for finding information about different drugs.
>
> And I do think that a more effective drug would be the first step for you. Right now, it sounds as though you have plenty of reasons why you won't or can't do anything to improve your situation. To me, that's something I see in myself when I'm depressed. And I don't find it particularly attractive while I'm doing it. What I have found in the past, is that once I have adequate antidepressant activity going on biochemically, I *can* take steps to find the additional help I might need, or at least see options that I wasn't able to see before.
>
> That's only my opinion, of course.
>
> My last comment, though, is about your assessment of the therapists you've seen at community agencies so far: Are you familiar with the idea of a self-fulfilling prophecy? I guess I'd suggest that you consider what it is you're hoping to get out of talk therapy, and then ask for that. If a therapist is telling you too much about herself, and not helping you -- tell her. You don't have to be rude about it, and you certainly don't have to be angry when you tell her, but you can certainly tell her, "You know, I'm not finding it very helpful to hear about your cat. Can we try to stay on topic?" That's your right, since it's your treatment.
>
> Just a few thoughts.... Good luck, whatever happens.I see. Im far from a medical expert though, I just know how it (the Abilify) effected me which was negatively. And Im not sure about the bi-polar: I dont know much about it except that I believe people usually have major highs and lows with it... and Ive never had a major (or even close) high.
Also see my next reply to gazo: Ive been reading the Col. Pres. Hospital webpage and Id be willing to at least consider the possibility of some type of med if they were convincing.
So what is your depression (and/or anxiety) like? How does it limit or prevent you from living life? And (if you dont mind telling) what meds do you take?
Also, if all of my experiences with therapists were the result of a self fulfilling prophecy then Id be very amazed by my mental powers : ) Ive actually gone into every new therapist with great hope that theyll be the one to help and its only when they prove themselves completely opposite from that hope (and as Ive described them) that I become very disenchanted.
The one with the cat who talked all about herself (and btw she also would annoyingly quote Oprah-isms and try to make it seem as though they were her own ideas) was someone I saw about 10 or 11 years ago: I was way too pathetic back then to even dream about asserting myself even in the way you suggested... I wouldve been too afraid to insult her or hurt her feelings (crazy I know but thats how it was).
The last one I saw (for 5 years) did almost no talking. I would talk and talk and talk until I repeated the same crap over and over (I have zero life so soon it was eventually impossible to think of anything new to talk about as nothing ever went on with me/my life). After awhile I managed to tell her that I was getting nothing out of coming there and talking and getting no feedback and that I felt like I wanted to stop seeing her: Thats as far as I got since all she had to do to convince me of otherwise was to agree with my next opinion that I was probably better off leaving the house once a week to go see her than I would be not doing so.
Although she was useless I could tell that she genuinely liked me and I liked her from what I knew about her, as she seemed like a really nice woman, so I especially didnt want to offend her/hurt her feelings by going so far as to leave her. She never did give a reason for her no reply method but I continued to see her and talk and talk and got nothing out of it until she finally left the place to open her own practice.
After her I gave up on therapists, until now, but have been on meds steadily since then.
I just desire a shrink like the ones I read about here, and whatnot, who speak and help and offer an opinion or suggestion once in awhile and who are actively involved in the therapy process so its not like talking to a cardboard cut out, etc... just a competent and qualified and caring person who can confidently help me in the right manner (which Im not exactly sure what that is but Im sure the qualified shrink would know).
Posted by Jeff Smith on March 20, 2007, at 1:33:39
In reply to Re: Your Opinion: Am I Right Or Just Crazy/Irratio, posted by gazo on March 19, 2007, at 20:41:24
> is there anyone who can help you with a more effective letter maybe? maybe that is one thing the guidance center people would be good for.
First: I just told racer to see my next post to you since I thought it was you who also referred the Col. Pres. Hospital but now I see it was cine...
So cine: If this is the Hospital you were talking about http://www.nyppsychiatry.org/abo_us.html
then Im very, very impressed! And thanks again.
They go on and on and on about their extensive tests and interviews and whatnot regarding your specific mental issues (which is explained much better on the page then Im doing here). Ive never experienced any of this... the most "evaluating" I ever got was about 40 minutes w/ a psychiatrist trying to hurry up and tell him my entire life's problems as quick as possible before our time ended.Gazo: Are you trying to get me to censor my anger? ; )
Seriously, I dont really know (but I would doubt if) there's anyone there who'd help me write a letter, but at this moment Im very impressed with the above mentioned Hospital so perhaps Ill be able to get acquainted with them.
Posted by Racer on March 20, 2007, at 1:52:22
In reply to Re: Another perspective » Racer, posted by Jeff Smith on March 20, 2007, at 1:08:48
You asked how my depression/anxiety affected my life, and what meds I'm on. So, I'll give you the short answer to those, although I don't want to go into too much detail.
First, I'm on disability, because of severe depression/anxiety and anorexia nervosa. My depression is the melancholic sort, and when it's bad, it leaves me lying on the sofa, unable to do much of anything. Anxiety is a big problem, too, mostly physical, with some OCD type aspects to it. I'll get intrusive thoughts that I just can't get away from, guilt over past events, shame, etc. The anorexia is chronic, although my weight is near normal range right now.
