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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Lisa's Husband on January 8, 2001, at 19:17:47
Hi all;
My wife just finished a 3-day stay at a Mental Health Facility.
It breaks my heart to watch one of the most incredible women on the planet (In the last 17 years, she has awakened every day to defeat the HIV that occupies her bloodstream and I am helping her successfully raise our 3 children) become stricken with depression and paralyzed with anxiety.
I have to admit, I have never been directly exposed to Clinical Depression before, and should also speak to my guilt. I am guilty of (many times) talking to depressed friends with tones of "snap out of it" and "you need to go to the beach or Disneyland". I post before you as a reformed, and humbled believer in the uncontrolled pain of Clinical Depression.
Here is a quick synopsis of her treatment to date:
5 weeks ago, she was struck down by a massive depression. Put on Zoloft (.5) and Zanax (1.0 x3) by her (trusted?) doctor, 1 week later, there was no effect. A Psychiatrist (who seemed to prefer medicating via telephone over an office visit) said it would be okay to double the zoloft.
Within days, Lisa was paralyzed with anxiety, from the time she opened her eyes in the morning. After a few days of torture, she woke up with a pulse of 160 (normally 45). At the emergency room that day, they took her off Zoloft for 2 days, followed by a reduction to .5 per day.
Oh, did I mention the addition of a small quantity of Wellbutrin? Another inept decision from the same lazy Psychiatrist (Or, as I saw in one of your posts, Psycho-Pharmacologist?) AFTER her Emergency Room visit . If she didn't like the Zoloft version of anxiety, let's see if she can tolerate the Wellbutrin version, right?
The final blow for Lisa was having to admit herself to a Mental Health Ward last Wednesday. A move that may have been necessary solely in order for her to stabilize her treatment and get a REAL Psychiatrist.
Now, back at home, she is still struggling with depression (now taking .75 Zoloft and 50mg x 3 Klonopin).
The HELP! in the Subject line is 2-fold:
1. What should I/should I not be doing to give her the support she needs from her husband. I struggle with the question of talking directly to her feelings vs providing an "escape" by diverting her to activities, pushing her to get out of the house, etc.
2. Did we choose Pharmacology too early? She had one visit with a PHSYCHOLOGIST prior to going on meds. Is it possible that the Pharmacology might be inhibiting her ability to get help via Psychotherapy?
ANY feedback/insight you have will be greatly appreciated.
David
Posted by Pandora on January 8, 2001, at 20:10:10
In reply to Help! Meds vs Psychotherapy, posted by Lisa's Husband on January 8, 2001, at 19:17:47
> Hi all;
>
> My wife just finished a 3-day stay at a Mental Health Facility.
>
> It breaks my heart to watch one of the most incredible women on the planet (In the last 17 years, she has awakened every day to defeat the HIV that occupies her bloodstream and I am helping her successfully raise our 3 children) become stricken with depression and paralyzed with anxiety.
>
> I have to admit, I have never been directly exposed to Clinical Depression before, and should also speak to my guilt. I am guilty of (many times) talking to depressed friends with tones of "snap out of it" and "you need to go to the beach or Disneyland". I post before you as a reformed, and humbled believer in the uncontrolled pain of Clinical Depression.
>
> Here is a quick synopsis of her treatment to date:
>
> 5 weeks ago, she was struck down by a massive depression. Put on Zoloft (.5) and Zanax (1.0 x3) by her (trusted?) doctor, 1 week later, there was no effect. A Psychiatrist (who seemed to prefer medicating via telephone over an office visit) said it would be okay to double the zoloft.
>
> Within days, Lisa was paralyzed with anxiety, from the time she opened her eyes in the morning. After a few days of torture, she woke up with a pulse of 160 (normally 45). At the emergency room that day, they took her off Zoloft for 2 days, followed by a reduction to .5 per day.
