![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Steffany on February 23, 2001, at 19:24:08
hi. i stumbled upon this site kind of randomly this afternoon, and read through some of the postings. this seems like maybe what i need. my depression/anxiety get worse every spring, and this past week i've been seriously considering looking for a therapist. i've had some really bad luck with them before, plus there's the money, and my general fear/distrust of professional strangers. the thing is, i'm no longer quite sure what i'd even want from therapy. i guess i'd want my terror of people and various other quirks acknowledged in a truly nonjudgmental way, and i'd want to be reassured by someone who is not a daily part of my life, like friends/parents/boyfriend/books.
i often have imaginary conversations with my imaginary therapist in my head. i suppose that he'd start with at least a cursory overview of my life, i.e. what do i think made me so fucked up? so i guess i'll start with telling something about myself and my history.
i just turned 25; i live with my boyfriend in a small midwestern college town where neither of us really knows anyone. i've just applied to grad school and am waiting for a decision there.
i've been on psychotropic medication since i was 19. zoloft, luvox, serzone, buspar, ativan, perphenezine, depakote (not prescribed), ritalin (not prescribed), and adderall (not prescribed). currently i'm taking a combination of wellbutrin and klonopin--i've been on that since my last suicide attempt, about 2 1/2 yrs ago. it was working remarkably well for a long time, but now i'm not so sure, but even admitting that really frightens me. i don't want anyone to know my medication might not be working anymore. somehow i'd feel like i'd failed. also, i don't want to be put on effexor, ever.
i'm also just interested in pharmaceuticals as a hobby. i'm thinking of writing a zine about the various psychotropic drugs out there, based on personal experience, reading, and friends' stories (i think almost everyone i know has been on medication for at least some time.)i'm really afraid that this is somehow vain. writing about myself. does anyone else have this problem? i sort of feel like writing about my childhood and growing up and all of that, but it seems narcissistic. but i also want to do it.
i was born in russia and came to the u.s w/my parents when i was 3. they started out as rather freewheeling graduate students but the cultural conflict in my house escalated rapidly. i'm an only child, so all the attention was focused on me. my parents were very concerned that i not be 'infected' with american values such as materialism, commercialism, relativism, etc. they switched the tv off during the commercials. i think this made me overly conscious of the need to fit in, to keep the secret of my 'weird' family hidden.
what most stands out in my mind as the point where i first became aware of being depressed was the year i was 13, when my parents took me out of my junior high and enrolled me in a catholic school in another town b/c they didn't like the influence my friends were having on me. it was the most miserable year of my life up until then. i was completely isolated; hated the school & its hypocrisy; was just totally invisible there. despite my hysterical pleas, my parents would not move me back to my old school. this was the first year i began to think seriously about suicide; i experimented by
taking 3 or 4 of my father's fiorinals (migraine medication containing a barbituate) and making myself pass out, or holding razors to my wrists. mostly i think i just listened to a lot of pink floyd and cried. i always feel like this seems a pretty trivial "trauma," compared with hostile divorces, sexual abuse, death of a loved one, everything else that could possibly turn a child against herself. but it was just truly a frightening, horrible experience. i felt betrayed and abandoned by my parents, and although our relationship now is good, i don't think i ever regained my trust in them.after that year i was allowed to return to public school. i was basically a 'geek' until a certain point during junior year when that stopped being bad and became sort of enjoyable. i always had a few close friends. my senior year my parents received an anonymous letter from someone (i still don't know whom) saying that i was doing lsd and really needed help, etc. i don't think i've fully processed how scary it was that someone was "watching" me; i still have NO clue who's well-meaning parent wrote that. anyway, my parents freaked out and told me i could no longer live in their house. i spent