I take Wellbutrin XL, Prozac, Ritalin, and my pdoc just had me add SAMe. He's also just prescribed a new B complex vitamin, a new prescription formulation, but my pharmacy hasn't gotten that in yet, so I don't know if it will be helpful or not. I have a lot of paradoxical reactions to medications, and a few more common adverse effects, so it's hard to treat either depression or anxiety. Benzodiazepines, like Valium or Xanax, often increase my anxiety a great deal. When I take Ritalin, I often need an afternoon nap. Right now, though, the side effects seem benign enough, and I guess I'm getting back to being pretty OK with this combination. It's early days, though.
And when I was without insurance, I experienced a series of nightmares with trying to get treatment. I won't go into details, but some of it was very, very bad. The most recent horror story is only a couple of years old, and it's here in the archives. Basically, though, I lost a third of my body weight, telling the "therapist" that I had lapsed back into anorexia, and was ignored. The pdoc's notes continued to call me "well nourished" as my BMI dropped below 14. I know that there are horror stories out there. I really do. There are also some good stories, though. It's just hard to find them when you need them.
Abilify may not have been the right drug for you, but there are others like Seroquel and Risperdal that might be a better fit for you. Even Buspar is great for some people. Wellbutrin is a nice drug if it works for you, but it often isn't enough on its own. Adding a low dose of one of the SSRIs is often a good adjunct to it, providing a more robust response. There really are a lot of options out there. And you really do sound as if you're in so much pain right now.
As for the bipolar, it doesn't necessarily mean "highs" and "lows." Many people don't have full blown mania at all -- just hypomania, or mixed states. Hypomania is not quite mania, it's like mania lite. Mixed states, though, can present as depression with rage, or with agitation or anxiety. That sounds a bit like what you're describing, and a lot of the mood stabilizers are also used to augment antidepressants. Lamictal is one that a lot of people have a lot of good luck with. Even Lithium is used successfully to augment antidepressants. You really can get a better response than you're getting right now.
I hope Columbia works out for you. I know a few people there, and they're all good folks. My mother's life was saved there, years ago, and a few people there did a big favor for me by providing second (and third) opinions for me when I wasn't able to access adequate health care a few years back. You're lucky to live close enough to access them, and I truly hope it works out for you.
If it doesn't, for some reason, check with the universities in your area which offer doctoral programs in psychology. Psych candidates have to do some internship work, and often you can get pretty good care from an intern. It's not the most experienced care, but sometimes the students are older, and have more experience of the world. It's certainly worth a shot.
Good luck.
Posted by Honore on March 20, 2007, at 6:02:39
In reply to Your Opinion: Am I Right Or Just Crazy/Irrational, posted by JeffSmith on March 19, 2007, at 12:15:39
Jeff, you say that your problems have a chemical basis. The first line of treatment for you might very well be be medication. Therapy itself could be more effective if the turmoil you've in was somewhat alleviated.
I know this isn't what you want to hear and that you've more or less given up on medications. However, there are ones that you haven't tried. Moreover, given that we live in a profit-based world, and medicare does pay for medications, your chances of getting the best medications is, unfortunately, better than your chances of getting the very best in long term therapy. I don't mean to be harsh-- it isn't fair or very admirable-- but it's just a fact of life--
Anyway, to be a honest, after a lifetime of therapy, and even one therapist who has helped me a lot, I personally think the medications have made (and continue to make) an unequalled effect in helping me. So after many years of distrust, I'm pretty pro=medication-- with the proviso, that it's not necessarily easy to get that right combination that will help.
Besides SSRIs and wellbutrin, there are tricyclics (older generation Anti-depressants, some of which are newer and have fewer side effects), cymbalta, remeron, and MAOIs.--and others These can be supplemented with mood stabilizers or Anti-psychotics-- not because one is psychotic, but because they help to enhance anti-depressant effects and also to help free people from certain hard-to-overcome destructive thought and emotional patterns.
My sugggestion is somehwat like Onewomancine's-- I had looked recently for a place for a friend without insurance to get a good evaluation for medications. Payne Whitney, which is a leading psychiatric hospital in New York, has an outpatient clinic which has highly qualified psychiatrists in training, being supervised by really good clinicians. A consultation is expensive== $125-- but visits after that are on a sliding scale, based on income.
I know that you want a person to talk to-- I understand and empathize with that. And you don't want to be foisted off on another med. But I think, realistically, if you do want your life to get better, the first road to take is that of the best meds you can get.
After that, you may be able to strategize and act in a a more concerted way to find a therapist who can respond more appropriately-- and also you might be able to use better the therapists you do find.
I can find out more details about Payne Whitney, if you're interested. Or Columbia Psych might be also as good.
Honore
Posted by one woman cine on March 20, 2007, at 8:03:47
In reply to Re: Another perspective » Racer, posted by Jeff Smith on March 20, 2007, at 1:08:48
Jeff, I know you've said you've done the "mental health" thing for years - but I think it's always best to be open minded when things start to look bad. Taking medications other than prescribed (ie pot) will interfere with other meds. AP's are not just solely used for psychotic symptoms - they can be used for a host of other things as well.
I would hope you wouldn't go into Columbia needing to be "convinced" to try something else. Is it better living like this, (& smoking pot) - than to give something else a try? One has to be willing to try some other things, other treatments - or nothing will be the same. I second the thoughts about self-fulfilling prophecy in terms of therapy - it is a relationship albeit limited.
But it is a relationship that is also dependent on what you put in too. The therapist can guide you, but you have to be the one to want to do the work and do it.
Therapists cannot perform miracles on patients who are unwilling - again I would urge you to be open minded. Cooperation makes therapy rewarding in terms of building a therapuetic relationship.
