Psycho-Babble Medication Thread 3247

Shown: posts 1 to 11 of 11. This is the beginning of the thread.

 

new therapist-help

Posted by jane on February 25, 1999, at 21:21:56

after years of therapy with the same doctor,
I have had to switch psychiatrist. I'm finding it overwhelming to "educate" someone new to my personal and medical history. How do I know the 'new' doctor is the right match for me? How do I not feel like I am repeating myself - it is exhausting emotionally and financially. I feel like I'm lost. thanks

 

Re: new therapist-help

Posted by Victoria on February 26, 1999, at 18:13:07

In reply to new therapist-help, posted by jane on February 25, 1999, at 21:21:56

I haven't had quite the same experience, but I re-entered therapy with a new doctor after a long-term therapy with someone else. Obviously, some of the same issues come up. I found that talking to the new dr about what had been good and bad about the previous experience was very helpful, helped us to establish our relationship and me to learn about what different things he can offer me, and so on. If the switch was unavoidable, then maybe it would help to think of this first phase not as "educating" your dr but forming a new relationship with him/her. As you explore what that relationship will be like, you'll most likely get a good feeling for whether that relationship is right for you. Good luck!


therapy with the same doctor,
> I have had to switch psychiatrist. I'm finding it overwhelming to "educate" someone new to my personal and medical history. How do I know the 'new' doctor is the right match for me? How do I not feel like I am repeating myself - it is exhausting emotionally and financially. I feel like I'm lost. thanks

 

Re: new therapist-help

Posted by Carol on March 1, 1999, at 8:24:58

In reply to Re: new therapist-help, posted by Victoria on February 26, 1999, at 18:13:07

Jane,

I have made Dr. switches before, and they are not "easy" times. One of the things that I have found useful is to write down everything that I can remember about my psych history, including medications, dosages (if I remember), and my reaction to them. Also, if you have had postive repsonses to any particular kind of therapy, (for me-cognitive therapy), you will do yourself a favor by letting your new Dr. know all this.

You can have a mis-fit between you and your doctor. The Dr. I had before the one who is helping me now was very traditional, and did not think that combining medications or "pushing dosages" were acceptable treatments. She also kept pushing me to evaluate my marriage as one of the root causes of my problem. (Depression has been a problem since I was 13).

I worked with that doctor for almost 8 months before I moved on to my current Dr. I can work with his style much more easily.

There are a couple of methods to "interview" doctors. Possible questions: 1) How long do your patients stay in therapy with you? 2) What "style" would you describe yourself as having? 3) What is a "good" treatment outcome (problem here if the Dr. wants to see you every week for the next 10 years) 4)What is your approach to medications? (i.e. are they tools to assist, the only "cure", or only to be used as a last resort?) 5) How do you diagnose a patient as having particular problems? (I've had a LOT of trouble with mis-diagnoses) 6) Describe what a "normal" session will look like.

In the 15 years or so that I've been working on my depression, I've seen 7 or 8 different psychiatrists and about that many therapists and social workers. Bad fits happen. They do NOT mean that you are not applying yourself to solving your problem, or that you are looking for a miracle that no one can provide. You DO need to assume responsibility and determine that YOU are in charge of your life. (The cognitive stuff REALLY works for me, as long as my meds are working.)

I hope some of this helps.

Good Luck
Carol

 

Re: new therapist-help

Posted by jane on March 1, 1999, at 21:48:46

In reply to Re: new therapist-help, posted by Carol on March 1, 1999, at 8:24:58

thank you for all the help - I really needed the input - jane

 

Re: new therapist-help

Posted by Mike on March 15, 1999, at 21:19:52

In reply to Re: new therapist-help, posted by jane on March 1, 1999, at 21:48:46

> thank you for all the help - I really needed the input - jane

how do you know when you need a change. i been with this guy for 2 months and told him how i almost comit suicide and he suggested another way i could do it. time to leave him?