the rest of my senior year between my aunt's house in a differnt state and various friends' houses, as well as brief stints at home. i was getting really into anarchism and drug philosophy, and i self-consciously lost my virginity to a preppy boy whom i'd considered a friend until he completely ignored me afterward. my AP/honors class girl friends and i played at being 'sex goddesses' a la anais nin, but i don't know if any of us ever felt comfortable in the role.i went away to an ivy league college in new england, far away from where i'd grown up. my freshman year i made a lot of seemingly close friends, all of whom seemed to have psychiatrists or psychologists for parents (even the 'player' boy i was sleeping with was the product of two hyper-intellectual new york city jewish psychologists). suddenly everyone and their mother (literally) was telling me about my psychological problems--that i had no 'healthy sense of self' or 'boundaries,' that i was 'self-destructive' and just basically didn't know when to stop. i felt particularly betrayed when i returned
for my sophomore year and my best friend informed me that we could no longer be close because i had been spending too much time with her ex-boyfriend (which was an honestly platonic friendship on my part). i felt really isolated again that year, just... condemned somehow. i knew that i used guys for attention, that i had sex with a lot of people--boys and girls--basically in order to have a good story to tell at the breakfast table in the dining hall the next morning. but soon, in place of meaningless and basically un-enjoyable sexual encounters, i discovered heroin, which became my new best friend for the
next two years. at first it was almost a joke--my friend matt and i taking the train into new york city and buying bags of dope on the outskirts of alphabet city with a bunch of frat boys and club kids and elderly ladies in fur coats. eventually it was no longer recreational. an acquaintance died of an overdose and matt and i just went on with it. at christmas of junior year matt dropped out of school because he could no longer handle the life we were living, and i was alone again. things went downhill rapidly--everything but my grades, oddly. by spring i was working for my dealer in the city in the mornings
before my first class, stealing and cashing my neighbors' checks, and hooking off the street (it somehow seemed okay b/c matt had worked as a high-end call boy in new york). i was shooting up about eight times a day and picked up a crack habit, yet surprisingly no one seemed to notice much. at some point one of my friends from childhood had 'informed' on me in the hope that i would get some real help, but i just ended up seeing a completely ineffectual school counselor whom i lied to about everything. they put me on zoloft, which didn't seem to help. at one point i know that i attempted to kill myself by
overdose. finally i called my parents and told them that i was a junkie and needed to come home. they were surprisingly understanding--i guess their fear had just reached a certain limit. i came home and checked into rehab and never went back to that school or that town again.rehab was my first 'real' encounter with therapists and social workers and other drug addicts. when i look back on it now, i feel like there wasn't really enough emphasis placed on the underlying conditions which precipitated self-medication and often, addiction. they had a really "outcomes-based" approach. twelve-step programs and the whole bit. it was actually helpful for a time, for what it was. i went in there voluntarily and tried to really believe in the 'addiction' theory of mental illness, which basically boiled down to: addiction is a physiological illness caused by a chemical imbalance in the brain.
the only way to overcome it is to realize you are helpless against it, etc etc. i spent about 4 or 5 months being a good little girl "in recovery" and actually not even drinking alcohol. i began a relationship with a guy whom i'd been sort of obsessed with in high school. i got a job in a cool vintage clothing store, and i eventually graduated from the local state university. i tried to convince myself that i was doing as well as i could under the circumstances, but there were definetely times when i couldn't help feeling deeply ashamed that i hadn't stuck it out at school, lived up to my "gifted child" potential,
etc. my parents were struggling to accept a whole new worldview--all the "psychiatric jargon" which they had dismissed all their lives was suddenly the philosophy that was keeping me alive. but when my father asked me to be sure to wear long sleeved shirts when i came by his office to hide my track marks, i just felt like an alien. yet it was at this same time that i started cutting myself on a regular basis. i think on some level i was afraid of the needle-scars fading away, because the first cuts i made were vertical ones along my arms. i later moved on to legs and stomach as favorite spots. i still do this
to relieve stress, and despite what i've read i can't really accept that it's an utterly harmful and sick behavior. i would rather cut myself as a response to stress than get drunk any day.i ended up becoming friends with the local "indie-punk kids," who were comfortable b/c generally non-judgmental and hard to shock. yet in the next year i continued to get worse. my psychiatrist switched me from one medication to another but nothing seemed to work and everything was frustrating b/c of the whole ssri/orgasm problem. my new drug of choice became dextromethorphan cough syrup, which produced a pleasant ecstasy-like high, allowing me to open up and dance around and goof off. i became close friends with another girl whose psychological problems were very similar to mine, and it helped a lot to have someone