Best of luck.
Posted by gazo on March 20, 2007, at 8:25:19
In reply to Re: Your Opinion: Am I Right Or Just Crazy/Irrit » gazo, posted by Jeff Smith on March 20, 2007, at 1:33:39
I am glad you can laugh at your own anger and that you know it is there. I am being this direct because it sounds like you want actual answers.
I am going to go check out that hospital site just out of curiosity. I am glad someone was able to find you something so concrete.I very much hope you get the help you want and need.
Posted by fayeroe on March 20, 2007, at 8:45:09
In reply to Re: Your Opinion: Am I Right Or Just Crazy/Irrit » gazo, posted by Jeff Smith on March 20, 2007, at 1:33:39
Jeff, i'd open up a bit to what is available to you and try just a teeny bit to get that chip off of your shoulder.
i say this as someone much older than you and i've struggled with severe depression all of my life. i've had to be humble and flexible to find what works for me best.
i'm semi-retired now and when i worked as a T, the angry patient was very difficult to help. peeling away all those layers took time and a T only has so much time to give one patient. if you could work on acceptance, on your own, and mellow out (without the pot), i think you'll find that people will be much more receptive to trying to find you some help.
the hospital link sounds good and i know it has a very good reputation.
depression makes us angry, sad, tired, cranky, etc. and we have to just keep trying to find what will give us a better quality of life.
good luck, pat
Posted by gazo on March 20, 2007, at 8:46:56
In reply to Re: Your Opinion: Am I Right Or Just Crazy/Irrit » gazo, posted by Jeff Smith on March 20, 2007, at 1:33:39
I am not in the US, so forgive my ignorance of the system.. but will they take medicare or work with you in a way you can afford?
It sounds like they will with a referral.. can you get one?
I will tell you something else, something of my personal experience. I know for a fact that many pdocs and T's will not take on patients with certain types of illnesses. SOmetimes it's because those illnesses present very difficult issues that they just don't deal with. Other times it's because some illnesses cause the patient to be very resistant to treatment even if they feel they want help. I am NOT suggesting you are either of those.. just that is how it works sometimes, their bad not yours. Some won't take on patients that they think will bore them!
Personally I had a T turn me down outright because of the illness I have, even though I didn't want help with that, I wanted help with life issues.
You would think that with all their training in the workings of the human mind and heart they would be more caring and compassionate.. but sadly, that is not a pre-requisite. Also in my experience, many can be just plain cold.
I do hope this new place works out for you.
Posted by Jeff Smith on March 20, 2007, at 9:36:06
In reply to Re: Another perspective » Jeff Smith, posted by Racer on March 20, 2007, at 1:52:22
> You asked how my depression/anxiety affected my life, and what meds I'm on. So, I'll give you the short answer to those, although I don't want to go into too much detail.
>
> First, I'm on disability, because of severe depression/anxiety and anorexia nervosa. My depression is the melancholic sort, and when it's bad, it leaves me lying on the sofa, unable to do much of anything. Anxiety is a big problem, too, mostly physical, with some OCD type aspects to it. I'll get intrusive thoughts that I just can't get away from, guilt over past events, shame, etc. The anorexia is chronic, although my weight is near normal range right now.
>
> I take Wellbutrin XL, Prozac, Ritalin, and my pdoc just had me add SAMe. He's also just prescribed a new B complex vitamin, a new prescription formulation, but my pharmacy hasn't gotten that in yet, so I don't know if it will be helpful or not. I have a lot of paradoxical reactions to medications, and a few more common adverse effects, so it's hard to treat either depression or anxiety. Benzodiazepines, like Valium or Xanax, often increase my anxiety a great deal. When I take Ritalin, I often need an afternoon nap. Right now, though, the side effects seem benign enough, and I guess I'm getting back to being pretty OK with this combination. It's early days, though.
>
> And when I was without insurance, I experienced a series of nightmares with trying to get treatment. I won't go into details, but some of it was very, very bad. The most recent horror story is only a couple of years old, and it's here in the archives. Basically, though, I lost a third of my body weight, telling the "therapist" that I had lapsed back into anorexia, and was ignored. The pdoc's notes continued to call me "well nourished" as my BMI dropped below 14. I know that there are horror stories out there. I really do. There are also some good stories, though. It's just hard to find them when you need them.
>
> Abilify may not have been the right drug for you, but there are others like Seroquel and Risperdal that might be a better fit for you. Even Buspar is great for some people. Wellbutrin is a nice drug if it works for you, but it often isn't enough on its own. Adding a low dose of one of the SSRIs is often a good adjunct to it, providing a more robust response. There really are a lot of options out there. And you really do sound as if you're in so much pain right now.
>
> As for the bipolar, it doesn't necessarily mean "highs" and "lows." Many people don't have full blown mania at all -- just hypomania, or mixed states. Hypomania is not quite mania, it's like mania lite. Mixed states, though, can present as depression with rage, or with agitation or anxiety. That sounds a bit like what you're describing, and a lot of the mood stabilizers are also used to augment antidepressants. Lamictal is one that a lot of people have a lot of good luck with. Even Lithium is used successfully to augment antidepressants. You really can get a better response than you're getting right now.
>
> I hope Columbia works out for you. I know a few people there, and they're all good folks. My mother's life was saved there, years ago, and a few people there did a big favor for me by providing second (and third) opinions for me when I wasn't able to access adequate health care a few years back. You're lucky to live close enough to access them, and I truly hope it works out for you.