>
> Oh, did I mention the addition of a small quantity of Wellbutrin? Another inept decision from the same lazy Psychiatrist (Or, as I saw in one of your posts, Psycho-Pharmacologist?) AFTER her Emergency Room visit . If she didn't like the Zoloft version of anxiety, let's see if she can tolerate the Wellbutrin version, right?
>
> The final blow for Lisa was having to admit herself to a Mental Health Ward last Wednesday. A move that may have been necessary solely in order for her to stabilize her treatment and get a REAL Psychiatrist.
>
> Now, back at home, she is still struggling with depression (now taking .75 Zoloft and 50mg x 3 Klonopin).
>
> The HELP! in the Subject line is 2-fold:
>
> 1. What should I/should I not be doing to give her the support she needs from her husband. I struggle with the question of talking directly to her feelings vs providing an "escape" by diverting her to activities, pushing her to get out of the house, etc.
>
> 2. Did we choose Pharmacology too early? She had one visit with a PHSYCHOLOGIST prior to going on meds. Is it possible that the Pharmacology might be inhibiting her ability to get help via Psychotherapy?
>
> ANY feedback/insight you have will be greatly appreciated.
>
> DavidGenerally speaking, meds can help a person get more out of therapy, especially where acute anxiety is present - if you can't stand to sit through a session, you don't get much out of it. I'm sure you've looked into this, but could this be a complication related to her HIV status? Either way, I would imagine that someone who is HIV positive might benefit from therapeutic support regardless of how supportive her family is... obviously in this case, your wife is incredibly lucky to have such a supportive partner. Certainly, therapy won't hurt and since the symptoms began "out of the blue", there might be a psychological componant that can be helped by counseling. I would also keep bugging the docs if the meds don't seem to help - there are so many out there that it's unnecessary to suffer when one or two don't work...
I applaud you for seeking help and wish you the best of luck.
Posted by stjames on January 8, 2001, at 22:58:17
In reply to Help! Meds vs Psychotherapy, posted by Lisa's Husband on January 8, 2001, at 19:17:47
I would suspect the cause of her problems are both psychological and medical. Depression in AIDS is common. This would indicate the need for meds and thearpy. Keep in mind a pdoc is just a medical doctor who treats with medications. Don't expect
a pdoc to do thearpy, too. Both the thearpist and pdoc should have had experience treating persons with AIDS.James
Posted by judy1 on January 8, 2001, at 23:56:23
In reply to Help! Meds vs Psychotherapy, posted by Lisa's Husband on January 8, 2001, at 19:17:47
Dear David,
I'm sorry you and your wife had to experience the fallout of an inept psychiatrist (I'm sure many on this forum have shared this situation). I have been fortunate enough to have found 2! compassionate psychiatrists (after going through over a dozen) who have provided both therapy and medication to me- at times one is emphasized over the other. I would hope that the physician who is treating your wife's AIDS would have referrals to a psychiatrist who would treat her unique needs and communicate with her other doctor(s). Again, I'm sorry she had to go through this, and really admire the support you are providing. Take care- Judy
Posted by Greg on January 9, 2001, at 9:50:27
In reply to Help! Meds vs Psychotherapy, posted by Lisa's Husband on January 8, 2001, at 19:17:47
David,
I wanted to echo that it's very important to get Lisa pdoc and therapy treatment from a qualified professional who has experience with HIV. I found the following website that has a lot of information on the subject along with some contact numbers for getting specific info on treatments.
http://www.nimh.nih.gov/publicat/hivdepression.cfm
I commend you for your efforts here, it would be easy for some to say there was nothing they could do to help. You are obviously a good husband and Father, Lisa is very lucky to have you.
My thoughts and prayers go out to you and your family
Greg
> Hi all;
>
> My wife just finished a 3-day stay at a Mental Health Facility.
>
> It breaks my heart to watch one of the most incredible women on the planet (In the last 17 years, she has awakened every day to defeat the HIV that occupies her bloodstream and I am helping her successfully raise our 3 children) become stricken with depression and paralyzed with anxiety.