there who was not horrified by my thoughts of suicide or the increasing episodes of dissociation i was experiencing, in which i heard auditory hallucinations and could not distinguish between dreaming and reality. however, that friendship ended badly when i started sleeping w/her boyfriend--who was about as messed up as we were--and the whole thing degenerated into a sad mess.about a year later i decided to go off all medication. i was convinced that i could no longer write or do anything creative on it. i tried taking st. john's wort and gingko biloba for a while, but it didn't seem to help. my relationship with my new boyfriend was a series of extreme ups and downs, with lots of tearful fights, threats, break-ups, and dramatic reconciliations. i was constantly terrified. it still strikes me as... weird, surprising, the way i sunk so deeply into depression that year off my medications without ever being aware that that was what was happening. i didn't associate my obsessive relationship
or my morning panic attacks with my previous feelings of absolute hopelessness. the summer after graduating from college i was accepted into a summer program at nyu, but as soon as i got to new york i immediately resumed daily heroin use. the more i thought about it, the more convinced i was that without my boyfriend i literally did not exist. he was dealing with his own mental problems and did not handle my every-few-hours long distance phone calls, checking up to make sure he still loved me. i was offered a good job in new york but instead came home after the program was over, which just seemed like another failure, but
by that point i just no longer cared. a month later my boyfriend broke up with me and i overdosed on my roommate's tranquilizers and my father's migraine medication. by some miracle of my mother's intervention i was not committed to the state mental hospital, as was required by law, and allowed to go home. that's when i started on the wellbutrin/klonopin combination--august of 1998. it seemed to help miraculously. within a week i was hit by the overwhelming feeling of being "back," of being myself and having that be tolerable.my boyfriend and i eventually got back together after about a year and moved to chicago together. now we're here. our relationship is good but i think we're both maybe a little too wary of "becoming each other's therapist" again, so while we give each other unlimited comfort, we don't spend a lot of time analyzing our problems and personalities.
anyway... that's about where i am now. there is nothing especially wrong except that i can feel the fear coming back on and i don't want to deal with it in the ways that have proven ineffectual year after year--large quantities of 'recreational' drugs. there's nothing inherently wrong with that, but it doesn't help me. i would like to finally approach some understanding of why i can't talk to anyone except the oldest friends or the most superficial acquaintances, and why i haven't been picking up the phone for the past year and a half (the phone just really scares me--does anyone else have this problem?) in the past few days
i've become obsessed with saving the life of a racoon who lives in our roof, whom the landlord wants to trap and kill. but literally anything--like hearing someone say "that's an ugly car"--makes me burst into tears of this horrible pity and anger. it's just like an extreme sensitivity, i guess. and it does come on every spring, and i've learned to expect it. i'm still taking my medication, though like i've said, i'm secretly afraid that it's finally worn itself out, and i hate to think of the alternatives. i've been reading this book called "prozac backlash" by joseph (?) glenmullen, whose basic premise is that ssri's (he
somehow manages to include wellbutrin with these, although it's not) are overprescribed and carry a much greater risk of permanent brain damage--tardive dyskenisia & such--than previously thought. a part of me wishes i could just be off medication, that i could be exercising and running and doing yoga and writing zines and that somehow everything would turn out all right. but i don't believe that at all.i'm not really sure how this works... i think i need to read more of what other people have written. but if anyone has any advice or related experiences or suggestions on free mental health or any information whatsoever on "social panic," please write me. thanks for listening to me.
Posted by Cece on February 23, 2001, at 21:22:55
In reply to 'virtual' therapy, posted by Steffany on February 23, 2001, at 19:24:08
Hi Steffany-
I'm pretty new to this site also, so don't really know what the conventions are yet. Personally, I like hearing some of people's stories- I also used to be in a 12 step program, and what I liked best was getting to hear people's stories- I think it's a real privilege.