>
> If it doesn't, for some reason, check with the universities in your area which offer doctoral programs in psychology. Psych candidates have to do some internship work, and often you can get pretty good care from an intern. It's not the most experienced care, but sometimes the students are older, and have more experience of the world. It's certainly worth a shot.
>
> Good luck.
Aha, so I see we have some "crazinesses" in common. : ) or actually : (
Wowza though. Sorry to hear about all your issues too (I wouldnt have earlier mentioned all the overweight talk if I knew about the anorexia).I find the idea that you were so severely neglected during your last episode to be really inexcusable. I can see if a "therapist" decides to go into their profession on the basis of making money or other things besides the primary desire to help people... but when they ignore you to the point of your life is endangered and they lie (or are just so demented and pre occupied with themselves) and write you were "well nourished" then thats really scary and so not right.
It reminds me of so many medical shows I watch and things I read on the net: So many people go from Dr to Dr to Dr w/ physical ailments (and they can afford the good ones) only to be repeatedly misdiagnosed until the eventual Dr comes along and discovers what their problem is. It just makes you wonder if this is incompetency or just not paying attention/not caring or is it just genuinely that hard to diagnose the real problem even though the testing is so extensive?
Well anyway we'll see how the med thing works out for me... hopefully Ill find a good place. And also very good luck to you too.
Posted by Jeff Smith on March 20, 2007, at 10:08:19
In reply to Re: Your Opinion: Am I Right Or Just Crazy/Irratio » JeffSmith, posted by Honore on March 20, 2007, at 6:02:39
> Jeff, you say that your problems have a chemical basis. The first line of treatment for you might very well be be medication. Therapy itself could be more effective if the turmoil you've in was somewhat alleviated.
>
> I know this isn't what you want to hear and that you've more or less given up on medications. However, there are ones that you haven't tried. Moreover, given that we live in a profit-based world, and medicare does pay for medications, your chances of getting the best medications is, unfortunately, better than your chances of getting the very best in long term therapy. I don't mean to be harsh-- it isn't fair or very admirable-- but it's just a fact of life--
>
> Anyway, to be a honest, after a lifetime of therapy, and even one therapist who has helped me a lot, I personally think the medications have made (and continue to make) an unequalled effect in helping me. So after many years of distrust, I'm pretty pro=medication-- with the proviso, that it's not necessarily easy to get that right combination that will help.
>
> Besides SSRIs and wellbutrin, there are tricyclics (older generation Anti-depressants, some of which are newer and have fewer side effects), cymbalta, remeron, and MAOIs.--and others These can be supplemented with mood stabilizers or Anti-psychotics-- not because one is psychotic, but because they help to enhance anti-depressant effects and also to help free people from certain hard-to-overcome destructive thought and emotional patterns.
>
> My sugggestion is somehwat like Onewomancine's-- I had looked recently for a place for a friend without insurance to get a good evaluation for medications. Payne Whitney, which is a leading psychiatric hospital in New York, has an outpatient clinic which has highly qualified psychiatrists in training, being supervised by really good clinicians. A consultation is expensive== $125-- but visits after that are on a sliding scale, based on income.
>
> I know that you want a person to talk to-- I understand and empathize with that. And you don't want to be foisted off on another med. But I think, realistically, if you do want your life to get better, the first road to take is that of the best meds you can get.
>
> After that, you may be able to strategize and act in a a more concerted way to find a therapist who can respond more appropriately-- and also you might be able to use better the therapists you do find.
>
> I can find out more details about Payne Whitney, if you're interested. Or Columbia Psych might be also as good.
>
> Honore
Howdy Honore,First of all we'd all damn well better hope that Tom Cruise isnt reading about all the psychiatric med pushing going on here or he is gonna go ape sh*t on our a$$e$!! (Thats a jab at him that youll get if you know of his insane/ignorant/Scientology brain washed based hatred of the "evil" psychiatrists and their mind control drugs).
As for my opinion on meds: I really hope I never came across as thinking they were useless for everyone cause I in no way believe that. They just havent worked for me.
Yes, if its possible that I find a good shrink that can properly evaluate me based on actually listening to me and questioning me (and whatever other potential testing they may do) and can come to a definite and specific diagnosis/theory and was confident that drugs X, Y or Z would help me (and could guarantee that they wouldnt cause me to gain any weight) then I cant see that I would have any objection to taking those drugs.
And thanks for the tip on Payne Whitney and for offering to find details : ) I can google it though (unless you meant more details as in only things that you could privately find out?).
Posted by Racer on March 20, 2007, at 11:32:42
In reply to Re: Another perspective » Racer, posted by Jeff Smith on March 20, 2007, at 9:36:06
Listen, Jeff, as far as the weight thing goes, I do know what you're talking about. (And the good part of this place is that you don't have to self-censor yourself on someone else's behalf -- except for staying inside the civility guidelines, which can be found http://www.dr-bob.org/babble/faq.html#civil -- so don't let my problem stop you from stating yours.)
(By the way, I strongly urge you to check out the civility guidelines at that link, because some of what you've written here might bring on a "Please be civil" warning from a deputy or from Dr Bob himself. This is a great site, and everyone is very supportive, but the rules about civility are part of what allows us to be such a supportive community. I'd hate to see you get dinged for civility, when you just didn't know the rules.)