 

Re: new therapist-help

Posted by Carol on March 17, 1999, at 8:04:02

In reply to Re: new therapist-help, posted by Mike on March 15, 1999, at 21:19:52

Mike wrote:
> how do you know when you need a change. i been with this guy for 2 months and told him how i almost comit suicide and he suggested another way i could do it. time to leave him?

Mike,
Two months seems like a long time when you're depressed, and it probably feels like you've given this Dr. a chance. Two thoughts: How often do you see the Dr., and are you also seeing someone for "talk" therapy? If you're only seeing the Dr. for med. therapy, you know that there is a "lead time" for any medications that runs from 1 to 4 weeks to see if the med. is effective.
Maybe the Dr. is challenging you to LOOK at what you're thinking and doing-- for example, the "advice" on how to kill yourself some other way may be just to get your attention, and to help you realize that suicide is not a good solution. Having someone else for "talk" therapy can also help. That person can help you take a look at yourself, and usually is more available then the Dr. for helping on short notice or for emergencies.
You might need a change to a new Dr. if:
- after 2 or 3 more months, you are not agreeing on what is the next step to take
- the Dr. insists that you take meds with side effects you just can't stand
- the Dr. can't define what a "success" will look like
- there is a personality clash For example, I have had some Drs. who could not deal with the way I looked at meds, and did not understand that I could look at stuff in a detached way (I'm a scientist by training)
I'm not sure if you're in any of these circumstances. Step back, evaluate the situation, then decide and ACT. Take control of this part of your life. You could also ASK the Dr. why he's telling you this...

Carol

 

Re: new therapist-help

Posted by Mark on March 24, 1999, at 0:32:38

In reply to Re: new therapist-help, posted by Carol on March 17, 1999, at 8:04:02

I am a psychiatry resident and agree with
Carol, though I would add the following---

I would hope that your doctor wasn't "suggesting"
ways to kill yourself nor baiting you or
trying some "Good Will Hunting" like
tough love approach. I would hope that instead
he or she was trying to assess if you had tried
or thought of other means to kill your self, what
means to kill youself did you have available at
home. In other words, we often want to
know and anticipate the potential dangers ahead.
This can help the treatment team develop a
safety plan.

Also, one more thing. Antidepressants can take
1-4 weeks for some effect, but can sometimes
take 4-12 weeks for full effect. Improvement
can be delayed by dosing and side effect
issues as well.

Otherwise, what Carol said was very wise.

Mark

> Mike wrote:
> > how do you know when you need a change. i been with this guy for 2 months and told him how i almost comit suicide and he suggested another way i could do it. time to leave him?
>
> Mike,
> Two months seems like a long time when you're depressed, and it probably feels like you've given this Dr. a chance. Two thoughts: How often do you see the Dr., and are you also seeing someone for "talk" therapy? If you're only seeing the Dr. for med. therapy, you know that there is a "lead time" for any medications that runs from 1 to 4 weeks to see if the med. is effective.
> Maybe the Dr. is challenging you to LOOK at what you're thinking and doing-- for example, the "advice" on how to kill yourself some other way may be just to get your attention, and to help you realize that suicide is not a good solution. Having someone else for "talk" therapy can also help. That person can help you take a look at yourself, and usually is more available then the Dr. for helping on short notice or for emergencies.
> You might need a change to a new Dr. if:
> - after 2 or 3 more months, you are not agreeing on what is the next step to take
> - the Dr. insists that you take meds with side effects you just can't stand
> - the Dr. can't define what a "success" will look like
> - there is a personality clash For example, I have had some Drs. who could not deal with the way I looked at meds, and did not understand that I could look at stuff in a detached way (I'm a scientist by training)
> I'm not sure if you're in any of these circumstances. Step back, evaluate the situation, then decide and ACT. Take control of this part of your life. You could also ASK the Dr. why he's telling you this...
>
> Carol

 

Re: therapist- is it me or MD?