On the other hand, NOTHING can replace a good therapist. I've had to go for low-cost therapy most of my life (I'm 52), and have found it various ways- mostly through teaching hospitals/clinics for psychologists/psychiatrists, which usually have sliding scale fees. But I live in an urban area, so probably have more choices than in a small town. It sounds like what would be best for you (and for most of us) is a psychiatrist who also does therapy. If by any chance there is a medical school within reach for you, check out if they offer anything. Even though the people practicing/training in such places are new, they have a lot of supervision, and I've found that new docs/therapists have a lot of interest in their patients (they aren't worn out yet!) which can balance out their lack of experience.
Sometimes cities have mental health clinics that offer medical and therapy services for low cost or free. And colleges and universities often offer therapy for students, or at least referrals.
In both these cases you are taking potluck, rather than going out with referrals and checking people out in private practice. So, I've found it necessary on occasion to get up the nerve to say 'I don't feel like we are a good match and I'd like to see someone else'- when I've done that, even though it was scary to do, I've been offered someone else to try.
Another thought, I have found that most doctors and therapists take on some patients for less than their regular fee. If you ask them if their fee is negotiable, a surprising number will say yes.
I'd also like to say that while I think it's important to educate yourself about meds (I am amazed how much some people who post on this site know), it's really much to complex to try and figure out by yourself what is appropriate for your particular problems without GOOD medical guidance. Especially since you've abused substances in the past (me too), I don't think that you should even think about self-prescribing.
I wish you luck- try and be resourceful and persistent, and keep believing in yourself and your right to get the help that you need.
Cece
P.S. When I added Neurontin to my regimen, I found that my cravings for alcohol disappeared. My doc said that other patients have reported the same.
Posted by Steffany on February 24, 2001, at 19:15:38
In reply to Re: 'virtual' therapy » Steffany, posted by Cece on February 23, 2001, at 21:22:55
hi cece--thanks for that advice. i've thought about trying to look through the university for a therapist... i think you're right, that there would be far less of that jaded, pre-programmed approach which i've experienced before. i guess it's really hard for me to get up the nerve to "put myself out there"--to go through the phone calls, receptionists, messages on my answering machine, and particularly letting a therapist know if it doesn't seem like it's working out--that would absolutely terrify me, although i know they are professionally trained not to have their feelings hurt by this. i wish i had the luxury or confidence of being able to ask a potential therapist particularly about his/her feelings about drug abuse, in the sense that i've often found my problems immediately categorized into "substance abuser" problems as soon as that information comes out. and i just don't feel as though that's at the center of my problems right now--it's definetely been my response to acute stress over certain periods in my life, but i think if i could learn something more about being comfortable in my head it would no longer seem like such a viable and reliable recourse. have you ever found yourself labeled that way by therapists? i don't know, it always seems so condescending and basically dispels my trust, yet i still feel like i have to sit there and politely answer questions about these "lurid" elements of my past... so yeah, i guess i'd really like to see someone who was neither shocked nor fascinated by it. i'm going to try to look into it. thanks again.
Posted by Cece on March 1, 2001, at 1:07:32
In reply to Re: 'virtual' therapy , posted by Steffany on February 24, 2001, at 19:15:38
Steffany-
Sorry to take so long to get back to you- I have been thinking about your question re therapists/pdocs and substance abuse history- both trying to remember my experiences, and gathering my thoughts.
I guess I never had any really bad experiences in this area. When I was still drinking and smoking dope, I was in therapy and I was upset with myself, scared, but not ready/not able to stop- I thought that I could work out some way to control my use, and episodically succeeded. I made an agreement inside myself to be honest with my therapist about my use and my feelings about it. I wasn't really aware at that time that I was self-medicating- or actually, originally I was self-medicating, and eventually I just got caught in the whole horrible addictive cycle. The "medicine" didn't work anymore, it made everything worse, but there I was.
That therapist left the problem to me, with periodic reminders about AA and the futility of "control". But she didn't grind my nose in it, and we went on with therapy (for 6 years). About halfway through that time, I got into a really crazy relationship and really scared myself. The only thing that was clear to me that I could change was my addiction- so I crawled into AA and surrendered.Later I was in a substance abuse program at my HMO (the program was very good), and sought the help of a pdoc there for my mood problems. He was a real tight-ass by-the-book kind of guy, and saw everything through the filter of my addictions. I didn't trust him, and decided not to work with him.