I have had trouble with weight gain from meds. It's ranged from 45 to 70 pounds, although to be fair I've started out underweight each time. On the other hand, that sort of weight gain has pushed me above normal weight range. It's terrible, and I won't even try to tell you how devastating it was for me. But there's been a big change in more recent times: most doctors now know that these drugs really do cause weight gain, and many doctors are finally starting to take it seriously. There are strategies that can mitigate weight gain, ranging from adding Wellbutrin -- which can also help with sexual side effects -- to adding other sorts of drugs to help mitigate the problem. Weight gain is one of those quality of life issues that lead to non-compliance, so doctors do take it seriously.
As for the stories of doctors dismissing patients' complaints, you know the joke, right? "WNL" doesn't really mean "within normal limits," it means "we never looked." (That's actually a doctor joke, they tell it themselves.)
It sounds as though both Columbia and Payne Whitney are good leads for you. I gotta agree that meds are probably a better first line for you. My own experience is that talk therapy goes much better when I'm adequately medicated -- and goes no where when I'm not.
Good luck.
Posted by Jeff Smith on March 20, 2007, at 11:49:28
In reply to Another perspective - open minded-ness » Jeff Smith, posted by one woman cine on March 20, 2007, at 8:03:47
> Jeff, I know you've said you've done the "mental health" thing for years - but I think it's always best to be open minded when things start to look bad. Taking medications other than prescribed (ie pot) will interfere with other meds. AP's are not just solely used for psychotic symptoms - they can be used for a host of other things as well.
>
> I would hope you wouldn't go into Columbia needing to be "convinced" to try something else. Is it better living like this, (& smoking pot) - than to give something else a try? One has to be willing to try some other things, other treatments - or nothing will be the same. I second the thoughts about self-fulfilling prophecy in terms of therapy - it is a relationship albeit limited.
>
> But it is a relationship that is also dependent on what you put in too. The therapist can guide you, but you have to be the one to want to do the work and do it.
>
> Therapists cannot perform miracles on patients who are unwilling - again I would urge you to be open minded. Cooperation makes therapy rewarding in terms of building a therapuetic relationship.
>
> Best of luck.Cine,
Yup, I agree/have agreed that I need to be more open minded to meds (in so many words) and Im totally open minded to other therapy but there are just certain facts that are true regarding many therapists (such as like at the Center I go to where the majority of therapists are interns who appear to be in their younger 20's and who I am not open minded to seeing). I have reasons to think they arent qualified or experienced enough to have any idea how to counsel me with my extensive mental/emotional issues... not to mention none of them stay very long so Id be changing therapists every 6 months (Im estimating). I may be wrong or I may be right about them but I dont believe my beliefs regarding them has anything to do with a need for or a lack of medication. If I needed an operation I (if I had the choice) would just prefer the older, more experienced surgeon whos done it a thousand times over the intern/new surgeon who has very little experience and is trying to recall his/her medical books and classes in order to get the job done.
And yes, of course I would go into Columbia needing to be "convinced" to try something else. If I didnt need to be convinced of things then I might blindly go around doing anything others said I should, and that would be not good. If I didnt need to be convinced then I might go to a faith healer and believe him when he says he's cured my illness... and then Id die from lack of medical attention.
Dont you need to be convinced that any drug you take will do what it claims and will be safe and is being prescribed to you by a qualified prescriber for an accurate diagnosis rather than someone who's giving you the wrong stuff for the wrong reason?
You said: "Is it better living like this, (& smoking pot) - than to give something else a try?"
Well its not better living like this than giving something else a try... but where does the "& smoking pot" part come into the "living like this" part? Pot has no effect on how I live.
Im not sure what you think, but:
-I dont smoke enormous quantities of pot. I smoke small amounts. It has nothing to do with any of my issues as Ive had the exact issues my entire life and notice no difference at all while smoking pot as opposed to life without smoking pot. Ive heard of studies saying it causes depression and Ive heard of studies that say it doesnt (and that it does benefit certain people for physical and mental problems) but Im no expert and dont study these studies.
(And for anyone who's wondering how I can afford pot when I cant afford shrinks: I cant. I smoke my roomates when he has it.)You also said "But it is a relationship that is also dependent on what you put in too. The therapist can guide you, but you have to be the one to want to do the work and do it.
Therapists cannot perform miracles on patients who are unwilling - again I would urge you to be open minded. Cooperation makes therapy rewarding in terms of building a therapuetic relationship. ".Are you suggesting that the reason Ive had no success with any of my (lets call them) talk therapists in the past has been because I have been "unwilling" and not "open minded" to them and that I havent cooperated with them?
Ultimately I agree though that I need to try something new. Im trying. : )
Posted by Jeff Smith on March 20, 2007, at 11:52:26
In reply to Re: Your Opinion: Am I Right Or Just Crazy/Irrit, posted by gazo on March 20, 2007, at 8:25:19
> I am glad you can laugh at your own anger and that you know it is there. I am being this direct because it sounds like you want actual answers.
>
> I am going to go check out that hospital site just out of curiosity. I am glad someone was able to find you something so concrete.I very much hope you get the help you want and need.
Thanks gazo, youre very sweet.
And yes, thank you... I do want actual answers and love when people are as direct as possible.
Posted by Jeff Smith on March 20, 2007, at 12:33:02
In reply to Re: Your Opinion: Am I Right Or Just Crazy/Irrit » Jeff Smith, posted by fayeroe on March 20, 2007, at 8:45:09
> Jeff, i'd open up a bit to what is available to you and try just a teeny bit to get that chip off of your shoulder.