Posted by jane on April 6, 1999, at 20:25:40

In reply to Re: new therapist-help, posted by Mark on March 24, 1999, at 0:32:38

thanks to everyone for help in past- BUT-
Is it me, my brain, or the MD???
I have a new doc past seven months,referred from old MD who I was with for many years. I've been seeing new doc weekly (on/off, mostly 'on') for past seven months. He does have background in my Dx:DID and depression (although not too well informed on my unique arthritis) - BUT -
I just don't feel like we are 'clicking'. I spent this week staying alive, not great. I finally called to say i was in trouble ( am coming off drugs) and that we had to talk. He agreed and said we could talk at our regular appt in two days. I have never called him for HELP before - just I wanted advice and TLC, not to confirm my appt time(that has been the same for months) So where do I go from here? I've told him that I don't feel like I'm accomplishing anything.
He says-'well, I think we're getting somewhere and we can talk about that next time.
Am I wrong to expect more? Was I spoiled by my old doc? Shouldn't I call someone if I'm
"on-the-edge"? ---lost--

 

Re: therapist- is it me or MD?

Posted by Victoria on April 8, 1999, at 14:27:04

In reply to Re: therapist- is it me or MD?, posted by jane on April 6, 1999, at 20:25:40

Sounds like it's the doc to me. What happens when you do talk about lack of progress "next time"? Has he explained what progress he thinks is being made? If he doesn't take your perceptions seriously, he sounds like he might be the wrong doc for you. But I'm also wondering if you've been able to mourn the loss of your relationship with the previous doctor and whether feelings about having to change are getting in the way of "clicking" with the new doc. Just because it's such a hassle to change and start over, I'd want to think about that before leaving this one. But if he isn't willing to deal with WHATEVER it is that's making you not click, I'd say go with your gut feeling about whether you should change..

> thanks to everyone for help in past- BUT-
> Is it me, my brain, or the MD???
> I have a new doc past seven months,referred from old MD who I was with for many years. I've been seeing new doc weekly (on/off, mostly 'on') for past seven months. He does have background in my Dx:DID and depression (although not too well informed on my unique arthritis) - BUT -
> I just don't feel like we are 'clicking'. I spent this week staying alive, not great. I finally called to say i was in trouble ( am coming off drugs) and that we had to talk. He agreed and said we could talk at our regular appt in two days. I have never called him for HELP before - just I wanted advice and TLC, not to confirm my appt time(that has been the same for months) So where do I go from here? I've told him that I don't feel like I'm accomplishing anything.
> He says-'well, I think we're getting somewhere and we can talk about that next time.
> Am I wrong to expect more? Was I spoiled by my old doc? Shouldn't I call someone if I'm
> "on-the-edge"? ---lost--

 

Re: Victoria--re: therapist

Posted by jane on April 12, 1999, at 16:38:57

In reply to Re: therapist- is it me or MD?, posted by Victoria on April 8, 1999, at 14:27:04

> Sounds like it's the doc to me. What happens when you do talk about lack of progress "next time"? Has he explained what progress he thinks is being made? If he doesn't take your perceptions seriously, he sounds like he might be the wrong doc for you. But I'm also wondering if you've been able to mourn the loss of your relationship with the previous doctor and whether feelings about having to change are getting in the way of "clicking" with the new doc
Victoria--wow-i'm impressed--you hit what I thought couldn't be "my" issue--"mourning".
yep-big,scary,sad,old garbage. Thanks for your response, I got brave enough to meet with 'new' doc and put that and other issues on the table.
Part of my problem is that I tend to 'forget' what we have done in the session (too scary to remember); he now makes sure that "I" know (in simplest terms) what we've accomplished in THAT session. Even if he has to write it down for me to remember.
So, I'm still hanging in there---thanks alot.

 

Re: Victoria--re: therapist

Posted by Victoria on April 13, 1999, at 17:51:23

In reply to Re: Victoria--re: therapist , posted by jane on April 12, 1999, at 16:38:57

Glad my guess was helpful! Thanks for letting me know.


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