I wound up going outside of my HMO and paying out of pocket to see a young doctor affiliated with a medical school (I had originally met him when I went to the teaching hospital for an evaluation- sliding scale, cheap). By that time I had been clean and sober for about 6 years. He did not make a big deal of it, although of course it was part of my history and diagnosis- he looked at it as part of the larger picture of my life and my mood disorder. I've worked with him for 8 years, and among the meds I take are benzodiazepines- great benefit to me, and something that the HMO doc would never have considered safe for someone with my history. I have never had even the slightest temptation to abuse them- they are just useful tools to me. I don't go to AA anymore- at some point I stopped identifying myself as an alcoholic/drug addict. I am now, that my mood disorder is (at least reasonably) in hand, able to drink, without effort or control, in moderation. I have no desire to abuse alcohol, or any other substance. I know that this is AA sacrilege, and I hesitate to tell this part of my story, cuz I wouldn't want to give anyone an excuse to return to the horror of addiction. But it is my true story.
The problem that I HAVE had with docs (even some pdocs) is that when they see the list of medications that I take (it is long), they either assume that my doctor is crazy, or that I am crazy, or both. I can watch their faces and see it happen, even if they don't say anything outright. They don't even know what the meds are, or the significance of the dosages that I take (most are very low, even sub-clinical). It infuriates me completely! I have finally come to the point where I don't give the full list unless there is really a reason for them to know. And even then, I usually write on the form under "medications taken", the words "will discuss". And sometimes all I say then is that I take medication for a bipolar disorder. I play it by ear and use my good sense.
I don't think that it is unreasonable for a therapist/pdoc to spend some time on your SA history- it's necessary to sort out its significance for treatment. Are you maybe being a little too thin-skinned about it? But then, I also agree completely that shock or fascination are unprofessional, ignorant responses, and should send up a big red flag as to this person's ability to truly help you. So it's that chronic therapy dilemma- combining trusting and respecting yourself with letting down your defenses and being open to new input. I guess I'd suggest monitoring yourself and trying to figure out when you're being defensive as opposed to being self-respecting.
By the way, plenty of therapists and docs are quite unprofessional about being rejected. Don't worry about it- it's their problem.
Cece
Posted by Steffany on March 1, 2001, at 13:21:15
In reply to Re: 'virtual' therapy » Steffany, posted by Cece on March 1, 2001, at 1:07:32
yeah... there are definetely both benefits and drawbacks to the whole AA thing; on the one hand, you can't argue that it's worked and saved many, many people's lives. and i understand WHY they're so restrictive--i think the structure is really welcomed by a lot of people, even when it involves "starting all over from scratch" b/c you had that one drink and sabotaged all your "sober time," etc. i think that while i was going (to NA) i had this nagging sort of feeling that i was a fraud--that compared to what so many of these people had suffered, i was totally privileged, middle-class, sheltered, had not really lost much of anything b/c of my addiction except for the chance to graduate from yale. i was embarrassed about it... also, i tended to be the youngest person at these meetings, except for the occasional 16-yr old acid-kid who was there on the orders of their p.o.
anyway, there's that feeling of 'sacrilege' you described when you said you were now able to drink recreationally (after 6 years! that's really amazing. wow.) i remember writing to one of my therapists from rehab, one whom i'd felt pretty close to (she was a social worker), and telling her that i was drinking every now and then but not feeling out of control about it at all. i expected her to disapprove at least somewhat, but instead she just never answered. i felt like she'd written me off. (though there's also a chance she never received my letter, etc.)
i'm sure i would be overly sensitive on the subject of substance abuse w/a therapist... that's why, again, i wonder: is youth (relative inexperience/un-jadedness) a plus or a minus? are they going to see "heroin" and freak out b/c i look so utterly normal? i don't know. i'm definetely wary on this issue and particularly b/c i don't use heroin anymore, or any drugs really except some alcohol, cigarettes, and cough syrup. (okay, that's probably not too great. but comparatively!) i guess i kind of wish i'd had a therapist i could talk to honestly when i was abusing drugs. i wonder if doctors ever realize how often people lie to them to protect themselves? i'm amazed, too, that so often doctors have never heard of the medications i take--they're not in the least obscure. and do i really want this person giving me a pelvic exam or whatever if she doesn't know what wellbutrin is?