>
> i say this as someone much older than you and i've struggled with severe depression all of my life. i've had to be humble and flexible to find what works for me best.
>
> i'm semi-retired now and when i worked as a T, the angry patient was very difficult to help. peeling away all those layers took time and a T only has so much time to give one patient. if you could work on acceptance, on your own, and mellow out (without the pot), i think you'll find that people will be much more receptive to trying to find you some help.
>
> the hospital link sounds good and i know it has a very good reputation.
>
> depression makes us angry, sad, tired, cranky, etc. and we have to just keep trying to find what will give us a better quality of life.
>
> good luck, patHey Pat,
Do you really think Ive had a "chip on my shoulder"? I mean obviously Im angry but its due to being "mentally ill" to begin with and then frustrated (with great reason) and etc, etc. and not just some bad or mean or confrontational attitude/ chip on my shoulder.
I do realize that anger turns people off but Im sure its understandable why Id be angry and Id hope that any therapist who heard my reasons for being angry would especially understand it, even if the therapist thought my reasons were invalid. Aside from this NYPGroup Ive not even expressed any anger to anyone who was in a position to try to find me help... and I didnt start out angry towards them, I only got angry after their reply.Honestly Im not capable of working on (or more specifically achieving) acceptance (if you mean self acceptance) on my own or mellowing out. Ive gotten nowhere in 37 years and I believe I need help for these things. Im very mentally weak.
Posted by Jeff Smith on March 20, 2007, at 12:48:29
In reply to Re: Your Opinion: Am I Right Or Just Crazy/Irrit, posted by gazo on March 20, 2007, at 8:46:56
> I am not in the US, so forgive my ignorance of the system.. but will they take medicare or work with you in a way you can afford?
>
> It sounds like they will with a referral.. can you get one?
>
> I will tell you something else, something of my personal experience. I know for a fact that many pdocs and T's will not take on patients with certain types of illnesses. SOmetimes it's because those illnesses present very difficult issues that they just don't deal with. Other times it's because some illnesses cause the patient to be very resistant to treatment even if they feel they want help. I am NOT suggesting you are either of those.. just that is how it works sometimes, their bad not yours. Some won't take on patients that they think will bore them!
>
> Personally I had a T turn me down outright because of the illness I have, even though I didn't want help with that, I wanted help with life issues.
>
> You would think that with all their training in the workings of the human mind and heart they would be more caring and compassionate.. but sadly, that is not a pre-requisite. Also in my experience, many can be just plain cold.
>
> I do hope this new place works out for you.
Well some of the ones who (if you mean private shrinks?) dont take medicare will work with a sliding scale fee.
But now Im not sure who you mean regarding needing a referral for?
And that sucks that you were rejected for that reason. Im sure weve all heard that cliche (dont know if its true or not) that shrinks are all f*cked up themselves... but lets assume its true and theyre all evil just for now. : )
Posted by one woman cine on March 20, 2007, at 12:58:01
In reply to Re: Your Opinion: Am I Right Or Just Crazy/Irrit, posted by Jeff Smith on March 20, 2007, at 12:48:29
>>>>>Im sure weve all heard that cliche (dont know if its true or not) that shrinks are all f*cked up themselves... but lets assume its true and theyre all evil just for now.
Um, then why seek help at all if they are *all* just stupid, evil and money hungry as you say they are?
Posted by Jeff Smith on March 20, 2007, at 13:20:31
In reply to Re: Another perspective » Jeff Smith, posted by Racer on March 20, 2007, at 11:32:42
> Listen, Jeff, as far as the weight thing goes, I do know what you're talking about. (And the good part of this place is that you don't have to self-censor yourself on someone else's behalf -- except for staying inside the civility guidelines, which can be found http://www.dr-bob.org/babble/faq.html#civil -- so don't let my problem stop you from stating yours.)
>
> (By the way, I strongly urge you to check out the civility guidelines at that link, because some of what you've written here might bring on a "Please be civil" warning from a deputy or from Dr Bob himself. This is a great site, and everyone is very supportive, but the rules about civility are part of what allows us to be such a supportive community. I'd hate to see you get dinged for civility, when you just didn't know the rules.)
>
> I have had trouble with weight gain from meds. It's ranged from 45 to 70 pounds, although to be fair I've started out underweight each time. On the other hand, that sort of weight gain has pushed me above normal weight range. It's terrible, and I won't even try to tell you how devastating it was for me. But there's been a big change in more recent times: most doctors now know that these drugs really do cause weight gain, and many doctors are finally starting to take it seriously. There are strategies that can mitigate weight gain, ranging from adding Wellbutrin -- which can also help with sexual side effects -- to adding other sorts of drugs to help mitigate the problem. Weight gain is one of those quality of life issues that lead to non-compliance, so doctors do take it seriously.
>
> As for the stories of doctors dismissing patients' complaints, you know the joke, right? "WNL" doesn't really mean "within normal limits," it means "we never looked." (That's actually a doctor joke, they tell it themselves.)
>
> It sounds as though both Columbia and Payne Whitney are good leads for you. I gotta agree that meds are probably a better first line for you. My own experience is that talk therapy goes much better when I'm adequately medicated -- and goes no where when I'm not.
>
> Good luck.
Hey,
Alright, good... I just didnt want to bring up unecessarily an issue which wouldve been very upsetting.