>
> I have to admit, I have never been directly exposed to Clinical Depression before, and should also speak to my guilt. I am guilty of (many times) talking to depressed friends with tones of "snap out of it" and "you need to go to the beach or Disneyland". I post before you as a reformed, and humbled believer in the uncontrolled pain of Clinical Depression.
>
> Here is a quick synopsis of her treatment to date:
>
> 5 weeks ago, she was struck down by a massive depression. Put on Zoloft (.5) and Zanax (1.0 x3) by her (trusted?) doctor, 1 week later, there was no effect. A Psychiatrist (who seemed to prefer medicating via telephone over an office visit) said it would be okay to double the zoloft.
>
> Within days, Lisa was paralyzed with anxiety, from the time she opened her eyes in the morning. After a few days of torture, she woke up with a pulse of 160 (normally 45). At the emergency room that day, they took her off Zoloft for 2 days, followed by a reduction to .5 per day.
>
> Oh, did I mention the addition of a small quantity of Wellbutrin? Another inept decision from the same lazy Psychiatrist (Or, as I saw in one of your posts, Psycho-Pharmacologist?) AFTER her Emergency Room visit . If she didn't like the Zoloft version of anxiety, let's see if she can tolerate the Wellbutrin version, right?
>
> The final blow for Lisa was having to admit herself to a Mental Health Ward last Wednesday. A move that may have been necessary solely in order for her to stabilize her treatment and get a REAL Psychiatrist.
>
> Now, back at home, she is still struggling with depression (now taking .75 Zoloft and 50mg x 3 Klonopin).
>
> The HELP! in the Subject line is 2-fold:
>
> 1. What should I/should I not be doing to give her the support she needs from her husband. I struggle with the question of talking directly to her feelings vs providing an "escape" by diverting her to activities, pushing her to get out of the house, etc.
>
> 2. Did we choose Pharmacology too early? She had one visit with a PHSYCHOLOGIST prior to going on meds. Is it possible that the Pharmacology might be inhibiting her ability to get help via Psychotherapy?
>
> ANY feedback/insight you have will be greatly appreciated.
>
> David
Posted by Lisa's Husband on January 9, 2001, at 11:36:06
In reply to Re: Help! Meds vs Psychotherapy » Lisa's Husband, posted by Greg on January 9, 2001, at 9:50:27
Hi Greg;
Thank-you for the link. I have learned how to mirror Lisa in support of her HIV challenges, but I am still struggling to find my "place" in the landscape of her Clinical Depression. This resource will be very helpful.
We are fortunate in that Lisa has maintained a viral load of under 10,000 (currently 3,000) all this time (under 10,000 is cited by the press as "undetectable"). Her I/D specialist has seen and treated/referred many patients to Psychiatrists as a direct result of their high counts driving chemical-based mental health problems, but claims that with her low load, her problem is probably Psychological, not Chemical.
Thank-you for your compassionate and prayerful support, Greg.
David
Posted by stjames on January 9, 2001, at 13:09:17
In reply to Re: Help! Meds vs Psychotherapy » Greg, posted by Lisa's Husband on January 9, 2001, at 11:36:06
Her I/D specialist has seen and treated/referred many patients to Psychiatrists as a direct result of their high counts driving chemical-based mental health problems, but claims that with her low load, her problem is probably Psychological, not Chemical.
>James here....
Keep in mind that it is well known that if psychological conditions continue long enough
this will cause chemical or medical depression.James
Posted by RobiniboR on January 9, 2001, at 19:05:56
In reply to Help! Meds vs Psychotherapy, posted by Lisa's Husband on January 8, 2001, at 19:17:47
Dear David
Too many docs do a disservice to their patients by putting them on meds without proper follow-up and/or psychotherapy. Learn as much as
you can from books, visit my husband's website (he's a therapist who suffers from depression himself) at
http://www.undoingdepression.com, and keep talking to people here. The more you know, the more helpful you can be to your wife.
Good luck to you both.
This is the end of the thread.
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