i'm thinking of something that happened a few months ago when i went to the gynecologist for the routine pelvic exam. she asked me all this stuff about my medications--what's this one for? what do you take this for? (this was an m.d.) then when i was up on the table, feeling totally exposed and just "uggh, get this over with please", she saw the scars on my stomach from cutting myself and just literally gave me the most disgusted look. and then asked: "so, do you just like really hate yourself or something?" it was just so unprofessional that i almost started laughing in spite of myself. WHERE did this woman come from? it was only afterward that i started feeling really invaded and humiliated.
you said that you were taking a lot of medications, some of which were pretty obscure...? have you ever taken an maoi? i just never really considered them as a real possibility until reading some of the stuff posted here. i don't think i'd really want to try them yet, though i've heard they can be remarkably effective when few other things are. but i'd kind of like to know if there's anything out there if or when i get depressed again. something besides effexor!
thanks for writing me.
-steffany
Posted by Cece on March 2, 2001, at 1:11:29
In reply to Re: 'virtual' therapy , posted by Steffany on March 1, 2001, at 13:21:15
Hi Steffany-
This is an interesting correspondence. I wonder if other people are reading it...? If so, I hope that it's helpful in some way.
Let's see:
I didn't mean in any way to put down AA- it really saved my life, and it saves many lives. Addiction is horrible, horrible, horrible. However, I don't worry about the "addiction" issue when it comes to meds. With good medical supervision, withdrawal can be handled if needed, and in the face of depression, hating being alive, and suicide, "addiction" to a med that is helpful is a non-issue.
I don't have a clue from what you've written who is presently prescribing psychotropics to you. It doesn't seem like it's someone you can really talk to, or you would have mentioned him/her. You need a really good pdoc who you can work WITH! Obviously you are very intelligent, but you need someone with psychiatric training. You are not going to figure out what med you should be taking just from reading these posts. Even doctors (good ones) know better than to try and diagnose and treat themselves. Sometimes being smart can be isolating. There ARE smart, compassionate, up-to-date pdocs out there in the world and you need one. I don't know if it's possible, but maybe you could try emailing Dr. Bob and seeing if he knows of anyone in your area.
The incident with the gynecologist is disgusting!
The medications that I take aren't obscure- it's just that some of them are newer. I take a long list becuz different meds have helped different aspects of my particular mood problems, and some of them I only need to take a very small amount of to get a therapeutic effect. My problems have been "treatment resistent" and I've had to try a LOT of meds to find helpful ones- and I'm still working on it. I say "I" because I work with a doctor who is open to collaboration- I really should be saying "we". I'm going to change doctors soon- for a few reasons, including finances- and I'm scared. But, I know that ultimately I am on my own side, and I will persist and I will not turn myself over to someone I don't trust- I will find someone who is right for me. I truly believe that this persistence has saved my life- and the underlying knowing that what I want most of all is to live and enjoy living. But I went many years trying to solve all my problems with just therapy- the insight and support was great, but I needed psychopharmacology. However, as it turns out, the drugs I needed first of all to get my feet on the ground weren't even around until pretty recently (mood stabilizers (other than lithium, which my body totally rejected)). But you are younger, and your body chemistry is more flexible (as I'm sure your joints are too!)
No, I've never tried an MAOI- not yet. Initially, I always opted for other choices becuz I didn't think I could deal with the dietary restrictions. Now I know I could, but conventional AD's don't happen to be the area we are working in right now. The only AD that I take now is Nortriptyline- it has helped my sleep problems and also fibromyalgia symptoms. I have tried several other AD's along the way. I know that MAOI's can be a godsend for some people- in fact, reading this board, every med is a godsend for somebody.
Why do you think you'll have to take Effexor? I don't get it! There are LOTS of meds out there, and I sure don't know what's right for you, but I do know that it's not limited to one drug. Is this your doctor's idea? Do you know why? Have you been offered a choice of possibilities?