OK, can you please clue me in as to what I said that would be considered uncivil? I honestly cant think of anything I said that was uncivil towards anyone here... aside from maybe the Scientology remarks and suicide talk but you wont find any Scientologists on a psychiatric message board (unless theyre here to collect data from the evil doers) and the suicide talk wasnt threatening or anything towards anyone here. Was it the censored cursing? If you dont mind telling me then I dont mind if you say it here but if youd prefer you can private message me. Thanks. : )Its good to hear that the shrinks are realizing weight is an issue (again I dont mean to harp on it, but its obviously important). Are your current meds allowing you to maintain a healthy and happy weight for you?
Oh, and very funny (not really) joke the Dr's share. How dare they mock us! : )
Posted by Racer on March 20, 2007, at 13:50:05
In reply to Re: Another perspective » Racer, posted by Jeff Smith on March 20, 2007, at 13:20:31
Jeff, the civility issues in your posts do include the Scientology remarks, as well as the remarks about mental health professionals being "evil" or "f*'d up." This forum is a place to offer support -- within limits that are in place to protect us all. I hope you'll read the FAQ about civility, at http://www.dr-bob.org/babble/faq.html#civil
It can take a while to learn the rules of civility here, but they're good for the group as a whole, and this place functions better if we all follow them. That includes not making sweeping generalizations, especially those that might lead others to feel accused or put down. While there's a little leeway when it comes to Ts and pdocs -- since many of us need a safe place to vent about them now and again -- there's not a lot of leeway. After reading the FAQ, the best advice I can offer is to follow The Golden Rule, and not post anything that might upset you if it was posted about you.
I hope you understand.
This post to you, by the way, is made as a poster, and not as a deputy for Dr Bob. I'm considering it a friendly explanation, to help you avoid an official warning. Please do read the FAQ about civility. It can save a lot of hurt feelings on all sides.
Posted by Jeff Smith on March 20, 2007, at 14:17:37
In reply to Re: Your Opinion: Am I Right Or Just Crazy/Irrit » Jeff Smith, posted by one woman cine on March 20, 2007, at 12:58:01
> >>>>>Im sure weve all heard that cliche (dont know if its true or not) that shrinks are all f*cked up themselves... but lets assume its true and theyre all evil just for now.
>
> Um, then why seek help at all if they are *all* just stupid, evil and money hungry as you say they are?
>
>
Why seek help at all? Because I need it and these are the poeple you go to for it. Same reason anyone else would seek help.
I never said they were *all* "just stupid" (or if I did then please just quote where I said that?).
When I said the word evil (which you just took out of context) I said it like this: "And that sucks that you were rejected for that reason. Im sure weve all heard that cliche (dont know if its true or not) that shrinks are all f*cked up themselves... but lets assume its true and theyre all evil just for now. : )"
If you couldnt tell, that was said in jest. Note the smilie face and words "just for now". : )
I dont at all believe all shrinks are evil or that they have any higher percentage of "evil" people than non shrinks do.
Money hungry? It would be unfair to say theyre ALL money hungry as I dont know statistics or all of them personally... but yes I believe theyre more money hungry than humanitarian. What percentage I dont know and have no way of finding out.So:
Why did you not reply to my last post to you or answer any of the questions in it, and instead come up with this question apparently in response to that quote from me to gazo?
Are you for some reason angry or insulted or offended?
Im confused.
Posted by Jeff Smith on March 20, 2007, at 14:29:44
In reply to Civility » Jeff Smith, posted by Racer on March 20, 2007, at 13:50:05
> Jeff, the civility issues in your posts do include the Scientology remarks, as well as the remarks about mental health professionals being "evil" or "f*'d up." This forum is a place to offer support -- within limits that are in place to protect us all. I hope you'll read the FAQ about civility, at http://www.dr-bob.org/babble/faq.html#civil
>
> It can take a while to learn the rules of civility here, but they're good for the group as a whole, and this place functions better if we all follow them. That includes not making sweeping generalizations, especially those that might lead others to feel accused or put down. While there's a little leeway when it comes to Ts and pdocs -- since many of us need a safe place to vent about them now and again -- there's not a lot of leeway. After reading the FAQ, the best advice I can offer is to follow The Golden Rule, and not post anything that might upset you if it was posted about you.
>
> I hope you understand.
>
> This post to you, by the way, is made as a poster, and not as a deputy for Dr Bob. I'm considering it a friendly explanation, to help you avoid an official warning. Please do read the FAQ about civility. It can save a lot of hurt feelings on all sides.
Got it. Thanks Racer. I was here briefly before so I knew a bit about the civility rules, but at the time I wrote it never thought the Scientology remarks would be considered uncivil considering their stance on psychiatry, but they are a group/ "religion" so I shouldve known the rule applys.
Oh, and yes I also see how those shrink comments would be uncivil too, but if you see my last post to Cine it will explain the comments.
My apologies to Dr. Bob, all mental health professionals on board and everywhere and especially to all Scientologists... particularly the lovely Mr. Tom Cruise. : )
Posted by gazo on March 20, 2007, at 17:08:42
In reply to Re: Civility » Racer, posted by Jeff Smith on March 20, 2007, at 14:29:44
> ....particularly the lovely Mr. Tom Cruise. : )
>You have great sense of humor...too funny.
Posted by gazo on March 20, 2007, at 17:19:53
In reply to Re: Your Opinion: Am I Right Or Just Crazy/Irrit, posted by Jeff Smith on March 20, 2007, at 12:48:29
> Well some of the ones who (if you mean private shrinks?) dont take medicare will work with a sliding scale fee.
> But now Im not sure who you mean regarding needing a referral for?