I wish that I could go back and read your other posts while I'm writing this, but I tried it once and lost my whole text. I think that you said that you are crying a lot? It's called lability, and meds can help, and THEN therapy can help. It's not possible to really get the benefit of therapy when your whole system is freaking out- my experience anyway.
Just do it! Be on your own side, and find trained people who'll be on your side too. Don't obsess about the past- you have a whole lot of life waiting for you. Who know's what's waiting around the next bend in the road- aren't you curious?
Cece
Posted by Steffany on March 2, 2001, at 19:28:07
In reply to Re: 'virtual' therapy » Steffany, posted by Cece on March 2, 2001, at 1:11:29
hi cece. that's a very good idea, actually--to ask 'dr. bob' (he seems like this weird entity to me, who comes in every once in a while to ask people to be nice to each other in their postings, but i also understand he's a psychiatrist at u of c). anyway, since we're in the same state, even, i think there's a good chance he would know of someone over here (we don't have a med school, but i know there's a psychology doctorate program) who might be good for me, maybe even (dare to dream?) a psychiatrist instead of just a psychotherapist. i'm going to write him right after this. thanks for the idea.
i had a great doctor in my old hometown--i mean, she was a g.p. and so her scope of action was inherently limited, but within it she did everything she could for me and in a really caring, non-judgmental way... (i think the only thing that ever annoyed me about her was that she always said "if i had my druthers..." i don't know why! :) anyway, she's the one who followed up with me on the wellbutrin and klonopin; after my suicide attempt i went straight to the local doc-in-the-box (one of those medcenters that are open on saturdays and will always give you tylenol 3's if you ask) and he gave me a week's worth of wellbutrin and told me to go see a real doctor. so i did. she was really great and has seen me for free when i was uninsured, without ever telling me that she wasn't going to bill me, thus sparing me the embarrassment... that was really kind. and i appreciate her 'trusting' me with the klonopin despite my drug abuse history, understanding that i have panic attacks that just don't respond to buspar. i guess i was relieved to be getting my meds from a gp instead of a pdoc b/c i'd had such bad experiences w/pdocs in the past... and that's just chance, but it really soured me. i hated how they could play around with my life... i'd come in and say, "i don't like this (zoloft, luvox, whatever, fill in the blank): i feel like a zombie and i can't concentrate and i can't have orgasms and this really bothers me..." and they'd say: "okay. well, let's try raising your dose for a few weeks and see how you do then!" that was just awful.
next week i'm actually going to see my current doctor... she's just an internist assigned to me by the insurance company. she doesn't speak english very well which makes me wonder a little about communication issues (besides the general possibility that, like any gp, she might not know much about psychiatric conditions and meds). the reason i'm going to see her is that i want to try adding 5 mg of adderall 2xday to my regimen, at least for a month. i guess all i have to go on with this is trial and error, but whenever i take half of one of these pills (my boyfriend takes them for ADD) i feel the way i did in the first months when wellbutrin was first kicking in for me... calm, focused, un-self-conscious, not terrified of really random human contact like saying hi to co-workers or calling for a pizza. these symptoms have become really distressing--the social phobia and kind of self-absorbed embarrassment which often prevents me from really listening to whomever i'm talking to--b/c i'm too busy thinking about how stupid/hateful/ugly i must seem. obviously, these aren't issues that can simply be changed by adding an amphetamine to one's daily drug diet. but for the time being, at least, it seems like a step in a positive direction... if this doctor goes for it, of course. i'm not sure about how popular it is to prescribe these medications for conditions other than ADD, which i don't think i have. but we'll see. at any rate, it's worth a shot; i'm just starting to feel the spring 'illies' come on again, this happens pretty much every year but this time i just feel determined not to give into it and go on drug binges and tell the people at work i have mono so i don't have to come in every day (i've used this excuse for two springs now... it's just not that funny anymore.)
i really wish you all the best in finding your new doctor. let me know how it's going. i've noticed that many people are lucky enough to develop 'real' relationships w/their pdocs... which i guess are outside the realm of friendships and romantic relationships and family, so it's just not something i've ever experienced. but it sounds really good, and i hope you find that in someone else.
-steffany
Posted by Cece on March 2, 2001, at 20:36:51
In reply to Re: 'virtual' therapy » Cece, posted by Steffany on March 2, 2001, at 19:28:07
Hello there-
I recently started taking Adderall! I used the word "daydreaming" in trying to explain to my pdoc what was keeping me from getting my work act together (I have my own business, and just haven't gotten it back together in a real way since I had a major come-apart about 5 years ago). He said that that word was most commonly associated with ADD, which I don't have the absolute classic symptoms of, but as we talked about it, it seemed a direction worth exploring. I had tried a stimulant (Cylert) several years ago to try and clear brain fog- it worked great for about a week and then starting driving me up the wall. But I wasn't on the spectrum of mood stabilizers that I am now on (have you investigated mood stabilizers at all? they can really be miracle workers and there is a new generation of them available now- Neurontin, Topomax, and Lamictal. A regular GP isn't going to know how to suggest one for you or how to dose you- their use for mood disorders is off-label, even though they are widely used by pdocs). So anyway, I like Adderall- it has helped me to focus my thinking better, although I still tend to hop from one thing to another and be distractible. I can only handle a small amount- 10mg/day- or I get really hyper. Sometimes I take an extra 2.5mg in the evening if I start to lose it and need to focus. My doctor said that for people who have ADD, that Adderall calms them down- sounds like your reaction, so maybe that's part of your picture.
Do you know about using the "Tips" section? You can search topics/drugs and read tips sent in by pdocs describing their patients' reactions to different meds and their opinions about their usefulness- it's really neat. I went there today to check out a drug that I had heard people mention in posts- naltrexone- and as it turned out, it was mentioned several times in the treatment of self-injury and substance abuse.
As opposed to some other psych bulletin boards (like the Panic Disorders board run by a Dr. Stuart Shipko), Dr. Bob seems to stay out of the way here, except as you say to be an occasional Mr. Manners, but I think that it is possible to mail him. I hope so- could you even travel to Chicago occasionally if you could get really top-notch help there?
I have a seasonal affective disorder also, but the reverse of the common one. I really get the heeby-jeebies (sp?) and then bad depression in the summer, when most people are living it up. It feels like the bright light, and especially glare are attacking me. In the winter, I enjoy the calm and quiet (I live in N. Calif.- SF area, so our winters are mild), although I do get frustrated by the short days, as I like to spend a lot of time outside. Spring and Fall are my favorite seasons- balanced light day to night, interesting things happening in nature, change in the air.
BUT, this last summer things changed- maybe because I was starting on Lamictal, not sure. I actually enjoyed (most of) the summer- only got the oppressed feelings briefly and was able to work with them okay. I actually lost my chronic social withdrawal and started dating again after a long hiatus. Now this winter, I'm not enjoying the season as much as I used to, and have been having problems. But also, I just got out of a relationship that I started last summer which was fun, sexy, but also depressing and frustrating- a dead end because of the guy's many defenses and our different styles. I went with him for 7 months and never told him about my psych stuff- I just didn't trust him to handle it. I would slip out of bed after hours of intimacy and go to the bathroom and take my meds. Kind of strange, but I know now that I was right and protected myself in a positive way. So,we'll see how I feel once I get through this separation pain. Hard to have this happen at the same time I'm changing doctors- separation is not my forte. But I'm doing much better with it all than I might expect given my past patterns- only obsessing moderately and not falling into a huge black pit (knock on wood).I'm sure that you are not stupid, hateful, or ugly. You seem like a really neat person. But I understand those kind of feelings and social phobia.
Cece
Posted by Cece on March 5, 2001, at 2:14:33
In reply to Re: 'virtual' therapy » Cece, posted by Steffany on March 2, 2001, at 19:28:07
Hi Steffany-
I forgot to direct my last post specifically to you, so don't know if you found it.
I hope you're doin OK. I'm interested to hear if you got a response from Dr. Bob...?
Cece
This is the end of the thread.
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