> And that sucks that you were rejected for that reason. Im sure weve all heard that cliche (dont know if its true or not) that shrinks are allWell, I don't think they are all f*ed up or evil, although I am sure that like every segment of the population there are some. What does bother me is the lack of consideration of aptitude when accepting people into the programs. Same goes for medical doctors. We tend to have this idea that they will genuinely care... and some just don't.
I have seen mental health workers, of many varieties, just acting badly in their private lives. It's like seeing a priest steal someone's wallet... leaves a bad taste in your mouth.
Granted, the ones I have seen clinically myself have done alright by me I guess.
ABout the referral.. I meant that hospital clinic, same thing with the cost. Can you go there without having to pay a bunch of money? I looked at the site and they seem impressive.
Posted by Jeff Smith on March 21, 2007, at 7:03:00
In reply to Re: Your Opinion: Am I Right Or)) Jeff, posted by gazo on March 20, 2007, at 17:19:53
>
> > Well some of the ones who (if you mean private shrinks?) dont take medicare will work with a sliding scale fee.
> > But now Im not sure who you mean regarding needing a referral for?
> > And that sucks that you were rejected for that reason. Im sure we all heard that cliche (dont know if its true or not) that shrinks are all
>
> Well, I don't think they are all f*ed up or evil, although I am sure that like every segment of the population there are some. What does bother me is the lack of consideration of aptitude when accepting people into the programs. Same goes for medical doctors. We tend to have this idea that they will genuinely care... and some just don't.
>
> I have seen mental health workers, of many varieties, just acting badly in their private lives. It's like seeing a priest steal someone's wallet... leaves a bad taste in your mouth.
>
> Granted, the ones I have seen clinically myself have done alright by me I guess.
>
> About the referral.. I meant that hospital clinic, same thing with the cost. Can you go there without having to pay a bunch of money? I looked at the site and they seem impressive.Hey gazo,
Just to completely clarify, since Im not sure if you read my post to cine yesterday, I explained that it was in jest that I referred to the "cliche" about shrinks and also about them being "evil"... and well here's what I said to cine about that:
"When I said the word evil (which you just took out of context) I said it like this: "And that sucks that you were rejected for that reason. Im sure we all heard that cliche (dont know if its true or not) that shrinks are all f*cked up themselves... but lets assume its true and theyre all evil just for now. : )"
If you could tell, that was said in jest. Note the smiley face and words "just for now". : )
I dont at all believe all shrinks are evil or that they have any higher percentage of "evil" people than non shrinks do."And Ill also add that I dont believe that all shrinks are "f*cked up"... I just found it an appropriately funny and obnoxious cliche at the time (which I had assumed everyone has heard before... in fact I know Ive seen it written here once (I believe in administration) but another term was used instead of "F'd up").
As for the hospital in NYC I agree, they seem very, very impressive : )
But Im also confused: They seem to have a million different programs and whatnot but some say they dont take insurance (but charge very low cost), one says the whole intake evaluation (or whatever it was called) was like $1500, a couple say they take medicare and I think others dont mention anything.
I dont know, its all very confusing so Ill definitely have to call to find out exactly where to go, what to do, how to pay, if theyll take me, etc, etc...
Posted by Honore on March 21, 2007, at 10:42:32
In reply to Re: Another perspective » Racer, posted by Jeff Smith on March 20, 2007, at 1:08:48
It is really tough at this moment to find a good, affordable T, or pdoc. Esp. in NYC. The irony is that there probably are more good ones in NYC than in many other cities-- they just charge extraordinary fees.
The thing is, if you approach the situation with a "show me" attitude, you're likely to get less out of it. Or course, you're depressed, frustrated, angry. It's all too natural to feel as if some expert needs to find the right answer and then prove that it's the right one, before you go through any more misery.
There are a couple of people here who've gone through the mill and finally, after many failures and disappointments, found drug combos which, despite being unusual, work for them- when all the standard treatments not only failed, but wreaked various forms of temporary havoc. It's a hard road, but they did get to something that worked.
The best answer is to try (as much as possible) to adopt their attitude--as unfamiliar as it is, as difficult as adoption may be ( I do mysekf)-- despite falling into cynicism, dismissiveness, and angry despair when the person isn't who I've wanted, and their approach isn't that much what I'd like. It's a big part of the struggle to give some degree of trust, without trusting too much, and therefore feeling un bearably awful when things don't work.
There are drugs, for example, that don't cause weight gain-- Wellbutrin, Parnate, and combinations. Not everyone gains weight even with the drugs that do have that tendency. You have to submit to the unfortunate process== if you want to get to that place where you feel better. No expert can spare you that-- although I'm sure they woudl, if they could. Science just isn't at that point-- at the moment.
So we TR people are stuck with going through a lot of yuckiness if we want to have a chance to get to a better life.
It's understandable to be angry, to be furious even at the pdocs and Ts who weren't very well trained, or on-the-mark. I guess the best thing to do is try to forgive them their limitations-- and to invest yourself in looking for something better.
I take a small dose of abilify myself-- and have found it incredibly much better than my AD alone-- but that's me, and my body chemistry. It's really finding out, by trial and error, what you can use, and what you can't. Doing research, looking for the right person, despite the hard road. I think everyone here will try to give you support and suggestions, if it gets disappointing-- but if you turn away in anger and resentment, you, in the end, are the one left without the treatment you need.
That, I think, is what everyone is saying, in one way or another.
Honore
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